bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between male and female endogenous reproductive hormones levels and subjective cognitive decline score: A cross‐sectional analysis of the Pingyin cohort study
Authors: Wang Qi , Yu Ruihong , Fu Chunying , Li Meiling , Wang Xiaoyi , Zhu Dongshan 
Published: July 2024

AbstractObjectiveReproductive hormones might impact disease course in cognitive decline. We examined the association between male and female endogenous reproductive hormones and subjective cognitive decline (SCD) score.Design, Patients and MeasurementsA cross‐sectional study design was used with baseline data from the Pingyin cohort study, involving 1943 participants aged 45–70 years. Oestrogen (E2), testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured in females and E2 and testosterone were measured in males. We categorised hormones into three levels of low, intermediate and high level. The 9‐item subjective cognitive decline questionnaire (SCD‐Q9) scores were collected to assess the symptoms of SCD. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) between categorised hormone levels and SCD status. Multivariable linear regression models were also used.ResultsOverall, 1943 participants were involved and 1285 (66.1%) were female. The mean age at baseline was 59.1 (standard deviation 7.1) years. Women with high testosterone levels had a higher probability of having SCD compared with those with low testosterone levels (OR 1.43, 95% CI 1.01–2.05). Men with a high level of testosterone (0.59, 0.35–0.98) and high testosterone/E2 ratio (0.55, 0.33–0.90) were related to decreased chances of having SCD. Each one‐unit increase of testosterone was linked to reduced SCD score in males [(β: −.029, 95% CI (−0.052, −0.007)].ConclusionThere was sex‐specific relationship between hormone levels and SCD abnormal. Those with higher testosterone levels in females may increase likelihood of experiencing SCD. Males with higher testosterone levels and higher testosterone/E2 ratio may be associated with reduced likelihood of SCD. The roles of endogenous reproductive hormone levels and their dynamic changes in cognitive function need further investigation.
The Spread Pattern of New Practice in Liver Transplantation in the United States
Authors: Akabane Miho , Imaoka Yuki , Esquivel Carlos O. , Kim W. Ray , Sasaki Kazunari 
Published: July 2024

ABSTRACTBackgroundIntroducing new liver transplantation (LT) practices, like unconventional donor use, incurs higher costs, making evaluation of their prognostic justification crucial. This study reexamines the spread pattern of new LT practices and its prognosis across the United States.MethodsThe study investigated the spread pattern of new practices using the UNOS database (2014–2023). Practices included LT for hepatitis B/C (HBV/HCV) nonviremic recipients with viremic donors, LT for COVID‐19‐positive recipients, and LT using onsite machine perfusion (OMP). One year post‐LT patient and graft survival were also evaluated.ResultsLTs using HBV/HCV donors were common in the East, while LTs for COVID‐19 recipients and those using OMP started predominantly in California, Arizona, Texas, and the Northeast. K‐means cluster analysis identified three adoption groups: facilities with rapid, slow, and minimal adoption rates. Rapid adoption occurred mainly in high‐volume centers, followed by a gradual increase in middle‐volume centers, with little increase in low‐volume centers. The current spread patterns did not significantly affect patient survival. Specifically, for LTs with HCV donors or COVID‐19 recipients, patient and graft survivals in the rapid‐increasing group was comparable to others. In LTs involving OMP, the rapid‐ or slow‐increasing groups tended to have better patient survival (p = 0.05) and significantly improved graft survival rates (p = 0.02). Facilities adopting new practices often overlap across different practices.DiscussionOur analysis revealed three distinct adoption groups across all practices, correlating the adoption aggressiveness with LT volume in centers. Aggressive adoption of new practices did not compromise patient and graft survivals, supporting the current strategy. Understanding historical trends could predict the rise in future LT cases with new practices, aiding in resource distribution.
Once‐weekly insulin icodec compared with daily basal insulin analogues in type 2 diabetes: Participant‐level meta‐analysis of the ONWARDS 1–5 trials
Authors: Bajaj Harpreet S. , Ásbjörnsdóttir Björg , Bari Tanvir J. , Begtrup Kamilla , Vilsbøll Tina , Rosenstock Julio 
Published: July 2024

AbstractAimTo perform a participant‐level post hoc meta‐analysis of Phase 3a trials in type 2 diabetes (T2D) to characterize the hypoglycaemia safety and glycaemic efficacy of once‐weekly insulin icodec (icodec).Materials and MethodsAll ONWARDS 1–5 randomized participants were pooled as overall T2D, insulin‐naive, an insulin‐experienced subgroups, and by once‐daily trial comparator (degludec or glargine U100). The main outcomes included incidence and rates of clinically significant and severe hypoglycaemia. Additional endpoints included change in glycated haemoglobin (HbA1c) from baseline and HbA1c target achievement without clinically significant or severe hypoglycaemia.ResultsThe meta‐analysis comprised 3765 participants (1882 icodec vs. 1883 comparators). In the overall T2D pool, clinically significant hypoglycaemia incidence was similar in the icodec group versus the comparator group (17.9% vs. 16.2%, odds ratio [OR] 1.14, 95% confidence interval [CI] 0.94, 1.38); however, rates were low but significantly higher in the icodec group (1.15 vs. 1.00 episodes/participant‐year of exposure, estimated rate ratio 1.51 [95% CI 1.24, 1.85]). Fewer severe hypoglycaemic episodes occurred with icodec than with comparators (8 vs. 18). A greater reduction in HbA1c occurred with icodec versus comparators, irrespective of subgroup (estimated treatment difference range [−0.10 to −0.29%]; all p < 0.05). Across subgroups, except for the insulin‐experienced subgroup, the odds of achieving HbA1c <53 mmol/mol (7.0%) without clinically significant or severe hypoglycaemia were greater with icodec than with comparators (OR range 1.30–1.55; all p < 0.05).ConclusionsIcodec was associated with a similar incidence but higher rates of clinically significant hypoglycaemia (equating to one additional hypoglycaemic episode every 6 years) and fewer severe hypoglycaemic episodes versus comparators. Our findings also confirmed the greater efficacy of icodec that was demonstrated in the ONWARDS trial programme.
Metformin monotherapy versus predominantly older non‐metformin antidiabetic medications for cerebrovascular risk in early type 2 diabetes management
Authors: Sun Mingyang , Lu Zhongyuan , Chen Wan‐Ming , Lv Shuang , Fu Ningning , Yang Yitian , Wang Yangyang , Miao Mengrong , Wu Szu‐Yuan , Zhang Jiaqiang 
Published: July 2024

AbstractAimChoosing the initial treatment for type 2 diabetes (T2D) is pivotal, requiring consideration of solid clinical evidence and patient characteristics. Despite metformin's historical preference, its efficacy in preventing cerebrovascular events lacked empirical validation. This study aimed to evaluate the associations between first‐line monotherapy (metformin or non‐metformin antidiabetic medications) and cerebrovascular complications in patients with T2D without diabetic complications.MethodsWe analysed 9090 patients with T2D without complications who were prescribed either metformin or non‐metformin medications as initial therapy. Propensity score matching ensured group comparability. Cox regression analyses, stratified by initial metformin use, assessed cerebrovascular disease risk, adjusting for multiple covariates and using competing risk analysis. Metformin exposure was measured using cumulative defined daily doses.ResultsMetformin users had a significantly lower crude incidence of cerebrovascular diseases compared with non‐users (p < .0001). Adjusted hazard ratios (aHRs) consistently showed an association between metformin use and a lower risk of overall cerebrovascular diseases (aHRs: 0.67‐0.69) and severe events (aHRs: 0.67‐0.69). The association with reduced risk of mild cerebrovascular diseases was significant across all models (aHRs: 0.73‐0.74). Higher cumulative defined daily doses of metformin correlated with reduced cerebrovascular risk (incidence rate ratio: 0.62‐0.94, p < .0001), indicating a dose‐dependent effect.ConclusionMetformin monotherapy is associated with a reduced risk of cerebrovascular diseases in early‐stage T2D, highlighting its dose‐dependent efficacy. However, the observed benefits might also be influenced by baseline differences and the increased risks associated with other medications, such as sulphonylureas. These findings emphasize the need for personalized diabetes management, particularly in mitigating cerebrovascular risk in early T2D stages.
Trajectories of quality of life among disaster victims: A national longitudinal study
Authors: Lee Haeyoung , Kim Yujeong 
Published: July 2024

AbstractAimThis study categorized quality‐of‐life trajectories among disaster victims in South Korea and identified the characteristics and predictors of each trajectory.BackgroundDisaster victims experience tremendous physical and mental distress, which has a long‐term impact on their quality of life.MethodsWe conducted a cross‐sectional study using data obtained from the fourth Long‐term Survey on the Change of Life of Disaster Victims conducted from 2017 to 2019. The study included 257 participants who experienced a typhoon, earthquake, or fire and completed the three‐year follow‐up. Latent transition analysis was used to identify the potential class of quality‐of‐life trajectories among disaster victims. Independent t tests, χ2 tests, and logistic regression were used to identify the predictors of quality‐of‐life trajectories.ResultsTwo latent quality‐of‐life classes were identified: persistent low‐level and persistent high‐level. Factors associated with the persistent high‐level trajectory included higher education level, no injury/disease from the disaster, better subjective health status, higher social support, and lower social maladjustment.DiscussionQuality of life early after a disaster is maintained throughout subsequent years; early and active support following disasters is essential to promote its rapid improvement.ConclusionTargeted educational programs in disaster‐prone areas are recommended to bolster resilience among individuals with lower education. Moreover, governmental and institutional efforts are needed to support victims who lack resources for disaster recovery.Implications for nursing and health policyThere is a need to establish community‐based social support systems and enhance nurses' disaster response capabilities to support vulnerable groups, with such interventions tailored to reflect disaster‐affected victims’ unique characteristics and needs, along with ongoing research and evaluation for continuous improvements to nursing practice and disaster response.
Role of oxidative stress in the concurrent development of osteoporosis and tendinopathy: Emerging challenges and prospects for treatment modalities
Authors: Xia Xianting , Fang Zhengyuan , Qian Yinhua , Zhou Yu , Huang Haoqiang , Xu Feng , Luo Zhiwen , Wang Qing 
Published: July 2024

AbstractBoth osteoporosis and tendinopathy are widely prevalent disorders, encountered in diverse medical contexts. Whilst each condition has distinct pathophysiological characteristics, they share several risk factors and underlying causes. Notably, oxidative stress emerges as a crucial intersecting factor, playing a pivotal role in the onset and progression of both diseases. This imbalance arises from a dysregulation in generating and neutralising reactive oxygen species (ROS), leading to an abnormal oxidative environment. Elevated levels of ROS can induce multiple cellular disruptions, such as cytotoxicity, apoptosis activation and reduced cell function, contributing to tissue deterioration and weakening the structural integrity of bones and tendons. Antioxidants are substances that can prevent or slow down the oxidation process, including Vitamin C, melatonin, resveratrol, anthocyanins and so on, demonstrating potential in treating these overlapping disorders. This comprehensive review aims to elucidate the complex role of oxidative stress within the interlinked pathways of these comorbid conditions. By integrating contemporary research and empirical findings, our objective is to outline new conceptual models and innovative treatment strategies for effectively managing these prevalent diseases. This review underscores the importance of further in‐depth research to validate the efficacy of antioxidants and traditional Chinese medicine in treatment plans, as well as to explore targeted interventions focused on oxidative stress as promising areas for future medical advancements.
Associations between oral health and depression and anxiety: A cross‐sectional and prospective cohort study from the UK Biobank
Authors: Wang Jingjing , Wang Yani , Li Huihui , Wang Weijing , Zhang Dongfeng 
Published: July 2024

AbstractAimTo investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort.Materials and MethodsOral health problems were self‐reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ‐4) in a cross‐sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.ResultsA total of 305,188 participants were included in the cross‐sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73–1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10–1.19), depression (HR: 1.19, 95% CI: 1.13–1.25) and anxiety (HR: 1.13, 95% CI: 1.07–1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16–1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C‐reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow‐up (N = 10,673) were not significant.ConclusionsPeriodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
Mass mortality event of round sardinella Sardinella aurita Valenciennes associated with Glugea Thélohan, 1891 microsporidian infection off the southern Italian coast
Authors: López‐Verdejo Alejandro , Occhibove Flavia , Uberti Barbara degli , Montero Francisco E. , Santoro Mario 
Published: July 2024

AbstractIntracellular parasites of the genus Glugea Thélohan, 1891 (Microsporidia) comprise about 34 putative species capable of causing high morbidity and mortality in freshwater and marine teleost fishes. In this study, we report on the first mass mortality event associated with Glugea sp. infecting free‐ranging round sardinella Sardinella aurita in the southern Tyrrhenian Sea (Italy). Here, we describe the ultrastructure of mature spores of this microsporidian and characterize it molecularly, as well as report its phylogenetic position. Most of the affected fish showed an irregular swelling of its abdomen. At necropsy, a variable number of xenomas, spherical to ellipsoidal in shape, were found in the peritoneal cavity strongly attached to the viscera of all fish. Histological analysis revealed varying severity of chronic inflammation along with occasional necrosis in visceral organs associated with multiple xenoma proliferation. These pathological findings were considered the main cause of this mass mortality event. Morphologically, the present material was closely related to G. sardinellesis and G. thunni. The phylogenetically closest taxa to the newly SSU rDNA sequence were G. thunni and an erroneusly identified G. plecoglossi, which were very closely related to each other, also suggesting that all these sequences might belong to the same species.
Knowledge, attitudes and practices of nurses regarding airway clearance in neurocritical illness patients: A cross‐sectional study
Authors: Liu Shengnan , Zhou Hui , Zhang Xuelian , Yan Qi , Zhang Haiying , Wu Chao , Shen Hongying 
Published: July 2024

AbstractAimWe aimed to assess the level of knowledge, attitudes and practices regarding airway clearance among nurses and explore the factors affecting the knowledge, attitudes and practices.DesignA questionnaire‐based cross‐sectional study.BackgroundAirway clearance is an important method of eliminating excess secretions. In neuroscience nursing, nurses are important executors of airway management, and their knowledge, attitudes and practices can influence the effectiveness of airway clearance.MethodsThis study was conducted from July to September 2023 in four hospitals in Jiangsu Province, China. A structured questionnaire about airway clearance was designed and used to collect the data. The nurses used this questionnaire to self‐rate. The STROBE checklist for cross‐sectional studies was followed.ResultsThe age, work experience, highest educational attainment and technical title of the nurses can significantly influence their knowledge. The age, highest educational attainment and technical title of the nurses can significantly impact their attitudes. Practice scores were significantly influenced by age, work experience, technical title, whether the nurses had received any training on airway clearance techniques, and whether the department developed procedures for implementing the airway clearance technology. Nurses' attitudes were significantly associated with knowledge and practice, and there was no significant correlation between knowledge and practice.ConclusionThis study showed that age, work experience, highest educational attainment and training were related to knowledge, attitudes and practices. These findings suggest that nursing managers can conduct airway clearance training according to age group, working experience and education level of the nurses.Patient or Public ContributionNo patient or public contribution.ImpactThe findings show that the level of knowledge, attitudes and practices related to airway clearance in neuroscience nursing among nurses were acceptable, which means that nurses can better perform airway management on patients. These findings serve as a significant reference for designing an airway clearance education for nurses and meet the needs of nurses in clinical nursing practice.
Healthy lifestyles and better periodontal health: Results from two large population‐based surveys
Authors: Marruganti Crystal , Luthra Shailly , Hussain Syed Basit , Suvan Jeanie , D'Aiuto Francesco 
Published: July 2024

AbstractAimTo ascertain whether healthy lifestyles are associated with periodontal diseases in two large‐scale surveys in the US (National Health and Nutrition Examination Survey – NHANES) and the UK Biobank.Methods9854 US adults and 111 679 UK adults were included in the analyses. A healthy lifestyle score (HLS), ranging between 0 and 5, was calculated based on the reported number of healthy behaviours, including never smoking, no heavy alcohol consumption, top third of leisure‐time physical activity, higher dietary quality, and ideal sleep duration. The prevalence of periodontal diseases was the primary outcome in both surveys. In the NHANES, periodontal status was assessed through a full‐mouth periodontal examination, while in the UKB, only self‐reported periodontal status was available.ResultsMultiple regression analyses confirmed that the presence of at least 2–3 healthy behaviours (vs. 0–1) was associated with lower odds of overall and severe periodontitis (ORs 0.5, 0.4–0.6; p < .001 and 0.5, 0.3–0.8; p = .003, respectively) in the NHANES, and of bleeding gums (OR = 0.9, 0.8–1.0; p = .092) and loose teeth (OR = 0.6, 0.5–0.7; p < .001) in UKB. This association increased when considering prevalence of 4–5 healthy behaviours (vs. 0–1) in both the NHANES (periodontitis: OR = 0.3, 0.2–0.4; p < .001; severe periodontitis: OR = 0.1, 0.01–0.2; p < .001) and the UKB (bleeding gums: OR = 0.8, 0.7–0.9; p < .001; loose teeth: OR = 0.5, 0.4–0.6; p < .001). Mediation analyses revealed how these protective associations could be partially mediated (1–14%) by differences in biomarkers of systemic inflammation (white blood cells and neutrophils count as well as C‐reactive protein).ConclusionsAdoption of healthy lifestyle behaviours is associated with a lower prevalence of periodontal diseases within two large population‐based samples. This relationship exhibits a dose–response pattern, implying that greater adherence to healthy habits leads to a more significant protective effect against the odds of periodontal diseases. Additionally, our findings suggest that this protective effect is, in part, mediated by reductions in systemic inflammation.
Evolutionary variation in gene conversion at the avian MHC is explained by fluctuating selection, gene copy numbers and life history
Authors: Minias Piotr 
Published: July 2024

AbstractThe major histocompatibility complex (MHC) multigene family encodes key pathogen‐recognition molecules of the vertebrate adaptive immune system. Hyper‐polymorphism of MHC genes is de novo generated by point mutations, but new haplotypes may also arise by re‐shuffling of existing variation through intra‐ and inter‐locus gene conversion. Although the occurrence of gene conversion at the MHC has been known for decades, we still have limited understanding of its functional importance. Here, I took advantage of extensive genetic resources (~9000 sequences) to investigate broad scale macroevolutionary patterns in gene conversion processes at the MHC across nearly 200 avian species. Gene conversion was found to constitute a universal mechanism in birds, as 83% of species showed footprints of gene conversion at either MHC class and 25% of all allelic variants were attributed to gene conversion. Gene conversion processes were stronger at MHC‐II than MHC‐I, but inter‐specific variation at both MHC classes was explained by similar evolutionary scenarios, reflecting fluctuating selection towards different optima and drift. Gene conversion showed uneven phylogenetic distribution across birds and was driven by gene copy number variation, supporting significant role of inter‐locus gene conversion processes in the evolution of the avian MHC. Finally, MHC gene conversion was stronger in species with fast life histories (high fecundity) and in long‐distance migrants, likely reflecting variation in population sizes and host–pathogen coevolutionary dynamics. The results provide a robust comparative framework for understanding macroevolutionary variation in gene conversion at the avian MHC and reinforce important contribution of this mechanism to functional MHC diversity.