bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic arch calcification increases major adverse cardiac event risk, modifiable by echocardiographic left ventricular hypertrophy, in end-stage kidney disease patients
Authors: Chao Chia-Ter , Liao Min-Tser , Wu Chung-Kuan 
Published: January 2024

Background: The factors affecting cardiovascular risk associated with vascular calcification in patients with chronic kidney disease are less well addressed. Distinct risk factors may contribute synergistically to this elevated cardiovascular risk in this population. Objectives: We aimed to determine whether echocardiographic left ventricular hypertrophy (LVH) affects the risk of major adverse cardiac events (MACE) associated with vascular calcification in end-stage kidney disease (ESKD) patients. Methods: In this retrospective cohort study, ESKD patients underwent chest radiography and echocardiography to assess aortic arch calcification (AoAC) and LVH, respectively, and were classified into three groups accordingly: non-to-mild AoAC without LVH, non-to-mild AoAC with LVH, and moderate-to-severe AoAC. The risks of MACE, cardiovascular mortality, and overall mortality were assessed using Cox proportional hazard analysis. Results: Of the 283 enrolled ESKD patients, 44 (15.5%) had non-to-mild AoAC without LVH, 117 (41.3%) had non-to-mild AoAC with LVH, and 122 (43.1%) had moderate-to-severe AoAC. After 34.1 months, 107 (37.8%) participants developed MACE, including 6 (13.6%), 40 (34.2%), and 61 (50%) from each respective group. Those with moderate-to-severe AoAC (Hazard ratio, 3.72; 95% confidence interval, 1.58–8.73) had a significantly higher risk of MACE than did those with non-to-mild AoAC without LVH or with non-to-mild AoAC and LVH (Hazard ratio, 2.73; 95% confidence interval, 1.16–6.46). A similar trend was observed for cardiovascular and overall mortality. Conclusion: Echocardiographic LVH could modify the risk of adverse cardiovascular events associated with vascular calcification in ESKD patients. Interventions aiming to ameliorate both morbidities might be translated into a lower MACE risk in this population.
Digital Innovations for Occupational Safety: Empowering Workers in Hazardous Environments
Authors: Dodoo Joana Eva , Al-Samarraie Hosam , Alzahrani Ahmed Ibrahim , Lonsdale Maria , Alalwan Nasser 
Published: January 2024

Background: The quest to increase safety awareness, make job sites safer, and promote decent work for all has led to the utilization of digital technologies in hazardous occupations. This study investigated the use of digital innovations for safety and health management in hazardous industries. The key challenges and recommendations associated with such use were also explored. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a total of 48 studies were reviewed to provide a framework for future pathways for the effective implementation of these innovations. Findings: The results revealed four main categories of digital safety systems: wearable-based systems, augmented/virtual reality-based systems, artificial intelligence-based systems, and navigation-based systems. A wide range of technological, behavioral, and organizational challenges were identified in relation to the key themes. Conclusion: Outcomes from this review can inform policymakers and industrial decision-makers about the application of digital innovations for best safety practices in various hazardous work conditions.
A Pandemic in Review: The Impact on Surgical Volume of Cleft Lip and Palate
Authors: Shah Pearl , Ahmed Asim , Moody Robert , Thawanyarat Kometh , Navarro Yelissa , Collar John , Holmes Kathryne , Yu Jack 
Published: January 2024

Introduction:We seek to evaluate the financial impact of the COVID-19 pandemic on pediatric craniomaxillofacial surgeries for cleft lip and/or palate. These surgeries are carefully timed for optimal outcomes, but the pandemic necessitated postponement or cancellation of elective procedures. Our study quantifies the decline in cases and associated charges at a single academic medical center before and after the pandemic.Methods:After receiving Institutional Review Board approval, we analyzed the financial billing data of 83 patients who underwent cleft lip and/or palate repair at an academic medical center. The caseload and charges incurred in the year before the COVID-19 pandemic (March 2019 to February 2020) were compared to the 2 years following the pandemic’s onset (March 2020 to February 2022). Statistical analysis was conducted using paired t-tests and the Wilcoxon signed-rank.Results:In the year following the onset of the pandemic, we observed a significant decrease in the number of cleft lip and/or palate repairs performed per month (from 2.75 to 1.42 per month, P-value .021) and a decrease in per-month charges for these procedures ($13 334.75 to $7237.17 per month, P-value .036). However, when examining data over the 2 years post-COVID, these differences no longer remain statistically significant ( P-value .25 for cases and P-value .32 for charges), indicating a return to pre-COVID baseline.Conclusion:There was a statistically significant decrease in cleft lip/palate repair surgeries in the 12 months following the start of the COVID-19 pandemic. Both the caseload and total charges decreased after March 2020, with a subsequent return to baseline after 2 years. These findings emphasize that the pandemic had a transient impact on pediatric craniomaxillofacial surgical volume at our institution. While acknowledging our study’s external validity, we advocate for a nuanced approach, with flexible staffing crucial in facilitating a swift return to normal elective volumes.
Complete responses in AL amyloidosis are unequal: the impact of free light chain mass spectrometry in AL amyloidosis
Authors: Bomsztyk Joshua , Ravichandran Sriram , Giles Hannah V. , Wright Nicola , Berlanga Oscar , Khwaja Jahanzaib , Mahmood Shameem , Wisniowski Brendan , Cohen Oliver , Foard Darren , Gilbertson Janet , Rauf Muhammad U. , Starr Neasa , Martinez-Naharro Ana , Venneri Lucia , Whelan Carol , Fontana Marianna , Hawkins Philip N. , Gillmore Julian D. , Lachmann Helen , Harding Stephen , Pratt Guy , Wechalekar Ashutosh D. 
Published: January 2024

Abstract
Amyloidogenic serum free light chains (sFLCs) drive disease progression in AL amyloidosis. Matrix-assisted laser desorption/ionization time of flight mass spectrometry–based FLC assay (FLC-MS) has greater sensitivity than conventional sFLC assays allowing for the detection of serological residual disease. We report the utility of FLC-MS in a large series of patients with AL amyloidosis assessing the impact of FLC-MS negativity after treatment on overall survival (OS) and organ response rates. Serum samples were analyzed using FLC-MS at diagnosis and at 6 and 12 months after treatment. The impact of FLC-MS negativity over standard hematologic responses on survival and organ response was assessed. A total of 487 patients were included; 290 (59%) and 349 (71.5%) had cardiac and renal involvement, respectively. There was 100% concordance between the light chain (LC) fibril type and LC isotype identified by FLC-MS. At 6 and 12 months, 81 (16.6%) and 101 (20.7%) were FLC-MS negative. Of those achieving a conventional hematologic complete response (CR) at 6 and 12 months, 45 (27.7%) and 64 (39%) were FLC-MS negative. At 12 months, median OS for CR + FLC-MS negative was not reached vs 108 months in CR + FLC-MS positive (P = .024). At 12 months, 70% of patients with FLC-MS negativity (vs 50% FLC-MS positive) achieved a cardiac response (P = .015). In a multivariate analysis, FLC-MS negativity at 12 months was an independent predictor of better outcomes. FLC-MS can detect persistent monoclonal light chains in a significant proportion of patients in a conventional hematologic CR. FLC-MS assessment promises to be a new standard for response assessment in AL amyloidosis.
Arterio-occlusive events among patients with chronic myeloid leukemia on tyrosine kinase inhibitors
Authors: Veltmaat Lukas , Cortes Jorge 
Published: January 2024

Abstract
Tyrosine kinase inhibitors (TKIs) are standard therapy for patients with chronic myeloid leukemia. Each of these drugs has a specific profile of tyrosine kinases that they inhibit and, although all are clinically effective, they each have unique toxicity profiles. With the introduction of ponatinib, arterio-occlusive events were first noted and later found to occur with all TKIs to various extents. The recognition of this “class effect” was delayed considering ponatinib was introduced 10 years after the introduction of imatinib. The reasons for the delay in identification of this class effect are likely multifaceted. Importantly, there is an inconsistency in adverse event reporting criteria among the major clinical trials of the various TKIs, likely resulting in mixed reporting of arterio-occlusive events. Reporting events based on a frequency threshold, lack of sufficient follow-up, attempts at causality attribution, and the primary focus on molecular response may all have played an additional role. Considering the increasing rate of arterio-occlusive events over time, the termination of many trials after only 5 years prevents full assessment of the impact of these events. A comprehensive evaluation of TKI adverse effects using uniform Medical Dictionary for Regulatory Activities terms and comprehensive adjudication of these events may be helpful in better assessing the real risk for patients with each TKI. Future clinical trials should use a uniform and comprehensive approach to reporting adverse events without attempting to assign causality to the study drug.
Land use alters cross-ecosystem transfer of high value fatty acids by aquatic insects
Authors: Ohler Katharina , Schreiner Verena C. , Reinhard Lukas , Link Moritz , Liess Matthias , Brack Werner , Schäfer Ralf B. 
Published: January 2024

Abstract
Background
Many aquatic insects emerge as adults from water bodies to complete parts of their life cycle in terrestrial ecosystems and are potential prey for riparian predators. The benefits of riparian predators from aquatic insects include higher contents of long-chain polyunsaturated fatty acids (PUFA) compared to terrestrial insects. Aquatic insects are therefore considered a high-quality food. Food containing high levels of PUFA can enhance growth and immune response of spiders. However, agricultural stressors like nutrient increase, pesticides and habitat degradation can affect the biomass of aquatic insects and in turn the diet of spiders. Studies quantifying the influence of land use on fatty acid (FA) profiles of emergent aquatic insects and riparian predators are lacking. We quantified differences in exports of FA, saturated FA, monounsaturated FA, and PUFA, FA profiles of aquatic insects and spiders between forested and agricultural sites over the primary emergence period within one year. The FA export to the riparian food web is crucial to understand energy fluxes between ecosystems. Furthermore, we monitored environmental variables to identify associations between agricultural stressors and FA profiles of aquatic insects and spiders.

Results
We found differences in FA export and profiles of aquatic insects between land-use types. The quantity of total FA export via aquatic insects was lower in agricultural sites (95% CI 1147–1313 µg m−2) in comparison to forested sites (95% CI 1555–1845 µg m−2), while the biomass export was higher in agricultural sites. Additionally, in spring the PUFA export was significantly lower (up to 0.06 µg d−1 m−2) in agricultural than forested sites. Agricultural stressors explained only little variation in the FA profiles of aquatic insects, e.g., 4% for caddisflies and 12% for non-biting midges. Percentage of shading and pool habitats were identified as most important variables explaining the variation in FA profiles.

Conclusion
The quality of aquatic insects as food source for riparian spiders was smaller in agricultural than forested sites, which can decrease the fitness of riparian predators. To improve our capacity to predict potential adverse effects in the riparian food web, future studies should identify the mechanisms underlying a lower PUFA content.
Ventral tegmental area dopaminergic circuits participates in stress-induced chronic postsurgical pain in male mice
Authors: Liu Weizhen , Wang Wang , Wang Ziliang , Xing Ying 
Published: January 2024

Abstract
Background
Chronic postsurgical pain (CPP) markedly impairs patients’ quality of life. Research has shown that chronic stress may extend incisional nociception in male mice. Dopaminergic (DAergic) neurons in the ventral tegmental area (VTA) are integral to stress-related mental disorders (including major depressive disorder, anxiety disorders, and PTSD) and pain. However, the impact of chronic social defeat stress (CSDS) on mesolimbic dopamine (DA) transmission in the development of CPP is yet to be established. It remains uncertain whether the dopamine signals in the rostral anterior cingulate cortex (rACC), which regulate pain, derive from the VTA. This study aims to explore the role of VTA-rACC dopaminergic circuits in a mouse model of CPP induced by CSDS.

Methods
We conducted CSDS on C57BL/6 J wild-type male mice (n = 12–16 mice/group) and DAT-cre male mice (n = 10–12 mice/group). After 10 days of CSDS, a left posterior plantar incision was made to establish a mouse model of CPP. Paw withdrawal thresholds (PWTs) were evaluated using Von-Frey fibre stimulation. The open field test (OFT) and elevated plus maze test (EPM) were used to assess pain-related negative emotions. We used immunofluorescence staining and Western Blot to analyse D1, D2, c-Fos, and TH expression. DAergic fibre projections in the VTA-rACC neural pathway were traced using retrograde tracing and immunofluorescence staining. Optogenetics and Chemogenetics were employed to manipulate DAergic neurons in the VTA and their axons in the rACC.

Results
The ipsilateral PWTs in male C57BL/6 J mice significantly decreased after surgery, returning to baseline after seven days. Conversely, in CSDS mice, ipsilateral PWTs remained reduced for at least 30 days post-incision. A significant reduction in TH-positive neurons expressing c-Fos in the VTA of CPP mice was observed 15 days post-incision. Activating DAergic neurons significantly improved ipsilateral PWTs and locomotor performance in the OFT and EPM in CPP mice post-incision. Additionally, D1 expression in the rACC was found to decrease in CPP mice, and this reduction counteracted the increase in PWTs caused by activating DAergic neuron axon terminals in the rACC.

Conclusion
CSDS results in chronicity of postsurgical nociception and anxiety-like negative emotions, with alterations in DA transmission playing a role in CPP. Specific activation of DAergic neurons mitigates nociceptive responses and anxiety-like bahaviors, possibly mediated by D1 receptors in the rACC.
Adaptive potential of maritime pine under contrasting environments
Authors: Alía Ricardo , Climent Jose , Santos-del-Blanco Luis , Gonzalez-Arrojo Amelia , Feito Isabel , Grivet Delphine , Majada Juan 
Published: January 2024

Abstract
Background
Predicting the adaptability of forest tree populations under future climates requires a better knowledge of both the adaptive significance and evolvability of measurable key traits. Phenotypic plasticity, standing genetic variation and degree of phenotypic integration shape the actual and future population genetic structure, but empirical estimations in forest tree species are still extremely scarce. We analysed 11 maritime pine populations covering the distribution range of the species (119 families and 8 trees/family, ca. 1300 trees) in a common garden experiment planted at two sites with contrasting productivity. We used plant height as a surrogate of fitness and measured five traits (mean and plasticity of carbon isotope discrimination, specific leaf area, needle biomass, Phenology growth index) related to four different strategies (acquisitive economics, photosynthetic organ size, growth allocation and avoidance of water stress).

Results
Estimated values of additive genetic variation would allow adaptation of the populations to future environmental conditions. Overall phenotypic integration and selection gradients were higher at the high productivity site, while phenotypic integration within populations was higher at the low productivity site. Response to selection was related mainly to photosynthetic organ size and drought-avoidance mechanisms rather than to water use efficiency. Phenotypic plasticity of water use efficiency could be maladaptive, resulting from selection for height growth.

Conclusions
Contrary to the expectations in a drought tolerant species, our study suggests that variation in traits related to photosynthetic organ size and acquisitive investment of resources drive phenotypic selection across and within maritime pine populations. Both genetic variation and evolvability of key adaptive traits were considerably high, including plasticity of water use efficiency. These characteristics would enable a relatively fast micro-evolution of populations in response to the ongoing climate changes. Moreover, differentiation among populations in the studied traits would increase under the expected more productive future Atlantic conditions.
General practice staff and patient experiences of a multicomponent intervention for people at high risk of poor health outcomes: a qualitative study
Authors: Javanparast Sara , Roeger Leigh , Reed Richard L. 
Published: January 2024

Abstract
Background
This study reports the experiences of general practice staff and patients at high risk of poor health outcomes who took part in a clustered randomised controlled trial of a multicomponent general practice intervention. The intervention comprised patient enrolment to a preferred General Practitioner (GP) to promote continuity of care, access to longer GP appointments, and timely general practice follow-up after hospital care episodes. The aims of the study were to better understand participant’s (practice staff and patients) perspectives of the intervention, their views on whether the intervention had improved general practice services, reduced hospital admissions and finally whether they believed the intervention would be sustainable after the trial had completed.

Methods
A qualitative study design with semi-structured interviews was employed. The practice staff sample was drawn from both the control and intervention groups. The patient sample was drawn from those who had expressed an interest in taking part in an interview during the trial and who had also experienced a recent hospital care episode.

Results
Interviews were conducted with 41 practice staff and 45 patients. Practice staff and patients expressed support for the value of appointments with a regular GP and having sufficient time in appointments for the provision of comprehensive care. There were mixed views with respect to the extent to which the intervention had improved services. The positive changes reported were related to services being provided in a more proactive, thorough, and systematic manner with a greater emphasis on team based care involving the Practice Nurse. Patients nominated after hours care and financial considerations as the key reasons for seeking hospital care. Practice staff noted that the intervention would be difficult to sustain financially in the absence of additional funding.

Conclusions
The multicomponent intervention was supported by practice staff and patients and some patients perceived that it had led to improvements in care.
Growth development of children and adolescents with inflammatory bowel disease in the period 2000–2014 based on data of the Saxon pediatric IBD registry: a population-based study
Authors: Zhou Xueming , Kern Ivana , Rothe Ulrike , Schoffer Olaf , Weidner Jens , Richter Thomas , Laass Martin W. , Kugler Joachim , Manuwald Ulf 
Published: January 2024

Abstract
Background
The incidence of inflammatory bowel disease (IBD) in children is on the increase worldwide. Growth disorders are common in pediatric patients with inflammatory bowel disease. The aim of this paper is to investigate anthropometric indicators, including height and weight in children with inflammatory bowel disease in Saxony, one of the German federal states, and to evaluate growth trends in patients by comparing their height and weight with that of healthy children in Germany.

Methods
In Saxony, all children and adolescents with IBD were registered in the Saxon Pediatric IBD Registry from 2000 to 2014. The data used are therefore based on a total area-wide survey over 15 years. For this study, 421 datasets of children and adolescents aged 0–14 years with Crohn’s disease (CD) (n = 291) or ulcerative colitis (UC) (n = 130) were analyzed.
Z-score and percentile calculations were used to compare differences between IBD patients and the general population.

Results
The children with CD or UC (both sexes) had a significant lower weight at diagnosis (the mean weight z-score had negative values) versus the general population. The weight values lay mostly below P50 (the 50th percentile, median), more precisely, mostly between P10 and P50 of the body weight child growth curve for corresponding sexes (KiGGS 2003–2006).
The height values of both sexes at diagnosis lay also mostly below P50 (the 50th percentile, median) of the child body growth curve for corresponding sexes (KiGGS 2003–2006), i.e. the mean height z-score was negative. But only the children with CD had a significant lower height, more precisely, mostly between P25 and P50 versus the general population (KIGGS). For children with UC the difference was not significant.

Conclusion
In pediatric patients with IBD the possibility of growth disturbance, mainly in the form of weight retardation, is very probable.
Esophageal cancer: a twenty-four-year experience at a tertiary care center with an evaluation of the prognostic significance of the neutrophil-lymphocyte ratio
Authors: Mahmoud Walaa , Hassoun Lara , Kerbage Anthony , Mukherji Deborah , Shamseddine Ali , Tamraz Sally , Hakim Ayman , Barada Kassem 
Published: January 2024

Abstract
Background
A high neutrophil-lymphocyte ratio (NLR) may be associated with worse survival in esophageal cancer (EC). Our aims were to describe the demographic and clinical data of EC in a tertiary referral center in Lebanon and to determine the prognostic value of NLR.

Methods
A retrospective cohort study based on chart review of patients diagnosed with EC was conducted at the American University of Beirut Medical Center (AUBMC). The demographic characteristics, clinical presentation and outcomes were described and compared between squamous cell carcinomas (ESCC) and adenocarcinomas (EAC). Data about esophageal cancer incidence were obtained from the National Cancer Registry, the Ministry of Public Health and GLOBOCAN 2020. Cox regression analysis was performed to determine whether the NLR is an independent predictor of survival, using variables based on clinical knowledge and previously established data.

Results
110 patients were diagnosed with EC, which was the least common among other gastrointestinal malignancies. Our follow up rates reached 86.4%. The median survival was 9 months (IQR 3–25.5.) and was comparable between ESCC (median of 7 months, IQR 2–25) and EAC (median of 9 months, IQR 3–26.3), p = 0.803. Advanced stage was associated with a worse prognosis (p = 0.037). The mean NLR(±SD) was 5.20 ± 6.8, with no significant difference between EAC and ESCC (4.5 ± 3.4 vs. 5.9 ± 9.2, p = 0.420) or between early or advanced stages (5.4 ± 8.1 vs. 4.7 ± 6.8, p = 0.732). The area under the curve for the NLR was 0.560 (95% CI: 0.374–0.746, p = 0.488). After adjusting for age, gender, TNM staging and grading, cox regression analysis showed that an increased NLR was a significant predictor of mortality, with an adjusted hazard ratio of 1.095 (p = 0.011).

Conclusion
EC is quite uncommon in Lebanon despite a high prevalence of smoking and obesity. Advanced stage and high NLR were associated with a negative prognostic value.