bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term impact of low‐energy femtosecond laser and manual cataract surgery on macular layer thickness: A prospective randomized study
Authors: Schwarzenbacher Luca , Schmidt‐Erfurth Ursula , Schartmüller Daniel , Röggla Veronika , Leydolt Christina , Menapace Rupert , Reiter Gregor S. 
Published: March 2024

AbstractPurposeTo evaluate change in retinal layers 18 months after femtosecond laser‐assisted cataract surgery (LCS) and manual cataract surgery (MCS) in a representative age‐related cataract population using artificial intelligence (AI)‐based automated retinal layer segmentation.MethodsThis was a prospective, randomized and intraindividual‐controlled study including 60 patients at the Medical University of Vienna, Austria. Bilateral same‐day LCS and MCS were performed in a randomized sequence. To provide insight into the development of cystoid macular oedema (CME), retinal layer thickness was measured pre‐operatively and up to 18 months post‐operatively in the central 1 mm, 3 mm and 6 mm.ResultsFifty‐six patients completed all follow‐up visits. LCS compared to MCS did not impact any of the investigated retinal layers at any follow‐up visit (p > 0.05). For the central 1 mm, a significant increase in total retinal thickness (TRT) was seen after 1 week followed by an elevated plateau thereafter. For the 3 mm and 6 mm, TRT increased only after 3 weeks and 6 weeks and decreased again until 18 months. TRT remained significantly increased compared to pre‐operative thickness (p < 0.001). Visual acuity remained unaffected by the macular thickening and no case of CME was observed. Inner nuclear layer (INL) and outer nuclear layer (ONL) were the main causative layers for the total TRT increase. Photoreceptors (PR) declined 1 week after surgery but regained pre‐operative values 18 months after surgery.ConclusionLow‐energy femtosecond laser pre‐treatment did not influence thickness of the retinal layers in any topographic zone compared to manual high fluidic phacoemulsification. TRT did not return to pre‐operative values 18 months after surgery. The causative layers for subclinical development of CME were successfully identified.
Nature‐versus‐nurture considered harmful: Actionability as an alternative tool for understanding the exposome from an ethical perspective
Authors: Safarlou Caspar W. , Bredenoord Annelien L. , Vermeulen Roel , Jongsma Karin R. 
Published: March 2024

AbstractExposome research is put forward as a major tool for solving the nature‐versus‐nurture debate because the exposome is said to represent “the nature of nurture.” Against this influential idea, we argue that the adoption of the nature‐versus‐nurture debate into the exposome research program is a mistake that needs to be undone to allow for a proper bioethical assessment of exposome research. We first argue that this adoption is originally based on an equivocation between the traditional nature‐versus‐nurture debate and a debate about disease prediction/etiology. Second, due to this mistake, exposome research is pushed to adopt a limited conception of agential control that is harmful to one's thinking about the good that exposome research can do for human health and wellbeing. To fully excise the nature‐versus‐nurture debate from exposome research, we argue that exposome researchers and bioethicists need to think about the exposome afresh from the perspective of actionability. We define the concept of actionability and related concepts and show how these can be used to analyze the ethical aspects of the exposome. In particular, we focus on refuting the popular “gun analogy” in exposome research, returning results to study participants and risk‐taking in the context of a well‐lived life.
Longitudinal evaluation of adverse events due to steroid use in primary immune thrombocytopenia: A population‐based study
Authors: Wang Jiaan‐Der , Ku Fan‐Chen , Chiang I‐Ju , Ku Meng‐Yun , Chen Yi‐Ming , Chien Li‐Nien 
Published: March 2024

SummaryThis study aimed to investigate the association between the steroid use patterns and the risk of AEs in patients with primary immune thrombocytopenia (ITP). A total of 2691 newly diagnosed adults with ITP between 2011 and 2018 were identified from the National Health Insurance Research Database in Taiwan, and the date of first steroid use was defined as the index date. Post‐index steroid use was calculated on a 90‐day basis as a time‐dependent variable and categorized by the average prednisolone‐equivalent daily dose (<10 mg vs. ≥10 mg) and intensity (medication possession ratio <80% vs. ≥80%). Patients were followed up for 1 year from the index date for acute AE events, while chronic AEs were assessed until death, or end of 2019. Compared to patients with low‐dose+low‐intensity steroid use, those with high‐dose+high‐intensity steroid use were associated with a higher risk of acute AE (adjusted incident rate ratio [aIRR]: 1.57, 95% confidence interval [CI]: 1.38–1.78, p < 0.01) and chronic AE (aIRR: 1.26, 95% CI: 1.08–1.47, p < 0.01). Metabolic/endocrine and ophthalmologic disorders demonstrated the strongest correlation with a high dose and intensity. The joint effect of steroid dose and intensity was observed in patients with ITP, and the findings suggest that steroids should be used carefully.
Analysis of 20 years of turtle exports from theUSreveals mixed effects ofCITESand a need for better monitoring
Authors: Easter Tara , Carter Neil 
Published: March 2024

AbstractThe Convention on International Trade of Endangered Species (CITES) is the primary mechanism for controlling international wildlife trade and preventing overexploitation, but measuring its efficacy is difficult, which complicates management efforts. We examined the effects of CITES listings on the trade of freshwater turtles from the US and compared spatiotemporal trends and dynamics of trade across 16 genera using 20 years of export data, triangulated with mixed qualitative data. For each CITES‐listed genus, we analyzed the average changes, immediate changes, and changes in trends of export volumes and spatial diversity of trade. Boom‐and‐bust trends of exports for different taxa were driven by several factors, including CITES listings, but CITES had mixed effects on export volumes for both Appendix II and III species while the diversity of spatial trade networks consistently declined for CITES and non‐CITES listed genera. These results point to differences in demand and species' availability from captive breeders, farms, or wild harvest which are important to consider in future listing decisions. However, a lack of reliable data on the source of turtles limited our ability to understand these drivers as well as the efficacy of CITES listings in preventing overexploitation.
Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study
Authors: Petermann‐Rocha Fanny , Apolinar Evelia , Nazar Gabriela , Diaz‐Toro Felipe , Celis Andrés , Deo Salil , Ferrari Gerson , O'Donovan Gary 
Published: March 2024

AbstractAimTo investigate the joint associations of diabetes and obesity with all‐cause and cardiovascular disease (CVD) mortality in the Mexico City Prospective Study.Materials and MethodsIn total, 154 128 participants (67.2% women) were included in this prospective analysis. Diabetes was self‐reported, while body mass index was used to calculate obesity. Using diabetes and obesity classifications, six groups were created: (a) normal (no diabetes and normal weight); (b) normal weight and diabetes; (c) overweight but not diabetes (overweight); (d) overweight and diabetes (prediabesity); (e) obesity but not diabetes (obesity); and (f) obesity and diabetes (diabesity). Associations between these categories and outcomes were investigated using Cox proportional hazard models adjusted for confounder factors.ResultsDuring 18.3 years of follow‐up, 27 197 (17.6%) participants died (28.5% because of CV causes). In the maximally adjusted model, participants those with the highest risk {hazard ratio (HR): 2.37 [95% confidence interval (CI): 2.24‐2.51]}, followed by those with diabesity [HR: 2.04 (95% CI: 1.94‐2.15)]. Similar trends of associations were observed for CVD mortality. The highest CV mortality risk was observed in individuals with diabesity [HR: 1.80 (95% CI: 1.63‐1.99)], followed by normal weight and diabetic individuals [HR: 1.78 (95% CI: 1.60‐1.98)].ConclusionThis large prospective study identified that diabetes was the main driver of all‐cause and CVD mortality in all the categories studied, with diabesity being the riskiest. Given the high prevalence of both conditions in Mexico, our results reinforce the importance of initiating prevention strategies from an early age.
Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state
Authors: Casarotto Silvia , Hassan Gabriel , Rosanova Mario , Sarasso Simone , Derchi Chiara‐Camilla , Trimarchi Pietro Davide , Viganò Alessandro , Russo Simone , Fecchio Matteo , Devalle Guya , Navarro Jorge , Massimini Marcello , Comanducci Angela 
Published: March 2024

AbstractThe analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (n = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power—more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients—was found in a non‐negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.
Multimodal diagnostic imaging and treatment of cheek tooth hypercementosis associated with chronic ocular discharge in a horse
Authors: Scilimati Nicola , Bertoletti Alice , Angeli Giovanni , Nannarone Sara , Sforna Monica , Santi Agnese , Ortolani Flaminia , Gialletti Rodolfo 
Published: March 2024

SummaryThis case report discusses the clinical signs, diagnostic findings, treatment and outcome of a 6‐year‐old Italian Warmblood gelding referred for evaluation of a chronic unilateral ocular mucopurulent discharge that had been ongoing for several months. Dacryocystorhinography and computed tomography dacryocystography (CT‐DCG) allowed the identification of a neoformation associated with tooth 206 connected to a cystic lesion occupying the ipsilateral ventral nasal concha. It is likely that both lesions caused stenosis of the nasolacrimal duct and secondary recurrent ocular discharge. Once the 206 tooth had been surgically removed, a histological diagnosis of nodular hypercementosis associated with a small cystic lesion was made. In this case, CT‐DCG was extremely important in identifying the source of the ocular discharge and guiding the surgical planning for tooth removal. A follow‐up telephone conversation with the owner 6 months postoperatively reported that the horse had not shown further ocular discharge.
Insulin resistance and osteocalcin associate with the incidence and severity of postoperative delirium in elderly patients undergoing joint replacement
Authors: Mi Yang , Wen Ouyang , Lei Zhou , Ge Long , Xing Liu , Xi He 
Published: March 2024

AimWhile insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin.MethodsA total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non‐delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose. Insulin resistance was assessed through the homeostatic model assessment of insulin resistance (HOMA‐IR).Main resultsOut of the total, 28 patients (23.3%) experienced POD within 5 days after surgery. Patients with delirium exhibited higher levels of preoperative HOMA‐IR and ucOC in CSF and plasma, and of tOC in CSF (P = 0.028, P < 0.001, P = 0.005, P = 0.019). After adjusting for variables, including age, Mini‐Mental State Examination score, surgical site and preoperative fracture, only preoperative ucOC in CSF and HOMA‐IR were significantly linked to the incidence of delirium (OR = 5.940, P = 0.008; OR = 1.208, P = 0.046, respectively), both of which also correlated with the severity of delirium (P = 0.007, P < 0.001). Receiver operating curve analysis indicated that preoperative HOMA‐IR and ucOC in CSF might partly predict POD (area under the curve [AUC] = 0.697, 95% confidence interval [CI] = 0.501–0.775, AUC = 0.745, 95% CI = 0.659–0.860).ConclusionsWe observed that preoperative elevated HOMA‐IR and ucOC in CSF were associated with the incidence and severity of POD. While these preliminary results need confirmation, they suggest a potential involvement of insulin resistance and osteocalcin in the pathological mechanism of POD. Geriatr Gerontol Int 2024; 24: 421–429.
Does diversified environmental regulation effect the foreign direct investment inflows and technological innovation? A three‐stage least square approach
Authors: Liu Lingcai , Bai Dongbei , Fahad Shah , Ozturk Ilhan 
Published: March 2024

AbstractForeign direct investment (FDI) inflows have been significantly impacted by environmental regulation (ER). This study is aiming at analyzing the ER effect on the FDI inflows. By using the data of 2008–2018, we use Three‐stages least square (3SLS) method to assess the connection between FDI inflows and ER. The study results reveal that in Chinese industries, technological innovation (TI) is stipulated by the ER, and as a result, FDI has been engrossed. The results further reveal that TI has been enhanced by capital penetration, and a positive effect is perceived between TI and FDI. The findings of our study also show that there is a significant association between foreign capital (FC) inflows and TI, which indicates that technological policies are effective and advanced environmental policies would intensify the relevant policies between firms. Based on the study outcomes, this research proposes some policy suggestions for constructing a attuned policy system of environmental protection and FDI by regulating the implementation of conforming strategies.
Evaluation of the prognostic significance of clinical features of tumoral lesions in an extensive series of mycosis fungoides
Authors: Atci Tugba , Ozturk Sari Sule , Buyukbabani Nesimi , Besisik Sevgi , Baykal Can 
Published: March 2024

AbstractBackgroundTumors indicating the advanced stage of mycosis fungoides (MF) have a rich clinical spectrum. Although it is known that the prognosis of MF generally worsens following the development of tumors, some cases may have a relatively indolent course, and the role of clinical characteristics regarding prognosis has still not been well understood.MethodsMF patients were retrospectively evaluated regarding the development of tumors. Besides demographic characteristics, data of the subtype and stage of the disease were recorded. The clinical features of tumors, including number (<5, 5–10, 11–20, or >20), location, dimension (diameter of ≥5 cm), presence of ulceration, and surrounding inflammation, were noted. Univariate and multivariate analyses evaluated the relationship between overall survival (OS) with demographic and clinical features.ResultsAmong 730 consecutive MF patients, tumors developed in 8.2% (n = 60), of whom 46.7% were diagnosed with advanced‐stage MF from the beginning. The most common subtype was folliculotropic MF (53.3%). Most patients (55%) had multiple tumors, and the most frequent localization was the trunk (71.7%). Most tumors presented as smooth‐surfaced, indurated papules and/or nodules (70%), while others were reddish‐purple, occasionally accompanied by ulceration (50%), perilesional inflammation (23.3%), and attaining large dimensions (25%). Mortality was recorded in 51.7% of patients, and the 5‐year OS rate from the diagnosis of tumors was 49%. Independent poor prognostic factors for OS in multivariate analysis included older age at the time of diagnosis, presence of tumors at the initial MF diagnosis, presence of over 20 tumors, and the existence of large tumors.ConclusionsTumoral MF seen in older patients, the first diagnosis of MF in this stage, presenting with generalized and large tumors, seems to be a predictive factor for OS.
White blood cells scattergram as a valuable tool for COVID‐19 screening: A multicentric study
Authors: Osman Jennifer , Gonnin Cécile , Lambert Jérome , Behier Céline , Chapuis Nicolas , Chevalier Simon , Debus Jérôme , Delaval Anne , Depoorter Maxime , Dumas Cécile , Dumesges Amély , Dussert Pascale , Vacher Corinne Ferrero , Dubois‐Galopin Frédérique , Gerard Delphine , Bollotte Pauline Gravière , Guignedoux Geoffroy , Mayeur‐Rousse Caroline , Mercier‐Bataille Delphine , Ronez Emily , Trichet Catherine , Wiber Margaux , Raggueneau Victoria 
Published: March 2024

AbstractIntroductionNew tools have been developed to distinguish the COVID‐19 diagnosis from other viral infections presenting similar symptomatology and mitigate the lack of sensitivity of molecular testing. We previously identified a specific “sandglass” aspect on the white blood cells (WBC) scattergram of COVID‐19 patients, as a highly reliable COVID‐19 screening test (sensitivity: 85.9%, specificity: 83.5% and positive predictive value: 94.3%). We then decided to validate our previous data in a multicentric study.MethodsThis retrospective study involved 817 patients with flu‐like illness, among 20 centers, using the same CBC instrument (XN analyzer, SYSMEX, Japan). After training, one specialist per center independently evaluated, under the same conditions, the presence of the “sandglass” aspect of the WDF scattergram, likely representing plasmacytoid lymphocytes.ResultsOverall, this approach showed sensitivity: 59.0%, specificity: 72.9% and positive predictive value: 77.7%. Sensitivity improved with subgroup analysis, including in patients with lymphopenia (65.2%), patients presenting symptoms for more than 5 days (72.3%) and in patients with ARDS (70.1%). COVID‐19 patients with larger plasmacytoid lymphocyte cluster (>15 cells) more often have severe outcomes (70% vs. 15% in the control group).ConclusionOur findings confirm that the WBC scattergram analysis could be added to a diagnostic algorithm for screening and quickly categorizing symptomatic patients as either COVID‐19 probable or improbable, especially during COVID‐19 resurgence and overlapping with future influenza epidemics. The observed large size of the plasmacytoid lymphocytes cluster appears to be a hallmark of COVID‐19 patients and was indicative of a severe outcome. Furthers studies are ongoing to evaluate the value of the new hematological parameters in combination with WDF analysis.
Complex needs and ethical dilemmas—Care managers processing older clients to gerontological social work
Authors: Kinni Riitta‐Liisa , Tiilikainen Elisa 
Published: March 2024

AbstractIn the times of neoliberal policies, care managers work as gatekeepers to different elder care services. In this study, we examined how care managers categorise older adults' life situations in relation to needs for gerontological social work. Our data consisted of focus group interviews with 19 care managers working in different parts of Finland and were analysed by category analysis. The results show that processing older adults as clients of social work is not unambiguous. The Finnish legislation does not offer a solid foundation for defining the complex needs of older adults in everyday practices of care managers, but abuse and several coincident support needs were recognised as criteria for social work services. Importantly, ethical issues concerning sensitive situations and the self‐determination of older adults were categorised as situations where social work is needed. This sets high expectations for the ethical expertise of social work in elder care.
Conveying the pathogenesis of type 1 diabetes to the blind, low‐vision and diverse needs communities through sensory stimulation
Authors: Tran Mai T , Ciacchi Laura , Ciacchi Lisa , Reid Hugh H 
Published: March 2024

AbstractTo educate members of the blind, low‐vision and diverse needs communities on the pathogenesis of the chronic autoimmune disease, type 1 diabetes, members of our team with research expertise in immune‐mediated diseases, participated in the 2023 Monash Sensory Science (MSS) Exhibition. Using QR code linked audio commentary, participants were guided through tactile displays demonstrating normal insulin action in the regulation of blood glucose levels and its vital role in providing energy to tissues, followed by displays describing the various stages of the immune system's aberrant attack and the eventual complete destruction of the insulin producing beta‐cells of the pancreatic islets in type 1 diabetes. These models conveyed to the participants the huge effect that this autoimmune‐mediated disease has on the quality of life of affected individuals including the subsequent lifelong reliance on insulin injections to maintain glucose homeostasis. This MSS Exhibition provided a unique opportunity for our researchers to engage with under‐represented members of the community and to raise awareness about such a debilitating and common autoimmune disease.