bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating a novel 24-hour rest/activity rhythm marker of preclinical β-amyloid deposition
Authors: Spira Adam P , Liu Fangyu , Zipunnikov Vadim , Bilgel Murat , Rabinowitz Jill A , An Yang , Di Junrui , Bai Jiawei , Wanigatunga Sarah K , Wu Mark N , Lucey Brendan P , Schrack Jennifer A , Wanigatunga Amal A , Rosenberg Paul B , Simonsick Eleanor M , Walker Keenan A , Ferrucci Luigi , Resnick Susan M 
Published: February 2024

Abstract

Study Objectives
To compare sleep and 24-hour rest/activity rhythms (RARs) between cognitively normal older adults who are β-amyloid-positive (Aβ+) or Aβ− and replicate a novel time-of-day-specific difference between these groups identified in a previous exploratory study.

Methods
We studied 82 cognitively normal participants from the Baltimore Longitudinal Study of Aging (aged 75.7 ± 8.5 years, 55% female, 76% white) with wrist actigraphy data and Aβ+ versus Aβ− status measured by [11C] Pittsburgh compound B positron emission tomography. RARs were calculated using epoch-level activity count data from actigraphy. We used novel, data-driven function-on-scalar regression analyses and standard RAR metrics to cross-sectionally compare RARs between 25 Aβ+ and 57 Aβ− participants.

Results
Compared to Aβ− participants, Aβ+ participants had higher mean activity from 1:00 p.m. to 3:30 p.m. when using less conservative pointwise confidence intervals (CIs) and from 1:30 p.m. to 2:30 p.m. using more conservative, simultaneous CIs. Furthermore, Aβ+ participants had higher day-to-day variability in activity from 9:00 a.m. to 11:30 a.m. and lower variability from 1:30 p.m. to 4:00 p.m. and 7:30 p.m. to 10:30 p.m. according to pointwise CIs, and lower variability from 8:30 p.m. to 10:00 p.m. using simultaneous CIs. There were no Aβ-related differences in standard sleep or RAR metrics.

Conclusions
Findings suggest Aβ+ older adults have higher, more stable day-to-day afternoon/evening activity than Aβ− older adults, potentially reflecting circadian dysfunction. Studies are needed to replicate our findings and determine whether these or other time-of-day-specific RAR features have utility as markers of preclinical Aβ deposition and if they predict clinical dementia and agitation in the afternoon/evening (i.e. “sundowning”).
Ectopic Expression of the Executor-Type R Gene Paralog Xa27B in Rice Leads to Spontaneous Lesions and Enhanced Disease Resistance
Authors: Tian Dongsheng , Teo Joanne , Yin Zhongchao 
Published: February 2024

Plant disease resistance ( R) gene-mediated effector-triggered immunity (ETI) is usually associated with hypersensitive response (HR) and provides robust and race-specific disease resistance against pathogenic infection. The activation of ETI and HR in plants is strictly regulated, and improper activation will lead to cell death. Xa27 is an executor-type R gene in rice induced by the TAL effector AvrXa27 and confers disease resistance to Xanthomonas oryzae pv. oryzae ( Xoo). Here we reported the characterization of a transgenic line with lesion mimic phenotype, designated as Spotted leaf and resistance 1 ( Slr1), which was derived from rice transformation with a genomic subclone located 5,125 bp downstream of the Xa27 gene. Slr1 develops spontaneous lesions on its leaves caused by cell death and confers disease resistance to both Xoo and Xanthomonas oryzae pv. oryzicola. Further investigation revealed that the Slr1 phenotype resulted from the ectopic expression of an Xa27 paralog gene, designated as Xa27B, in the inserted DNA fragment at the Slr1 locus driven by a truncated CaMV35Sx2 promoter in reverse orientation. Disease evaluation of IRBB27, IR24, and Xa27B mutants with Xoo strains expressing dTALE-Xa27B confirmed that Xa27B is a functional executor-type R gene. The functional XA27B-GFP protein was localized to the endoplasmic reticulum and apoplast. The identification of Xa27B as a new functional executor-type R gene provides additional genetic resources for studying the mechanism of executor-type R protein-mediated ETI and developing enhanced and broad-spectrum disease resistance to Xoo through promoter engineering. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Risk of Fracture and Complications Following Fixation in Patients with Pre-injury Psychiatric Illness: A Propensity-Matched Cohort Study
Authors: Zhu Kevin Y. , Bobak Lukas , Dorney Ian , Breslin Mary A. , Hendrickson Sarah B. , Vallier Heather A. 
Published: February 2024

OBJECTIVE:
The purpose was to describe the frequency of orthopaedic trauma and post-surgical complications associated with psychiatric diagnoses.

METHODS:

Design:
Query of TriNetx Analytics Network

Setting:
Participating hospitals

Patient selection criteria:
Those ≥ 18 years old with psychiatric illness and orthopaedic trauma
Outcome measures and comparisons: Fractures and post-operative complications were described. A 1:1 propensity score matching function was utilized. Odds ratios compared inter-cohort complications.

RESULTS:
A total of 11,266,415 patients were identified with a psychiatric diagnosis, including bipolar disorder (8.9%), schizophrenia (3.3%), major depression (12.4%), stress-related disorder (9.6%), anxiety disorder (64.5%), borderline personality disorder (BPD) (1.1%), or antisocial personality (0.2%). Prevalence of 30.2% was found for a fracture and at least one psychiatric diagnosis. Antisocial personality disorder had the highest risk ratio relative to people without that mental disorder (RR = 5.09) of having one or more associated fracture, followed by depression (RR = 3.03), stress-related disorders (RR = 3.00), anxiety disorders (RR = 2.97), BPD (RR = 2.92), bipolar disorder (RR = 2.80), and schizophrenia (RR = 2.69). Patients with at least one psychiatric comorbidity had greater risk of pulmonary embolism, superficial and deep surgical site infections, pneumonia, urinary tract infection, deep venous thrombosis, osteonecrosis, and complex regional pain syndrome by 1 month after fixation, when compared with patients without psychiatric disorder. By 1 year, they were also at an increased risk for stroke and myocardial infarction.

CONCLUSIONS:
All psychiatric comorbidities were associated with increased relative risk of fracture and higher odds of complications compared with patients without psychiatric comorbidities. Providers should be aware of pre-existing psychiatric diagnoses during treatment of acute injuries due to these risks.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Evaluation of Intraoperative Fluoroscopic Techniques to Estimate Femoral Rotation: A Cadaveric Study
Authors: Ivanov David V. , Welby John P. , Khanna Ankur , Barlow Jonathan D. , Sems S. Andrew , Torchia Michael E. , Yuan Brandon J. 
Published: February 2024

Objectives:
To compare three fluoroscopic methods for determining femoral rotation.

Methods:
Native femoral version was measured by computed tomography in 20 intact femurs from 10 cadaveric specimens. Two Steinmann pins were placed into each left femur above and below a planned transverse osteotomy which was completed through the diaphysis. Four surgeons utilized the true lateral (TL), neck-horizontal angle (NH), and lesser trochanter profile (LTP) techniques to correct the injured femur’s rotation using the intact right femur as reference, yielding 120 measurements. Accuracy was assessed by comparing the angle subtended by the two Steinmann pins before and after manipulation and comparing against version measurements of the right femur.

Results:
Absolute mean rotational error in the fractured femur compared to its uninjured state was 6.0° (95% CI, 4.6-7.5), 6.6° (95% CI, 5.0-8.2), and 8.5° (95% CI, 6.5-10.6) for the TL, NH, and LTP techniques, respectively, without significant difference between techniques (p=0.100). Compared to the right femur, absolute mean rotational error was 6.6° (95% CI, 1.0-12.2), 6.4° (95% CI, 0.1-12.6), and 8.9° (95% CI, 0.8-17.0) for the TL, NH, and LTP techniques, respectively, without significant difference (p=0.180). Significantly more femurs were malrotated by >15° using the LTP method compared to the TL and NH methods (20.0% vs 2.5% and 5.0%, p=0.030). Absolute mean error in estimating femoral rotation of the intact femur using the TL and NH methods compared to CT was 6.6° (95% confidence interval [CI], 5.1-8.2) and 4.4° (95% CI, 3.4-5.4), respectively, with significant difference between the two methods (p=0.020).

Conclusions:
The true lateral (TL), neck-horizontal angle (NH), and the lesser trochanter profile (LTP) techniques performed similarly in correcting rotation of the fractured femur, but significantly more femurs were malrotated by >15° using the LTP technique. This supports preferential use of the TL or NH methods for determining femoral version intraoperatively.
Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area
Authors: Yamasaki Lisa , Kamada Takuma , Ng Chris Fook Sheng , Takane Yuya , Nakajima Ko , Yamaguchi Kazuki , Oka Kazutaka , Honda Yasushi , Kim Yoonhee , Hashizume Masahiro 
Published: February 2024

Background:
Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area.

Methods:
We conducted event study analyses to compare temperature–HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature–HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER.

Results:
We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality.

Conclusions:
A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.
Full adherence to cirrhosis quality indicators is associated with lower mortality in acute variceal bleeding: Nationwide audit
Authors: Wong Yu Jun , Teng Margaret , Sim Alyssa , Thet Htay Myat , Teoh Xuhui , De Roza Marianne Anastasia , Sen Kew Guan , Koh Jia Hong , Loi Pooi Ling , Lim Kai , Kang Garrett , Kuang Jonathan , Low En Xian Sarah , HO Jing Liang , Cher Liu Yuan Gabriel , Sze Kenny , Wong Guan Wee , Kwek Boon Yew Andrew , Yang Wei Lyn , Abraldes Juan G. , Chang Jason 
Published: February 2024

Background and Aims:
Acute variceal bleeding (AVB) is a major complication in patients with cirrhosis. Using a nationwide AVB audit, we performed a nested cohort study to determine whether full adherence to the AVB quality indicator (QI) improves clinical outcomes in patients with cirrhosis and AVB.

Approach and Results:
We assessed real-world adherence to AVB QI among patients with cirrhosis admitted for AVB in all public hospitals in Singapore between January 2015 and December 2020. Full adherence was considered when all 5 QIs were fulfilled: prophylactic antibiotics, vasoactive agents, timely endoscopy, endoscopic hemostasis during index endoscopy, and nonselective beta-blockers after AVB. We compare 6-week mortality between the full adherence and suboptimal adherence groups using a propensity-matched cohort.
A total of 989 patients with AVB were included. Full adherence to all AVB QI was suboptimal (56.5%). Analysis of the propensity-matched cohort with comparable baseline characteristics showed that full adherence was associated with a lower risk of early infection (20.0% vs. 26.9%), early rebleeding (5.2% vs. 10.2%), and mortality at 6 weeks (8.2% vs. 19.7%) and 1 year (21.3% vs. 35.4%) (p<0.05 for all). While full adherence was associated with a lower 6-week mortality regardless of the MELD score, nonadherence was associated with a higher 6-week mortality despite a lower predicted risk of 6-week mortality. Despite high adherence to the recommended process measures, patients with CTP-C remain at a higher risk of rebleeding, 6-week and 1-year mortality.

Conclusions:
Full adherence to the AVB QI should be the target for quality improvement in patients with cirrhosis.
Serious Adverse Events of Inclisiran in Patients With Hypercholesterolemia, a Meta-Analysis of ORION Trials
Authors: Jawwad Mohammad , Riaz Monazza , Mehtab Mehreen , Naveed Chaudhary Muhammad Yafaa , Kumari Jaya , Ahmad Waqas , Aslam Hina , Masood Fatima , Rehman Wajeeh Ur , Rahman Ihtisham , Lara-Vega Israel , Ratani Sunny , Muhammad Aqeel , Affa Baig Alnehyan , Rauf Abdul 
Published: February 2024

Background:
Several studies have been conducted over the years to find an effective and safe therapeutic agent to treat hypercholesterolemia. Inclisiran is a novel drug being studied for its efficacy and safety in reducing low-density lipoprotein cholesterol levels in patients to reduce the risk of cardiovascular diseases. No previous study was done to review the trials for the serious adverse events of this drug. The primary objective of this research is to investigate the incidence of serious adverse events of this drug.

Design:
A systematic review and meta-analysis of clinical trials is performed.

Methods:
A systematic search of PubMed, Embase, and ClinicalTrials.gov, from their inception till July 3, 2023, was performed for ORION trials, studying the efficacy and safety of inclisiran. The random-effects model was used in the meta-analysis to provide a pooled proportion of serious adverse events. The risk of bias in each study was assessed by the Cochrane Risk of Bias Tool.

Results:
From 319 studies searched from the databases, only 8 relevant articles remained after a detailed evaluation. These studies, having a total of 4981 patients, were involved in the analysis, with a pooled estimate showing a nonsignificant incidence of serious adverse events. Each adverse event was studied individually, and product issues and endocrine disorders had the highest odds ratio among them. All included studies were classified as moderate quality.

Conclusion:
Following systematic review and meta-analysis, we found no significant differences in any serious adverse events following the administration of inclisiran. However, larger ongoing trials will provide additional data to evaluate the safety profile of this agent.
The Majority of Participants With Suspected Hypertrophic Cardiomyopathy Documented During Screening Echocardiography Have a Normal Electrocardiogram
Authors: Movahed Mohammad Reza , Irannejad Kyvan , Bates Sharon 
Published: February 2024

Background:
Patients with hypertrophic cardiomyopathy (HCM) usually have abnormal electrocardiograms consistent with left ventricular hypertrophy (LVH). The goal of this study was to evaluate the prevalence of abnormal ECG findings (LVH, T wave inversion, left bundle branch block, and left atrial enlargement) in participants with suspected HCM detected during screening echocardiography.

Method:
The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001. A total of 682 subjects between the ages of 8 and 71 underwent echocardiographic screening together with ECG documentation. We evaluated the prevalence of abnormal ECG in participants with suspected HCM defined as any left ventricular wall thickness ≥15 mm.

Results:
The prevalence of LVH and T wave inversion were higher in HCM subjects as expected [HCM occurred in 23.5% (4/17) vs. 5.6% (37/665), P = 0.002, T wave inversion occurred in 17.6% (3/17) vs. 4.1% (27/664), P = 0.007]. However, despite adding these 2 common ECG abnormalities in this population, the presence of detected abnormal ECG remained less than 25% (23.5% of HCM subjects had LVH or T wave inversion on ECG vs. 8.7% of control, P = 0.036). Left bundle branch block or abnormal left atrium on ECG were not found in any participants with suspected HCM.

Conclusions:
The prevalence of abnormal ECG in the participants with suspected HCM detected during screening echocardiography is less than 25%. This suggests that ECG alone is not a sensitive marker for the detection of HCM.
Modified Method for Nanothin Descemet Stripping Automated Endothelial Keratoplasty
Authors: Zhao Zelin , Lin Lei , Zhou Weihe , Chen Jiaqi , Xiao Yinling , Jhanji Vishal , Liu Yang , Zheng Qinxiang , Chen Wei 
Published: February 2024

Purpose:
The purpose of this study was to describe a method to achieve a high success rate for nanothin (NT, ≤50 μm) Descemet stripping automated endothelial keratoplasty (DSAEK) graft preparation using anterior chamber pressurizer (ACP) with a modified setting and evaluate its postoperative efficacy.

Methods:
A prospective cohort (study group) of 24 patients with corneal endothelial dysfunction was consecutively enrolled and received DSAEK grafts using the modified ACP method from December 2021 to May 2022. The control group included 24 historical patients who received DSAEK grafts using conventional ACP procedure. Central graft thickness (CGT), graft regularity (3-mm and 5-mm diameter zones), best spectacle–corrected visual acuity, and endothelial cell density (ECD) were compared between 2 groups.

Results:
A 100% ultrathin (UT, ≤100 μm) DSAEK rate and 62.5% NT-DSAEK rate was achieved at 3 months postsurgery in the study group, with a 51.3 ± 14.8 μm CGT, while a 70.8% UT-DSAEK rate and 4.2% NT-DSAEK rate was achieved in the control group, with an 89.0 ± 15.4 μm CGT (P <0.001). At 3-month postoperative follow-up, the regularity of graft thickness was significantly better in the study group (central-to-peripheral thickness difference: P = 0.044 and 0.014 for 3-mm and 5-mm diameter zones, respectively, graft thickness uniformity: P <0.001 and 0.012, respectively). There was no statistical difference in the best spectacle–corrected visual acuity (P = 0.170) or ECD (P = 0.833) between 2 groups at 3-month postoperative follow-up.

Conclusions:
DSAEK grafts harvested using modified ACP method were thinner and more regular compared with the conventional ACP method.
Ezetimibe treatment reduces oxidized low-density lipoprotein in biliary cirrhotic rats
Authors: Chang Ching-Chih , Huang Hui-Chun , Hsu Shao-Jung , Pun Chon-Kit , Chuang Chiao-Lin , Hou Ming-Chih , Lee Fa-Yauh 
Published: February 2024

Background:
In liver cirrhosis, chronic inflammation is associated with an increase in oxidative stress, and subsequently an increase in the concentration of oxidized low-density lipoprotein (ox-LDL). Ezetimibe is a lipid-lowering agent with anti-inflammation and anti-oxidative stress activities. This study aimed to investigate the effect of ezetimibe treatment on ox-LDL in cirrhotic rats.

Methods:
Biliary cirrhosis was induced in Sprague-Dawley rats with common bile duct ligation (BDL). Sham-operated rats served as surgical controls. Ezetimibe (10 mg/kg/d) or vehicle was administered in the sham-operated or BDL rats for 4 weeks, after which hemodynamic parameters, biochemistry data, and oxidative stress were evaluated. Plasma and intrahepatic ox-LDL levels were also examined, and hepatic proteins were analyzed to explore the mechanism of ezetimibe treatment.

Results:
The BDL rats had typical features of cirrhosis including jaundice, impaired liver function, hyperlipidemia, and elevated ox-LDL levels compared to the sham-operated rats. Ezetimibe treatment did not affect hemodynamics, liver biochemistry, or plasma lipid levels. However, it significantly reduced oxidative stress, plasma levels of ox-LDL, and tumor necrosis factor α. In addition, ezetimibe upregulated the hepatic protein expression of an ox-LDL scavenger (lectin-like ox-LDL rececptor-1), which resulted in reductions in intrahepatic ox-LDL and fat accumulation in the BDL rats. Nevertheless, ezetimibe treatment did not ameliorate hepatic inflammation or liver fibrosis.

Conclusion:
Ezetimibe reduced plasma and intrahepatic ox-LDL levels in the cirrhotic rats. Furthermore, it ameliorated intrahepatic fat accumulation and oxidative stress. However, ezetimibe did not alleviate hepatic fibrosis or inflammation in the biliary cirrhotic rats.
Bridging the gap: Implementing a pilot radiology-focused curriculum in an acute care Nurse Practitioner program
Authors: Zuma Danielle , Zink Mara , Tran Nhani , Chen Leon 
Published: February 2024

ABSTRACT
Knowledge in diagnostic radiology and performance of point-of-care ultrasound are integral to acute care nurse practitioners (ACNPs) in the inpatient settings, especially true in specialty areas such as interventional radiology and critical care. However, existing ACNP training programs, including at our institution, often lack robust relevant course content. To address this educational gap, we designed and implemented a pilot acute care radiology course, incorporating a flipped classroom approach and hands-on simulation activities led by expert faculty. Our course evaluation revealed high levels of student satisfaction, self-reported confidence, and perceived course effectiveness. The course aligns with key competencies outlined by the American Association of Colleges of Nursing, demonstrating its potential to advance ACNP education in radiology content.
Restoration of reproductive capacity in a male patient with congenital adrenal hyperplasia and bilateral testicular adrenal rest tumors (TARTs) after six months of glucocorticoid intensification: A case report
Authors: Ahmad Jihan , Ahmad Adnan , Hadid Lama 
Published: February 2024

Rationale:
Congenital adrenal hyperplasia (CAH) is considered one of the most common inherited disorders. In about more than 95% of all CAH cases, the deficient enzyme is 21-hydroxylase. Infertility is an important complication of this disease, and although this topic has been studied more frequently in females, cases, and literature reviews of the causes of infertility in male patients are constantly increasing.

Patient concerns:
A 28 old male with congenital adrenal hyperplasia (we assume to be a nonclassical type) presented to our institution with infertility and suspected bilateral testicular masses after 4 years of stopping dexamethasone.

Diagnosis:
Testicular adrenal rest tumors.

Interventions:
Dexamethasone was reapplied in a supraphysiologic dose (1.5 mg before bedtime) with periodic monitoring of the patient.

Outcomes:
Treatment with supraphysiologic dose of dexamethasone led to regression of these tumors and significant improvement in sperm count, resulting in being capable of having a child.

Lessons:
There are many suspected causes of reduced male fertility in male CAH patients and the presence of testicular adrenal rest tumors is the main cause of infertility in this population. These benign tumors are believed to arise from ectopic adrenal cells in the testes, that grow under adrenocorticotropic hormone stimulation in poorly controlled patients. Annual scrotal ultrasound is recommended in all males with CAH for detection and treatment of these tumors as early as possible before they cause permanent damage to the seminiferous tubules and irreversible infertility.