bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balancing innovation and affordability in anti-obesity medications: the role of an alternative weight-maintenance program
Authors: Kim David D , Hwang Jennifer H , Fendrick A Mark 
Published: May 2024

Abstract
Despite remarkable clinical advances in highly effective anti-obesity medications, their high price and potential budget impact pose a major challenge in balancing equitable access and affordability. While most attention has been focused on the amount of weight loss achieved, less consideration has been paid to interventions to sustain weight loss after an individual stops losing weight. Using a policy simulation model, we quantified the impact of a weight-maintenance program following the weight-loss plateau from the initial full-dose glucagon-like peptide 1 (GLP-1) receptor agonists or incretin mimetic use. We measured long-term health care savings and the loss of some health benefits (eg, maintenance of weight loss, improvements in cardiometabolic risk factors, and reductions in diabetes and cardiovascular events). Our model suggested that, compared with continuous long-term full-dose GLP-1 receptor agonists or incretin mimetic drugs, the alternative weight-maintenance program would generate slightly fewer clinical benefits while generating substantial savings in lifetime health care spending. Using less expensive and potentially less effective alternative weight-maintenance programs may provide additional headroom to expand access to anti-obesity medications during the active weight-loss phase without increasing total health care spending.
Patterns of collateral arteries to the spinal cord after thoraco-abdominal aortic aneurysm repair
Authors: Saitoh Daiki , Yamazaki Yuya , Tsuji Tatsunori , Sakoda Naoya , Yakuwa Kazuki , Tabayashi Azuma , Koizumi Junichi , Ohsawa Satoshi , Kin Hajime 
Published: May 2024

Abstract

OBJECTIVES
Our goal was to evaluate postoperative patterns of collateral arteries to the spinal cord during occlusion of the segmental arteries supplying the artery of Adamkiewicz (AKA).

METHODS
Between April 2011 and December 2022, a total of 179 patients underwent thoraco-abdominal aortic aneurysm repair; 141 had an identifiable AKA on preoperative multidetector computed tomography scans, 40 underwent thoraco-abdominal aortic aneurysm replacement (TAAR) and 101 underwent thoracic endovascular aortic repair (TEVAR). New postoperative collateral blood pathways invisible on preoperative contrast-enhanced computed tomography scans were identified in 42 patients (10 patients who had TAAR vs 32 patients who had TEVAR) who underwent preoperative and postoperative multidetector computed tomography scanning for AKA identification.

RESULTS
The thoracodorsal and segmental arteries were the main collateral pathways in both groups. Th9-initiated collaterals were the most common. Collaterals from the internal thoracic artery were observed in the TEVAR group but not in the TAAR group. One patient in the TEVAR group experienced postoperative paraparesis, which was not observed in the TAAR group. Postoperative paraplegia was more common in the non-Th9-origin group, but this difference was not significant.

CONCLUSIONS
Thoracodorsal and segmental arteries may be important collateral pathways after TEVAR and TAAR. For thoracodorsal arteries, preserving the thoracodorsal muscle during the approach would be crucial; for segmental arteries, minimizing the area to be replaced or covered would be paramount. An AKA not initiated at the Th9 level poses a high risk of postoperative paraplegia.
Multicentre experience of sutureless prostheses inside degenerated stentless aortic valves and bioroots
Authors: Bakhtiary Farhad , Silaschi Miriam , El-Sayed Ahmad Ali , Salamate Saad , Meuris Bart 
Published: May 2024

Abstract

OBJECTIVES
Patients with failed stentless aortic prostheses are a challenging population to treat, as reoperative procedures may be complex and catheter-based treatments are associated with a high rate of procedural events. Reoperative surgery using sutureless valves may be an alternative.

METHODS
In this multicentre experience, we assess outcomes of 17 patients who underwent reoperative surgery using the Perceval valve (Corcym UK Limited, London, UK) inside Freestyle prosthesis (Medtronic Inc., Dublin, Ireland) or bioroots from 2018 to 2023.

RESULTS
Mean age was 71.1 ±  standard deviation 15.1 years and mean EuroSCORE II was 13.5 ± 15.8%, Society of Thoracic Surgeons Score was 5.9 ± 11.7%. Mean transvalvular gradient at baseline was 25.3 ± 19.9 mmHg and left ventricular ejection fraction was 53.5 ±  standard deviation 8.5%. In 70.6% (12/17), moderate or severe aortic regurgitation was present. Implant success was 100%. Aortic cross-clamp time was 44.5 ±  standard deviation 23.6 min. No patient needed a pacemaker and no mild paravalvular regurgitation occurred. Mean gradient was 12.5 ± 4.7 mmHg; 30-day mortality was 5.9% (1/17).

CONCLUSIONS
Rate of mortality was lower than predicted by EuroSCORE II in these high-risk patients and haemodynamic outcomes were favourable. Heart teams should consider this treatment concept when discussing patients with failed stentless valves or bioroots.
Multidrug-Resistant Organisms: The Silent Plight of Burn Patients
Authors: Elsheikh Randa , Makram Abdelrahman M 
Published: May 2024

Abstract
The global increasing spread of multidrug-resistant organisms (MDROs) is threatening the control of various infections in vulnerable populations and patient groups. One of the most affected groups is patients with burns, who are prone to hyperinfection as they suffer from a hypermetabolic state and weaken immune barriers. Those patients also share the infection risk of patients hospitalized for a long time, including ventilator-associated pneumonia and urinary tract infections. While some preventative and therapeutic management styles are still controversial, we discuss consensuses here. In this review, we aim to present the current knowledge on multidrug resistance with a special focus on patients with burns, discuss various causative organisms and their treatment options, and highlight the importance of antibiotic stewardship and teamwork in responding to an outbreak of MDROs.
HSD17B13 liquid–liquid phase separation promotes leukocyte adhesion in chronic liver inflammation
Authors: Ye Jing , Huang Xiyu , Yuan Manman , Wang Jinglin , Jia Ru , Wang Tianyi , Tan Yang , Zhu Shun , Xu Qiang , Wu Xingxin 
Published: May 2024

Abstract
The rs72613567:TA polymorphism in 17-beta hydroxysteroid dehydrogenase 13 (HSD17B13) has been found to reduce the progression from steatosis to metabolic dysfunction-associated steatohepatitis (MASH). In this study, we sought to define the pathogenic role of HSD17B13 in triggering liver inflammation. Here, we demonstrate that HSD17B13 forms liquid–liquid phase separation (LLPS) around lipid droplets in the livers of MASH patients. The dimerization of HSD17B13 supports the LLPS formation and promotes its enzymatic function. HSD17B13 LLPS increases the biosynthesis of platelet activating factor (PAF), which in turn promotes fibrinogen synthesis and leukocyte adhesion. Blockade of the PAF receptor or STAT3 pathway inhibits the fibrinogen synthesis and leukocyte adhesion. Importantly, adeno-associated viral-mediated xeno-expression of human HSD17B13 exacerbates western diet/carbon tetrachloride-induced liver inflammation in Hsd17b13−/− mice. In conclusion, our results suggest that HSD17B13 LLPS triggers liver inflammation by promoting PAF-mediated leukocyte adhesion, and targeting HSD17B13 phase transition could be a promising therapeutic approach for treating hepatic inflammation in chronic liver disease.
Young metal-rich stars in the halo of M82: a tidal dwarf galaxy?
Authors: Suwannajak Chutipong , Sarajedini Ata 
Published: May 2024

ABSTRACT
We present Hubble Space Telescope Advanced Camera for Surveys photometry of an arc structure of stars in the southern halo of M82. The structure is located at a projected height of ≈5 kpc from the disc of M82 but its stellar content exhibits a younger mean age than that of typical halo stars. We measured the distance, mean age, and peak metallicity of the stars in the arc and used them to determine the structure’s origin. The arc colour–magnitude diagram yields a tip of the red giant branch (RGB) distance of 3.63 ± 0.08 Mpc, similar to that of M82, confirming its association with the galaxy. The colour–magnitude diagram also reveals a population of predominantly young stars with a mean age of ≈100–160 Myr, which is similar to that of the young stars formed in the tidal debris between M81, M82, and NGC 3077. We derived the mean metallicity of the halo stars surrounding the arc to be [Fe/H] ≈ −1.0, similar to that of the RGB population of the halo of M81. The RGB stars in the arc, while they are slightly more metal-rich than the halo RGB, show no spatial correlation with the young stars, suggesting that the arc is consists of mainly young stellar population. Furthermore, the observed age gradient along the structure of the arc indicates that the arc began forming from the closer side to M82, then moving outward. Taken together, the results suggest that the formation of the young stars that give rise to the arc structure could have been triggered by the interactions between M82’s southern outflow and the H i gas clouds surrounding it, representing a snapshot of a tidal dwarf galaxy in the process of forming.
A brain metastasis liquid biopsy: Where are we now?
Authors: Robinson Stephen David , de Boisanger James , Pearl Frances M G , Critchley Giles , Rosenfelder Nicola , Giamas Georgios 
Published: May 2024

Abstract
Brain metastases remain a challenging and feared complication for patients with cancer and research in this area has lagged behind research into metastases to other organs. Due to their location and the risks associated with neurosurgical biopsies, the biology underpinning brain metastases response to treatment and evolution over time remains poorly understood. Liquid biopsies are proposed to overcome many of the limitations present with tissue biopsies, providing a better representation of tumor heterogeneity, facilitating repeated sampling, and providing a noninvasive assessment of tumor biology. Several different liquid biopsy approaches have been investigated including circulating tumor cells, circulating tumor DNA, extracellular vesicles, and tumor-educated platelets; however, these have generally been less effective in assessing brain metastases compared to metastases to other organs requiring improved techniques to investigate these approaches, studies combining different liquid biopsy approaches and/or novel liquid biopsy approaches. Through this review, we highlight the current state of the art and define key unanswered questions related to brain metastases liquid biopsies.
Trends in Daily Cigarette Consumption Among Smokers: A Population Study in England, 2008–2023
Authors: Jackson Sarah E , Tattan-Birch Harry , Buss Vera , Shahab Lion , Brown Jamie 
Published: May 2024

Abstract

Introduction
This study aimed to estimate time trends in cigarette consumption among smokers in England between 2008 and 2023 and to explore differences by key potential moderators.

Aims and Methods
We used data from 57 778 adult cigarette smokers participating in a nationally representative monthly cross-sectional survey between January 2008 and September 2023. We estimated monthly time trends in mean daily consumption of (1) any, (2) manufactured, and (3) hand-rolled cigarettes among all smokers and by main type of cigarettes smoked, smoking frequency, age, gender, occupational social grade, region, nicotine replacement therapy use, and vaping status.

Results
Overall cigarette consumption fell from 13.6 [95% CI = 13.3 to 13.9] to 10.6 [10.5 to 10.8] per day between January 2008 and October 2019 (a 22% decrease), then remained stable up to September 2023. Over this period, the proportion mainly or exclusively smoking hand-rolled cigarettes increased (from 30.6% [29.1%–32.1%] in 2008 to 52.1% [49.7%–54.5%] in 2023). As a result, manufactured cigarette consumption fell by 47%, from 9.5 [9.2–9.8] per day in January 2008 to 5.0 [4.7–5.3] in September 2023, while hand-rolled cigarette consumption increased by 35%, from 4.2 [3.9–4.4] to 5.6 [5.3–5.9], respectively. The decline in overall cigarette consumption was observed across all subgroups, but was greater among non-daily smokers, younger smokers, and those who vaped.

Conclusions
Over the last 15 years, the average number of cigarettes consumed each day by smokers in England has fallen by almost a quarter, but has plateaued since October 2019. There has been a sharp decline in the number of manufactured cigarettes consumed and an increase in the number of hand-rolled cigarettes consumed, as smokers have increasingly shifted towards using hand-rolled tobacco.

Implications
While average cigarette consumption in England has fallen over the past 15 years, this declining trend has stalled (and reversed in some population groups) since 2019. The availability of cheap, hand-rolled tobacco appears to be undermining policies that aim to reduce smoking by raising the price of tobacco (eg, through taxation) and could be targeted to reignite the decline in cigarette consumption.
Development and Psychometric Evaluation of a Novel Measure of Nicotine E-cigarette Withdrawal for Use With Adolescents and Young Adults
Authors: Morean Meghan E , Rajeshkumar Lavanya , Krishnan-Sarin Suchitra 
Published: May 2024

Abstract

Introduction
Nicotine withdrawal is a well-established construct that prompts continued nicotine product use and contributes to failed cessation efforts. Despite ongoing public health concerns about nicotine e-cigarette use in adolescents and young adults (AYAs), no psychometrically sound measure of nicotine e-cigarette withdrawal exists for this population.

Aims and Methods
A mixed methods approach comprising a literature review to identify existing nicotine withdrawal items; subject matter expert feedback on existing items and novel item generation; cognitive interviews assessing the measure’s instructions, items, and response options; and a large quantitative validation survey (N = 997) was employed to develop the novel retrospective measure of nicotine e-cigarette withdrawal.

Results
A 25-item solution comprising four subscales—negative affect, negative physical symptoms, craving, and appetite/food—and an overall withdrawal score was supported. Internal reliability was excellent (mean alpha = 0.91), and scalar measurement invariance was reached for all subgroups tested (eg, sex, age, exclusive e-cigarette use vs. dual tobacco product use, and daily vs. non-daily nicotine vaping). Overall withdrawal and its subscales evidenced concurrent validity with time to first vape in the morning, e-cigarette dependence, and previous vaping cessation attempts, although not each subscale was associated with each outcome. Importantly, cross-sectional incremental validity analyses indicated that retrospective withdrawal accounted for variance in each outcome above and beyond e-cigarette dependence.

Conclusions
The novel retrospective AYA Nicotine E-cigarette Withdrawal Scale (AYA NEWS) evidenced strong psychometric properties for use in this population. Future research can determine whether the AYA NEWS can be used to assess acute e-cigarette nicotine withdrawal.

Implications
While e-cigarette use remains the most prevalent form of nicotine product use among AYAs, there are limited options for psychometrically sound measures of e-cigarette-related constructs in this population. Withdrawal from nicotine is associated with failed cessation attempts and continued use of nicotine-containing products, making it a critical construct within tobacco-related research. This study outlines the development and preliminary psychometric evaluation of a novel, retrospective measure of nicotine e-cigarette withdrawal. Study findings support using the Adolescent and Young Adult Nicotine E-cigarette Withdrawal Scale (NEWS) to assess retrospective withdrawal from nicotine e-cigarettes in young people.
Epidemiological anomaly detection in Philippine public health surveillance data through Newcomb-Benford analysis
Authors: Parreño Samuel John E 
Published: May 2024

Abstract

Background
Public health surveillance is vital for monitoring and controlling disease spread. In the Philippines, an effective surveillance system is crucial for managing diverse infectious diseases. The Newcomb-Benford Law (NBL) is a statistical tool known for anomaly detection in various datasets, including those in public health.

Methods
Using Philippine epidemiological data from 2019 to 2023, this study applied NBL analysis. Diseases included acute flaccid paralysis, diphtheria, measles, rubella, neonatal tetanus, pertussis, chikungunya, dengue, leptospirosis and others. The analysis involved Chi-square tests, Mantissa Arc tests, Mean Absolute Deviation (MAD) and Distortion Factor calculations.

Results
Most diseases exhibited nonconformity to NBL, except for measles. MAD consistently indicated nonconformity, highlighting potential anomalies. Rabies consistently showed substantial deviations, while leptospirosis exhibited closer alignment, especially in 2021. Annual variations in disease deviations were notable, with acute meningitis encephalitis syndrome in 2019 and influenza-like illness in 2023 having the highest deviations.

Conclusions
The study provides practical insights for improving Philippine public health surveillance. Despite some diseases showing conformity, deviations suggest data quality issues. Enhancing the PIDSR, especially in diseases with consistent nonconformity, is crucial for accurate monitoring and response. The NBL’s versatility across diverse domains emphasizes its utility for ensuring data integrity and quality assurance.
Interstitial fibrosis increases the risk of end-stage kidney disease in patients with lupus nephritis
Authors: Sun Yi-Syuan , Huang De-Feng , Chang Fu-Pang , Chen Wei-Sheng , Liao Hsien-Tzung , Chen Ming-Han , Tsai Hung-Cheng , Tsai Ming-Tsun , Tsai Chang-Youh , Lai Chien-Chih , Yang Chih-Yu 
Published: May 2024

Abstract

Objective
To evaluate the risk of end-stage kidney disease (ESKD) in LN patients using tubulointerstitial lesion scores.

Methods
Clinical profiles and histopathological presentations of 151 biopsy-proven LN patients were retrospectively examined. Risk factors of ESKD based on characteristics and scoring of their tubulointerstitial lesions [e.g. interstitial inflammation (II), tubular atrophy (TA) and interstitial fibrosis (IF)] were analysed.

Results
The mean age of 151 LN patients was 36 years old, and 136 (90.1%) were female. The LN cases examined included: class I/II (n = 3, 2%), class III/IV (n = 119, 78.8%), class V (n = 23, 15.2%) and class VI (n = 6, 4.0%). The mean serum creatinine level was 1.4 mg/dl. Tubulointerstitial lesions were recorded in 120 (79.5%) patients. Prior to receiving renal biopsy, nine (6.0%) patients developed ESKD. During the follow-up period (mean, 58 months), an additional 47 patients (31.1%) progressed to ESKD. Multivariate analyses identified serum creatinine [hazard ratio (HR): 1.7, 95% CI: 1.42–2.03, P &lt; 0.001] and IF (HR: 3.2, 95% CI: 1.58–6.49, P = 0.001) as independent risk factors of ESKD. Kaplan–Meier analysis further confirmed a heightened risk of ESKD associated with IF.

Conclusion
Tubulointerstitial involvement is commonly observed in the histopathological presentation of LN. However, IF, rather than II or TA, was found to increase the risk of ESKD in our cohort. Therefore, to predict renal outcome in LN patients prior to adjusting immunosuppressive treatment, the degree of IF should be reviewed.
Transformational Leadership, Secondary Traumatic Stress, and Burnout of Child Welfare Workers: Multilevel Moderation Effects
Authors: Park Tae Kyung , Kim Jangmin , Pierce Barbara , Lee Hyunji 
Published: May 2024

AbstractThis study examines the moderating effects of distant leader’s practice of transformational leadership on the relationship between secondary traumatic stress (STS) and burnout among child welfare workers. Caseworkers and supervisors in a Midwest U.S. state (N = 210) rated their regional director’s use of transformational leadership skills using a survey. Given the nature of the clustered data, multilevel modeling was employed to examine the main effects of transformational leadership on worker burnout and its cross-level interaction effect on the association between worker STS and burnout. Multilevel modeling demonstrated that worker burnout was positively associated with STS and negatively associated with organizational-level transformational leadership. The cross-level interaction between transformational leadership and STS was significant. Specifically, the positive association between workers’ STS and burnout decreased as transformational leadership increased. These findings suggest that organizational approaches such as transformational leadership can influence workforce results. Further research will guide child welfare policymakers to develop more sophisticated training programs in leadership skills and strategies.
Effects of zinc supplementation and implant abscess on the immune system and growth performance of growing beef steers
Authors: Rients Emma , Franco Carlos , Diaz Fabian , McGill Jodi , Hansen Stephanie 
Published: May 2024

Abstract
Seventy-two Angus-cross steers (261 ± 14 kg) were utilized to determine the effects of supplemental Zn sulfate on growth, trace mineral status, circulating immune cells, and functional innate immune responses. Steers were stratified by weight and implanted with a Component E-S with Tylan implant (Elanco Animal Health, Greenfield, IN) on day 0. Dietary treatments included: control (CON; no supplemental Zn), Zn100 (100 mg supplemental Zn/kg DM), and Zn150 (150 mg supplemental Zn/kg DM). Analyzed dietary concentrations of Zn were 58, 160, and 207 mg Zn/kg DM, respectively. On days 13 and 57, blood from nine steers per treatment was collected for immune analyses (cell phenotyping and response to stimulus). On day 16, implant abscesses were evaluated by palpation and visual appraisal. Sixty percent of steers had abscesses; however, there were no differences in abscess prevalence due to treatment (P = 0.67). Data were analyzed as a split-plot design using the Mixed procedure of SAS 9.4 (Cary, NC) with effects of dietary treatment, abscess, and their interaction. There was a tendency (treatment × abscess; P ≤ 0.09) for steers without abscesses to have greater average daily gain (ADG; treatment × abscess P = 0.06) and gain:feed (G:F; treatment × abscess P = 0.09) from d 14 to 27 in CON and Zn100 while within Zn150 steers without abscesses tended to have lesser ADG and G:F than abscessed steers. There were no other treatment × abscess effects for growth performance, but steers with abscesses tended to have decreased final body weight (P = 0.10) and overall G:F (days 0 to 57; P = 0.08). There was no interaction of treatment and abscess on immune cell populations on days 13 or 58 (treatment × abscess P ≥ 0.11). On day 13, Zn150 steers had increased CD45RO + gamma delta (P = 0.04) T cells. Abscessed steers had increased CD21 + B cells (P = 0.03) and tended to have increased CD21 + (P = 0.07) and CD21 + MHCIIhi (P = 0.07) B cells in circulation. This study shows zinc supplementation and implant abscesses can alter the immune system and growth performance of growing beef steers.