bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Adherence to Beta-Blockers in Patients With All-Comers ST-Segment Elevation Myocardial Infarction and According to Left Ventricular Ejection Fraction at Discharge: Results From the Real-World Registry FAST-STEMI
Authors: Giannino Giuseppe , Giacobbe Federico , Annone Umberto , Ravetti Emanuele , Rollo Cesare , Nebiolo Marco , Troncone Mattia , Di Vita Umberto , Morena Arianna , Carmagnola Ludovica , Angelini Filippo , De Filippo Ovidio , Bruno Francesco , Pancotti Corrado , Gaido Luca , Fariselli Piero , D'Ascenzo Fabrizio , Giammaria Massimo , De Ferrari Gaetano Maria 
Published: September 2024

Abstract:
Beta-blockers are a crucial part of post–myocardial infarction (MI) pharmacological therapy. Recent studies have raised questions about their efficacy in patients without reduced left ventricular ejection fraction (LVEF). This study aims to assess adherence to beta-blockers after discharge for ST-segment elevation myocardial infarction (STEMI) and the impact of adherence on outcomes based on LVEF at discharge. The retrospective registry FAST-STEMI evaluated real-world adherence to main cardiovascular drugs in patients with STEMI between 2012 and 2017 by comparing purchased tablets with expected ones at 1 year through pharmacy registries. Optimal adherence was defined as ≥80%. Primary outcomes included all-cause and cardiovascular death while secondary outcomes were MI, major/minor bleeding events, and ischemic stroke. The study included 4688 patients discharged on beta-blockers. The mean age was 64 ± 12.3 years, 76% were male, and the mean LVEF was 49.2 ± 8.8%. The mean adherence at 1 year was 87.1%. Optimal adherence was associated with lower all-cause (adjusted hazard ratio, 0.62, 95% confidence interval, 0.41–0.92, P: 0.02) and cardiovascular (adjusted hazards ratio, 0.55, 95% confidence interval, 0.26–0.98, P: 0.043) mortality. In patients with LVEF ≤40%, optimal adherence was linked to reduced all-cause and cardiovascular mortality, but this was not found in patients with either preserved or mildly reduced LVEF. Predictors of cardiovascular mortality included older age, chronic kidney disease, male gender, and atrial fibrillation. Optimal adherence to beta-blocker therapy in patients with all-comers STEMI reduced all-cause and cardiovascular mortality at 1 year; once stratified by LVEF, this effect was confirmed only in patients with reduced LVEF (<40%) at hospital discharge. Impact of adherence to beta-blockers in all-comers STEMI patients and according to LVEF at discharge: results from the real-world registry FAST-STEMI.
Differential distribution of NAT2 polymorphisms and NAT2 acetylator phenotypes among indigenous populations of the Brazilian Amazon
Authors: Perini Jamila A. , Basta Paulo C. , Cardoso Jessica V. , Elias Anna Beatriz R. , Suarez-Kurtz Guilherme 
Published: September 2024

Objectives
We report, for the first time, the distribution of four no-function NAT2 single nucleotide polymorphisms and inferred NAT2 acetylator phenotypes in three indigenous groups (Munduruku, Paiter-Suruí, and Yanomami), living in reservation areas in the Brazilian Amazon.

Methods
Two hundred and seventy-six participants from three indigenous groups (92 for each group) were included and genotyped for four NAT2 polymorphisms (rs1801279, rs1801280, rs1799930, and rs1799931) by the TaqMan system. Minor Allele Frequency (MAF) was determined and NAT2 acetylator phenotypes were inferred.

Results

NAT2 rs1801279G>A was absent in all cohorts; rs1799930G>A was absent in Yanomami and rare (MAF 0.016) in Munduruku and Paiter-Suruí; MAF of rs1801280T>C ranged five-fold (0.092–0.433), and MAF of rs1799931G>A varied between 0.179 and 0.283, among the three groups. The distribution of NAT2 phenotypes differed significantly across cohorts; the prevalence of the slow acetylator phenotype ranged from 16.3% in Yanomami to 33.3% in Munduruku to 48.9% in Paiter-Suruí. This three-fold range of variation is of major clinical relevance because the NAT2 slow phenotype is associated with higher risk of hepatotoxicity with antituberculosis chemotherapy and high incidence rates of tuberculosis and burden of latent infection among Munduruku, Paiter-Surui, and Yanomami peoples. According to the frequency of the NAT2 slow acetylator phenotype, the estimated number of individuals needed to be genotyped to prevent one additional event of hepatotoxicity range from 31 (Munduruku) to 39 (Paiter-Surui) and to 67 (Yanomami).

Conclusion
The rs1801279 polymorphism was not found in any of the cohorts, while the MAF of the other polymorphisms showed significant variation between the cohorts. The difference in the prevalence of the NAT2 slow acetylator phenotype, which is linked to isoniazid-induced hepatotoxicity, was observed in the different study cohorts.
Artificial intelligence for geographic atrophy: pearls and pitfalls
Authors: Enzendorfer Marie Louise , Schmidt-Erfurth Ursula 
Published: September 2024

Purpose of review
This review aims to address the recent advances of artificial intelligence (AI) in the context of clinical management of geographic atrophy (GA), a vision-impairing late-stage manifestation of age-related macular degeneration (AMD).

Recent findings
Recent literature shows substantial advancements in the development of AI systems to segment GA lesions on multimodal retinal images, including color fundus photography (CFP), fundus autofluorescence (FAF) and optical coherence tomography (OCT), providing innovative solutions to screening and early diagnosis. Especially, the high resolution and 3D-nature of OCT has provided an optimal source of data for the training and validation of novel algorithms. The use of AI to measure progression in the context of newly approved GA therapies, has shown that AI methods may soon be indispensable for patient management. To date, while many AI models have been reported on, their implementation in the real-world has only just started. The aim is to make the benefits of AI-based personalized treatment accessible and far-reaching.

Summary
The most recent advances (pearls) and challenges (pitfalls) associated with AI methods and their clinical implementation in the context of GA will be discussed.
Privacy preserving technology in ophthalmology
Authors: Yang Yahan , Chen Xinwei , Lin Haotian 
Published: September 2024

Purpose of review
Patient privacy protection is a critical focus in medical practice. Advances over the past decade in big data have led to the digitization of medical records, making medical data increasingly accessible through frequent data sharing and online communication. Periocular features, iris, and fundus images all contain biometric characteristics of patients, making privacy protection in ophthalmology particularly important. Consequently, privacy-preserving technologies have emerged, and are reviewed in this study.

Recent findings
Recent findings indicate that general medical privacy-preserving technologies, such as federated learning and blockchain, have been gradually applied in ophthalmology. However, the exploration of privacy protection techniques of specific ophthalmic examinations, like digital mask, is still limited. Moreover, we have observed advancements in addressing ophthalmic ethical issues related to privacy protection in the era of big data, such as algorithm fairness and explainability.

Summary
Future privacy protection for ophthalmic patients still faces challenges and requires improved strategies. Progress in privacy protection technology for ophthalmology will continue to promote a better healthcare environment and patient experience, as well as more effective data sharing and scientific research.
Vision language models in ophthalmology
Authors: Lim Gilbert , Elangovan Kabilan , Jin Liyuan 
Published: September 2024

Purpose of review
Vision Language Models are an emerging paradigm in artificial intelligence that offers the potential to natively analyze both image and textual data simultaneously, within a single model. The fusion of these two modalities is of particular relevance to ophthalmology, which has historically involved specialized imaging techniques such as angiography, optical coherence tomography, and fundus photography, while also interfacing with electronic health records that include free text descriptions. This review then surveys the fast-evolving field of Vision Language Models as they apply to current ophthalmologic research and practice.

Recent findings
Although models incorporating both image and text data have a long provenance in ophthalmology, effective multimodal Vision Language Models are a recent development exploiting advances in technologies such as transformer and autoencoder models.

Summary
Vision Language Models offer the potential to assist and streamline the existing clinical workflow in ophthalmology, whether previsit, during, or post-visit. There are, however, also important challenges to be overcome, particularly regarding patient privacy and explainability of model recommendations.
Maximum Diameter of Ileocecal Lymph Nodes Measured Using Abdominal Ultrasonography Allows for the Discrimination of Yersinia pseudotuberculosis Infection from Kawasaki Disease
Authors: Kato Atsushi , Miyata Ippei , Nakamura Yoshitaka , Tanaka Takaaki , Koguchi Yutaka , Oishi Tomohiro , Nakano Takashi , Ouchi Kazunobu 
Published: September 2024

Background:
This study aimed to determine whether the maximum diameter of ileocecal lymph nodes measured using abdominal ultrasonography is useful for differentiating Yersinia pseudotuberculosis infection from Kawasaki disease in the acute phase. The optimal maximum diameter cutoff of the ileocecal lymph nodes was also explored to optimize differentiation between these 2 diseases.

Methods:
We included pediatric patients <15 years old who met the diagnostic criteria for Kawasaki disease. Stool culture testing, loop-mediated isothermal amplification of stool specimens, and serological diagnosis were performed to confirm the presence or absence of Y. pseudotuberculosis infection.

Results:
Of the 122 patients included in the analysis, 17 were confirmed to have Y. pseudotuberculosis infection and 105 were not. The age (in months), white blood cell count, C-reactive protein level, prediction score (risk score) for nonresponse to intravenous immunoglobulin, and number of intravenous immunoglobulin doses did not differ significantly between the Y. pseudotuberculosis-positive and -negative groups. The maximum diameter of ileocecal lymph nodes was 6.0 (5.5–9.5) mm in the Y. pseudotuberculosis-positive group and 3.0 (2.5–3.8) mm in the Y. pseudotuberculosis-negative group (numbers presented as median, interquartile range), with a significantly larger diameter in the Y. pseudotuberculosis-positive group (P < 0.01, Mann–Whitney U test), suggesting potency of ultrasonography.

Conclusion:
In patients meeting the diagnostic criteria for Kawasaki disease, the possibility of Y. pseudotuberculosis infection is significantly higher if the maximum ileocecal lymph node diameter ≥5.1 mm. Its sensitivity and specificity being 100%, and 89.5%, respectively.
Accelerated Severity of Illness Score Enhances Prediction of Complicated Acute Hematogenous Osteomyelitis in Children
Authors: Jahan Tahmina A. , Lapin Norman A. , O’Connell Michael T. , Jo Chanhee , Ma Yuhan , Tareen Naureen G. , Copley Lawson A. 
Published: September 2024

Background:
Severity of illness determination for children with acute hematogenous osteomyelitis should be accomplished during the earliest stages of evaluation to guide treatment and establish prognosis. This study objectively defines an outcome of complicated osteomyelitis and explores an illness severity-based model with an improved ability to predict this outcome as soon and accurately as possible, comparing it to existing models.

Methods:
Children with Staphylococcus aureus acute hematogenous osteomyelitis (n = 438) were retrospectively studied to identify adverse events and predictors of severity. The outcome of complicated osteomyelitis was ultimately defined as the occurrence of any major or at least 3 minor adverse events, which occurred in 52 children. Twenty-four clinical and laboratory predictors were evaluated through univariate and stacked multivariable regression analyses of chronologically distinct groups of variables. Receiver operating characteristic curve analyses were conducted to compare models.

Results:
Accelerated Severity of Illness Score included: triage tachycardia [odds ratio: 10.2 (95% confidence interval: 3.48–32.3], triage tachypnea [6.0 (2.4–15.2)], C-reactive proteininitial ≥17.2 mg/dL [4.5 (1.8–11.8)], white blood cell count band percentageinitial >3.8% [4.6 (2.0–11.0)], hemoglobininitial ≤10.4 g/dL [6.0 (2.6–14.7)], methicillin-resistant S. aureus [3.0 (1.2–8.5)], septic arthritis [4.5 (1.8–12.3)] and platelet nadir [7.2 (2.7–20.4)]. The receiver operating characteristic curve of Accelerated Severity of Illness Score [area under the curve = 0.96 (0.941–0.980)] were superior to those of Modified Severity of Illness Score = 0.903 (0.859–0.947), Acute Score for Complications of Osteomyelitis Risk Evaluation = 0.878 (0.830–0.926) and Chronic Score for Complications of Osteomyelitis Risk Evaluation = 0.858 (0.811–0.904). Successive receiver operating characteristic curve analyses established an exponentially increasing risk of complicated osteomyelitis for children with mild (0/285 or 0%), moderate (4/63 or 6.3%), severe (15/50 or 30.0%) and hyper-severe (33/40 or 82.5%) acute hematogenous osteomyelitis (P<0.0001).

Conclusions:
This study improves upon previous severity of illness models by identifying early predictors of a rigorously defined outcome of complicated osteomyelitis.
Continuous Versus Intermittent Vancomycin Infusions for Coagulase-negative Staphylococcus Bacteremia in Neonates: A Propensity-matched Cohort Study
Authors: Gérard Rémy , Pauquet Emilie , Ros Barbara , Lehours Philippe , Renesme Laurent 
Published: September 2024

Background:
Coagulase-negative staphylococci (CONS) are a major cause of late-onset neonatal sepsis, particularly in preterm infants, with high morbidity and mortality. While vancomycin is the first-line treatment for these infections, the optimal administration in neonates remains uncertain.

Objective:
We aim to compare the outcomes of neonates with CONS bacteremia treated with adjusted continuous infusion (CIV) versus standard intermittent infusion (IIV) of vancomycin.

Methods:
This retrospective study included 110 neonates, with 29 in the CIV group and 47 in the IIV group after propensity score matching. The primary outcome was treatment failure defined by the persistence of a positive blood culture for the same organism after at least 48 hours of vancomycin treatment.

Results:
After matching, the CIV group exhibited significantly lower treatment failure rates [5/29 (17%) vs. 26/47 (44%); P = 0.014] and a higher rate of achieving therapeutic vancomycin levels after 24 hours [20/29 (69%) vs. 26/47 (44%); P = 0.002] compared to the IIV group. No significant differences were observed in terms of acute kidney failure between the 2 groups.

Conclusion:
Adjusted continuous vancomycin infusion in neonates with CONS bacteremia is associated with a lower treatment failure rate without an increase in renal toxicity compared to standard intermittent infusion. However, due to the observational design, larger prospective studies are needed to validate these results.
School-Based Protective Factors for HIV Prevention in the United States: Secondary Analysis of the Youth Risk Behavior Survey 2015–2019
Authors: Garcia David R. , Fletcher Jason , Goldsamt Lloyd , Bell David L. , Zheng Yaguang , Dunn Navarra Ann-Margaret 
Published: September 2024

Abstract
This secondary analysis of the National Youth Risk Behavior Survey (years 2015–2019) examines associations between school-based protective factors (i.e., safe school environments and academic achievement) and HIV risk behaviors among sexually experienced adolescent gay and bisexual men (n = 644), a population with the highest prevalence of undiagnosed HIV infections. Demographics included Hispanics/Latinos (25%, n = 158), Other race/ethnicity (14%, n = 88), and non-Hispanic Blacks/African Americans (13%, n = 81). Adjusted models showed that protective factors reduced odds for early sexual debut, multiple sexual partners, sex under the influence of drugs/alcohol, and condomless sex, with an additive effect demonstrated when two protective factors were present. Hispanics/Latinos had greater odds of reporting multiple sexual partners and HIV testing, indicating opportunities for school-based HIV prevention and further research. Our findings provide support for school-based programs that aim to improve social and structural determinants of health and ultimately reduce adolescent HIV burdens.
Justice, Equity, Diversity, and Inclusion–Related Curricular Elements in Entry-Level Physical Therapist Education: A Delphi Study
Authors: Sutkowi-Hemstreet Allyson , Covington J. Kyle , Adams Tiffany N. 
Published: September 2024

Introduction.
The purpose of this Delphi study was to determine whether experts in justice, equity, diversity, and inclusion (JEDI) in the field of physical therapy could achieve consensus on the key JEDI-related curricular content topics to be included in entry-level physical therapist education.

Review of Literature.
Inequities exist at all levels of health care for historically underserved populations, including referrals, access, and quality of physical therapy services. The physical therapy field is facing challenges and opportunities in how to best prepare providers to address individual, community, and population health inequities. There is a lack of consensus in physical therapist education regarding essential curricular content related to justice, equity, diversity, inclusion, and antiracism.

Subjects.
Eighty-four experts in JEDI in the physical therapy profession were invited through email to participate in the Delphi process.

Methods.
A Delphi survey brought together 39 identified experts in justice, equity, diversity, and inclusion within the field of physical therapy to reach consensus on key JEDI-related curricular topics in physical therapist education. In the first-round survey, participants answered an open-ended question: “What JEDI-related curricular content should be included in entry-level physical therapist education?” The work team coded these free-text responses to populate an initial list of curricular elements. Over 2 subsequent rounds of surveys, the experts came to a consensus on which curricular elements should be addressed within physical therapist education. Nineteen experts completed all survey rounds.

Results.
In round I, coding of the expert group's responses generated 61 initial JEDI-related curricular elements. By round III, the group refined the list to 43 curricular elements; 41 of the 43 (95%) elements garnered 94% or higher consensus. The expert group deemed 30 of the elements “entry-level” content and 13 as more “advanced practice” topics.

Discussion and Conclusions.
Experts had a strong consensus on key JEDI-related curricular elements that physical therapist education programs should include to best prepare providers to improve the health of society. Future scholarship will explore recommendations for how physical therapist education programs might prioritize and implement JEDI-related content.
The use of an online learning module to improve knowledge for prevention of back pain and injury in industrial workers
Authors: Spain Scarlet R. , Li Zheng , Akbar Raza 
Published: September 2024

ABSTRACT
Back pain is a significant public health problem that accounts for a high percentage of morbidity and disability worldwide. Low back pain is a frequent cause of missed workdays and job-specific disability and is associated with poor outcomes for employees and employers. An online learning module that focused on normal anatomy of the spine, common pathophysiologic diagnosis or findings that may contribute to back pain, and techniques for back pain reduction was created for employees at risk due to the nature of their labor-intensive jobs. This module also contained case studies and graphics that demonstrated ways to reduce risks or hazards by incorporating job-specific changes in the work environment. A mixed method statistical analysis of knowledge change was completed after participation in the online module. This demonstrated that participants had a marked increase in knowledge in all areas examined. In addition, participants perceived the module as beneficial for grasping anatomical concepts, understanding injury prevention and management strategies, valuing the shared information, leveraging visual aids, and applying practical examples per qualitative questions answered. Participants gained knowledge that can be used on the job to decrease risk of sustaining back pain or injury. The intervention approach enhances the understanding of back pain among industrial workers and holds profound implications for public health on a broader scale. Monitoring population health and preventing back pain and injury while at work is essential for safety and is also a core competency in public health.
Manual mastery vs. mechanized magic: current opinions on manual vs. mechanical chest compressions
Authors: Crowley Conor , Salciccioli Justin , Pocock Helen , Moskowitz Ari 
Published: September 2024

Purpose of review
Mechanical chest compression devices are increasingly deployed during cardiopulmonary resuscitation. We discuss the data supporting the use of mechanical chest compression devices during cardiac arrest and provide an opinion about the future of the technology.

Recent findings
Multiple randomized trials investigating the use of mechanical chest compression devices for out-of-hospital cardiac arrest have not demonstrated improved outcomes. There is little prospective evidence to support the use of mechanical chest compression devices in other settings. Data from observational studies do not support the routine use of mechanical chest compression devices for in-hospital cardiac arrest, but there may be a role for mechanical chest compressions for cardiac arrest in procedural areas and cardiac arrest prior to cannulation for extracorporeal membrane oxygenation.

Summary
Mechanical chest compression devices offer a solution to some of the human limiting factors of resuscitation, but have failed to demonstrate meaningful improvement in outcomes from cardiac arrest. Routine use of mechanical chest compression devices during cardiac arrest is not supported by evidence.
Tissue factor pathway inhibitor – cofactor-dependent regulation of the initiation of coagulation
Authors: Ahnström Josefin , Petri Anastasis , Crawley James T.B. 
Published: September 2024

Purpose of review
In humans, tissue factor pathway inhibitor (TFPI) exists in two alternatively spliced isoforms, TFPIα and TFPIβ. TFPIα consists of three Kunitz domains (K1, K2 and K3) and a highly basic C-terminal tail. K1 inhibits the tissue factor-activated factor VII complex, K2 specifically inhibits activated factor X, K3 is essential for interaction with its cofactor, protein S, and the basic C-terminus is binds factor V-short (FV-short) with high affinity. TFPIβ consists of K1 and K2 that is glycosylphosphatidylinositol anchored directly to cell surfaces. This review explores the structure/function of TFPI and its cofactors (protein S and FV-short), and the relative contributions that different TFPI isoforms may play in haemostatic control.

Recent findings
Recent data have underscored the importance of TFPIα function and its reliance on its cofactors, protein S and FV-short, in influencing haemostatic control as well as bleeding and thrombotic risk

Summary
TFPIα is likely the most important pool of TFPI in modifying the risk of thrombosis and bleeding. TFPIα forms a trimolecular complex with FV-short and protein S in plasma. FV-short expression levels control the circulating levels of TFPIα, whereas protein S exerts essential cofactor mediated augmentation of it anticoagulant function.