bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular Therapy and Outcomes Among Patients With Very Large Ischemic Core Stroke
Authors: Xie Dongjing , Huang Jiacheng , Fan Shitao , Guo Changwei , Sun Wenzhe , Peng Zhouzhou , Zhang Lingyu , Yue Chengsong , Qiu Zhongming , Sang Hongfei , Liang Dingwen , Hu Jinrong , Yang Jie , Huang Jiandi , Li Linyu , Liu Juan , Yang Dahong , Liu Xiang , Kong Weilin , Liu Shuai , Yang Qingwu , Zi Wenjie , Li Fengli 
Published: May 2024

ImportanceThe association of endovascular therapy (EVT) with outcomes is unclear for patients with very low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) within 24 hours of stroke onset.ObjectiveTo explore the association of EVT with functional and safety outcomes among patients with ASPECTS of 0 to 2 scored with noncontrast computed tomography.Design, Setting, and ParticipantsThis cohort study used data from an ongoing, prospective, observational, nationwide registry including all patients treated at 38 stroke centers in China with an occlusion in the internal carotid artery or M1 or M2 segment of the middle cerebral artery within 24 hours of witnessed symptom onset. Patients with ASPECTS of 0 to 2 between November 1, 2021, and February 8, 2023, were included in analysis. Data were analyzed October to November 2023.ExposuresEVT vs standard medical treatment (SMT).Main Outcomes and MeasuresThe primary outcome was favorable functional outcome, defined as modified Rankin Scale score (mRS) of 0 to 3, at 90 days. Safety outcomes included symptomatic intracerebral hemorrhage (sICH) within 48 hours and mortality at 90 days.ResultsA total of 245 patients (median [IQR] age, 71 [63-78] years; 118 [48%] women) with ASPECTS of 0 to 2 were included, of whom 111 patients (45.1%) received SMT and 135 patients (54.9%) received EVT. The EVT group had significantly greater odds of favorable functional outcome at 90 days than the SMT group (30 patients [22.2%] vs 11 patients [9.9%]; P = .01; adjusted odds ratio [aOR], 3.07 [95% CI, 1.29-7.31]; P = .01). Patients in the EVT group, compared with the SMT group, had significantly greater odds of any ICH (56 patients [41.5%] vs 16 patients [11.4%]; P &amp;lt; .001; aOR, 4.27 [95% CI, 2.19-8.35]; P &amp;lt; .001) and sICH (24 patients [17.8%] vs 1 patient [0.9%]; P &amp;lt; .001; aOR, 23.07 [95% CI, 2.99-177.79]; P = .003) within 48 hours. There were no differences between groups for 90-day mortality (80 patients [59.3%] vs 59 patients [53.2%]; P = .34; aOR, 1.38 [95% CI, 0.77-2.47]; P = .28). The results remained robust in the propensity score–matched analysis.Conclusions and RelevanceIn this cohort study of patients with very low ASPECTS based on NCCT within 24 hours of stroke onset, those treated with EVT had higher odds of a favorable functional outcome compared with those who received SMT. Randomized clinical trials are needed to assess these findings.
Comparative Outcomes of Empagliflozin to Dapagliflozin in Patients With Heart Failure
Authors: Modzelewski Katherine L. , Pipilas Alexandra , Bosch Nicholas A. 
Published: May 2024

ImportanceSodium-glucose cotransporter-2 (SGLT2) inhibitors have been shown to have benefits when used in patients with heart failure. The comparative outcomes of SGLT2 inhibitors relative to each other has not been well defined and may impact medication selection.ObjectiveTo determine the comparative outcomes of empagliflozin and dapagliflozin on reducing the composite of all-cause mortality and hospitalizations in patients with heart failure.Design, Setting, and ParticipantsThis multicenter retrospective cohort study included patients with heart failure from August 18, 2021, and December 6, 2022, in the TriNetX Research Collaborative, a centralized database of deidentified electronic medical record data from a network of 81 health care organizations. Eligible patients had a diagnosis of heart failure, had never received an SGLT2 inhibitor previously, and were newly started on empagliflozin or dapagliflozin. Patients were followed up for 1 year.ExposureInitiation of dapagliflozin or empagliflozin.Main Outcomes and MeasuresThe primary outcome was the time to the composite of all-cause mortality or hospitalization between study days 1 to 365. Kaplan-Meier analyses, hazard ratios (HRs), and 95% CIs were used to assess the primary outcome.ResultsAmong 744 914 eligible patients, 28 075 began empagliflozin (15 976 [56.9%]) or dapagliflozin (12 099 [43.1%]). After nearest-neighbor matching for demographics, diagnoses, and medication use, there were 11 077 patients in each group. Of patients who received empagliflozin, 9247 (57.9%) were male, 3130 (19.6%) were Black individuals, and 9576 (59.9%) were White individuals. Similarly, of those who received dapagliflozin, 7439 (61.5%) were male, 2445 (20.2%) were Black individuals, and 7131 (58.9%) were White individuals. Patients receiving empagliflozin were less likely to experience the composite of all-cause mortality or hospitalization compared with those initiated on dapagliflozin (3545 [32.2%] vs 3828 [34.8%] events; HR, 0.90 [95% CI, 0.86-0.94]) in the year following SGLT2 inhibitor initiation and less likely to be hospitalized (HR, 0.90 [95% CI, 0.86-0.94]). All-cause mortality did not differ between exposure groups (HR, 0.91 [95% CI, 0.82-1.00]). There was no difference in mean hemoglobin A1c or adverse events between groups.Conclusions and RelevanceIn this cohort study, patients who initiated empagliflozin were less likely to experience the composite of all-cause mortality or hospitalization compared with patients who started dapagliflozin. Additional studies are needed to confirm these finding.
Medically Assisted Reproduction and Risk of Cancer Among Offspring
Authors: Rios Paula , Herlemont Philippe , Fauque Patricia , Lacour Brigitte , Jouannet Pierre , Weill Alain , Zureik Mahmoud , Clavel Jacqueline , Dray-Spira Rosemary 
Published: May 2024

ImportanceCancer is a leading cause of death among children worldwide. Treatments used for medically assisted reproduction (MAR) are suspected risk factors because of their potential for epigenetic disturbance and associated congenital malformations.ObjectiveTo assess the risk of cancer, overall and by cancer type, among children born after MAR compared with children conceived naturally.Design, Setting, and ParticipantsFor this cohort study, the French National Mother-Child Register (EPI-MERES) was searched for all live births that occurred in France between January 1, 2010, and December 31, 2021 (and followed up until June 30, 2022). The EPI-MERES was built from comprehensive data of the French National Health Data System. Data analysis was performed from December 1, 2021, to June 30, 2023.ExposureUse of assisted reproduction technologies (ART), such as fresh embryo transfer (ET) or frozen ET (FET), and artificial insemination (AI).Main Outcomes and MeasuresThe risk of cancer was compared, overall and by cancer type, among children born after fresh ET, FET, or AI and children conceived naturally, using Cox proportional hazards regression models adjusted for maternal and child characteristics at birth.ResultsThis study included 8 526 306 children with a mean (SD) age of 6.4 (3.4) years; 51.2% were boys, 96.4% were singletons, 12.1% were small for gestational age at birth, and 3.1% had a congenital malformation. There were 260 236 children (3.1%) born after MAR, including 133 965 (1.6%) after fresh ET, 66 165 (0.8%) after FET, and 60 106 (0.7%) after AI. A total of 9256 case patients with cancer were identified over a median follow-up of 6.7 (IQR, 3.7-9.6) years; 165, 57, and 70 were born after fresh ET, FET, and AI, respectively. The overall risk of cancer did not differ between children conceived naturally and those born after fresh ET (hazard ratio [HR], 1.12 [95% CI, 0.96 to 1.31]), FET (HR, 1.02 [95% CI, 0.78 to 1.32]), or AI (HR, 1.09 [95% CI, 0.86 to 1.38]). However, the risk of acute lymphoblastic leukemia was higher among children born after FET (20 case patients; HR 1.61 [95% CI, 1.04 to 2.50]; risk difference [RD], 23.2 [95% CI, 1.5 to 57.0] per million person-years) compared with children conceived naturally. Moreover, among children born between 2010 and 2015, the risk of leukemia was higher among children born after fresh ET (45 case patients; HR, 1.42 [95% CI, 1.06 to 1.92]; adjusted RD, 19.7 [95% CI, 2.8 to 43.2] per million person-years).Conclusions and RelevanceThe findings of this cohort study suggest that children born after FET or fresh ET had an increased risk of leukemia compared with children conceived naturally. This risk, although resulting in a limited number of cases, needs to be monitored in view of the continuous increase in the use of ART.
Rate of Initial Optic Nerve Head Capillary Density Loss and Risk of Visual Field Progression
Authors: Tansuebchueasai Natchada , Nishida Takashi , Moghimi Sasan , Wu Jo-Hsuan , Mahmoudinezhad Golnoush , Gunasegaran Gopikasree , Kamalipour Alireza , Zangwill Linda M. , Weinreb Robert N. 
Published: May 2024

ImportanceRapid initial optic nerve head capillary density loss may be used to assess the risk of glaucoma visual field progression.ObjectiveTo investigate the association between the rate of initial optic nerve head capillary density loss from optical coherence tomography angiography (OCTA) and visual field progression.Design, Setting, ParticipantsThis was a retrospective study of a longitudinal cohort at a glaucoma referral center. A total of 167 eyes (96 with primary open-angle glaucoma and 71 with glaucoma suspect) of 109 patients were monitored for a mean (SD) of 5.7 (1.4) years from January 2015 to December 2022. Data analysis was undertaken in April 2023.Main Outcomes and MeasuresThe rates of initial capillary density and average retinal nerve fiber layer loss were calculated from the first 3 optic nerve head OCTA and OCT scans, respectively, during the initial follow-up (mean [SD], 2.0 [1.0] years). Based on the median rate, eyes were categorized into fast and slow progressor groups. The association between initial capillary density change or retinal nerve fiber layer thinning and visual field progression was evaluated using linear-mixed and time-varying Cox models.ResultsA total of 167 eyes of 109 patients (mean [SD] age, 69.0 [11.1] years; 56 [51.4%] female and 53 [48.6%] male) were assessed. Eighty-three eyes were slow OCTA progressors, while 84 eyes were fast with mean capillary density loss of −0.45% per year and −1.17% per year, respectively (mean difference, −0.72%/year; 95% CI,−0.84 to −0.60; P &amp;lt; .001). Similarly, 83 eyes were slow OCT progressors, while 84 eyes were fast with mean retinal nerve fiber layer thinning of −0.09 μm per year and −0.60 μm per year, respectively (mean difference, −0.51 μm/year; 95% CI,−0.59 to −0.43; P &amp;lt; .001). The fast OCTA and OCT progressors were associated with more rapid visual field loss (mean difference, −0.18 dB/year; 95% CI,−0.30 to −0.06; P = .004 and −0.17 dB/year; 95% CI,−0.29 to −0.06; P = .002, respectively). Fast OCTA progressing eyes were more likely to have visual field progression (hazard ratio, 1.96; 95% CI, 1.04-3.69; P = .04). Seventeen of 52 eyes (32.7%; 95% CI, 32.5-32.8) with fast OCTA and OCT progression developed subsequent visual field likely progression.Conclusion and RelevanceRapid initial optic nerve head capillary density loss from OCTA was associated with a faster rate of visual field progression and a doubling of the risk of developing event progression in this study. These findings may support clinical use of OCTA and OCT optic nerve head measurements for risk assessment of glaucoma progression.
Photokeratitis in Outdoor Event Participants Exposed to UV Radiation Display
Authors: Chan Julia Y. Y. , Chow Vanissa W. S. , Chan Carmen K. M. , Chan Edmund Y. M. , Lau James S. K. , Lai Timothy Y. Y. , Young Alvin L. , Tham Clement C. Y. 
Published: May 2024

ImportanceWhile UV radiation displays may be used for recreational purposes at outdoor events, unprotected eyes have been reported to have symptoms consistent with photokeratitis. Such symptoms warrant documentation and evaluation in ophthalmic peer reviewed literature.ObjectiveTo describe a case series of photokeratitis associated with a single ultraviolet radiation display at an outdoor event.Design, Setting, and ParticipantsThis case series involved a retrospective record review of 8 patients who presented in public and private health sectors in November 2023 after developing photokeratitis following UV radiation exposure at an outdoor event in Hong Kong on the night of November 4, 2023.Main Outcomes and MeasuresClinical symptoms, signs, and clinical course of patients who were diagnosed acute photokeratitis following exposure to UV radiation.ResultsThe mean time of UV display exposure for the 8 patients (mean [SD] age, 33.12 [5.19] years; 4 [50%] female) was 3.00 (1.41) hours, and symptoms presented at a mean (SD) 8.88 (8.24) hours after the exposure. None of the patients were wearing spectacles during the exposed period. All patients were affected bilaterally. All patients experienced eye pain, 6 experienced red eye, and 5 experienced tearing and photophobia. Mean (SD) presenting visual acuity was logMAR 0.10 (0.14) (approximate Snellen equivalent, 20/25) for right eyes and 0.06 (0.89) (approximate Snellen equivalent, 20/25) for left eyes. On examination, there were findings of cornea and conjunctival involvement with punctate epithelial erosions and ciliary vasodilation, but none of the patients presented with anterior chamber reaction. Corticosteroids, lubricants, and antibiotics, all provided topically, were prescribed. Five patients were not scheduled for a review, and 3 had follow-up visits, with the length of follow-up ranging from 7 to 10 days. All patients had undergone a complete recovery.Conclusions and RelevanceThese findings provide evidence of an association between UV radiation used for recreational purposes and photokeratitis, which may help guide evaluation and management of future cases.
Epilepsy in Duchenne and Becker muscular dystrophies
Authors: Armijo Gómez Jesus Alfonso , Fernandez‐Garcia Miguel A. , Camacho Ana , Liz Marlin , Ortez Carlos , Lafuente‐Hidalgo Miguel , Toledo Bravo‐de Laguna Laura , Estévez‐Arias Berta , Carrera‐García Laura , Expósito‐Escudero Jessica , Domínguez‐Carral Jana , Nascimento Andres , Natera‐de Benito Daniel 
Published: May 2024

AbstractObjectiveDuchenne and Becker muscular dystrophies (DMD and BMD) are dystrophinopathies caused by variants in DMD gene, resulting in reduced or absent dystrophin. These conditions, characterized by muscle weakness, also manifest central nervous system (CNS) comorbidities due to dystrophin expression in the CNS. Prior studies have indicated a higher prevalence of epilepsy in individuals with dystrophinopathy compared to the general population. Our research aimed to investigate epilepsy prevalence in dystrophinopathies and characterize associated electroencephalograms (EEGs) and seizures.MethodsWe reviewed 416 individuals with dystrophinopathy, followed up at three centers between 2010 and 2023, to investigate the lifetime epilepsy prevalence and characterize EEGs and seizures in those individuals diagnosed with epilepsy. Associations between epilepsy and type of dystrophinopathy, genotype, and cognitive involvement were studied.ResultsOur study revealed a higher epilepsy prevalence than the general population (1.4%; 95% confidence interval: 0.7–3.2%), but notably lower than previously reported in smaller dystrophinopathy cohorts. No significant differences were found in epilepsy prevalence between DMD and BMD or based on underlying genotypes. Cognitive impairment was not found to be linked to higher epilepsy rates. The most prevalent epilepsy types in dystrophinopathies resembled those observed in the broader pediatric population, with most individuals effectively controlled through monotherapy.InterpretationThe actual epilepsy prevalence in dystrophinopathies may be markedly lower than previously estimated, possibly half or even less. Our study provides valuable insights into the epilepsy landscape in individuals with dystrophinopathy, impacting medical care, especially for those with concurrent epilepsy.
cAIMD Simulations Guided Design of Atomic Praseodymium Doping In–Bi Nanofibers for High‐Energy‐Efficiency CO2 Electrolysis to Formate in Ultra‐Wide Potential Window
Authors: Li Yumeng , Jin Yingmin , Zhang Xuebai , Fu Mengyu , Lin Ruifan , Li Guanshu , Xiong Yueping 
Published: May 2024

AbstractThe electrochemical CO2 reduction reaction (ECO2RR) has emerged as a promising technology for achieving carbon neutralization. Even though considerable efforts are dedicated to gain deep insight into the understanding of ECO2RR on a mechanism level through density functional theory (DFT) studies, effects of solvent molecules and temperature have long been neglected by conventional DFT calculations as a consequence of limitations in current technologies and computational power of supercomputers. Under this context, the lack of comprehensive understanding over the energy changes in the reaction derived from the only concern on free energy changes between reaction intermediates have arouse an urgent call for exploring feasible calculation options toward generalized theoretical study. Here, a systematic mechanism study is provided toward ECO2RR via constrained ab initio molecular dynamics (cAIMD) simulations, in which the effects of solvent water molecules and temperature are taken into consideration to guide the synthesis of single‐atom alloy (SAA) catalyst. Consequently, the resultant Pr0.05/InBi achieves a maximum Faradic efficiency (FE) of 96.4% and an energy efficacy (EE) of 59.41% for formate. This work offers a novel approach to the design and screening of SAA catalysts, presenting foreseeable future in accelerating the industrial application process of ECO2RR.
Spatially Precise Genetic Engineering at the Electrode‐Tissue Interface
Authors: Xu Ke , Yang Yinan , Ding Jianfei , Wang Jinfen , Fang Ying , Tian Huihui 
Published: May 2024

AbstractThe interface between electrodes and neural tissues plays a pivotal role in determining the efficacy and fidelity of neural activity recording and modulation. While considerable efforts have been made to improve the electrode‐tissue interface, the majority of studies have primarily concentrated on the development of biocompatible neural electrodes through abiotic materials and structural engineering. In this study, an approach is presented that seamlessly integrates abiotic and biotic engineering principles into the electrode‐tissue interface. Specifically, ultraflexible neural electrodes with short hairpin RNAs (shRNAs) designed to silence the expression of endogenous genes within neural tissues are combined. The system facilitates shRNA‐mediated knockdown of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and polypyrimidine tract‐binding protein 1 (PTBP1), two essential genes associated in neural survival/growth and neurogenesis, within specific cell populations located at the electrode‐tissue interface. Additionally, it is demonstrated that the downregulation of PTEN in neurons can result in an enlargement of neuronal cell bodies at the electrode‐tissue interface. Furthermore, the system enables long‐term monitoring of neuronal activities following PTEN knockdown in a mouse model of Parkinson's disease and traumatic brain injury. The system provides a versatile approach for genetically engineering the electrode‐tissue interface with unparalleled precision, paving the way for the development of regenerative electronics and next‐generation brain–machine interfaces.
Efficient Deep‐Blue Multiple‐Resonance Emitters Based on Azepine‐Decorated ν‐DABNA for CIEy below 0.06
Authors: Mamada Masashi , Aoyama Akio , Uchida Ryota , Ochi Junki , Oda Susumu , Kondo Yasuhiro , Kondo Masakazu , Hatakeyama Takuji 
Published: May 2024

AbstractUltrapure deep‐blue emitters are in high demand for organic light‐emitting diodes (OLEDs). Although color coordinates serve as straightforward parameters for assessing color purity, precise control over the maximum wavelength and full‐width at half‐maximum is necessary to optimize OLED performance, including luminance efficiency and luminous efficacy. Multiple‐resonance (MR) emitters are promising candidates for achieving ideal luminescence properties; consequently, a wide variety of MR frameworks have been developed. However, most of these emitters experience a wavelength displacement from the ideal color, which limits their practical applicability. Therefore, a molecular design that is compatible with MR emitters for modulating their energy levels and color output is particularly valuable. Here, it is demonstrated that the azepine donor unit induces an appropriate blue‐shift in the emission maximum while maintaining efficient MR characteristics, including high photoluminescence quantum yield, narrow emission, and a fast reverse intersystem crossing rate. OLEDs using newly developed MR emitters based on the ν‐DABNA framework simultaneously exhibit a high quantum efficiency of ≈30%, luminous efficacy of ≈20 lm W−1, exceptional color purity with Commission Internationale de l’Éclairage coordinates as low as (0.14, 0.06), and notably high operational stability. These results demonstrate unprecedentedly high levels compared with those observed in previously reported deep‐blue emitters.
Metallic Ru─Ru Interaction in Ruthenium Oxide Enabling Durable Proton Exchange Membrane Water Electrolysis
Authors: Zhao Guoqiang , Guo Wei , Shan Minmin , Fang Yanyan , Wang Gongming , Gao Mingxia , Liu Yongfeng , Pan Hongge , Sun Wenping 
Published: May 2024

AbstractDeveloping efficient and robust electrocatalysts toward the oxygen evolution reaction (OER) is critical for proton exchange membrane water electrolysis (PEMWE). RuO2 possesses intrinsically high OER activity, but the concurrent electrochemical dissolution leads to rapid deactivation. Here a unique RuO2 catalyst containing metallic Ru─Ru interactions (m‐RuO2) is reported, which maintains stability in practical PEMWE for 100 h at 60 °C and 1 A cm−2. Experimental and theoretical investigations suggest that the presence of Ru─Ru interactions significantly increases the energy barrier for the formation of RuO2(OH)2, which is a key intermediate for Ru dissolution, and hence substantially mitigates the electrochemical corrosion of m‐RuO2. Meanwhile, the Ru4d band center downshifts, accordingly, ensuring the high OER activity, and the participation of lattice oxygen in the OER is also suppressed at the Ru─Ru sites, further contributing to the enhanced durability. Interestingly, such enhanced stability is also dependent on the size of metallic Ru─Ru cluster, where the energy barrier is further increased for Ru3, but is decreased for Ru5. These results highlight the significance of local coordination structure modulation on the electrochemical stability of RuO2 and open a feasible avenue toward the development of robust OER electrocatalysts for high‐performance PEMWE.