bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evolving contribution of MRI measures towards the prediction of secondary progressive multiple sclerosis
Authors: Ananthavarathan Piriyankan , Sahi Nitin , Chung Karen , Haider Lukas , Prados Ferran , Trip S Anand , Ciccarelli Olga , Barkhof Frederik , Tur Carmen , Chard Declan T 
Published: July 2024

BackgroundIn multiple sclerosis (MS), both lesion accrual and brain atrophy predict clinical outcomes. However, it is unclear whether these prognostic features are equally relevant throughout the course of MS. Among 103 participants recruited following a clinically isolated syndrome (CIS) and followed up over 30 years, we explored (1) whether white matter lesions were prognostically more relevant earlier and brain atrophy later in the disease course towards development of secondary progressive (SP) disease; (2) if so, when the balance in prognostic contribution shifts and (3) whether optimised prognostic models predicting SP disease should include different features dependent on disease duration.MethodsBinary logistic regression models were built using age, gender, brain lesion counts and locations, and linear atrophy measures (third ventricular width and medullary width) at each time point up to 20 years, using either single time point data alone or adjusted for baseline measures.ResultsBy 30 years, 27 participants remained CIS while 60 had MS (26 SPMS and 16 MS-related death). Lesions counts were prognostically significant from baseline and at all later time points while linear atrophy measure models reached significance from 5 years. When adjusted for baseline, in combined MRI models including lesion count and linear atrophy measures, only lesion counts were significant predictors. In combined models including relapse measures, Expanded Disability Status Scale scores and MRI measures, only infratentorial lesions were significant predictors throughout.ConclusionsWhile SPMS progression is associated with brain atrophy, in predictive models only infratentorial lesions were consistently prognostically significant.
Critical reviews of exposure assessment in carcinogenic hazard identification: the IARCMonographsexperience
Authors: Middleton Daniel R S , Wedekind Roland , Hall Amy L , Suonio Eero , DeBono Nathan , Vermeulen Roel , Fritschi Lin , Stewart Patricia A , Schubauer-Berigan Mary K 
Published: July 2024

ObjectivesTo summarise the rationale, workflow and recommendations for the conduct of exposure assessment critiques in key human studies evaluated for International Agency for Research on Cancer (IARC)Monographson the Identification of Carcinogenic Hazards.MethodsApproaches to evaluating exposure assessment quality in human cancer and mechanistic studies were reviewed according to the precepts outlined in the IARCMonographsPreamble, using two agents as case studies. Exposure assessment ‘domains’, that is, salient aspects of exposure assessment for the agent under evaluation, were selected for review across the key human studies.ResultsThe case studies of night shift work (volume 124) and 1,1,1-trichloroethane (volume 130) used a common approach, tailored to the agents’ specific exposure scenarios, to evaluate exposure assessment quality. Based on the experiences of IARC Working Groups to date, the implementation of exposure assessment critique requires the need for agent-specific knowledge, consideration of the validity of time-varying exposure metrics related to duration and intensity, and transparent, concise reviews that prioritise the most important strengths and limitations of exposure assessment methods used in human studies.ConclusionsExposure assessment has not historically been a fully appreciated component for evaluating the quality of epidemiological studies in cancer hazard identification. Exposure assessment critique in key human cancer and mechanistic studies is now an integral part of IARCMonographsevaluations and its conduct will continue to evolve as new agents are evaluated. The approaches identified here should be considered as a potential framework by others when evaluating the exposure assessment component of epidemiological studies for systematic reviews.
Bitter taste of the tobacco industry interference in Brazil
Authors: Szklo André Salem , Carvalho Adriana , Coutinho Marques de Pinho Mariana , Carvalho de Souza Mirian , Bertoni Neilane , Luiz Oliveira da Silva Andre 
Published: July 2024

ObjectiveAlthough Brazil became the first country worldwide to ban the sale of all tobacco products with any additive that could alter their flavours and tastes in 2012, its implementation was effectively halted by tobacco industry lawsuits, including a constitutional challenge filed in the Federal Supreme Court in 2013. This study aimed at examining, for the first time in the country, the evolution over time of the new registrations of tobacco products with additives that would have been banned if not for the tobacco industry’s interference (’counterfactual scenario’).MethodsWe used the newly available public database on the registration of tobacco products developed by the Health Regulatory Agency (from 2008 onwards). All types of tobacco products intended for the domestic market that contained ‘banned additives in a counterfactual scenario’ and were registered between January 1 and December 31 of each year were selected.ResultsBetween 2012 and 2023, a total of 1112 new registrations of tobacco products with ‘banned additives’ were recorded. The spread of hookah tobacco registrations started in 2014, and by 2023, the cumulative incidence of registrations containing ‘banned additives’ was 641. Both manufactured cigarettes and hookah products reached their peaks in new registrations in 2020.ConclusionsAfter 12 years since the resolution intended to ban all additives that change the aroma and taste of tobacco products in Brazil, primarily to prevent smoking initiation, the tobacco industry’s interference continues to successfully block its implementation. Countries facing similar challenges in tobacco control could consider generating comparable national data that might help expose the adverse impacts of tobacco industry interference on public health.
Exploration of soliton structures in the Hirota–Maccari system with stability analysis
Authors: Alam Noor , Ma Wen-Xiu , Ullah Mohammad Safi , Seadawy Aly R. , Akter Mahinur 
Published: July 2024

In this research, the modified extended tanh-function (METF) and the extended Jacobi elliptic function expansion (EJEFE) techniques are used to investigate the generation and detection of soliton structures in the Hirota–Maccari (HM) model. Consequently, we obtain soliton solutions with advanced structures, including singular bright soliton, dark soliton, periodic waves, breather waves, periodic breather waves, and multiple bright and dark breather waves. In addition, a lump-type breather wave is also included in the presented solutions. Stability analysis of the obtained solutions is addressed by employing the Hamiltonian technique. 3D surfaces and 2D visuals of the outcomes are represented with the help of a computer application. These findings contribute to understanding nonlinear wave phenomena with potential applications in optics, fluid dynamics, and plasma physics.
Discordant High Remnant Cholesterol With LDL-C Increases the Risk of Stroke: A Chinese Prospective Cohort Study
Authors: Han Minghui , Huang Keyong , Shen Chong , Hu Hongyue , Liu Fangchao , Li Jianxin , Yang Xueli , Chen Jichun , Liu Xiaoqing , Cao Jie , Chen Shufeng , Yu Ling , Zhao Yingxin , Wu Xianping , Zhao Liancheng , Li Ying , Hu Dongsheng , Huang Jianfeng , Lu Xiangfeng , Gu Dongfeng 
Published: July 2024

BACKGROUND:
Previous studies focusing on assessing the effects of remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-C) on stroke may not consider their mutual influence. We aimed to explore the associations of RC and discordant high RC with LDL-C with stroke, ischemic stroke (IS), and hemorrhagic stroke.

METHODS:
This prospective cohort study was conducted based on 3 cohorts of the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. RC was calculated as non–high-density lipoprotein cholesterol minus LDL-C estimated by Martin/Hopkins equations. Concordant/discordant categories for RC versus LDL-C were determined based on cut-points of 130 mg/dL for LDL-C and equivalent percentile (32.50 mg/dL) for RC. Cox models were used to estimate adjusted hazard ratios and 95% CIs for incident stroke.

RESULTS:
Among 113 448 participants recruited at baseline, a total of 98 967 participants were eligible for the final analysis (mean age of 51.44 years; 40.45% were men). During 728 776.87 person-years of follow-up, 2859 stroke cases, 1811 IS cases, and 849 hemorrhagic stroke cases were observed. RC was positively associated with stroke and IS, but not hemorrhagic stroke, with adjusted hazard ratios (95% CIs) of 1.06 (1.02–1.10), 1.09 (1.04–1.13), and 0.95 (0.88–1.03) for per SD increase in RC. Compared with low LDL-C/low RC group, low LDL-C/high RC group had higher risks of stroke (adjusted hazard ratio, 1.15 [95% CI, 1.02–1.30]) and IS (1.19, 1.03–1.38), while high LDL-C/low RC group had no increased risk of stroke (1.07 [0.95–1.20]) and IS (1.09 [0.94–1.25]).

CONCLUSIONS:
Higher RC was associated with increased risks of stroke and IS but not hemorrhagic stroke. Discordantly high RC, not discordantly high LDL-C, conferred higher risks of stroke and IS. Our findings support further lowering RC by interventions to reduce residual IS risk.
Gradual change of cortical representations with growing visual expertise for synthetic shapes
Authors: Kakaei Ehsan , Braun Jochen 
Published: July 2024

Abstract
Objective: Visual expertise for particular categories of objects (e.g., mushrooms, birds, flowers, minerals, and so on) is known to enhance cortical responses in parts of the ventral occipitotemporal cortex. How is such additional expertise integrated into the prior cortical representation of life-long visual experience? To address this question, we presented synthetic visual objects rotating in three dimensions and recorded multivariate BOLD responses as initially unfamiliar objects gradually became familiar.
Main results: An analysis of pairwise distances between multivariate BOLD responses (“representational similarity analysis,” RSA) revealed that visual objects were linearly discriminable in large parts of the ventral occipital cortex, including the primary visual cortex, as well as in certain parts of the parietal and frontal cortex. These cortical representations were present from the start, when objects were still unfamiliar, and even though objects were shown from different sides. As shapes became familiar with repeated viewing, the distribution of responses expanded to fill more of the available space. In contrast, the distribution of responses to novel shapes (which appeared only once) contracted and shifted to the margins of the available space.
Conclusion: Our results revealed cortical representations of object shape and gradual changes in these representations with learning and consolidation. The cortical representations of once-viewed shapes that remained novel diverged dramatically from repeatedly viewed shapes that became familiar. This disparity was evident in both the similarity and the diversity of multivariate BOLD responses.
The relationship between visual acuity loss and GABAergic inhibition in amblyopia
Authors: Ip I. Betina , Clarke William T. , Wyllie Abigail , Tracey Kathleen , Matuszewski Jacek , Jbabdi Saad , Starling Lucy , Templer Sophie , Willis Hanna , Breach Laura , Parker Andrew J. , Bridge Holly 
Published: July 2024

Abstract
Early childhood experience alters visual development, a process exemplified by amblyopia, a common neurodevelopmental condition resulting in cortically reduced vision in one eye. Visual deficits in amblyopia may be a consequence of abnormal suppressive interactions in the primary visual cortex by inhibitory neurotransmitter γ-aminobutyric acid (GABA). We examined the relationship between visual acuity loss and GABA+ in adult human participants with amblyopia. Single-voxel proton magnetic resonance spectroscopy (MRS) data were collected from the early visual cortex (EVC) and posterior cingulate cortex (control region) of 28 male and female adults with current or past amblyopia while they viewed flashing checkerboards monocularly, binocularly, or while they had their eyes closed. First, we compared GABA+ concentrations between conditions to evaluate suppressive binocular interactions. Then, we correlated the degree of visual acuity loss with GABA+ levels to test whether GABAergic inhibition could explain visual acuity deficits. Visual cortex GABA+ was not modulated by viewing condition, and we found weak evidence for a negative correlation between visual acuity deficits and GABA+. These findings suggest that reduced vision in one eye due to amblyopia is not strongly linked to GABAergic inhibition in the visual cortex. We advanced our understanding of early experience dependent plasticity in the human brain by testing the association between visual acuity deficits and visual cortex GABA in amblyopes of the most common subtypes. Our study shows that the relationship was not as clear as expected and provides avenues for future investigation.
Axial Ablation versus Terminal Interruption of the Reflux Source (AAVTIRS): A Randomised Controlled Trial
Authors: CR Keohane , D Westby , M Twyford , T Aherne , W Tawfick , SR Walsh 
Published: July 2024

Introduction Treatment of reflux has been shown to improve time to healing of Venous Leg Ulcers (VLU). Terminal Interruption of the Reflux Source (TIRS) treats reflux within the plexus of veins around an active VLU using foam sclerotherapy. The efficacy of TIRS in managing VLU has never been tested. Methods We performed a pragmatic, single centre, assessor-blinded, randomised controlled trial comparing endovenous ablation of the axial superficial veins (Axial Ablation-AA) vs TIRS. Patients of any age with VLU of any duration were eligible. Results 98 Participants were randomised to AA or TIRS. 39/55, 70.9% (95%CI; 57.1-82.37) healed their VLU in the AA group, while 29/39, 74.36% (95%CI; 57.87-86.96) healed their VLU in the TIRS group, P = 0.45.4 were lost to follow-up. Median time to ulcer healing was 84 days (95%CI; 74.67-93.33) in the axial ablation group and 84 days (95%CI; 73.02-94.98) in the TIRS group. Hazard Ratio for ulcer healing with AA vs TIRS was 0.96 (95%CI 0.59-1.56). There were no significant quality of life differences. Conclusion The AAVTIRS trial did not show that axial ablation was superior to TIRS in the primary outcome of number of VLU healed in 6 months, or time to VLU healing. This trial is not powered to show non-inferiority. TIRS is a viable option for treatment of VLU. Further investigation is necessary before it can be recommended as an alternative to axial ablation. Trial registered at clinicaltrials.gov NCT04484168.
Treatment of Medial Patellar Instability With Bipolar Patellofemoral Cartilage Lesions: Staged De-rotational Distal Femoral Osteotomy Followed by Bipolar Osteochondral Allograft Transplantation and Tibial-Tubercle Osteotomy
Authors: Lurie Benjamin , Hatch George F. 
Published: July 2024

Background: Patellar instability with symptomatic cartilage lesions in young patients is a challenging problem to treat. The use of osteotomies to correct malalignment and fresh osteochondral allograft transplantation (OCA) to address cartilage lesions and patellofemoral dysplasia is a viable treatment option for carefully selected patients. Indications: The patient is a 22-year-old woman with medial patellar instability caused by iatrogenic distal femoral external rotation and uncontained grade IV patellofemoral lesions. The patient was indicated for OCA because the lesions were too large for an osteochondral autograft transfer system (OATS) and were uncontained and not amenable to autologous chondrocyte implantation. Bipolar OCA also addresses the patient’s patellofemoral dysplasia by restoring a more morphologically normal patellofemoral joint. The external rotation and mild varus deformity are corrected with a biplanar distal femoral osteotomy. Correction of malalignment is necessary prior to OCA transplantation to avoid abnormal graft loading and thereby decrease the risk of graft failure. Technique Description: (1) Diagnostic arthroscopy and fluoroscopic examination under anesthesia. (2) Lateral closing wedge de-rotational distal femoral osteotomy. (3) Bipolar OCA with tibial tubercle osteotomy and removal of hardware. Results: In this case, the patient had significant improvement in her symptoms and had full knee range of motion with a normal gait at 3 months after surgery. Depending on a patient’s preoperative function and the specific pathology, full recovery can take considerably longer. A successful outcome is considered return to activities of daily living without significant pain. Return to higher level athletic activities is significantly more unpredictable. Graft survival of bipolar patellofemoral OCA is variable, and the literature is limited by the small number of procedures performed, but published series range from 60% to 85% at 5 years. Discussion/Conclusion: A successful outcome in these unique, complex cases depends on good patient selection, preoperative planning, and surgical execution. Patellar instability can be reliably treated when the predisposing anatomical factors are appropriately corrected. Bipolar OCA can provide significant improvement in pain and function, but continues to have the highest rate of graft failure compared with other sites within the knee, and should be considered a salvage operation for patients with significant limitations in activities of daily living. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Gut microbiota in preterm infants with late-onset sepsis and pneumonia: a pilot case-control study
Authors: Ma Ye , Peng Xiaoming , Zhang Juan , Zhu Yulian , Huang Ruiwen , Li Guinan , Wu Yunqin , Zhou Changci , You Jiajia , Fang Siwei , Xiang Shiting , Qiu Jun 
Published: July 2024

Abstract
Background
Late-onset sepsis (LOS) and pneumonia are common infectious diseases, with high morbidity and mortality in neonates. This study aimed to investigate the differences in the gut microbiota among preterm infants with LOS, or pneumonia, and full-term infants. Furthermore, this study aimed to determine whether there is a correlation between intestinal pathogenic colonization and LOS.

Methods
In a single-center case‒control study, 16 S rRNA gene sequencing technology was used to compare gut microbiota characteristics and differences among the LOS group, pneumonia group, and control group.

Results
Our study revealed that the gut microbiota in the control group was more diverse than that in the LOS group and pneumonia group (P < 0.05). No significant differences in diversity were detected between the LOS and pneumonia groups (P > 0.05). Compared with the control group, the abundances of Akkermansia, Escherichia/Shigella, and Enterococcus increased, while the abundances of Bacteroides and Stenotrophomonas decreased in the LOS and pneumonia groups. The pathogenic bacteria in infants with LOS were consistent with the distribution of the main bacteria in the intestinal microbiota. An increase in Escherichia/Shigella abundance may predict a high risk of LOS occurrence, with an area under the curve (AUC) of 0.773.

Conclusion
Changes in the gut microbiota composition were associated with an increased risk of LOS and pneumonia. The dominant bacteria in the gut microbiota of the LOS group were found to be associated with the causative pathogen of LOS. Moreover, preterm infants exhibiting an elevated abundance of Escherichia/Shigella may be considered potential candidates for predicting the onset of LOS.
An investigation on the prevalence and patterns of multi-morbidity among a group of slum-dwelling older women of Kolkata, India
Authors: Ghosh Anushka , Mukhopadhyay Susmita , Mukhopadhyay Barun 
Published: July 2024

Abstract
Background
Multi-morbidity is a pervasive and growing issue worldwide. The prevalence of multi-morbidity varies across different populations and settings, but it is particularly common among older adults. It poses substantial physical, psychological, and socio-economic burdens on individuals, caregivers and healthcare systems. In this context, the present study aims to provide an insight on the prevalence and degree of multi-morbidity; and also, on the relationship between level of multi-morbidity and morbid conditions among a group of slum-dwelling older women.

Methods
This community based cross-sectional study was conducted in the slum areas of urban Kolkata, West Bengal, India. It includes total 500 older women, aged 60 years or above. Pre-tested schedules on so-demographic and morbidity profile have canvassed to obtain the information by door-to-door survey. To determine the relationship between the level of multi-morbidity and morbid conditions, correspondence analysis has performed.

Results
The study revealed three most prevalent morbid conditions- back and/or joint pain, dental caries/cavity and hypertension. The overall prevalence of multi-morbidity was 95.8% in this group of older women. It was highly over-represented by the oldest-old age group (80 years and above). Majority were found to suffer from five simultaneous morbid conditions that accounted for 15.2% of the total respondents. All of the oldest-old women of this study reported to suffer from more than two medical conditions simultaneously. Three distinct groups were formed based on the inter-relationship between level of multi-morbidity and morbid conditions. The group 1 and 2 represents only 27.8% and 18% of the total sample. Whereas, group 3 comprises the highest level of morbidities (≥ 6) and 52.8% of total sample, and strongly related with general debilities, cardiac problems, asthma/COPD, gastrointestinal, musculoskeletal problems, neurological disorders, hypothyroidism and oral health issues.

Conclusion
The findings confirmed the assertion that multi-morbidity in slum living older adults is a problem with high prevalence and complexity. This study proposes an easily replicable approach of understanding complex interaction of morbidities that can help further in identifying the healthcare needs of older adults to provide them with healthy and more productive life expectancy.