bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Clinics in Neuromuscular Medicine
Authors: Gwathmey Kelly , Heiman-Patterson Terry D. 
Published: October 2023

ABSTRACT
Multidisciplinary care is comprehensive, coordinated clinical care across medical disciplines and allied health professions. Neuromuscular disorders, such as amyotrophic lateral sclerosis and muscular dystrophies, are often associated with disabling weakness and extramuscular symptoms and may benefit from care in a model that consolidates numerous clinic visits into a single more efficient multidisciplinary clinic visit. The goal of the neuromuscular multidisciplinary care model is to improve patient outcomes, patient satisfaction, quality of life, access to medications and equipment, and survival. Although the costs of running a multidisciplinary clinic are high, they are likely associated with cost savings from the patient's perspective. Several barriers to acceptance of multidisciplinary clinics include the distance needed to travel to the clinic and the duration of the clinic visit. Telehealth multidisciplinary clinic visits may address some of these concerns. Further study is needed to understand the value of multidisciplinary clinics and is a necessary step toward creating a sustainable model.
Association Between Intraoperative Landiolol Use and In-Hospital Mortality After Coronary Artery Bypass Grafting: A Nationwide Observational Study in Japan
Authors: Iwasaki Yudai , Ohbe Hiroyuki , Nakajima Mikio , Sasabuchi Yusuke , Ikumi Saori , Kaiho Yu , Yamauchi Masanori , Fushimi Kiyohide , Yasunaga Hideo 
Published: October 2023

BACKGROUND:
Ischemic heart disease is a leading cause of death worldwide, and coronary artery bypass grafting (CABG) is a major treatment. Landiolol is an ultra–short-acting beta-antagonist known to prevent postoperative atrial fibrillation. However, the effectiveness of intraoperative landiolol on mortality remains unknown. This study aimed to evaluate the association between intraoperative landiolol use and the in-hospital mortality in patients undergoing CABG.

METHODS:
To conduct this retrospective cohort study, we used data from the Japanese Diagnosis Procedure Combination inpatient database. All patients who underwent CABG during hospitalization between July 1, 2010, and March 31, 2020, were included. Patients who received intraoperative landiolol were defined as the landiolol group, whereas the other patients were defined as the control group. The primary outcome was in-hospital mortality. Propensity score matching was used to compare the landiolol and control groups.

RESULTS:
In total, 118,506 patients were eligible for this study, including 25,219 (21%) in the landiolol group and 93,287 (79%) in the control group. One-to-one propensity score matching created 24,893 pairs. After propensity score matching, the in-hospital mortality was significantly lower in the landiolol group than that in the control group (3.7% vs 4.3%; odds ratio 0.85; 95% confidence interval 0.78 to 0.94; P = .010).

CONCLUSIONS:
Intraoperative landiolol use was associated with decreased in-hospital mortality in patients undergoing CABG. Further randomized controlled trials are required to confirm these findings.
Postdischarge Survival After Sepsis: A Cohort Study
Authors: Engoren Milo , Maile Michael D. , Seelhammer Troy , Freundlich Robert E. , Schwann Thomas A. 
Published: October 2023

BACKGROUND:
After hospital discharge, patients who had sepsis have increased mortality. We sought to estimate factors associated with postdischarge mortality and how they vary with time after discharge.

METHODS:
This was a retrospective study of hospital survivors of sepsis using time-varying Cox proportional hazard models, which produce a baseline hazard ratio (HR) and a second number (δHR) that reflects the amount by which the baseline HR changes with time.

RESULTS:
Of the 32,244 patients who survived sepsis at hospital discharge, 13,565 patients (42%) died (mean ± standard deviation: 1.41 ± 1.87 years) after discharge from the index hospitalization, while 18,679 patients were still alive at follow-up (4.98 ± 2.86 years). The mortality rate decreased with time after discharge: approximately 8.7% of patients died during the first month after discharge, 1.1% of patients died during the 12th month after discharge, and 0.3%% died during the 60th month; after Kaplan-Meier analysis, survival was 91% (95% confidence interval [CI], 91%–92%) at 1 month, 76% (95% CI, 76%–77%) at 1 year, 57% (95% CI, 56%–58%) at 5 years, and 48% (95% CI, 47%–48%) at 10 years after discharge. Organ dysfunction at discharge was associated with worse survival. In particular, elevated urea nitrogen at discharge (HR, 1.10 per 10 mg/dL, 95% CI, 1.08–1.12, P < .001) was associated with increased mortality, but the HR decreased with time from discharge (δHR, 0.98 per 10 mg/dL per year, 95% CI, 0.98–0.99, P < .001). Higher hemoglobin levels were associated with lower mortality (HR, 0.92 per g/dL, 95% CI, 0.91–0.93, P < .001), but this association increased with increasing time after discharge (δHR, 1.02 per g/dL per year, 95% CI, 1.01–1.02, P < .001). Older age was associated with an increased risk of mortality (HR, 1.29 per decade of age, 95% CI, 1.27–1.31, P < .001) that grew with increasing time after discharge (δHR, 1.01 per year of follow-up per decade of age, 95% CI, 1.00–1.02, P < .001). Compared to private insurances Medicaid as primary insurance was associated with an increased risk of mortality (HR, 1.17, 95% CI, 1.10–1.25, P < .001) that did not change with time after discharge. In contrast, Medicare status was initially associated with a similar risk of mortality as private insurance at discharge (HR, 1), but was associated with greater risk as time after discharge increased (δHR, 1.04 per year of follow-up, 95% CI, 1.03–1.05, P < .001).

CONCLUSIONS:
Acute physiologic derangements and organ dysfunction were associated with postdischarge mortality with the associations decreasing over time.
Association of Central Nervous System–Affecting Medications With Occurrence and Short-Term Mortality of Traumatic Brain Injury
Authors: Cajanus Kristiina , Kytö Ville , Ruuskanen Jori O. , Luoto Teemu M. , Rautava Päivi , Tornio Aleksi , Posti Jussi P. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
The use of medications commonly prescribed after traumatic brain injury (TBI) has been little studied before TBI. This study examined the association between the use of medications that affect the central nervous system (CNS) and the occurrence and short-term mortality of TBI.

METHODS:
Mandatory Finnish registries were used to identify TBI admissions, fatal TBIs, and drug purchases during 2005–2018. Patients with TBI were 1:1 matched to nontrauma control patients to investigate the association between medications and the occurrence of TBI and 30-day mortality after TBI. Number needed to harm (NNH) was calculated for all medications.

RESULTS:
The cohort included 59 606 patients with TBI and a similar number of control patients. CNS-affecting drugs were more common in patients with TBI than in controls [odds ratio = 2.07 (2.02-2.13), P < .001)]. Benzodiazepines were the most common type of medications in patients with TBI (17%) and in controls (11%). The lowest NNH for the occurrence of TBI was associated with benzodiazepines (15.4), selective serotonin uptake inhibitors (18.5), and second-generation antipsychotics (25.8). Eight percent of the patients with TBI died within 30 days. The highest hazard ratios (HR) and lowest NNHs associated with short-term mortality were observed with strong opioids [HR = 1.41 (1.26-1.59), NNH = 33.1], second-generation antipsychotics [HR = 1.36 (1.23-1.50), NNH = 37.1], and atypical antidepressants [HR = 1.17 (1.04-1.31), NNH = 77.7].

CONCLUSION:
Thirty-seven percent of patients with TBI used at least 1 CNS-affecting drug. This proportion was significantly higher than in the control population (24%). The highest risk and lowest NNH for short-term mortality were observed with strong opioids, second-generation antipsychotics, and atypical antidepressants. The current risks underscore the importance of weighing the benefits and risks before prescribing CNS-affecting drugs in patients at risk of head injury.
Mitochondrial metabolism in Drosophila macrophage-like cells regulates body growth via modulation of cytokine and insulin signaling
Authors: Sriskanthadevan-Pirahas Shrivani , Tinwala Abdul Qadeer , Turingan Michael J. , Khan Shahoon , Grewal Savraj S. 
Published: October 2023

ABSTRACT
Macrophages play critical roles in regulating and maintaining tissue and whole-body metabolism in normal and disease states. While the cell–cell signaling pathways that underlie these functions are becoming clear, less is known about how alterations in macrophage metabolism influence their roles as regulators of systemic physiology. Here, we investigate this by examining Drosophila macrophage-like cells called hemocytes. We used knockdown of TFAM, a mitochondrial genome transcription factor, to reduce mitochondrial OxPhos activity specifically in larval hemocytes. We find that this reduction in hemocyte OxPhos leads to a decrease in larval growth and body size. These effects are associated with a suppression of systemic insulin, the main endocrine stimulator of body growth. We also find that TFAM knockdown leads to decreased hemocyte JNK signaling and decreased expression of the TNF alpha homolog, Eiger in hemocytes. Furthermore, we show that genetic knockdown of hemocyte JNK signaling or Eiger expression mimics the effects of TFAM knockdown and leads to a non-autonomous suppression of body size without altering hemocyte numbers. Our data suggest that modulation of hemocyte mitochondrial metabolism can determine their non-autonomous effects on organismal growth by altering cytokine and systemic insulin signaling. Given that nutrient availability can control mitochondrial metabolism, our findings may explain how macrophages function as nutrient-responsive regulators of tissue and whole-body physiology and homeostasis.
Analysis of the chromatin landscape and RNA polymerase II binding at SIN3-regulated genes
Authors: Soukar Imad , Mitra Anindita , Pile Lori A. 
Published: October 2023

ABSTRACT
The chromatin environment has a significant impact on gene expression. Chromatin structure is highly regulated by histone modifications and RNA polymerase II binding dynamics. The SIN3 histone modifying complex regulates the chromatin environment leading to changes in gene expression. In Drosophila melanogaster, the Sin3A gene is alternatively spliced to produce different protein isoforms, two of which include SIN3 220 and SIN3 187. Both SIN3 isoforms are scaffolding proteins that interact with several other factors to regulate the chromatin landscape. The mechanism through which the SIN3 isoforms regulate chromatin is not well understood. Here, we analyze publicly available data sets to allow us to ask specific questions on how SIN3 isoforms regulate chromatin and gene activity. We determined that genes repressed by the SIN3 isoforms exhibited enrichment in histone H3K4me2, H3K4me3, H3K14ac and H3K27ac near the transcription start site. We observed an increase in the amount of paused RNA polymerase II on the promoter of genes repressed by the isoforms as compared to genes that require SIN3 for maximum activation. Furthermore, we analyzed a subset of genes regulated by SIN3 187 that suggest a mechanism in which SIN3 187 might exhibit hard regulation as well as soft regulation. Data presented here expand our knowledge of how the SIN3 isoforms regulate the chromatin environment and RNA polymerase II binding dynamics.
A Novel Custom Cycle Ergometer Protocol to Determine V̇O2max: Validation with ACSM’s Cycle Ergometry Metabolic Equation
Authors: Lankford Dianne M. , Cummings Donald M. 
Published: October 2023

ABSTRACT

Introduction
Protocols for determination of maximal oxygen consumption (V̇O2max) on a cycle ergometer should be easily administered while maximizing physiological efficiency and minimizing premature local muscle fatigue for individuals of variable fitness levels. Current protocols typically increase workload by adding resistance to the flywheel; however, increasing pedal rate later in the test, rather than resistance, may provide increased physiological efficiency, yielding a more valid determination of V̇O2max.

Purpose
The purpose of this study was to design and validate a novel V̇O2max cycle ergometer protocol that can be used for measuring and predicting submaximal oxygen consumption (V̇O2) and V̇O2max during exercise testing in healthy, asymptomatic adults.

Methods
Subjects (n = 60, 19–60 yr old) performed a V̇O2max test using the new cycle ergometer protocol. Workload increases were based on predetermined incremental target heart rates (ITHR) using heart rate reserve. Stages commenced at a workload of 150 kg·m·min−1 (0.5 kg, 50 rpm) and increased every 2 min by adding 0.5 or 1.0 kg resistance based on ITHR. When an ITHR representing ≥60% heart rate reserve was achieved, workloads increased by 10 rpm for subsequent stages. Pearson’s r was used to examine relationships between predicted (American College of Sports Medicine cycle equation) and measured V̇O2 at workload intensities representing moderate, vigorous, and maximal exercise. Bland–Altman plots were used to display predicted and measured V̇O2 at all exercise intensities and heart rate values at maximal exercise.

Results
There was a strong and statistically significant correlation between predicted and measured V̇O2 at moderate (r = 0.92, P < 0.001), vigorous (r = 0.94, P < 0.001), and maximal (r = 0.90, P < 0.001) exercise intensities. All subjects reached ≥90% of age-predicted maximum heart rate.

Conclusion
This novel cycle ergometer protocol was demonstrated to be a viable tool to predict and/or measure submaximal V̇O2 and V̇O2max in a population of healthy, asymptomatic adults.
Impact of COVID-19 on Mobile Technology use in adults in the United States
Authors: Lin Yi , Rowles Graham D. , Stromberg Arnold J. , Zeidan Rola S. , Mankowski Robert T. 
Published: October 2023

Background: Mobile technology (MT) has become essential in receiving information and services during the COVID-19 pandemic. Imposed quarantines could have led to varying adaptations of MT use. This study explored how COVID-19 impacted behavior, perception, and attitudes toward MT use in the United States. Methods: We distributed a pilot-tested survey online. Participants were MT users ≥ 35 years old. All participants responded based on their recalled experience of using MT before COVID-19 and their recent experience during COVID-19. Data analysis involved descriptive statistics and the Wilcoxon signed-rank test. Results: The average age of the 1212 participants was 56.1±12.2 years (55% female). Daily use frequency (from ≤3 to ≥4 hours/day) and perceived necessity (from some need to a strong need) during COVID-19 significantly increased (p<0.001) compared to before COVID-19. There was a significant increase (p<0.001) in video calls/meetings, online education, grocery/food delivery, and ordering taxi/car during COVID-19 compared to before. Participants increased (p≤0.001) their attention to the physical, social, and emotional benefits of using MT during the pandemic. COVID-19 increased MT use and acceptance in the United States. Conclusion: The knowledge gained from this study will help remove barriers to using and accepting MT and provide directions for MT development in middle-aged and older populations.
Association of the CD28 markers with the disease activity in systemic lupus erythematosus patients
Authors: Pratama Mirza Zaka , Handono Kusworini , Kalim Handono , Susianti Hani 
Published: October 2023

Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with diverse manifestations and unpredictable activity. CD28 markers, particularly sCD28, is a promising biomarker for evaluating SLE disease activity. This study aimed to investigate the significance of CD28 markers in evaluating disease activity in SLE and the role of sCD28 in various clinical manifestations. Methods: A total of 40 female subjects, aged between 18 and 45 years, who fulfilled the 2019 EULAR/ACR classification criteria for SLE were recruited in this study. Twenty healthy matched individuals were also recruited as control. Comprehensive data on demographic information, clinical manifestations, laboratory test findings, and treatment history were collected from all participants. The Indonesian version of SLEDAI-2K score was utilized to assess disease activity, categorizing patients into active SLE and lupus low disease activity (LLDAS). Collected data were analyzed on SPSS for Windows version 25.0. Results: Patients with SLE in LLDAS category had significantly lower SLEDAI scores (1.8 ± 1.4 vs 11.7 ± 4.9, p<0.001) with mild clinical manifestation. Active SLE patients had the lowest percentages of CD4+CD28+ cells (5.7 ± 4.1%) and the highest sCD28 concentration (26.2 ± 11.3 ng/ml) compared to other groups. Moreover, sCD28 concentration demonstrated a moderate positive correlation with SLE disease activity. In most cases, higher sCD28 concentrations were associated with clinical manifestations, particularly in neuropsychiatric lupus (OR 7.1 [1.8 – 67.9], p=0.047), nephritis (OR 14.5 [1.6 – 131.9], p=0.017), and mucocutaneous manifestations (OR 3.4 [1.9 – 12.8], p=0.035). Conclusions: Our study establishes the link between CD28 markers and disease activity, including certain clinical manifestations in SLE. We suggest that CD28 has a potential role in predicting disease activity. However, further research through longitudinal studies is required to strengthen these findings.
Case Report: Prostate adenocarcinoma presented with inguinal lymph node metastasis
Authors: Lamture Yeshwant , Lamture Prajwal , Lamture Varsha , Gharde Pankaj 
Published: October 2023

Prostate cancer has the highest chance of spreading to the bones. After pelvic and bone involvement, pulmonary metastases and extensive lymphadenopathy are expected consequences. Some men with prostate cancer develop symptomatic metastatic lung lesions and lymphadenopathy despite the absence of other signs of distant spread. Prostate cancer is exceedingly common and the leading cause of cancer in males. Prostate cancer patients with metastases account for half of all cases. In some cases, it occurs in the peritoneum but can also invade the surrounding structures, the bladder, seminal vesicles, and urinary sphincters. For example, we report the case of a 62-year-old man who presented to our hospital with inguinal swelling as his primary symptom. The patient has a history of constipation, burning micturition, and weight loss. The patient was advised of ultrasonography (U.S.G.) abdominonopelvic, which revealed enlarged, irregular, heterogeneous prostate and cystitis and multiple hepatic metastases. Also, there was a lobulated mass lesion in the inguinal canal. The most common spread occurs in bone and lymph nodes. It's uncommon to witness inguinal lymph node metastasis without pelvic lymphadenopathy or other metastasis. The spread occurs usually through a hematogenous, lymphatic, or direct route. Hence this one is a rare presentation. One possible explanation might be abnormal or aberrant lymphatic drainage of the prostate to the inguinal lymph node.
Effect of Nigella sativa on general health and immune system in young healthy volunteers; a randomized, placebo-controlled, double-blinded clinical trial
Authors: Salem Ayad , Bamosa Abdullah , Alam Mohammed , Alshuraim Saleh , Alyalak Hamad , Alagga Abdulrahman , Tarabzouni Faisal , Alisa Omar , Sabit Hussein , Mohsin Ashfaq , Shaikh Mohammad , Farea Abdulaziz , Alshammari Thamer , Obeid Obeid 
Published: October 2023

Nigella sativa (N. sativa) is traditionally used as an immune enhancer in different communities. The aim of this study was to evaluate the effect of N. sativa on immunity related parameters in young healthy subjects. This study was a double blind, randomized, placebo controlled clinical trial. Fifty-two healthy subjects (48 male and 4 female) 18-25 years old were enrolled in the study. They were randomly divided into four groups; the first received charcoal capsules and served as controls and the other three received 0.5, 1 g, and 2 g of powdered N. sativa capsules, respectively. Two blood samples were obtained from all participant, before initiation of the trial and at the end of the four weeks intervention. One sample was used for routine health screening by evaluating liver and renal functions as well as complete blood count and differential. The second sample was used to measure certain cytokines including; IL-1, IL-4, IL-6, IL-10, and TNF. A third and fourth samples were obtained from the last cohort of subjects before and after treatment; the third was used for measuring immunoglobulins and CD profile and the fourth for evaluating certain gene expressions (INF-γ, NF-κ-B, TNF-α, IL-1β, IL-13, IL-8, and IL-6). Only 1 g dose of N. sativa produced a significant elevation in total lymphocyte count, CD3+ and CD4+ counts. One gram N. sativa increased the absolute lymphocyte count from 1850±0.24 to 2170±0.26 (p=0.008), CD3+ from 1184.4±75.60 to 1424±114.51 (p=0.009), and CD4+ from 665.6±141.66 to 841±143.36 (p=0.002). This elevation in T cells was lost by increasing the dose of N. sativa to 2g. The rest of the parameters were not changed significantly in all doses. The results show a promising immunopotentiation effect of N. sativa by elevating helper T cells and the optimum dose for young age group seems to be 1 g.
Exploring attitudes to research involving human subjects among Vietnamese university students: establishing a prospective longitudinal mixed-methods student cohort at the University of Medicine and Pharmacy at Ho Chi Minh City
Authors: Pham -Tram Vy , Nguyen Nguyet Minh , Heatherley Susan , Vu Duy Kien , Vu Bao Hung , Pham Thi Huong Giang , Nguyen Thi Thu Hang , Huynh Thuy Phuong Hong , Thi Tuyet Thanh Truong , Le Phuong Chi , Nguyen Thi Van Thuy , Dinh The Trung , Thi Hoai Tam Dong , Chambers Mary , Lawson Katrina , Ilo Van Nuil Jennifer , Do Van Dung , Diep Tran Tuan , Kestelyn Evelyne , Wills Bridget 
Published: October 2023

Research capacity is increasing in low- and middle-income countries (LMICs), with progressive development in the range and complexity of studies being undertaken, often in collaboration with high-income country partners. Although senior local stakeholders are typically involved in ensuring that research is conducted according to accepted standards for ethical and scientific quality, to date there has been little exploration of the views of younger generations around the ethics of research involving human subjects. We present our protocol to establish a longitudinal mixed-methods student cohort at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam, that is investigating students’ views around the ethics of clinical and public-health oriented research. We use a synergistic approach involving initial deliberative engagement activities (e.g. science cafes, debates) to inform participants about complex concepts, prior to formal quantitative and qualitative methods (surveys, focus group discussions and in-depth interviews) that are designed to explore the students’ views in detail. We focus in particular on dengue, as an example of a locally relevant disease, and probe students’ thoughts on such themes as appropriate remuneration for research participants, involvement of vulnerable groups, use of human challenge trials in LMICs etc. A snapshot of the cohort and its activities after one year is also presented; among 429 active students, primarily from the Faculty of Medicine, the proportions of male and female students were similar, the majority were from southern or central Vietnam where dengue is endemic, and available data indicates the cohort to be representative of the expected spectrum of socioeconomic groups. The cohort provides a unique resource to investigate the views of young people on medical ethics, an important but hitherto underrepresented group in such discussions. Feedback indicates a clear interest in contributing thoughts and ideas to the development of clinical research in Vietnam.