bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic sarcopenic obesity measurements in elderly trauma patients do not predict adverse discharge disposition over injury severity score
Authors: Oh John S. , Peterson Christine M. , Alvarez Carolina , Layng Stephen C. , Pradhan Sandeep , Shen Chan , Lee Jungeun Jasmine , Osevala Nicole M. , Armen Scott B. 
Published: February 2024

Introduction There is a need for a predictive tool for adverse discharge disposition in the injured elderly patient population. However, many measurements of frailty are not practical and radiographic measurements of muscle and adipose tissue have yet to be correlated with adverse discharge disposition in this population. Methods A retrospective review of a prospectively gathered trauma database at a level one trauma center was performed, studying all adult trauma patients aged 55 years or older with an inpatient stay of greater than 2 days. Patients with a non-survivable head trauma (head Abbreviated Injury Score of 6) or serious central nervous system injury, history of cirrhosis or solid organ transplantation, those actively being treated with immunosuppressive medications, and those without an abdominal computerized tomography (CT) scan within the first 48 h of admission were excluded. Sarcopenia, sarcopenic obesity (SO), and five-item frailty index (5-iFI) score were obtained and analyzed against adverse discharge disposition. Results The study evaluated 444 patients, of which 48.9% were male with a median age of 78 years (range 55–99 years). All patients sustained blunt trauma, shock index was positive in 13.7%, and median ISS was 10 (range 1–43). SO was not independently predictive of adverse discharge disposition. Additionally, neither sarcopenia nor 5-iFI scores were found to be independently predictive. Lower ISS and age were found to be protective against adverse discharge disposition. Conclusion CT-based measurements of muscle and adipose tissue may not add value over traditional injury scores in older trauma patients.
Pioneering the Use of Tracker Data to Evaluate Lean-Led Hospital Design
Authors: Schouten Hannelore , Heusinkveld Stefan , Benders Jos 
Published: February 2024

Objective: This study aims to examine how we can effectively and affordably evaluate the impact of design concepts such as Lean-Led Hospital Design (LLHD) on the allocation of nurses’ time spent at different locations. Particularly in patient rooms, as this can be seen as value-adding time. Background: LLHD aims to create a hospital environment that supports value creation for patients and reduces waste. However, only a few studies measure its’ effects. One of the reasons for this absence is the lack of an adequate and affordable way to evaluate. Method: Nurses’ time spent in patient rooms was used as a proxy for value-adding time. Through studying a pioneering case of LLHD, and drawing on a pre-/postoccupancy evaluation approach, this study used an innovative methodology utilizing mobile tracking devices to adequately provide reliable data about the time nurses spend at specific locations. Results: Our analysis reveals that the answer to the question concerning the impact of LLHD, as advocated by its proponents, on nurses’ allocation of time for value-adding activities versus waste time remains inconclusive. Our findings indicate no discernible difference in the amount of value-adding time nurses spent in the old facility compared to the new one. Conclusion: Our experience suggests that mobile tracking devices offer an affordable, efficient means of collecting data that produces objective measurements. Nevertheless, the interpretation of this time-based data necessitates the inclusion of supplementary qualitative information.
Proton Pump Inhibitors Use in Kidney Transplant Recipients: A Population-Based Study
Authors: Kiberd James , Quinn Robert R. , Ravani Pietro , Lentine Krista L. , Clarke Alix , Jeong Rachel , Faruque Labib , Lam Ngan N. 
Published: February 2024

Background: Kidney transplant recipients are commonly prescribed proton-pump inhibitors (PPIs), but due to concern for polypharmacy, chronic use should be limited. Objective: The objective was to describe PPI use in kidney transplant recipients beyond their first year of transplant to better inform and support deprescribing initiatives. Design: We conducted a retrospective, population-based cohort study using linked health care databases. Setting: This study was conducted in Alberta, Canada. Patients: We included all prevalent adult, kidney-only transplant recipients between April 2008 and December 2017 who received their transplant between May 2002 and December 2017. Measurements: The primary outcome was ongoing or new PPI use and patterns of use, including frequency and duration of therapy, and assessment of indication for PPI use. Methods: We ascertained baseline characteristics, covariate information, and outcome data from the Alberta Kidney Disease Network (AKDN). We compared recipients with evidence of a PPI prescription in the 3 months prior to study entry to those with a histamine-2-receptor antagonist (H2Ra) fill and those with neither. Results: We identified 1823 kidney transplant recipients, of whom 868 (48%) were on a PPI, 215 (12%) were on an H2Ra, and 740 (41%) were on neither at baseline. Over a median follow-up of 5.4 years (interquartile range [IQR] = 2.6-9.3), there were almost 45 000 unique PPI prescriptions dispensed, the majority (80%) of which were filled by initial PPI users. Recipients who were on a PPI at baseline would spend 91% (IQR = 70-98) of their graft survival time on a PPI in follow-up, and nephrologists were the main prescribers. We identified an indication for ongoing PPI use in 54% of recipients with the most common indication being concurrent antiplatelet use (26%). Limitations: Our kidney transplant recipients have access to universal health care coverage which may limit generalizability. We identified common gastrointestinal indications for PPI use but did not include rare conditions due to concerns about the validity of diagnostic codes. In addition, symptoms suggestive of reflux may not be well coded as the focus of follow-up visits is more likely to focus on kidney transplant. Conclusions: Many kidney transplant recipients are prescribed a PPI at, or beyond, the 1-year post-transplant date and are likely to stay on a PPI in follow-up. Almost half of the recipients in our study did not have an identifiable indication for ongoing PPI use. Nephrologists frequently prescribe PPIs to kidney transplant recipients and should be involved in deprescribing initiatives to reduce polypharmacy.
Surgical Approach to Acute Osteochondral Fracture With Patellar Instability in Skeletally Immature Patients
Authors: Coladonato Carlo , Wilson Sean M. , Freedman Kevin B. 
Published: February 2024

Background: Patellar instability is a common condition that affects many young, active patients and can lead to long-term disability. This video aims to provide insights in the treatment of acute osteochondral fractures in skeletally immature patients after acute patellar dislocation. Indications: Patients who present with acute patellar dislocation and evidence of osteochondral fracture or osteochondral fracture with a loose body are potential candidates for medial patellofemoral ligament reconstruction (MPFLR) with osteochondral fragment fixation. Technique Description: In case 1, arthroscopy revealed a medial patellar facet defect. A medial patellar incision was made with dissection down to the vastus medialis oblique fascia and medial retinaculum. Before continuing to capsulotomy, the dissection for the MPFLR is completed by dissecting down to create a plane between layers 2 and 3. Capsulotomy is then performed with retrieval of the loose body, preparation of the patellar defect, and fixation of the osteochondral fragment. The MPFLR is then performed. An allograft is fixed to the patella with 2 pushlock anchors, and to a distally directed femoral tunnel using a 7-mm pitchfork SwiveLock tenodesis anchor, with care to avoid the medial femoral physis. The capsulotomy is then closed underneath the graft, with layer 2 closed above it. In case 2, a large osteochondral fracture of the lateral femoral condyle with loose cartilage flaps was arthroscopically identified. An anterior incision was made and a lateral lengthening was completed to perform a laterally based arthrotomy to expose the defect on the lateral femoral condyle. The defect site was prepared and the loose body was secured and fixated into the donor site lesion using bioabsorbable screws. The MPFLR was completed as in case 1, and the wound was closed in standard fashion. Results: Acute patellar dislocation with osteochondral fracture has been shown to lower both subjective and functional patient outcome measures. A recent study suggests that in large osteochondral fractures after patella dislocation, internal fixation improves mid- and long-term outcomes when compared with debridement alone. Conclusion: The MPFLR with concurrent osteochondral fracture fixation in patients with open physes is a reliable option for improving patellar stability and protecting articular cartilage from further injury. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
Folic acid-functionalized PEGylated niosomes co-encapsulated cisplatin and doxoribicin exhibit enhanced anticancer efficacy
Authors: Safari Sharafshadeh Mona , Tafvizi Farzaneh , Khodarahmi Parvin , Ehtesham Somayeh 
Published: February 2024

AbstractThe medical field is faced with the difficult task of developing a new approach to curing cancer, which is prevalent in organs such as the breast and ovaries and has a high mortality rate. Since chemotherapy is the conventional method of treatment, efforts are being made to improve it to help patients function better. Fortunately, with the use of nanocarriers and their remarkable ability to manage and direct drug delivery, progress is being made in cancer treatment. In addition, folic acid-coated nanocarriers offer several advantages in drug delivery, including improved stability, bioavailability, targeted delivery and drug solubility. These properties make them promising tools for improving cancer treatment efficacy. This research focused on investigating the stability of a specific niosomal formulation (consisting of Span 60 and cholesterol) under different temperature conditions (4 and 25 ℃) for 2 months. In addition, the drug release rate of the formulation was evaluated. The results showed that the size and polydispersity index increased significantly in the stability studies, but the entrapment efficiency% decreased dramatically over time. In addition, encapsulation of drugs in niosomal formulations resulted in stable and slow drug release. The cytotoxicity evaluation results of formulations containing doxorubicin and cisplatin show their significant inhibitory effect on both breast and ovarian cancer cell lines (IC50 for DOX–CIS–Nio@PEG–FA formulation was 6.11 and 17.87 µg/mL for A2780 and MCF-7, respectively). Niosomes loaded with a combination of two drugs were found to affect gene expression in the cancer cell lines tested. They decreased the expression of BCl2, VEGF, CCND1, and HER2 genes while increasing the expression of BAX gene. Flow cytometry results indicated that niosomes loaded with doxorubicin and cisplatin increased the rate of apoptosis in both cell lines compared to a drug mixture. ROS and cell cycle arrest, confirm the significant inhibition of cancer cells and their destruction in the presence of the synthesized noisome formulation in comparison to free drugs and the combination of two drugs. The potential of this novel approach for delivering drugs to cancer cells lies in the ability to combine treatments and target multiple cancers simultaneously. Such formulations allow co-delivery of drugs to different cancer cells, thereby improving the efficacy of chemotherapy through synergistic effects between drugs.
Graphical Abstract
Transcriptomic analysis of intestinal organoids, derived from pigs divergent in feed efficiency, and their response to Escherichia coli
Authors: Madsen Ole , Rikkers Roxann S.C. , Wells Jerry M. , Bergsma Rob , Kar Soumya K. , Taverne Nico , Taverne-Thiele Anja J. , Ellen Esther D. , Woelders Henri 
Published: February 2024

AbstractBackgroundThere is increasing interest in using intestinal organoids to study complex traits like feed efficiency (FE) and host-microbe interactions. The aim of this study was to investigate differences in the molecular phenotype of organoids derived from pigs divergent for FE as well as their responses to challenge with adherent and invasiveEscherichia coli(E. coli).ResultsColon and ileum tissue from low and high FE pigs was used to generate 3D organoids and two dimensional (2D) monolayers of organoid cells forE. colichallenge. Genome-wide gene expression was used to investigate molecular differences between pigs that were phenotypically divergent for FE and to study the difference in gene expression after challenge withE. coli. We showed, (1) minor differences in gene expression of colon organoids from pigs with low and high FE phenotypes, (2) that anE. colichallenge results in a strong innate immune gene response in both colon and ileum organoids, (3) that the immune response seems to be less pronounced in the colon organoids of high FE pigs and (4) a slightly stronger immune response was observed in ileum than in colon organoids.ConclusionsThese findings demonstrate the potential for using organoids to gain insights into complex biological mechanisms such as FE.
Effects of circadian clock disruption on gene expression and biological processes in Aedes aegypti
Authors: Shetty Vinaya , Adelman Zach N. , Slotman Michel A. 
Published: February 2024

Abstract
Background
This study explores the impact of disrupting the circadian clock through a Cycle gene knockout (KO) on the transcriptome of Aedes aegypti mosquitoes. The investigation aims to uncover the resulting alterations in gene expression patterns and physiological processes.

Results
Transcriptome analysis was conducted on Cyc knockout (AeCyc-/-) and wild-type mosquitoes at four time points in a light-dark cycle. The study identified system-driven genes that exhibit rhythmic expression independently of the core clock machinery. Cyc disruption led to altered expression of essential clock genes, affecting metabolic processes, signaling pathways, stimulus responses and immune responses. Notably, gene ontology enrichment of odorant binding proteins, indicating the clock's role in sensory perception. The absence of Cyc also impacted various regulation of metabolic and cell cycle processes was observed in all time points.

Conclusions
The intricate circadian regulation in Ae. aegypti encompasses both core clock-driven and system-driven genes. The KO of Cyc gene instigated extensive gene expression changes, impacting various processes, thereby potentially affecting cellular and metabolic functions, immune responses, and sensory perception. The circadian clock's multifaceted involvement in diverse biological processes, along with its role in the mosquito's daily rhythms, forms a nexus that influences the vector's capacity to transmit diseases. These insights shed light on the circadian clock's role in shaping mosquito biology and behavior, opening new avenues for innovative disease control strategies.
Association between C10X polymorphism in the CARD8 gene and inflammatory markers in young healthy individuals in the LBA study
Authors: Fransén Karin , Hiyoshi Ayako , Paramel Geena V. , Hurtig-Wennlöf Anita 
Published: February 2024

AbstractBackgroundThe Caspase activation and recruitment domain 8 (CARD8) protein is a component of innate immunity as a negative regulator of NF- ĸB, and has been associated with regulation of proteins involved in inflammation. Expression ofCARD8mRNA and protein has been identified in human atherosclerotic lesions, and the truncated T30A variant (rs2043211) ofCARD8has been associated with lower C-reactive (CRP) and MCP-1 levels in myocardial infarction patients. The present study examines the role of a genetic variation in theCARD8gene in relation to a selection of markers of inflammation.MethodsIn a cross-sectional study of young healthy individuals (18.0–25.9 yrs,n = 744) the association between the rs2043211 variant in theCARD8gene and protein markers of inflammation was assessed. Genotyping of theCARD8C10X (rs2043211) polymorphism was performed with TaqMan real time PCR on DNA from blood samples. Protein levels were studied via Olink inflammation panel (https://olink.com/). Using linear models, we analyzed men and two groups of women with and without estrogen containing contraceptives separately, due to previous findings indicating differences between estrogen users and non-estrogen using women. Genotypes were analyzed by additive, recessive and dominant models.ResultsThe minor (A) allele of the rs2043211 polymorphism in theCARD8gene was associated with lower levels of CCL20 and IL-6 in men (CCL20, Additive model:p = 0.023; Dominant model:p = 0.016. IL-6, Additive model:p = 0.042; Dominant model:p = 0.039). The associations remained significant also after adjustment for age and potential intermediate variables.ConclusionsOur data indicate that CARD8 may be involved in the regulation of CCL20 and IL-6 in men. No such association was observed in women.These findings strengthen and support previous in vitro data on IL-6 and CCL20 and highlight the importance ofCARD8as a factor in the regulation of inflammatory proteins. The reason to the difference between sexes is however not clear, and the influence of estrogen as a possible factor important for the inflammatory response needs to be further explored.
Contextual effects: how to, and how not to, quantify them
Authors: Saueressig Tobias , Pedder Hugo , Owen Patrick J , Belavy Daniel L 
Published: February 2024

AbstractThe importance of contextual effects and their roles in clinical care controversial. A Cochrane review published in 2010 concluded that placebo interventions lack important clinical effects overall, but that placebo interventions can influence patient-reported outcomes such as pain and nausea. However, systematic reviews published after 2010 estimated greater contextual effects than the Cochrane review, which stems from the inappropriate methods employed to quantify contextual effects. The effects of medical interventions (i.e., the total treatment effect) can be divided into three components: specific, contextual, and non-specific. We propose that the most effective method for quantifying the magnitude of contextual effects is to calculate the difference in outcome measures between a group treated with placebo and a non-treated control group. Here, we show that other methods, such as solely using the placebo control arm or calculation of a ‘proportional contextual effect,’ are limited and should not be applied. The aim of this study is to provide clear guidance on best practices for estimating contextual effects in clinical research.
Sex steroid and cognitive function among community-dwelling older men with or without vascular risk factors: a cross-sectional study
Authors: Tang Shuning , Huang Limei , Lin Fangting , Chen Xiuqin , Wang Yunhui , Xu Jixiang , Wang Yujie , Gao Junling , Xiao Qianyi 
Published: February 2024

Abstract
Background
The relationship of testosterone and estradiol concentrations with cognitive function among community-dwelling older men was inconclusive. To examine the association of serum testosterone and estradiol concentrations with cognitive function in older men with or without vascular risk factors (VRFs).

Methods
This cross-sectional study consisted of 224 community-dwelling men aged 65–90 years in the Songjiang District of Shanghai, China. Serum testosterone and estradiol were measured by electrochemiluminescence immunoassay. The following five factors were defined as VRFs in this study: obesity, history of hypertension, diabetes, stroke, and coronary heart disease. Multivariable linear regression was used to examine the association of testosterone and estradiol with the Mini-Mental State Examination (MMSE) in participants with or without VRF. Restricted cubic spline (RCS) regression was performed to account for the nonlinearity of these associations.

Results
An inverted “U” shaped non-linear relationship was found between testosterone concentration and MMSE score in men with one VRF (P overall =.003, non-linear P =.002). Estradiol showed an inverted “U” shaped non-linear relationship with MMSE score independent of VRFs (men without VRF, P overall =.049, non-linear P =.015; men with one VRF, overall P =.007, non-linear P =.003; men with two or more VRFs, overall P =.009, non-linear P =.005).

Conclusion
In older men, an optimal level of sex steroid concentration may be beneficial to cognitive function and the VRFs should be considered when interpreting the relationship between sex steroid and cognitive function.
Dexamethasone versus methylprednisolone for multiple organ dysfunction in COVID-19 critically ill patients: a multicenter propensity score matching study
Authors: Aljuhani Ohoud , Korayem Ghazwa B. , Altebainawi Ali F. , AlMohammady Daniah , Alfahed Amjaad , Altebainawi Elaf F. , Aldhaeefi Mohammed , Badreldin Hisham A. , Vishwakarma Ramesh , Almutairi Faisal E. , Alenazi Abeer A. , Alsulaiman Thamer , Alqahtani Rahaf Ali , Al Dhahri Fahad , Aldardeer Namareq , Alenazi Ahmed O. , Al Harbi Shmeylan , Kensara Raed , Alalawi Mai , Al Sulaiman Khalid 
Published: February 2024

Abstract
Background
Dexamethasone usually recommended for patients with severe coronavirus disease 2019 (COVID-19) to reduce short-term mortality. However, it is uncertain if another corticosteroid, such as methylprednisolone, may be utilized to obtain better clinical outcome. This study assessed dexamethasone’s clinical and safety outcomes compared to methylprednisolone.

Methods
A multicenter, retrospective cohort study was conducted between March 01, 2020, and July 31, 2021. It included adult COVID-19 patients who were initiated on either dexamethasone or methylprednisolone therapy within 24 h of intensive care unit (ICU) admission. The primary outcome was the progression of multiple organ dysfunction score (MODS) on day three of ICU admission. Propensity score (PS) matching was used (1:3 ratio) based on the patient’s age and MODS within 24 h of ICU admission.

Results
After Propensity Score (PS) matching, 264 patients were included; 198 received dexamethasone, while 66 patients received methylprednisolone within 24 h of ICU admission. In regression analysis, patients who received methylprednisolone had a higher MODS on day three of ICU admission than those who received dexamethasone (beta coefficient: 0.17 (95% CI 0.02, 0.32), P = 0.03). Moreover, hospital-acquired infection was higher in the methylprednisolone group (OR 2.17, 95% CI 1.01, 4.66; p = 0.04). On the other hand, the 30-day and the in-hospital mortality were not statistically significant different between the two groups.

Conclusion
Dexamethasone showed a lower MODS on day three of ICU admission compared to methylprednisolone, with no statistically significant difference in mortality.