bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the Relationship Between Time in Range, Time in Tight Range, and HbA1c in Youth and Young Adults With Type 1 Diabetes? Results From the German/Austrian/Luxembourgian/Swiss Diabetes Prospective Follow-Up Registry
Authors: Burckhardt Marie-Anne , Auzanneau Marie , Rosenbauer Joachim , Binder Elisabeth , Weiskorn Jantje , Hess Melanie , Klinkert Christof , Mirza Joaquina , Zehnder Lara-Sophie , Wenzel Sandra , Placzek Kerstin , Holl Reinhard W. 
Published: November 2024

Objectives: Time in range (TIR, 70-180 mg/dL) is an established marker of glycemic control. More recently, time in tight range (TTR, 70-140 mg/dL) has been proposed as well. The aim of this study was to examine the relationship between TIR, TTR, and HbA1c in youth and young adults with type 1 diabetes (T1D) in the German/Austrian/Luxembourgian/Swiss Diabetes Prospective Follow-up (DPV) registry. Methods: Data of youth and young adults aged ≤25 years with T1D for >3 months, documented in the DPV registry between 2019 and 2022 were analyzed. The most recent available HbA1c and corresponding continuous glucose monitoring (CGM) profiles in the 12 preceding weeks with at least 80% completeness were included. Associations were investigated using correlation and adjusted regression models. Results: 1901 individuals (median age 14.0 years [IQR 10.4-16.9]) were included in the analysis. TIR and TTR correlated strongly, r = 0.965 (95% CI [0.962, 0.968]), P < .001. TTR estimates predicted from TIR were significantly higher in the group with high coefficient of variation (CV group ≥ 36%), P < .001. Correlations between TIR or TTR and HbA1c were both strong, r = −0.764 (95% CI [−0.782, −0.745]) and r = −0.777 (95% CI [−0.795, −0.759]), both P < .001, with no significant difference ( P = .312) However, adjusted regression models indicated a slightly better fit for the prediction of HbA1c from TIR compared with TTR. Conclusions: Based on large, real-world data from a multinational registry, TIR and TTR correlated strongly, and both showed a good prediction of HbA1c. TTR estimates predicted from TIR were significantly higher in people with high glucose variability (CV).
Posterior cardiac drain for atrial fibrillation after aortic valve replacement
Authors: Koga Yuichi , Sato Manabu , Sadashima Eiji , Ushigusa Jun , Kawasaki Hiromitsu , Kamohara Keiji 
Published: November 2024

Background: Postoperative atrial fibrillation occurs in 27% to 40% of patients after cardiac surgery. One cause of postoperative atrial fibrillation is pericardial effusion, which can be a significant source of inflammation. In this study, we investigated the effect of a drain placed in a posterior site to the heart to reduce pericardial effusion in the early postoperative period to prevent postoperative atrial fibrillation. Methods: Participants were patients who underwent initial standby aortic valve replacement at Saga-Ken Medical Centre Koseikan from January 2010 to December 2021. Patients with a history of atrial fibrillation, complex surgery, or emergency surgery were excluded. The patients were divided into two groups: those with a posterior cardiac drain in addition to the usual intrapericardial and subpleural drains from September 2017 (group P) and those without posterior cardiac drain from January 2010 to August 2017 (group N). Multiple logistic regression analysis was performed to evaluate the usefulness of posterior cardiac drain. Results: Of the 79 patients included the study, 40 were male and groups P and N comprised 27 and 52 patients, respectively. Of the 79 patients, 32 developed postoperative atrial fibrillation; among whom, 7/27 (25.9%) had posterior cardiac drain and 25/52 (48.1%) had no posterior cardiac drain ( p = 0.09). When adjusted for body surface area, left ventricular end-diastolic and left atrial diameter, the incidence of postoperative atrial fibrillation was significantly lower in group P than in group N (adjusted odds ratio 0.270, 95% confidence interval 0.077–0.953, p = 0.042). Furthermore, no patient in the group P underwent postoperative thoracentesis in the subanalysis. Conclusions: The results suggest that early postoperative reduction of pericardial effusion by posterior cardiac drain placement may reduce the incidence of postoperative atrial fibrillation.
Front-Line Insights Into the Social Determinants of Health in Housing Instability: A Multi-Province Study
Authors: Draper Ethan C. , Burgess Heather J. , Chisholm Cheryl , Mazerolle Erin L. , Barker Conor 
Published: November 2024

Introduction: Individuals experiencing housing instability face significant health inequities. Addressing housing instability requires an understanding of the factors that contribute to these inequities—a responsibility that has been assumed by community-based organizations. Interviewing individuals from 3 Canadian provinces, the present study aimed to examine the perspectives of individuals from front-line services of the social determinants of health (SDoH) needs of individuals experiencing housing instability. Methods: As part of a larger knowledge translation study, we conducted 8 semi-structured interviews with individuals from front-line services (eg, shelter workers and shelter mental health nurses) in Canada (Nova Scotia, Saskatchewan, and Alberta) and used thematic analysis to identify predominant unmet SDoH needs. Results: Individuals from front-line services discussed the roles of many SDoH that may perpetuate housing instability in their clients. These included: (1) limited social supports; (2) poor access to health services; (3) poor opportunities for income and employment; (4) lack of transportation; (5) gender-based discrimination; (6) race-based discrimination; and (7) limited access to education and limited literacy skills. Conclusion: This study reveals how front-line service providers observe SDoH factors contributing to housing instability and create barriers to accessing support services. They advocate for a multi-system approach to addressing intersecting SDoH factors to validate clients’ experiences and help them achieve stable housing. Additionally, more research and consultation with front-line providers are necessary to understand and overcome systemic barriers to stable housing.
Circulating collagen breakdown products as a biomarker for presence and instability of human intracranial aneurysms
Authors: Hackenberg Katharina AM , Richter Peter , Hetjens Svetlana , Dreier Rita , Ratliff Thomas , Akanji Oluwadamilola , Dremel Judith , Abdulazim Amr , Al Masalmeh Ibrahim , Alzghloul Mansour , Neumaier-Probst Eva , Groden Christoph , Chou Sherry H-Y , Rinkel Gabriel JE , Etminan Nima 
Published: November 2024

Introduction: There is an unmet need for improved detection of intracranial aneurysms (IAs) and distinction between stable and unstable (high rupture risk) IAs. Within the IA wall, synthesis and degradation of type I collagen as the main molecular constituent balance each other to maintain IA stability. We hypothesized that collagen breakdown products could serve as molecular markers for IA presence and instability. Patients and methods: This prospective, cross-sectional, single-center study included patients with unstable (growing/symptomatic/ruptured) and stable IAs and controls. We determined C-telopeptide (CTx) and c-terminal telopeptide (ICTP) as breakdown products of type I collagen in arterial and venous blood. Results: We included 107 participants with IAs (52 stable/44 unstable) and 41 controls. The correlation between intra-aneurysmal and venous levels was r = 0.63 ( p < 0.001) for ICTP, r = 0.55 ( p = 0.001) for CTx. The odds of harboring an IA were five times higher for participants with high compared to low venous levels of collagen breakdown products (ICTP: odds ratio (OR) 4.9 (95% CI 1.1–22.7); CTx: OR 5.3 (95% CI 1.4–20.0)). The OR for having an unstable IA was 9.3 (95% CI 2.1–41.5) for patients with high compared to low venous ICTP levels. The area under the curve for ICTP levels as a marker for IA instability was 0.75. Discussion and conclusion: Increased levels of venous collagen breakdown products, especially ICTP levels, could serve as a biomarker for IA presence and instability and complement current data for management of unruptured IAs on an individual patient level. Future studies with longitudinal data are needed to validate ICTP as a biomarker for high risk IAs.
Food Insecurity and Depressive Symptoms Among Persons With Diabetes in the United States: Findings From the 2022 National Health Interview Survey (NHIS)
Authors: McClintock Heather F. , Edmonds Sarah , Okronipa Harriet 
Published: November 2024

Purpose The purpose of this study is to examine whether food insecurity increases risk for depressive symptoms among adults with diabetes. Food insecurity is associated with depression in the general population. However, minimal research has examined this relationship among persons with diabetes. Methods Adults with diabetes were identified from the 2022 National Health Interview Survey. Depressive symptoms were assessed by the 8-item Patient Health Questionnaire. Food insecurity status was measured with the USDA 10-item food insecurity scale. Participants were categorized as food secure, low food security, and very low food security. The association between food insecurity and depressive symptoms was examined using weighted logistic regression, adjusting for potentially influential covariates (age, sex, ethnicity, poverty to income ratio, education, diabetes type, body mass index, region, and general health). Results Among 2595 persons with diabetes, nearly one third (29.8%) reported symptoms of depression. Over one tenth (11.7%) had low or very low food security. Persons who had low or very low food security were more than twice as likely to report depressive symptoms (adjusted odds ratio [AOR] = 2.15, 95% CI, 1.39-3.32; AOR = 3.84, 95% CI, 2.28-6.45, respectively). Persons who were older, had higher income, and better general health were less likely to report depressive symptoms. Conclusions Among adults with diabetes, low or very low food security was associated with increased risk for depressive symptoms. Further research is needed to evaluate the relationship between food insecurity and depressive symptoms among persons with diabetes.
Addressing Dietary-Related Health Disparities in Underserved Communities: Outcomes From a 24-Month Pilot, Subsidized Food Prescription Program in the Mississippi Delta
Authors: Arnold Austin , Zigmont Victoria , Sefidmooye Azar Pouria , Barannik Kima , Cafer Anne , Rosenthal Meagen 
Published: November 2024

Background: This study examines the outcomes of the 24-months Charleston FoodRx food prescription program implemented in rural Mississippi to address dietary-related health disparities. Purpose: Examine changes in participant produce consumption, food seccurity, and anthropometrics over a 24-month period. Research Design: A one-group, repeated measures design, was utilized to assess changes in produce consumption, food security, and anthropometric data from baseline. Study Sample: A total of 55 households completed the study. Data analyses: longitudinal and regression analyses were conducted to identify significant change over time. Results: Results indicated an increase in weekly produce consumption, and a decrease in the prevalence of food insecurity over the follow-up periods. Among adults, statistically significant reductions in weight, body mass index (BMI), waist circumference, and triglyceride levels were observed at the 24-month endpoint. Conclusions: These outcomes support the efficacy of food prescription programs in promoting healthier dietary behaviors and improving health-related outcomes. The study provides valuable insights into the impact of such interventions on dietary-related health disparities in underserved communities. However, more robust research is needed to maximize the potential of these interventions.
Unveiling the therapeutic potential of anthocyanin/cisplatin-loaded chitosan nanoparticles against breast and liver cancers
Authors: Awad Mai G. , Hanafy Nemany A. N. , Ali Ramadan A. , El‑Monem Dalia D. Abd , El-Shafiey Sara H. , El‑Magd Mohammed A. 
Published: November 2024

Abstract
Background
Liver and breast cancers are among the leading causes of cancer-related deaths worldwide, prompting researchers to seek natural anticancer agents and reduce chemotherapy side effects. Red beetroot (Beta vulgaris Linnaeus), rich in polyphenols and powerful antioxidants, has shown potential in cancer prevention. This study aimed to evaluate the impact of red beetroot-derived anthocyanin (Ant), Ant-loaded chitosan nanoparticles (Ant NPs), cisplatin (Cis), Cis-loaded chitosan (Cis NPs), and Cis + Ant-loaded chitosan NPs on human hepatoma HepG2 and breast adenocarcinoma MCF7 cell lines.

Methods
NPs preparation was evaluated by zeta potential, FTIR, and SEM. The cytotoxic, apoptotic, antioxidant, anti-inflammatory, anti-metastatic, and anti-angiogenic effects were assessed by MTT assay, qPCR, AO/EB staining, and flow cytometry.

Results
Treatment with Ant, Ant NPs, Cis, Cis NPs, and Cis + Ant NPs caused cytotoxicity in HepG2 and MCF7 with best effect in Cis-treated cells. The anticancer effects were attributed to mitochondrial-dependent apoptosis (with high Bax and low Bcl2 expression), chromatin disintegration, and cell cycle arrest in G2/M and S phases. All treatments inhibited migration by downregulating the migration-related gene MMP9 and upregulating the anti-migratory gene TIMP1 and decreased the angiogenesis-related gene VEGF and the inflammatory gene TNFα with best results in Cis NPs-treated cells. Interestingly, Ant, Ant NPs, and Cis + Ant NPs increased the antioxidant status (high GSH and upregulated expression of Nrf2 and OH-1) and decreased drug resistance-related MAPK1 and MDR1 genes compared to Cis and Cis NPs-treated cells.

Conclusions
Anthocyanin and cisplatin-loaded chitosan nanoparticles effectively combat breast and liver cancers by inducing cancer cell apoptosis, enhancing antioxidant defenses, and reducing inflammation. They also inhibit tumor spread and blood vessel formation through downregulation of MMP9 and VEGF, highlighting their therapeutic potential.
What do community paramedics in Germany do regarding the care of older people? A retrospective, descriptive analysis of low-acuity cases
Authors: Obst Anna Lena , Seeger Insa , Hoffmann Falk 
Published: November 2024

Abstract
Background
Non-life-threatening cases treated by emergency services have been increasing in recent years, especially in older people. In a region in Germany with approximately 600,000 inhabitants, the role of a specially trained community paramedic (Gemeindenotfallsanitäter, G-NFS) was introduced in 2019. The G-NFS is dispatched to low-acuity requests, attends the assignment alone and is allowed to treat patients at home.

Aim
The aim of this study was to analyse the assignments attended by the G-NFS relating to the suspected diagnoses, with a focus on older people (≥ 65 years) according to their care setting.

Methods
In this descriptive, retrospective study, we analysed the anonymous assignment report forms 07/2023–12/2023 of cases where patients were aged ≥ 65 years. The suspected diagnoses (free text field) were categorised according to the International Classification of Primary Care 2nd Edition (ICPC-2) scheme. Furthermore, baseline characteristics, urgency of the assignment, provided measures, transport and further treatment were analysed, stratified by care setting.

Results
Of the 1,643 included anonymous assignment report forms, 52.9% (n = 869) related to patients aged ≥ 65 years. In this population, the mean age was 80.7 years (SD 8.2), 49.6% were female and most were in long-term care, whether as home care recipients (34.8%) or as nursing home residents (26.9%). The most frequent diagnoses were categorised as urological (24.9%), general and unspecified (13.7%), circulatory (13.6%), digestive (12.8%), musculoskeletal (11.5%) and respiratory (10.3%). In 52.7% of the cases no transport was necessary, while 73.7% of urological cases did not need to be transported.

Conclusion
The G-NFS was dispatched mainly to older people. Most of them were in long-term care and were not transported. The most common suspected diagnoses were categorised as urological, followed by general and unspecified, and circulatory, and differed by care setting. There is a strong need to strengthen outpatient healthcare structures for low-acuity health issues in older and immobile patients.
Quality priorities related to the management of type 2 diabetes in primary care: results from the COMPAS + quality improvement collaborative
Authors: Gaid Dina , Giasson Guylaine , Gaboury Isabelle , Houle Lise , Layani Géraldine , Menear Matthew , de Tilly Véronique Noël , Pomey Marie-Pascale , Vachon Brigitte 
Published: November 2024

Abstract
Background
This study aims to describe the main type 2 diabetes mellitus (T2DM) quality improvement (QI) challenges identified by primary care teams in the province of Quebec who participated in the COMPAS + QI collaborative.

Methods
A qualitative descriptive design was used to analyse the results of 8 COMPAS + workshops conducted in 4 regions of the province between 2016 and 2020. Deductive content analysis was performed to classify the reported QI priorities under the Consolidated Framework for Implementation Research domains; and proposed change strategies under the Behavior Change Wheel (BCW) intervention functions.

Results
A total of 177 participants attended the T2DM COMPAS + workshops. Three QI priorities were identified: (1) lack of coordination and integration of T2DM care and services; (2) lack of preventive services for pre-diabetes and T2DM; and (3) lack of integration of the patients-as-partners approach to support T2DM self-management. The proposed QI strategies to address those priorities were classified under the education, training, persuasion, habilitation and restructuring BCW intervention functions.

Conclusion
This study provides insights on how QI collaboratives can support the identification of QI priorities and strategies to improve T2DM management in primary care.
Evaluation of different inflammatory markers during the infection of domestic cats (Felis catus) by Cystoisospora felis (Coccidia: Apicomplexa)
Authors: Attia Marwa M. , Barsoum Sara S. , Baghdadi Hanadi B. A. , Mahdy Olfat A. , EL Gameel Sohila M. 
Published: November 2024

Abstract
Background
Cystoisospora felis or Isospora felis is a ubiquitous apicomplexan protozoon parasite infecting domestic cats worldwide.

Objectives of the study
this study aims to identify the causative agent of diarrhea in cats by determining several elevating stressors caused by these coccidian protozoans with molecular characterization. So, from January 2023 to April 2023, a total of 370 domestic cats were hospitalized at various clinics in the Cairo and Giza Governorates. Fecal samples were taken from these animals and examined by concentration floatation techniques using a saturated salt solution. The positive samples were sporulated to identify the collected oocyst. Venous blood was taken from the infected cats to evaluate the associated oxidative stress marker (lipid peroxidation products (MDA).

Results
Out of 370 examined domestic cats, 27(7.29%) were positive for C. felis. The MDA levels increased with age, and females were higher than males. DNA was extracted from fecal samples for amplification of the ITS1 gene, followed by sequencing. The ITS1 gene was amplified and showed bands at 224 bp. The partial nucleotide sequence of the ITS1 gene was aligned with the reference sequences.

In a conclusion
C. felis increases the free radicals, which in turn means the animals have stress and need a schedule to treat these animals with new, safe protocol drugs that give no resistance and are highly efficient.
The association between the stress hyperglycaemia ratio and mortality in cardiovascular disease: a meta-analysis and systematic review
Authors: Esdaile Harriet , Khan Shaila , Mayet Jamil , Oliver Nick , Reddy Monika , Shah Anoop S. V. 
Published: November 2024

Abstract
Background
A raised stress hyperglycaemia ratio (SHR) has been associated with all-cause mortality and may better discriminate than an absolute glucose value. The aim of this meta analysis and systematic review is to synthesise the evidence assessing the relationship between the SHR and all-cause mortality across three common cardiovascular presentations.

Methods
We undertook a comprehensive search of Medline, Embase, Cochrane CENTRAL and Web of Science from the date of inception to 1st March 2024, and selected articles meeting the following criteria: studies of patients hospitalised for acute myocardial infarction, ischaemic stroke or acute heart failure reporting the risk (odds ratio or hazard ratio) for all-cause mortality associated with the SHR. A random effects model was used for primary analysis. Subgroup analysis by diabetes status and of mortality in the short and long term was undertaken. Risk of bias assessment was performed using the Newcastle Ottawa quality assessment scale.

Results
A total of 32 studies were included: 26 studies provided 31 estimates for the meta-analysis. The total study population in the meta analysis was 80,010. Six further studies were included in the systematic review. Participants admitted to hospital with cardiovascular disease and an SHR in the highest category had a significantly higher risk ratio of all-cause mortality in both the short and longer term compared with those with a lower SHR (RR = 1.67 [95% CI 1.46–1.91], p < 0.001). This finding was driven by studies in the myocardial infarction (RR = 1.75 [95% CI 1.52–2.01]), and ischaemic stroke cohorts (RR = 1.78 [95% CI 1.26–2.50]). The relationship was present amongst those with and without diabetes (diabetes: RR 1.49 [95% CI 1.14–1.94], p < 0.001, no diabetes: RR 1.85 [95% CI 1.49–2.30], p < 0.001) with p = 0.21 for subgroup differences, and amongst studies that reported mortality as a single outcome (RR of 1.51 ([95% CI 1.29–1.77]; p < 0.001) and those that reported mortality as part of a composite outcome (RR 2.02 [95% CI 1.58–2.59]; p < 0.001). On subgroup analysis by length of follow up, higher SHR values were associated with increased risk of mortality at 90 day, 1 year and > 1year follow up, with risk ratios of 1.84 ([95% CI 1.32–2.56], p < 0.001), 1.69 ([95% CI 1.32–2.16], p < 0.001) and 1.58 ([95% CI 1.34–1.86], p < 0.001) respectively.

Conclusions
A raised SHR is associated with an increased risk of all-cause mortality following myocardial infarction and ischaemic stroke. Further work is required to define reference values for the SHR, and to investigate the potential effects of relative hypoglycaemia. Interventional trials targeting to the SHR rather than the absolute glucose value should be undertaken.

PROSPERO database registration
CRD 42023456421 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023456421