bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study
Authors: Hutten Christina G , Padalia Kishan , Vasbinder Alexi , Huang Yiyuan , Ismail Anis , Pizzo Ian , Machado Diaz Kristen , Catalan Tonimarie , Presswalla Feriel , Anderson Elizabeth , Erne Grace , Bitterman Brayden , Blakely Pennelope , Giamarellos-Bourboulis Evangelos J , Loosen Sven H , Tacke Frank , Chalkias Athanasios , Reiser Jochen , Eugen-Olsen Jesper , Banerjee Mousumi , Pop-Busui Rodica , Hayek Salim S 
Published: April 2024

Abstract

Context
Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear.

Objective
The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes.

Methods
The International Study of Inflammation in COVID-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients, was conducted at 10 hospitals in the United States and Europe. Participants were adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022. Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed.

Results
Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI ≥ 35), those with BMI &gt; 40 (n = 485) had 55% higher odds of the composite outcome (95% CI, 1.21-1.98) compared with nonobese individuals (BMI &lt; 30, n = 2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants.

Conclusion
Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.
Genetic Underpinnings of Fasting and Oral Glucose-stimulated Based Insulin Sensitivity Indices
Authors: Suleman Sufyan , Madsen Anne L , Ängquist Lars H , Schubert Mikkel , Linneberg Allan , Loos Ruth J F , Hansen Torben , Grarup Niels 
Published: April 2024

Abstract

Context
Insulin sensitivity (IS) is an important factor in type 2 diabetes (T2D) and can be estimated by many different indices.

Objective
We aimed to compare the genetic components underlying IS indices obtained from fasting and oral glucose-stimulated plasma glucose and serum insulin levels.

Methods
We computed 21 IS indices, classified as fasting, OGTT0,120, and OGTT0,30,120 indices, using fasting and oral glucose tolerance test (OGTT) data in 2 cohorts. We used data from a family cohort (n = 313) to estimate the heritability and the genetic and phenotypic correlations of IS indices. The population cohort, Inter99 (n = 5343), was used to test for associations between IS indices and 426 genetic variants known to be associated with T2D.

Results
Heritability estimates of IS indices ranged between 19% and 38%. Fasting and OGTT0,30,120 indices had high genetic (ρG) and phenotypic (ρP) pairwise correlations (ρG and ρP: 0.88 to 1) The OGTT0,120 indices displayed a wide range of pairwise correlations (ρG: 0.17-1.00 and ρP: 0.13-0.97). We identified statistically significant associations between IS indices and established T2D-associated variants. The PPARG rs11709077 variant was associated only with fasting indices and PIK3R rs4976033 only with OGTT0,30,120 indices. The variants in FAM63A/MINDY1, GCK, C2CD4A/B, and FTO loci were associated only with OGTT0,120 indices.

Conclusion
Even though the IS indices mostly share a common genetic background, notable differences emerged between OGTT0,120 indices. The fasting and OGTT-based indices have distinct associations with T2D risk variants. This work provides a basis for future large-scale genetic investigations into the differences between IS indices.
Drug-Induced Atypical Lipodystrophy
Authors: Rajakumar Priyadarshini , Mahadevan Shriraam , Asirvatham Adlyne Reena , Ranjan Asha 
Published: April 2024

Abstract
We describe a case of an Asian-Indian female patient who presented to us with abnormal fat accumulations in the torso and upper arms following indiscriminate use of corticosteroid and anabolic steroids for about 7 years. Despite prolonged steroid use, the patient did not display cushingoid phenotype or metabolic decompensation. Bone density, echocardiography, and ultrasonogram of the liver were also normal with no evidence of excess pericardial fat, hepatic steatosis, or peliosis hepatis. Concurrent use of anabolic androgen is thought to be protective against the ill effects of steroids, especially on the muscle and bone. This phenomenon has been observed in children and adolescents with Cushing syndrome where the adrenal androgen excess and increased physical activity have shown to reasonably reduce protein catabolism and help in preserving muscle and bone mass. The patient was withdrawn from the drugs and was put on replacement hydrocortisone that was gradually tapered over the next few weeks and planned for surgical correction. This case highlights the fact that medical providers should be aware that a combination of anabolic steroids and glucocorticoids are still used for weight-building purposes, and these patients may present with atypical signs/symptoms as a result of this combination of drugs.
Female Self-Attack and Suicide in Tayeb Salih’s Season of Migration to the North and Liana Badr’s The Eye of the Mirror
Authors: Hamamra Bilal , Mleitat Ayman , Qabaha Ahmad 
Published: April 2024

Abstract
Drawing on psychoanalytic and sociocultural theories of suicide and self-harm, this article argues that Hosna’s suicide in Tayeb Salih’s Season of Migration to the North (1969) and Aisha’s self-harm in Liana Badr’s The Eye of the Mirror (1994) delineate two psychological modes of the protagonists’ coping with patriarchal oppression. While Aisha’s self-harm is therapeutic and cathartic, Hosna’s suicide is revolutionary on societal levels. Although both acts stem from the destructive patriarchal practice of forced marriage, they vary in their extremity and significance. While Aisha temporarily acts out her internal distress and communicates her discontent by cutting off her hair, Hosna’s suicide embodies a feminist agenda based on self-esteem and resistance and threatens the sovereignty of the whole patriarchal structure.
The scaling of metabolic traits differs among larvae and juvenile colonies of scleractinian corals
Authors: Bean Nina K. , Edmunds Peter J. 
Published: April 2024

ABSTRACT
Body size profoundly affects organism fitness and ecosystem dynamics through the scaling of physiological traits. This study tested for variation in metabolic scaling and its potential drivers among corals differing in life history strategies and taxonomic identity. Data were compiled from published sources and augmented with empirical measurements of corals in Moorea, French Polynesia. The data compilation revealed metabolic isometry in broadcasted larvae, but size-independent metabolism in brooded larvae; empirical measurements of Pocillopora acuta larvae also supported size-independent metabolism in brooded coral larvae. In contrast, for juvenile colonies (i.e. 1–4 cm diameter), metabolic scaling was isometric for Pocillopora spp., and negatively allometric for Porites spp. The scaling of biomass with surface area was isometric for Pocillopora spp., but positively allometric for Porites spp., suggesting the surface area to biomass ratio mediates metabolic scaling in these corals. The scaling of tissue biomass and metabolism were not affected by light treatment (i.e. either natural photoperiods or constant darkness) in either juvenile taxa. However, biomass was reduced by 9–15% in the juvenile corals from the light treatments and this coincided with higher metabolic scaling exponents, thus supporting the causal role of biomass in driving variation in scaling. This study shows that metabolic scaling is plastic in early life stages of corals, with intrinsic differences between life history strategy (i.e. brooded and broadcasted larvae) and taxa (i.e. Pocillopora spp. and Porites spp.), and acquired differences attributed to changes in area-normalized biomass.
Impact of hindlimb length variation on jumping dynamics in the Longshanks mouse
Authors: Bradley-Cronkwright Madison , Moore Sarah , Hou Lily , Cote Susanne , Rolian Campbell 
Published: April 2024

ABSTRACT
Distantly related mammals (e.g. jerboa, tarsiers, kangaroos) have convergently evolved elongated hindlimbs relative to body size. Limb elongation is hypothesized to make these species more effective jumpers by increasing their kinetic energy output (through greater forces or acceleration distances), thereby increasing take-off velocity and jump distance. This hypothesis, however, has rarely been tested at the population level, where natural selection operates. We examined the relationship between limb length, muscular traits and dynamics using Longshanks mice, which were selectively bred over 22 generations for longer tibiae. Longshanks mice have approximately 15% longer tibiae and 10% longer femora compared with random-bred Control mice from the same genetic background. We collected in vivo measures of locomotor kinematics and force production, in combination with behavioral data and muscle morphology, to examine how changes in bone and muscle structure observed in Longshanks mice affect their hindlimb dynamics during jumping and clambering. Longshanks mice achieved higher mean and maximum lunge-jump heights than Control mice. When jumping to a standardized height (14 cm), Longshanks mice had lower maximum ground reaction forces, prolonged contact times and greater impulses, without significant differences in average force, power or whole-body velocity. While Longshanks mice have longer plantarflexor muscle bodies and tendons than Control mice, there were no consistent differences in muscular cross-sectional area or overall muscle volume; improved lunge-jumping performance in Longshanks mice is not accomplished by simply possessing larger muscles. Independent of other morphological or behavioral changes, our results point to the benefit of longer hindlimbs for performing dynamic locomotion.
Association of Hospital Market Competition with Outcomes of Complex Cancer Surgery
Authors: Munir Muhammad Musaab , Woldesenbet Selamawit , Endo Yutaka , Dillhoff Mary , Tsai Susan , Pawlik Timothy M. 
Published: April 2024

Abstract
Background
The association of hospital market competition, financial costs, and quality of oncologic care has not been well-defined. This study sought to evaluate variations in patient outcomes and financial expenditures after complex cancer surgery across high- and low-competition markets.

Methods
Medicare 100% Standard Analytic Files were used to identify patients with lung, esophageal, gastric, hepatopancreaticobiliary, or colorectal cancer who underwent surgical resection between 2018 and 2021. Data were merged with the annual hospital survey database, and the hospital market Herfindahl–Hirschman index was used to categorize hospitals into low- and high-concentration markets. Multi-level, multivariable regression models adjusting for patient characteristics (i.e., age, sex, comorbidities, and social vulnerability), year of procedure, and hospital factors (i.e., case volume, nurse-bed ratio, and teaching status) were used to assess the association between hospital market competition and outcomes.

Results
Among 117,641 beneficiaries who underwent complex oncologic surgery, the mean age was 73.8 ± 6.1 years, and approximately one-half of the cohort was male (n = 56,243, 47.8%). Overall, 63.8% (n = 75,041) of the patients underwent care within a high-competition market. Notably, there was marked geographic variation relative to market competition. High versus low market-competition hospitals were more likely to be in high social vulnerability areas (35.1 vs 27.5%; p < 0.001), as well as care for racial/ethnic minority individuals (13.8 vs 7.7%; p < 0.001), and patients with more comorbidities (≥ 2 Elixhauser comorbidities: 63.1 vs 61.1%; p < 0.001). In the multivariable analysis, treatment at hospitals in high- versus low-competition markets was associated with lower odds of achieving a textbook outcome (odds ratio, 0.95; 95% confidence interval, 0.91–0.99; p = 0.009). Patients at high-competition hospitals had greater mean index hospitalization costs ($19,462.2 [16211.9] vs $18,844.7 [14994.7]) and 90-day post-discharge costs ($7807.8 [15431.3] vs $7332.8 [14038.2]) (both p < 0.001) than individuals at low-competition hospitals.

Conclusions
Hospital market competition was associated with poor achievement of an optimal postoperative outcome and greater hospitalization costs.
Atopic biomarker changes after exposure to Porphyromonas gingivalis lipopolysaccharide: a small experimental study in Wistar rats
Authors: Nelwan Sindy Cornelia , Nugraha Ricardo Adrian , Endaryanto Anang , Meizarini Asti , Tedjosasongko Udijanto , Pradopo Seno , Utomo Haryono , Nowwarote Nunthawan 
Published: April 2024

Background IgE and IgG4 are implicated in atopic development and clinically utilized as major biomarkers. Atopic responses following certain pathogens, such as Porphyromonas gingivalis (Pg), are currently an area of interest for further research. The aim of this study is to measure the level of IgE, IgG4, and IgG4/IgE ratio periodically after exposure of periodontal pathogen Pg lipopolysaccharide (LPS). Methods We used 16 Wistar rats (Rattus norvegicus) randomly subdivided into four groups: Group 1, injected with placebo; Group 2, injected with 0.3 µg/mL of Pg LPS; Group 3, injected with 1 µg/mL of Pg LPS; and Group 4, injected with 3 µg/mL of Pg LPS. Sera from all groups were taken from retro-orbital plexus before and after exposure. Results Levels of IgE and IgG4 increased significantly following exposure of Pg LPS at day-4 and day-11. Greater increase of IgE rather than IgG4 contributed to rapid decline of IgG4/IgE ratio, detected in the peripheral blood at day-4 and day-11. Conclusion Modulation of atopic responses following exposure to Pg is reflected by a decrease in IgG4/IgE ratio that accompanies an increase of IgE. Therefore, Pg, a keystone pathogen during periodontal disease, may have a tendency to disrupt atopic biomarkers.
Upper gastrointestinal training in the UK and Ireland: a Roux Group Study
Authors: Robinson DBT , Zakeri R , Brown LR , Laing RW , Choh C , Askari A , Abouelazayem M , Bradley A , Currie AC , Elmasry M , Evans RPT , Gall TMH , Jerome E , Raftery NB , Samuel M , Spiers HVM , Chan BKY ,   ; on behalf of the Roux Group
Published: April 2024

Introduction Surgical training programmes in the United Kingdom and Ireland (UK&I) are in a state of flux. This study aims to report the contemporary opinions of trainee and consultant surgeons on the current upper gastrointestinal (UGI) training model in the UK&I. Methods A questionnaire was developed and distributed via national UGI societies. Questions pertained to demographics, current training evaluation, perceived requirements and availability. Results A total of 241 responses were received with representation from all UK&I postgraduate training regions. The biggest discrepancies between rotation demand and national availability related to advanced/therapeutic endoscopy and robotic surgery, with 91.7% of respondents stating they would welcome greater geographical flexibility in training. The median suggested academic targets were 3–5 publications (trainee vs consultant <3 vs 3–5, p<0.001); <3 presentations (<3 vs 3–5, p=0.002); and 3–5 audits/quality improvement projects (<3 vs 3–5, p<0.001). Current operative requirements were considered achievable (87.6%) but inadequate for day one consultant practice (74.7%). Reassuringly, 76.3% deemed there was role for on-the-job operative training following consultant appointment. Proficiency in diagnostic endoscopy was considered a minimum requirement for Certificate of Completion of Training (CCT) yet the majority regarded therapeutic endoscopy competency as non-essential. The median numbers of index UGI operations suggested were comparable with the current curriculum requirements. Post-CCT fellowships were not considered necessary; however, the majority (73.6%) recognised their advantage. Conclusions Current CCT requirements are largely consistent with the opinions of the UGI community. Areas for improvement include flexibility in geographical working and increasing national provisions for high-quality endoscopy training.
What is beyond 50G: future standards of optical access networks [Invited]
Authors: Luo Yuanqiu , Effenberger Frank 
Published: April 2024

In the past two decades, optical access networks have been widely deployed by operators around the world. The global optical access network market reaches about 1 billion users with a revenue of over 10 billion US dollars. As strategic tools to facilitate mass production, the optical access network standards play a crucial role in driving the product deployment and market growth. This paper overviews the latest effort in international standards bodies on the next generation optical access networks. It discusses projects in this area within the International Telecommunication Union’s Telecommunication Standardization Section (ITU-T), the IEEE, and the European Telecommunications Standards Institute (ETSI). Promising technologies are investigated with the goal of providing rates beyond 50 Gbps. Challenges are highlighted to satisfy the requirements on balancing access rates, loss budgets, and cost. Candidate systems are analyzed in three categories: point-to-multipoint (PtMP), point-to-point (PtP), and new applications. These standardization endeavors will jointly guarantee optical access networks as the premiere solution of wireline broadband access.
Burst-mode pulse generation in passively mode-locked all-fiber green/orange lasers at 543  nm and 602  nm
Authors: Ruan Qiujun , Zou Jinhai , Feng Chunna , Chen Tingting , Wang Hang , Dong Zhipeng , Luo Zhengqian 
Published: April 2024

We report on the experimental realization of, to the best of our knowledge, the first green and orange passively mode-locked all-fiber lasers. Stable mode-locking in the burst-pulse status is achieved at the wavelengths of 543.3 nm and 602.5 nm. The figure-9 cavity comprises the fiber end-facet mirror, gain fiber (Ho3+:ZBLAN fiber or Pr3+/Yb3+:ZBLAN fiber), and fiber loop mirror (FLM). The FLM with long 460 HP fiber is not only used as an output mirror, but also acts as a nonlinear optical loop mirror for initiating visible-wavelength mode-locking. The green/orange mode-locked fiber lasers with the fundamental repetition rates of 3.779/5.662 MHz produce long bursts containing ultrashort pulses with the 0.85/0.76 GHz intra-burst repetition rates, respectively. The ultrashort intra-burst pulses stem from the dissipative four-wave-mixing effect in the highly nonlinear FLM as well as the intracavity Fabry–Perot filtering. Long bursts of 22.2/11.6 ns with ultrashort pulses of 87/62 ps are obtained in our experiment. The visible-wavelength passively mode-locked lasers in an all-fiber configuration and burst-mode would represent an important step towards miniaturized ultrafast fiber lasers and may contribute to the applications in ablation-cooling micromachining, biomedicine imaging, and scientific research.
Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review
Authors: Toniolo Jean , Ngoungou Edgard Brice , Preux Pierre-Marie , Beloni Pascale 
Published: April 2024

Background
31.4 million people in low- and middle-income countries die from chronic diseases annually, particularly in Africa. To address this, strategies such as task-shifting from doctors to nurses have been proposed and have been endorsed by the World Health Organization as a potential solution; however, no comprehensive review exists describing the extent of nurse-led chronic disease management in Africa.

Aims
This study aimed to provide a thorough description of the current roles of nurses in managing chronic diseases in Africa, identify their levels of knowledge, the challenges, and gaps they encounter in this endeavor.

Methods
We performed a scoping review following the key points of the Cochrane Handbook, and two researchers independently realized each step. Searches were conducted using five databases: MEDLINE, PyscINFO, CINAHL, Web of Science, and Embase, between October 2021 and April 2023. A descriptive analysis of the included studies was conducted, and the quality of the studies was assessed using the Downs and Black Scale.

Results
Our scoping review included 111 studies from 20 African countries, with South Africa, Nigeria, and Ghana being the most represented. Findings from the included studies revealed varying levels of knowledge. Nurses were found to be actively involved in managing common chronic diseases from diagnosis to treatment. Facilitating factors included comprehensive training, close supervision by physicians, utilization of decision trees, and mentorship. However, several barriers were identified, such as a shortage of nurses, lack of essential materials, and inadequate initial training.

Conclusion
There is significant potential for nurses to enhance the screening, diagnosis, and treatment of chronic diseases in Africa. Achieving this requires a combination of rigorous training and effective supervision, supported by robust policies. To address varying levels of knowledge, tailored training programs should be devised. Further research is warranted to establish the effectiveness of nurse-led interventions on population health outcomes.
Using emulated clinical trials to investigate the risk of being diagnosed with psychiatric ill health following the cancer diagnosis of a sibling
Authors: Kjellsson Sara , Rajaleid Kristiina , Modin Bitte 
Published: April 2024

Background
The sibling bond is often the longest relationship in an individual’s life, spanning both good and bad times. Focusing on the latter, we investigated whether a cancer diagnosis in one adult sibling is predictive of psychiatric illness in the other, and if any such effect differs according the ‘sociodemographic closeness’ between the siblings in terms of sex, age, education, marital status and residence.

Methods
We used hospital records to identify psychiatric diagnoses (2005–2019) in a Swedish total-population cohort born in 1953, and cancer diagnoses (2005–2017) in their full siblings. By means of emulated clinical trials, the cohort member’s risk of a diagnosis within two years following a first exposure (or non-exposure) to a sibling’s cancer was analyzed through Cox regression.

Results
Exposed cohort members had a higher risk of psychiatric diagnosis than unexposed (HR = 1.15; CI: 1.08–1.23), with men displaying a higher risk (1.19; CI: 1.09–1.31) than women (HR = 1.11; CI: 1.01–1.22). Sub-analyses of the exposed group showed that women with a cancer-stricken sister had a higher risk of adverse psychiatric outcomes (HR = 1.31; CI: 1.07–1.61) than women with a cancer-stricken brother. Furthermore, unmarried cohort members ran a higher risk, both when the cancer-stricken sibling was married (HR = 2.03; CI: 1.67–2.46) and unmarried (HR = 2.61; CI: 2.16–3.15), than in cases where both siblings were married. No corresponding difference were detected for ‘closeness’ in age, education and residence.

Conclusions
In line with theories of linked lives, our findings suggest that negative events in one sibling’s life tend to ‘spill over’ on the other sibling’s wellbeing, at least during the 15-year-long period leading up to retirement age.