bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic associations between adverse events after lung transplantation and allograft ischaemic time
Authors: Zhang Wenxi , Qiu Tong , Metelmann Isabella B , Fritz Ashley V , Rucker A Justin , Du Wenxing , Sef Davorin , Jiao Wenjie 
Published: December 2024

Abstract

OBJECTIVES
The effect of allograft ischaemic time (AIT) on postoperative events after lung transplantation remains unclear. This study aims to assess the feasibility of extending the duration of AIT.

METHODS
The United Network for Organ Sharing database was queried for adult lung transplantation from 4 May 2005 to 30 June 2020. Patients were divided as per AIT into standard ischaemic time (&lt;6 h) and prolonged ischaemic time (≥6 h) groups using propensity score matching and evaluated on a continuous scale using restricted cubic splines. The primary outcome was overall 1-year and 5-year survival.

RESULTS
Among 11 438 propensity-matched recipients, standard ischaemic time and prolonged ischaemic time showed no differences in overall 1-year (P = 0.29) or 5-year (P = 0.29) survival. Prolonged ischaemic time independently predicted early postoperative ventilator support for &gt;48 h (OR = 1.33, 95% CI 1.22–1.44), dialysis (OR = 1.55, 95% CI 1.30–1.84), primary graft dysfunction (PGD; OR = 1.28, 95% CI 1.09–1.50), acute rejection (OR = 1.42, 95% CI 1.24–1.62), and interestingly, decreased 5-year bronchiolitis obliterans syndrome (HR = 0.91, 95% CI 0.85–0.97). In relative risk curves, 1-year mortality, prolonged ventilation, dialysis and PGD steadily increased per hour as AIT extended. The risk of acute rejection and 5-year bronchiolitis obliterans syndrome also showed significant changes between 5 and 8 h of AIT. In contrast, 5-year mortality remained constant despite rising AIT.

CONCLUSIONS
Prolonged AIT worsened early outcomes such as PGD, but improved bronchiolitis obliterans syndrome freedom at later time points. Despite this, both short- and long-term survival were similar between prolonged ischaemic time and standard ischaemic time patients. Dynamic risk changes in post-transplant events should be noted for prolonged ischaemia lung use.
Artificial intelligence–derived electrocardiographic aging and risk of atrial fibrillation: a multi-national study
Authors: Cho Seunghoon , Eom Sujeong , Kim Daehoon , Kim Tae-Hoon , Uhm Jae-Sun , Pak Hui-Nam , Lee Moon-Hyoung , Yang Pil-Sung , Lee Eunjung , Attia Zachi Itzhak , Friedman Paul Andrew , You Seng Chan , Yu Hee Tae , Joung Boyoung 
Published: December 2024

Abstract

Background and Aims
Artificial intelligence (AI) algorithms in 12-lead electrocardiogram (ECG) provides promising age prediction methods. This study investigated whether the discrepancy between ECG-derived AI-predicted age (AI-ECG age) and chronological age, termed electrocardiographic aging (ECG aging), is associated with atrial fibrillation (AF) risk.

Methods
An AI-ECG age prediction model was developed using a large-scale dataset (1 533 042 ECGs from 689 639 participants) and validated with six independent and multi-national datasets (737 133 ECGs from 330 794 participants). The AI-ECG age gap was calculated across two South Korean cohorts [mean (standard deviation) follow-up: 4.1 (4.3) years for 111 483 participants and 6.1 (3.8) years for 37 517 participants], one UK cohort [3.0 (1.6) years; 40 973 participants], and one US cohort [12.9 (8.6) years; 90 639 participants]. Participants were classified into two groups: normal group (age gap &lt; 7 years) and ECG-aged group (age gap ≥ 7 years). The predictive capability of ECG aging for new- and early-onset AF risk was assessed.

Results
The mean AI-ECG ages were 51.9 (16.2), 47.4 (12.5), 68.4 (7.8), and 56.7 (14.6) years with age gaps of .0 (6.8), −.1 (6.0), 4.7 (8.7), and −1.4 (8.9) years in the two South Korean, UK, and US cohorts, respectively. In the ECG-aged group, increased risks of new-onset AF were observed with hazard ratios (95% confidence intervals) of 2.50 (2.24–2.78), 1.89 (1.46–2.43), 1.90 (1.55–2.33), and 1.76 (1.67–1.86) in the two South Korean, UK, and US cohorts, respectively. For early-onset AF, odds ratios were 2.89 (2.47–3.37), 1.94 (1.39–2.70), 1.58 (1.06–2.35), and 1.79 (1.62–1.97) in these cohorts compared with the normal group.

Conclusions
The AI-derived ECG aging was associated with the risk of new- and early-onset AF, suggesting its potential utility to identify individuals for AF prevention across diverse populations.
Average Age of Resuscitation Blood Products Is not Associated With In-Hospital Mortality Among Trauma Patients: A Retrospective Cohort Study
Authors: Corrigan Kaitlyn T , Skilton Frederick J , Shea Lisa , McHugh Sean P , DeChiara James R , Porter John M , Roberts Brian W , Sarkisian Simon A 
Published: December 2024

ABSTRACT

Introduction
Transfusion of packed red blood cells (PRBC) or low-titer group O whole blood (LTOWB) has become standard practice in trauma patients with significant blood loss. As blood ages, it undergoes metabolic and structural changes. This study aimed to test the association between age of PRBC/LTOWB and mortality among adult trauma patients.

Materials and Methods
This is a retrospective cohort study at an academic level one trauma center. Adult trauma patients who received at least one unit of PRBC or LTOWB within the first hour of arrival to the emergency department (ED) between January 2016 and December 2019 were included. The primary outcome was in-hospital mortality. Multivariable logistic regression models were used to test the associations between the mean age of PRBC and LTOWB units transfused during the initial 24 hours and in-hospital mortality.

Results
Of 388 patients included, 362 received PRBC and 121 received LTOWB. In-hospital mortality occurred in 31% of patients. The median (interquartile range) mean age of transfused PRBC units was 21 (16-26) days and LTOWB units was 11 (9-12) days. Neither age of PRBC nor LTOWB were found to be associated with in-hospital mortality: PRBC adjusted odds ratio (aOR) = 0.99 (95% CI 0.95 to 1.03) and LTOWB aOR = 1.12 (95% CI 0.88 to 1.41).

Conclusions
The mean age of LTOWB or PRBC units transfused during the first 24 hours after presenting to the ED for a traumatic injury was not found to be associated with in-hospital mortality.
Temporal attention amplifies stimulus information in fronto-cingulate cortex at an intermediate processing stage
Authors: Zhu Jiating , Tian Karen J , Carrasco Marisa , Denison Rachel N 
Published: December 2024

Abstract
The human brain faces significant constraints in its ability to process every item in a sequence of stimuli. Voluntary temporal attention can selectively prioritize a task-relevant item over its temporal competitors to alleviate these constraints. However, it remains unclear when and where in the brain selective temporal attention modulates the visual representation of a prioritized item. Here, we manipulated temporal attention to successive stimuli in a two-target temporal cueing task, while controlling for temporal expectation with fully predictable stimulus timing. We used magnetoencephalography and time-resolved decoding to track the spatiotemporal evolution of stimulus representations in human observers. We found that temporal attention enhanced the representation of the first target around 250 ms after target onset, in a contiguous region spanning left frontal cortex and cingulate cortex. The results indicate that voluntary temporal attention recruits cortical regions beyond the ventral stream at an intermediate processing stage to amplify the representation of a target stimulus. This routing of stimulus information to anterior brain regions may provide protection from interference in visual cortex by a subsequent stimulus. Thus, voluntary temporal attention may have distinctive neural mechanisms to support specific demands of the sequential processing of stimuli.
Methadone-Buprenorphine Transfers Using Low Dosing of Buprenorphine: An Open-label, Nonrandomized Clinical Trial
Authors: Tremonti Chris , Blogg James , Jamshidi Nazila , Harjanto Ricky , Miles Nicholas , Ismay Charlotte , Page Robert , Mills Llew , Buckley Nicholas , Perananthan Varan , Lintzeris Nicholas , Haber Paul 
Published: December 2024

Aims
To compare a low-dosing protocol to standard practice for methadone-buprenorphine transfers.

Methods
We undertook a nonrandomized open-label clinical trial across 8 sites from NSW, Australia. Participants prescribed methadone wishing to transfer to buprenorphine could either choose or be randomized to a low-dose transfer or standard care transfer as per NSW health guidelines. The low-dose protocol started at 0.2 mg BD and increased to 16 mg on day 6, with flexible dosing thereafter. The primary outcome was continuation of buprenorphine 1 week post-transfer. Binary logistic regression was used to access the primary outcome with demographic differences between the groups included as covariates.

Results
There were 117 participants who commenced the study, 101 in the low-dose arm and 16 in standard care. Mean methadone dose was 82 mg in the low-dose arm and 46 mg in standard care. The primary outcome was met by 81 participants in the low-dose arm (80%) and 13 participants in standard care (81%). There was no significant between-arm difference in the odds of the primary outcome (OR = 2.22; 95% CI: 0.45–10.91; P = 0.327). Four participants (4%) in the low-dose arm experienced precipitated withdrawal against 1 (6%) in standard care. Higher methadone dose decreased the odds of successful transfer by 20% (OR = 0.8 per 10 mg methadone; 95% CI: 0.7–0.99; P = 0.04). Withdrawal scores between the 2 arms were similar.

Conclusions
We were unable to detect a difference between low dosing and standard care for methadone to buprenorphine transfers. Increasing methadone dose was a predictor of success; setting (ambulatory or inpatient) was not.
Frustrations in Providing Orthopaedic Trauma Care: An OTA Member Survey Study
Authors: Kleinsmith Rebekah M. , Doxey Stephen A. , Puckett Haley D. , Duckworth Elizabeth A. , Milshteyn Michael , Hill Austin D. , Cunningham Brian P. 
Published: December 2024

OBJECTIVES:
To determine sources of frustration for surgeons and how they might affect job satisfaction within the orthopaedic trauma community.

METHODS:

Design:
Cross-Sectional Survey Study.

Setting:
International Online Survey.

Participant Selection Criteria:
After approval by the OTA research committee, the survey was available to all active and associate OTA Members.

Outcome Measures and Comparisons:
A 25-question survey regarding potential common causes of frustration, operating room (OR) utilization, and career satisfaction was electronically distributed to the Orthopaedic Trauma Association (OTA) membership.

RESULTS:
Four hundred seventy-one surgeons participated in the survey (response rate 27.5%). The highest ranked source of frustration was OR turnover time, followed by staff turnover, and OR scheduling. Most reported they were very satisfied with their career (n = 240, 51.0%). The top 3 strategies to increase career satisfaction from most to least effective were increased compensation, case delay reduction, and decreased work hours. Most surgeons reported that if their number 1 frustration was solved, they would feel a higher level of career satisfaction (very satisfied: n = 344, 73.1%). Most felt their cases did not start on time (n = 273, 58.0%), with most respondents reporting that their cases were delayed on average between 15 and 60 minutes (n = 222, 81.9%). The number 1 ranked reason for case start delays was OR turnover and case setup, followed by the anesthesia team.

CONCLUSIONS:
Many surgeons within the orthopaedic trauma community reported concern with OR turnover time and staff turnover. Addressing these sources of frustration is crucial to maintaining surgeon well-being and can aid in optimizing delivery of patient care. Future studies should seek out institutions that have successfully addressed these common frustrations and identify potential strategies to improve the delivery of orthopaedic trauma care across North America.
The menopausal transition and multiple physiologic measures of early brain health in the Coronary Artery Risk Development in Young Adults study
Authors: Tahir Muna J. , Xie Yang , Nasrallah Ilya M. , Elbejjani Martine , Wellons Melissa F. , Bryan R. Nick , Dolui Sudipto , Erus Guray , Launer Lenore J. , Schreiner Pamela J. 
Published: December 2024

Abstract

Objective
This study proposed to investigate the cross-sectional and longitudinal associations of menopausal status with physiologic brain magnetic resonance imaging measures.

Methods
The sample included women from the Coronary Artery Risk Development in Young Adults study who self-reported their reproductive histories and participated in the brain magnetic resonance imaging substudies at the year 25 (n = 292) and year 30 (n = 258) follow-up examinations. Menopausal status was classified based on natural menstrual cycle regularity/cessation at both time points. Gray matter cerebrovascular reactivity (CVR) was calculated as mean percent change in blood oxygen level–dependent signals in activated voxels following a breath-hold challenge. Gray matter cerebral blood flow (CBF) was assessed using pseudo-continuous arterial spin labeling. Linear regression models were used to examine cross-sectional and longitudinal associations of menopausal status with gray matter CVR and CBF after adjustment for potential age-related covariates.

Results
Women were mean age 50 years at year 25; 37% were Black; and 46% were postmenopausal. Relative to premenopause or perimenopause, postmenopause was associated with lower gray matter CVR at year 30 cross-sectionally (1.86% vs 1.69%, P = 0.03, respectively) and longitudinally for women who were postmenopausal at both time points (−0.32% [95% CI, −0.63% to −0.02%]) after covariate adjustment. Mean CVR values were also lower for these women when compared with women who remained premenopausal or perimenopausal (1.71% compared with 2.04%, respectively). Menopausal status was unrelated to either concurrent or longitudinal gray matter CBF.

Conclusions
These findings suggest that the ability of vessels to adapt in response to hypercapnia may be impaired during menopause, even within a relatively short time window.
N-Acetylcysteine enhances low-dose estrogen efficacy against ischemia-reperfusion injury in estrogen-deprived obese insulin-resistant rats
Authors: Sivasinprasasn Sivaporn , Chattipakorn Kenneth , Pratchayasakul Wasana , Chattipakorn Siriporn C. , Chattipakorn Nipon 
Published: December 2024

Abstract

Objectives
Postmenopausal women are at higher risk of metabolic syndrome and cardiovascular disease, which are aggravated by obesity. Although estrogen provides cardiometabolic protection, chronic high-dose treatment could be harmful. This study investigated the efficacy of combined N-acetylcysteine (NAC) and low-dose estrogen treatment against cardiometabolic dysfunction in female estrogen-deprived obese rats with cardiac ischemia-reperfusion (I/R) injury.

Methods
Bilateral ovariectomized (O) female Wistar rats were fed a high-fat diet (H) for 12 weeks. Then, rats were treated for 4 weeks with one of the following: vehicle (OH; sesame oil), regular-dose estrogen (E; 50 μg/kg/d), low-dose estrogen (e; 25 μg/kg/d), NAC (N; 100 mg/kg/d), or combined low-dose estradiol with NAC (eN). All rats then underwent cardiac I/R injury, and the left ventricle (LV) function and mitochondrial function were investigated (n = 6/group). Statistical analysis was performed by one-way ANOVA followed by Fisher's least significant difference post hoc test.

Results
Body weight, visceral fat, plasma glucose, and plasma cholesterol were significantly increased with impaired LV function and heart rate variability in OH rats. OH-E rats had decreased plasma insulin and Homeostatic Model Assessment for Insulin Resistance index. Both OH-E and OH-eN rats had similarly improved heart rate variability and LV function. During cardiac I/R, OH-E and OH-eN rats had preserved left ventricular ejection fraction, stroke volume, and attenuated arrhythmias. Impaired cardiac mitochondrial function and infarct size were similarly reduced in OH-E and OH-eN rats.

Conclusions
Combined NAC and low-dose estrogen treatment shares similar efficacy as regular-dose estrogen in attenuating cardiac dysfunction, cardiac mitochondrial dysfunction, and protecting the heart against I/R injury in estrogen-deprived obese insulin-resistant rats.
Validation of the Laryngeal Cognitive-affective Tool in a Taiwanese Population
Authors: Krause Amanda J. , Yadlapati Rena , Wong Ming-Wun , Taft Tiffany , Pandolfino John E. , Gyawali C. Prakash , Chen Chien-Lin 
Published: December 2024

Background and Aim:
The laryngeal cognitive-affective tool (LCAT) was recently validated in the US to assess laryngeal-specific hypervigilance and anxiety. The aim of this study was to examine LCAT validity in the Taiwanese population.

Methods:
This prospective single-center study enrolled adults from Hualien Tzu Chi Hospital with laryngeal symptoms for >6 months.

Results:
One hundred four patients included: mean age 49.5 years (SD 13.3), 69% female, mean BMI 25.3 kg/m2 (5.8), and mean LCAT 25.9 (15.2). The LCAT had excellent internal consistency (α=0.969) and split-half reliability (Guttman=0.925).

Conclusions:
The LCAT is newly validated in the Taiwanese population and assesses laryngeal-specific cognitive-affective processes in patients with chronic laryngeal symptoms.
Evaluating Continuous Glucose Monitoring After Total Pancreatectomy With or Without Islet Autotransplantation
Authors: Bashir Ayat , Joseph Nejo , Hammond John S. , White Steve , Abu-El-Haija Maisam , Drewes Asbjørn Mohr , Shaw James A. M. , Pandanaboyana Sanjay 
Published: December 2024

Objectives
This scoping review aims to provide evidence synthesis of continuous glucose monitoring (CGM) and insulin pump use after undergone total pancreatectomy (TP) with or without islet autotransplantation (TPIAT).

Methods
The review was conducted adhering to PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist.

Results
Fifteen studies including 147 patients (adult n = 71/pediatric n = 76) reported on CGM use post-TP (n = 42) and TPIAT (n = 105). Four were randomized controlled trials and 10 observational studies. Six studies evaluated CGM use in the perioperative and 6 in the immediate postoperative period (n = 8) with variable follow-up (14 hours to 20 months). CGM was used as a stand-alone device (8 studies), which allowed assessment of glycemic variability (n=5) and detection of hypoglycemia (n = 1), resulting in lower glucose levels (n = 1). Six studies evaluated insulin pump with CGM with reduction in postoperative mean glucose (n = 4) and hypoglycemic episodes (n = 2). No patient-reported outcome measures (PROMs) or quality of life (QoL) measures were reported.

Conclusions
CGM can be used following TP for glucose monitoring and/or linked with insulin pump device in the perioperative period with improved glycemic control. However, the data are limited by short follow-up and lack of PROMs and QoL measures.
High Diagnostic Yield of Fine Needle Biopsy for Pancreatic Serous Cystadenomas – a Multi-Center Study
Authors: Kim Grace E. , Mercado Michael , Barrett Margarita Riojas , Breese Miles , Umar Shifa , Ayoub Fares , Chen Dennis , Othman Mohamed O. , Siddiqui Uzma D. 
Published: December 2024

Abstract

Background
Distinguishing serous cystadenoma, a benign pancreatic cyst, from potentially malignant mucinous pancreatic cystic lesions carries significant clinical and prognostic implications; and while endoscopic ultrasound-guided fine needle aspiration is the standard diagnostic tool, its low diagnostic yield often results in additional workup.

Objective
This study evaluates diagnostic yield of fine needle biopsy (FNB) on lesions suggestive of serous cystadenoma on endoscopic ultrasound.

Methods
Patients with microcystic EUS appearance were identified through retrospective chart review in two institutions. Prior cross sectional imaging diagnosis was also obtained. All microcystic lesions with classic “honeycomb” appearance for serous cystadenoma on EUS were targeted for FNB and their pathology evaluated. Patients were identified through database search from 2015 to 2022 and procedure information was obtained through a retrospective chart review from two large academic centers.

Results
Thirty-one patients with suspected serous cystadenoma who underwent EUS-FNB were included. EUS FNB was successful in obtaining diagnosis in 96.8% of patients. Serous cystadenoma was diagnosed via EUS FNB in 27 of 31 patients (87.1%). Of the remaining four patients, there was one invasive pancreatic ductal adenocarcinoma, one pancreatic neuroendocrine tumor, one intraductal papillary mucinous neoplasm, and one nondiagnostic sample.

Conclusion
EUS-FNB sampling for histopathology is a safe and accurate diagnostic tool for pancreatic serous cystadenoma. When microcytic lesions are found on endoscopic ultrasound, our study results suggest that fine needle biopsy for histopathology should be considered as the initial diagnostic evaluation tool given the demonstrated improved diagnostic yield for serous cystadenoma.
Serum trypsin is a reliable biomarker of pancreas function
Authors: Gummadi Vybhav Venkatesh , Gonska Tanja 
Published: December 2024

Abstract
Pancreatic diseases pose significant diagnostic and therapeutic challenges necessitating robust biomarkers for accurate diagnosis, management and monitoring of pancreas function. Pancreas function can be measured with direct (invasive) and indirect tests. However, both approaches do not allow continuous disease monitoring to identify disease progression or therapeutic response. We demonstrate literature evidence suggesting that trypsin, an important pancreatic digestive enzyme, holds promise as such a continuous biomarker. On one hand, assessment of trypsin concentration in the serum sensitively and specifically detects pancreas inflammation; whereas on the other hand, declining trypsin levels in serum showed good correlation with direct pancreatic function tests to identify exocrine pancreatic insufficiency. With this comprehensive review, we aimed to evaluate the existing evidence on the utility of trypsin as a continuous biomarker, spanning from acute to chronic pancreatitis and pancreas function, highlighting its potential in monitoring disease evolution on an individual patient level.