bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of interleukin-6 signal inhibition on Treg subpopulations and association of Tregs with clinical outcomes in rheumatoid arthritis
Authors: Yoshida Hiroto , Magi Mayu , Tamai Hiroya , Kikuchi Jun , Yoshimoto Keiko , Otomo Kotaro , Matsumoto Yoshihiro , Noguchi-Sasaki Mariko , Takeuchi Tsutomu , Kaneko Yuko 
Published: March 2024

Abstract

Objectives
Anti-IL-6 receptor antibodies are clinically efficacious in the management of RA with an associated increase in Tregs; however, the role of functional Treg subsets has yet to be clarified. This study aimed to evaluate how functional Treg subsets are altered by IL-6 receptor blockade and to analyse the relationship between these Treg subsets and the clinical outcome of RA.

Methods
We collected frozen peripheral blood mononuclear cells (PBMCs) from 40 patients with RA who started tocilizumab (TCZ) with or without MTX and 11 healthy controls (HCs). We fractionated Tregs with flow cytometry based on markers of phenotype and function and measured the proportions of detailed Treg subsets sequentially from baseline to week 52.

Results
The proportions of resting Tregs (rTregs) and rTregs+activated Tregs (aTregs) were significantly lower in RA patients at baseline than in HCs. The proportions of all those CD127low Tregs, rTregs, aTregs and rTregs+aTregs were significantly increased with TCZ treatment. In patients treated with TCZ without MTX, rTreg were increased. Patients with an increase in the proportion of rTregs at week 12 had significantly less arthritis flares during the observation period.

Conclusions
Blocking the IL-6 receptor with TCZ increased the proportion of rTregs, a functional Treg subpopulation. Patients with an early increase in rTregs showed a favourable treatment course and this increase in rTregs may reflect molecular remission induced by IL-6 signal inhibition.
Heart rate variability analysis in obstructive sleep apnea patients with daytime sleepiness
Authors: Ucak Seren , Dissanayake Hasthi U , de Chazal Philip , Bin Yu Sun , Sutherland Kate , Setionago Bianca , Tong Benjamin , Yee Brendon J , Kairaitis Kristina , Wheatley John R , Piper Amanda J , Cistulli Peter A ,   Sydney Sleep Biobank Investigators, Cistulli Peter , de Chazal Philip , Sutherland Kate , Sarkissian Nina , Moi Chow Chin , Chan Andrew , Lowth Aimee , Graham Jacob , Wood William , Cohen Gary , Bennett Callum , Ahmadi Mohammad , Wheatley John , Kairaitis Kristina , Lambert Stephen , Ginn Rita , Burns Tracey , Yee Brendon , Piper Amanda , Wong Keith , Melehan Kerri , Chan Margaret , Wang David , Gauthier Gislaine 
Published: March 2024

Abstract

Study Objectives
Recent studies suggest that sleepy patients with obstructive sleep apnea (OSA) are at higher risk for incident cardiovascular disease. This study assessed cardiac autonomic function in sleepy versus non-sleepy patients with OSA using heart rate variability (HRV) analysis. We hypothesized that HRV profiles of sleepy patients would indicate higher cardiovascular risk.

Methods
Electrocardiograms (ECG) derived from polysomnograms (PSG) collected by the Sydney Sleep Biobank were used to study HRV in groups of sleepy (ESS ≥ 10) and non-sleepy OSA patients (ESS &lt; 10). HRV parameters were averaged across available ECG signals during N2 sleep.

Results
A total of 421 patients were evaluated, with a mean age of 54 (14) years, body mass index of 33 (9) kg/m2, apnea–hypopnea index of 21 (28) events/h, and 66% male. The sleepy group consisted of 119 patients and the non-sleepy group 302 patients. Sleepy patients exhibited lower HRV values for: root mean square successive difference (RMSSD, p = 0.028), total power (TP, p = 0.031), absolute low frequency (LF, p = 0.045), and high-frequency (HF, p = 0.010) power compared to non-sleepy patients. Sleepy patients with moderate-to-severe OSA exhibited lower HRV values for: (RMSSD, p = 0.045; TP, p = 0.052), absolute LF (p = 0.051), and HF power (p = 0.025). There were no differences in other time and frequency domain HRV markers.

Conclusions
This study shows a trend toward parasympathetic withdrawal in sleepy OSA patients, particularly in moderate-to-severe cases, lending mechanistic support to the link between the sleepy phenotype and CVD risk in OSA.
Family Composition, Race, and Teachers’ Perceptions of Parent-Teacher Alliance
Authors: Romell Emma 
Published: March 2024

Abstract
Both family composition and teachers’ perceptions of parents are important for student success. However, we know little about whether teachers’ perceptions of parents vary by family composition. Using data from the Future of Families and Child Wellbeing Study, I show that teachers perceive single mothers with multipartner fertility and, to a lesser extent, repartnered mothers with multipartner fertility as less aligned with their school’s goals than parents who have nuclear families. Socioeconomic status, children’s behavior, and parents’ involvement do not explain this association. I also show that white teachers’ perceptions—of both white and black parents—drive this relationship. Further, I show that white teachers perceive black parents as less aligned with their school’s goals than white parents with the same family type. By focusing on mesolevel interactions between the family and school settings, this study expands research on the implications of family composition for students’ and parents’ experiences at school.
Genetic impact of external Targhee sires at the U.S. Sheep Experiment Station: a case study of introgression
Authors: Wilson Carrie S , Taylor J Bret , Lewis Ronald M , Notter David R 
Published: March 2024

Abstract
Sheep breeders requested that the U.S. Sheep Experiment Station (USSES) to participate in national genetic evaluation through the National Sheep Improvement Program (NSIP). The reasons included the need for (1) a comparison of the productivity of industry and United States Department of Agriculture (USDA) lines, (2) transparency of USDA flocks, (3) genetic ties for NSIP by sampling of industry flocks, and (4) development of premium genetic lines for public release. In response, USSES began to incorporate external sires from NSIP participating flocks into the USSES Targhee flock. Our objective, based on a pedigree analysis, was to test if introgression of external genetics into the flock was achieved. The pedigree included 13,189 animals with mean maximum generations, mean complete generations, and mean equivalent complete generations of 4.2, 1.8, and 2.6, respectively. The mean generation interval was 3.1 yr. The reference population was defined as lambs born from 2021 to 2023 (n = 792). Two additional populations were defined as the current mature ewe flock (n = 123) and the current mature rams (n = 14). The Genetic Conservation Index averaged 7.7 for the full population and 25.7 for the reference population. Overall inbreeding was 0.003 for the full population and 0.006 for the reference population. The rate of inbreeding was 0.0003 per generation. Average relatedness was 0.015 for the full population and 0.018 for the reference population. The effective number of founders, effective number of ancestors, and founder genome equivalents contributing to the reference population were 60, 39, and 19.1, respectively. The ratio of the effective number of founders to the effective number of ancestors was 1.5, indicating the presence of genetic bottlenecks. Measures of effective population size ranged from 102 to 547. Of the 704 offspring produced by external sires, 17 ram lambs and 132 ewe lambs were retained for breeding. The USSES sires produced 299 offspring with 2 ram lambs and 51 ewe lambs retained. Incorporating external sires resulted in a cumulative percentage of genetic variance of 48.8, 49.1, and 44.2 of external genetics for the reference population, current mature ewe flock, and current mature rams, respectively. Stakeholder needs were addressed by introgression of external sires and participation in NSIP, but future selection practices need to be modified to maintain a minimum of 50% USSES core genetics in the flock.
Sensitivity of the Causal Agent of Northern Leaf Blight of Corn, Exserohilum turcicum, to the Demethylase-Inhibiting Fungicide Flutriafol
Authors: Anderson Nolan R. , McCoy Austin G. , Castellano Cristina , Chilvers Martin I. , Alinger Eric , Allen Tom W. , Bissonnette Kaitlyn , Copeland Drake , Hustedde Nick , Jackson-Ziems Tamra A. , Kleczewski Nathan , Leon Christopher , Mueller John , Price Paul , Raid Richard , Robertson Alison E. , Sikora Edward J. , Telenko Darcy E. P. , Wiggins Matthew , Wise Kiersten A. 
Published: March 2024

Fungicides including active ingredients in the demethylation inhibitor group (Fungicide Resistance Action Committee Group 3) are used to manage corn diseases such as northern corn leaf blight, caused by Exserohilum turcicum. This study assessed the level of sensitivity to the demethylation-inhibiting fungicide flutriafol on a population of 81 E. turcicum isolates collected from across the United States in 2020. Sensitivity to flutriafol for E. turcicum was assessed using fungicide-amended media to determine the effective concentration needed to limit hyphal growth by 50%. The mean absolute EC50 values of the overall population calculated using the four-parameter log-logistic and Weibull2 four-parameter models were 2.1881 and 3.2643 µg/ml, respectively. The growth of most isolates ( n = 70, 86.4%) was completely inhibited by 1 µg/ml of flutriafol. However, the growth of seven isolates (8.6%) was only completely inhibited at 10 or 100 µg/ml, and complete inhibition was not observed at 100 µg/ml for four isolates (4.9%). These results suggest that there may be isolates of E. turcicum in the United States that are resistant to flutriafol. Additional fungicide sensitivity screening is critical to monitor the development of fungicide resistance in U.S. populations of E. turcicum.
PAs in India
Authors: Muraleedharan Manesh , Chandak Alaka Omprakash , Chatterjee Somu , Shivakumar R. , Swapna Nalla 
Published: March 2024

ABSTRACT

Background:
This report is based on a 2023 nationwide survey and literature review of physician associates/assistants (PAs) in India. The National Commission for Allied and Healthcare Professions Act, 2021, which is being implemented in India, included guidelines for PA licensing, creating a unified national curriculum, and preventing malpractice.

Methods:
Using a purposive sampling strategy, we surveyed 536 PAs in India between February 10 and April 30, 2023. The survey collected data on demographics, academic qualifications, specialties, salaries, job satisfaction, and future outlooks through an online questionnaire.

Results:
The survey showed that most PAs are below age 30 years, and most graduated PAs were involved in clinical practice in 2023. PAs work in almost all clinical specialties; most practice in private hospitals. States in southern India continued to dominate educating and employing PAs, with a nationwide representation of more than 14 states. More than 80% of practicing PAs are satisfied with their profession; however, the majority are unsatisfied with their wages.

Conclusions:
This first formal survey on India's PAs illustrates the challenges of PA professional practice and standardization of education and licensure in the Indian healthcare system.
Association of Previous Antibiotics Use and Kawasaki Disease: A Cohort Study of 106,908 Patients
Authors: Kim Tae-Hwan , Shin Ji Seong , Kim Sin Young , Kim Jihye 
Published: March 2024

Background:
Microbial imbalance in the gut from antibiotic use may be an etiologic factor of Kawasaki disease (KD). We aimed to identify the association between the use of antibiotics and the development of KD, considering various antibiotic profiles.

Methods:
A population-based, case-control study was performed using data from the Health Insurance Review and Assessment Service database. Children <5 years of age, who were diagnosed with KD between 2016 and 2019, were identified. Propensity score-matched controls were selected from the general population in a 1:5 ratio. Four separate study cohorts were created according to different periods of antibiotic use: (1) within 28 days and (2) 12 months after birth and (3) within 6 months and (4) 12 months from the index date. Profiles regarding antibiotic use were compared between patients with KD and matched controls.

Results:
We included 17,818 patients with KD and 89,090 matched controls. Use of antibiotics within 6 months [odds ratio (OR): 1.18; 95% confidence interval (CI): 1.12–1.26] and 12 months (OR: 1.23; 95% CI: 1.14–1.32) from the index date were associated with the development of KD. The association between antibiotic use and KD was most prominent in patients who had received 3 or more types of antibiotics within 12 months from the index date (OR: 1.26; 95% CI: 1.17–1.37).

Conclusions:
Antibiotic use within the preceding 6 or 12 months was associated with KD. Alteration in gut microbiota due to antibiotic usage might play a role in the development of KD.
Identifying drivers of cost in pediatric liver transplantation
Authors: Sabapathy Divya G. , Hosek Kathleen , Lam Fong W. , Desai Moreshwar S. , Williams Eric A. , Goss John , Raphael Jean L. , Lopez Michelle A. 
Published: March 2024

Understanding the economics of pediatric liver transplantation (LT) is central to high-value care initiatives. We examined cost and resource utilization in pediatric LT nationally to identify drivers of cost and hospital factors associated with greater total cost of care. We reviewed 3295 children (<21 y) receiving an LT from 2010 to 2020 in the Pediatric Health Information System to study cost, both per LT and service line, and associated mortality, complications, and resource utilization. To facilitate comparisons, patients were stratified into high-cost, intermediate-cost, or low-cost tertiles based on LT cost. The median cost per LT was $150,836 [IQR $104,481–$250,129], with marked variance in cost within and between hospital tertiles. High-cost hospitals (HCHs) cared for more patients with the highest severity of illness and mortality risk levels (67% and 29%, respectively), compared to intermediate-cost (60%, 21%; p<0.001) and low-cost (51%, 16%; p<0.001) hospitals. Patients at HCHs experienced a higher prevalence of mechanical ventilation, total parental nutrition use, renal comorbidities, and surgical complications than other tertiles. Clinical (27.5%), laboratory (15.1%), and pharmacy (11.9%) service lines contributed most to the total cost. Renal comorbidities ($69,563) and total parental nutrition use ($33,192) were large, independent contributors to total cost, irrespective of the cost tertile (p<0.001). There exists a significant variation in pediatric LT cost, with HCHs caring for more patients with higher illness acuity and resource needs. Studies are needed to examine drivers of cost and associated outcomes more granularly, with the goal of defining value and standardizing care. Such efforts may uniquely benefit the sicker patients requiring the strategic resources located within HCHs to achieve the best outcomes.
Desialylation by neuraminidases in platelets, kiss of death or bittersweet?
Authors: Butta Nora , van der Wal Dianne E. 
Published: March 2024

Purpose of review
Loss of surface sialic acid by neuraminidases is known as ‘desialylation’. Platelets are desialylated in bacterial or viral infections, during storage, senescence, various mutations, platelet auto antibodies, hemostasis and shear stress. In this review the recent literature on the different sialic acid capped glycan structures will be covered as well as platelet desialylation in inherited glycan disorders and induced by external neuraminidases.

Recent findings
Neuraminidases are released from platelet intracellular stores and translocated to the platelet surface. Apart from clearance, loss of surface sialic acid by neuraminidases (‘desialylation’) affects platelet signaling including ligand binding and their procoagulant function. Platelets are also desialylated in infections, various mutations, presence of platelet auto antibodies.

Summary
Since platelet desialylation occurs in various healthy and pathological conditions, measuring desialylation might be a new diagnostic tool.
How safe are proprotein convertase subtilisinekexin type 9 inhibitors in diabetes?
Authors: Chen Tian , Liu Naifeng 
Published: March 2024

Purpose of review
To examine the safety of proprotein convertase subtilisinekexin type 9 (PCSK9) inhibitors in patients with diabetes, specifically focusing on their impact on glucose metabolism.

Recent findings
Patients with diabetes often require intensified lipid-lowering therapy. PCSK9 inhibitors can reduce low-density lipoprotein cholesterol (LDL-C) concentrations by approximately 60%, and significantly reduce cardiovascular risk when added to statin therapy. Some studies have suggested an association between low LDL-C levels and an increased risk of new-onset diabetes, and genetics has almost consistently shown an increased glucose concentration and risk of diabetes. Most clinical trials have not demonstrated a deterioration in glycaemic control in patients with diabetes after the use of PCSK9 inhibitors, and they do not lead to other significant treatment-emergent adverse events.

Summary
Although the majority of patients with diabetes are undergoing background statin therapy, which may mask potential adverse effects of PCSK9 inhibitors on glycaemic control, current data suggest that the benefits outweigh the risks for diabetic patients using PCSK9 inhibitors. Considering the different nature of genetic studies and of clinical trials, close monitoring of glucose parameters is necessary, especially in individuals with prediabetes.
Mixed Connective Tissue Disease Presenting With Psychosis—A Case Report
Authors: Tondehal Nikhil , Sengupta Arnab , Mohankumar Kavya , Trivedi Chintan , Mansuri Zeeshan , Jain Shailesh 
Published: March 2024

Abstract
Mixed connective tissue disease (MCTD) is a systemic autoimmune disease with features overlapping multiple autoimmune disorders. One study found that over 55% of patients with MCTD experienced neuropsychiatric symptoms, the most common of which was an “aseptic meningitis-like syndrome.” We present a case of a 17-year-old adolescent girl presenting with abnormal speech and behavior, auditory hallucinations, and paranoid delusions after an isolated episode of fever. She was treated for her psychotic symptoms but later developed symptoms resembling neuroleptic malignant syndrome. An antibody screen revealed elevated anti-U1-ribonucleoprotein antibodies with a possible diagnosis of MCTD. She finally responded to steroid therapy. To our knowledge, this is the first reported case of MCTD initially presenting with psychosis. A diagnosis of autoimmune disorders should be kept in the differential of similar clinical presentations including connective tissue disorders and autoimmune thyroid conditions.
Are rehabilitation professionals familiar with visual impairments? A survey of professional orders in Quebec, Canada
Authors: Nemargut Joseph P. , Boucher-Costi Geneviève , Ta Angel , St-Amant Laurie 
Published: March 2024

Significance
The number of patients with mild to moderate visual impairments (MVIs) is increasing as the average age of the population increases. Thus, it is important to understand the training and resources available for rehabilitation practitioners to provide adequate care to these patients within their scope of practice.

Purpose
This study explores rehabilitation professionals' perceptions of their competence in screening and treating patients with MVI, and identifying the tools and resources needed to increase these professionals' comfort level in managing these patients.

Methods
Data collection was carried via an online questionnaire to Quebec rehabilitation professionals and student-trainees who are members of their respective professional orders. The questionnaire consisted of 29 to 30 questions (open- and close-ended) related to demographics, service provision to MVI patients, education in MVI and future training, and future service delivery to MVI patients.

Results
Data were collected from 96 professionals, with 52 fully completing the questionnaire, with all the responses included in the analysis. Most respondents had little or no confidence in adequately screening or treating patients with MVI and mentioned that they knew little or nothing about the range of services offered by vision rehabilitation centers in Quebec (81%), whereas 55% at least occasionally offer services to these patients. The majority felt that their profession would benefit from continuing education on MVI (73%), with a marked interest in online training.

Conclusions
Rehabilitation professionals in Quebec are not confident in identifying or treating patients presenting MVI but express an interest in attending continuing education courses given by optometrists, low vision professionals, or a member of their own profession. Numerous barriers account for this problem, including a lack of experience and competence in the assessment and treatment options for MVI, as well as a lack of informational and human resources available in their workplaces.
Spinal Muscular Atrophy Mortality Despite Novel Medications
Authors: Bach John R. , Conceição Nayara , Goncalves Miguel R. 
Published: March 2024

Abstract
Despite new effective medications, patients with spinal muscular atrophy types 1–3 can continue to have inadequate cough flows to prevent episodes of acute respiratory failure. Ventilator unweanable intubated patients are thought to require tracheostomy tubes. As a result, potentially beneficial medications may be discontinued and patients die despite receiving these medications. Three cases are presented of medically treated, physically strengthening children, with spinal muscular atrophy type 1. All three subsequently died or underwent tracheotomy. However, there is no evidence of extubation attempts to noninvasive ventilatory support settings or optimal mechanical insufflation-exsufflation despite this option being described to be over 98% successful for extubating unweanable medically untreated children with spinal muscular atrophy 1.