bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect modification by statin use status on the association between fine particulate matter (PM2.5) and cardiovascular mortality
Authors: Bai Li , Kwong Jeffrey C , Kaufman Jay S , Benmarhnia Tarik , Chen Chen , van Donkelaar Aaron , Martin Randall V , Kim JinHee , Lu Hong , Burnett Richard T , Chen Hong 
Published: July 2024

Abstract

Background
Numerous studies have linked fine particulate matter (PM2.5) to increased cardiovascular mortality. Less is known how the PM2.5-cardiovascular mortality association varies by use of cardiovascular medications. This study sought to quantify effect modification by statin use status on the associations between long-term exposure to PM2.5 and mortality from any cardiovascular cause, coronary heart disease (CHD), and stroke.

Methods
In this nested case-control study, we followed 1.2 million community-dwelling adults aged ≥66 years who lived in Ontario, Canada from 2000 through 2018. Cases were patients who died from the three causes. Each case was individually matched to up to 30 randomly selected controls using incidence density sampling. Conditional logistic regression models were used to estimate odds ratios (ORs) for the associations between PM2.5 and mortality. We evaluated the presence of effect modification considering both multiplicative (ratio of ORs) and additive scales (the relative excess risk due to interaction, RERI).

Results
Exposure to PM2.5 increased the risks for cardiovascular, CHD, and stroke mortality. For all three causes of death, compared with statin users, stronger PM2.5-mortality associations were observed among non-users [e.g. for cardiovascular mortality corresponding to each interquartile range increase in PM2.5, OR = 1.042 (95% CI, 1.032–1.053) vs OR = 1.009 (95% CI, 0.996–1.022) in users, ratio of ORs = 1.033 (95% CI, 1.019–1.047), RERI = 0.039 (95% CI, 0.025–0.050)]. Among users, partially adherent users exhibited a higher risk of PM2.5-associated mortality than fully adherent users.

Conclusions
The associations of chronic exposure to PM2.5 with cardiovascular and CHD mortality were stronger among statin non-users compared to users.
HESS energy configuration strategy based on load regulation for wind power
Authors: Liu Zenglei , Chen Bangjun 
Published: July 2024

Abstract
Energy storage systems are particularly suitable for renewable energy sources, such as wind power, because these renewable energy sources are volatile. The hybrid energy storage system (HESS) considers the advantages of multiple energy storage systems and is considered very promising; therefore, the energy configuration strategy of an excellent HESS that considers both cost and performance is crucial. This article based on HESS consists of battery and supercapacitor (SC), additional consideration of user load; thus, by adjusting user translatable load and reducible load, the pressure of wind power and HESS can be alleviated to take into account the cost and performance of HESS. Further, a simple and easy-to-implement energy configuration strategy for HESS is proposed, which takes into account that the energy stored in the battery is almost the energy stored in the HESS and calculates the battery energy and then the SC energy through the gap between the load and the wind power. We used three sets of cases: without HESS, with HESS but without load control, and with HESS and load control. The results show that, compared with HESS without load control, HESS with load control can achieve lower HESS cost, wind abandonment rate, and load power shortage rate, which is impossible to combine with traditional strategies.
Unique Continuation at Infinity: Carleman Estimates on General Warped Cylinders
Authors: De Ponti Nicolò , Pigola Stefano , Veronelli Giona 
Published: July 2024

Abstract
We obtain a vanishing result for solutions of the inequality $|\Delta u| \leq q_{1} |u| + q_{2} |\nabla u|$ that decay to zero along a very general warped cylindrical end of a Riemannian manifold. The appropriate decay condition at infinity on $u$ is related to the behavior of the potential functions $q_{1}$ and $q_{2}$ and to the asymptotic geometry of the end. The main ingredient is a new Carleman estimate of independent interest. Geometric applications to conformal deformations and to minimal graphs are presented.
A DNA Methylation Signature From Buccal Swabs to Identify Tuberculosis Infection
Authors: Karlsson Lovisa , Öhrnberg Isabelle , Sayyab Shumaila , Martínez-Enguita David , Gustafsson Mika , Espinoza Patricia , Méndez-Aranda Melissa , Ugarte-Gil Cesar , Diero Lameck , Tonui Ronald , Paues Jakob , Lerm Maria 
Published: July 2024

Abstract

Background
Tuberculosis (TB) is among the largest infectious causes of death worldwide, and there is a need for a time- and resource-effective diagnostic methods. In this novel and exploratory study, we show the potential of using buccal swabs to collect human DNA and investigate the DNA methylation (DNAm) signatures as a diagnostic tool for TB.

Methods
Buccal swabs were collected from patients with pulmonary TB (n = 7), TB-exposed persons (n = 7), and controls (n = 9) in Sweden. Using Illumina MethylationEPIC array, the DNAm status was determined.

Results
We identified 5644 significant differentially methylated CpG sites between the patients and controls. Performing the analysis on a validation cohort of samples collected in Kenya and Peru (patients, n = 26; exposed, n = 9; control, n = 10) confirmed the DNAm signature. We identified a TB consensus disease module, significantly enriched in TB-associated genes. Last, we used machine learning to identify a panel of 7 CpG sites discriminative for TB and developed a TB classifier. In the validation cohort, the classifier performed with an area under the curve of 0.94, sensitivity of 0.92, and specificity of 1.

Conclusions
In summary, the result from this study shows clinical implications of using DNAm signatures from buccal swabs to explore new diagnostic strategies for TB.
Reasoning with large language models for medical question answering
Authors: Lucas Mary M , Yang Justin , Pomeroy Jon K , Yang Christopher C 
Published: July 2024

Abstract

Objectives
To investigate approaches of reasoning with large language models (LLMs) and to propose a new prompting approach, ensemble reasoning, to improve medical question answering performance with refined reasoning and reduced inconsistency.

Materials and Methods
We used multiple choice questions from the USMLE Sample Exam question files on 2 closed-source commercial and 1 open-source clinical LLM to evaluate our proposed approach ensemble reasoning.

Results
On GPT-3.5 turbo and Med42-70B, our proposed ensemble reasoning approach outperformed zero-shot chain-of-thought with self-consistency on Steps 1, 2, and 3 questions (+3.44%, +4.00%, and +2.54%) and (2.3%, 5.00%, and 4.15%), respectively. With GPT-4 turbo, there were mixed results with ensemble reasoning again outperforming zero-shot chain-of-thought with self-consistency on Step 1 questions (+1.15%). In all cases, the results demonstrated improved consistency of responses with our approach. A qualitative analysis of the reasoning from the model demonstrated that the ensemble reasoning approach produces correct and helpful reasoning.

Conclusion
The proposed iterative ensemble reasoning has the potential to improve the performance of LLMs in medical question answering tasks, particularly with the less powerful LLMs like GPT-3.5 turbo and Med42-70B, which may suggest that this is a promising approach for LLMs with lower capabilities. Additionally, the findings show that our approach helps to refine the reasoning generated by the LLM and thereby improve consistency even with the more powerful GPT-4 turbo. We also identify the potential and need for human-artificial intelligence teaming to improve the reasoning beyond the limits of the model.
Fentanyl-related deaths in Ontario, Canada: toxicological findings and circumstances of death in 4395 cases (2020–22)
Authors: Adamo Alexandra , Marshall Karlie , Woodall Karen L 
Published: July 2024

Abstract
Over the last 20 years, there has been a significant increase in fentanyl-related deaths in Ontario, Canada. This report examines toxicological findings in a series of death investigations in which fentanyl was quantitated to identify the prevalence, trends, and demographic data associated with fentanyl in Ontario, Canada, and to highlight the changes in these trends since fentanyl began appearing in casework in Ontario in the early 2000s. A retrospective study of all cases in which fentanyl was quantitated in blood, using liquid chromatography (LC)–tandem mass spectrometry (MS-MS), was conducted for the time period between 1 January 2020 and 31 December 2022. A total of 4395 cases were included; 77% of the decedents were male, and 23% was female with ages ranging from 0 to 95 years. The most frequently classified cause of death was mixed drug toxicity (69%) followed by fentanyl intoxication at 19%. Less than 10% of cases where fentanyl was quantitated were classified as nondrug-related deaths. Fentanyl concentrations in all cases ranged from 1.3 to &gt;2000 ng/mL. Other drugs were frequently detected with fentanyl. In mixed drug toxicity cases, stimulants were the most frequently encountered class of drugs: cocaine was identified in 51.8%, and methamphetamine was observed in 43.0% of cases. Detailed reports for select cases were included to provide additional insight into the different case types and to show the difficulty in interpreting blood concentrations without additional detailed case histories. This study provides valuable information for the scientific and medical community regarding the continued use of fentanyl and how patterns of fentanyl use have evolved since it began to appear in forensic casework.
An Occupation-Based Review of Outcome Measures Used to Assess Hand Function After Burn Injury
Authors: Cancio Jill M , Stav Wendy B , Colaianni Donna 
Published: July 2024

Abstract
While occupation began as the central concept of occupational therapy at the dawn of the profession, the use of occupation throughout the therapy process, including assessment, has wavered in recent decades. Occupation is defined as meaningful and purposeful activities that individuals do to occupy their time and attention. The use of occupation-based assessments is vital to establishing care with an occupational focus. The purpose of this article is to review the outcome assessment tools commonly used in the burn literature to evaluate hand function and critique the presence of occupation in each assessment using the Occupation-Based Practice Assessment. Knowledge of the occupational nature of assessments is important to the delivery of an occupational therapy evaluation comprised of a battery of assessments inclusive of discrete measures of movement as well as performance-based tools to represent the person from an occupational perspective. Many outcome measures used in upper extremity burn rehabilitation are discrete in nature and do not measure occupations of clients. The Suitcase Packing Activity may be a viable addition to an assessment battery to address this essential need.
Household chaos and childhood obesity-related health outcomes
Authors: Burton E Thomaseo , Choquette Adora E , Gray Emily , Odulana Adebowale , Kim Ahlee , Smith Webb A 
Published: July 2024

Abstract

Objective
Household chaos, defined as a lack of organization, structure, and predictability, has been linked to deleterious childhood health outcomes and may hinder attempts to initiate and maintain healthy lifestyle changes. This study examined the associations of household chaos and obesity-related health conditions in a sample of youth being treated for obesity.

Methods
Participants were 715 patients (61.8% girls; Mage = 12.3 years; 68.7% non-Hispanic Black; M% of 95th BMI %-ile = 146.9%) enrolled in a pediatric weight management clinic. Caregiver report of household chaos was measured using the Confusion, Hubbub and Order Scale (CHAOS). Physiological obesity-related comorbidities (e.g., insulin resistance, hypertension, dyslipidemia) were assessed by a medical clinician and abstracted from electronic medical records; health conditions were dichotomized as present or not present. Psychological functioning was measured with the Pediatric Symptom Checklist, a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention concerns.

Results
The Wilcoxon rank-sum test was used to test differences in household chaos scores for each obesity-related health condition. Caregivers of youth diagnosed with hypertension and obstructive sleep apnea reported significantly lower levels of household chaos, while caregivers who reported clinical levels of psychological dysfunction reported higher levels of chaos.

Conclusions
Traditional management of childhood obesity requires changes across multiple health domains (e.g., dietary, exercise, sleep), and such change may be facilitated by structure and consistency. Present findings suggest that psychological resources within pediatric weight management settings should address individual patient-level factors associated with physiological and mental health as well as household functioning.
The X-ray rise and fall of the symbiotic recurrent nova system T CrB
Authors: Toalá Jesús A , González-Martín Omaira , Sacchi Andrea , Vasquez-Torres Diego A 
Published: July 2024

ABSTRACT
We present the analysis of publicly available NuSTAR, Suzaku, and XMM–Newton observations of the symbiotic recurrent nova T CrB covering the 2006.77–2022.66 yr period. The X-ray spectra are analysed by adopting a model that includes a reflection component produced by the presence of a disc that mimics the accretion disc and the immediate surrounding medium. Our best-fitting model requires this disc to have a radius of 1 au, effective thickness of 0.1 au, averaged column density 10$^{25}$ cm$^{-2}$ and orientation of 50$^{\circ }$ with respect to the line of sight. This disc is about a factor of two larger than recent estimations for the accretion disc and its presence contributes significantly via reflection to the total X-ray flux detected from T CrB, which naturally produces the emission of the 6.4 keV Fe line. Our analysis suggests that the temperature of the boundary layer evolved from 14.8 keV in the steady-state phase (before 2016), to 2.8 keV in the 2017.24 epoch, to finally stabilize to about $\sim$8 keV in the subsequent epochs. These variations in the plasma temperature of the boundary layer are attributed to the evolution of the mass accretion rate ($\dot{M}_\mathrm{acc}$), which is estimated to have an averaged value of $\dot{M}_\mathrm{acc}$ = 2.6$\times \,10^{-8}$ M$_\odot$ yr$^{-1}$ for the current active phase. The presence of emission lines in the XMM–Newton Reflection Grating Spectrometer spectrum of 2017.24 prevents from adopting a blackbody emission model to fit the soft X-ray range. Instead, we use plasma emission models that suggest the presence of adiabatically shocked gas produced by gas velocities of 110–200 km s$^{-1}$, very likely tracing jet-like ejections similar to what is found in other symbiotic systems. The analysis of X-ray and optical data together show that T CrB has a similar evolution as black hole binaries, accreting neutron stars and active galactic nuclei in the hardness–intensity diagram.
The three-dimensional structure of black hole accretion flows within the plunging region
Authors: Mummery Andrew , Stone James M 
Published: July 2024

ABSTRACT
We analyse, using new analytical models and numerical general relativistic magnetohydrodynamic simulations, the three-dimensional properties of accretion flows inside the plunging region of black hole spacetimes (i.e. at radii smaller than the innermost stable circular orbit). These simulations are of thick discs, with aspect ratios of order unity $h/r \sim 1$, and with a magnetic field geometry given by the standard low-magnetization ‘SANE’ configuration. This work represents the first step in a wider analysis of this highly relativistic region. We show that analytical expressions derived in the ‘thin disc’ limit describe the numerical results remarkably well, despite the large aspect ratio of the flow. We further demonstrate that accretion within this region is typically mediated via spiral arms, and that the geometric properties of these spiral structures can be understood with a simple analytical model. These results highlight how accretion within the plunging region is fundamentally two-dimensional in character, which may have a number of observational implications. We derive a modified theoretical description of the pressure within the plunging region which accounts for turbulent heating and may be of use to black hole image modelling.
Diffuse glioma molecular profiling with arterial spin labeling and dynamic susceptibility contrast perfusion MRI: A comparative study
Authors: Prysiazhniuk Yeva , Server Andres , Leske Henning , Bech-Aase Øystein , Helseth Eirik , Eijgelaar Roelant Sjouke , Fuster-García Elies , Brandal Petter , Bjørnerud Atle , Otáhal Jakub , Petr Jan , Nordhøy Wibeke 
Published: July 2024

Abstract

Background
Evaluation of molecular markers (IDH, pTERT, 1p/19q codeletion, and MGMT) in adult diffuse gliomas is crucial for accurate diagnosis and optimal treatment planning. Dynamic Susceptibility Contrast (DSC) and Arterial Spin Labeling (ASL) perfusion MRI techniques have both shown good performance in classifying molecular markers, however, their performance has not been compared side-by-side.

Methods
Pretreatment MRI data from 90 patients diagnosed with diffuse glioma (54 men/36 female, 53.1 ± 15.5 years, grades 2–4) were retrospectively analyzed. DSC-derived normalized cerebral blood flow/volume (nCBF/nCBV) and ASL-derived nCBF in tumor and perifocal edema were analyzed in patients with available IDH-mutation (n = 67), pTERT-mutation (n = 39), 1p/19q codeletion (n = 33), and MGMT promoter methylation (n = 31) status. Cross-validated uni- and multivariate logistic regression models assessed perfusion parameters’ performance in molecular marker detection.

Results
ASL and DSC perfusion parameters in tumor and edema distinguished IDH-wildtype (wt) and pTERT-wt tumors from mutated ones. Univariate classification performance was comparable for ASL-nCBF and DSC-nCBV in IDH (maximum AUROCC 0.82 and 0.83, respectively) and pTERT (maximum AUROCC 0.70 and 0.81, respectively) status differentiation. The multivariate approach improved IDH (DSC-nCBV AUROCC 0.89) and pTERT (ASL-nCBF AUROCC 0.8 and DSC-nCBV AUROCC 0.86) classification. However, ASL and DSC parameters could not differentiate 1p/19q codeletion or MGMT promoter methylation status. Positive correlations were found between ASL-nCBF and DSC-nCBV/-nCBF in tumor and edema.

Conclusions
ASL is a viable gadolinium-free replacement for DSC for molecular characterization of adult diffuse gliomas.
The Frequently Used Industrial Food Process Additive, Microbial Transglutaminase: Boon or Bane
Authors: Lerner Aaron , Benzvi Carina , Vojdani Aristo 
Published: July 2024

Abstract
Microbial transglutaminase (mTG) is a frequently consumed processed food additive, and use of its cross-linked complexes is expanding rapidly. It was designated as a processing aid and was granted the generally recognized as safe (GRAS) classification decades ago, thus avoiding thorough assessment according to current criteria of toxicity and public health safety. In contrast to the manufacturer's declarations and claims, mTG and/or its transamidated complexes are proinflammatory, immunogenic, allergenic, pathogenic, and potentially toxic, hence raising concerns for public health. Being a member of the transglutaminase family and functionally imitating the tissue transglutaminase, mTG was recently identified as a potential inducer of celiac disease. Microbial transglutaminase and its docked complexes have numerous detrimental effects. Those harmful aspects are denied by the manufacturers, who claim the enzyme is deactivated when heated or by gastric acidity, and that its covalently linked isopeptide bonds are safe. The present narrative review describes the potential side effects of mTG, highlighting its thermostability and activity over a broad pH range, thus, challenging the manufacturers' and distributers' safety claims. The national food regulatory authorities and the scientific community are urged to reevaluate mTG's GRAS status, prioritizing public health protection against the possible risks associated with this enzyme and its health-damaging consequences.
Tyrosine phenol-lyase inhibitor quercetin reduces fecal phenol levels in mice
Authors: Kobayashi Takuma , Oishi Shiori , Matsui Misaki , Hara Kodai , Hashimoto Hiroshi , Watanabe Kenji , Yoshioka Yasukiyo , Miyoshi Noriyuki 
Published: July 2024

Abstract
Tyrosine phenol-lyase (TPL), which is expressed in intestinal bacteria, catalyzes the formation of phenol from the substrate L-Tyr. Bacterial metabolite phenol and the sulfate conjugate (phenyl sulfate) are known as a type of uremic toxins, some of which exert cytotoxicity. Therefore, pathologically elevated phenol and phenyl sulfate levels are strongly implicated in the etiology and outcome of uremia. In this study, we explored the inhibitory effects of dietary polyphenols on TPL-catalyzed phenol production using a TPL activity assay. Quercetin, one of the most popular polyphenols, exhibited the strongest inhibitory activity (Ki = 19.9 µM). Quercetin competitively inhibited TPL, and its activity was stronger than that of a known TPL inhibitor (Tyr analog; 2-aza-Tyr, Ki = 42.0 µM). Additionally, quercetin significantly inhibited phenol production in TPL-expressing bacterial cultures (Morganella morganii and Citrobacter koseri) and Tyr-rich (5%) diet-fed C57BL/6J mouse feces. Our findings suggest that quercetin is the most promising polyphenol for reducing phenol levels. Because quercetin has a low gastrointestinal absorption rate, TPL inhibition in the intestinal tract by quercetin may be an effective strategy for treating uremia.