bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-treatment level of LDL cholesterol and all-cause mortality in patients with atherosclerotic cardiovascular disease: evidence from real-world setting
Authors: Luo Fan , Lin Yuxin , Zhang Xiaodong , Li Yanqin , Su Licong , Zhou Shiyu , Xu Ruqi , Gao Qi , Chen Ruixuan , Guo Zhixin , Nie Sheng , Xu Xin ,   CRDS study Investigators, Xu Hong , Liu Bicheng , Weng Jianping , Chunbo Chen , Liu Huafeng , Yang Qiongqiong , Li Hua , Kong Yaozhong , Li Guisen , Wan Qijun , Zha Yan , Hu Ying , Xu Gang , Shi Yongjun , Zhou Yilun , Su Guobin , Tang Ying , Gong Mengchun 
Published: November 2023

Abstract

Aims
This study aimed to evaluate the safety of the currently recommended target of LDL cholesterol (LDL-C) control on mortality in patients with atherosclerotic cardiovascular disease (ASCVD).

Methods and results
Using deidentified electronic health record data, we conducted a multicentre retrospective cohort study involving individuals with documented ASCVD who had received statin treatment for at least 3 months across China. The primary outcomes assessed encompassed all-cause mortality, CV mortality, and non-CV mortality. Relationships between post-treatment LDL-C concentrations and outcomes were evaluated using restricted cubic spline curves based on Cox proportional hazards regression analyses. Additionally, competitive risk models were employed to explore associations between LDL-C levels and cause-specific mortality. Among 33 968 participants, we identified nearly linear associations of post-treatment LDL-C level with all-cause mortality and CV mortality during a median follow-up of 47 months. Notably, patients who achieved the recommended target of LDL-C (&lt;1.4 mmol/L) were at significantly lower risks of all-cause mortality [hazard ratio (HR), 0.77; 95% confidence interval (CI), 0.69–0.86] and CV mortality (subdistribution HR, 0.68; 95% CI, 0.58–0.79), compared with those with LDL-C ≥ 3.4 mmol/L. This survival benefit was consistent in patients with different intensities of LDL-C reduction and other subgroup analyses. And no correlation was found between post-treatment LDL-C concentration and non-CV mortality.

Conclusion
Our findings supported the safety of currently recommended target of LDL-C control and the ‘lower is better’ principle in patients with ASCVD.
Sodium–glucose co-transporter-2 inhibitors for the prevention of atrial fibrillation: a systemic review and meta-analysis
Authors: Zhang Hong-Da , Ding Lei , Mi Li-Jie , Zhang Ai-Kai , Zhang Kuo , Jiang Zi-Han , Yu Feng-Yuan , Yan Xin-Xin , Shen Yu-Jing , Tang Min 
Published: November 2023

Abstract

Aims
Sodium–glucose co-transporter-2 (SGLT2) inhibitors are reported to have cardiac benefits. The effects of SGLT2 inhibitors on the prevention of atrial fibrillation (AF) remain inconclusive. We aimed to investigate whether SGLT2 inhibitors can prevent AF occurrence in patients with cardiometabolic diseases.

Methods and results
We searched MEDLINE, EMBASE, and the Cochrane CENTRAL database up to 1 July 2023. Randomized, placebo-controlled trials of SGLT2 inhibitors in patients with diabetes, heart failure, chronic kidney diseases (CKDs), or cardiometabolic risk factors were included. The primary outcome was AF occurrence. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated in the overall population and selected subgroups. Forty-six trials comprising 101 100 patients were included. Overall, no significant risk reduction of AF occurrence was observed with SGLT2 inhibitors, although there was a favourable trend (RR 0.90, 95% CI 0.80–1.01). In trials with follow-up durations of over 1 year, a similar result was achieved (RR 0.90, 95% CI 0.80–1.01). The results were consistent across different SGLT2 inhibitors, with RRs (95% CIs) of 0.82 (0.60–1.12) for canagliflozin, 0.87 (0.73–1.03) for dapagliflozin, 0.97 (0.78–1.22) for empagliflozin, 0.99 (0.66–1.50) for sotagliflozin, and 0.87 (0.58–1.29) for ertugliflozin. Analyses in different doses of SGLT2 inhibitors yielded similar results. The associations between SGLT2 inhibitors and AF occurrence were also absent in patients with diabetes, heart failure, and CKDs.

Conclusion
For patients with cardiometabolic diseases or risk factors, SGLT2 inhibitors did not decrease the risk of AF occurrence, regardless of follow-up duration, type or dose of the drug, or the patient population.
A chromosome-level genome assembly of Zasmidium syzygii isolated from banana leaves
Authors: van Westerhoven Anouk C , Mehrabi Rahim , Talebi Reza , Steentjes Maikel B F , Corcolon Benny , Chong Pablo A , Kema Gert H J , Seidl Michael F 
Published: November 2023

Abstract
Accurate taxonomic classification of samples from infected host material is essential for disease diagnostics and genome analyses. Despite the importance, diagnosis of fungal pathogens causing banana leaf diseases remains challenging. Foliar diseases of bananas are mainly caused by 3 Pseudocercospora species, of which the most predominant causal agent is Pseudocercospora fijiensis. Here, we sequenced and assembled four fungal isolates obtained from necrotic banana leaves in Bohol (Philippines) and obtained a high-quality genome assembly for one of these isolates. The samples were initially identified as P. fijiensis using PCR diagnostics; however, the assembly size was consistently 30 Mb smaller than expected. Based on the internal transcribed spacer (ITS) sequences, we identified the samples as Zasmidium syzygii (98.7% identity). The high-quality Zasmidium syzygii assembly is 42.5 Mb in size, comprising 16 contigs, of which 11 are most likely complete chromosomes. The genome contains 98.6% of the expected single-copy BUSCO genes and contains 14,789 genes and 10.3% repeats. The 3 short-read assemblies are less continuous but have similar genome sizes (40.4–42.4 Mb) and contain between 96.5 and 98.4% BUSCO genes. All 4 isolates have identical ITS sequences and are distinct from Zasmidium isolates that were previously sampled from banana leaves. We thus report the first continuous genome assembly of a member of the Zasmidium genus, forming an essential resource for further analysis to enhance our understanding of the diversity of pathogenic fungal isolates as well as fungal diversity.
Fixed point theorems for minimal numberings
Authors: Faizrahmanov Marat 
Published: November 2023

Abstract
This paper considers various forms of the fixed point theorem (Kleene’s recursion theorem with and without parameters, Arslanov’s and Ershov’s recursion theorems) in arbitrary numberings. We prove that the classes of minimal numberings satisfying different of the listed forms of the fixed point theorem are pairwise distinct.
The precarity paradox: the precarity-driven inefficiencies of research at a public university
Authors: Ferreira António , Quesado Delgado João 
Published: November 2023

Abstract
Precarity is often interpreted as a neoliberal management strategy to maximize profits in private companies through the endorsement of insecure jobs, inadequate wages, and limited rights for workers. This interpretation, however, is unsuitable to analyse situations where the State endorses precarity in non-profit public organizations, for example, State-sponsored universities. We hypothesize that in these situations, the ‘precarity paradox’ is particularly prone to manifest. Such a paradox can be defined as the endorsement of precarity to induce organizational productivity and flexibility that, instead, leads to overwhelming inefficiencies and productivity losses. To test this hypothesis, we conducted empirical research at the faculty of engineering of a Portuguese public university where precarious contracts are dominant among researchers. Based on the analysis of the quantitative and qualitative data collected, it is concluded that productivity- and flexibility-oriented precarities reduce the productivity of researchers while jeopardizing the capacity of the faculty to rationally employ its human resources.
The potential for graphical abstracts to enhance science communication
Authors: Krukowski Rebecca A , Goldstein Carly M 
Published: November 2023

Abstract
Science communication, including formats such as podcasts, news interviews, or graphical abstracts, can contribute to the acceleration of translational research by improving knowledge transfer to patient, policymaker, and practitioner communities. In particular, graphical abstracts, which are optional for articles published in Translational Behavioral Medicine as well as many other journals, are created by authors of scientific articles or by editorial staff to visually present a study’s design, findings, and implications, to improve comprehension among non-academic audiences. The use of graphical abstracts in scientific journals has increased in the past 10–15 years; however, most scientists are not trained in how to develop them, which presents a challenge for creating graphical abstracts that engage the public. In this article, the authors describe graphical abstracts and offer suggestions for their construction based on the extant literature. Specifically, graphical abstracts should use a solid background, employ an easily readable font, combine visuals with words, convey only the essential study design information and 1–3 “take-home” points, have a clear organizational structure, contain restrained and accessible use of color, use single-color icons, communicate ways to access the full-text article, and include the contact information for the lead author. Authors should obtain feedback on graphical abstract drafts prior to dissemination. There is emerging research on the benefits of graphical abstracts in terms of impact and engagement; however, it will be essential for future research to determine how to optimize the design of graphical abstracts, in order to engage patient, policymaker, and practitioner communities in improving behavioral health.
Cardiovascular outcomes according to on-treatment systolic blood pressure in older hypertensive patients: a multicenter cohort using a common data model
Authors: Kim Ju Hyeon , Joo Hyung Joon , Chung Se Hwa , Yum Yunjin , Kim Yong Hyun , Kim Eung Ju 
Published: November 2023

Objective:
In the growing population of older patients with hypertension, limited evidence supports an association between lowering systolic blood pressure (SBP) and decreased adverse events. We aimed to investigate cardiovascular outcomes according to on-treatment SBP in older hypertensive patients.

Methods:
This multicenter, retrospective study used data from the Korea University Medical Center database built on electronic health records from 2017 to 2022. Patients initiated on at least two antihypertensive drugs in combination were followed for three years. The patients were grouped by average on-treatment SBP in 10-mmHg increments from <110 to 160 mmHg or more. The primary outcome was a composite of all-cause death, myocardial infarction, stroke, and hospitalization due to heart failure.

Results:
A total of 6427 patients aged ≥75 years (mean age, 80 years) were identified. The incidence of the primary outcome was lowest in individuals with an SBP of 120–129 mmHg (14.0%, P < 0.001), and the adjusted hazard ratio for the primary outcome showed a J-shaped relationship with on-treatment SBP. Achieving an SBP of 120–129 mmHg showed acceptable safety profiles, including electrolyte imbalance, acute kidney injury, new-onset atrial fibrillation, and new-onset dementia or Alzheimer's disease when compared to the group with SBP of 130–139 mmHg.

Conclusions:
An average on-treatment SBP of less than 130 mmHg was associated with improved outcomes in older hypertensive patients without raising safety concerns. These findings support the target SBP of 130 mmHg in older patients, if tolerated.
Cataract wound infection and endophthalmitis treated with partial conjunctival pedicle flap and pars plana vitrectomy
Authors: Rohowetz Landon J. , Hudson Julia , Sayed-Ahmed Ibrahim O. , Amescua Guillermo , Flynn Harry W. 
Published: November 2023

Introduction:
Corneal wound infection is an infrequent complication of cataract surgery that can progress to endophthalmitis. Surgical treatment of endophthalmitis associated with microbial keratitis traditionally involves therapeutic penetrating keratoplasty and pars plana vitrectomy (PPV). In this case report, we describe a patient with cataract wound infection and endophthalmitis treated with PPV and partial conjunctival pedicle flap surgery.

Patient and Clinical Findings:
A 74-year-old female patient complained of eye pain and decreased corrected distance visual acuity (CDVA) to 2/200 4 weeks after cataract surgery in the left eye. Examination revealed an infiltrate overlying her cataract wound with posterior segment inflammation consistent with endophthalmitis.

Diagnosis, Intervention, and Outcomes:
Vitreous culture revealed methicillin-resistant Staphylococcus aureus. The patient was initially treated with topical and intravitreal antibiotics but demonstrated signs of disease progression, so the patient underwent PPV with partial conjunctival pedicle flap surgery. One month postoperatively, CDVA was 20/80 with resolution of the infection and no evidence of recurrence at 6 months.

Conclusions:
In conjunction with PPV, conjunctival flap surgery may be an effective alternative to therapeutic penetrating keratoplasty in patients with cataract wound-associated microbial keratitis and endophthalmitis.
Effect of Maternal Speech on Neural Development in Premature Infant
Authors: Bubshait Khlood S. , Maldonado Mildred M. , Krueger Charlene 
Published: November 2023

Introduction:
Maternal speech has been shown to benefit premature infants by improving feeding outcomes and potentiating the development of the auditory cortex. To our knowledge, limited studies have addressed the benefits of exposure to maternal speech on neural development in premature infants. The objective of this study was to investigate the effect of early controlled exposure to maternal recording a passage of speech on heart rate variability (obtained before, during, and after playback of a test stimulus of a female stranger speaking the same passage) in very low-birth-weight premature infants tracked weekly from 28 to 34 weeks.

Methods:
Prospective, randomized controlled trial, longitudinal, and repeated-measures design were conducted on 49 subjects. Infants heard a recording of their mother's speech twice a day from either 28 to 34 weeks (group 1) or from 32 to 34 weeks (group 2). Spectral analysis was measured weekly for 45 seconds before, during, and after playback of maternal speech. A generalized linear mixed model was conducted to examine the 2-way interaction in the log high-frequency power between groups, genders, sessions, and conditions.

Results:
It was found that there were no significant differences between groups before, during, and after playback of the stimulus. A significant difference, however, was noted between conditions (before vs during period).

Conclusion:
It can be concluded cautiously that playing back of maternal speech recordings to the premature infant has a beneficial impact on neural development after 32 weeks gestational age.
Reducing Facial Hospital-Acquired Pressure Injuries Related to Prone Positioning in the Intensive Care Unit
Authors: Hughes Pamela J. 
Published: November 2023

PURPOSE:
The purpose of this quality improvement (QI) initiative was to evaluate the effects of a repositioning intervention bundle on the occurrences and severity of hospital-acquired pressure injuries (HAPIs) of the face in patients with COVID-19–related acute respiratory distress syndrome (ARDS) managed by ventilation and placed in a prone position.

PARTICIPANTS AND SETTING:
Eighteen critically ill, ventilated patients were placed in a prone position for extended periods (range, 1-13 days). The study setting was critical care units in a 504-bed nonprofit teaching hospital located in the Northeastern United States.

APPROACH:
Standard of care for the prevention of pressure injury (PI) in ventilated patients placed in a prone position at our facility included use of foam dressings over bony prominences on the face and the application of tape to secure the endotracheal (ET) tube as compared to commercial ET tube securement devices. We also placed a fluidized pillow with pillowcase wrapped with an absorbent pad under the head to absorb secretions. We added 2 interventions to our facility's existing HAPI prevention bundle. The first was a repositioning strategy; ventilated and prone patients were lifted by their shoulders by critical care RNs while their ET tube was stabilized by a respiratory therapist every 6 hours. The RNs then repositioned the patient's head and arms to the opposite side into a swimmer's position (head lying to the side with one cheek in contact with the fluidized pillow). The second intervention was micromovement of the head performed by an RN every 4 hours.

OUTCOMES:
Prior to implementation of the QI initiative, data collected during the early pandemic demonstrated that multiple patients developed facial PIs secondary to prone positioning; a majority were full-thickness or unstageable PIs, whereas a minority were partial-thickness PIs (stage 2). Following implementation of the QI initiative, data indicated that 5 of 18 (28%) patients placed in a prone position had HAPIs of the face; 4 (22%) of the HAPIs were stage 1 or 2 and 1 was unstageable. Patients were placed in a prone position from 1 to 13 days. All facial HAPIs developed within the first 2 days of placement in a prone position.

IMPLICATIONS FOR PRACTICE:
The addition of an RN and a respiratory therapist repositioning intervention and micromovements of the head every 4 hours by the RN to an existing pressure prevention bundle during prone positioning led to a clinically relevant reduction in the severity of facial HAPIs. As a result, care for these patients has been changed to incorporate the repositioning interventions implemented during this QI project.
Complications and Healthcare Costs Associated With the First Year Following Colostomy and Ileostomy Formation
Authors: Brady Richard R. W. , Scott Julia , Grieveson Stephanie , Aibibula Miriayi , Cawson Matthew , Marks Tatjana , Page Jennifer , Artignan Audrey , Boisen Esben Bo 
Published: November 2023

PURPOSE:
The purpose of this study was to evaluate clinical and economic outcomes during the first year following ostomy formation.

DESIGN:
Single-center retrospective audit.

SUBJECTS AND SETTING:
The sample comprised 200 patients who underwent surgery leading to ileostomy or colostomy at a large English National Health Service (NHS) Trust.

METHODS:
Clinical complications, medicine prescriptions, and interactions with healthcare services were reported over 12 months postsurgery, and interactions with the NHS were matched to the closest NHS unit cost to determine mean patient cost.

RESULTS:
The most common ostomy-related surgical site complications were high output (35.0%; n = 70), followed by moderate/severe peristomal skin complications (24.5%; n = 49) and bleeding (23.5%; n = 47). Ostomy management–related complications included general difficulties with ostomy management (50.0%; n = 100) and leakage-related mild peristomal skin issues (48.5%; n = 97). Clinical complication rates were highest in the first quarter following ostomy formation, except parastomal hernia, which increased in incidence over time. Ileostomy patients more frequently experienced high output, acute renal failure, and ostomy management–related complications and had increased length of inpatient admission. However, healthcare resource use was high in both groups, with a median of 13 inpatient admission days and 12 outpatient contacts overall within the first year. Mean cost per patient was £20,444.60 (US $26,018.41); 90.5% of these costs were attributed to ostomy-related factors.

CONCLUSIONS:
Patients are likely to experience at least one clinical complication following intestinal ostomy formation and have multiple interactions with the NHS. While a number of complications are more frequent in patients with ileostomies, both groups experienced considerable costs within the first year following surgery associated with ostomy management and recovery.
The Effects of Incontinence Pad Application on Loaded Skin With Reference to Biophysical and Biochemical Parameters
Authors: Abiakam Nkemjika S. , Jayabal Hemalatha , Abbas Shabira , Filingeri Davide , Bader Dan L. , Worsley Peter R. 
Published: November 2023

PURPOSE:
The purpose of this study was to evaluate temporal changes in skin responses following exposure to moisture alone or moisture in combination with mechanical loading.

DESIGN:
Comparison cohort with a repeated-measures design.

SUBJECTS AND SETTINGS:
The sample comprised 12 healthy volunteers. Participants were purposely sampled from 2 different age groups; half were 32 to 39 years old and half were 50 to 62 years old. Participants identified as White, Black, or mixed; 83% (n = 10) identified as White; 8 (67%) were female.

METHODS:
Four sites at the sacrum were challenged with the application of specimens taken from 2 absorbent products; the pad specimens were applied dry or saturated with synthetic urine (SU; pH = 8); a further site from the sacral skin was also selected and used as a control. Skin assessments were performed at different points in time: (1) 60 minutes after exposure to dry or SU-saturated pad specimens; (2) 60 minutes after exposure to pads and mechanical loading (application of pressure in the form of 45°C high sitting); and (3) 30 minutes after removal of all pads (recovery period). Outcome measures were transepidermal water loss (TEWL), stratum corneum (SC) hydration, erythema, pH, and skin inflammatory biomarkers measured at each of the time points described earlier.

RESULTS:
The control site and those exposed to dry pads showed minimal time-dependent changes irrespective of the parameter investigated. In contrast, significant increases in TEWL (P = .0000007) and SC hydration responses (P = .0000007) were detected at the sites under absorbent pad specimens after saturation with SU (exposure to moisture). In some participants, TEWL and SC hydration parameters were significantly higher during pressure application. Skin pH remained in the mildly acidic range throughout the test session, and no consistent trends were observed with erythema. Skin inflammatory biomarkers also exhibited considerable variability across participants; none changed significantly over time. Significant differences (P = .02) were also detected following the exposure of moisture in combination with pressure.

CONCLUSION:
We evaluated an array of parameters to identify changes following skin exposure to 2 absorbent pads in the presence and absence of SU and mechanical loading. Analysis revealed changes in skin barrier properties in the presence of moisture and/or pressure. This observation suggests a need for frequent pad changing as well as periods of skin off-loading to protect the skin health of individuals with incontinence.