bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician contributions to central nervous system‐active polypharmacy among older adults with dementia in the United States
Authors: Vordenberg Sarah E. , Davis Rachel C. , Strominger Julie , Marcus Steven C. , Kim Hyungjin Myra , Blow Frederic C. , Wallner Lauren P. , Caverly Tanner , Krein Sarah , Maust Donovan T. 
Published: November 2024

AbstractBackgroundExposure to central nervous system (CNS)‐active polypharmacy—overlapping exposure to three or more CNS‐active medications—is potentially harmful yet common among persons living with dementia (PLWD). The extent to which these medications are prescribed to community‐dwelling PLWD by individual clinicians versus distributed across multiple prescribers is unclear.MethodsWe identified community‐dwelling Medicare beneficiaries with a dementia diagnosis and Medicare Parts A, B, and D coverage for at least one month in 2019. Using fill date and days' supply for prescriptions filled between January 1, 2019 and December 31, 2019, we identified beneficiaries exposed to CNS‐active polypharmacy (i.e., >30 days of overlapping exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, nonbenzodiazepine benzodiazepine receptor agonists, or skeletal muscle relaxant medications). We examined the number and type of clinicians who contributed to polypharmacy person‐days among PLWD.ResultsThe cohort included 955,074 PLWD who were primarily female (64.0%), were White (78.5%), and had a mean age of 83.4 years (standard deviation 8.0). Notably, 14.3% were exposed to CNS‐active polypharmacy. At the person level, 24.6% of PLWD experienced polypharmacy prescribed by a single clinician. Considering total days of exposure, 45.3% of polypharmacy person‐days were prescribed by a single clinician. Primary care physicians prescribed 63.0% of polypharmacy person‐days and accounted for the plurality of days for all seven medication classes, followed by psychiatrists for antipsychotics and benzodiazepines and primary care advanced practice providers (APPs) for antidepressants and antiseizure medications.ConclusionIn this cross‐sectional analysis of Medicare claims data, primary care clinicians (both physicians and APPs) prescribed the majority of medications that contributed to CNS‐active polypharmacy for PLWD. Future research is needed to identify strategies to support primary care clinicians in appropriate prescribing of CNS‐active medications to PLWD.
The activation of inflammatory responses in the brain is potentiated by over‐expressing acetylcholinesterase in myeloid lineage of transgenic mice
Authors: Xia Yingjie , Wang Xiaoyang , Guo Maggie Suisui , Wu Jiahui , Gao Jin , Dong Tina T. X. , Tsim Karl W. K. 
Published: November 2024

AbstractAcetylcholinesterase (AChE) has functions in neuroinflammation, beyond its classical role in neurotransmission. Understanding the role of AChE in neuroinflammation is of great significance, as it highlights the potential therapeutic targets for the treatment of neurodegenerative diseases. In an in vitro study, the expression of AChE was up‐regulated in lipopolysaccharide (LPS)‐induced microglia/macrophage and contrarily potentiated the inflammatory responses via disturbing the cholinergic anti‐inflammatory pathway (CAP). However, the regulation of AChE in neuroinflammation has not been revealed in vivo yet. Here, we aim to uncover the inflammatory roles of microglial AChE in LPS‐induced neuroinflammation by using the conditional AChE over‐expression mouse model. AChE was specifically over‐expressed in the myeloid cell linkage of mouse by applying CRISPR/cas9 combined with Cre‐LoxP system. LPS was intraperitoneally injected into the mice to induce inflammation. The results showed that the inflammation, induced by LPS, was aggravated in the brain of transgenic mice having over‐expression of AChE in microglia. The expressions of pro‐inflammatory cytokines were robustly up‐regulated in the brains of LPS‐treated transgenic mice, as compared to the LPS‐treated wildtypes. In parallel, the activations of microglia and astrocytes in hippocampus were enhanced significantly in AChE transgenic mice. Transcriptomics analysis further confirmed the severer inflammation in the transgenic mice than the wildtype after LPS administration. These findings shed light on the regulation of microglial AChE in neuroinflammation in vivo for the first time, presenting another angle to understand the role of AChE in neurodegenerative diseases.image
When to change needles during neuromodulator injections—An electron‐microscopy investigation into needle tip deformation
Authors: Akintilo Lisa , Green Jeremy B. , Kaufman Joely , Ghane‐Motlagh Bahar , Freytag David L. , Frank Konstantin , Alfertshofer Michael , Cotofana Sebastian 
Published: November 2024

AbstractBackgroundNeuromodulator injections are minimally invasive procedures performed across the globe. Despite their ubiquity, there is a dearth of information on whether and how needle tips used for neuromodulator procedures are deformed after repeated injections.ObjectiveWe investigated the magnitude of needle tip deformation following sequential injection passes (3×, 5×, and 10×) during facial neuromodulator injections with three commonly used needle sizes (30G, 31G, and 32G).MethodsNeuromodulator was administered for four different aesthetic indications. Each collected needle was mounted and imaged in a Philips XL‐30 Scanning electron microscope. Images were processed using ImageJ photo analysis software.ResultsForty‐five needle tips were investigated. When comparing the facial regions of interest, a statistically significant difference in deformation percentage was found when injecting 10× (p = 0.044) with greatest damage after injecting the glabella (38.4%), followed by lateral canthus (27.9%), forehead (27.5%), and midface (23.1%). Independent of facial region targeted, the mean percentage of needle deformation at 3× was 14.8%, at 5× 19.6%, and at 10× 29.2% with p < 0.001. Smaller needle size corresponded to smaller percentage of damage.ConclusionExchanging needles after more than five injection passes will minimize needle deformation and likely increase injection precision.
Psychological‐Distress Factors in Patients With Breast Cancer: A Qualitative Meta‐Synthesis
Authors: Tao Lin , Xiang Yuping , Zeng Xiaohong , Fu Lan , Li Junying , Chen Hong 
Published: November 2024

ABSTRACTAimsTo systematically review and integrate qualitative‐research results pertaining to psychological distress in patients with breast cancer and to clarify its causes and drivers.BackgroundPatients with breast cancer experience psychological distress in the stages of diagnosis, treatment, and rehabilitation, which seriously affects their quality of life. Through comprehensive qualitative research, the study comprehensively describes the experiences of patients with breast cancer to guide medical personnel in taking better care of them.DesignA systematic review and synthesis of qualitative studies.MethodsQualitative studies were included if they were related to the psychological‐distress experiences of patients with breast cancer. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. Data were synthesised using the Thomas and Harden method of thematic and content analysis.Data SourcesNine electronic databases (PubMed, Embase, Cochrane Library, CINAL [via EBSCO], and PsycINFO, China Knowledge Resource Integrated Database, Wanfang, Chinese Biomedical, and Weipu) were searched from inception until February 2024.ResultsThirteen studies were included in the meta‐synthesis. Four analytical themes were identified: diagnostic and therapeutic, individual, environmental, and interpersonal factors.ConclusionsPsychological distress is a subjective feeling influenced by interactions among individual, therapeutic, environmental, and interpersonal factors, and it is commonly encountered among patients with breast cancer. Therefore, to optimise the management of psychological distress, the characteristics and external environment of patients with breast cancer should be carefully considered when delivering routine nursing care.ImpactPatients experience psychological distress at different stages of breast cancer; however, the causes of psychological distress at different stages differ. Medical staff should implement targeted psychological‐distress intervention measures based on factors relevant to different stages.Reporting MethodThe Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.RegistrationThe protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023417364).
Commentary: Revisiting developmental science research practices during a global crisis
Authors: Magis‐Weinberg Lucía , Gray Carly E. 
Published: November 2024

AbstractThe effects of the COVID‐19 pandemic on adolescents were extensive, touching aspects of their lives such as those reviewed in this Special Section : school experiences, family relationships, peer relationships, and civic engagement. In parallel with these effects on individuals, the fields of developmental and psychological science were shaken up by this global crisis. The accelerated transition to online data collection and collaboration presented opportunities to expand research on adolescence, breaking down many physical and social barriers to participation and sparking methodological innovation. Yet, this crisis also shed light on the global digital divides and the uneven impacts of the pandemic across the research community. This commentary reflects on the influence of the COVID‐19 pandemic on the methods and methodologies of developmental science, the challenges and opportunities it surfaced, and the populations included and omitted in this period of research. We integrate reflections on how the pandemic shaped our own research and on how the pandemic has shaped the future of developmental science.
Mergers and Licensing With Horizontal Differentiation
Authors: Fauli‐Oller Ramon , Poddar Sougata , Sandonis Joel 
Published: November 2024

ABSTRACTWe consider a research laboratory that owns a patented process innovation and two firms producing differentiating goods in a Bertrand setting. The laboratory considers the possibility to license the innovation as an outsider patentee or to merge with one of the firms in the industry, becoming an incumbent patentee. Licensing takes place through observable two‐part tariff contracts. We show that the merger is profitable only for small innovations and increases social welfare for both small and large innovations. Even though we allow the royalty to be higher than the size of the innovation, and opposite to the result in a Cournot setting, we find a region where the merger is both profitable and welfare improving. This occurs only for small innovations and sufficiently differentiated goods. The same result arises for consumer surplus which allows us to derive the optimal merger policy: compared with Cournot competition, a Bertrand setting calls for a more lenient merger policy.
Self‐care behaviours in patients with restless legs syndrome (RLS): development and psychometric testing of the RLS‐Self‐care Behaviour questionnaire
Authors: Odzakovic Elzana , Sandlund Christina , Hellström Amanda , Ulander Martin , Blom Kerstin , Jernelöv Susanna , Kaldo Viktor , Björk Maria , Knutsson Susanne , Lind Jonas , Pakpour Amir , Broström Anders 
Published: November 2024

SummaryRestless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self‐care, the RLS‐Self‐care Behaviour questionnaire (RLS‐ScBq). Self‐care, defined as an active decision‐making process, can empower patients to effectively participate in their own healthcare through awareness, self‐control, and self‐reliance to cope with their disease. Self‐care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS‐ScBq in patients with RLS. A cross‐sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS‐related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS‐6 scale) were collected. The validity and reliability of the RLS‐ScBq were investigated using exploratory factor analysis and Rasch models. The two‐factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self‐care Behaviour Frequency part and 36.28% for The Benefit of Self‐care Behaviour part. The internal consistency measured by Cronbach's α was 0.57 and 0.60, and McDonald's ω was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight‐item RLS‐ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self‐care activities in patients with RLS.
Spectral EEG and heart rate changes associated with leg movements during the suggested immobilization test in patients with restless legs syndrome
Authors: Benbir Senel Gulcin , Tunali Aysun , Demirel Onur , Köse Seher , Cakir Volkan , Resadiyeli Burak , Karadeniz Derya , Ferri Raffaele 
Published: November 2024

SummaryRestless legs syndrome is usually associated with periodic limb movements during sleep, which are defined as repetitive, stereotyped movements in sleep. Changes in spectral analysis of electroencephalography and heart rate were shown to be associated with periodic limb movements during sleep and non‐periodic leg movements in sleep. Considering the circadian distribution of symptoms of restless legs syndrome, we investigated spectral electroencephalography and heart rate accompanying periodic limb movements, isolated leg movements and short‐interval leg movements during suggested immobilization test. The mean age of 53 patients was 51.9 ± 13 years, 54.7% were females. Prominent increases in electroencephalography activation were associated with periodic limb movements, isolated leg movements and short‐interval leg movements during the suggested immobilization test, which were significant in all spectral bands (p < 0.001). An increase in all electroencephalography bands started ~10 s before periodic limb movements, isolated leg movements and short‐interval leg movements; increases in delta and theta band activities ended ~10 s after the movements, while increases in alpha and beta band activities lasted for about ~20 s. Maximum increases in delta, theta, alpha and beta bands were all observed after periodic limb movements and short‐interval leg movements, but before isolated leg movements in theta and alpha bands, and after isolated leg movements in delta and beta bands. A notably longer increase in alpha and beta bands was evident for periodic limb movements and short‐interval leg movements. An increase in heart rate was prominent at 4–12 s after movement onset in short‐interval leg movements, being significantly higher than those associated with periodic limb movements and isolated leg movements. Our study shows that, in patients with restless legs syndrome, periodic limb movements, isolated leg movements and short‐interval leg movements during suggested immobilization test are associated with prominent cortical and cardiac activation, which warrants confirmation in larger restless legs syndrome cohorts and requires long‐term follow‐up studies to delineate its possible clinical consequences.
Safety and Effectiveness of Vibegron in Japanese Patients With Overactive Bladder: A Japanese Postmarketing Survey
Authors: Yoshimura Shoko , Yagi Hiromitsu , Abe Kazunori , Yamasaki Masakazu 
Published: November 2024

ABSTRACTObjectivesTo evaluate the safety and effectiveness of vibegron, a highly selective β3‐adrenoceptor agonist, in Japanese patients with overactive bladder (OAB) in a real‐world clinical setting.MethodsThis prospective survey was conducted from August 2019 to July 2023 using a central registration method. Patients newly treated with vibegron for OAB were followed for 12 weeks, and those who continued treatment were observed for up to 52 weeks. Adverse drug reactions (ADRs) and the overall improvement level were assessed, and overactive bladder symptom score (OABSS) and International Prostate Symptom Score‐Quality of Life (IPSS QOL) score were collected.ResultsOf the 1848 patients in the safety analysis set, 154 ADRs were reported in 141 patients (7.63%). Common ADRs were increased residual urine volume (1.30%), constipation (1.14%), dysuria and urinary retention (0.97% each), cystitis (0.65%), and dry mouth (0.32%). The incidence of urinary retention‐related adverse events (AEs) was higher in male patients, patients ≥ 65 years old, and patients with benign prostatic hyperplasia. The effectiveness rate was 88.8% among the 1561 patients in the effectiveness analysis set. Significant improvement in both OABSS and IPSS QOL scores was observed at all observation periods. The rate of achieving the minimal clinically important change in OABSS total score at the final evaluation was 75.35%. OABSS scores were also significantly reduced in all subgroup analyses.ConclusionsThis survey found no major concerns regarding the safety and effectiveness of vibegron in Japanese OAB patients, except for urinary retention‐related AEs. Vibegron is considered to represent a useful drug for treating OAB symptoms in a real‐world clinical setting.
Flg22‐facilitated PGPR colonization in root tips and control of root rot
Authors: Li Yanan , Li Yafei , Wang Yuepeng , Yang Yanqing , Qi Man , Su Tongfu , Li Rui , Liu Dehai , Gao Yuqian , Qi Yuancheng , Qiu Liyou 
Published: November 2024

AbstractPlant root border cells (RBCs) prevent the colonization of plant growth‐promoting rhizobacteria (PGPR) at the root tip, rendering the PGPR unable to effectively control pathogens infecting the root tip. In this study, we engineered four strains of Pseudomonas sp. UW4, a typical PGPR strain, each carrying an enhanced green fluorescent protein (EGFP)‐expressing plasmid. The UW4E strain harboured only the plasmid, whereas the UW4E‐flg22 strain expressed a secreted EGFP‐Flg22 fusion protein, the UW4E‐Flg(flg22) strain expressed a non‐secreted Flg22, and the UW4E‐flg22‐D strain expressed a secreted Flg22‐DNase fusion protein. UW4E‐flg22 and UW4E‐flg22‐D, which secreted Flg22, induced an immune response in wheat RBCs and colonized wheat root tips, whereas the other strains, which did not secrete Flg22, failed to elicit this response and did not colonize wheat root tips. The immune response revealed that wheat RBCs synthesized mucilage, extracellular DNA, and reactive oxygen species. Furthermore, the Flg22‐secreting strains showed a 33.8%–93.8% higher colonization of wheat root tips and reduced the root rot incidence caused by Rhizoctonia solani and Fusarium pseudograminearum by 24.6%–35.7% compared to the non‐Flg22‐secreting strains in pot trials. There was a negative correlation between the incidence of wheat root rot and colonization of wheat root tips by these strains. In contrast, wheat root length and dry weight were positively correlated with the colonization of wheat root tips by these strains. These results demonstrate that engineered secretion of Flg22 by PGPR is an effective strategy for controlling root rot and improving plant growth.
mHealth‐Based Self‐Management Program for Patients With Rheumatoid Arthritis: A Pilot Randomized Controlled Study
Authors: Oh Hyunjin , Suh Chang‐Hee , Kim Ji‐Won , Boo Sunjoo 
Published: November 2024

ABSTRACTRheumatoid arthritis (RA) is a chronic autoimmune disease that gradually limits physical function and decreases quality of life (QOL). We evaluated an mHealth‐based self‐management program to help patients with RA improve their physical and psychological health, self‐efficacy, physical activity, and QOL. The sample included 73 experimental and 69 control participants. A pilot randomized controlled design was employed to identify the effectiveness of an 8‐week mHealth‐based self‐management program, which comprised educational modules regarding disease management and exercise, cognitive training, and motivational support through mobile messages and periodic phone calls. Knowledge of the health effects of RA, disease activity, perceived health, depression, self‐efficacy for controlling symptoms, physical activity, and QOL were evaluated pre‐ and postintervention and after the 4‐week follow‐up period. This pilot study indicates that the mHealth‐based program for people with RA is feasible. The mHealth self‐management program improved patients' knowledge of RA, depression, self‐efficacy for controlling symptoms, physical activity, and perceived health; however, disease activity and QOL did not significantly change. This pilot study demonstrates the potential of mHealth intervention as an effective program for strengthening self‐management capacities in patients with RA.Trial Registration: KCT0007523
Progress Stalled? The Uncertain Future of Mortality in High‐Income Countries
Authors: Dowd Jennifer Beam , Polizzi Antonino , Tilstra Andrea M. 
Published: November 2024

AbstractSteady and significant improvements in life expectancy have been a bright spot for human progress for the last century or more. Recently, this success has shown signs of faltering in some high‐income countries, where mortality improvements have slowed or even reversed since the early 2010s. Combined with the large mortality shock of the COVID‐19 pandemic, guaranteed forward progress feels less certain. We review mortality trends in high‐income countries since 2000 through the COVID‐19 pandemic. While deteriorating mortality in the United States has received the most attention, countries including the United Kingdom, Canada, the Netherlands, Greece, and Germany are also seeing slowdowns. Before COVID‐19, these slowdowns largely reflected stalling improvements in cardiovascular disease mortality and increases in deaths from external causes in young and midlife for the worst‐performing countries. We discuss prospects for the future of mortality in high‐income countries, including lingering impacts of the COVID‐19 pandemic, challenges and opportunities related to the obesity epidemic, and emerging reasons for both optimism and pessimism. While biological limits to increased life expectancy may eventually dominate long‐term trends, human‐made social factors are currently holding many countries back from already achievable best‐practice life expectancy and will be key to near‐term improvements.