bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue Affects Body Acceleration During Vertical Jumping and Agility Tasks in Elite Young Badminton Players
Authors: Cheng Kai-Chia , Chiu Ya-Lan , Tsai Chia-Liang , Hsu Yu-Liang , Tsai Yi-Ju 
Published: April 2024

Background: Badminton is a sport demanding both high aerobic and anaerobic fitness levels, and fatigue can significantly impact game performance. However, relevant studies are limited, and none have employed a wearable inertial measurement unit (IMU) to investigate the effects of fatigue on athletic performance in the field. Hypothesis: Overall performance and body acceleration in both time and frequency domains during the fundamental badminton skills of vertical jumping and changes of direction will be affected by fatigue. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 38 young badminton players competing at the Division I level participated. Body accelerations while performing vertical jump and agility-T tests before and immediately after undergoing a fatigue protocol were measured by an IMU, positioned at the L4 to L5 level. Results: Jumping height decreased significantly by 4 cm ( P < 0.01) after fatigue with greater downward acceleration (1.03 m/s2, P < 0.05) during the squatting subphase. Finishing time increased significantly by 50 ms only during the 10-m side-shuffling of the agility-T test ( P = 0.02) after fatigue with greater peak and mean accelerations (3.83 m/s2, P = 0.04; 0.43 m/s2, P < 0.01), and higher median and mean frequency (0.38 Hz, P = 0.04, 0.11 Hz, P = 0.01). Conclusion: This study using a wearable IMU demonstrates the effects of fatigue on body acceleration in badminton players. The frequency-domain analysis further indicated that fatigue might lead to loss of voluntary control of active muscles and increased impacts on the passive elastic elements. Clinical Relevance: The findings imply that fatigue can lead to diminished athletic performance and highlight the potential for an increased risk of sports injuries. Consequently, maintaining precision in monitoring fatigue is crucial for elite young badminton players.
Appropriateness of magnetic resonance imaging of the lumbar spine orders for low back pain in a general hospital
Authors: Lee Weiyong , Salkade Parag Ratnakar , Tang Phua Hwee 
Published: April 2024

Introduction Inappropriate magnetic resonance imaging (MRI) for low back pain contributes to increased healthcare costs. The American College of Radiology (ACR) appropriateness criteria for low back pain is a guideline to reduce these unnecessary MRIs. Methods Retrospective study of the MRI lumbar spine performed for the investigation of low back pain in a General Hospital from 2016-2017. Divided into six clinical categories. (1) No Red Flags. (2) Low-velocity trauma, osteoporosis, elderly individuals, or chronic steroid use. (3) Suspicion of cancer, infection, or immunosuppression. (4) Failed conservative management. (5) Prior lumbar surgery. (6) Suspected cauda equina syndrome or neurological deficit. MRI findings are divided into 1) Critical findings of spinal cord/cauda equina compression, metastatic cancer, spinal epidural abscess, and vertebral osteomyelitis. 2) Significant findings of vertebral compression fracture or compression of the lumbar spinal nerves. 3) Non-specific findings with no compression of the lumbar spinal nerves and no critical findings. Results 670 MRI lumbar spine were performed. 25.3% in group (1) with 0% critical findings. 35.3% in group (2) with 4.6% critical findings. 5.8% in group (3) with 39.5% critical findings. 23.4% in group (4) with 0% critical findings. 2.8% in in group (5) with 0% critical findings. 7.3% in group (6) with 91.7% critical findings. Conclusion 25.3% of MRI lumbar spine performed were inappropriate based on the ACR criteria. Moreover, there were no critical findings in this group. The use of ACR appropriateness criteria can reduce unnecessary MRI lumbar spine for low back pain without compromising patient safety.
Drug–drug interaction between tacrolimus and caspofungin in Chinese kidney transplant patients with different CYP3A5 genotypes
Authors: Zhang Yundi , Shen Bowen , Li Yue , Zong Huiying , Zhang Xiaoming , Cao Xiaohong , Liu Fengxi , Li Yan 
Published: April 2024

Background: The effect of drug–drug interaction between tacrolimus and caspofungin on the pharmacokinetics of tacrolimus in different CYP3A5 genotypes has not been reported in previous studies. Objectives: To investigate the effect of caspofungin on the blood concentration and dose of tacrolimus under different CYP3A5 genotypes. Design: We conducted a retrospective cohort study in The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital from January 2015 to December 2022. All kidney transplant patients were divided into the combination or non-combination group based on whether tacrolimus was combined with caspofungin or not. Patients were subdivided into CYP3A5 expressers ( CYP3A5*1/*1 or CYP3A5*1/*3) and CYP3A5 non-expressers ( CYP3A5*3/*3). Methods: Data from the combination and the non-combination groups were matched with propensity scores to reduce confounding by SPSS 22.0. A total of 200 kidney transplant patients receiving tacrolimus combined with caspofungin or not were enrolled in this study. Statistical analysis was conducted on the dose-corrected trough concentrations ( C0/ D) and dose requirements ( D) of tacrolimus using independent sample two-sided t-test and nonparametric tests to investigate the impact on patients with different. Results: In this study, the C0/ D values of tacrolimus were not significantly different between the combination and non-combination groups ( p = 0.054). For CYP3A5 expressers, there was no significant difference in tacrolimus C0/ D or D values between the combination and non-combination groups ( p = 0.359; p = 0.851). In CYP3A5 nonexpressers, the C0/ D values of tacrolimus were significantly lower in the combination than in the non-combination groups ( p = 0.039), and the required daily dose of tacrolimus was increased by 11.11% in the combination group. Conclusion: Co-administration of caspofungin reduced tacrolimus blood levels and elevated the required daily dose of tacrolimus. In CYP3A5 non-expressers, co-administration of caspofungin had a significant effect on tacrolimus C0/ D values. An approximate 10% increase in the weight-adjusted daily dose of tacrolimus in CYP3A5 non-expressers is recommended to ensure the safety of tacrolimus administration.
Epidemiological trends and clinical outcomes of cryptococcosis in a medically insured population in the United States: a claims-based analysis from 2017 to 2019
Authors: Chastain Daniel B. , Zhang Qian , Chen Xianyan , Young Henry N. , Franco-Paredes Carlos , Tuells Jose , Thompson George R. , Henao-Martínez Andrés F. 
Published: April 2024

Background:Emerging risk factors highlight the need for an updated understanding of cryptococcosis in the United States.Objective:Describe the epidemiological trends and clinical outcomes of cryptococcosis in three patient groups: people with HIV (PWH), non-HIV-infected and non-transplant (NHNT) patients, and patients with a history of solid organ transplantation.Methods:We utilized data from the Merative Medicaid Database to identify individuals aged 18 and above with cryptococcosis based on the International Classification of Diseases, Tenth Revision diagnosis codes from January 2017 to December 2019. Patients were stratified into PWH, NHNT patients, and transplant recipients according to Infectious Diseases Society of America guidelines. Baseline characteristics, types of cryptococcosis, hospitalization details, and in-hospital mortality rates were compared across groups.Results:Among 703 patients, 59.7% were PWH, 35.6% were NHNT, and 4.7% were transplant recipients. PWH were more likely to be younger, male, identify as Black, and have fewer comorbidities than patients in the NHNT and transplant groups. Notably, 24% of NHNT patients lacked comorbidities. Central nervous system, pulmonary, and disseminated cryptococcosis were most common overall (60%, 14%, and 11%, respectively). The incidence of cryptococcosis fluctuated throughout the study period. PWH accounted for over 50% of cases from June 2017 to June 2019, but this proportion decreased to 47% from July to December 2019. Among the 52% of patients requiring hospitalization, 61% were PWH and 35% were NHNT patients. PWH had longer hospital stays. In-hospital mortality at 90 days was significantly higher in NHNT patients (22%) compared to PWH (7%) and transplant recipients (0%). One-year mortality remained lowest among PWH (8%) compared to NHNT patients (22%) and transplant recipients (13%).Conclusion:In this study, most cases of cryptococcosis were PWH. Interestingly, while the incidence remained relatively stable in PWH, it slightly increased in those without HIV by the end of the study period. Mortality was highest in NHNT patients.
Clinical utility of metagenomic next-generation sequencing in fever of undetermined origin
Authors: Daher Marilyne , Iordanov Roumen , Al Mohajer Mayar , Sohail M. Rizwan , Staggers Kristen Andrews , Hamdi Ahmed Mufeed 
Published: April 2024

Background: Metagenomic next-generation sequencing (mNGS) is a novel diagnostic tool increasingly used in the field of infectious diseases. Little guidance is available regarding its appropriate use in different patient populations and clinical syndromes. We aimed to review the clinical utility of mNGS in patients with a specific clinical syndrome and identify factors that may increase its utility. Methods: We retrospectively reviewed charts of 72 non-immunocompromised adults hospitalized with the clinical syndrome of ‘fever of undetermined origin’ and underwent mNGS testing. Standardized criteria from a previously published study were used to determine the clinical impact of mNGS testing. We applied logistic regression to identify factors associated with a positive clinical impact. Results: Of the 72 patients identified, 62.5% were males with a median age of 56. All patients had a fever at the time of evaluation. At least one organism was identified in 65.3% of cases; most commonly were Epstein–Barr virus (13.9%), cytomegalovirus (12.5%), and Rickettsia typhi (11.1%). Of those determined to have an infectious etiology of their febrile syndrome, 89.5% ( n = 34/38) had a positive mNGS. Consistency between the organism(s) on mNGS and the clinically determined infectious etiology was 82.4%. mNGS had a positive clinical impact in 40.3% of cases, a negative impact in 2.8%, and no impact in 56.9% of cases. Besides age, we did not identify other factors associated with a higher likelihood of positive clinical impact. Conclusion: In our review, mNGS had a positive clinical impact in a large proportion of adults with fever of undetermined origin, with minimal negative impact. However, mNGS results should be interpreted carefully given the high rate of detection of pathogens of unclear clinical significance. Randomized clinical trials are needed to assess the clinical utility of this novel diagnostic tool.
Spousal Involvement in Collaborative Management and Glycemic Behavior Change among Patients with Diabetes Mellitus: A Systematic Review
Authors: Pratiwi Ika Nur , Nursalam Nursalam , Widyawati Ika Yuni , Ramoo Vimala 
Published: April 2024

Introduction The marked increase in the number of individuals with diabetes mellitus (DM) worldwide each year has resulted in the importance of the spouse's contribution to the promotion and support of patient self-management programs. Objectives This study aimed to systematically explore the role or involvement of spouses in collaborative management and glycemic behavior change in DM. Methods Five databases including Scopus, PubMed, Cumulative Index of Nursing and Allied Health Literature, SAGE, and Web of Science were reviewed for relevant articles retrieved from 2017 to 2022. Literature search used keywords, including “Spouse,” “Support,” “Self-management,” “Glycemic Control,” and “Diabetes mellitus.” The Joanna Briggs Institute guidelines were used for appraisal review of journals. The component of partner support in the self-management of patients with DM is associated with an increase in the patient's glycemic level. Results Twenty-five studies were identified that describe the different spousal roles and strategies in the promotion and support of DM management. Overall, spouses’ involvement positively impacted healthy diets, higher self-efficacy, improved quality of psychological well-being, increased perceived support, and changes in glycemic-influenced behavior. Adaptation in the spouse patient relationship including maintaining cohesiveness can result in positive coping is essential in normalizing and contextualizing the chronic condition of DM. Partner-based collaboration is important for diabetes management, overcoming management barriers, and generating communal coping. Conclusion This systematic review observed that the involvement of a spouse is important in improving collaborative management and results in better glycemic behavior in patients with DM. A better understanding of the relationship between spousal involvement, coping strategies, and adherence in daily management and the subsequent use of this information are highly useful for creating targeted and effective interventions.
Age-specific sex-differences in cerebral blood flow velocity in relation to haemoglobin levels
Authors: Mazzucco Sara , Li Linxin , Tuna Maria Assuncao , Rothwell Peter M 
Published: April 2024

Introduction: Cerebral blood flow (CBF) declines with age and abnormalities in CBF are associated with age-related cerebrovascular disease and neurodegeneration. Women have higher CBF than men, although this sex-difference diminishes to some extent with age in healthy subjects. The physiological drivers of these age/sex differences are uncertain, but might be secondary to age and sex-differences in haemoglobin (Hb) level. Hb levels are inversely correlated with CBF, are lower in women, and decline with age in men, but the interrelations between these factors have not been explored systematically either in healthy subjects or across the full age-range in patients with vascular risk factors. We aimed to determine the age-specific interrelations between sex, Hb, and CBF velocity in a large cohort of patients with cerebrovascular disease. Patients and methods: In patients with a recent transient ischaemic attack or minor stroke (Oxford Vascular Study) and no ipsilateral or contralateral stenosis of the carotid or intracranial arteries, we related peak-systolic velocity (PSV) and other parameters on transcranial Doppler ultrasound (TCD) of the middle cerebral artery to sex, age, Hb and vascular risk factors. Results: Of 958 eligible subjects (mean age/SD = 68.04/14.26, 53.2% male), younger women (age < 55 years) had higher CBF velocities than men (mean sex difference in PSV at age < 55 years = 16.31 cm/s; p < 0.001), but this difference declined with age (interaction p < 0.001), such that it was no longer significant at age 75–84 (∆PSV = 3.26 cm/s; p = 0.12) and was reversed at age ⩾ 85 (∆PSV = −7.42 cm/s; p = 0.05). These changes mirrored trends in levels of Hb, which were higher in men at age < 55 (∆Hb = 1.92 g/dL; p < 0.001), but steadily decreased with age in men but not in women (interaction p < 0.001), with no residual sex-difference at age ⩾ 85 (∆Hb = 0.12 g/dL; p = 0.70). There was an inverse correlation between Hb and PSV in both women and men (both p ⩽ 0.01), and the sex-difference in PSV at age < 55 was substantially diminished after adjustment for Hb (∆PSV = 6.92; p = 0.036; ∆PSV = 5.92, p = 0.13 with further adjustment for end-tidal CO2). In contrast, the sex difference in PSV was unaffected by adjustment for systolic and diastolic blood pressure, heart rate, and vascular risk factors (history of hypertension, diabetes, hyperlipidaemia and smoking). Discussion: CBF velocity is strongly correlated with Hb level at all ages, and sex-differences in CBF velocity appear to be explained in major part by age-related sex-differences in Hb.
Assigning disease clusters to people: A cohort study of the implications for understanding health outcomes in people with multiple long-term conditions
Authors: Beaney Thomas , Clarke Jonathan , Salman David , Woodcock Thomas , Majeed Azeem , Barahona Mauricio , Aylin Paul 
Published: April 2024

Background Identifying clusters of co-occurring diseases may help characterise distinct phenotypes of Multiple Long-Term Conditions (MLTC). Understanding the associations of disease clusters with health-related outcomes requires a strategy to assign clusters to people, but it is unclear how the performance of strategies compare. Aims First, to compare the performance of methods of assigning disease clusters to people at explaining mortality, emergency department attendances and hospital admissions over one year. Second, to identify the extent of variation in the associations with each outcome between and within clusters. Methods We conducted a cohort study of primary care electronic health records in England, including adults with MLTC. Seven strategies were tested to assign patients to fifteen disease clusters representing 212 LTCs, identified from our previous work. We tested the performance of each strategy at explaining associations with the three outcomes over 1 year using logistic regression and compared to a strategy using the individual LTCs. Results 6,286,233 patients with MLTC were included. Of the seven strategies tested, a strategy assigning the count of conditions within each cluster performed best at explaining all three outcomes but was inferior to using information on the individual LTCs. There was a larger range of effect sizes for the individual LTCs within the same cluster than there was between the clusters. Conclusion Strategies of assigning clusters of co-occurring diseases to people were less effective at explaining health-related outcomes than a person’s individual diseases. Furthermore, clusters did not represent consistent relationships of the LTCs within them, which might limit their application in clinical research.
Algorithmically mediating communication to enhance collective decision-making in online social networks
Authors: Burton Jason W , Almaatouq Abdullah , Rahimian M Amin , Hahn Ulrike 
Published: April 2024

Digitally enabled means for judgment aggregation have renewed interest in “wisdom of the crowd” effects and kick-started collective intelligence design as an emerging field in the cognitive and computational sciences. A keenly debated question here is whether social influence helps or hinders collective accuracy on estimation tasks, with recent results on the role of network structure hinting at a reconciliation of seemingly contradictory past results. Yet, despite a growing body of literature linking social network structure and collective accuracy, strategies for exploiting network structure to harness crowd wisdom are underexplored. We introduce one such strategy: rewiring algorithms that dynamically manipulate the structure of communicating social networks. Through agent-based simulations and an online multiplayer experiment, we provide a proof of concept showing how rewiring algorithms can increase the accuracy of collective estimations—even in the absence of knowledge of the ground truth. However, we also find that the algorithms’ effects are contingent on the distribution of estimates initially held by individuals before communication occurs. CCS Concepts •Human-centered computing → Collaborative and social computing• Applied computing → Psychology.
Human herpesvirus 6 reactivation and disease are infrequent in chimeric antigen receptor T-cell therapy recipients
Authors: Kampouri Eleftheria , Krantz Elizabeth M. , Xie Hu , Ibrahimi Sarah S. , Kiem Erika S. , Sekhon Mandeep K. , Liang Emily C. , Cowan Andrew J. , Portuguese Andrew , Green Damian J. , Albittar Aya , Huang Jennifer J. , Gauthier Jordan , Pérez-Osorio Ailyn C. , Jerome Keith R. , Zerr Danielle M. , Boeckh Michael J. , Hill Joshua A. 
Published: April 2024

Abstract
Human herpesvirus 6B (HHV-6B) reactivation and disease are increasingly reported after chimeric antigen receptor (CAR) T-cell therapy (CARTx). HHV-6 reactivation in the CAR T-cell product was recently reported, raising questions about product and patient management. Because of overlapping manifestations with immune effector cell–associated neurotoxicity syndrome, diagnosing HHV-6B encephalitis is challenging. We provide 2 lines of evidence assessing the incidence and outcomes of HHV-6B after CARTx. First, in a prospective study with weekly HHV-6B testing for up to 12 weeks after infusion, HHV-6B reactivation occurred in 8 of 89 participants; 3 had chromosomally integrated HHV-6 and were excluded, resulting in a cumulative incidence of HHV-6B reactivation of 6% (95% confidence interval [CI], 2.2-12.5). HHV-6B detection was low level (median peak, 435 copies per mL; interquartile range, 164-979) and did not require therapy. Second, we retrospectively analyzed HHV-6B detection in the blood and/or cerebrospinal fluid (CSF) within 12 weeks after infusion in CARTx recipients. Of 626 patients, 24 had symptom-driven plasma testing, with detection in 1. Among 34 patients with CSF HHV-6 testing, 1 patient had possible HHV-6 encephalitis for a cumulative incidence of 0.17% (95% CI, 0.02-0.94), although symptoms improved without treatment. Our data demonstrate that HHV-6B reactivation and disease are infrequent after CARTx. Routine HHV-6 monitoring is not warranted.
Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery
Authors: Jensen Helena Amstrup , Nielsen Torsten Grønbech , Lind Martin 
Published: April 2024

Abstract
Background
The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.

Materials and methods
A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.

Results
Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46–2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12–1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34–1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15–1.40; P < 0.001).

Conclusion
The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.
Level of evidence: II.