bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nigroincertal projection mediates aversion and enhances coping responses to potential threat
Authors: Ho Ping‐Chen , Hsiao Fu‐Yun , Chiu Shi‐Hong , Lee Syun‐Ruei , Yau Hau‐Jie 
Published: November 2023

AbstractRecent studies have shown that the non‐DA neurons in the ventral tegmental area (VTA) and substantia nigra (SN) not only modulate motivational behaviors but also regulate defensive behaviors. While zona incerta (ZI) is a threat‐responsive substrate and receives innervations from the ventral midbrain, the function of the ventral midbrain‐to‐ZI connection remains poorly defined. Here, we demonstrate that the ZI receives heterogenous innervations from the ventral midbrain. By utilizing a retrograde AAV preferentially labeling non‐DA neurons in the ventral midbrain, we found that ZI‐projecting non‐DA cells in the ventral midbrain are activated by restraint stress. We focused on the SN and found that SN‐to‐ZI GABAergic input is engaged by a predatory odor. Sustained pan‐neuronal SN‐to‐ZI activation results in aversion and enhances defensive behaviors, likely through a disinhibition mechanism to recruit downstream brain regions that regulate defensive behaviors. Collectively, our results reveal a novel role of nigroincertal projection in mediating negative valence and regulating defensive behaviors.
Malignant pleural effusion due to angiosarcoma
Authors: Meerschaert Ashley N. , DeCoste Robert J. 
Published: November 2023

ABSTRACT
Angiosarcoma is a rare and aggressive vascular malignancy that typically originates in the skin or soft tissue of the body. It is known to have a propensity for metastasis to the lung parenchyma in the form of pulmonary nodules and cavitary lesions; however, a less commonly described entity is in the form of a malignant pleural effusion. Management of a malignant pleural effusion due to angiosarcoma presents a unique challenge. This article describes the challenges faced during one patient's diagnostic and treatment course, and the anticipated future complications of his aggressive disease.
Gastroesophageal reflux disease management and chronic use of proton pump inhibitors
Authors: Howland Anne M. 
Published: November 2023

ABSTRACT
Proton pump inhibitors (PPIs) are one of the most commonly prescribed drugs worldwide and have changed the treatment of gastroesophageal reflux disease (GERD). However, these drugs have been associated with several potentially serious adverse reactions if used chronically. Guidelines from the American College of Gastroenterology in 2021 and the American Gastroenterological Association's 2022 clinical practice updates reflect the latest recommendations. This article reviews the management and treatment of GERD and the adverse reactions to long-term PPI use.
Hypoglossal nerve stimulation for adults with obstructive sleep apnea
Authors: Hardin Laura 
Published: November 2023

ABSTRACT
Obstructive sleep apnea (OSA) is a common chronic condition in which upper airway collapse interferes with breathing during sleep, reducing sleep quality. Untreated OSA can impair a patient's health and quality of life. The recommended first-line treatment for OSA in adults is positive airway pressure, but difficulty tolerating this device limits adherence to treatment for many patients. Treatment with an implanted hypoglossal nerve stimulation (HNS) device is a relatively new second-line option for these patients, and is gaining more widespread use. Clinicians who treat OSA or provide other healthcare services to patients with HNS implants should be familiar with these devices. This article reviews HNS technology and relevant OSA pathophysiology, along with device candidacy criteria, efficacy, risks, and considerations related to use of other medical technologies for patients with HNS implants.
Vaginal Compared With Oral Misoprostol Induction at Term
Authors: Adhikari Emily H. , McGuire Jennifer , Lo Julie , McIntire Donald D. , Spong Catherine Y. , Nelson David B. 
Published: November 2023

OBJECTIVE:
To evaluate efficacy in achieving vaginal delivery with a standardized vaginal compared with oral misoprostol regimen for labor induction at term.

METHODS:
In this single-center, cluster randomized trial, we randomized induction method by week among individuals with gestational age of 37 weeks or more, cervical dilation of 2 cm or less, intact membranes, and indication for delivery to either oral (100 micrograms every 4 hours for up to two doses), or vaginal (25 micrograms every 3 hours for up to five doses) misoprostol regimens, followed by a standardized oxytocin protocol. Individuals with an antepartum stillbirth, major fetal anomalies, malpresentation, ruptured membranes, nonreassuring fetal status, or contraindication to prostaglandin were excluded. The primary outcome was vaginal delivery at first induction attempt. Secondary outcomes included time to delivery, need for oxytocin, chorioamnionitis, and adverse maternal and neonatal outcomes. Outcomes were recorded at the individual level and adjusted for clustering, with analysis by intention to treat.

RESULTS:
Between May 24, 2021, to September 19, 2022, 1,322 women were randomized to vaginal misoprostol in 33 clusters and 1,224 to oral misoprostol in 37 clusters. Demographic characteristics or initial cervical dilation did not differ between groups. The primary outcome did not differ between induction regimens and occurred in 1,032 (78.1%) of the vaginal misoprostol arm and 945 (77.2%) of the oral misoprostol arm (adjusted relative risk [RR] 1.01, 95% CI, 0.97–1.05). Tachysystole with fetal heart rate changes occurred less frequently with vaginal compared with oral misoprostol (3.5% vs 5.9%, adjusted RR 0.59, 95% CI, 0.40–0.87). Time to delivery did not differ between groups. Oxytocin was less frequently required before delivery in the vaginal misoprostol group (68.8% vs 78.4%, adjusted RR 0.88, 95% CI, 0.84–0.92).

CONCLUSION:
Induction of labor with vaginal compared with oral misoprostol protocols did not increase the frequency of vaginal delivery at term but did reduce the need for oxytocin use before delivery.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT04755218.
Mycosis Fungoides and Granulomatous Slack Skin: A Single Entity With Distinct Clinical Phenotypes
Authors: Bakr Farrah , Ziaj Stela , Cardoso José , Wain E. Mary , Theaker Jeffrey , Whittaker Sean , Child Fiona , Robson Alistair 
Published: November 2023

Abstract:
Granulomatous cutaneous T-cell lymphoma includes mycosis fungoides with significant granulomatous inflammation (GMF) and granulomatous slack skin (GSS), listed in the WHO classification as a subtype of mycosis fungoides (MFs).
1
These overlapping entities have shared clinical and histopathologic features which can present a diagnostic challenge. The dominance of the granulomatous infiltrate and the often sparse lymphocytic infiltrate frequently with minimal cytological atypia are features that distract from the correct diagnosis, even when raised by the clinician. We describe the clinical and histopathologic characteristics of 3 cases of granulomatous cutaneous T-cell lymphoma, illustrate the close clinical and pathologic relationship between GMF and GSS and emphasize the diagnostic difficulties that the granulomatous infiltrate can present. Furthermore, we demonstrate, for the first time, considerable elastolysis in a significant proportion of classical (Alibert-Bazin) MF lesions and therefore postulate that the differences observed between GMF and GSS are one of degree and secondary to their anatomic location rather than reflecting meaningful separate entities.
Country-Level Factors Associated With Nurse Salaries: Empirical Evidence From Organisation for Economic Co-operation and Development Countries and Taiwan
Authors: CHANG Yu-Hung , HSU Chia Hui , TSENG Yu-Chun , HSIUNG Chao A. 
Published: November 2023

ABSTRACT

Background
Salary impacts nurse retention rates and thus is a factor affecting the nursing shortage both in Taiwan and around the world. Nurses in Taiwan earn a low salary compared with other health professionals and may be undervalued compared with their international counterparts.

Purpose
This study was designed to analyze the factors associated with nurse salary (NS) in Organisation for Economic Co-operation and Development (OECD) countries and to compare NS in Taiwan with those in OECD member states.

Methods
Data were extracted from the OECD statistics database and official statistics for Taiwan. For the 28 OECD member countries considered in this study and Taiwan, 21 indicators characterizing healthcare systems, including demographics, socioeconomic status, health behaviors and risks, healthcare resources, health financing, healthcare utilization, health outcomes, and economic inequality, were examined for the period of 2009–2018. A random-effects model (REM) and a fixed-effects model (FEM) were used to investigate the associations between these indicators and annual NS levels. The expected annual NS for Taiwan was estimated and compared with the actual NS for Taiwan using the REM.

Results
In the REM, higher NS in OECD countries was shown to be positively associated with gross domestic product per capita (0.49, 95% confidence interval [CI] [0.41, 0.56]), proportion of population aged 65 years and over (2.72, 95% CI [2.17, 3.26]), crude birth rate (1.02, 95% CI [0.56, 1.49]), number of computerized tomography scanners per million population (0.26, 95% CI [0.17, 0.35]), alcohol consumption per person (0.94, 95% CI [0.26, 1.61]), and prevalence of obesity (0.64, 95% CI [0.40, 0.89]) and to be in inversely associated with infant mortality rate (−3.13, 95% CI [−3.94, −2.32]), bed density (−0.99, 95% CI [−1.72, −0.25]), number of hospital discharges (−0.08, 95% CI [−0.11, −0.05]), household out-of-pocket expenditure as a percentage of health expenditure (−0.34, 95% CI [−0.56, −0.11]), and the Gini coefficient (−0.25, 95% CI [−0.50, −0.01]). The FEM results were similar to those of the REM. The predicted annual NS for Taiwan based on the REM rose from 29,390 U.S. dollars (corrected for purchasing power parity; 95% CI [22,532, 36,247]) in 2009 to 49,891 U.S. dollars (95% CI [42,344, 57,438]) in 2018. The actual annual NS in Taiwan in 2018 was approximately 12% lower than the model-predicted value.

Conclusions/Implications for Practice
Taiwan has a lower NS compared with its OECD counterparts. These findings may help policymakers, healthcare managers, and nurse organizations develop effective strategies to improve the remuneration system for nurses in Taiwan.
Effects of whole-body vibration on chronic ankle instability: a systematic review
Authors: Hoveidaei Amir Human , Hashemi Seyedeh Melika , Pazoki Shayan , Nakhostin-Ansari Amin , Maleki Ghorbani Zahra , Eghdami Shayan , Bahari Hossein , Sarzaeim Mojdeh , Forogh Bijan 
Published: November 2023

Background and objective:
Chronic ankle instability (CAI) is one of the most common sports injuries, and whole-body vibration (WBV) training has been used lately as a potential rehabilitation modality for these patients. The authors conducted a systematic review and meta-analysis to assess whether WBV training positively affects patients with CAI.

Materials and methods:
The authors systematically searched four databases, including MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials, for randomized and non-randomized trials evaluating the effects of WBV on individuals with CAI. The authors used Cochrane RoB2 to assess the risk of bias in randomized trials. A meta-analysis was conducted if three or more studies measured the same outcome. Effect estimates were pooled using a random-effects model.

Results:
Results were retrieved from seven articles encompassing 288 participants who had CAI. The reach distance of the Star Excursion Balance Test (SEBT) was regarded as the study’s main finding. The authors saw a significant training effect on certain planes of motion on dynamic balance. The findings showed that the post-intervention measurements in the WBV group compared to control groups showed improvements in the posterolateral, posteromedial, and medial directions, respectively. There were also promising results on improvements in muscle activity, strength, and proprioception sense measurements with a great diversity in the reported parameters.

Conclusion:
The authors observed a significant WBV training effect on dynamic balance over posterolateral, posteromedial, and medial reach distances. These findings suggest future studies on the effects of WBV on muscle activity, strength, and proprioception in addition to dynamic and static balance.
Brief Report: Decreased Physical Activity and Prolonged Sitting Time Are Associated With Liver Steatosis in People With HIV
Authors: Riebensahm Carlotta , Berzigotti Annalisa , Surial Bernard , Haerry David , Günthard Huldrych F. , Tarr Philip E. , Furrer Hansjakob , Rauch Andri , Wandeler Gilles ,   Swiss HIV Cohort Study
Published: November 2023

Background:
Physical activity (PA) regulates intrahepatic storage of fat and reduces the risk of liver steatosis. Given our limited understanding of the pathogenesis of metabolic complications in people with HIV (PWH), it remains unclear whether evidence from the general population can be extrapolated to PWH. We investigated the association between PA and liver steatosis in a single site of the Swiss HIV Cohort Study.

Methods:
We screened consecutive Swiss HIV Cohort Study participants using vibration-controlled transient elastography and defined liver steatosis as controlled attenuation parameter ≥248 dB/m. PA was measured using the International PA Questionnaire. We evaluated the association of 3 different measures of PA with liver steatosis in separate multivariable logistic regression models.

Results:
Of 466 participants, 127 (27.3%) were female, median age was 52 years (interquartile range 43–59), and 244 (52.4%) were overweight (body mass index [BMI] ≥25 kg/m2). Liver steatosis was present in 235 (50.4%) individuals. In multivariable analysis, PA below the recommendations of the European Association for the Study of the Liver was associated with steatosis (adjusted odds ratio, 2.34; 95% confidence interval [CI]: 1.44 to 3.85). Using alternative scales of PA, including metabolic equivalents task minutes (min) per week (adjusted odds ratio 0.76, 95% CI: 0.60 to 0.94) and sitting hours per day (aOR, 1.16; 1.07 to 1.26), yielded comparable results, and associations were similar when we restricted the analyses to lean (BMI <25 kg/m2) subjects.

Conclusions:
Insufficient PA and prolonged sitting time were associated with liver steatosis among PWH, independent of BMI. Our results support the importance of promoting PA to prevent liver steatosis in PWH.
Comprehensive contact tracing during an outbreak of alpha-variant SARS-CoV-2 in a rural community reveals less viral genomic diversity and higher household secondary attack rates than expected
Authors: Sivertsen Audun , Mortensen Nicolay , Solem Unni , Valen Eivind , Bullita Marie Francoise , Wensaas Knut-Arne , Litleskare Sverre , Rørtveit Guri , Grewal Harleen M. S. , Ulvestad Elling 
Published: November 2023

AbstractSequencing of SARS-CoV-2 genomes throughout the COVID-19 pandemic has generated a wealth of data on viral evolution across populations, but only a few studies have so far explored SARS-CoV-2 evolution across transmission networks of tens to hundreds of persons. Here, we couple data from SARS-CoV-2 sequencing with contact tracing data from an outbreak with a single origin in a rural Norwegian community where samples from all exposed persons were collected prospectively. A total of 134 nasopharyngeal samples were positive by PCR. Among the 121 retrievable genomes, 81 were identical to the genome of the introductor, thus demonstrating that genomics offers limited additional value to manual contact-tracing. In the cases where mutations were discovered, five small genetic clusters were identified. We observed a household secondary attack rate of 67%, with 92% of household members infected among households with secondary transmission, suggesting that SARS-CoV-2 introduction into large families are likely to affect all household members.ImportanceIn outbreak investigations, obtaining a full overview of infected individuals within a population is seldom acheived. We here present an example of just that, where a single introduction of B1.1.7 SARS-CoV-2 within a rural community allowed for tracing of the virus, from an introductor via dissemination through larger gatherings, into households. The outbreak occurred before widespread vaccination, allowing for a “natural” outbreak development with community lock-down. We show through sequencing that the virus can infect up to five consecutive persons without gaining mutations, thereby showing that contact tracing seems more important than sequencing for local outbreak investigations. We also show how families with small children are less likely to contain spread to all family members if SARS-CoV-2 enters the household either by a child or a caregiver, as isolation of the primary infected is difficult in such scenarios.
EPCs-derived conditioned medium mitigates chronic cerebral ischemic injury through the MIF-activated AKT pathway
Authors: Cheng Ya-Wen , Yang Ling-Yu , Chen Yi-Tzu , Chou Sheng-Che , Chen Kuo-Wei , Chen Yi-Hsing , Deng Chuan-Rou , Chen I-Chin , Chou Wan-Ju , Chang Chen-Chih , Chen Yong-Ren , Hwa Hsiao-Lin , Wang Kuo-Chuan , Kuo Meng-Fai 
Published: November 2023

AbstractBackgroundChronic cerebral ischemia (CCI) is considered as a prelude to neurodegeneration. Endothelial progenitor cells (EPCs) have been implicated in revascularization and vascular repair in cerebral ischemic diseases. Due to the safety concern and the low survival rate of the transplanted cells, interest has shifted toward the paracrine effect of EPCs. Here, we investigate the effects of EPC-derived conditioned medium (EPC-CM) on the vascular and functional impairments in a rodent model of CCI and the mechanism via which the EPC-CM involves.MethodsBilateral internal carotid artery ligation (BICAL) was performed in rats to induce cerebral ischemia. EPC-CM was intracisternally injected 1 week after BICAL. The changes of the microvasculature and behavior were examined 3 weeks after BICAL. The EPC-CM was analyzed by cytokine array for the factors that involved in angiogenesis. The therapeutic effects and mechanism of the candidate factor was validated with oxygen-glucose deprivation-injured endothelial cells and EPCsin vitro.ResultsEPC-CM significantly improved the vascular, motor and cognitive impairments of the BICAL rats. Macrophage migration inhibitory factor (MIF) was identified as a key factor in EPC-CM involved in angiogenesis and anti-senescence. Furthermore, recombinant MIF protein mirrored the effects of EPC-CM on EPCs and ECs. These therapeutic effects were decreased by the co-treatment with EPC-CM and MIF-specific antibody bothin vivoandin vitro. MIF operates through multiple pathways, including the AKT pathway, which plays a crucial role in cellular homeostasis. Inhibiting the AKT pathway diminished the protective effect of MIF in the CCI model.ConclusionsWe demonstrated that EPC-CM protected the chronic ischemic rat brain from ischemic injury and promoted functional recovery in rats through MIF-mediated AKT pathway, which indicated that EPC-CM may serve as an alternative potential therapy in chronic cerebral ischemia.
Evaluation of polygenic scoring methods in five biobanks reveals greater variability between biobanks than between methods and highlights benefits of ensemble learning
Authors: Monti Remo , Eick Lisa , Hudjashov Georgi , Läll Kristi , Kanoni Stavroula , Wolford Brooke N. , Wingfield Benjamin , Pain Oliver , Wharrie Sophie , Jermy Bradley , McMahon Aoife , Hartonen Tuomo , Heyne Henrike , Mars Nina ,   Genes & Health Research Team, Hveem Kristian , Inouye Michael , van Heel David A. , Mägi Reedik , Marttinen Pekka , Ripatti Samuli , Ganna Andrea , Lippert Christoph 
Published: November 2023

AbstractMethods to estimate polygenic scores (PGS) from genome-wide association studies are increasingly utilized. However, independent method evaluation is lacking, and method comparisons are often limited. Here, we evaluate polygenic scores derived using seven methods in five biobank studies (totaling about 1.2 million participants) across 16 diseases and quantitative traits, building on a reference-standardized framework. We conducted meta-analyses to quantify the effects of method choice, hyperparameter tuning, method ensembling and target biobank on PGS performance. We found that no single method consistently outperformed all others. PGS effect sizes were more variable between biobanks than between methods within biobanks when methods were well-tuned. Differences between methods were largest for the two investigated autoimmune diseases, seropositive rheumatoid arthritis and type 1 diabetes. For most methods, cross-validation was more reliable for tuning hyperparameters than automatic tuning (without the use of target data). For a given target phenotype, elastic net models combining PGS across methods (ensemble PGS) tuned in the UK Biobank provided consistent, high, and cross-biobank transferable performance, increasing PGS effect sizes (β-coefficients) by a median of 5.0% relative to LDpred2 and MegaPRS (the two best performing single methods when tuned with cross-validation). Our interactively browsable online-results (https://methodscomparison.intervenegeneticscores.org/) and open-source workflow prspipe (https://github.com/intervene-EU-H2020/prspipe) provide a rich resource and reference for the analysis of polygenic scoring methods across biobanks.
Analysis of associations between polygenic risk score and COVID-19 severity in a Russian population using low-pass genome sequencing
Authors: Nostaeva Arina V. , Shimansky Valentin S. , Apalko Svetlana V. , Kuznetsov Ivan A. , Sushentseva Natalya N. , Popov Oleg S. , Anisenkova Anna Y. , Mosenko Sergey V. , Karssen Lennart C. , Aulchenko Yurii S. , Shcherbak Sergey G. 
Published: November 2023

ABSTRACTThe course of COVID-19 is characterized by wide variability, with genetics playing a contributing role. Through large-scale genetic association studies, a significant link between genetic variants and disease severity was established. However, individual genetic variants identified thus far have shown modest effects, indicating a polygenic nature of this trait. To address this, a polygenic risk score (PRS) can be employed to aggregate the effects of multiple single nucleotide polymorphisms (SNPs) into a single number, allowing practical application to individuals within a population. In this work, we investigated the performance of a PRS model in the context of COVID-19 severity in 1,085 Russian participants using low-coverage NGS sequencing. By developing a genome-wide PRS model based on summary statistics from the COVID-19 Host Genetics Initiative consortium, we demonstrated that the PRS, which incorporates information from over a million common genetic variants, can effectively identify individuals at significantly higher risk for severe COVID-19. The findings revealed that individuals in the top 10% of the PRS distribution had a markedly elevated risk of severe COVID-19, with an odds ratio (OR) of 2.1 (95% confidence interval (CI): 1.4–3.2, p-value = 0.00046). Furthermore, incorporating the PRS into the prediction model significantly improved its accuracy compared to a model that solely relied on demographic information (p-value < 0.0001). This study highlights the potential of PRS as a valuable tool for identifying individuals at increased risk of severe COVID-19 based on their genetic profile.