bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-stratified Genomic Structural Equation Models of Posttraumatic Stress Inform PTSD Etiology: L'utilisation de la modélisation génomique par équations structurelles stratifiée par sexe du stress post-traumatique pour expliquer l'étiologie du TSPT
Authors: Moo-Choy Ashley , Stein Murray B. , Gelernter Joel , Wendt Frank R. 
Published: December 2024

Objective Posttraumatic stress disorder (PTSD) affects 3.9%–5.6% of the worldwide population, with well-documented sex-related differences. While psychosocial and hormonal factors affecting sex differences in PTSD and posttraumatic stress (PTS) symptom etiology have been explored, there has been limited focus on the genetic bases of these differences. Many symptom combinations may confer a PTSD diagnosis. We hypothesized that these symptom combinations have sex-specific patterns, the examination of which could inform etiological differences in PTSD genetics between males and females. Methods To investigate this, we performed a sex-stratified multivariate genome-wide association study (GWAS) in unrelated UK Biobank (UKB) individuals of European ancestry. Using GWAS summary association data, genomic structural equation modelling was performed to generate sex-specific factor models using 6 indicator variables: trouble concentrating, feeling distant from others, irritability, disturbing thoughts, upset feelings, and avoidance of places/activities which remind the individual of a traumatic event. Results Models of male and female PTSD symptoms differed substantially (local standardized root mean square difference = 3.12) and significantly (χ2(5) = 28.03, P = 3.6 × 10−5). Independent 2-factor models best fit the data in both males and females; these factors were subjected to GWAS in each sex, revealing 3 genome-wide significant loci in females, mapping to SCAND3, WDPCP, and FAM120A. No genome-wide significant loci were identified in males. All 4 PTS factors (2 in males and 2 in females) were heritable. Conclusions By assessing the relationship between sex and PTSD symptoms, this study informs correlative and putatively causal etiological differences between males and females which support further investigation of sex differences in PTSD genetics.
A systematic review of using clinical decision support systems in corneal diseases
Authors: Ebrahimi Farzad , Ayatollahi Haleh , Zeraatkar Kimia 
Published: December 2024

Background Corneal diseases encompass a wide spectrum of eye diseases, and are among the leading causes of blindness. The use of clinical decision support systems (CDSSs) can assist physicians in timely diagnosis of these diseases and prevent their progression. Objective The present study aimed to conduct a systematic review of using CDSSs in corneal diseases to identify gaps in the current knowledge and propose for future research in designing, implementation, and effective use of health information technology in ophthalmology, with a specific focus on corneal diseases. Methods This systematic review was conducted in 2024. To retrieve relevant articles, PubMed, Web of Knowledge, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched until end of September 2024. After assessing the quality of the articles and risk of bias, the results were reported descriptively. Results Out of 279 articles, only eight articles met the research criteria. The results showed that clinical decision support systems were mainly developed for diagnosing corneal diseases, referring patients with low vision for rehabilitation, and identifying extraocular muscle pathology in strabismus. The systems were developed using different programming languages, their input data were patient data and images, and the output was diagnosis and more information about diseases. Most of the systems were active and used a knowledge base. The performance of the systems was evaluated by comparing physicians’ diagnosis and the system outputs, investigating users’ perspectives, and calculating accuracy, specificity, and sensitivity values. Conclusion The use of clinical decision support systems in corneal diseases leads to improve timely diagnosis, error reduction, and user satisfaction. However, further research is recommended to expand the use of new technologies such as artificial intelligence in the diagnosis of corneal diseases.
Loss of protein C vs protein S results in discrepant thrombotic phenotypes
Authors: Ku Chia-Jui , Yu Xinge , Zhao Queena Y. , Grzegorski Steven J. , Daniel Jeffrey G. , Ferguson Allison C. , Shavit Jordan A. 
Published: December 2024

Abstract
Venous thrombosis is a leading cause of morbidity/mortality and associated with deficiencies of the anticoagulant protein C (PC; PROC) and its cofactor, protein S (PS; PROS1). Heterozygous mutations increase the risk of adult-onset thrombosis, whereas homozygous mutations result in pre/neonatal lethal thrombosis. Phenotypes of patients with PC and PS deficiency are generally considered clinically indistinguishable. Here, we generate proc (zebrafish PROC ortholog) and pros1 knockouts through genome editing in zebrafish and uncover partially discordant phenotypes. proc−/− mutants exhibited ∼70% lethality at 1 year of age, whereas pros1−/− survival was unaffected. Induced venous endothelial injury in both mutants revealed reduced occlusive thrombus formation. This is consistent with the consumptive coagulopathy of zebrafish antithrombin 3 knockouts, which also results in spontaneous venous thrombosis. However, proc and pros1 mutants revealed a discrepancy. Although both mutants demonstrated spontaneous thrombosis, proc−/− was localized to the cardiac and venous systems, whereas pros1−/− was intracardiac. Aside from coagulation, PC has been shown to have PS-independent roles in inflammation. proc mutants displayed altered inflammatory markers and defects in neutrophil migration independent of pros1. Transcriptomic analysis and gene knockdown identified novel proc genetic interactions with adgrf7, a G protein-coupled receptor (GPCR) not previously known to be involved in coagulation. In summary, our data reveal differences between PC- and PS-deficient thrombosis, with cardiovascular tissue–specific phenotypes and survival differences, suggesting the possibility of underlying clinical differences in affected patients. This model of complete proc−/− deficiency in an accessible organism will facilitate further in vivo study of these distinctions, as well as PS-dependent and -independent functions of PC.
Tailored internet-delivered cognitive behavior therapy for depression in older adults: a randomized controlled trial
Authors: Nordgren Lise Bergman , Ludvigsson Mikael , Silfvernagel Kristin , Törnhage Linnéa , Sävås Lisa , Söderqvist Sophie , Dinnetz Sofia , Henrichsén Paulina , Larsson Johanna , Ström Hanna , Lindh Malin , Berger Thomas , Andersson Gerhard 
Published: December 2024

Abstract
Background
Depression is a common and serious problem in older adults, but few have access to psychological treatments. Internet-delivered Cognitive Behavioral Therapy (ICBT) has the potential to improve access and has been found to be effective in adults with depression. The aim of this study was to examine the effects of tailored ICBT for depression in older adults aged 65 years or older. We also investigated if cognitive flexibility could predict outcome.

Methods
Following online recruitment from the community, included participants were randomly allocated to either ten weeks of clinician guided ICBT (n = 50) or to an active control group in the form of non-directive support (n = 51). Primary depression outcome was the Geriatric Depression Scale (GDS-15). Several secondary outcomes were used, such as the Beck Depression Inventory (BDI-II) and the Patient Health Questionnaire (PHQ-9).

Results
Both treatment and active control groups significantly reduced their levels of depression, and the treatment group showed significantly greater improvement on the GDS-15 and BDI-II, but not on the PHQ-9. Between-group effect sizes as Cohen’s d were 0.78 (CI95% 0.36–1.20) on the GDS-15 and 0.53 (CI95% 0.11–0.94) on the BDI-II.

Conclusions
Tailored ICBT is superior to an active control for older adults with depression. Between-group effects were smaller than in previous RCTs, most likely because of the use of an active control condition. Cognitive flexibility did not predict outcome. We conclude that ICBT can be used for older adults with depression, and thus increase access to psychotherapy for this group.

Trial registration
This trial was retrospectively registered in clinicaltrials.gov (no. NCT05269524) the 8th of March 2022.
Antimicrobial effect of bioceramic sealer in necrotic primary molars
Authors: Aly Esraa Hamed 
Published: December 2024

Abstract
Background
Pulpally infected primary teeth should be retained until exfoliation whenever possible, as deciduous teeth are ideal space maintainers. Removing bacteria from the root canal is essential for a successful root canal treatment. Therefore, the present study compared the antimicrobial effects of resorbable bioceramic sealer with pastes of calcium hydroxide and iodoform mixed with zinc oxide and zinc oxide eugenol when used as intracanal medication on microorganisms of necrotic primary molars. The materials used in the study were: Paste A: Non-setting calcium hydroxide paste mixed with iodoform, Paste B: Zinc oxide eugenol, Paste C: Metapex with zinc oxide, Paste D: Metapex with zinc oxide eugenol, Paste E: Bio-C Pulpecto. Polymicrobial growth inhibition zone diameters around each of the five pastes were measured in mm to determine antimicrobial activity. The collected data were presented, tabulated, and statistically analyzed.

Results
Comparison among all groups demonstrated a significant difference between them (P < 0.0001) using the Kruskal–Wallis test. Furthermore, Dunn's multiple comparisons test revealed that: Paste C (0.93 ± 3.55) and Paste A (2.13 ± 2.67) exhibited significantly the lowest antibacterial activity with no significant difference between them. Subsequently, Paste D (5.2 ± 5.89) and Paste E (8.73 ± 1.36) displayed no significant difference between them. In contrast, Paste B (11.8 ± 1.58) demonstrated significantly the highest antibacterial activity.

Conclusions
Bioceramic sealers could be utilized as filling material for root canal in primary molars because of their antimicrobial and biological properties.
Estimating Net Bone Formation Relative to Resorption Using Reference Bone Turnover Markers
Authors: Shieh Albert , Karlamangla Arun S , Gossiel Fatma , Eastell Richard , Burnett-Bowie Sherri-Ann , Greendale Gail A 
Published: December 2024

Abstract

Context
Individually, bone resorption or formation markers do not reflect bone balance.

Objective
(1) Combine reference bone resorption [collagen type I C-telopeptide (CTX)] and formation [procollagen type I propeptide (PINP)] markers to estimate balance by creating a bone balance index (BBI); (2) examine associations of BBI, CTX, or PINP with bone mineral density (BMD) change.

Design
Mixed effects linear regression quantified associations of BBI, CTX, or PINP with BMD change rate.

Setting
Community-based cohort (Study of Women's Health Across the Nation).

Participants
535 women transitioning through menopause.

Main Outcome Measures
Annualized percent change in lumbar spine (LS) and femoral neck (FN) BMD.

Results
In mixed effects linear regression, adjusted for age, body mass index, race/ethnicity, menopause transition stage, and study site, more negative BBI (less favorable balance) related to more BMD loss. Each SD decrement in BBI was associated with a 0.26% greater decline in LS BMD annually and 0.42% greater decline in FN BMD annually (each P &lt; .0001). In separate models, accounting for the previous covariates, greater CTX or PINP predicted more bone loss. Per SD increment in log2CTX, annual BMD decline was 0.37% greater (P &lt; .0001) and 0.47% greater (P &lt; .0001) at the LS and FN, respectively. Per SD increment in log2PINP, annual BMD loss was 0.22% (P &lt; .0001, LS) and 0.19% (P = .01, FN) greater.

Conclusion
When combined as a BBI, CTX and PINP estimate bone balance; more negative BBI predicts faster BMD loss. Separately, CTX or PINP reflect overall amount of bone turnover; greater CTX or PINP are related to more bone loss.
Impaired Awareness and Symptomatology of Hypoglycemia in Adults With Type 1 Diabetes Using Continuous Glucose Monitoring
Authors: Lin Yu Kuei , Ye Wen , Hepworth Emily , Rickels Michael R , Amiel Stephanie A , Speight Jane , Shaw James A M 
Published: December 2024

Abstract

Context and Objective
Sparse large-scale studies have characterized hypoglycemia symptomatology in adults with type 1 diabetes (T1D) who use continuous glucose monitoring (CGM). This research aimed to evaluate the relationship of impaired awareness of hypoglycemia (IAH) with hypoglycemia symptomatology and frequency in this population.

Design
A cross-sectional survey was conducted in 2023. HypoA-Q was used to evaluate hypoglycemia frequency, symptomatology, and awareness.

Setting & Participants
Registrants who used CGM in the T1D Exchange, a U.S. national T1D registry.

Results
Surveys were completed by 1480 adults with T1D who used CGM (53% female; mean diabetes duration 26 years). Compared to those with intact hypoglycemia awareness, IAH was associated with less frequent hypoglycemia symptom presentation across various glucose levels and lower glucose concentrations for first presenting hypoglycemia symptoms when awake (P &lt; .05 for all). More than 70% of individuals with IAH did not regularly experience symptoms during episodes with glucose &lt;54 mg/dL. When asleep, those with IAH were less frequently awoken by symptoms, more frequently awoken by others who recognized their hypoglycemia, and more frequently acknowledged hypoglycemia after an episode (P &lt; .05 for all) despite using CGM. With reduced symptoms, both when awake and asleep, those with IAH experienced more hypoglycemic episodes that they were unable to self-treat than those with intact awareness (P &lt; .05).

Conclusion
IAH continues to be associated with a significant reduction in detection of hypoglycemia symptoms, both when awake and asleep, in adults using CGM. Current diabetes technologies do not fully protect adults with T1D from hypoglycemia.
Effectiveness of Bisphosphonates in Young Adults With Fragility Fractures: Representative Population-based Cohort Study
Authors: Kong Sung Hye , Park Ju-young , Shin Moon-Kyung , Lee Hyo-Jung , Kim Jin Woo , Park Seung Shin , Kim Sang Wan , Shin Chan Soo , Song Tae-Jin 
Published: December 2024

Abstract

Context
Fragility fractures in young adults present significant clinical challenges due to the limited evidence on the effectiveness of bisphosphonates in preventing subsequent fractures.

Objective
To evaluate the effectiveness of bisphosphonate therapy in reducing the fracture risk among premenopausal women with a history of osteoporotic fractures.

Design
A population-based retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort in South Korea, covering the years 2003 to 2014.

Setting
A nationwide healthcare setting utilizing a representative cohort database.

Participants
Among 2087 premenopausal women with osteoporotic fractures, participants were propensity score-matched based on age and body mass index at a 1:3 ratio, resulting in 132 bisphosphonate users and 396 nonusers.

Intervention
Bisphosphonate treatment.

Main Outcome Measures
The incidence of osteoporotic fractures.

Results
Bisphosphonate users had a significantly lower risk of major osteoporotic fractures [hazard ratio (HR) 0.618, 95% confidence interval (CI) 0.396-0.963] compared to nonusers. Ibandronate users showed significant reductions in both major osteoporotic (HR 0.376, 95% CI 0.164-0.861) and nonvertebral fractures (HR 0.214, 95% CI 0.052-0.877). Also, longer duration of bisphosphonate use (≥180 days) was associated with a significantly lower risk of major osteoporotic and nonvertebral fractures (HR 0.528, 95% CI 0.300-0.929; HR 0.409, 95% CI 0.187-0.895, respectively).

Conclusion
Bisphosphonate therapy significantly reduces fracture risk in premenopausal women with previous osteoporotic fractures, especially at higher cumulative doses. These findings support considering bisphosphonates as a treatment option in premenopausal women at high risk of fractures.
Gamified Mobile Health Strategies for Promoting Physical Activity in Autistic Adults
Authors: Lee Daehyoung , Frey Georgia C. , Shih Patrick C. 
Published: December 2024

Abstract
Physical inactivity and sedentarism among autistic adults are a growing public health concern. Focusing on the integration of behavior change theories and emphasizing the unique preference for visuospatial learning and gaming technology, we hypothesize that gamified mobile health (mHealth) applications can be effective at increasing free-living physical activity and reducing sedentary behavior in autistic adults.
Flow of the Game: A Hidden Markov Model of Player Engagement in Online Mobile Games
Authors: Deng Jiaying , Lee Stephanie , Tan Yong 
Published: December 2024

Practice- and Policy-Oriented Abstract Mobile gaming is a prominent component of the entertainment industry, yet high attrition rates and low engagement are notorious problems faced by most mobile game publishers. This paper investigates the effects of in-game challenge-related factors and reward ads on player engagement in mobile games. Using a Hidden Markov Model, we analyze how perceived challenge, fluctuation of perceived challenge, and reward ads impact players’ engagement states. Our findings indicate that whereas moderate levels of perceived challenge enhance engagement, excessive challenge level has diminishing returns. Furthermore, fluctuations in perceived challenge help sustain engagement by providing a balance between stimulation and cognitive restoration. Third, reward ads provide access to scaffolds, offering temporary support that helps players move to a higher engagement state, especially during challenging phases of the game. For game developers, incorporating dynamic challenge adjustments can improve player experience and keep players engaged. Additionally, reward ads offer a strategic opportunity for game publishers to monetize their games while maintaining engagement, with a stronger impact when players perceive a higher level of challenge. These insights provide valuable practices for designing mobile games that effectively balance user engagement and monetization strategies, ensuring sustained growth in a competitive landscape.
Investigating Erosion under Perennial Ground Cover (PGC) Using a Rainfall Simulation Experiment
Authors: Olowoyeye Oluwatuyi S. , Kaleita Amy L. 
Published: December 2024

HighlightsThe Perennial Groundcover (PGC) system lowered the runoff rate.Both Grass only and Perennial Groundcover (PGC) systems showed reduced amount of sediment transport.Abstract. The intensive corn and soybean production in the Midwest, USA, exacerbates environmental challenges, particularly concerning runoff and sediment transport. The perennial groundcover (PGC) system is a new system that allows the growth of row crop and perennial grass simultaneously, potentially lowering the runoff and erosion rate. This study aims to quantify runoff rate and erosion rate in PGC treatment compared to Bare land (BL), corn (C), corn on residue (CR), and perennial grass (G) using rain simulation. The experiment was conducted in summer 2023 at the Iowa State University Sorenson Research Farm, near Ames, Iowa. We simulated rainfall on each plot until it reached field capacity and eventual saturation; at this point, the runoff rate was estimated and sediment load was measured. Furthermore, we tested for infiltration rate across these treatments using a Cornell Infiltrometer. Statistical comparison was done using Analysis of Variance and Tukey’s method to determine treatment effects. The PGC took longer to generate runoff, and the runoff rate was lower in the PGC compared to all other treatments aside from the G plot. No consistent differences were found for the infiltration rate. However, we observed a 92% reduction in sediment load for PGC compared to BL, with statistically significant mean differences (p &lt; 0.05) between treatments. The data retrieved from the experiment will be critical in modeling soil erosion under a PGC system and further aid cross-disciplinary research being carried out to develop a robust PGC system. Keywords: Ecosystem services, Groundcover, Rainfall simulator, Runoff rate, Soil loss.
Utilizing Super Capacitors to Improve Battery Performance in Electric Mobile Machinery
Authors: Dvorak Joe 
Published: December 2024

HighlightsMaximum voltage levels were reduced from 22% over nominal to only 11% to 12%.Maximum regeneration currents into the battery were reduced from 590 to 220 A.Total current into and out of the battery was reduced by 18%, which would improve battery life.A super capacitor can improve power capabilities of energy storage without harming vehicle feel or operation.Abstract. This project tested the impact of incorporating a super capacitor into a battery electric drivetrain for off-road machinery. The 188 F super capacitor was added to a 1250 Ah, 36 V nominal battery system of a three-wheel production forklift with a rated load capacity of 2268 kg. The forklift was operated according to the procedures outlined in Abnormal Operation Heat Rise Test per UL 583 with an 1800 kg load. The test was conducted twice with the super capacitor in operation and twice without. Current into the super capacitor and battery as well as system voltage were recorded. The super capacitor reduced maximum voltage spikes, which were caused by regenerative braking, from 42 V (22% over nominal) to 39 V or less (12% over nominal). Maximum regeneration currents into the battery were reduced from 590 A to 220 A. Total current into and out of the battery during each test run was reduced by 18% when the super capacitor was added, which would improve battery life. Vehicle power levels and responsiveness during the operation were not negatively impacted by the addition of the super capacitor. The addition of a super capacitor had a beneficial impact on the electrical system of the vehicle without altering the operator feel or its responsiveness. Keywords: Battery, Battery life, Electric vehicles, Power, Super capacitor, Voltage spikes.