bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic Susceptibility Modifies Relationships Between Air Pollutants and Stroke Risk: A Large Cohort Study
Authors: Ma Yudiyang , Zhang Jing , Li Dankang , Tang Linxi , Li Yimeng , Cui Feipeng , Wang Jianing , Wen Chen , Yang Jian , Tian Yaohua 
Published: December 2023

BACKGROUND:
The extent to which genetic susceptibility modifies the associations between air pollutants and the risk of incident stroke is still unclear. This study was designed to investigate the separate and joint associations of long-term exposure to air pollutants and genetic susceptibility on stroke risk.

METHODS:
The participants of this study were recruited by the UK Biobank between 2006 and 2010. These participants were followed up from the enrollment until the occurrence of stroke events or censoring of data. Hazard ratios (HRs) and 95% CIs for stroke events associated with long-term exposure to air pollutants were estimated by fitting both crude and adjusted Cox proportional hazards models. Additionally, the polygenic risk score was calculated to estimate whether the polygenic risk score modifies the associations between exposure to air pollutants and incident stroke.

RESULTS:
A total of 502 480 subjects were included in this study. After exclusion, 452 196 participants were taken into the final analysis. During a median follow-up time of 11.7 years, 11 334 stroke events were observed, with a mean age of 61.60 years, and men accounted for 56.2% of the total cases. Long-term exposures to particulate matter with an aerodynamic diameter smaller than 2.5 µm (adjusted HR, 1.70 [95% CI, 1.43–2.03]) or particulate matter with an aerodynamic diameter smaller than 10 µm (adjusted HR, 1.50 [95% CI, 1.36–1.66]), nitrogen dioxide (adjusted HR, 1.10 [95% CI, 1.07–1.12]), and nitrogen oxide (adjusted HR, 1.04 [95% CI, 1.02–1.05]) were pronouncedly associated with increased risk of stroke. Meanwhile, participants with high genetic risk and exposure to high air pollutants had ≈45% (31%, 61%; particulate matter with an aerodynamic diameter smaller than 2.5 µm), 48% (33%, 65%; particulate matter with an aerodynamic diameter smaller than 10 µm), 51% (35%, 69%; nitrogen dioxide), and 39% (25%, 55%; nitrogen oxide) higher risk of stroke compared with those with low genetic risk and exposure to low air pollutants, respectively. Of note, we observed additive and multiplicative interactions between genetic susceptibility and air pollutants on stroke events.

CONCLUSIONS:
Chronic exposure to air pollutants was associated with an increased risk of stroke, especially in populations at high genetic risk.
The Moral Duty Not to Confirm Negative Stereotypes
Authors: Smilansky Saul 
Published: December 2023

Abstract
Social interaction is laden with stereotypes. Throughout history negative stereotypes have been immensely harmful, leading to hatred, vilification, and direct harm such as discrimination, and they continue to be so in almost all societies. It is widely accepted that we ought not to view members of other groups negatively in stereotypical ways, and also ought not to apply negative stereotypes to members of our own group (or even to ourselves). However, is there any special moral obligation on the targets of such negative stereotypes to take care not to confirm them? May one even be blameworthy for not doing so? The very thought seems outrageous. Yet I will argue that it is plausible to think that, in fact, the victims, too, have pro tanto obligations to prevent stereotype confirmation (henceforth sc), in many central contexts. I am not aware of any sustained philosophical discussion making this claim.
Cloud-Top Phase Characterization of Extratropical Cyclones over the Northeast and Midwest United States: Results from IMPACTS
Authors: Zaremba Troy J. , Rauber Robert M. , Heimes Kaylee , Yorks John E. , Finlon Joseph A. , Nicholls Stephen D. , Selmer Patrick , McMurdie Lynn A. , McFarquhar Greg M. 
Published: December 2023

Abstract
Cloud-top phase (CTP) impacts cloud albedo and pathways for ice particle nucleation, growth, and fallout within extratropical cyclones. This study uses airborne lidar, radar, and Rapid Refresh analysis data to characterize CTP within extratropical cyclones as a function of cloud-top temperature (CTT). During the 2020, 2022, and 2023 Investigation of Microphysics and Precipitation for Atlantic Coast-Threatening Snowstorms (IMPACTS) field campaign deployments, the Earth Resources 2 (ER-2) aircraft flew 26 research flights over the northeast and midwest United States to sample the cloud tops of a variety of extratropical cyclones. A training dataset was developed to create probabilistic phase classifications based on Cloud Physics Lidar measurements of known ice and liquid clouds. These classifications were then used to quantify dominant CTP in the top 150 m of clouds sampled by the Cloud Physics Lidar in storms during IMPACTS. Case studies are presented illustrating examples of supercooled liquid water at cloud top at different CTT ranges (−3° < CTTs < −35°C) within extratropical cyclones. During IMPACTS, 19.2% of clouds had supercooled liquid water present at cloud top. Supercooled liquid was the dominant phase in extratropical cyclone cloud tops when CTTs were >−20°C. Liquid-bearing cloud tops were found at CTTs as cold as −37°C.

Significance Statement
Identifying supercooled liquid cloud tops’ frequency is crucial for understanding ice nucleation mechanisms at cloud top, cloud radiative effects, and aircraft icing. In this study, airborne lidar, radar, and model temperature data from 26 research flights during the NASA IMPACTS campaign are used to characterize extratropical cyclone cloud-top phase (CTP) as a function of cloud-top temperature (CTT). The results show that liquid was the dominant CTP present in extratropical cyclone cloud tops when CTTs were >−20°C with decreasing supercooled liquid cloud-top frequency at temperatures < −20°C. Nevertheless, liquid was present at CTTs as cold as −37°C.
Connection of Summer Surface Temperature Anomalies between the East European Plain–West Siberian Plain and North America on the Interannual Time Scale
Authors: Lv Chenyu , Lu Riyu , Chen Wei 
Published: December 2023

Abstract
This study identifies a significantly positive relationship between summer surface air temperature (SAT) anomalies over two remote regions in the Eurasian continent and North America during the period 1979–2021 on the interannual time scale. The former region includes the East European Plain and the West Siberian Plain, and the latter region includes central and eastern North America. The regionally averaged summer SAT anomalies show a correlation coefficient of 0.66 between these two regions, which is significant at the 99% confidence level. This intercontinental SAT relationship can be explained by a wavelike pattern of circulation anomalies, which is the leading mode of upper-tropospheric circulation anomalies over the middle and high latitudes of the Northern Hemisphere in summer. Further analysis suggests that the sea surface temperature (SST) anomalies over the Pacific and North Atlantic in the preceding spring, being coupled with the leading mode of atmospheric circulation anomalies over the Pacific–Atlantic sector, persist into summer and affect the SATs in the two remote regions, resulting in the intercontinental SAT connection.

Significance Statement
Summer surface air temperature (SAT) has profound effects on public health and agricultural production. Here we find a significantly positive relationship between interannual variations of summer SATs over two remote regions, one in the Eurasian continent and the other in North America. This intercontinental relationship in SATs can be explained as a result of atmosphere–ocean coupling over the Pacific and North Atlantic in the preceding spring. The result is likely to be a critical implication for the seasonal forecast of SAT variations over the two regions. In addition, the concurrence of higher or lower temperatures in these two regions may have impacts on global grain production, since these two regions include many major grain-producing areas in the world.
Motion tracking virtual reality technology in improving gait in the elderly: A randomized controlled trial
Authors: Abd El-Kafy Ehab M , Alayat Mohamad S , Subahi Moayad S , Badghish Mohammed S 
Published: December 2023

Objective This study aimed to assess the effectiveness of virtual reality-based treadmill training on gait performance and tolerance in the elderly. Design Two-armed randomized controlled trial. Setting The Medical Rehabilitation Sciences Department, Umm Al Qura University, Saudi Arabia. Participants Sixty Saudi elderly of both sexes, aged 65–75 years, were included. Interventions Participants were divided into two groups. The control group received treadmill training without virtual reality, alongside a conventional exercise program. The experimental group received a training program that was similar to the control group's exercises but with C-Mill virtual reality treadmill training. The program lasted one hour, three times per week, over four consecutive weeks. Main Measures The study assessed changes in outcome measures at baseline, Post-1 (after four weeks of training), and Post-2 (four weeks post-training). These measures encompassed the primary outcome, the 6-minute walk test (meter), as well as secondary outcomes such as stride length (meter), stride time (second), cadence (steps/minute), and velocity (meter/second). These parameters were evaluated using the GaitRite electronic gait analysis walkway. Results The experimental group showed better improvement in the mean values of the 6-minute walk test, stride length, stride time, cadence, and velocity compared to the control group at post-1 and post-2. The P-values were respectively at post-1 (0.019, 0.015, 0.041, 0.013, and 0.021) and (0.011, 0.025, 0.073, 0.061, and 0.017) at post-2 (all, P < .05). Conclusions C-Mill virtual reality treadmill training shows potential in improving gait parameters and walking tolerance in the elderly in Saudi Arabia.
Diagnostic roles of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, and cancer antigen 125 for ovarian cancer
Authors: Ye Liuqing , Zhou Guoming , Zhou Lingling , Wang Dongguo , Xiong Shunqiang , Liu Chibo , Zhang Guobing 
Published: December 2023

Objective To compare the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein (CRP) level, and cancer antigen 125 (CA125) level for ovarian cancer (OC). Methods Data of 72 patients with OC, 50 patients with benign ovarian disease, and 46 healthy controls were retrospectively analyzed, and receiver operating characteristic analysis was performed. Results The platelet count was higher in patients with a tumor diameter of ≥10 vs. <10 cm. The absolute lymphocyte count was significantly higher in patients with stage I/II OC than in those with multiple and stage III/IV OC. The absolute monocyte count, NLR, MLR, and CA125 were significantly higher in patients with multiple and stage III/IV OC than in those with single and stage I/II OC. The NLR, PLR, MLR, fibrinogen, D-dimer, CRP, and CA125 were useful for distinguishing between the OC and healthy control groups. Conclusions Our analysis showed that the following combinations have practical diagnostic value in OC: NLR + PLR + MLR + CA125, NLR + PLR + MLR + CA125 + CRP, NLR + MLR +PLR + CA125 + CRP + fibrinogen, and NLR + MLR + PLR + CA125 + CRP + fibrinogen + D-dimer.
Decreased circulating transforming growth factor-beta (TGF-β) and kidney TGF-β immunoreactivity predict renal disease in cats with naturally occurring chronic kidney disease
Authors: Piyarungsri Kakanang , Chuammitri Phongsakorn , Pringproa Kidsadagon , Pila Pattiya , Srivorakul Saralee , Sornpet Benjaporn , Pusoonthornthum Rosama 
Published: December 2023

Objectives The aim of the present study was to compare the circulating transforming growth factor-beta (TGF-β) of clinically normal age-matched and naturally occurring chronic kidney disease (CKD) cats and to determine the correlation between the TGF-β expression and histopathological changes in cats with CKD. Methods A total of 11 clinically normal age-matched and 27 cats with naturally occurring CKD were included in this study. Circulating TGF-β was quantified by immunoassays. Kaplan–Meier analysis was used to calculate the association between survival time and the concentration of circulating TGF-β. A general linear model was used to compare the circulating TGF-β between groups. Immunohistochemical analyses revealed TGF-β expression in renal tissues from cats with CKD that died during the study (n = 7) and in available archived renal tissue specimens taken at necropsy from cats that had previous CKD with renal lesions (n = 10). Correlations of the TGF-β expression and clinical parameters (n = 7) and histopathological changes (n = 17) were analysed using Spearman’s rank correlation. Results The median survival time of cats with a lower concentration of circulating TGF-β was shorter than that of cats with a higher concentration. The area under the curve of circulating TGF-β for predicting CKD was 0.781, indicating good differentiation. The study indicated a significant difference in circulating TGF-β concentrations between clinically normal cats and those with CKD and demonstrated that TGF-β expression is correlated with tubular atrophy. Conclusions and relevance The study findings suggest that decreased serum TGF-β and tubular atrophy with TGF-β immunoreactivity may be significant in cats with CKD.
Neurotrophic keratopathy: Clinical presentation and outcomes in 354 eyes in a community-based population
Authors: Choi Catherine J , Liu Liyan , Qian Ying , Herrinton Lisa J 
Published: December 2023

Purpose To describe the frequency, clinical presentation, and outcomes of neurotrophic keratopathy (NK). Methods Retrospective cohort study of Kaiser Permanente Northern California patients diagnosed with NK using ICD-10 code H16.23X from October 1, 2016 through May 31, 2021 was conducted. The electronic medical record was used to obtain demographic information, systemic and ocular comorbidities, corrected distance visual acuity (CDVA), Mackie stage, laterality, etiology, complications, interventions, and medications. The data were analyzed using cross-tabulations. Results 354 eyes in 322 patients presented with an initial or recurrent episode of NK. 9.9% had bilateral NK, 40% were 75 years and older, and 55% were women. Baseline vision was worse than 20/100 in 47.5%. Mackie staging was stage 1 in 37.3%, stage 2 in 32.5%, and stage 3 in 30.2%. Herpetic causes comprised 34.9%, followed by diabetes (12.4%), ocular surgery (10.4%), and central nervous system etiologies (9.0%). Topical antibiotics (74.5%), steroids (54.0%), autologous serum tears (46.0%), and oral antivirals (43.8%) were the most used treatments. There were 8 eyes with perforation, 4 endophthalmitis, and 3 evisceration/enucleations. An increased difference of approximately 0.1 logMAR in CDVA in the affected eye compared with the unaffected eye over one year was not statistically significant. Clinic utilization for stage 2 (average visits per month, 3.2) and stage 3 (5.0) NK gradually decreased over 6 months. Conclusions Summary of the current management, outcomes, and healthcare utilization of NK provides valuable benchmarks in assessing the disease burden in the community and for further development of novel therapies.
Attendance at remote versus in-person outpatient appointments in an NHS Trust
Authors: Kerr Gabriele , Greenfield Geva , Hayhoe Benedict , Gaughran Fiona , Halvorsrud Kristoffer , Pinto da Costa Mariana , Rehill Nirandeep , Raine Rosalind , Majeed Azeem , Costelloe Ceire , Neves Ana Luisa , Beaney Thomas 
Published: December 2023

Introduction With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. Methods We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). Results There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and ‘other’ ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Discussion Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.
Interactive virtual reality training to improve socio-emotional functioning in adolescents with developmental language disorders: A feasibility study
Authors: Arts Elke , De Castro Bram O , Luteijn Ellen , Elsendoorn Ben , Vissers Constance TWM 
Published: December 2023

Methods to effectively improve socio-emotional functioning by adolescents with developmental language disorders (DLD) are scarce. Current methods to improve socio-emotional functioning in adolescents with other neurobiological disorders seem less suitable, as these methods are highly language based. This study therefore examined the feasibility of the virtual reality (VR) training for socio-emotional skills: ‘InterAction’. The aims of the present study were to (1) examine whether interactive VR is a feasible training method for adolescents with DLD; (2) investigate adolescents’ appreciation of the VR training; (3) examine whether the virtual reality training facilitates the participants’ sense of presence during social practice situations in an interactive digital world; and (4) explore whether adolescents socio-emotional skills improved during the six-session training. A sample of nine adolescents (13–16 years) with DLD reported on their presence in VR contexts and their appreciation toward the VR training. They also completed weekly self-reports on their socio-emotional functioning. Results indicated that ‘InterAction’ was a feasible method to practice socio-emotional functioning with adolescents with DLD. Adolescents highly appreciated the VR training. In addition, adolescents rated the sense of presence as high in the VR training. The individual trajectories showed that improvements in the trained skills varied both between and within participants. The results were also not uniform between the specific skills trained. The findings suggest that interactive virtual reality training may be a promising tool for improving socio-emotional functioning in adolescents with DLD. Future studies should examine the positive indications of this study in a larger sample.
Preoperative Endoscopic Ultrasound-Guided Hepaticogastrostomy for Definite Biliary Drainage in Hilar Cholangiocarcinoma Laparoscopic Resection: A Hybrid Minimal-Invasive Technique
Authors: Tzedakis Stylianos , Belle Arthur , Berzan Diana , Nassar Alexandra , Dohan Antony , Coriat Romain , Sindayigaya Remy , Fuks David 
Published: December 2023

Background and study aims Laparoscopic approach of perihilar cholangiocarcinoma (PHC) is still challenging. We report the original use of a endoscopic hepaticogastrostomy (EHG) for definite biliary drainage in order to avoid biliary reconstruction. Patients and methods A 70-year-old man presenting with jaundice was referred for resection of a Bismuth type IIIa PHC. Repeated endoscopic retrograde cholangiopancreatography failed to drain the future liver remnant, enabling only right anterior liver section drainage. EHG was performed three weeks before surgery. A hepatogastric anastomosis was created, placing a half-coated self-expanding endoprosthesis between biliary duct of segment 2 and the lesser gastric curvature. Results A laparoscopic right hepatectomy extended to segment 1, common bile duct, and hepatic pedicle lymphadenectomy was performed. The left hepatic duct was sectioned and ligated downstream to the biliary confluence of segment 2-3 and 4 allowing exclusive biliary flow through the EHG. The patient was disease free at 12 months, postoperative outcomes were uneventful except three readmissions for acute cholangitis due to prosthesis obstruction. Conclusions EHG may be used as definite biliary drainage technique in laparoscopic PHC resection, at the expense of prosthesis obstruction and cholangitis.
Predictors of Progressing Toward Lifestyle Change Among Participants of an Interprofessional Lifestyle Medicine Program
Authors: Cheng Abby L , Dwivedi Mollie E , Martin Adriana , Leslie Christina G , Fulkerson Daniel E , Bonner Kirk H , Huecker Julia B , Salerno Elizabeth A , Steger-May Karen , Hunt Devyani M 
Published: December 2023

Background Therapeutic lifestyle change can be challenging, and not every attempt is successful. Purpose To identify predictors of making progress toward lifestyle change among patients who participate in a lifestyle medicine program. Methods This was a single-center, retrospective cohort study of 205 adults who enrolled in a goal-directed, individualized, interprofessional lifestyle medicine program. The primary outcome was whether, by the end of participation with the program, a patient reported making progress toward lifestyle change. Candidate predictors included sociodemographic, psychological, and health-related variables. Results Among 205 patients (median (IQR) age 58 (44-66) years, 164 (80%) female), 93 (45%) made progress toward lifestyle change during program participation. A predictor of making progress was being motivated by stress reduction (OR 2.8 [95% CI 1.1-7.6], P = .038). Predictors of not making progress included having a primary goal of losing weight (OR .3 [.2-.8], P = .012) and having a history of depression (OR .4 [.2-.7], P = .041). Conclusions To maximize a patient’s likelihood of successfully making lifestyle changes, clinicians and patients may consider focusing on identifying goals that are immediately and palpably affected by lifestyle change. Additional research is warranted to identify effective program-level approaches to maximize the likelihood of success for patients with a history of depression.