bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy and childbirth in Takayasu arteritis in Japan: A nationwide retrospective study
Authors: Miyamae Takako , Manabe Yusuke , Sugihara Takahiko , Umezawa Natsuka , Yoshifuji Hajime , Tamura Naoto , Abe Yoshiyuki , Furuta Shunsuke , Nagafuchi Hiroko , Ishizaki Jun , Nakano Naoko , Atsumi Tatsuya , Karino Kohei , Amano Koichi , Kurasawa Takahiko , Ito Shuichi , Yoshimi Ryusuke , Ogawa Noriyoshi , Banno Shogo , Naniwa Taio , Ito Satoshi , Hara Akinori , Hirahara Shinya , Uchida Haruhito A , Onishi Yasuhiro , Murakawa Yohko , Komagata Yoshinori , Nakaoka Yoshikazu , Harigai Masayoshi 
Published: August 2024

ABSTRACT

Objectives
This study aimed to understand the status quo of medical treatments and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children’s birth outcomes.

Methods
This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis.

Results
This study enrolled 51 cases and 68 pregnancies during 2019–21. Of these, 48 cases and 65 pregnancies resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31 years, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. TAK relapsed in four (6.2%) and eight (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low-birth-weight infants were observed, and none had serious postnatal abnormalities.

Conclusions
Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in &lt;20% of pregnancies.
Unveiling the arthritis divide: Exploring treatment response and impact in late-onset vs. young-onset rheumatoid arthritis
Authors: Hao Nariaki , Ishikawa Hajime , Abe Asami , Sudo Masanori , Takamura Sayuri , Otani Hiroshi , Ito Satoshi , Nakazono Kiyoshi , Murasawa Akira 
Published: August 2024

ABSTRACT

Objectives
The impact of osteoarthritis (OA) on the initial treatment response of rheumatoid arthritis (RA) by treat-to-target practice was compared between the patients with an onset age of ≥65 years old [late-onset RA (LORA)] and those with an onset age of &lt;65 years old [young-onset RA (YORA)].

Methods
A retrospective study was conducted on the patients with RA, who were referred to Department of Rheumatology, Niigata Rheumatic Center without treatment between January 2021 and July 2022. Patients with grade ≥3 OA according to the Kellgren–Lawrence (K–L) classification in either the knee or hand were classified in the OA (+) group and others were in the OA (−) group. The clinical data were compared at diagnosis and 1 year after the initial treatment between the groups for 74 LORA and 59 YORA patients, respectively.

Results
One year after starting treatment in the LORA patients, the OA (+) group had poorer disease activity control and greater disability in several activities of daily living than the OA (−) group. In the YORA patients, there were no differences in activities of daily living disability between the groups.

Conclusions
In the initial treatment of the LORA patients, the prevalence of OA was high, and the impact of OA on LORA was larger than on YORA.
Mitigating radiation-induced cognitive toxicity in brain metastases: More questions than answers
Authors: Simó Marta , Rodríguez-Fornells Antoni , Navarro Valentín , Navarro-Martín Arturo , Nadal Ernest , Bruna Jordi 
Published: August 2024

Abstract
The emergence of advanced systemic therapies added to the use of cranial radiation techniques has significantly improved outcomes for cancer patients with multiple brain metastases (BM), leading to a considerable increase in long-term survivors. In this context, the rise of radiation-induced cognitive toxicity (RICT) has become increasingly relevant. In this critical narrative review, we address the controversies arising from clinical trials aimed at mitigating RICT. We thoroughly examine interventions such as memantine, hippocampal avoidance irradiation during BM treatment or in a prophylactic setting, and the assessment of cognitive safety in stereotactic radiosurgery (SRS). Our focus extends to recent neuroscience research findings, emphasizing the importance of preserving not only the hippocampal cortex but also other cortical regions involved in neural dynamic networks and their intricate role in encoding new memories. Despite treatment advancements, effectively managing patients with multiple BM and determining the optimal timing and integration of radiation and systemic treatments remain areas requiring further elucidation. Future trials are required to delineate optimal indications and ensure SRS safety. Additionally, the impact of new systemic therapies and the potential effects of delaying irradiation on cognitive functioning also need to be addressed. Inclusive trial designs, encompassing patients with multiple BM and accounting for diverse treatment scenarios, are essential for advancing effective strategies in managing RICT and the treatment of BM patients.
Starch metabolism in guard cells: At the intersection of environmental stimuli and stomatal movement
Authors: Dang Trang , Piro Lucia , Pasini Carlo , Santelia Diana 
Published: August 2024

Abstract
Starch metabolism in guard cells plays a central role in regulating stomatal movement in response to light, elevated ambient CO2 and potentially other abiotic and biotic factors. Here, we discuss how various guard cell signal transduction pathways converge to promote rearrangements in guard cell starch metabolism for efficient stomatal responses, an essential physiological process that sustains plant productivity and stress tolerance. We suggest manipulation of guard cell starch dynamics as a previously overlooked strategy to improve stomatal behavior under changing environmental conditions.
Computerized Adaptive Testing for the Berg Balance Scale Improves Measurement Efficiency Without Compromising Precision in People With Stroke
Authors: Seamon Bryant A , Kautz Steven A , Velozo Craig A 
Published: August 2024

Abstract

Objective
The objectives of this study were to confirm the Berg Balance Scale’s (BBS) measurement properties and unidimensionality with an item response theory analysis in persons with subacute and chronic stroke and to examine the precision and efficiency of computerized adaptive testing (CAT).

Methods
Data were obtained from 519 ambulatory persons with subacute and chronic stroke in 2 retrospective databases. A principal component analysis (PCA) of residuals was used to evaluate unidimensionality. BBS fit to a rating scale model versus a partial credit model was examined, and item parameters were generated for CAT calibration. Person measures from all 14 items were defined as actual balance ability. BBS CAT simulations were used to examine changes in measurement precision with increasing number of items administered and a precision-based stopping rule (0.5 logit standard error [SE] threshold).

Results
A PCA of residuals supports the BBS unidimensionality and Rasch analysis supports using the rating scale model for measurement. Maximum precision for BBS CAT was SE = 0.40 logits when administering all items. BBS CAT estimated balance ability was highly correlated with actual ability when 4 or more items were administered (r &gt; 0.9). Precision was within 0.5 logits when 5 or more items were administered (SE &lt; 0.48 logits). BBS CAT estimated balance ability was highly correlated with actual ability (r = 0.952) using a precision-based stopping rule. The average number of items administered with the precision-based stopping rule was 5.43.

Conclusion
The BBS is sufficiently unidimensional, and the rating scale model can be used for measurement. BBS CAT is efficient and replicates the full instrument’s reliability when measuring balance ability in ambulatory persons with subacute and chronic stroke. Future work should aim to enhance the interpretability of measures to facilitate clinical decision-making.

Impact
BBS CAT provides an efficient way of measuring balance ability for individuals in stroke rehabilitation giving clinicians more time with patients.
Public health unit engagement in school mental health programs and adolescent mental health during the COVID-19 pandemic: COMPASS, 2018–2022
Authors: Benny Claire , Smith Brendan T , Patte Karen A , Leatherdale Scott T , Pabayo Roman 
Published: August 2024

Abstract

Background
Public health unit (PHU) engagement in schools is important for promoting wellness in students. We aimed to investigate if PHU engagement with schools may have provided protection against the risk of depression and anxiety in students during the COVID-19 pandemic.

Methods
We used longitudinal data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour survey between the 2018/19 and 2020/21 academic years. Multilevel models were used to assess the association between PHU engagement with school mental health programs prior to the COVID-19 pandemic and depressive (Center for Epidemiologic Studies Depression scale Revised) and anxiety symptoms (Generalized Anxiety Disorder scale) during the COVID-19 pandemic.

Results
The sample included 23 894 students across 104 secondary schools in British Columbia, Alberta, Ontario and Quebec. In confounder-adjusted models, PHU engagement before the pandemic was not associated with student depressive symptoms (B = −0.01, 95% CI = −0.04, 0.02), but was protective against anxiety symptoms (B = −0.03, −0.06, 0.001) during the COVID-19 pandemic.

Discussion
The results highlight that PHU engagement with mental health programming in schools was protective against anxiety for students during the COVID-19 pandemic. The findings support the importance of PHU engagement for improving student mental health and pandemic recovery.
Effects of a Triage Checklist to optimize insomnia treatment outcomes and reduce hypnotic use: the RCT of the effectiveness of stepped-care sleep therapy in general practice study
Authors: Manber Rachel , Gumport Nicole B , Tully Isabelle A , Kim Jane P , Kim Bohye , Simpson Norah , Rosas Lisa G , Zulman Donna M , Goldhaber-Fiebert Jeremy D , Rangel Elizabeth , Dietch Jessica R , Tutek Joshua , Palaniappan Latha 
Published: August 2024

Abstract

Study Objectives
Evaluate a triaged stepped-care strategy among adults 50 and older with insomnia disorder.

Methods
Participants (N = 245) were classified at baseline by a Triage Checklist. Those projected to do better if they start treatment with therapist versus digitally delivered CBT-I (tCBT-I vs dCBT-I) constituted the YES stratum (n = 137); the rest constituted the NO stratum (n = 108). Participants were randomized within stratum to a strategy that utilized only dCBT-I (ONLN) or to a strategy that prospectively allocated the first step of care to dCBT-I or tCBT-I based on the Triage Checklist and switched dCBT-I nonresponders at 2-months to tCBT-I (STEP). Co-primary outcomes were the insomnia severity index (ISI) and the average nightly amount of prescription hypnotic medications used (MEDS), assessed at 2, 4, 6, 9, and 12 months postrandomization.

Results
Mixed effects models revealed that, compared to ONLN, participants in STEP had greater reductions in ISI (p = .001; η2 = 0.01) and MEDS (p = .019, η2 = 0.01). Within the YES stratum, compared to ONLN, those in STEP had greater reductions in ISI (p = .0001, η2 = 0.023) and MEDS (p = .018, η2 = 0.01). Within the ONLN arm, compared to the YES stratum, those in the NO stratum had greater reductions in ISI (p = .015, η2 = 0.01) but not in MEDS. Results did not change with treatment-dose covariate adjustment.

Conclusions
Triaged-stepped care can help guide the allocation of limited CBT-I treatment resources to promote effective and safe treatment of chronic insomnia among middle-aged and older adults. Further refinement of the Triage Checklist and optimization of the timing and switching criteria may improve the balance between effectiveness and use of resources.

Clinical Trial Information
Name: The RESTING Insomnia Study: Randomized Controlled Study on Effectiveness of Stepped-Care Sleep Therapy.

Trial registration ID
NCT03532282. URL: https://clinicaltrials.gov/study/NCT03532282
Exploring healthcare professionals’ perspectives on neglected tropical diseases in Eastern Uganda: a qualitative study with a focus on schistosomiasis and soil-transmitted helminths
Authors: Kihumuro Raymond Bernard , Atimango Lorna , Kintu Timothy Mwanje , Makai Conrad , Kanyike Andrew Marvin , Bazira Joel 
Published: August 2024

Abstract

Background
Neglected tropical diseases (NTDs), including soil-transmitted helminths (STHs) and schistosomiasis, continue to impose a heavy burden, especially in sub-Saharan Africa and Uganda, despite being preventable. Integration of NTD management into primary healthcare has been inadequate. While researchers have explored community perspectives, there is a notable gap in understanding the viewpoints of healthcare workers (HCW), which is crucial for effective NTD control strategies. This study explores HCW’ perspectives in Eastern Uganda, highlighting challenges in schistosomiasis and STH prevention and management.

Methods
In this qualitative descriptive study, we conducted semistructured interviews with 10 key informants who were HCW in Eastern Uganda with experience in managing STHs and schistosomiasis. Participants were selected purposively and interviewed through Zoom guided by a comprehensive interview guide. The data were transcribed, coded and analyzed thematically.

Results
We identified five key themes regarding the impact and management of NTDs: (i) the burden of NTDs, where schistosomiasis and STHs were notably prevalent among children and communities adjacent to water bodies; (ii) transmission of NTDs, emphasizing water bodies and poor sanitation as primary routes of disease spread; (iii) clinical manifestations of NTDs, detailing the symptomatic presentations that complicate diagnosis and management; (iv) challenges in managing and diagnosing NTDs, highlighting the shortages of essential medications and diagnostic tools, along with the under-prioritization of NTDs within healthcare systems; and (v) fatalities and complications arising from NTDs, reporting on the severe outcomes and under-reporting of deaths associated with NTDs due to misdiagnosis, delayed treatment and traditional healing preferences.

Conclusion
The interviewed Ugandan HCW demonstrated sufficient knowledge of schistosomiasis and STHs, but faced challenges due to inadequate diagnostic tools and medication shortages. The study underscores the need for NTD prioritization with direct funding and government involvement, alongside strategies that integrate continuous medical training, effective community outreach and an enhanced healthcare system response to reduce the burden of NTDs.
Virtual Compared With In-Office Postoperative Visits After Urogynecologic Surgery
Authors: Lua-Mailland Lannah L. , Nowacki Amy S. , Paraiso Marie Fidela R. , Park Amy J. , Wallace Shannon L. , Ferrando Cecile A. 
Published: August 2024

OBJECTIVE:
To compare patient satisfaction, health care resource utilization, and adverse events among patients receiving a virtual video compared with in-office postoperative visit after urogynecologic surgery. We hypothesized that virtual video visits would be noninferior to in-office visits.

METHODS:
This was a randomized noninferiority clinical trial of patients undergoing surgery for pelvic organ prolapse and urinary incontinence at a single academic tertiary referral center. Participants were randomized to receive either a virtual video postoperative visit or a standard in-office postoperative visit. The primary outcome was patient satisfaction measured by the validated PSQ-18 (Patient Satisfaction Questionnaire-18) (noninferiority margin 5 points) at the 6-week postoperative visit. Secondary outcomes included PSQ-18 domain scores (noninferiority margin 0.5 points) and composite health care resource utilization and adverse events after the 6-week postoperative visit up to 12 weeks after surgery (noninferiority margin 10%). A sample size of 100 participants (50 per group) would allow 80% power to assess a 5-point noninferiority margin on the total PSQ-18 with an SD of 10 and α=0.05.

RESULTS:
From January 2023 to September 2023, 265 patients were screened for eligibility, and 104 were randomized. A total of 100 participants (50 per arm) completed the study and were included in the analysis. The mean±SD age of all participants was 57.0±13.2 years. The mean±SD PSQ-18 total score was 75.18±8.15 in the virtual group and 75.14±8.7 in the in-office group. The mean PSQ-18 total score was 0.04 points higher (ie, greater degree of satisfaction) in the virtual group, with a 95% CI of −2.75 to 2.83, which met the criterion for noninferiority. Between-group differences for all PSQ-18 domain scores likewise met criterion for noninferiority. Composite health care resource utilization was 14.0% lower in the virtual group than in the in-office group (20.0% vs 34.0%, 95% CI, −28.0% to 1.0%). For composite adverse events, the between-group difference was 2.0% (2.0% in virtual group vs 0.0% in in-office group, 95% CI,−3.0% to 8.0%).

CONCLUSION:
Virtual video postoperative visits were noninferior to in-office visits with regard to patient satisfaction, health care resource utilization, and adverse events and can be offered as an alternative to in-office visits for postoperative follow-up after urogynecologic surgery.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT05641077.
Standard Compared With Extended Red Blood Cell Antigen Matching for Prevention of Subsequent Hemolytic Disease of the Fetus and Newborn
Authors: Sugrue Ronan P. , Olsen Jaxon , Abi Antoun Marie Elise , Skalla Lesley A. , Cate Jennifer , James Andra H. , Stonehill Alexandra , Watkins Virginia , Telen Marilyn J. , Federspiel Jerome J. 
Published: August 2024

OBJECTIVE:
To systematically review and meta-analyze alloimmunization among recipients of red blood cells (RBCs) matched for ABO blood type and Rhesus D (ABO+D) antigen compared with those also matched for c, E, and Kell (cEK).

DATA SOURCES:
Four online databases (Medline, Scopus, EMBASE, ClinicalTrials.gov) were searched from March 28, 2023, to April 1, 2024. The search protocol was peer reviewed and published on PROSPERO (CRD42023411620).

METHODS OF STUDY SELECTION:
Studies reporting alloimmunization as the primary outcome among recipients of RBCs matched for ABO+D or additional cEK matching were included. Patients transfused with unmatched RBCs or a mixture of matching regimens were excluded. Risk of bias was assessed with Cochrane Tool to Assess Risk of Bias in Cohort Studies and Tool for Risk of Bias. Random-effects meta-analysis was used to combine effect estimates.

TABULATION, INTEGRATION, AND RESULTS:
Ten studies met criteria. Risk of bias was low. Overall, 91,221 patients were transfused, of whom 40,220 (44.1%) received additional cEK-matched RBCs. The overall rate of alloimmunization was 6.2% (95% CI, 2.5–14.9%) for ABO+D–only matching and 1.9% (95% CI, 0.7–5.1%) when cEK was added. Time of follow-up antibody testing ranged from 6 to 18 months after transfusion. Additional cEK match was associated with significantly less alloimmunization compared with standard ABO+D match (odds ratio [OR] 0.37, 95% CI, 0.20–0.69). This association remained when chronically transfused patients were excluded (OR 0.65, 95% CI, 0.54–0.79) and for alloimmunization to c, E, or K antigens only (OR 0.29, 95% CI, 0.18–0.47).

CONCLUSION:
Additional cEK RBC matching protocols were associated with lower odds of recipient alloimmunization. Given severe sequelae of alloimmunization in pregnancy, routine cEK matching for transfusion in people with pregnancy potential younger than age 50 years in the United States merits consideration.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42023411620.
The Combination of Valsartan and Spironolactone Mitigated Mitral Regurgitation–Induced Cardiac Dysfunction in a Novel Rat Model
Authors: Chang Wei-Ting , Lin Yu-Wen , Chen Chin-Yu , Hong Chon-Seng , Chen Zhih-Cherng , Lin You-Cheng , Shih Jhih-Yuan 
Published: August 2024

Abstract:
Despite its high prevalence, effective treatment for degenerative mitral regurgitation (MR) remains elusive. Although the mineralocorticoid-receptor antagonist spironolactone, in conjunction with renin–angiotensin–aldosterone system inhibitors, has been shown to reduce mortality in patients with heart failure with reduced ejection fraction, its efficacy in managing degenerative MR is uncertain. In this study, we aimed to compare the effectiveness of valsartan (a renin–angiotensin system inhibitor), spironolactone, and combination therapy in mitigating MR-induced myocardial dysfunction. Using a mini-invasive model of degenerative MR, we administered valsartan (31 mg/kg/d), spironolactone (80 mg/kg/d), or a combination of both to rats over a 4-week period. Serial echocardiography and pressure–volume loops were utilized to assess cardiac function and hemodynamics. Rats with degenerative MR treated with valsartan or spironolactone alone did not show significant improvement in myocardial dysfunction. In contrast, combination therapy resulted in significant improvement. Similarly, the pressure–volume relationship was significantly improved in rats treated with the combination therapy compared with that in rats treated with a single therapy. Mechanistically, combination therapy effectively suppressed circulating and cardiac expression of aldosterone- and apoptosis-associated proteins. Overall, combination treatment with valsartan and spironolactone significantly attenuated the degenerative MR-induced myocardial stress and dysfunction, suggesting a potential therapeutic avenue for managing degenerative MR-induced heart failure.
Sodium–Glucose Cotransporter 2 Inhibitors, Malnutrition, Cachexia, and Survival in Patients With Heart Failure With a History of Anthracycline Treatment
Authors: Henson Benjamin D. , Bale-Neary Claudia A. , Mecaskey Ryan , Gbujie Ogechi , Zhan Michelle , Rao Krishnasree , Carbone Salvatore 
Published: August 2024

Abstract:
Patients undergoing anthracycline-based cancer treatments have an increased risk of heart failure or worsening preexisting heart failure as well as adverse metabolic outcomes such as malnutrition and cachexia. This retrospective study explored the impact of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on these outcomes in patients with heart failure previously treated with anthracyclines. Using the TriNetX research network, we identified 1545 patients with a history of SGLT2i use and 17,681 patients without a history of SGLT2i use. We then performed 1:1 propensity score matching resulting in 1323 patients within each cohort. Patients were analyzed over a 5-year period. SGLT2i use was associated with significantly reduced risks of cachexia {hazard ratio (HR) 0.453, 95% confidence interval (CI) [0.286–0.718]}, malnutrition (HR 0.702, 95% CI [0.547–0.900]), adult failure to thrive (HR 0.489, 95% CI [0.345–0.693]), and all-cause mortality (HR 0.490, 95% CI [0.423–0.568]). These findings call for additional research to determine whether SGLT2i may indeed improve nutritional status and survival in patients with heart failure receiving anthracycline therapy.