bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Severe Mental Illness and Receipt of Acute Cardiac Care for Myocardial Infarction, and the Impact of the COVID-19 Pandemic
Authors: Fleetwood Kelly , Mercer Stewart , Padmanabhan Sandosh , Smith Daniel , Jackson Caroline 
Published: August 2024

AimsTo compare receipt of acute cardiac care in people with versus without severe mental illness (SMI) and investigate the impact of the COVID-19 pandemic on any differences in care. We hypothesised that, compared with those without SMI, patients with an SMI are less likely to receive guideline recommended acute cardiac care and that disparities worsened as a result of the pandemic.MethodsWe conducted a cohort study using data from the CVD-COVID-UK resource, which links electronic health data from multiple sources. Our cohort included 95,125 adults with a non-ST-elevation MI (NSTEMI) recorded in the Myocardial Infarction National Audit Programme (MINAP) dataset between 1 November 2019 and 31 March 2022. We defined SMI as schizophrenia, schizoaffective disorders or bipolar disorder (BD), ascertained through recorded diagnosis in primary care or hospital admission records. We examined receipt of cardiac care standards for NSTEMI, including: admission to a cardiac ward; angiogram eligibility; receipt of angiogram (in those eligible); angiogram within 72 hours; secondary prevention medication prescribing at discharge, and arrangement of post-discharge cardiac rehabilitation. We used logistic regression to obtain odds ratios (ORs) for the association between SMI and receipt of each care indicator, adjusting for age, sex and time period. We tested for an interaction between SMI and time period in order to determine if any disparities had changed since the start of the COVID-19 pandemic.ResultsWithin our cohort, 620 patients (0.6%) had schizophrenia and 575 (0.6%) had BD. Compared with people without SMI and after adjusting for age, sex and period, patients with an SMI were less likely to receive each of the cardiac care standards. For example, compared with those without SMI, those with SMI were less likely to: be admitted to a cardiac ward (schizophrenia: OR 0.72, 95% CI 0.61–0.85; BD: 0.74, 95% CI 0.63–0.88); be eligible for an angiogram (schizophrenia: 0.37, 95% CI 0.29–0.47; BD: 0.52, 95% CI 0.40–0.68); receive an angiogram (schizophrenia: 0.22, 95% CI 0.18–0.28; BD: 0.51, 95% CI 0.39–0.66); and receive an angiogram within 72 hours (schizophrenia: 0.71, 95% CI 0.56–0.90); BD: 0.80, 95% CI 0.64–1.00). We generally found no evidence that disparities had changed since the start of the COVID-19 pandemic.ConclusionWe identified marked SMI disparities in receipt of acute cardiac care among people treated in hospital for a NSTEMI. Further research should seek to identify reasons for, and inform interventions to, address these disparities.
Effect of Cognitive Stimulation Therapy on Cognition and Social Independence in People With Dementia at the North Norfolk Memory Service
Authors: Olaluwoye Oluwaseun , Ridel Gemma , Jones Bethan , Ighomereho Abosede 
Published: August 2024

AimsCognitive stimulation therapy (CST) is a psychosocial treatment for people with dementia. It is an evidence-based treatment which shows improvement in cognition, well-being and quality of life of people living with dementia. CST is recognised as one of the interventions which is cost-effective.The National Institute of Health and Care Excellence (NICE) guideline recommends that people with mild to moderate dementia should be given opportunities to take part in CST. The CST sessions done in North Norfolk are weekly sessions which span 90 minutes. A group of between 8–10 people attend a 14-week CST treatment course.The aim of this study is to evaluate the effectiveness of the CST on cognition and social independence of patients with dementia in North Norfolk.MethodsPatients diagnosed with mild to moderate dementia at the memory service were referred for CST sessions. A trained professional assessed the patients to determine their eligibility for CST. The assessment included: assessing motivation to join a group therapy, administration of the short-version of the Addenbrooke Cognitive Examination questionnaire (MINI-ACE) to assess cognitive functions and the administration of Engagement and Independence in Dementia Questionnaire (EIDQ) which measures the social independence of the patients. A higher score on both questionnaires indicates better cognitive function and social independence, respectively.The CST sessions spanned from February 2023 to May 2023. The patients were re-assessed after the 14-week sessions of CST for their MINI-ACE and EIDQ scores. A qualitative questionnaire was administered for feedback about the sessions.Data were obtained from patients' clinical record following approval from the research and service evaluation team of the Trust.ResultsNine patients completed the 14-week CST sessions. The mean age of the patients was 82.9 ± 4.8. 66.7% were male and 33.3% were female. 77.8% were on memory medication and 22.2% were not on memory medication. 44.4%, 33.3%, 11.1% and 11.1% were diagnosed with dementia in Alzheimer's Disease; Mixed Alzheimer's-Vascular Dementia, Lewy Body Dementia and Frontotemporal Dementia, respectively.The same proportion of patients (44.5%) had both increased and decreased MINI-ACE score after CST while 11% had no changes in MINI-ACE score. Majority (66.7%) had increased EIDQ score after CST, 22.2% had decreased EIDQ score and 11.1% had no changes.ConclusionThe CST sessions done in North Norfolk showed more positive effect on social independence than cognition in people with dementia.
Randomized Controlled Trial of a Nurse-Led Brief Behavioral Intervention for Dyspnea in Patients With Advanced Lung Cancer
Authors: Greer Joseph A. , Post Kathryn E. , Chabria Reena , Aribindi Seetha , Brennan Natalie , Eche-Ugwu Ijeoma Julie , Halpenny Barbara , Fox Erica , Lo Stephen , Waldman Lauren P. , Pintro Kedie , Rabideau Dustin J. , Pirl William F. , Cooley Mary E. , Temel Jennifer S. 
Published: August 2024

PURPOSE
In patients with lung cancer, dyspnea is one of the most prevalent and disabling symptoms, for which effective treatments are lacking. We examined the efficacy of a nurse-led brief behavioral intervention to improve dyspnea in patients with advanced lung cancer.

METHODS
Patients with advanced lung cancer reporting at least moderate breathlessness (n = 247) were enrolled in a randomized trial of a nurse-led two-session intervention (focused on breathing techniques, postural positions, and fan therapy) versus usual care. At baseline and weeks 8 (primary end point), 16, and 24, participants completed measures of dyspnea (Modified Medical Research Council Dyspnea Scale [mMRCDS]; Cancer Dyspnoea Scale [CDS]), quality of life (Functional Assessment of Cancer Therapy-Lung [FACT-L]), psychological symptoms (Hospital Anxiety and Depression Scale), and activity level (Godin-Shephard Leisure Time Physical Activity Questionnaire). To examine intervention effects, we conducted analysis of covariance and longitudinal mixed effects models.

RESULTS

The sample (Age
mean
= 66.15 years; 55.9% female) primarily included patients with advanced non–small cell lung cancer (85.4%). Compared with usual care, the intervention improved the primary outcome of patient-reported dyspnea on the mMRCDS (difference = –0.33 [95% CI, –0.61 to –0.05]) but not the CDS total score at 8 weeks. Intervention patients also reported less dyspnea on the CDS sense of discomfort subscale (difference = –0.59 [95% CI, –1.16 to –0.01]) and better functional well-being per the FACT-L (difference = 1.39 [95% CI, 0.18 to 2.59]) versus the control group. Study groups did not differ in overall quality of life, psychological symptoms, or activity level at 8 weeks or longitudinally over 24 weeks.

CONCLUSION
For patients with advanced lung cancer, a scalable behavioral intervention alleviated the intractable symptom of dyspnea. Further research is needed on ways to enhance intervention effects over the long-term and across additional outcomes.
Plasma Steroid Profiling Between Patients With and Without Diabetes Mellitus in Nonfunctioning Adrenal Incidentalomas
Authors: Nakano Yui , Yokomoto-Umakoshi Maki , Nakatani Kohta , Umakoshi Hironobu , Nakao Hiroshi , Fujita Masamichi , Kaneko Hiroki , Iwahashi Norifusa , Ogasawara Tatsuki , Fukumoto Tazuru , Matsuda Yayoi , Sakamoto Ryuichi , Izumi Yoshihiro , Bamba Takeshi , Ogawa Yoshihiro 
Published: August 2024

Abstract

Context
Adrenal incidentalomas, including nonfunctioning adrenal incidentalomas (NFAI), are associated with a high prevalence of diabetes mellitus (DM). While NFAI is diagnosed by exclusion when no hormone excess exists, subtle cortisol secretion may exist and contribute to DM development. However, it alone cannot explain the increased risk, and whether other steroid metabolites are involved remains unclear.

Purpose
To investigate steroid metabolites associated with DM in patients with NFAI using plasma steroid profiles.

Methods
Using liquid chromatography-tandem mass spectrometry, 22 plasma steroid metabolites were measured in 68 patients with NFAI (31 men and 37 women). Data were adjusted for age before normalization.

Results
Discriminant analysis showed that plasma steroid profiles discriminated between patients with and without DM in men (n = 10 and = 21, respectively) but not women: 11β-hydroxytestosterone, an adrenal-derived 11-oxygenated androgen, contributed most to this discrimination and was higher in patients with DM than in those without DM (false discovery rate = .002). 11β-hydroxytestosterone was correlated positively with fasting plasma glucose (r = .507) and hemoglobin A1c (HbA1c) (r = .553) but negatively with homeostatic model assessment of β-cell function (HOMA2-B) (r = −.410). These correlations remained significant after adjusting for confounders, including serum cortisol after the 1-mg dexamethasone suppression test. Bayesian kernel machine regression analysis verified the association of 11β-hydroxytestosterone with HbA1c and HOMA2-B in men.

Main Conclusion
Plasma steroid profiles differed between those with and without DM in men with NFAI. 11β-hydroxytestosterone was associated with hyperglycemia and indicators related to pancreatic β-cell dysfunction, independently of cortisol.
Overview and Diagnostic Approach in Autoimmune Neurology
Authors: McKeon Andrew , Pittock Sean J. 
Published: August 2024

ABSTRACT

OBJECTIVE
The field of autoimmune neurology is rapidly evolving. This article reviews the epidemiology and pathophysiology as well as current approaches to clinical and paraclinical assessment, testing paradigms, and general principles of treatment.

LATEST DEVELOPMENTS
Improved recognition of autoimmune diagnoses among patients who have phenotypically diverse, subacute onset neurologic presentations is facilitated by disease-specific antibody biomarker discovery. These antibodies have varying associations with paraneoplastic causation (from no association to greater than 70% positive predictive value), immunotherapy responses, and outcomes. To simplify assessment in an increasingly complex discipline, neurologic phenotype-specific serum and CSF antibody evaluations are recommended. Clinical trials have led to the approval of monoclonal therapies for neuromyelitis optica spectrum disorder (NMOSD) and are underway for N-methyl-d-aspartate (NMDA) receptor and leucine-rich glioma inactivated protein 1 (LGI1) encephalitides.

ESSENTIAL POINTS
Autoimmune neurology is now a mainstream subspecialty, consisting of disorders with diverse presentations detectable using antibody testing of serum and CSF. Early and sustained immunotherapy (eg, corticosteroids, intravenous immunoglobulin [IVIg], plasma exchange) is recommended and may be supplemented by immune suppressants (eg, rituximab or cyclophosphamide) to sustain responses and optimize outcomes.
Autoimmune Movement Disorders
Authors: Balint Bettina 
Published: August 2024

ABSTRACT

OBJECTIVE
This article reviews the clinical and antibody spectrum of autoimmune cerebellar ataxia and other autoimmune movement disorders. It highlights characteristic phenotypes and red flags to the diagnosis and how these rare, but treatable, disorders are integrated into a differential diagnosis.

LATEST DEVELOPMENTS
An increasing number of neuronal antibodies have been identified in patients with cerebellar ataxia, for example, against Kelch-like protein 11 (KLHL11), seizure-related 6 homolog–like 2, septin-3 and septin-5, or tripartite motif containing protein 9 (TRIM9), TRIM46, and TRIM67. Ig-like cell adhesion molecule 5 (IgLON5) antibody–associated syndromes have emerged as an important alternative diagnostic consideration to various neurodegenerative diseases such as Huntington disease or atypical parkinsonism. Opsoclonus-myoclonus syndrome emerged as the most relevant parainfectious movement disorder related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

ESSENTIAL POINTS
Autoimmune cerebellar ataxia and other autoimmune movement disorders encompass a broad spectrum of different clinical syndromes, antibodies, and immunopathophysiologic mechanisms. Clinical acumen is key to identifying the cases that should undergo testing for neuronal antibodies. Given the overlap between phenotypes and antibodies, panel testing in serum and CSF is recommended.
Stiff Person Syndrome and GAD Antibody–Spectrum Disorders
Authors: Dalakas Marinos C. 
Published: August 2024

ABSTRACT

OBJECTIVE
Antibodies against glutamic acid decarboxylase (GAD), originally associated with stiff person syndrome (SPS), define the GAD antibody–spectrum disorders that also include cerebellar ataxia, autoimmune epilepsy, limbic encephalitis, progressive encephalomyelitis with rigidity and myoclonus (PERM), and eye movement disorders, all of which are characterized by autoimmune neuronal excitability. This article elaborates on the diagnostic criteria for SPS and SPS spectrum disorders, highlights disease mimics and misdiagnoses, describes the electrophysiologic mechanisms and underlying autoimmunity of stiffness and spasms, and provides a step-by-step therapeutic scheme.

LATEST DEVELOPMENTS
Very-high serum GAD antibody titers are diagnostic for GAD antibody–spectrum disorders and also predict the presence of GAD antibodies in the CSF, increased intrathecal synthesis, and reduced CSF γ-aminobutyric acid (GABA) levels. Low serum GAD antibody titers or the absence of antibodies generates diagnostic challenges that require careful distinction in patients with a variety of painful spasms and stiffness, including functional neurologic disorders. Antibodies against glycine receptors, first found in patients with PERM, are seen in 13% to 15% of patients with SPS, whereas amphiphysin and gephyrin antibodies, seen in 5% of patients with SPS spectrum disorders, predict a paraneoplastic association. GAD-IgG from different SPS spectrum disorders recognizes the same dominant GAD intracellular epitope and, although the pathogenicity is unclear, is an excellent diagnostic marker. The biological basis of muscle stiffness and spasms is related to autoimmune neuronal hyperexcitability caused by impaired reciprocal γ-aminobutyric acid–mediated (GABA-ergic) inhibition, which explains the therapeutic response to GABA-enhancing agents and immunotherapies.

ESSENTIAL POINTS
It is essential to distinguish SPS spectrum disorders from disease mimics to avoid both overdiagnoses and misdiagnoses, considering that SPS is treatable if managed correctly from the outset to prevent disease progression. A step-by-step, combination therapy of GABA-enhancing medications along with immunotherapies ensures prolonged clinical benefits.
Angiographic Features of Meningiomas Predicting Extent of Preoperative Embolization
Authors: Matsoukas Stavros , Feng Rui , Faulkner Denzel E. , Odland Ian C. , Durbin John , Tabani Halima , Schlachter Leslie , Gutzwiller Eveline , Kellner Christopher P. , Shigematsu Tomoyoshi , Shoirah Hazem , Majidi Shahram , De Leacy Reade , Berenstein Alejandro , Mocco J , Fifi Johanna T. , Bederson Joshua B. , Shrivastava Raj K. , Rapoport Benjamin I. 
Published: August 2024

BACKGROUND AND OBJECTIVES:
Preoperative embolization is used as an endovascular adjunct to surgical resection of meningiomas. However, there is no standardized system to assess the efficacy or extent of embolization during the embolization procedure. We sought to establish a purely angiographic grading system to facilitate consistent reporting of the outcome of meningioma embolization and to characterize the anatomic and other features of meningiomas that predict the degree of devascularization achieved through preoperative embolization.

METHODS:
We identified patients with meningiomas who underwent preoperative cerebral angiography and subsequent resection between 2015 and 2021. Demographic, clinical, and imaging data were collected in a research registry. We defined an angiographic devascularization grading scale as follows: grade 0 for no embolization, 1 for partial embolization, 2 for majority embolization, 3 for complete external carotid artery embolization, and 4 for complete embolization.

RESULTS:
Eighty consecutive patients were included, 60 of whom underwent preoperative tumor embolization (20 underwent angiography with an intention to treat but ultimately not embolization). Embolized tumors were larger (59.0 vs 35.9 cc; P = .03). Gross total resection, length of stay, and complication rates did not differ among groups. The distribution of arterial feeders differed significantly across tumors in a location-specific manner. Both the tumor location and the identity of arterial feeders were predictive of the extent of embolization. Anterior midline meningiomas were associated with internal carotid (ophthalmic, ethmoidal) supply and lower devascularization grades (P = .03). Tumors fed by meningeal feeders (convexity, falcine, lateral sphenoid wing) were associated with higher devascularization grades (P < .01). The procedural complication rate for tumor embolization was 2.5%.

CONCLUSION:
Angiographic outcomes can be graded to indicate the extent of tumor embolization. This system may facilitate consistency of reported angiographic results. In addition, arterial feeders vary in a manner predicted by tumor location, and these patterns correlate with typical degrees of devascularization achieved in those tumor locations.
A single dose of radiation elicits comparable acute salivary gland injury to fractionated radiation
Authors: Johnson Amanda L. , Elder Sonia S. , McKendrick John G. , Hegarty Lizi M. , Mercer Ella , Emmerson Elaine 
Published: August 2024

ABSTRACT
The salivary glands are often damaged during head and neck cancer radiotherapy. This results in chronic dry mouth, which adversely affects quality of life and for which there is no long-term cure. Mouse models of salivary gland injury are routinely used in regenerative research. However, there is no clear consensus on the radiation regime required to cause injury. Here, we analysed three regimes of γ-irradiation of the submandibular salivary gland. Transcriptional analysis, immunofluorescence and flow cytometry was used to profile DNA damage, gland architecture and immune cell changes 3 days after single doses of 10 or 15 Gy or three doses of 5 Gy. Irrespective of the regime, radiation induced comparable levels of DNA damage, cell cycle arrest, loss of glandular architecture, increased pro-inflammatory cytokines and a reduction in tissue-resident macrophages, relative to those observed in non-irradiated submandibular glands. Given these data, coupled with the fact that repeated anaesthetic can negatively affect animal welfare and interfere with saliva secretion, we conclude that a single dose of 10 Gy irradiation is the most refined method of inducing acute salivary gland injury in a mouse model.
The Effects of Daily-Living Risks on Breast Cancer-Related Lymphedema
Authors: Fu Mei Rosemary , Liu Bowen , Qiu Jeanna Mary , Sun Yuanlu , Axelrod Deborah , Guth Amber , Korth Stephanie , Kremer Howard L. , Wang Yao 
Published: August 2024

Abstract
Background
Conventional advice to reduce the risk of breast cancer-related lymphedema (BCLE) suggests avoidance of daily-living risks, and limited research has investigated these risks.

Objective
This study aimed to examine the occurrence, patterns, and effects of daily-living risks on BCLE.

Methods
A cross-sectional design was used to collect data from 567 patients at a metropolitan cancer center in the United States. The Lymphedema Risk-Reduction Behavior Checklist was used to assess the occurrence of 11 daily-living risks. Descriptive, regression, and factor analyses were performed.

Results
Significant odds of BCLE were associated with infection (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.95–3.42), cuts/scratches (OR 2.65, 95% CI 1.97–3.56), sunburn (OR 1.89, 95% CI 1.39–3.56), oil splash or steam burns (OR 2.08, 95% CI 1.53–3.83), and insect bites (OR 1.59, 95% CI 1.18–2.13). The daily-living risks were clustered into factors related to skin trauma and carrying objects. Skin trauma risk was significantly associated with BCLE (B = 0.539, z = 3.926, OR 1.714, 95% CI 1.312–2.250; p < 0.001). Having three, four, or five skin trauma risks significantly increased the odds of BCLE to 4.31, 5.14, and 6.94 times, respectively. The risk of carrying objects had no significant or incremental effects on BCLE.

Conclusion
Complete avoidance of daily-living risks is challenging given 52.73% of patients incurred more than five daily-living risks. Our study findings underscore the importance of ‘what to do’ strategies to minimize infection and skin trauma.