bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the discontinuation of antihypertensive treatment on neuropsychiatric symptoms and quality of life in nursing home residents with dementia (DANTON): a multicentre, open-label, blinded-outcome, randomised controlled trial
Authors: Bogaerts Jonathan M K , Gussekloo Jacobijn , de Jong-Schmit Bianca E M , Le Cessie Saskia , Mooijaart Simon P , van der Mast Roos C , Achterberg Wilco P , Poortvliet Rosalinde K E 
Published: July 2024

Abstract

Background
Based on observational studies and randomised controlled trials (RCTs), the benefit–harm balance of antihypertensive treatment in older adults with dementia is unclear.

Objective
To assess whether discontinuing antihypertensive treatment reduces neuropsychiatric symptoms (NPSs) and maintains quality of life (QoL) in nursing home residents with dementia.

Design
Open-label, blinded-outcome RCT. Randomisation 1:1, stratified by nursing home organisation and baseline NPS. Trial registration: NL7365.

Subjects
Dutch long-term care residents with moderate-to-severe dementia and systolic blood pressure (SBP) ≤160 mmHg during antihypertensive treatment. Exclusion criteria included heart failure NYHA-class-III/IV, recent cardiovascular events/procedures or life expectancy &lt;4 months (planned sample size n = 492).

Measurements
Co-primary outcomes NPS (Neuropsychiatric Inventory-Nursing Home [NPI-NH]) and QoL (Qualidem) at 16 weeks.

Results
From 9 November 2018 to 4 May 2021, 205 participants (median age 85.8 [IQR 79.6–89.5] years; 79.5% female; median SBP 134 [IQR 123–146] mmHg) were randomised to either antihypertensive treatment discontinuation (n = 101) or usual care (n = 104). Safety concerns, combined with lacking benefits, prompted the data safety and monitoring board to advice a premature cessation of randomisation. At 16-week follow-up, no significant differences were found between groups for NPI-NH (adjusted mean difference 1.6 [95% CI –2.3 to 5.6]; P = 0.42) or Qualidem (adjusted mean difference − 2.5 [95% CI –6.0 to 1.0]; P = 0.15). Serious adverse events (SAEs) occurred in 36% (discontinuation) and 24% (usual care) of the participants (adjusted hazard ratio 1.65 [95% CI 0.98–2.79]). All 32-week outcomes favoured usual care.

Conclusion
Halfway through this study, a non-significant increased SAE risk associated with discontinuing antihypertensive treatment was observed, and an associated interim analysis showed that significant worthwhile health gain for discontinuation of antihypertensive treatment was unlikely. This unbeneficial benefit–harm balance shows that discontinuation of antihypertensive treatment in this context does not appear to be either safe or beneficial enough to be recommended in older adults with dementia.
The use of natural language processing for the identification of ageing syndromes including sarcopenia, frailty and falls in electronic healthcare records: a systematic review
Authors: Osman Mo , Cooper Rachel , Sayer Avan A , Witham Miles D 
Published: July 2024

Abstract

Background
Recording and coding of ageing syndromes in hospital records is known to be suboptimal. Natural Language Processing algorithms may be useful to identify diagnoses in electronic healthcare records to improve the recording and coding of these ageing syndromes, but the feasibility and diagnostic accuracy of such algorithms are unclear.

Methods
We conducted a systematic review according to a predefined protocol and in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were run from the inception of each database to the end of September 2023 in PubMed, Medline, Embase, CINAHL, ACM digital library, IEEE Xplore and Scopus. Eligible studies were identified via independent review of search results by two coauthors and data extracted from each study to identify the computational method, source of text, testing strategy and performance metrics. Data were synthesised narratively by ageing syndrome and computational method in line with the Studies Without Meta-analysis guidelines.

Results
From 1030 titles screened, 22 studies were eligible for inclusion. One study focussed on identifying sarcopenia, one frailty, twelve falls, five delirium, five dementia and four incontinence. Sensitivity (57.1%–100%) of algorithms compared with a reference standard was reported in 20 studies, and specificity (84.0%–100%) was reported in only 12 studies. Study design quality was variable with results relevant to diagnostic accuracy not always reported, and few studies undertaking external validation of algorithms.

Conclusions
Current evidence suggests that Natural Language Processing algorithms can identify ageing syndromes in electronic health records. However, algorithms require testing in rigorously designed diagnostic accuracy studies with appropriate metrics reported.
Relationships of Office, Ambulatory, and Self-measured Blood Pressure With Cardiac, Renal, and Atherosclerotic Biomarkers
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi 
Published: July 2024

Abstract

BACKGROUND
Previous studies with several limitations have comparatively analyzed the relationship between ambulatory blood pressure (BP) and self-measured BP and biomarkers of organ damage. This study extends this line of research by examining the relationship between ambulatory and self-measured BP and cardiac, renal, and atherosclerotic biomarkers in outpatients at cardiovascular risk.

METHODS
In 1,440 practice outpatients who underwent office, ambulatory, and self-measured BP monitoring, we assessed the relationships of each BP with organ damage biomarkers including b-type natriuretic peptide (BNP), echocardiographic left ventricular mass index (LVMI), urine albumin-creatinine ratio (UACR), and brachial-ankle pulse wave velocity (baPWV).

RESULTS
In the comparison of correlation, self-measured systolic BP (SBP) was more strongly correlated to log-transformed (Ln) BNP (n = 1,435; r = 0.123 vs. r = −0.093, P &lt; 0.001), LVMI (n = 1,278; r = 0.223 vs. r = 0.094, P &lt; 0.001), Ln-UACR (n = 1,435; r = 0.244 vs. r = 0.154, P = 0.010), and baPWV (n = 1,360; r = 0.327 vs. r = 0.115, P &lt; 0.001) than daytime ambulatory SBP. In the linear regression models including office, ambulatory, and self-measured SBP, only self-measured SBP was significantly related to Ln-BNP (P = 0.016) and LVMI (P &lt; 0.001). In the logistic regression models for the top quartile of LVMI, adding self-measured SBP improved the model predictability (P = 0.027), but adding daytime ambulatory SBP did not. However, adding daytime ambulatory SBP improved the model predictability in the logistic model for the top quartile of baPWV including office and self-measured SBP (P = 0.030).

CONCLUSIONS
Our study findings suggested that self-measured BP was associated with cardiac biomarkers independent of ambulatory BP.
Stereospecific reduction of 2′S-configured strigolactones by cowpea OPR3 enzymes
Authors: Suzawa Shota , Yamauchi Misa , Homma Masato , Yamauchi Yasuo , Mizutani Masaharu , Wakabayashi Takatoshi , Sugimoto Yukihiro 
Published: July 2024

ABSTRACT
Strigolactones (SLs), plant-derived apocarotenoids, serve dual roles as phytohormones and rhizosphere signaling molecules. While exogenous administration of SLs to plants aids in studying their functions, the metabolic destiny of these administered SLs remains poorly elucidated. Our previous research demonstrated that among synthetic SL GR24 stereoisomers administered to cowpea (Vigna unguiculata), 2′-epi-GR24 undergoes selective reduction at the C-3′,4′ double bond in its D-ring. In this investigation, we isolated proteins from cowpea roots based on SL reducing activity and identified 12-oxophytodienoate reductase 3 homologs (VuOPR3s) as contributors to this reduction. Enzymatic assays conducted with recombinant proteins revealed that VuOPR3s exhibited a preference for reducing activity toward 2′S-configured SLs, including 2′-epi-GR24. This specificity for 2′S-configured SLs was congruent with that observed for orobanchol produced by cowpea and its stereoisomers. These findings suggest that exogenously administered SLs undergo enzymatic stereoselective reduction, underscoring the importance of considering stereospecificity when interpreting data obtained from SL usage.
LarvaTagger: manual and automatic tagging of Drosophila larval behaviour
Authors: Laurent François , Blanc Alexandre , May Lilly , Gándara Lautaro , Cocanougher Benjamin T , Jones Benjamin M W , Hague Peter , Barré Chloé , Vestergaard Christian L , Crocker Justin , Zlatic Marta , Jovanic Tihana , Masson Jean-Baptiste 
Published: July 2024

Abstract

Motivation
As more behavioural assays are carried out in large-scale experiments on Drosophila larvae, the definitions of the archetypal actions of a larva are regularly refined. In addition, video recording and tracking technologies constantly evolve. Consequently, automatic tagging tools for Drosophila larval behaviour must be retrained to learn new representations from new data. However, existing tools cannot transfer knowledge from large amounts of previously accumulated data. We introduce LarvaTagger, a piece of software that combines a pre-trained deep neural network, providing a continuous latent representation of larva actions for stereotypical behaviour identification, with a graphical user interface to manually tag the behaviour and train new automatic taggers with the updated ground truth.

Results
We reproduced results from an automatic tagger with high accuracy, and we demonstrated that pre-training on large databases accelerates the training of a new tagger, achieving similar prediction accuracy using less data.

Availability and implementation
All the code is free and open source. Docker images are also available. See gitlab.pasteur.fr/nyx/LarvaTagger.jl.
Semiparametric efficiency gains from parametric restrictions on propensity scores
Authors: Kono Haruki 
Published: July 2024

Abstract
We explore how much knowing a parametric restriction on propensity scores improves semiparametric efficiency bounds in the potential outcome framework. For stratified propensity scores, considered as a parametric model, we derive explicit formulas for the efficiency gain from knowing how the covariate space is split. Based on these, we find that the efficiency gain decreases as the partition of the stratification becomes finer. For general parametric models, where it is hard to obtain explicit representations of efficiency bounds, we propose a novel framework that enables us to see whether knowing a parametric model is valuable in terms of efficiency even when it is high dimensional. In addition to the intuitive fact that knowing the parametric model does not help much if it is sufficiently flexible, we discover that the efficiency gain can be nearly zero even though the parametric assumption significantly restricts the space of possible propensity scores.
Racially Determined Case Characteristics: Exploring Disparities in the Use of Sentencing Factors in England and Wales
Authors: Guilfoyle Eoin , Pina-Sánchez Jose 
Published: July 2024

Abstract
There is little understanding of how documented ethnic disparities in sentencing outcomes in England and Wales come to be and, consequently, how to address them. We argue that disparities in sentence outcomes could stem from how cases are constructed. We hypothesize that case characteristics determined through a high degree of judicial discretion and an assessment of the offender have a high risk of being racially determined, and therefore, operate as precursors of ethnic disparities in sentencing. We test this using Crown Court Sentencing Survey and Court Proceedings data. We identify three sentencing factors (remorse, good character and ability to rehabilitate) clearly favouring White offenders. We contextualize their operation and argue that all three should be classified as racially determined and sources of ethnic disparity. We conclude by setting out targeted policy solutions.
Unpaid Care Work Time and Women’s Employment Status: Evidence from India
Authors: Tripathi Saumya , Zhai Fuhua , Azhar Sameena 
Published: July 2024

Abstract
Using the first Indian 2019 Time Use Survey, we investigate the association between women’s time spent on unpaid care work (UCW) and their employment status and whether this association differs by socio-demographic characteristics such as age, marital status, education level and household size, controlling for religion, social group status, household monthly expenditure and geographical location (e.g. rural versus urban settings). Using multinomial logistic regression, an inverse association was found between women’s UCW and their employment status. An hour increase in women’s time spent on UCW decreased their odds of employment, self-employment or pursuing higher education by 38 per cent, 27 per cent and 34 per cent, respectively. According to a decomposition analysis, almost 80 per cent of the odds ratios for employment status were due to increased time spent on UCW rather than the influence of socio-demographic characteristics. Findings underscore the need for integrating care provisions into the broader social and economic agenda for the country.
Empathy incites a stable prosocial decision bias
Authors: Saulin Anne , Ma Yina , Hein Grit 
Published: July 2024

Abstract
Empathy toward suffering individuals serves as potent driver for prosocial behavior. However, it remains unclear whether prosociality induced by empathy for another person’s pain persists once that person’s suffering diminishes. To test this, participants underwent functional magnetic resonance imaging while performing a binary social decision task that involved allocation of points to themselves and another person. In block one, participants completed the task after witnessing frequent painful stimulation of the other person, and in block two, after observing low frequency of painful stimulation. Drift-diffusion modeling revealed an increased initial bias toward making prosocial decisions in the first block compared with baseline that persisted in the second block. These results were replicated in an independent behavioral study. An additional control study showed that this effect may be specific to empathy as stability was not evident when prosocial decisions were driven by a social norm such as reciprocity. Increased neural activation in dorsomedial prefrontal cortex was linked to empathic concern after witnessing frequent pain and to a general prosocial decision bias after witnessing rare pain. Altogether, our findings show that empathy for pain elicits a stable inclination toward making prosocial decisions even as their suffering diminishes.
Vertebral fractures in patients with CKD and the general population: a call for diagnosis and action
Authors: Gifre Laia , Massó Elisabet , Fusaro Maria , Haarhaus Mathias , Ureña Pablo , Cozzolino Mario , Mazzaferro Sandro , Calabia Jordi , Peris Pilar , Bover Jordi 
Published: July 2024

ABSTRACT
Vertebral fractures (VFs) are the most common osteoporotic fractures in the general population, and they have been associated with high mortality, decreased quality of life, and high risk of subsequent fractures, especially when recent, multiple, or severe. Currently, VF diagnosis and classification determine fracture risk and the most appropriate anti-osteoporotic treatment. However, VFs are clearly underdiagnosed, especially in patients with chronic kidney disease (CKD), and CKD-associated osteoporosis has been disregarded until recently. VFs are associated with higher morbidity and mortality, and their prevalence and incidence differ depending on the grade of renal dysfunction (CKD G1–G5) and/or the type of renal replacement therapy (dialysis or transplantation). In addition to classical risk factors [such as higher age, female sex, reduced bone mineral density, diabetes and steroid use], various other factors have been associated with an increased risk of VFs in CKD, including CKD grade, haemodialysis vintage, time since renal transplantation, low or high intact parathyroid hormone and phosphate levels, and/or vitamin D and K1 deficiencies. Importantly, several clinical societies have recently modified their algorithms according to the fracture risk classification (including the presence of VFs) and determined the most appropriate anti-osteoporotic treatment for the general population. However, there are no specific guidelines addressing this topic in patients with CKD despite an important paradigm shift regarding the prognostic value of bone mineral density in 2017 after the publication of the CKD-Mineral and Bone Disorder Kidney Disease: Improving Global Outcomes guidelines. A proactive attitude towards diagnosis, treatment, and research is proposed to avoid therapeutic nihilism.
Risk factors for major bleeding in patients with atrial fibrillation and CKD G3–G5D on oral anticoagulants
Authors: Welander Frida , Renlund Henrik , Själander Anders 
Published: July 2024

ABSTRACT

Background
Patients with chronic kidney disease (CKD) and atrial fibrillation (AF) on oral anticoagulants (OACs) are at high risk of bleeding. Determinants of major bleeding risk in OAC users with AF and CKD are not well established and available bleeding score systems do not perform well in CKD. This study aims to present risk factors associated with major bleeding in a Swedish cohort of OAC-treated patients with CKD G3–5D.

Methods
We conducted a Swedish register-based cohort study including patients with AF and CKD G3–5D on warfarin or direct OACs (DOACs) between 2009 and 2018. Data were collected from high-quality registers including the Swedish Renal Registry and Auricula, a register for AF and OACs. Risk factors for major bleeding were investigated with Cox regression analysis.

Results
Of 2453 included patients, 59% were on warfarin (time in therapeutic range 67%) and 41% on DOACs. Major bleeding rates were 8.9/100 patient-years. Factors associated with increased bleeding risk were glomerular filtration rate category, G5/5D versus G3 {hazard ratio [HR] 1.92 [95% confidence interval (CI) 1.43–2.56]}, previous gastrointestinal bleeding [HR 1.77 (95% CI 1.39–2.25)], previous other bleeding [HR 1.33 (95% CI 1.09–1.62)], congestive heart failure [HR 1.36 (95% CI 1.11–1.68)], male sex [HR 1.28 (95% CI 1.03–1.60)] and vascular disease [HR 1.35 (95% CI 1.01–1.79)].

Conclusion
Patients with AF and G3–5D on OACs are at a high risk of bleeding. Previous major bleeding and kidney failure are strongly associated with major bleeding. The present study also shows an association between OAC-associated bleeding and male sex, congestive heart failure and vascular disease. Knowledge about determinants of bleeding in advanced CKD is essential when deciding on when to anticoagulate or not.
Integrating multiple kidney function markers to predict all-cause and cardiovascular disease mortality: prospective analysis of 366 758 UK Biobank participants
Authors: Fujii Ryosuke , Melotti Roberto , Köttgen Anna , Teumer Alexander , Giardiello Daniele , Pattaro Cristian 
Published: July 2024

ABSTRACT

Background
Reduced kidney function is a risk factor of cardiovascular and all-cause mortality. This association was demonstrated for several kidney function markers, but it is unclear whether integrating multiple measured markers may improve mortality risk prediction.

Methods
We conducted an exploratory factor analysis (EFA) of serum creatinine– and cystatin C–based estimated glomerular filtration rate [eGFRcre and eGFRcys; derived by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and European Kidney Function Consortium (EKFC) equations], blood urea nitrogen (BUN), uric acid and serum albumin among 366 758 participants in the UK Biobank without a history of kidney failure. Fitting Cox proportional hazards models, we compared the ability of the identified latent factors to predict overall mortality and mortality by cardiovascular disease (CVD), also considering CVD-specific causes like coronary heart disease (CHD) and cerebrovascular disease.

Results
During 12.5 years of follow-up, 26 327 participants died from any cause, 5376 died from CVD, 2908 died from CHD and 1116 died from cerebrovascular disease. We identified two latent factors, EFA1 and EFA2, both representing kidney function variations. When using the CKD-EPI equation, EFA1 performed like eGFRcys, with EFA1 showing slightly larger hazard ratios for overall and CVD-related mortality. At 10 years of follow-up, EFA1 and eGFRcys showed moderate discrimination performance for CVD-related mortality, outperforming all other kidney indices. eGFRcre was the least predictive marker across all outcomes. When using the EKFC equation, eGFRcys performed better than EFA1 while all other results remaining similar.

Conclusions
While EFA is an attractive approach to capture the complex effects of kidney function, eGFRcys remains the most practical and effective measurement for all-cause and CVD mortality risk prediction.
Hypoaldosteronism due to a novel SEC61A1 variant successfully treated with fludrocortisone
Authors: Karpman Diana , Lindström Martin L , Möller Mattias , Ivarsson Sofie , Kristoffersson Ann-Charlotte , Bekassy Zivile , Fogo Agnes B , Elfving Maria 
Published: July 2024

Abstract

Background
Genetic variants in SEC61A1 are associated with autosomal dominant tubulointerstitial kidney disease. SEC61A1 is a translocon in the endoplasmic reticulum membrane and variants affect biosynthesis of renin and uromodulin.

Methods
A patient is described that presented at 1 year of age with failure-to-thrive, kidney failure (glomerular filtration rate, GFR, 18 ml/min/1.73m2), hyperkalemia and acidosis. Genetic evaluation was performed by whole genome sequencing.

Results
The patient has a novel de novo heterozygous SEC61A1 variant, Phe458Val. Plasma renin was low or normal, aldosterone was low or undetectable and uromodulin was low. Kidney biopsy at 2 years exhibited subtle changes suggestive of tubular dysgenesis without tubulocystic or glomerulocystic lesions and with renin staining of the juxtaglomerular cells. The patient experienced extreme fatigue due to severe hypotension attributed to hypoaldosteronism and at 8 years of age fludrocortisone treatment was initiated with marked improvement in her well-being. Blood pressure and potassium normalized. Biopsy at 9 years showed extensive glomerulosclerosis and mild tubulointerstitial fibrosis, as well as tubular mitochondrial abnormalities, without specific diagnostic changes. Her GFR improved to 54 ml/min/1.73m2.

Conclusions
As the renin-angiotensin system promotes aldosterone release, and the patient had repeatedly undetectable aldosterone levels, the SEC61A1 variant presumably contributed to severe hypotension. Treatment with a mineralocorticoid had a beneficial effect and corrected the electrolyte and acid-base disorder. We suggest that the increased blood pressure hemodynamically improved the patient's kidney function.