bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort
Authors: Zarghami Amin , Hussain Mohammad Akhtar , van der Mei Ingrid , Simpson-Yap Steve , Ponsonby Anne-Louise , Lechner-Scott Jeanette , Broadley Simon A , Lucas Robyn M , Zhou Yuan , Lin Xin , Investigator Group AusLong , Taylor Bruce V 
Published: September 2024

BackgroundPrevious natural history studies highlighted a consistent heterogeneity of disability trajectories among individuals with primary or secondary progressive multiple sclerosis (MS). However, evidence on disability progression in relapsing onset MS is scarce.The aim of this study was to investigate heterogeneity in disability accumulation over 10 years following a first clinical diagnosis of central nervous system demyelination (FCD) and identify genetic, demographic, environmental and clinical factors associated with these trajectories.MethodsWe used group-based trajectory models to measure heterogeneity in disability trajectories based on the Expanded Disability Status Scale (EDSS) in a prospectively assessed cohort of 263 participants. To capture sustained neurological impairments and avoid issues related to significant changes in EDSS associated with relapse, we did not consider EDSS points recorded within 3 months of a relapse.ResultsWe identified three distinct and clinically meaningful disability trajectories: No/minimal, moderate and severe. Those in the no/minimal disability trajectory showed no appreciable progression of disability (median EDSS∼1 at 10-year review) while those in the moderate and severe disability trajectories experienced disability worsening (median time to reach EDSS 4 was 9 and 7 years, respectively). Compared with the no/minimal disability trajectory, those with older age, a higher number of relapses within the first 5 years post-FCD, and a higher number of comorbidities at baseline were more likely to be in the worse disability trajectory. Surprisingly, baseline MRI and anatomical site of initial symptoms did not influence long-term outcomes.ConclusionsThose at higher risk of faster MS disability progression can be identified based on their early clinical characteristics with potential therapeutic implications for early intervention and treatment escalation.
Venous thromboembolism prophylaxis prescribing patterns for patients with orthopedic trauma: a clinical vignette survey
Authors: O'Hara Nathan N , Stein Deborah M , Haut Elliott R , Breazeale Stephen , Frey Katherine P , Slobogean Gerard P , Firoozabadi Reza , Castillo Renan , O'Toole Robert V 
Published: September 2024

BackgroundA recent clinical trial suggested aspirin is a viable alternative to enoxaparin for venous thromboembolism (VTE) prophylaxis in patients after orthopedic trauma. The initial impact of these findings on VTE prophylaxis prescribing is unknown. The study aimed to evaluate stated VTE prophylaxis prescribing patterns among clinicians who treat patients after orthopedic trauma.MethodsFor this clinical vignette survey, we recruited surgeons and advanced practice providers who prescribed VTE prophylaxis to patients with orthopedic trauma across 40 states. Clinicians were shown seven clinical vignettes describing hypothetical patients with orthopedic trauma based on their fracture type, treatment, VTE risk factors, additional injuries and health insurance status. We assessed the stated VTE prophylaxis medications prescribed in-hospital and at discharge, patient factors associated with changes in medication prescribing preferences and practice variation by specialty and provider training.ResultsAmong the 287 respondents, the median age was 43 years (IQR, 38–50), and 154 (weighted average, 63%) were men. For in-hospital VTE prophylaxis, enoxaparin was prescribed in 83% of the presented scenarios, and aspirin was prescribed in 13% (p<0.001). At discharge, aspirin was prescribed more frequently than enoxaparin (50% vs 41%, p<0.001). Healthcare providers with an aspirin discharge preference were 12% more likely to switch to enoxaparin if the patient had additional VTE risk factors, such as obesity (95% CI 4% to 19%, p=0.005).ConclusionsDespite new clinical evidence, in-hospital VTE prophylaxis prescribing practices for patients with orthopedic trauma remain consistent with those reported a decade ago. However, compared with historical data, clinicians have significantly increased their preference for aspirin for thromboprophylaxis at discharge—unless the patient has additional thromboembolic risk factors.Level of evidence5—expert opinion.
A comparison of critical power and the respiratory compensation point at slower and faster pedaling cadences
Authors: Micheli Lorenzo , Teso Massimo , Guluzade Nasimi A. , Rizzo Matteo , Ferri Marini Carlo , Lucertini Francesco , Keir Daniel A. , Pogliaghi Silvia 
Published: September 2024

We investigated whether pedal cadence (60 vs. 100 rpm) affects oxygen uptake (V̇O2) and power output (PO) at two indexes of the heavy-to-severe-intensity domain boundary (i.e., critical power (CP) and respiratory compensation point (RCP)) and their correspondence. Fourteen adults (7 females, 23 ± 2 years) cycled at 60 and 100 rpm during: (i) a “step-ramp-step” protocol to identify V̇O2 and PO at RCP; (ii) 4–5 exhaustive constant-PO bouts for CP identification; and (iii) a constant-power bout at CP to identify V̇O2 at CP. Separate two-way repeated measures Analysis of variance assessed whether V̇O2 and PO were affected by index (CP vs. RCP) and cadence (60 vs. 100 rpm). The V̇O2 was not affected by index (mean difference (MD) = 73 ± 197 mL·min−1; p = 0.136) but there was an index × cadence interaction ( p = 0.014), such that V̇O2 was higher at 100 versus 60 rpm for CP (MD = 142 ± 169 mL·min−1; p = 0.008), but not RCP ( p = 0526). The PO was affected by cadence (MD = 13 ± 9 W; p < 0.001) and index (MD = 8 ± 11 W; p = 0.016), with no cadence × index interaction ( p = 0.168). The systematic bias in PO confirms cadence-specificity of CP and RCP. The relationship between these indexes and their change in unison in PO suggests a mechanistic link between these two heavy-to-severe domain boundary candidates.
Acute effects of eccentric versus concentric exercise on executive function and attention of older adults
Authors: Huang Min-Jyue , Chen Trevor C. , Singh Favil , Taaffe Dennis R. , Nosaka Kazunori 
Published: September 2024

Cognitive function is improved acutely after aerobic and/or resistance exercise, but it is unclear if the types of muscle contraction can influence this effect. This study tested the hypothesis that undertaking an acute bout of exercise with eccentric than concentric contractions would be more beneficial for improving cognitive function post-exercise in older adults. Twenty healthy older adults (66–75 years) performed descending stair walking (DSW), ascending stair walking (ASW), and resistance exercise of the knee extensors with eccentric-only (RE-ECC) or concentric-only contractions (RE-CON) for ∼20 min each with a week between exercises in a randomized order. The Stroop tests of color naming (STCN) and conflicting color words (STCC), symbol digit modalities test, digit span test (DST), and two types of the trail making test (TMT-A, TMT-B) were assessed before and after sitting for 20 min (control session), and each exercise. A significant ( p < 0.05) improvement in the baseline test scores was found from the control session to the fourth exercise session. Time to complete the tests was significantly ( p < 0.05) reduced from pre- to post-exercise as well as after sitting for 20 min for STCN (−5.9 ± 7.4 s, Cohen’s d = 0.79), STCC (−8.9 ± 11.1 s, d = 0.80), TMT-A (−22.6 ± 9.7 s, d = 2.34) and TMT-B (−23.1 ± 13.7 s, d = 1.69) without significant difference among the four exercise conditions. A significant ( p < 0.05) improvement of DST score was found from pre- to post-exercise for DSW (9.0 ± 17.6%, d = 0.51) and RE-ECC (6.5 ± 10.6%, d = 0.61), but not for ASW and RE-CON. These results partially supported the hypothesis that eccentric exercise could affect acute changes in cognitive function greater than concentric exercise.
Dimethylsulfoniopropionate (DMSP): From Biochemistry to Global Ecological Significance
Authors: Li Chun-Yang , Cao Hai-Yan , Payet Rocky D. , Todd Jonathan D. , Zhang Yu-Zhong 
Published: September 2024

Dimethylsulfoniopropionate (DMSP) is one of Earth's most abundant organosulfur compounds with important roles in stress tolerance, chemotaxis, global carbon and sulfur cycling, and climate-active gas production. Diverse marine prokaryotes and eukaryotes produce DMSP via three known pathways (methylation, transamination, and decarboxylation) and metabolize DMSP via three further pathways (demethylation, cleavage, and oxidation). Over 20 key enzymes from these pathways have been identified that demonstrate the biodiversity and importance of DMSP cycling. The last dozen years have seen significant changes in our understanding of the enzymology and molecular mechanisms of these DMSP cycling enzymes through the application of biochemistry and structural biology. This has yielded more than 10 crystal structures and, in many cases, detailed explanations as to how and why organisms synthesis and metabolize DMSP. In this review, we describe recent progress in biochemical and mechanistic understandings of DMSP synthesis and metabolism, highlighting the important knowledge gleaned and current challenges that warrant further exploration.
Threat Impairs the Organization of Memory Around Motivational Context
Authors: Horwath Elizabeth A. , Katerman Brandon S. , Biju Meryl , DuBrow Sarah , Murty Vishnu P. 
Published: September 2024

Abstract
Previous work highlighted a critical role for top–down goals in shifting memory organization, namely, through studying the downstream influences of event segmentation and task switching on free recall. Here, we extend these frameworks into the realm of motivation, by comparing how threat motivation influences memory organization by capturing free recall dynamics. In Study 1, we manipulated individuals' motivation to successfully encode information by the threat of exposure to aversive sounds for forgetting. In Study 2, we conducted a parallel study manipulating motivation via instruction rather than threat, allowing us to examine changes directly related to threat motivation. Our findings showed that motivation to avoid threat broadly enhances memory for items presented within a threatening context, regardless of whether items were directly associated with the threat or not. Concurrently, these memory enhancements coincide with a decrease in the organization of memory around motivationally relevant features. These results highlight the importance of considering motivational valence when conceptualizing memory organization within adaptive memory frameworks.
Construction and verification of a risk prediction model for cognitive frailty in older patients with chronic obstructive pulmonary disease and diabetes mellitus
Authors: Liang Meng-yao , Li Rui , Feng Li , Qian Wei-peng 
Published: September 2024

Objective We explored risk factors for cognitive frailty in older patients with chronic obstructive pulmonary disease (COPD) and diabetes mellitus to develop and verify a risk prediction model for cognitive frailty. Methods This was a cross-sectional study. Convenience sampling was used to randomly select 378 patients hospitalized between February 2022 and December 2023. We allocated 265 patients who visited between February 2022 and February 2023 to a modeling group to analyze risk factors for cognitive frailty and create a logistic regression model for risk prediction. Another 113 patients who visited between March 2023 and December 2023 were included in a validation group for model verification. Results The cognitive frailty incidence in the 265 patients was 35.09% (93/265). Regression analysis showed that age >80 years (odds ratio [OR] = 4.576), regular exercise (OR = 0.390, polypharmacy (OR = 3.074), depression (OR = 2.395) duration of COPD combined with diabetes (OR = 1.902), Family APGAR index score (OR = 0.428), and chronic pain (OR = 2.156) were factors influencing the occurrence of cognitive frailty in older patients with COPD accompanied by diabetes. Conclusions The constructed risk prediction model for cognitive frailty in older patients with COPD and diabetes showed good predictive value, aiding in the clinical identification of high-risk patients and facilitating timely intervention and guidance.
Percentage mammographic density or absolute breast density for risk stratification in breast screening: Possible implications for socioeconomic health disparity
Authors: Hudson Sue , Kamangari Nahid , Wilkinson Louise S 
Published: September 2024

Objectives Obesity levels and mortality from breast cancer are higher in more deprived areas of the UK, despite lower breast cancer incidence. Supplemental imaging for women with dense breasts has been proposed as a potential improvement to screening, but it is not clear how stratification by percentage mammographic density (%MD) would be reflected across socioeconomic groups. This study aims to clarify the associations between breast composition (dense and fatty tissue) and socioeconomic status in a multi-ethnic screening population. Methods Demographic characteristics were collected for 62,913 participants in a UK breast screening programme (age, ethnicity, Index of Multiple Deprivation (IMD)). Automated mammographic measurements were derived: dense volume (DV), non-dense volume (NDV) and percent density (%MD). Correlations between deprivation and mammographic composition were examined before and after adjustment for age, ethnicity and NDV, using non-dense breast volume as a proxy for body mass index (BMI). Results There was negligible correlation between deprivation and DV (r = 0.017; P < 0.001 in all cases), but NDV increased with increasing deprivation (Pearson r = 0.101). Correlations were weaker in the Asian and Chinese ethnic groups. %MD decreased with deprivation (r = −0.094) and adjustment for ethnicity did not alter the association between %MD and IMD (relative change, most to least deprived quintile IMD: 1.18; 95% confidence interval: 1.16, 1.21). Conclusions Deprivation-related differences in %MD in the screening population are largely explained by differences in breast fat volume (NDV) which reflects BMI. Women in more deprived areas, where obesity and breast cancer mortality rates are higher, have increased breast adiposity and may miss out on risk-adapted screening if stratification is based solely on %MD or BIRADS classification.
Factors Associated With Sacubitril/Valsartan Continuation and the Methods of Combining Heart Failure Medications in Patients With Heart Failure
Authors: Iwasaki Erika , Kohyama Noriko , Inamoto Mayumi , Nagao Michiru , Sunaga Tomiko , Suzuki Hiroshi , Ebato Mio , Kogo Mari 
Published: September 2024

Background: Sacubitril/valsartan (SV) is recommended for patients with heart failure (HF). In addition, a combination of 4 HF medications, including SV, is recommended in patients with HF with reduced ejection fraction (HFrEF). However, evidence on the characteristics of patients who could continue SV and its initiation methods is limited. Objective: To investigate the factors associated with SV continuation and methods of combining HF medications. Methods: This retrospective cohort study included HF patients who initiated with SV at our institution. The endpoint was SV continuation for 6 months after its initiation. Multivariate analysis was used to extract factors associated with SV continuation. The relationship between the methods of combining HF medications (renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists, or sodium-glucose cotransporter 2 inhibitors), including the number of HF medications, their combination patterns, and the timing of their initiation, and SV continuation was examined in patients with HFrEF. Results: Of 186 eligible patients, 68.8% had HFrEF, and 79.0% continued SV for 6 months. Significant factors associated with SV continuation were albumin ≥ 3.5 g/dL (odds ratio, 4.81; 95% confidence interval, 2.19-10.59), body mass index (BMI) ≥ 18.5 kg/m2 (4.17; 1.10-15.85), and systolic blood pressure (SBP) ≥ 110 mmHg (2.66; 1.12-6.28). In patients with HFrEF, the proportion of HF medications not initiated simultaneously with SV was significantly higher in the continuation group than in the discontinuation group (67.3% vs 33.3%, P = 0.002). The number of HF medications and their combination patterns were not significantly associated with SV continuation. Conclusion and Relevance: Albumin, BMI, and SBP are useful indicators for selecting patients who are likely to continue SV. In addition, initiating only SV without simultaneously initiating other HF medications in patients with HFrEF may lead to SV continuation.
A Retrospective Cohort Analysis Comparing the Costs of Ankle Fracture Fixation in Orthopaedics and Podiatry in a U.S. Medicare Limited Data Set
Authors: Meyers James , Campbell Peter , Lieber Alexander , Luginbuhl Joshua , Zubizarreta Nicole , Gokcen Eric , Poeran Jashvant , Kelly Meghan 
Published: September 2024

Background: Increasing overlap exists between surgeries performed by podiatrists and orthopaedic surgeons. Large-scale cost comparisons between the two are lacking despite the current climate of cost containment in health care. Using national Medicare data, we aimed to compare per-case Medicare payments between podiatrists and orthopaedic surgeons for ankle fracture fixation. Methods: This retrospective cohort study included patients in an outpatient setting undergoing either unimalleolar, bimalleolar, or trimalleolar ankle fracture repair from the national Medicare Limited Data Set (2013-2019). Type of surgeon (podiatrist or orthopaedic surgeon) was determined using publicly available information. The primary outcome was total Medicare payments specific to the procedure, as a surrogate for cost. A subset analysis was also done to directly compare costs of orthopaedic surgeons to podiatric surgeons while excluding other fees (eg, hospital facility fees and surgery-related imaging payments). Additionally, patient demographics and hospital characteristics were compared to determine if any factors associated with costs may influence group differences. Univariable tests assessed significance of group differences. Results: Overall, 16 927 unimalleolar, 17 244 bimalleolar, and 11 717 trimalleolar fracture repairs were included; 86.7% and 13.3%, 92.4% and 7.6%, and 92.2% and 7.8% were performed by an orthopaedic surgeon or podiatrist, respectively. Median age (70-71 years) and median Charlson-Deyo Comorbidity Index (0) did not significantly differ between patients treated by either surgeon type. Median procedure-specific Medicare payments for all 3 categories of ankle fracture repairs (uni-, bi-, trimalleolar) were significantly lower for orthopaedic surgeons compared to podiatrists: $4156 vs $4300, $4205 vs $4379, and $4396 vs $4525, respectively (all P < .001). Conclusion: Our investigation using a national Medicare data set (2013-2019) found that the 3 types of ankle fractures (unimalleolar, bimalleolar, and trimalleolar) performed by orthopaedic surgeons in an outpatient setting were less expensive and that cost differences do not appear to be driven by patient characteristics. These results and further research into the causes of the cost differences may help improve the cost-effectiveness of ankle fracture surgery.
Green synthesis of antipathogenic particles by utilizing the citrus plant waste and their application in medicated fabrics
Authors: Ali Shaukat , Rasul Akhtar , Shah Pervaiz Akhtar , Al-Rawi Mahmood BA , Naseem Misbah 
Published: September 2024

Antipathogenic fabrics coated with different types of metallic nanoparticles were developed for the use in healthcare sector. The citrus plant waste was collected and processed to extract the bioactive molecules for the green synthesis of metal particles. Here, the citrus extract was used for a dual purpose, as a bio reductant and also as a bio dispersant (D-limonene). Subsequently, the green synthesis of a highly concentrated and stable colloidal dispersion of Silver nanoparticles (Ag-NPs), Copper nanoparticles (Cu-NPs) and Zinc Oxide (ZnO-NPs) was carried out using the self-assembled respective salts and green extracted reducing agents without using any other hazardous chemicals. Furthermore, the effect of the loaded D-limonene as a dispersant was justified by PDI, Zeta potential, particle size analysis and Dynamic Light Scattering (DLS). The synthesized particles were assessed for their morphology and geometric characteristics by Scanning Electron Microscopy (SEM), revealing the formation of particles with spherical and oval shapes. The justification for the formation of particles was also analyzed by using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) techniques. In the next step, the synthesized Ag-NPs, Cu-NPs and ZnO-NPs were applied to cotton fabric and their antipathogenic properties (antibacterial, antiviral, and antifungal) before and after severe washing were characterized. It was observed that the nanoparticles applied fabric at higher concentration (5g) exhibit even covering of fiber surface, average particles sizes between 350 and 470 nm, with excellent antimicrobial activity against Escherichia coli (3.4 ± 0.35 mm) and Staphylococcus aureus (5.5 ± 0.19 mm). The untreated fabric had a log CFU/ml value of 5.43, indicating no antibacterial effectiveness of the control sample. However, the log values of all the treated samples were significantly lower. Moreover, the intensity of concentration of zinc silver and copper particles explains the 88.48 %, 85.01 % and 94.23% antifungal activity respectively. While antiviral activity (84% reduction) was also highest against copper nanoparticles coated fabric. The level of significance against antipathogenic activities among all particles coated samples was analysed by applying the statistical analysis of simple linear regression with paired t test. In addition the comfort parameters (air and water vapor permeability) for developed medicated textiles were also analyzed.
Preconception and antenatal care for women with a history of haematopoietic stem cell transplantation: Results of a UK clinician survey
Authors: Birchenall Katherine A , David Anna L , Davies Melanie , Grandage Victoria , Griffin Melanie 
Published: September 2024

Background Female childhood cancer survivors with history of bone marrow transplant with or without total body irradiation have increased pregnancy risks. Preconception counselling and early referral to appropriate clinical pathways may improve pregnancy outcomes. Methods UK-wide survey of clinicians, promoted via social media and conferences, jointly funded by Action Medical Research/Borne. Results Forty responses received between 22 October 2020 and 21 October 2021: 43% reviewed this group monthly, 15% annually, 15% less than annually, and 27% never (for O & G only: 13%, 13%, 26%, and 48%, respectively). Pre-pregnancy, most discussed potential fertility/pregnancy implications. Early pregnancy discussions included late miscarriage (34%), preterm birth (44%), fetal growth restriction (31%), and health risks other than cancer (30%). During pregnancy: 80% refer to specialist clinics; 87% offer extra investigations; 33% prescribed aspirin; 20% offered cervical cerclage; and 13% prescribed progesterone. Conclusions Evidence of variation in care. As previous observations suggest pregnancy outcomes improve when managed in specialist clinics, clearer guidance is required.