bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of rosuvastatin versus atorvastatin on new-onset diabetes mellitus in patients treated with high-intensity statin therapy for coronary artery disease: a post-hoc analysis from the LODESTAR randomized clinical trial
Authors: Hong Sung-Jin , Lee Yong-Joon , Kang Woong Chol , Hong Bum-Kee , Lee Jong-Young , Lee Jin-Bae , Yang Tae-Hyun , Yoon Junghan , Lee Seung-Jun , Ahn Chul-Min , Kim Jung-Sun , Kim Byeong-Keuk , Ko Young-Guk , Choi Donghoon , Jang Yangsoo , Hong Myeong-Ki ,   for the LODESTAR investigators
Published: August 2024

Abstract
Background
The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial.

Methods
In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization. In this post-hoc analysis, the 3-year incidence of NODM was compared between rosuvastatin and atorvastatin treatment in the as-treated population with high-intensity statin therapy as the principal population of interest.

Results
Among 2932 patients without diabetes mellitus at baseline, 2377 were included in the as-treated population analysis. In the as-treated population with high-intensity statin therapy, the incidence of NODM was not significantly different between the rosuvastatin and atorvastatin groups (11.4% [106/948] versus 8.8% [73/856], hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 0.98 to 1.77, P = 0.071). When the risk of NODM with rosuvastatin versus atorvastatin was assessed according to the achieved low-density lipoprotein cholesterol (LDL-C) level, the risk of NODM began to increase at a LDL-C level below 70 mg/dL. The incidence of NODM was significantly greater in the rosuvastatin group than it was in the atorvastatin group when the achieved LDL-C level was < 70 mg/dL (13.9% versus 8.0%; HR = 1.79, 95% CI 1.18 to 2.73, P = 0.007).

Conclusions
Among CAD patients receiving high-intensity statin therapy, the incidence of NODM was not significantly different between rosuvastatin and atorvastatin. However, a drug effect of the statin type on NODM was observed when the achieved LDL-C level was < 70 mg/dL.

Trial registration
ClinicalTrials.gov, Identifier: NCT02579499.

Graphical abstract
Shear-wave elastography as a supplementary tool for axillary staging in patients undergoing breast cancer diagnosis
Authors: Togawa Riku , Riedel Fabian , Feisst Manuel , Fastner Sarah , Gomez Christina , Hennigs André , Nees Juliane , Pfob André , Schäfgen Benedikt , Stieber Anne , Wallwiener Markus , Heil Jörg , Golatta Michael 
Published: August 2024

Abstract
Background
Preoperative evaluation of axillary lymph node status is crucial for the selection of both systemic and surgical treatment in early breast cancer. This study assessed the particular role of additional shear wave elastography (SWE) in axillary staging in patients undergoing initial breast cancer diagnostics.

Methods
One hundred patients undergoing axillary lymph node biopsy due to a sonographically suspicious axillary lymph node were prospectively evaluated with SWE using virtual touch tissue imaging quantification (VTIQ). Mean values of tissue stiffness for axillary tissue and lymph node tissue were measured prior to core-cut biopsy of the lymph node. All lymph nodes were clip-marked during the biopsy. Cut-off values to differentiate between malignant and benign lymph nodes were defined using Youden’s index.

Results
Lymph nodes with evidence of malignant tumor cells in the final pathological examination showed a significantly higher velocity as measured by SWE, with a mean velocity of 3.48 ± 1.58 m/s compared to 2.33 ± 0.62 m/s of benign lymph nodes (p < 0.0001). The statistically optimal cutoff to differentiate between malignant and benign lymph nodes was 2.66 m/s with a sensitivity of 69.8% and a specificity of 87.5%.

Conclusions
Lymph node metastases assessed with SWE showed significantly higher elasticity values compared to benign lymph nodes. Thus, SWE provides an additional useful and quantifiable parameter for the sonographic assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support the guidance of definitive biopsy work-up.

Critical relevance statement
Shear-wave elastography provides an additional useful and quantifiable parameter for the assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support guiding the definitive biopsy work-up.

Key Points

SWE is a quantifiable ultrasound parameter in breast cancer diagnosis.

SWE shows a significantly higher velocity in malignant lymph nodes.

SWE is useful in improving the sensitivity and specificity of axillary staging.

Graphical Abstract
Shunt dysfunction and mortality after transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension
Authors: Büttner Laura , Pick Lisa , Jonczyk Martin , Fehrenbach Uli , Collettini Federico , Auer Timo Alexander , Schnapauff Dirk , De Bucourt Maximilian , Wieners Gero , Gebauer Bernhard , Aigner Annette , Böning Georg 
Published: August 2024

Abstract
Objectives
Transjugular intrahepatic portosystemic shunt (TIPS) is a catheter-based, minimally invasive procedure to reduce portal hypertension. The aim of the study was to investigate dysfunction and mortality after TIPS and to identify factors associated with these events.

Methods
A retrospective analysis of 834 patients undergoing TIPS implantation in a single center from 1993–2018 was performed. Cumulative incidence curves were estimated, and frailty models were used to assess associations between potentially influential variables and time to dysfunction or death.

Results
1-, 2-, and 5-year mortality rates were 20.9% (confidence interval (CI) 17.7–24.1), 22.5% (CI 19.1–25.8), and 25.0% (CI: 21.1–28.8), 1-year, 2-year, and 5-year dysfunction rates were 28.4% (CI 24.6–32.3), 38.9% (CI 34.5–43.3), and 52.4% (CI 47.2–57.6). The use of covered stents is a protective factor regarding TIPS dysfunction (hazard ratio (HR) 0.47, CI 0.33–0.68) but does not play a major role in survival (HR 0.95, CI 0.58–1.56). Risk factors for mortality are rather TIPS in an emergency setting (HR 2.78, CI 1.19–6.50), a previous TIPS dysfunction (HR 2.43, CI 1.28–4.62), and an increased Freiburg score (HR 1.45, CI 0.93–2.28).

Conclusion
The use of covered stents is an important protective factor regarding TIPS dysfunction. Whereas previous TIPS dysfunction, emergency TIPS implantation, and an elevated Freiburg score are associated with increased mortality. Awareness of risk factors could contribute to a better selection of patients who may benefit from a TIPS procedure and improve clinical follow-up with regard to early detection of thrombosis/stenosis.

Critical relevance statement
The use of covered stents reduces the risk of dysfunction after transjugular intrahepatic portosystemic shunt (TIPS). TIPS dysfunction, emergency TIPS placement, and a high Freiburg score are linked to higher mortality rates in TIPS patients.

Key Points

The risk of dysfunction is higher for uncovered stents compared to covered stents.

Transjugular intrahepatic portosystemic shunt dysfunction increases the risk of instantaneous death after the intervention.

A higher Freiburg score increases the rate of death after the intervention.

Transjugular intrahepatic portosystemic shunt implantations in emergency settings reduce survival rates.

Graphical Abstract
How do deep-learning models generalize across populations? Cross-ethnicity generalization of COPD detection
Authors: D. Almeida Silvia , Norajitra Tobias , Lüth Carsten T. , Wald Tassilo , Weru Vivienn , Nolden Marco , Jäger Paul F. , von Stackelberg Oyunbileg , Heußel Claus Peter , Weinheimer Oliver , Biederer Jürgen , Kauczor Hans-Ulrich , Maier-Hein Klaus 
Published: August 2024

Abstract
Objectives
To evaluate the performance and potential biases of deep-learning models in detecting chronic obstructive pulmonary disease (COPD) on chest CT scans across different ethnic groups, specifically non-Hispanic White (NHW) and African American (AA) populations.

Materials and methods
Inspiratory chest CT and clinical data from 7549 Genetic epidemiology of COPD individuals (mean age 62 years old, 56–69 interquartile range), including 5240 NHW and 2309 AA individuals, were retrospectively analyzed. Several factors influencing COPD binary classification performance on different ethnic populations were examined: (1) effects of training population: NHW-only, AA-only, balanced set (half NHW, half AA) and the entire set (NHW + AA all); (2) learning strategy: three supervised learning (SL) vs. three self-supervised learning (SSL) methods. Distribution shifts across ethnicity were further assessed for the top-performing methods.

Results
The learning strategy significantly influenced model performance, with SSL methods achieving higher performances compared to SL methods (p < 0.001), across all training configurations. Training on balanced datasets containing NHW and AA individuals resulted in improved model performance compared to population-specific datasets. Distribution shifts were found between ethnicities for the same health status, particularly when models were trained on nearest-neighbor contrastive SSL. Training on a balanced dataset resulted in fewer distribution shifts across ethnicity and health status, highlighting its efficacy in reducing biases.

Conclusion
Our findings demonstrate that utilizing SSL methods and training on large and balanced datasets can enhance COPD detection model performance and reduce biases across diverse ethnic populations. These findings emphasize the importance of equitable AI-driven healthcare solutions for COPD diagnosis.

Critical relevance statement
Self-supervised learning coupled with balanced datasets significantly improves COPD detection model performance, addressing biases across diverse ethnic populations and emphasizing the crucial role of equitable AI-driven healthcare solutions.

Key Points

Self-supervised learning methods outperform supervised learning methods, showing higher AUC values (p < 0.001).

Balanced datasets with non-Hispanic White and African American individuals improve model performance.

Training on diverse datasets enhances COPD detection accuracy.

Ethnically diverse datasets reduce bias in COPD detection models.

SimCLR models mitigate biases in COPD detection across ethnicities.

Graphical Abstract
Nocardamine mitigates cellular dysfunction induced by oxidative stress in periodontal ligament stem cells
Authors: He Hai-Peng , Zhao Mei-Zhen , Jiao Wei-Hua , Liu Zhi-Qiang , Zeng Xian-Hai , Li Quan-Li , Hu Tian-Yong , Cheng Bao-Hui 
Published: August 2024

AbstractBackgroundThe role of periodontal ligament stem cells (PDLSCs) in repairing periodontal destruction is crucial, but their functions can be impaired by excessive oxidative stress (OS). Nocardamine (NOCA), a cyclic siderophore, has been shown to possess anti-cancer and anti-bacterial properties. This study aimed to investigate the protective mechanisms of NOCA against OS-induced cellular dysfunction in PDLSCs.MethodsThe cytotoxicity of NOCA on PDLSCs was assessed using a CCK-8 assay. PDLSCs were then treated with hydrogen peroxide (H2O2) to induce OS. ROS levels, cell viability, and antioxidant factor expression were analyzed using relevant kits after treatment. Small molecule inhibitors U0126 and XAV-939 were employed to block ERK signaling and Wnt pathways respectively. Osteogenic differentiation was assessed using alkaline phosphatase (ALP) activity staining and Alizarin Red S (ARS) staining of mineralized nodules. Expression levels of osteogenic gene markers and ERK pathway were determined via real-time quantitative polymerase chain reaction (RT-qPCR) or western blot (WB) analysis. β-catenin nuclear localization was examined by western blotting and confocal microscopy.ResultsNOCA exhibited no significant cytotoxicity at concentrations below 20 µM and effectively inhibited H2O2-induced OS in PDLSCs. NOCA also restored ALP activity, mineralized nodule formation, and the expression of osteogenic markers in H2O2-stimulated PDLSCs. Mechanistically, NOCA increased p-ERK level and promoted β-catenin translocation into the nucleus; however, blocking ERK pathway disrupted the osteogenic protection provided by NOCA and impaired its ability to induce β-catenin nuclear translocation under OS conditions in PDLSCs.ConclusionsNOCA protected PDLSCs against H2O2-induced OS and effectively restored impaired osteogenic differentiation in PDLSCs by modulating the ERK/Wnt signaling pathway.
The impact of targeted local outreach clinics to improve COVID-19 vaccine uptake: controlled interrupted time series in South West England
Authors: Jones Tim , Adamali Huzaifa , Redaniel Maria Theresa , de Vocht Frank , Tilling Kate , Kenward Charlie , Ben-Shlomo Yoav , Creavin Sam 
Published: August 2024

Abstract
Background
Outreach clinics were part of efforts to maximise uptake in COVID-19 vaccination.

Methods
We used controlled interrupted time series, matching on age, sex, deprivation and vaccination eligibility date, to determine the effect of outreach clinics on time to first COVID-19 vaccine, using a population-based electronic health record database of 914,478 people, from December 2020 to December 2021; people living within 1 mile of each outreach clinics were exposed.

Results
50% of 288,473 exposed citizens were white British, and 71% were aged 0–49 years. There was no evidence for an overall statistically significant increase in cumulative percentage vaccinated due to the outreach clinic at 6 weeks, with an overall pooled effect estimate of -0.07% (95% CI: -1.15%, 1.02%). The pooled estimate for increased cumulative vaccine uptake varied slightly depending on how the analysis was stratified; by ethnic group it was − 0.12% (95% CI: -0.90%, 0.66%); by age group it was − 0.06% (95% CI: -0.41%, 0.28%); and by deprivation it was 0.03% (95% CI: -0.74%, 0.79%).

Conclusions
Living within a mile of an outreach clinic was not associated with higher vaccine uptake. Evaluation of future outreach clinics should consider the relative importance of travel amongst other barriers to accessing vaccines.
Peri-urban dynamics: assessing expansion patterns and influencing factors
Authors: Haldar Subrata , Chatterjee Uday , Bhattacharya Subhasis , Paul Suman , Bindajam Ahmed Ali , Mallick Javed , Abdo Hazem Ghassan 
Published: August 2024

Abstract
Background
Peri-urbanization, the expansion of large metropolitan centers into adjacent peri-urban regions, is a growing concern due to land scarcity and escalating housing costs. These zones, a blend of rural and urban features, blur the line between urban and rural areas, creating new landscapes. This study examines historical, present, and potential growth trends in the peri-urban area surrounding Durgapur Municipal Corporation (DMC). Analytical techniques and spatial metrics are used to track development intensity changes over time, including built-up density, Shannon’s entropy, Landscape expansion index, Average Weighted Mean Expansion Index, Annual Built-Up Expansion Rate, Built-Up Expansion Intensity Index, and Built-Up Expansion Difference Index. Landscape indices like Patch Density, Edge Density, Landscape Shape Index, Largest Patch Index, Ratio of Open Space, and Area Weighted Mean Patch Fractal are used to understand fragmentation, connectivity, and spatial relationships. The Logistic Regression Model (LRM) is used to identify influencing factors and CA-Markov modeling for future built-up areas.

Results
Between 1991 and 2001, built-up area in the region increased significantly, primarily due to urban development near industrial zones, roadways, and mining areas. The growth was primarily concentrated in the western sector and near National Highway-2 (NH-2). Urban sprawl was a continuous trend, with the highest built-up density in the South-South-East (SSE) direction from 1991 to 2011. Additionally, a key determinant of built-up development was the distance to the city core. By 2031, the built-up area is expected to concentrate in the western and southeast regions, reaching 177.90 km2.

Conclusions
This expansion is attributed to urban development near industrial zones, roadways, mining areas, and other infrastructure. The study identifies distance to the city center as a significant influencing factor for built-up development. The results emphasize the need for inclusive urban planning methods prioritizing sustainable development principles and prudent resource management for future growth and efficient management in the DMC’s peri-urban area.
Transcriptomic changes and gene fusions during the progression from Barrett’s esophagus to esophageal adenocarcinoma
Authors: Fu Yusi , Agrawal Swati , Snyder Daniel R. , Yin Shiwei , Zhong Na , Grunkemeyer James A. , Dietz Nicholas , Corlett Ryan , Hansen Laura A. , Waddah Al-Refaie , Nandipati Kalyana C. , Xia Jun 
Published: August 2024

AbstractThe incidence of esophageal adenocarcinoma (EAC) has surged by 600% in recent decades, with a dismal 5-year survival rate of just 15%. Barrett’s esophagus (BE), affecting about 2% of the population, raises the risk of EAC by 40-fold. Despite this, the transcriptomic changes during the BE to EAC progression remain unclear. Our study addresses this gap through comprehensive transcriptomic profiling to identify key mRNA signatures and genomic alterations, such as gene fusions. We performed RNA-sequencing on BE and EAC tissues from 8 individuals, followed by differential gene expression, pathway and network analysis, and gene fusion prediction. We identified mRNA changes during the BE-to-EAC transition and validated our results with single-cell RNA-seq datasets. We observed upregulation of keratin family members in EAC and confirmed increased levels of keratin 14 (KRT14) using immunofluorescence. More differentiated BE marker genes are downregulated during progression to EAC, suggesting undifferentiated BE subpopulations contribute to EAC. We also identified several gene fusions absent in paired BE and normal esophagus but present in EAC. Our findings are critical for the BE-to-EAC transition and have the potential to promote early diagnosis, prevention, and improved treatment strategies for EAC.
Evidence-based scientific thinking and decision-making in everyday life
Authors: Dawson Caitlin , Julku Hanna , Pihlajamäki Milla , Kaakinen Johanna K. , Schooler Jonathan W. , Simola Jaana 
Published: August 2024

AbstractIn today’s knowledge economy, it is critical to make decisions based on high-quality evidence. Science-related decision-making is thought to rely on a complex interplay of reasoning skills, cognitive styles, attitudes, and motivations toward information. By investigating the relationship between individual differences and behaviors related to evidence-based decision-making, our aim was to better understand how adults engage with scientific information in everyday life. First, we used a data-driven exploratory approach to identify four latent factors in a large set of measures related to cognitive skills and epistemic attitudes. The resulting structure suggests that key factors include curiosity and positive attitudes toward science, prosociality, cognitive skills, and openmindedness to new information. Second, we investigated whether these factors predicted behavior in a naturalistic decision-making task. In the task, participants were introduced to a real science-related petition and were asked to read six online articles related to the petition, which varied in scientific quality, while deciding how to vote. We demonstrate that curiosity and positive science attitudes, cognitive flexibility, prosociality and emotional states, were related to engaging with information and discernment of evidence reliability. We further found that that social authority is a powerful cue for source credibility, even above the actual quality and relevance of the sources. Our results highlight that individual motivating factors toward information engagement, like curiosity, and social factors such as social authority are important drivers of how adults judge the credibility of everyday sources of scientific information.
Exploring the association of serum prolactin with serum glucose levels and clinical findings in a cohort of patients with early rheumatoid arthritis
Authors: Bandeira de Santana Lidiana , de Souza Lima Thomas Alves , Costa Amanda Rodrigues , Sandoval Leticia Assad Maia , de Souza Talita Yokoy , da Mota Licia Maria Henrique , Naves Luciana Ansaneli 
Published: August 2024

Abstract
Background
In the context of rheumatoid arthritis and its systemic inflammatory implications, there is an increasing interest in investigating the role of prolactin in the clinical and metabolic aspects of the disease. This study aimed to explore the potential links between serum prolactin levels, serum glucose levels, and the clinical manifestations of arthritis.

Methods
This exploratory, cross-sectional, observational study focused on women diagnosed with rheumatoid arthritis. The research involved assessing prolactin and blood glucose concentrations, alongside specific clinical traits such as disease-related inflammation, morning stiffness, and fatigue intensity. The presence of changes in serum prolactin (PRL) was initially compared among the groups based on disease activity intensity. Using a multinomial regression analysis, the study analyzed the impact of predetermined clinical and metabolic factors on various categories of prolactin concentration.

Results
Out of the 72 participants included in the study, hyperprolactinemia was detected in 9.1% of the sample. No differences in serum PRL were identified among the evaluated groups based on disease activity. Following multivariate analysis, no statistically significant differences were identified for the outcomes of inflammatory activity and morning stiffness within each PRL category when compared to the reference category for PRL. There was no increased likelihood of encountering blood glucose levels below 100 mg/dl among individuals with higher prolactin concentrations compared to those in the lowest prolactin category (OR 5.43, 95% CI 0.51–58.28). The presence of clinically significant fatigue revealed a higher likelihood of encountering this outcome among patients with intermediate PRL values (prolactin categories 7.76–10.35 with OR 5.18, 95% CI 1.01–26.38 and 10.36–15.29 with OR 6.25, 95% CI 1.2–32.51) when compared to the reference category.

Conclusions
The study found no discernible correlation between prolactin concentrations and worse scores for inflammatory activity of the disease, nor between prolactin concentrations and serum glucose levels. The findings regarding fatigue should be approached with caution given the exploratory nature of this study.