bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational well-being of diplomatic personnel: a qualitative study
Authors: Brooks S K , Patel D , Greenberg N 
Published: October 2024

Abstract

Background
Diplomatic personnel face unique job demands due to their frequent relocations. There is some evidence that occupational stress contributes to poor well-being in this occupational group, but little research on the aspects of the job that are perceived to be particularly challenging.

Aims
This study aimed to explore diplomatic personnel’s perceptions of their organization and their roles and to identify aspects of the job, which could cause stress and potentially affect well-being.

Methods
Semi-structured interviews were carried out with 24 employees of the Foreign, Commonwealth and Development Office between September 2021 and February 2022. Participants were asked to reflect on their experiences before the coronavirus disease 2019 pandemic. Thematic analysis was used to analyse data.

Results
Participants enjoyed many aspects of their work including the variety, travel opportunities and feeling that they made a difference. They also identified several stressors relating to job demands, overseas postings, family needs, frequent relocation, hardship posts, workplace relationships, (lack of) appreciation and acknowledgement, and organizational culture. Good relationships with colleagues and managers were perceived to be very important.

Conclusions
Findings suggest various ways in which diplomatic organizations can better support their personnel, highlighting workload management; cross-cultural training; providing appropriate support to both accompanying families and unaccompanied staff members; practical and psychological preparation for those in high-risk locations; encouraging positive workplace relationships; good management; increased autonomy and increased recognition for good work.
Anorexia nervosa with comorbid autism spectrum disorder: Optimizing care for youth, caregivers, and health care providers
Authors: Coret Alon , Agostino Holly 
Published: October 2024

Abstract
Youth with anorexia nervosa (AN) have been reported to have high levels of comorbid autism spectrum disorder (ASD) and ASD-like traits suggesting a potential shared underlying neurodevelopmental or genetic link between the disorders. Youth with comorbid AN and ASD symptomatology generally require more intensive treatment and have worse psychological outcomes following treatment. To date, no Canadian national guidelines exist for the treatment of this comorbidity. An informal survey of tertiary paediatric eating disorder programs across Canada revealed that centres do not routinely screen for ASD at intake and few offer any treatment modifications for youth with AN and suspected/diagnosed comorbid ASD. This represents a significant care gap for this clinical sub-population and an important area for future study and healthcare provider training.
Exome sequencing for nonimmune hydrops fetalis and clinical utility of data reanalysis
Authors: Liu Chang , Huang Yanlin , Wang Yunan , Zhang Yan , Du Li , Yu Lihua , Ding Hongke , Li Fake , Qi Yiming , Liu Yuan , Wang Xingwang , Guo Fangfang , Xiong Ying , Zhao Xin , Fang Liyuan , Geng Juan , Fu Anpeng , Wu Jing , Yin Aihua 
Published: October 2024

Abstract

Background
Nonimmune hydrops fetalis (NIHF) presents as life-threatening fluid collections in multiple fetal compartments and may be led by numerous etiologies.

Aim
To establish the diagnostic yield of exome sequencing for single-gene disorders in unexplained NIHF and to evaluate the clinical utility of data reanalysis.

Methods
A series of 53 unexplained cases of NIHF were enrolled, including 39 cases met a strict definition of NIHF and 14 cases with increased nuchal translucency (NT) and/or cystic hygroma in combination with other fluid collections. Trio ES from fetal samples and parental blood was performed, and clinical reports were returned by geneticists and genetic counselors. Multidisciplinary team forums were conducted for accurate diagnoses and improved patient management. The clinical follow-up assessments were conducted, and the reanalysis was performed for cases with a non-positive result.

Results
Diagnostic variants were identified in 22.6% (12/53) of the cases, and variants of potential clinical significance were detected in an additional 13.2% (7/53) of the cases. Of them, three possible diagnoses (3/41, 7.3%) were obtained during reanalysis. Notably, half of the diagnosed cases were from the group exhibiting only skin edema and increased NT and/or cystic hygroma. The diagnostic rate in this group was 42.8% (6/14), while in the classically defined NIHF group, the rate was 15.4% (6/39). The pregnancy termination and live birth rates of the cases with positive genetic testing results were found to be statistically significantly different from those with negative results (91.7% vs. 53.6% and 8.3% vs. 36.6%, P &lt; 0.05 for both).

Conclusion
ES provides high incremental diagnostic yield for NIHF after standard-of-care testing, and reevaluating non-diagnostic exomes in light of updated knowledge can maximize diagnostic yield. Identifying the etiology of NIHF facilitates prenatal diagnosis, improves the management of NIHF cases and predicts recurrence risk in future pregnancies.
Racial diversities in lifespan bone mass: findings from the China BCL Study and US NHANES
Authors: Huang Yiwen , Ma Chuanwei , Dong Hongbo , Xiong Jingfan , Liu Li , Fan Hongmin , Shan Xinying , Chen Fangfang , Gao Liwang , Liu Junting , Wang Xi , Wang Xia , Yan Yinkun , Cheng Hong , Mi Jie 
Published: October 2024

Abstract

Background
Bone mass at different life stages is instrumental for developing effective, long-term osteoporosis prevention strategies.

Aim
We aimed to investigate the developmental patterns of bone mass across the entire lifespan among the Chinese population and to compare these patterns with those of different racial groups, including Whites, Blacks and Mexicans in the US population.

Design
A population-based study.

Methods
Our study analyzed data from the China Body Composition Life-course (2013–2023) Study and the United States National Health and Nutrition Examination Survey (2005–2018). We measured bone mineral content (BMC) and density (BMD) using dual-energy X-ray absorptiometry at various anatomical sites, including the whole-body (WB), lumbar spine, total hip and femoral neck.

Results
In the Chinese population, WB BMC and BMD increased rapidly during childhood and adolescence, with males and females achieving approximately 90.6% and 95.7% of their respective peak bone mass. Peak bone mass for WB, total hip and femoral neck BMC/BMD occurred generally between the ages of 21 and 30, whereas the lumbar spine BMD peak occurred approximately a decade later. After reaching the peak, a gradual bone loss was observed from ages 30 to 40, with an acceleration post age 40, especially in females. Comparative analyses indicated that Chinese individuals exhibited the lowest bone mass levels and accrual rates over their lifespan, followed successively by Whites, Mexicans and Blacks.

Conclusion
By exploring bone mass changes and racial disparities among the Chinese and US populations, this study emphasizes the need for establishing sex- and ethnic-specific public health strategies to prioritize bone health throughout the entire life course.
Association between colchicine use and adverse cardiovascular events in patients with gout: a nationwide nested case–control study
Authors: Kim Hyung Woo , Kang Minjin , Lim Hyunsun , Park Cheol Ho , Kim Jae Young , Chang Tae Ik , Han Seung Hyeok 
Published: October 2024

Abstract

Objective
The association between colchicine use and the primary prevention of atherosclerotic cardiovascular disease (ASCVD) remains unknown. This study aimed to explore the association between colchicine use and new development of ASCVD and ASCVD-related mortality in patients with incident gout.

Methods
This nested case–control study utilized the nationwide claims database of the Korean National Health Insurance System. Patients without a history of ASCVD who developed incident gout and were newly started on allopurinol as first-line therapy between 2011 and 2016 were initially screened. Individuals who experienced ASCVD event or ASCVD-related mortality during the follow-up period were matched with four controls for age, sex, income, residential area, co-morbidities and medications. The main exposure was colchicine use, assessed by (i) the cumulative defined daily doses (cDDDs) and (ii) the cumulative duration. For secondary analyses, the risk of ASCVD events and ASCVD-related mortality were examined separately.

Results
Overall, 9346 patients with ASCVD event or ASCVD-related mortality were matched with 35 070 controls. The patient population was predominantly male. Compared with non-users, a curvilinear relationship between higher cDDDs of colchicine and the odds of ASCVD event was observed; the odds ratios (95% CI) were 1.09 (1.04, 1.15) for &lt;90 cDDDs, 1.20 (1.07, 1.33) for 80–179 cDDDs and 1.21 (1.09, 1.35) for ≥180 cDDDs. This association was similarly observed for ASCVD events and ASCVD-related mortality.

Conclusion
Colchicine use was associated with an increased risk of ASCVD in patients with newly diagnosed gout who did not have a prior history of ASCVD.
Vasculitis associated with VEXAS syndrome
Authors: Sullivan Megan M , Mead-Harvey Carolyn , Sartori-Valinotti Julio C , Kalantari Kambiz , Kusne Yael N , Patnaik Mrinal M , Mangaonkar Abhishek A , Go Ronald S , Montes Daniel , Reichard Kaaren K , Olteanu Horatiu , Bois Melanie C , Hines Alexander S , Warrington Kenneth J , Koster Matthew J 
Published: October 2024

Abstract

Objectives
To define the prevalence, distribution and characteristics of patients with VEXAS (vacuoles, E1-enzyme, X-linked, autoinflammation, somatic) syndrome who have confirmed vasculitis.

Methods
Patients with VEXAS syndrome, verified by positive UBA1 mutation, were included. Chart review was performed to identify patient characteristics and outcomes. Vasculitis diagnosis was based on either histopathology showing vascular inflammation or non-invasive angiography findings. Summary statistics were calculated.

Results
Eighty-nine patients met inclusion criteria. All were male with a median age of onset of 66.9 years (interquartile range 60.1, 72.7). Median (interquartile range) follow-up was 3.8 (2.2–5.5) years, during which 21 patients (23.6%) had evidence of vasculitis. Vasculitis subtypes included small vessel vasculitis (19.1%), cutaneous medium vessel vasculitis (2.2%) and large vessel vasculitis (2.2%). No patient had more than one vessel size involved. Histopathology in small vessel vasculitis patients was consistent with cutaneous leukocytoclastic vasculitis in the majority, though one patient had leukocytoclastic peritubular capillaritis on renal biopsy. Cranial symptoms (headache, vision changes or jaw pain) were noted in 18.0%. Two additional patients not experiencing cranial symptoms exhibited large vessel involvement with confirmed carotid thickening on non-invasive angiography; one of these had a positive temporal artery biopsy.

Conclusion
VEXAS syndrome manifests as a variable vessel vasculitis in a quarter of patients, with cutaneous small and medium vessel involvement being particularly common. Some patients may have positive ANCA serologies or even renal vasculitis leading to misdiagnosis. Cranial symptoms are common and may mimic GCA, though documented large vessel inflammation is rare.
Inequality and socio-economic divides in parental transfers to young adults in the United States
Authors: Floridi Ginevra 
Published: October 2024

Abstract
Parental transfers of money and co-residence to young-adult children can serve as means of status reproduction. Yet, the relationship between inequality and socio-economic gaps in these forms of parental support has not been studied. Inequality may widen socio-economic differentials in monetary and co-residential transfers, potentially hindering social mobility. I test the association between income inequality and socio-economic divides in parental support to children aged 22–35 in the United States (U.S.), a context where the economic dependence of young adults has increased over decades of high or rising inequality. I link state-level inequality data to longitudinal data on 39,626 parent–child dyads from the Health and Retirement Study (1992–2018). Using state fixed-effects models I investigate how changes in income inequality within states relate to changes in wealth, income, and educational gradients in parental transfers over time. Socio-economic differences in the occurrence and amount of money transfers widen with inequality, as the probability of monetary support decreases among lower-class and lower-educated parents, while the amounts transferred increase among upper-class and higher-educated parents. Moreover, in times of higher inequality, co-residence is more strongly concentrated among lower-class, lower-educated parents. Previous research indicates that receiving money improves labor and housing market outcomes, while co-residence may restrict economic opportunities among young adults from disadvantaged backgrounds. In light of this, my findings suggest that rising U.S. inequality may hinder social mobility by shifting the socio-economic distribution of intergenerational support.
Complex Models of Sequence Evolution Improve Fit, But Not Gene Tree Discordance, for Tetrapod Mitogenomes
Authors: Toups Benjamin S , Thomson Robert C , Brown Jeremy M 
Published: October 2024

Abstract
Variation in gene tree estimates is widely observed in empirical phylogenomic data and is often assumed to be the result of biological processes. However, a recent study using tetrapod mitochondrial genomes to control for biological sources of variation due to their haploid, uniparentally inherited, and non-recombining nature found that levels of discordance among mitochondrial gene trees were comparable to those found in studies that assume only biological sources of variation. Additionally, they found that several of the models of sequence evolution chosen to infer gene trees were doing an inadequate job of fitting the sequence data. These results indicated that significant amounts of gene tree discordance in empirical data may be due to poor fit of sequence evolution models and that more complex and biologically realistic models may be needed. To test how the fit of sequence evolution models relates to gene tree discordance, we analyzed the same mitochondrial data sets as the previous study using 2 additional, more complex models of sequence evolution that each include a different biologically realistic aspect of the evolutionary process: A covarion model to incorporate site-specific rate variation across lineages (heterotachy), and a partitioned model to incorporate variable evolutionary patterns by codon position. Our results show that both additional models fit the data better than the models used in the previous study, with the covarion being consistently and strongly preferred as tree size increases. However, even these more preferred models still inferred highly discordant mitochondrial gene trees, thus deepening the mystery around what we label the “Mito-Phylo Paradox” and leading us to ask whether the observed variation could, in fact, be biological in nature after all.
Duration of a standard phototherapy course in jaundiced newborns with no neurotoxicity risk
Authors: Sarici Serdar Ümit , Arslan Kübra , Babacan Altay , Soylu Demet , Ergür Ayca Törel , Serdar Muhittin Abdulkadir , Sarici Dilek 
Published: October 2024

Abstract
In this study, we aimed to determine an ordinary/empiric/standard phototherapy treatment protocol for duration without controlling total serum bilirubin (TSB) levels after initiating phototherapy in early-term and full-term jaundiced newborns who had no hyperbilirubinemia neurotoxicity risk factors. We compared two groups, each receiving either 24 h (Group I) or 18 h (Group II) of continuous phototherapy in terms of demographic characteristics and efficacy (rate of decrease in TSB levels with phototherapy). No control TSB measurements were performed in the study groups until the end of phototherapy for the predetermined durations. Declines in TSB after phototherapy were significantly greater in Group I than in Group II, both in terms of mg/dl (11.81 ± 2.93 mg/dl vs. 10.75 ± 2.48 mg/dl, P = .0008) and percentage (56.71 ± 9.06% vs. 52.86 ± 8.37%, P = .0002). However, the rate of TSB reduction after phototherapy in mg/dl/h (0.59 ± 0.13 mg/dl/h vs. 0.49 ± 0.12 mg/dl/h, P = &lt;.0001) and percentage per hour (2.93 ± 0.37% vs. 2.36 ± 0.46%, P = &lt;.0001) were significantly higher in Group II than in Group I. This indicates an inverse time-response relationship between the duration of phototherapy and the response rate in the study groups. Although the 24-h phototherapy course showed greater efficacy concerning the primary bilirubin outcome measures (decline in TSB in mg/dl and %), the 18-h course of phototherapy treatment provided better hourly outcomes and reached its saturation point around the 18th hour. Therefore, an 18-h phototherapy without TSB monitoring until the end of the phototherapy should be considered for jaundiced newborns lacking neurotoxicity risk factors.
Correction of L5 Tilt in 2-Row Vertebral Body Tethering Versus Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: De Varona-Cocero Abel , Ani Fares , Kim Nathan , Robertson Djani , Myers Camryn , Ashayeri Kimberly , Maglaras Constance , Protopsaltis Themistocles , Rodriguez-Olaverri Juan C. 
Published: October 2024

Study Design:
Single-center retrospective cohort study.

Objective:
To compare the correction of fractional curve and L5 tilt in 2RVBT versus PSF with LIV in the lumbar spine.

Summary of Background Data:
Vertebral body tethering, an AIS fusion-alternative, avoids rigid constructs, allowing for lower instrumented vertebra (LIV) selection. Single-tether constructs break, but mini-open thoracoscopic assistant double-row vertebral body tethering (2RVBT) reduces this. Limited comparative studies exist with posterior spinal fusion (PSF).

Methods:
Retrospective analysis of AIS correction surgeries with lumbar LIV using preoperative and minimum 2-year postoperative imaging. Patients were divided into 2RVBT or PSF groups. Data included age, Riser, UIV, LIV, instrumented levels, and revision rates. Radiographic analyses included preoperative and postoperative main curve Cobb (MCC), secondary curve Cobb (SCC), fractional curve Cobb (FCC), and L5 tilt.

Results:
Ninety-nine patients participated (49 in 2RVBT, 50 in PSF). Preoperatively, secondary CC differed significantly (2RVBT: 44.6±10.4 degrees vs. PSF: 39.5±11.8 degrees, P=0.026), but not L5 tilt, MCC, or FCC. Postoperatively, MCC (2RVBT: 25.7±12.3 degrees vs. PSF: 19.5±7.4 degrees, P=0.003) and SCC (2RVBT: 18.0±8.4 degrees vs. PSF: 14.5±6.6 degrees, P=0.012) varied. Preoperative to postoperative changes in MCC (2RVBT: −32.0±11.3 degrees vs. PSF: −37.2±13.3 degrees, P=0.044) and L5 tilt (−13.8±9.0 degrees vs. PSF: −8.1±6.8 degrees, P=0.001) differed. Revision rates were similar (2RVBT: 2.0%, PSF: 4.0%, P=0.57). In 2RVBT, 3 tethers broke, 1 revision occurred for a broken tether, and 1 pleural effusion needed thoracocentesis. In PSF, 1 superficial infection needed surgery, and 1 revision was for add-on phenomenon. After PSM for Lenke classification, 54 patients remained (27 in each group). At 2 years, 2RVBT showed less MCC correction (−30.8±11.8 degrees vs. −38.9±11.9 degrees, P=0.017), but greater L5 tilt correction (−14.6±10.0 degrees vs. −7.5±6.0 degrees, P=0.003).

Conclusions:
This study with a minimum 2-year radiographic follow-up demonstrates that 2RVBT results in greater L5 tilt correction when compared with posterior spinal fusion after PSM for Lenke classification and similar rates of revision surgery.

Level of Evidence:
Level III.
A Rare Case of Carpal Tunnel Syndrome with Bifid Median Nerve and Palmaris Profundus Muscle
Authors: Yamazaki Takahiro , Matsuura Yusuke , Takahashi Hiroki , Ohtori Seiji 
Published: October 2024

Summary:
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. We report an extremely rare case of CTS associated with a bifid median nerve and palmaris profundus muscle. A 68-year-old man presented with numbness and pain in the right hand. Intraoperatively, a bifid median nerve was identified, with the ulnar branch severely compressed by the palmaris profundus muscle. The muscle was resected, leading to symptom resolution. Anatomical variations of the median nerve and anomalous muscles should be considered in CTS. Preoperative imaging and open carpal tunnel release are recommended to identify and address such variations.
Association Between Migraine and Open Angle Glaucoma: A 12-Year Nationwide Retrospective Korean Cohort Study
Authors: Kim Hyung Jun , Ro Jun-Soo , Lee Seung Hoon , Moon Jong Youn , Lee Si Hyung 
Published: October 2024

Précis:
Patients with migraine showed a significantly increased risk of developing open angle glaucoma (OAG) in the Korean population, without significant differences according to the presence of aura. Our results suggest the presence of migraine as a possible risk factor for OAG.

Purpose:
Previous studies have reported that migraine headaches may be one of the possible risk factors for open angle glaucoma (OAG); however, a consensus has not been reached regarding the association between OAG and migraine. In this study, we examined the risk of developing OAG in migraine patients using a 12-year nationwide cohort.

Materials and Methods:
In this study, data from the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015 was used to perform a retrospective cohort study. The study included 1,103,302 subjects, out of which 41,148 were diagnosed with migraine during 2003–2008 and were categorized as the migraine group, while 205,741 patients were selected as controls through propensity score matching at a 1:5 ratio. Subjects with migraine or OAG was ascertained based on the KCD code. Multivariate Cox regression analysis was used to evaluate the hazard rate of OAG onset in the migraine group, and subgroup analysis was performed to identify any differences based on sex and age.

Results:
Multivariate Cox regression analysis showed that the incidence of OAG was significantly greater among patients with migraine than among patients in the comparison group [hazard ratio (HR): 1.238; 95% CI: 1.160–1.132, P <0.001]. Moreover, the risk of developing OAG compared with subjects without migraine did not differ according to the presence of an aura (migraine with aura: HR: 1.235; 95% CI: 1.137–1.342, P < 0.001; migraine without aura: HR: 1.248; 95% CI: 1.143–1.363, P < 0.001). In subgroup analyses, the patients with migraine under 40-year-old were found to have a greater hazard rate (HR: 1.576, 95% CI: 1.268–1.957) of developing OAG in contrast with patients with migraine and over 40-year-old (HR: 1.167, 95% CI: 1.089–1.250) when compared with the corresponding nonmigraine patients.

Conclusion:
This study showed that migraine is a significant risk factor for OAG onset in the Korean population, and the presence of aura did not affect the HR of OAG development.