bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Dynamic Balance Performance Was Associated With Cognitive Function Among U.S. Community-Dwelling Low-Income Older Adults
Authors: Komalasari Renata , Mpofu Elias , Chen (Rita) (Chang) Hui , Talluntondok Eva Berthy , Uligraff Deby Kristiani , Zhan Rongfang , Thiamwong Ladda 
Published: November 2024

Introduction Multiple studies have reported the association between balance performance and cognitive function among older adults. However, few studies have been conducted in low-income settings. Objectives This cross-sectional study examined the relationships of dynamic and static balance with cognitive function in community-dwelling low-income older adults in Orlando, Florida. Methods Dynamic balance was assessed with a Short Physical Performance Battery (SPPB) and static balance with BTracks Balance System. Rowland Universal Dementia Assessment Scale (RUDAS) assessed cognition and Patient Health Questionnaire-9 assessed depressive symptoms. Results Multiple regression analysis showed dynamic balance was significantly associated with cognition, but static balance was not, controlling for depressive symptoms ( N = 89, Mage  = 72.70, SD ± 6.95; females = 79). Specifically, higher dynamic balance was associated with better cognitive function. Cognitively healthy participants (RUDAS scores ≥23) scored 2.526 points higher in SPPB than those with possible cognitive impairment (RUDAS scores <23). Conclusions Findings provide the evidence to suggest dynamic balance and cognitive function health disparities affecting older adults from low-income community. By implication, dynamic balance and cognitive function should be part of routine screening with older adults living in low-income communities.
Current knowledge on Inquilinus limosus, a scarcely researched human pathogen
Authors: Akinnurun Oluwafemi M. , Riedel Thomas , Müller Stephanie , Bunk Boyke , Schröttner Percy 
Published: November 2024

AbstractInquilinus limosus belongs to the class of the Alphaproteobacteria and was first described in 2002. So far, the species has mainly been isolated from respiratory specimens of patients with cystic fibrosis. A main characteristic of Inquilinus limosus is the prolonged time until bacterial colony growth is detectable. As the defined incubation times in many laboratories are too short to detect the growth of Inquilinus limosus, it is likely that the species is less frequently detected in the clinical setting than it actually occurs. This also explains why there are currently only very few data on the incidence available. Furthermore, as an uncommon pathogen, Inquilinus limosus may be familiar to only a few specialised clinicians. Due to these reasons, only little research (e.g. case reports and research papers) have been published on this species to date. However, given that a clear human pathogenic significance can be deduced from the existing literature, we have decided to present the current state of knowledge in this review and to address further aspects for the future elucidation of the pathogenesis of Inquilinus limosus.
Novel prognostic factors and combination therapy outcomes in Morbihan disease: insights from an Asian population
Authors: Park Jungyul , Kim Moon-Bum , Choi Hee-young , Yang Suk-woo 
Published: November 2024

Abstract
Purpose
This study aimed to identify novel prognostic factors for Morbihan disease (MD) treatment outcomes and evaluate the efficacy of combination therapy in an Asian population, addressing the gaps in current understanding of this rare condition.

Methods
We conducted a retrospective analysis of MD patients diagnosed and treated at a tertiary hospital between 2017 and 2023. Patients received combinations of oral medications (tetracycline, isotretinoin, corticosteroids), topical treatments (tacrolimus, ivermectin), and intralesional steroid injections. Treatment response (TR) was defined as complete symptom remission, while partial remission or recurrence was considered a poor response (PR). Clinical, histological, and biochemical parameters were analyzed to identify prognostic factors.

Results
The study included 24 patients (18 men; mean age 61.3 years). Ten patients (41.7%) achieved TR, while 14 (58.3%) showed PR. Significant prognostic factors for TR included shorter symptom duration (≤ 3 months, p = 0.016), lower LDL cholesterol levels (≤ 89 mg/dL, p = 0.046), combination treatment with oral and topical medications (p = 0.033 at 6 months), and partial response at 1 month (p = 0.017). GLMM analysis identified the number of visits (p < 0.001), symptom duration (p = 0.020), and dyslipidemia (p = 0.006) as significant prognostic factors. Histologically, perivascular and perifollicular lymphocytic infiltration were the most common findings (83.3%). Notably, 50% of patients were ANA-positive, challenging previous diagnostic criteria.

Conclusion
This study identifies novel prognostic factors for favorable outcomes in MD, including early intervention and lipid management. Combination therapy, particularly with tacrolimus ointment, shows promise in improving treatment responses. These findings suggest a potential link between lipid metabolism and MD pathophysiology, opening new avenues for targeted therapies.
Association of life’s essential 8 with chronic obstructive pulmonary disease: a population-based analysis of NHANES 2007–2018
Authors: Liu Yuhang , Li Weidong , Tang Jialing , Gao Siyao 
Published: November 2024

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is closely linked to cardiovascular diseases. We aimed to investigate the association between Life’s Essential 8 (LE8), the newly established measurement to assess cardiovascular health (CVH), and COPD among U.S. general adults.

Methods
This study extracted the National Health and Nutrition Examination Survey (2007–2018) data. Multivariate logistic regression models were used to examine the associations between LE8 and COPD. A restricted cubic spline regression model was used to explore the dose-response relationships between LE8 scores and COPD. In addition, subgroup and sensitivity analyses were performed to assess the robustness of our results.

Results
Our study included 19,774 participants representing 145.2 million non-institutionalized U.S. population aged ≥ 20 years. The overall age-adjusted prevalence of COPD was 4.5%. After adjusting for the potential covariates, LE8 was inversely associated with COPD [adjusted odds ratio (AOR) = 0.169, 95% CI: 0.115, 0.249], exhibiting a nonlinear dose-response relationship (P for nonlinearity < 0.05). Similar trends in the associations of health behavior score (AOR = 0.300, 95% CI: 0.223, 0.404) and health factor score (AOR = 0.603, 95% CI: 0.426, 0.852) with COPD were also identified. Furthermore, higher LE8 metric scores of nicotine exposure and sleep health were associated with a lower prevalence of COPD.

Conclusion
LE8 was inversely associated with spirometric/self-reported COPD in a nonlinear trend, primarily driven by the nicotine exposure metric of LE8. Adhering to LE8 guidelines, especially smoking cessation, to sustain optimal CVH levels may be beneficial to alleviate the burden of COPD.
Coping strategies for household water insecurity in rural Gambia, mediating factors in the relationship between weather, water and health
Authors: Bose Indira , Dreibelbis Robert , Green Rosemary , Murray Kris A. , Ceesay Omar , Kovats Sari 
Published: November 2024

Abstract
Background
Rural communities in low- and middle-income countries, such as The Gambia, often experience water insecurity periodically due to climate drivers such as heavy rainfall and reduced rainfall, as well as non-climate drivers such as infrastructural issues and seasonal workloads. When facing these challenges households use a variety of coping mechanisms that could pose a risk to health. We aimed to understand the drivers of water insecurity (climate and non-climate), the behavioural responses to water insecurity and the risks these responses pose to the health of communities in rural Gambia and map these findings onto a conceptual framework.

Methods
We interviewed 46 participants using multiple qualitative methods. This included in-depth interviews and transect walks. A subset of 27 participants took part in three participatory pile-sorting activities. In these activities participants were asked to rank water-related activities, intrahousehold prioritisation of water, and the coping strategies utilised when facing water insecurity.

Results
Multiple strategies were identified that people used to cope with water shortages, including: reductions in hygiene, changes to food consumption, and storing water for long periods. Many of these could inadvertently introduce risks for health. For example, limiting handwashing increases the risk of water-washed diseases. Deprioritising cooking foods such as millet, which is a nutrient-dense staple food, due to the high water requirements during preparation, could impact nutritional status. Additionally, storing water for long periods could erode water quality.
Social factors appeared to play an important role in the prioritisation of domestic water-use when faced with water shortages. For example, face-washing was often maintained for social reasons. Health and religion were also key influencing factors. People often tried to protect children from the effects of water insecurity, particularly school-aged children, but given the communal nature of many activities this was not always possible. Many people associated water insecurity with poor health.

Conclusions
To reduce the risks to health, interventions need to address the drivers of water insecurity to reduce the need for these risky coping behaviours. In the short term, the promotion of behavioural adaptations that can help buffer health risks, such as water treatment, may be beneficial.
Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial)
Authors: Blohm My , Sandblom Gabriel , Enochsson Lars , Cengiz Yücel , Bayadsi Haytham , Hennings Joakim , Diaz Pannes Angelica , Stenberg Erik , Bewö Kerstin , Österberg Johanna 
Published: November 2024

Abstract
Background
Laparoscopic cholecystectomy with ultrasonic dissection presents a compelling alternative to conventional electrocautery. The evidence for elective cholecystectomy supports the adoption of ultrasonic dissection, citing advantages such as reduced operating time, diminished bleeding, shorter hospital stays and decreased postoperative pain and nausea. However, the efficacy of this procedure in emergency surgery and patients diagnosed with acute cholecystitis remains uncertain. The aim of this study was to compare outcomes of electrocautery and ultrasonic dissection in patients with acute cholecystitis.

Methods
A randomized, parallel, double-blinded, multicentre controlled trial was conducted across eight Swedish hospitals. Eligible participants were individuals aged ≥ 18 years with acute cholecystitis lasting ≤ 7 days. Laparoscopic cholecystectomy was performed in the emergency setting as soon as local circumstances permitted. Random allocation to electrocautery or ultrasonic dissection was performed in a 1:1 ratio. The primary endpoint was the total complication rate, analysed using an intention-to-treat approach. The primary outcome was analysed using logistic generalized estimated equations. Patients, postoperative caregivers, and follow-up personnel were blinded to group assignment.

Results
From September 2019 to March 2023, 300 patients were enrolled and randomly assigned to electrocautery dissection (n = 148) and ultrasonic dissection (n = 152). No significant difference in complication rate was observed between the groups (risk difference [RD] 1.6%, 95% confidence interval [CI], − 7.2% to 10.4%, P = 0.720). No significant disparities in operating time, conversion rate, hospital stay or readmission rates between the groups were noted. Haemostatic agents were more frequently used in electrocautery dissection (RD 10.6%, 95% CI, 1.3% to 19.8%, P = 0.025).

Conclusions
Ultrasonic dissection and electrocautery dissection demonstrate comparable risks for complications in emergency surgery for patients with acute cholecystitis. Ultrasonic dissection is a viable alternative to electrocautery dissection or can be used as a complementary method in laparoscopic cholecystectomy for acute cholecystitis.

Trial registration
The trial was registered prior to conducting the research on http://clinical.trials.gov, NCT03014817.
Evaluating attachment-based family therapy in residential treatment in the United States: does adolescents’ increased attachment security to caregivers lead to decreases in depressive symptoms?
Authors: Diamond Guy , Rivers Alannah Shelby , Winston-Lindeboom Payne , Russon Jody , Roeske Michael 
Published: November 2024

Abstract

Background
The inclusion of family therapy in residential treatment centers (RTCs) has increased over time. However, there is little data on whether empirically-supported family therapies (ESFTs) are being adopted and if they contribute to treatment effectiveness. This study aimed to test whether Attachment-Based Family Therapy (ABFT), an ESFT integrated into a large residential psychiatric system, would improve perceived attachment insecurity (anxiety and avoidance) and contribute to decreases in depression for adolescents.

Method
ABFT was integrated into the clinical program of a large, residential psychiatric system. All family therapists were trained to a level of certification. Improvement was measured by changes in adolescent’s perceived attachment to caregivers and reduction in depressive symptoms. The sample included 4786 patients. Attachment insecurity and depressive symptoms were measured at intake, week 3, and week 5. A random-intercept, cross-lagged panel model was used to examine the relationships between attachment and depression over time.

Results
The results generally supported hypotheses. Attachment insecurity and depressive symptoms improved over the five weeks of treatment. Improvements in attachment avoidance preceded improvements in depressive symptoms within subjects, over time. Simultaneously, improvements in depressive symptoms preceded those in both dimensions of attachment. Thus, improvement in perceived attachment was associated with a reduction in depressive symptoms.

Conclusion
RTCs that can generate improvements in attachment insecurity and depressive symptoms, via ABFT or other ESFTs, might improve treatment outcomes, and ideally, adolescents’ successful transition back home to families. More research is needed to disentangle the contribution of ABFT and other treatment elements in a multimodal, residential treatment program. The study supports the call for increased incorporation of families into the RTC treatment process.
Natural killer cell biology and therapy in multiple myeloma: challenges and opportunities
Authors: Bisht Kamlesh , Merino Aimee , Igarashi Rob , Gauthier Laurent , Chiron Marielle , Desjonqueres Alexandre , Smith Eric , Briercheck Edward , Romee Rizwan , Alici Evren , Vivier Eric , O’Dwyer Michael , van de Velde Helgi 
Published: November 2024

AbstractDespite therapeutic advancements, multiple myeloma (MM) remains incurable. NK cells have emerged as a promising option for the treatment of MM. NK cells are heterogenous and typically classified based on the relative expression of their surface markers (e.g., CD56 and CD16a). These cells elicit an antitumor response in the presence of low mutational burden and without neoantigen presentation via germline-encoded activating and inhibitory receptors that identify the markers of transformation present on the MM cells. Higher NK cell activity is associated with improved survival and prognosis, whereas lower activity is associated with advanced clinical stage and disease progression in MM. Moreover, not all NK cell phenotypes contribute equally toward the anti-MM effect; higher proportions of certain NK cell phenotypes result in better outcomes. In MM, the proportion, phenotype, and function of NK cells are drastically varied between different disease stages; this is further influenced by the bone marrow microenvironment, proportion of activating and inhibitory receptors on NK cells, expression of homing receptors, and bone marrow hypoxia. Antimyeloma therapies, such as autologous stem cell transplant, immunomodulation, proteasome inhibition, and checkpoint inhibition, further modulate the NK cell landscape in the patients. Thus, NK cells can naturally work in tandem with anti-MM therapies and be strategically modulated for improved anti-MM effect. This review article describes immunotypic and phenotypic differences in NK cells along with the functional changes in homeostatic and malignant states and provides expert insights on strategies to harness the potential of NK cells for improving outcomes in MM.
Intraoperative Goal-Directed Fluid Therapy and Outcomes After Oncologic Surgeries: A Systematic Review and Meta-Analysis
Authors: Jin Zhaosheng , Razak Alina , Huang Huang , Muthukumar Arun , Murphy Jasper , Shteynman Lana , Bergese Sergio D. , Gan Tong J. 
Published: November 2024

BACKGROUND:
Surgery is the first-line curative treatment for most solid-organ malignancies. During major surgeries, fluid under- or over administration can have a significant impact on recovery and postoperative outcomes. For patients undergoing oncologic surgery, delayed recovery or complications could additionally impact subsequent oncologic treatment planning. This systematic review and meta-analysis aims to evaluate the impact of goal-directed fluid therapy (GDFT) on perioperative outcomes after oncologic surgeries.

METHODS:
We systematically searched PubMed, EMBASE, CINAHL, and Web of Science citation index for clinical trials comparing the GDFT to routine clinical care. The primary outcomes of interest are the hospital length of stay and the total incidence of postoperative complications. Secondary outcomes include organ-specific complications and recovery of bowel function.

RESULTS:
The literature search was last updated on February 17, 2024. We identified a total of 24 randomized controlled trials (RCTs) comparing GDFT to routine care with 1172 and 1186 patients, respectively. The GDFT arm had a significantly shorter length of hospital stay (mean difference [MD], 1.57 days, 95% confidence interval [CI], −2.29 to −0.85, P < .01), as well as lower incidence of complications (risk ratio, 0.74, 95% CI, 0.56–0.97, P = .03). The GDFT arm also had a shorter time to bowel function recovery (MD, 0.58 days, 95% CI, −1.02 to −0.14, P = .01). None of the included trials reported the longer-term oncologic outcomes. The overall certainty of evidence is low due to between-study variance and study risk of bias. Trial sequence analysis indicates that further studies are unlikely to alter the conclusion regarding postoperative length of stay but may provide further information on the postoperative complications.

CONCLUSIONS:
Our systematic review and meta-analysis suggests that in oncologic surgery, intraoperative GDFT significantly reduces the length of hospital stay, lowers the risk of complications, and facilitates bowel function recovery. Further studies are required to evaluate whether the improvement in early postoperative outcomes leads to better long-term oncologic outcomes.
Dorsolateral Transdural Surgical Management of Spontaneous Intracranial Hypotension From Ventral Dural Cerebrospinal Fluid Leaks: Case Series and Technical Report
Authors: Wu Adela , Mamlouk Mark D. , Sedrak Mark F. 
Published: November 2024

BACKGROUND and OBJECTIVES:
Spontaneous intracranial hypotension is an uncommon but debilitating condition that commonly involves positional headaches and vertigo. One cause is cerebrospinal fluid (CSF) leakage from ventral dural defects from calcified spinal discs. Patients can undergo epidural blood or fibrin glue patches as treatment; however, in cases where the leak does not resolve, surgical repair of the dural tear may be warranted. We aim to describe a case series and technical notes for these patients.

METHODS:
Patients with spontaneous intracranial hypotension because of myelography-confirmed ventral dural defect from calcified thoracic disc, who were treated surgically between June 2020 and March 2024, were included in the study cohort. Demographic information, clinical course, and postoperative outcomes were collected. The surgical technique was also described based on an illustrative case.

RESULTS:
Twelve consecutive patients underwent surgery between June 2020 and March 2024 with postoperative records. The median age at the time of surgery was 41.5 years (range: 28-58 years). Male patients comprised 50% of the cohort. Dural defects were spread throughout the thoracic spine in the cohort. While all patients reported positional headaches, other symptoms included vertigo, pulsatile tinnitus, and neck pain. Median length of follow-up time was 6.5 weeks. There were no surgical complications or permanent neurologic deficits. All patients had radiologic cure of their leaks with absence of extradural CSF on postoperative MR imaging. Ten patients (83.3%) had complete resolution of spontaneous intracranial hypotension-related symptoms. Two patients did suffer from rebound headaches postoperatively.

CONCLUSION:
The dorsolateral transdural surgical approach is a safe and effective method to repair type 1 CSF leaks caused by ventral dural defects. Our case series of 12 patients did not involve any surgical or immediate postoperative complications, and all patients had radiologic resolution of their leaks with relief of positional headaches. Two patients experienced continued headaches after treatment.
Does Transforaminal Endoscopic Lumbar Discectomy Provide More Value than Microdiscectomy? An Application of the Operative Value Index
Authors: Sarikonda Advith , Leibold Adam , Sami Ashmal , Amaravadi Cheritesh R. , Mansoor Ali Daniyal , Thalheimer Sara , Jallo Jack , Heller Joshua , Prasad Srinivas K. , Sharan Ashwini , Harrop James , Vaccaro Alexander R. , Sivaganesan Ahilan 
Published: November 2024

BACKGROUND AND OBJECTIVES:
A few studies have compared the value (outcomes per dollar spent) provided by transforaminal endoscopic discectomy (TED) vs microdiscectomy (MD) for lumbar disc herniations. Here, we attempt to address this gap using a novel Operative Value Index (OVI), which combines a procedure-specific patient-reported outcome with intraoperative cost data based on time-driven activity-based costing.

METHODS:
MD (n = 95) and TED (n = 23) performed by neurosurgeons at our institution from 2017 to 2022 were retrospectively identified. Time-driven activity-based costing was applied to identify both direct and indirect costs for all cases. Individual costs were obtained by direct observation, electronic medical records, and through consulting multiple departments (including business operations, sterile processing, plant operations, and pharmacy). Oswestry Disability Index (ODI) scores were prospectively collected at baseline and 3 months after surgery. Our primary outcome of interest was the OVI, defined as the percent change in the ODI per $1000 spent intraoperatively. Generalized linear mixed model regression was performed to assess whether TED was associated with significantly different OVI as compared to MD. Similar analyses were also performed for operative times and length of stay.

RESULTS:
The average intraoperative cost of a TED was $3698, as compared to $3410 for an MD. For both procedures, this total cost was largely driven by the cost of supplies and personnel. Multivariable regression revealed that MD was associated with significantly higher OVI (β-coefficient: 7.2, P < .05) and lower operative times (β-coefficient: - 34.6 minutes, P < .01) compared with TED, with no significant differences in length of stay (P = .17).

CONCLUSION:
When performed by surgeons at our institution from 2017 to 2022, MD was associated with a 7% greater improvement in ODI per $1000 spent intraoperatively. Continual assessment of value over time (both for established procedures and new techniques) will become increasingly important with the emergence of value-based care.