bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time-varying risks of infection in patients as they proceed through the phases of ‘pre-RA’: results from the Scottish Early RA inception cohort
Authors: Porter Duncan , Jain Sahil , Qian Evelyn , Morton Fraser R , McInnes Iain B 
Published: November 2023

ObjectiveRheumatoid arthritis (RA) develops after progressing through sequential ‘pre-RA’ phases. The mechanisms driving progression from one phase to the next remain poorly understood. This study examined the longitudinal rates of community and hospital infections in patients during sequential stages of pre-RA and early arthritis.MethodsThe Scottish Early RA inception cohort recruited patients with newly diagnosed RA. Incidences of infection were determined from community antibiotic prescriptions and serious infections were determined by hospital discharge coding. Dates of diagnosis and symptom onset allowed identification of asymptomatic/symptomatic pre-RA and early arthritis eras to analyse infection rates over time compared with age- and sex-matched controls.ResultsThe incidence rate ratio (IRR) seen in the period 0–6 months prior to symptom onset was 1.28 (95% CI 1.15 to 1.42). In ‘symptomatic pre-RA’, the IRR was 1.33 (95% CI 1.18 to 1.49) which persisted into ‘early arthritis’. The rate of hospital admissions was numerically greater in ‘pre-RA’ and significantly greater in ‘early arthritis’ (IRR 1.82, 95% CI 1.32 to 2.46).ConclusionAntibiotic risk is increased in patients with ‘pre-RA’ at least 6 months before symptoms develop, and this persists throughout the symptomatic pre-RA phase. Infections may be important in the mechanisms that drive progression to RA or be a manifestation of immune dysfunction (or both). These observations could inform safety and efficacy considerations for interventions in pre-RA to prevent progression. Patients with ‘pre-RA’ with recurrent antibiotic use may also be an identifiable ‘high risk’ group that could enrich the study population for intervention studies in pre-RA.
Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Authors: Bower Hannah , Frisell Thomas , di Giuseppe Daniela , Delcoigne Benedicte , Askling Johan 
Published: November 2023

ObjectivesTo compare the incidence of cardiovascular (CV) events in rheumatoid arthritis (RA) treated with janus kinase inhibitors (JAKi), tumour necrosis factor inhibitors (TNFi), or other biological disease-modifying antirheumatic drugs (bDMARDs), in clinical practice, and to contextualise these findings by comparing to the Swedish RA population and general population at large.MethodsPatients with RA initiating JAKi, TNFi and non-TNFi bDMARDs were identified in the Swedish Rheumatology Quality Register between 2016 and 2021. Through linkages to national registers, a cohort of patients with RA, general population comparators, as well as covariates and incident major acute CV event (MACE, including myocardial infarction, stroke and fatal CV events) were identified until 2022. Crude and age-sex standardised rates were calculated and HRs estimated from multivariable Cox regression models using TNFi as reference.ResultsWe identified 13 492 patients with RA initiating a JAKi, non-TNFi bDMARD or TNFi treatment. Among 3037 JAKi-initiators, 59 MACE events were observed. The age-sex standardised rates for MACE were similar in the JAKi (0.88 per 100 person years) and TNFi (0.91) cohorts. Fully adjusted models showed no increased rate of MACE with JAKi (HR=0.71, 95% CI 0.51 to 0.99), or non-TNFi bDMARD (HR=0.98; 95% CI 0.78 to 1.23) in comparison to TNFi. We found no evidence that this HR changed over time since treatment initiation. In a CV-enriched subset, we observed higher rates but similar HRs.ConclusionsAs used in present clinical practice in Sweden, we found no evidence that CV risk is higher with JAKis than TNFis in RA.
Aortic Pseudoaneurysm following Ventricular Septal Defect Closure in a Pediatric Patient: A Case Report and Literature Review
Authors: Zamani Hassan , Vahidshahi Kourosh , Khalilian Mohammad Reza , Tahouri Tahmineh , Rahimi-Movaghar Ehsanollah 
Published: November 2023

Aortic pseudoaneurysm, a rare condition characterized by localized transmural disruption and dilatation of the aorta, is very rare in the pediatric population. It is primarily caused by previous cardiovascular procedures such as aortic coarctation repair, aortic valve replacement, and subaortic membrane resection. We present a unique case of aortic pseudoaneurysm following surgery to repair a perimembranous ventricular septal defect in a 19-month-old boy who presented with fever as the sole symptom. The fever started on the 30th day after the surgery, and the patient exhibited abnormal laboratory results, including a white blood cell (WBC) count of

28.3
×
109
/
L

, neutrophil percentage of 68%, platelet count of

880
×
109
/
L

, erythrocyte sedimentation rate (ESR) of 200 mm/hour, and 3+ positive C-reactive protein. Echocardiogram revealed a large cystic mass (

5
×
4.8

cm

) in the ascending aorta, compressing the superior vena cava. Based on this finding, a diagnosis of aortic pseudoaneurysm was suspected. The diagnosis was confirmed through cardiac computed tomographic angiography, and the patient underwent emergent surgery for the repair of the aortic pseudoaneurysm under deep hypothermia and circulatory arrest. Unfortunately, our patient died shortly after the surgery.
Nocturnal Hypertension and Left Ventricular Diastolic Dysfunction in Patients With Diabetes With the Absence of Heart Failure: Prospective Cohort HSCAA Study
Authors: Kidawara Yonekazu , Kadoya Manabu , Igeta Masataka , Morimoto Akiko , Miyoshi Akio , Kakutani-Hatayama Miki , Kanzaki Akinori , Konishi Kosuke , Kusunoki Yoshiki , Daimon Takashi , Asakura Masanori , Ishihara Masaharu , Koyama Hidenori 
Published: November 2023

BACKGROUND:
Diabetes is an important risk factor for heart failure (HF) and is associated with left ventricular (LV) diastolic dysfunction. However, diabetic comorbid conditions, such as nocturnal hypertension, as predictors of diastolic dysfunction are not known in the absence of an HF period. The present study was conducted as the longitudinal examination of the predictive value of nocturnal hypertension profiles on the progression of LV diastolic dysfunction in patients with and without diabetes without HF.

METHODS:
The subjects (154 diabetes and 268 nondiabetes) in the absence of HF were followed for 36.8±18.2 months. The relationships among the patterns of nocturnal hypertension and the outcome of LV diastolic dysfunction, defined as an increase in E/e′>14, were investigated in the patients with and without diabetes.

RESULTS:

The interaction effect of the diabetes status and the patterns of nocturnal hypertension on the hazard rate of the occurrence of E/e′>14 was statistically significant (
P
=0.017). Kaplan-Meier analysis results revealed that patients with diabetes with nondipper (
P
=0.021 versus dipper) and riser (
P
=0.006 versus dipper) had a greater risk for a diastolic dysfunction event. Furthermore, multivariable Cox proportional hazards analysis revealed that nondipper (hazard ratio, 4.56 [95% CI, 1.49–13.96];
P
=0.007) and riser (hazard ratio, 3.89 [95% CI, 1.31–11.57];
P
=0.014) patterns were associated with elevated risk of the outcome of LV diastolic dysfunction. In contrast, no similar significant associations were found in patients without diabetes.

CONCLUSIONS:
During the absence of HF periods, nocturnal hypertension is an important predictor for the progression of LV diastolic dysfunction in patients with diabetes.
Within-person changes in the aging white matter microstructure and their modifiers: A meta-analysis and systematic review of longitudinal diffusion tensor imaging studies
Authors: Mendez Colmenares Andrea , Prytherch Ben , Thomas Michael L. , Burzynska Agnieszka Z. 
Published: November 2023

Abstract
This meta-analysis and systematic review synthesized data from 30 longitudinal diffusion tensor imaging (DTI) studies on the magnitude, direction, spatial patterns, and modifiers of naturally occurring within-person changes in healthy adult white matter (WM) microstructure. Results revealed: (1) significant within-person declines in fractional anisotropy (FA) in the whole WM (d = -0.12), genu (d = -0.16), and splenium (d = -0.13); (2) greater declines in FA associated with older age, longer follow-up times, and female sex; (3) a possible yet inconclusive vulnerability of late-myelinating WM (the “development-to-degeneration” gradient); and (4) factors decelerating (e.g., physical activity and social activities) and accelerating (e.g., vascular risk factors, biomarkers for Alzheimer’s disease, and alcohol consumption) age-related FA changes. Our findings encourage the consideration of WM as a new target for treatments and interventions against cognitive decline and lay the foundation for studying the plastic and regenerative potential of adult WM in clinical trials. Individual differences in WM changes could aid in the preclinical diagnosis of dementia, opening a window for earlier, more effective treatments.
The Right to Marry and the Right to Establish a Family in the Universal, European and Polish Dimension
Authors: Bucoń Paweł 
Published: November 2023

Abstract
The subject of the article is an analysis of the human right to marry and the right to establish a family. The author considers the guarantees of this right in three areas. The first one is the universal dimension, the essence of which are the documents guaranteeing the protection of human rights adopted by the United Nations: the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, and the International Covenant on Social, Economic and Cultural Rights. In the European dimension, the most important is Article 12 of the European Convention on Human Rights, ensuring the right to marry for a man and a woman who have reached the appropriate age. In the Polish national dimension, Article 18 of the Constitution of the Republic of Poland of 1997 solidified the existing traditional form of marriage, i.e. the state of a union between a man and a woman. It also ensures the care and protection of the state to families created on the basis of a formally concluded marriage, as well as to other families, especially those with many children and incomplete families. According to the author, the right to get married and the right to found a family are connected and complementary, but the right to start a family can be exercised independently of getting married.
Explicit Timing Differently Predicts Implicit Timing Performance in Younger and Older Adults
Authors: Otsuka Taku , Yotsumoto Yuko , Mioni Giovanna 
Published: November 2023

Abstract
Temporal processing can be divided into explicit timing and implicit timing. Explicit timing tasks require participants to attend to the temporal aspects of the task, whereas in implicit timing tasks, temporal information affects performance without explicit instruction to process time. Compared to younger adults, older adults have been shown to exhibit greater variability in explicit timing, while in implicit timing, they have been shown to rely more on temporal predictions formed by the hazard function. However, the relationship between explicit and implicit timing and its age-related changes have yet to be explored. To address this issue, we collected data in which younger and older adults performed a time bisection task (i.e., explicit timing task) and a foreperiod task (i.e., implicit timing task) in a within-subjects design. Based on a Bayesian optimization framework, we hypothesized that individuals with higher variability in explicit timing would show a stronger foreperiod effect, which is an index of the degree of reliance on temporal predictions. Results showed a different relation between explicit and implicit timing in younger and older adults. In older adults, results were consistent with the hypothesis that increased variability in explicit timing was associated with a stronger foreperiod effect. In contrast, bias in the temporal representation but not variability was associated with the foreperiod effect in younger adults. Implications for the age-related difference in the relation between explicit and implicit timing are discussed.
Age of heartwood initiation in trunks of young Pinus sylvestris L. trees in the taiga zone
Authors: Tarelkina Tatiana V. , Galibina Natalia A. , Ershova Maria A. , Moshnikov Sergei A. , Nikerova Kseniya M. , Afoshin Nikita V. , Semenova Ludmila I. 
Published: November 2023

Summary
This work is part of a project investigating the heartwood formation process in Scots pine. Despite the economic and ecological importance of pine heartwood (HW), the process of its formation in many respects remains poorly understood. Scientists believe that HW formation in Scots pine begins at 9–20 years, however, systematic studies of HW initiation age in this species have not previously been conducted. Samples were collected from 105 P. sylvestris trees aged 10 to 25 years, growing in the middle and northern taiga subzones, as well as on the border of the northern taiga subzone with the tundra. Samples were taken at the trunk base according to a single technique and processed using two biochemical (peroxidase activity, pinosylvin presence) and two anatomical markers (presence of extractives on the tracheid pit membranes, nuclei disappearance) characterizing different events during HW formation. Biochemical markers showed an overestimation in the number of HW annual rings compared with HW determination based on anatomical criteria by 1–3 years, on average. Attempts to detect peroxidase activity showed a negative result in the inner sapwood annual ring, while detectable pinosylvin accumulation occurred in the transition zone (TZ). We have detected for the first time true HW (without living cells) in Scots pine samples with a cambial age (CA) of 15–17 years. The number of growth rings in TZ and HW in young trees depended on growth conditions. These results are important for understanding the mechanisms of HW formation and developing realistic models of this process, including changing climate conditions.
Relationship between positive parenting and adolescents’ depressive symptoms: Evidence from a Chinese research survey
Authors: Jiang Qinqin , Liu Pei , Qin Yuchen , Zhao Zhe , Bing Yan , Sun Jinhai , Dai Zhixin , Qian Yi , Yuan Lei 
Published: November 2023

Background: Adolescents often carry their depression well into their adulthood. This creates perpetual difficulties for their family and society. Research on the relationship between positive parenting and adolescent depressive symptoms is rare. The protective effect of positive parenting on adolescent depressive symptoms also remains underexplored. Parents are a vital source of feedback that shapes adolescents’ self-view in crucial ways. Aims: This study examines the latent relationships between four factors related to positive parenting and adolescent depressive symptoms. Method: Using data from the Chinese Family Panel Studies (CFPS), Stata MP 17.0 was used for preliminary data processing and descriptive statistics. The structural equation model (SEM) was adopted to test the seven proposed hypotheses. Results: The study participants were 2,816 adolescents (52.34% male). The SEM showed that positive communication and parental praise can directly reduce depressive symptoms in adolescents (path coefficients of −0.24 and −0.13 [ p < .001], respectively). Additionally, both positive communication and positive parent-adolescent interactions can reduce adolescents’ depressive symptoms by heightening the intermediate factor of parental praise (path coefficients of 0.30 and 0.44 [ p < .001], respectively). Conversely, positive parent-adolescent interactions did not negatively affect adolescents’ depressive symptoms, as we hypothesized. Conclusions: High level of positive parenting negatively predicts the level of depressive symptoms among adolescents. Specifically, positive communication, positive parent-adolescent communication, and parental praise are the main protective factors related to positive parenting for adolescents’ depressive symptoms.
The Determinants of Inpatient Palliative Care Use in Patients With Pancreatic Cancer
Authors: Osagiede Osayande , Nayar Kapil , Raimondo Massimo , Kumbhari Vivek , Lukens Frank J. 
Published: November 2023

Introduction Symptom burden management is a major goal of pancreatic cancer care given that most patients are diagnosed late. Early palliative care is recommended in addition to concurrent active treatment; however, disparities exist. We sought to determine the factors associated with inpatient palliative treatment among pancreatic cancer patients and compare treatment outcomes in terms of mortality, discharge disposition and resource utilization. Methods We conducted a retrospective study of 22,053 pancreatic cancers using the National Inpatient Sample (NIS) database (January - December 2020). Patient and hospital characteristics, mortality, discharge disposition, length of stay (LOS), hospital costs and charges were compared between pancreatic cancer patients based on palliative treatment. Multivariate regression was used to evaluate patient and hospital characteristics and outcomes associated with palliative treatment. Results A total number of 3839 (17.4%) patients received palliative care. Patients who received palliative care were more likely to be older, Medicaid insured, and nonobese. Patients were less likely to receive palliative care if they are males, Medicare insured, had a lower Charlson comorbidity score, or treated in Urban nonteaching hospitals. Patients who received palliative care displayed higher odds of in-hospital mortality and prolonged LOS. The adjusted additional mean hospital cost and charges in patients who received palliative care were lower by $1459, and $4222 respectively. Conclusions Inpatient palliative treatment in pancreatic cancer patients is associated with an older age, a higher comorbidity burden, non-obesity, insurance status and urban teaching hospitals. Our study suggests that inpatient palliative treatment decreased hospital resource utilization without prolonging survival.
Physician-Modified Single-Fenestrated EndoSuture Aneurysm Repair (FESAR) for Urgent Juxtarenal AAA Repair
Authors: Piazza Michele , Squizzato Francesco , James Bilato Marco , Grego Franco , Antonello Michele 
Published: November 2023

Purpose: To describe the endovascular treatment of a symptomatic juxtarenal abdominal aortic aneurysm (JAAA) using a combination of endoanchors (Heli-FX EndoAnchor, Medtronic, Minneapolis, Minnesota) and a physician-modified single-fenestrated endograft. Technique: An 85 year-old patient unfit for open aortic repair presented for a symptomatic JAAA, characterized by an infrarenal neck with 0.6 cm in length and 23 mm in diameter. A 28 mm-diameter Endurant aortic cuff (Medtronic, Minneapolis, Minnesota) was modified with a single fenestration for the left renal artery (LRA) and diameter-reducing tie, then re-sheathed and deployed. The LRA was cannulated with a 7F sheath and the constraining wire was withdrawn. Being the shortest neck length on the right side of the cuff, the endograft was anchored to the aortic wall on this side with 2 endoanchors. The LRA was stented and flared, then a distal physician-modified (without free-flow) bifurcated Endurant graft (Medtronic, Minneapolis, Minnesota) was overlapped with the proximal cuff and stabilized with 6 endoanchors. Correct positioning with complete aneurysm exclusion was confirmed with a 30 day and 9 month computed tomography angiograms. Conclusions: In extremely selected cases, association of endoanchors and single-fenestrated physician-modified graft may be useful to treat complex urgent aortic aneurysm using readily available devices. Clinical Impact This technical note demonstrates the feasibility of a single-fenestrated physician-modified Endurant endograft deployed in combination with endosuture fixation (FESAR), to urgently treat a juxtarenal aortic aneurysm unfit for open repair and not suitable for standard endovascular repair nor off-the-shelf endografts.
Does the Timed-Up-and-Go Test Predict Length of Stay After Total Hip Arthroplasty? A Retrospective Study
Authors: Guttenberg Marissa , Argento Gabriella , McInerney Danielle , Nguyen Joseph , Wuest Olivia 
Published: November 2023

Background: The prevalence of ambulatory total hip arthroplasty (THA) is rising, but it is not appropriate for all patients. Preoperative patient selection considers medical and social factors but overlooks patients’ prior level of physical function. Purpose: The aim of this study was to evaluate if preoperative physical function, measured by the Timed-Up-and-Go (TUG) test, is associated with length of stay (LOS) in patients who underwent primary THA. Methods: A retrospective study was performed using 396 patients who underwent primary THA within a 2-month period at a single institution. Regression analysis evaluated the relationship between preoperative TUG scores and hospital LOS. Receiver-operating characteristic (ROC) curves were generated to identify a cutoff TUG score associated with LOS longer than 24 hours. Results: Univariate regression analysis of those discharged in less than 24 hours and those discharged in more than 24 hours found lower TUG scores (10.7 vs 13.7, respectively) were associated with patient discharge within 24 hours. Multivariate regression analysis showed a higher TUG score (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.84-0.99) was associated with decreased odds of discharge within 24 hours. Receiver-operating characteristic curve analysis was performed on the entire study cohort and the ambulatory surgery group and identified TUG scores of 10.3 and 10.5 seconds, respectively, associated with LOS of less than 24 hours (OR full cohort: 3.02, 95% CI: 1.94-4.71; OR ambulatory surgery: 2.97, 95% CI: 1.90-4.60). Sensitivity and specificity were not sufficient to support the use of these cutoff scores alone in predicting LOS. Conclusion: Although we were unable to establish a cutoff TUG score in patients who underwent primary THA that could determine LOS of more than 24 hours, the preoperative TUG score may be useful as a tool to aid in identifying patients who may require a longer hospital LOS. Further study is needed.