bluuebunny/crossref_metadata_2025_split huggingface dataset:
Student Loans, Access to Credit, and Consumer Credit Demand
Authors: Mezza Alvaro , Ringo Daniel , Sommer Kamila 
Published: September 2024

Abstract
This paper provides novel evidence that increased student loan debts, caused by rising tuitions, increase borrowers’ demand for additional consumer debt, while simultaneously restricting their ability to access it. The net effect of student loan debt on consumer borrowing varies by market, depending on whether the supply or demand channel dominates. In loosely underwritten credit markets, increased student loan debt causes borrowing to increase, while in tightly underwritten markets, increased student loan debt reduces credit use. These findings match predictions of a standard life cycle model of household consumption and borrowing, augmented by a realistic student loan repayment contract. (JEL G51, D15, I22, D14)
Syndicated Lending, Competition, and Relative Performance Evaluation
Authors: Schneider Thomas , Strahan Philip E , Yang Jun 
Published: September 2024

Abstract
Relative performance evaluation (RPE) intensifies competitive pressure by tying executive compensation to the profits of rivals. We show that these contracts make loan syndication harder by reducing banks’ willingness to participate in loans underwritten by banks named in their RPE contracts. Lead arranger banks, which are more frequently named in RPE, hold larger shares of the loans they syndicate, and their borrowers receive smaller and fewer loans and face higher spreads. Our results highlight the tension between the normal benefits of competition versus the need for cooperation in loan syndication.
Gastrointestinal dysmotility is associated with proton pump inhibitor refractory oesophagitis in patients with systemic sclerosis
Authors: Alcala-Gonzalez Luis G , Guillen-del-Castillo Alfredo , Aguilar Cayuelas Ariadna , Barber Caselles Claudia , Codina-Clavaguera Claudia , Marin García Antonio , Serra Jordi , Malagelada Carolina , Simeón-Aznar Carmen P 
Published: September 2024

Abstract

Objectives
Patients with systemic sclerosis present with severe gastroesophageal reflux disease, often refractory to proton-pump inhibitors (PPI) treatment. The aim of the present study was to identify factors associated with PPI-refractory oesophagitis.

Methods
We performed a cross-sectional study in a single-centre cohort of patients diagnosed with systemic sclerosis. We included patients who underwent an oesophagogastroduodenoscopy while on PPI treatment. Patients with PPI-refractory erosive oesophagitis were compared with those with endoscopically normal oesophageal mucosa.

Results
A total of 69 patients were included. From these, 23 patients (33%) had PPI-refractory oesophagitis (Grade A, n = 11; Grade B, n = 7; Grade C, n = 2; Grade D, n = 3) and 46 (67%) had an endoscopically normal oesophageal mucosa. On univariate analysis, patients with PPI-refractory oesophagitis were more frequently diffuse SSc subset (43% vs 17%; P = 0.041). Evaluating gastrointestinal motility tests, neither absent oesophageal contractility (39% vs 25%, P = 0.292) nor hypotensive lower oesophageal sphincter (47% vs 44%, P = 0.980) were significantly associated with PPI-refractory oesophagitis. Gastrointestinal dysmotility, defined as abnormal gastric emptying and/or small bowel dilated loops, was significantly associated with PPI-refractory oesophagitis (66 vs 8%, P =&lt;0.001). On a multivariate regression model to evaluate the association between motility test results adjusted for the diffuse subset, gastrointestinal dysmotility (β = 0.751, P = 0.010) was independently associated with PPI-refractory oesophagitis, while absent oesophageal contractility (β = 0.044, P = 0.886) or a hypotensive LES were not (β = −0.131, P = 0.663).

Conclusions
Our findings suggest that gastric and small intestinal motor dysfunction may be an important contributor to the development of PPI-refractory oesophagitis in patients with systemic sclerosis.
Normative data on lower extremity entheseal tendon thicknesses in healthy children: an ultrasound study correlating age, sex, and anthropometry
Authors: Türkmen Şeyma , Ata Serap , Ulu Kadir , Sözeri Betül 
Published: September 2024

Abstract

Objectives
This study aims to establish normative data on lower extremity entheseal tendon thicknesses in healthy children and examine correlations with age, gender, and anthropometric measures using musculoskeletal ultrasound. The secondary objective of the study is to investigate the power Doppler properties of entheseal tendons.

Methods
A total of 192 healthy children, aged 5–18 years, participated in this cross-sectional study. Participants underwent detailed physical and ultrasonographic examinations. Entheseal tendon thickness measurements were taken from five specific regions: distal quadriceps tendon (DQT), proximal patellar ligament (PPL), distal patellar ligament (DPL), Achilles tendon (AT), and plantar fascia (PF). Correlations between thicknesses and age, weight, height, and BMI were analysed. Intra-tendinous vascularity was evaluated using power Doppler. Interobserver and intraobserver agreements were assessed using intraclass correlation coefficients (ICC).

Results
Normative data on lower extremity entheseal tendon thicknesses according to age, weight, height, and BMI have been established. Significant positive correlations were found between thicknesses and age, weight, height, and BMI. Weight was identified as the most influential factor, particularly for the DPL and AT. Right side tendons (AT and PF) are statistically thicker. Minimal Doppler activity was detected in 10.6% of the entheseal DQTs in the group of children aged 5–9 years. The study achieved high to excellent interobserver and intraobserver agreement.

Conclusion
This study examined the ultrasonographic characteristics of lower extremity entheseal tendons in healthy children using B-mode and power Doppler, provided normative data on their thicknesses, and demonstrated significant correlations between tendon thicknesses and both age and anthropometric measures.
EEG-based Signatures of Schizophrenia, Depression, and Aberrant Aging: A Supervised Machine Learning Investigation
Authors: Sarisik Elif , Popovic David , Keeser Daniel , Khuntia Adyasha , Schiltz Kolja , Falkai Peter , Pogarell Oliver , Koutsouleris Nikolaos 
Published: September 2024

Abstract

Background
Electroencephalography (EEG) is a noninvasive, cost-effective, and robust tool, which directly measures in vivo neuronal mass activity with high temporal resolution. Combined with state-of-the-art machine learning (ML) techniques, EEG recordings could potentially yield in silico biomarkers of severe mental disorders.

Hypothesis
Pathological and physiological aging processes influence the electrophysiological signatures of schizophrenia (SCZ) and major depressive disorder (MDD).

Study Design
From a single-center cohort (N = 735, 51.6% male) comprising healthy control individuals (HC, N = 245) and inpatients suffering from SCZ (N = 250) or MDD (N = 240), we acquired resting-state 19 channel-EEG recordings. Using repeated nested cross-validation, support vector machine models were trained to (1) classify patients with SCZ or MDD and HC individuals and (2) predict age in HC individuals. The age model was applied to patient groups to calculate Electrophysiological Age Gap Estimation (EphysAGE) as the difference between predicted and chronological age. The links between EphysAGE, diagnosis, and medication were then further explored.

Study Results
The classification models robustly discriminated SCZ from HC (balanced accuracy, BAC = 72.7%, P &lt; .001), MDD from HC (BAC = 67.0%, P &lt; .001), and SCZ from MDD individuals (BAC = 63.2%, P &lt; .001). Notably, central alpha (8–11 Hz) power decrease was the most consistently predictive feature for SCZ and MDD. Higher EphysAGE was associated with an increased likelihood of being misclassified as SCZ in HC and MDD (ρHC = 0.23, P &lt; .001; ρMDD = 0.17, P = .01).

Conclusions
ML models can extract electrophysiological signatures of MDD and SCZ for potential clinical use. However, the impact of aging processes on diagnostic separability calls for timely application of such models, possibly in early recognition settings.
Exploring the interplay between cannabinoids and thymic functions
Authors: Lins Marvin Paulo , de Melo Igor Santana 
Published: September 2024

Abstract
Cannabinoids, derived from the Cannabis sativa plant, have garnered increasing attention for their potential therapeutic applications in various diseases. The pharmacologically active compounds in Cannabis, such as delta-9-tetrahydrocannabinol and cannabidiol, exhibit diverse immunomodulatory properties. Although studies have explored the effects of cannabinoids on immune function, their specific interactions with the thymus, a primary immune organ critical for T-cell development and maturation, remain an intriguing area of investigation. As the thymus plays a fundamental role in shaping the immune repertoire, understanding the interplay between cannabinoids and thymic function may shed light on potential benefits or concerns associated with Cannabis-based therapies. This article aims to provide an overview of the current scientific knowledge regarding the impact of medicinal Cannabis on the thymus and its implications for disease treatment and immune health.
Diversity and Risk Assessment of Phytophthora spp. Found on Plant Roots in Native Plant Nurseries and Interstate Shipping Nurseries in California
Authors: Harkness Rebecca , Suslow Karen , Sharma Supriya , Sakalidis Monique L. , Miles Timothy , Schweigkofler Wolfgang 
Published: September 2024

For many nurseries, it is difficult to diagnose Phytophthora-infected plants in time to prevent disease incursion and spread, especially if the infection occurs on roots and causes no or limited symptoms on aerial plant parts. Rapid, accurate, and specific diagnostic methods can facilitate the identification and removal of infected plants. This study was conducted to investigate whether specific nursery types within California are more likely to have different Phytophthora species and which hosts are more likely to test positive for a Phytophthora species using immunological and molecular diagnostic tools. From fall 2016 to spring 2019, we collected 1,180 root samples from 15 nurseries, each in California, that fell into one of three distinct plant-sourcing categories. Plant roots were tested with Phytophthora-specific Agdia ImmunoStrips, and positives samples were identified to the species-level by quantitative PCR (qPCR) and sequencing. Of the 1,180 samples collected, 262 (22%) were found positive for infection by a Phytophthora sp., and 152 of these samples (58%) could be diagnosed to the species level. Hosts in the genera Ceanothus (Rhamnaceae), Arctostaphylos (Ericaceae), and Salvia (Lamiaceae) tested positive for Phytophthora spp. most often. A total of 18 Phytophthora species were detected from the root samples over the course of this study. Despite its high rate of false positives (30%), the ImmunoStrip Phytophthora assay is useful as a preliminary screening tool for in-field diagnosis of root infection. qPCR testing of positive ImmunoStrip tests allows for more accurate detection and facilitates species assignment. [Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Mitochondrial functional impairment in ARL3‐mutation related rod‐cone dystrophy
Authors: Zhang Xiaoli , Yao Shun , Zhang Lujia , Zhang Beisi , Yang Mingzhu , Guo Qingge , Xu Jin , Wang Zhongfeng , Lei Bo , Jin Xiuxiu 
Published: September 2024

AbstractMitochondria are vital for retinal cell function and survival, and there is growing evidence linking mitochondrial dysfunction to retinal degenerations. Although ARL3 mutations have been linked to multiple forms of retinal degeneration, the relationship between ARL3 and mitochondria remains unexplored. Herein, we investigated the effects of ARL3T31A, ARL3C118F, and ARL3T31A/C118F mutations on mitochondrial function in fibroblasts obtained from patients with ARL3‐related rod‐cone dystrophy. Our findings revealed that these mutations led to a decrease in mitochondrial respiration, an increase in the accumulation mitochondrial reactive oxygen species (ROS), and induction of apoptosis in fibroblasts. Additionally, we conducted a comparative analysis of the effects of ARL3T31A, ARL3C118F, and ARL3T31A/C118F proteins on mitochondria in ARPE‐19 cells. Results showed that ARL3T31A and ARL3T31A/C118F not only affected mitochondrial function but also induced apoptosis in ARPE‐19 cells. Conversely, ARL3C118F primarily influenced cell apoptosis with minimal effects on mitochondrial function in ARPE‐19 cells. Transcriptome analysis further suggested the involvement of respiratory electron transport, response to ROS, and apoptotic signaling pathways in ARL3T31A/C118F cells. Our study demonstrated that ARL3‐related mutations play a significant role in the diversity of mitochondrial function, providing novel insights into the functional analysis of ARL3‐related mutations.
Ankle Fractures Treated With Locked Fibular Intramedullary Nailing: Description and Outcomes of a Minimally Invasive Open Technique
Authors: Ricketts Cassandra , Sajid Mir Ibrahim , McCaskey Meghan , Andrews Reed , Mir Hassan R. 
Published: September 2024

OBJECTIVES:
To describe and report outcomes of a minimally invasive open fibular intramedullary (IM) nailing technique for fixation of ankle fractures.

METHODS:

Design:
Case Series.

Setting:
Urban Level 1 trauma center.

Patient Selection Criteria:
Adult patients with ankle fractures (OTA 44A-C) treated with locked fibular IM nailing through a minimally invasive open technique for fracture and syndesmotic reduction between 2021 and 2024.

Outcome Measures and Comparisons:
Quality of reduction, complications, and patient-reported outcomes.

RESULTS:
A total of 150 consecutive patients operated by a single surgeon were included. Mean age was 53.3 (17–97) years, and mean body mass index was 30.6 ± 7.4 kg/m2. Ninety-three (62%) patients were female, and 78 (52%) patients were White. Seventy-two (48%) patients were obese, 40 (27.7%) patients were current/former smokers, 39 (26%) patients had diabetes, and 23 (15.3%) patients had open fractures. Thirty-seven (24.7%) patients had isolated lateral malleolus fractures, 48 (32%) had bimalleolar fractures, and 65 (43.3%) had trimalleolar fractures. One hundred and twenty-three (82%) patients had 2 syndesmotic screws placed, 26 patients (17.3%) had 1 screw, and 1 patient (0.7%) had none. Quality of reduction was good for 98%, fair for 2%, and poor for none per McLennan criteria. One hundred thirteen patients (75.3%) were followed until clinical and radiographic union for a mean of 7.6 months (range 3–22) months. One hundred and ten patients (97.3%) went on to successful clinical and radiographic union after the index procedure. No patient had a superficial surgical-site infection, and 3 (2.6%) had deep surgical-site infections. Three patients had a loss of reduction, and 6 patients had implant failure (5 broken syndesmotic screws, and 1 medial malleolus screw). Nine (8%) patients had unplanned reoperations (3 for debridement, 2 for loss of reduction, and 4 for removal of symptomatic implants). Mean ankle range of motion at final follow-up visit was 12.9 degrees (0–40) of dorsiflexion, 39.6 degrees (10–70) of plantar flexion, 23.5 degrees (5–40) of inversion, and 18.2 degrees (5–50) of eversion. Mean PROs at final follow-up visit were Global Physical Health: 42.4 (23.5–67.6), Global Mental Health: 47.5 (21–67.6), Physical Function: 37.5 (14.7–57.8), Pain: 54.9 (22–72), and Mobility: 36.9 (16–65.3).

CONCLUSIONS:
Minimally invasive open fibular IM nailing allowed for excellent reduction and results in union with low rates of complications and good patient-reported outcomes.

LEVEL OF EVIDENCE:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Genomic tests for risk stratification in patients with early human epidermal growth factor receptor 2-positive breast cancer
Authors: Berton Giachetti Pier Paolo M. , Giordano Elisa , Taurelli Salimbeni Beatrice , Trapani Dario , Curigliano Giuseppe 
Published: September 2024

Purpose of review
The purpose of this review is to provide a comprehensive overview of human epidermal growth factor receptor 2 (HER2) genomic tests, particularly focusing on the most recent developments and looking at the future prospects of this field, yet to be thoroughly explored.

Recent findings
HER2DX is a multifeatured assay, retrospectively proved to add prognostic information and to predict pathological complete response (pCR) in patients with HER2-positive early breast cancer (EBC) undergoing neoadjuvant treatment containing HER2-directed agents. Preliminary data have shown that the assay maintains its predictive capabilities even in the context of chemotherapy-free, anti-HER2 neoadjuvant regimens, potentially selecting patients suitable for treatment de-escalation, having highly HER2-driven malignancies.

Summary
Multigene prognostic assays have become essential tools in the management of EBC, providing crucial information for risk stratification.
Pediatric Desmoid Tumor of the Head and Neck: A Systematic Review and Modified Framework for Management by Age Group
Authors: Torres Bryan S. , Brown Hannah G. , Nuñez Julisa , Abongwa Chenue , Hajjar Fouad M. , Sawh-Martinez Rajendra F. , Lopez Joseph 
Published: September 2024

Background:
Unlike in adults, pediatric head and neck desmoid tumors (DTs) have greater capacity to interfere with normal anatomical development. Therefore, adequate interventions and management must be defined. We aimed to provide the most comprehensive systematic review on pediatric head and neck DTs to date, including assessment of lesion location predominance, intervention, and management, and examination of any associations between age and outcomes like surgical margin status, recurrence, and complications.

Methods:
A systematic literature review was conducted between January 1990 and December 2023 using PubMed, Scopus, and MEDLINE databases following the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 guidelines. We aimed to elucidate intervention and management strategies by studying various outcomes in 0–11 and 12–21 year olds.

Results:
The literature search yielded 44 studies, totaling 121 patients. Most head and neck DTs localized to the mandible, cranium, and neck; occurred early (P = 4.18 years); and underwent local resection with positive margins. Older and younger patients shared no difference in complication or recurrence rates.

Conclusions:
We found recurrence is likely to occur with positive margins. Because standard treatment of DTs is surgical resection with negative margins, if technically feasible with reasonable associated morbidity, we suggest additional resection of the tumor to achieve negative margins. We also recommend more robust follow-up data collection, not only due to desmoid’s high recurrence and data paucity in patients older than 12 years, but also, to better establish best management practices.
Insulin resistance is associated to future hypertension in normotensive salt-sensitive individuals: a 10-year follow-up study
Authors: Sanchez Ramiro A. , Sanchez María J. , Pessana Franco , Ramirez Agustin J. 
Published: September 2024

Background:
Salt-sensitive hypertension is associated with insulin resistance in nonobese individuals. However, no data have been reported for normotensive offspring of hypertensive salt-sensitive parents.

Aims:
To evaluate in normotensive salt-sensitive or salt-resistant offspring of hypertensive parents (offSS-HT and offSR-HT, respectively): the possible association between insulin resistance and endothelial dysfunction, and the risk of developing hypertension in a 10-year follow-up.

Design and methods:
Forty-one offSS-HT (29 ± 2 years; 20 female) and 36 offSR-HT (25 ± 3 years; 16 female) were followed up for 10 years. Both groups were considered lean. At baseline, creatinine clearance (CrCl), 24 h urinary albumin excretion (UAE), glycemia, and insulinemia were measured before and after 60 and 120 min of glucose overload (75 g). HOMA Index and the area under the curve (AUC) were calculated. Blood pressure (BP) and 24 h urine sodium excretion was measured annually. Postischemic minimum vascular resistance (forearm plethysmography) was assessed at baseline.

Results:
In offSS-HT, UAE (53 ± 3 mg/min) and CrCl (136 ± 8 ml/min) were higher in offSS-HT than in offSR-HT. (UAE: 12 ± 4 mg.min; p,0.01 and CrCl 107 ± 6 ml.min; P < 0.01). An impaired vasodilatory postischemic response was observed in offSS-HT compared with offSR-HT (P < 0.01). In offSS-HT glycemia, insulin, AUC at 69 and 120 min post OTG were greater than in offSR-HT, p < 0.02. In offSS-HT, blood pressure rose (P < 0.01) the 10 years follow-up compared with offSR-HT.

Conclusion:
Salt sensitivity in the offspring of hypertensive salt-sensitive individuals is associated with insulin resistance and endothelial dysfunction and is prone to hypertension over a short period of time.
Associations of ultra long-term visit-to-visit blood pressure variability, since childhood with vascular aging in midlife: a 30-year prospective cohort study
Authors: Wu Guan-Ji , Si Ai-Ma , Wang Yang , Chu Chao , Du Ming-Fei , Wang Dan , Jia Hao , Hu Gui-Lin , Niu Ze-Jiaxin , Zhang Xi , Sun Yue , Chang Ming-Ke , Zhang Teng , Man Zi-Yue , Wang Xia , Ren Jie , Chen Fang-Yao , Mu Jian-Jun 
Published: September 2024

Objective:
Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. In this study, we aimed to investigate the associations of ultra long-term blood pressure (BP) variability from childhood to midlife with vascular aging in midlife.

Methods:
Using data from the longitudinal cohort of Hanzhong Adolescent Hypertension Study, 2065 participants aged 6–18 years were enrolled and followed up with seven visits over 30 years. Ultra long-term BP variability (BPV) was defined as the standard deviation (SD) and average real variability (ARV) of BP over 30 years (seven visits). Vascular aging included arterial stiffness, carotid hypertrophy, and carotid plaque.

Results:
After adjusting for demographic variables, clinical characteristics and mean BP over 30 years, higher SDSBP, ARVSBP, SDDBP and ARVDBP since childhood were significantly associated with arterial stiffness in midlife. Additionally, higher SDDBP and ARVDBP were significantly associated with carotid hypertrophy and the presence of carotid plaque in midlife. When we used cumulative exposure to BP from childhood to midlife instead of mean BP as adjustment factors, results were similar. Furthermore, we found a significant association between long-term BPV from childhood to adolescence and the presence of carotid plaque, whereas long-term BPV from youth to adulthood is associated with arterial stiffness.

Conclusion:
Higher BPV from childhood to adulthood was associated with vascular aging in midlife independently of mean BP or cumulative BP exposure. Therefore, long-term BPV from an early age may serve as a predictor of cardiovascular diseases (CVDs) in later life.