bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGO2 Protects Against Diabetic Cardiomyopathy by Activating Mitochondrial Gene Translation
Authors: Zhan Jiabing , Jin Kunying , Xie Rong , Fan Jiahui , Tang Yuyan , Chen Chen , Li Huaping , Wang Dao Wen 
Published: December 2023

BACKGROUND:
Diabetes is associated with cardiovascular complications. microRNAs translocate into subcellular organelles to modify genes involved in diabetic cardiomyopathy. However, functional properties of subcellular AGO2 (Argonaute2), a core member of miRNA machinery, remain elusive.

METHODS:
We elucidated the function and mechanism of subcellular localized AGO2 on mouse models for diabetes and diabetic cardiomyopathy. Recombinant adeno-associated virus type 9 was used to deliver AGO2 to mice through the tail vein. Cardiac structure and functions were assessed by echocardiography and catheter manometer system.

RESULTS:

AGO2 was decreased in mitochondria of diabetic cardiomyocytes. Overexpression of mitochondrial AGO2 attenuated diabetes-induced cardiac dysfunction. AGO2 recruited
TUFM
, a mitochondria translation elongation factor, to activate translation of electron transport chain subunits and decrease reactive oxygen species. Malonylation, a posttranslational modification of AGO2, reduced the importing of AGO2 into mitochondria in diabetic cardiomyopathy. AGO2 malonylation was regulated by a cytoplasmic-localized short isoform of
SIRT3
through a previously unknown demalonylase function.

CONCLUSIONS:

Our findings reveal that the
SIRT3
–AGO2–
CYTB
axis links glucotoxicity to cardiac electron transport chain imbalance, providing new mechanistic insights and the basis to develop mitochondria targeting therapies for diabetic cardiomyopathy.
Vascular architecture mapping reveals sex-specific changes in cerebral microvasculature with aging
Authors: Hohmann Anja , Zhang Ke , Jende Johann M.E. , Mooshage Christoph M. , Görgen Kai , Rotkopf Lukas T. , Schlemmer Heinz-Peter , Vollmuth Philipp , Bendszus Martin , Wick Wolfgang , Kurz Felix T. 
Published: December 2023

AbstractObjectives: Previous studies indicate region-specific age- and sex-related changes in cerebral microvasculature. Using whole-brain vascular architecture mapping (VAM), our objective was to map and assess these changes in human microvasculature in vivo.Materials and methods: Cardiovascular healthy women (n = 40) and men (n = 32) with unifocal low-grade glioma, matched for age [range: 20-70 years] and BMI, were examined on the non-tumor hemisphere with a combined spin and gradient echo echo-planar imaging sequence at 3 T MRI. Vessel vortex curves were obtained by pair-wise plotting changes in relaxation rates R2* and R2 during contrast agent bolus passage, which each generate a set of VAM parameters that characterize microvascular properties, such as vessel type, lumen size, or blood flow. Averaged VAM values of cortical grey matter, white matter, putamen, globus pallidus, caudate nucleus, thalamus, insular cortex, and hippocampus were assessed for age- and sex-related changes.Results: With age, dominant vessel types changed from capillaries to an arteriole-dominated profile, particularly in insula, thalamus, and globus pallidus. In white matter, blood flow velocity decreased significantly with aging for both sexes (r = −0.33, p = 0.004). In women, aging was associated with an increase in microvessel caliber, particularly in thalamus (r = 0.39, p = 0.01) and insula (r = 0.34, p = 0.03). In all grey matter areas, women had a higher microvessel density than men (4.33 ± 0.26ˑ102 ms-1/3 vs. 4.18 ± 0.26ˑ102 ms-1/3; p = 0.025, respectively).Conclusions: Aging affects microvasculature differently across brain regions in women and men, especially in thalamus and insula.
Speak, Read and Prompt: High-Fidelity Text-to-Speech with Minimal Supervision
Authors: Kharitonov Eugene , Vincent Damien , Borsos Zalán , Marinier Raphaël , Girgin Sertan , Pietquin Olivier , Sharifi Matt , Tagliasacchi Marco , Zeghidour Neil 
Published: December 2023

Abstract
We introduce SPEAR-TTS, a multi-speaker text-to-speech (TTS) system that can be trained with minimal supervision. By combining two types of discrete speech representations, we cast TTS as a composition of two sequence-to-sequence tasks: from text to high-level semantic tokens (akin to “reading”) and from semantic tokens to low-level acoustic tokens (“speaking”). Decoupling these two tasks enables training of the “speaking” module using abundant audio-only data, and unlocks the highly efficient combination of pretraining and backtranslation to reduce the need for parallel data when training the “reading” component. To control the speaker identity, we adopt example prompting, which allows SPEAR-TTS to generalize to unseen speakers using only a short sample of 3 seconds, without any explicit speaker representation or speaker labels. Our experiments demonstrate that SPEAR-TTS achieves a character error rate that is competitive with state-of-the-art methods using only 15 minutes of parallel data, while matching ground-truth speech in naturalness and acoustic quality.
Trust but Verify? Utility of Intraoperative Angiography After Revascularization for Vascular Trauma
Authors: Lehrman Benjamin , Byerly Saskya , Mitchell Erica L. , Kerwin Andrew J. , Howley Isaac W. ,   AAST PROOVIT Study Group
Published: December 2023

Background Trauma surgical dogma teaches that patients should have intraoperative angiography (IA) if the surgeon cannot identify a pulse in the injured extremity following a vascular repair. This study was undertaken to assess the utility of IA in trauma patients who underwent open brachial or femoral artery revascularization. Methods Retrospective analysis of the Prospective Observational Vascular Injury Trial (PROOVIT) database from 2013 to 2021 evaluated patients >15 years with penetrating or blunt injuries requiring operative intervention of the brachial, superficial femoral, or common femoral arteries. Prospective Observational Vascular Injury Trial data evaluated included documented pulse in the injured extremity at revascularization completion, adjunctive IA, immediate revision, and vascular reintervention during the hospitalization. Results Of the 5057 patients with vascular injury, 185 patients met our inclusion criteria. The majority were male (86.5%) with a median age, injury severity score, and systolic blood pressure of 29, 12, and 117, respectively. Of the study patients, 39% underwent IA, 14% had immediate revision, and 8% required vascular reoperation during their admission. Patients who underwent IA and with no documented palpable pulse after repair were significantly more likely to require immediate revision before leaving the operating room (22% vs 9%, P = .013) and were not more likely to require reoperation, than those who did not undergo IA (7% vs 9%, P = .613). Conclusions Intraoperative angiography is a valuable tool for surgeons for vascular extremity trauma and is associated with a greater rate of immediate revision. Familiarity with angiographic technique is essential for vascular trauma and should be a focal point of training.
Should the Breast Cancer Staging System be Revised?
Authors: Sanli Ahmet Necati , Tekcan Sanli Deniz Esin , Aydogan Fatih , Altundag M. Kadri 
Published: December 2023

Objective The purpose of this study was to determine whether breast cancer patients at stage T2N0 with tumor size ≥4 cm and <4 cm. Method Patients with T2N0 stage breast cancer diagnosed between 2010 and 2019 were analyzed in 2 groups as <4 cm (T2a) and ≥4 cm (T2b) in the study using the SEER 17 Research Plus database. The patients’ clinicopathological characteristics and oncological outcomes were included. Group comparisons of prognostic factors, overall survival (OS), and cancer-specific survival (CSS) were made. Results In this study, which involved 70971 patients, the T2a group had higher 5-year OS rate (87.2 ± .2 vs 80.8 ± .5%) and 5-year CSS rate (93.7 ± .1% vs 89.4 ± .4%) than the T2b group ( P < .001). Univariate analysis revealed that the overall risk of death was 1.5 times higher in T2b than T2a (HR: 1.533 [95% CI: 1.450-1.622], P < .001), whereas multivariate analysis demonstrated the risk was 1.4 times higher (HR: 1.384 [95% CI: 1.307-1.466], P < .001). The risk of cancer-specific death was 1.7 times higher in univariate analysis (HR: 1.691 [95% CI: 1.561-1.832], P < .001) and 1.4 times higher in multivariate analysis (HR: 1.420 [95% CI: 1.309-1.541], P < .001). Conclusion Overall survival and BCSS rates in stage T2b breast cancer patients are significantly lower than in T2a patients. Tumor size ≥4 cm in breast cancer is a negative predictor of prognosis.
Treatment guesses in the Treatment for Adolescents with Depression Study: Accuracy, unblinding and influence on outcomes
Authors: Jureidini Jon , Moncrieff Joanna , Klau Julie , Aboustate Natalie , Raven Melissa 
Published: December 2023

Objective: We evaluated the presence and impact of unblinding during the influential Treatment for Adolescents with Depression Study (ClinicalTrials.gov Identifier: NCT00006286). Method: Our analysis was part of a Restoring Invisible and Abandoned Trials reanalysis. Treatment for Adolescents with Depression Study trialled fluoxetine, placebo, cognitive behaviour therapy or their combination, in treating adolescents with major depressive disorder. We analysed the accuracy of guesses of fluoxetine or placebo allocation, and their effects on change in Children’s Depression Rating Scale-Revised at 12 weeks. Results: Of 221 participants allocated to fluoxetine or placebo, 151 adolescents (68%) had their guess about pill-treatment-arm allocation recorded at week 6, and guesses were recorded for 154 independent evaluators, 159 parents and 164 pharmacotherapists. All of these groups guessed treatment allocation more accurately than would be expected by chance (60–66% accuracy; all p-values ⩽ 0.004). Guesses did not become more accurate between 6 and 12 weeks and were not predicted by adverse events, though event documentation was poor. Treatment guess had a substantial and statistically significant effect on outcome (Children’s Depression Rating Scale-Revised change mean difference 9.12 [4.69; 13.55], β = 0.334, p < 0.001), but actual treatment arm did not (1.53 [−2.83; 5.89], β = 0.056, p = 0.489). Removing guess from the analysis increased the apparent effect of treatment arm, making it almost statistically significant at the conventional alpha-level of 0.05 ( p = 0.06). Conclusions: For Treatment for Adolescents with Depression Study, treatment guesses strongly predicted outcomes and may have led to the exaggeration of drug effectiveness in the absence of actual effects. The integrity of double-blinding in trials should be routinely assessed and reported.
Clinical benefits and bioequivalence of vortioxetine oral drop solution versus oral tablets
Authors: Fagiolini Andrea , Adair Michael , Buchberg Petersen Kamilla , Areberg Johan , Christensen Michael Cronquist 
Published: December 2023

Background: Vortioxetine is efficacious and well tolerated in patients with major depressive disorder (MDD) and is available as an immediate-release tablet and oral drop solution. The oral drop solution may offer clinical benefits versus a tablet, such as the reduced risk of nausea, personalised dosing and ease of administration. Aims: To investigate the bioequivalence of vortioxetine 20 mg/mL oral drop solution versus a 20 mg immediate-release tablet. Methods: Healthy adults were randomised 1:1 to receive vortioxetine 20 mg oral drop solution or immediate-release 20 mg tablet after fasting on days 1 and 29 in an open-label, single-centre, single-dose crossover study. The area under the plasma concentration–time curve from 0 to 72 h (AUC0–72h) and maximum plasma concentration ( Cmax) were analysed. Bioequivalence was concluded if the 90% CI for the oral drop solution-to-immediate-release tablet ratio for AUC0–72h and Cmax were contained within a range of 0.80−1.25. Results: Vortioxetine oral drop solution was bioequivalent to the tablet ( n = 26; estimated AUC0–72h ratio 1.06 (90% CI: 1.03–1.10); Cmax ratio 1.01 (90% CI: 0.97–1.05)). A similar proportion of participants reported adverse events in each study arm but more headache events (7 vs 1) were reported with the oral drop solution versus tablet. The most common adverse event was nausea (16–23% of participants; all mild intensity). Conclusions: Vortioxetine oral drop solution is bioequivalent to immediate-release tablets. Oral drop solution provides an alternative to tablets and facilitates clinical benefit through individualised treatment, including gradual dose up-titration, for patients with MDD.
Dose of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding in older adults
Authors: Li Yu-Hsien , Hang Liang-Wen , Muo Chih-Hsin , Chen Sheng-Jen , Chen Pei-Chun 
Published: December 2023

Background: Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of upper gastrointestinal bleeding (UGIB) in older patients but little is known about the risk associated with individual SSRI drugs and doses. Aims: To quantify the risk of UGIB in relation to individual SSRI use in older adults. Methods: We conducted a nested case–control study within a cohort of 9565 patients aged ⩾65 years prescribed SSRIs from 2000 to 2013 using claims data of universal health insurance in Taiwan. Incident cases of UGIB during the follow-up period were identified and matched with three control subjects. Conditional logistic regression was used to estimate the odds ratio (OR) of UGIB associated with individual SSRI use and cumulative dose. Results: UGIB risk increased with the increasing cumulative doses of SSRIs (adjusted OR: 1.28, 95% confidence interval (CI): 1.02–1.62 for the highest vs. the lowest tertile). Compared with users of other SSRIs, fluoxetine users were at an increased risk of UGIB (adjusted OR: 1.25, 95% CI: 1.03–1.50) with a dose–response manner, whereas paroxetine users had 29% decreased odds (95% CI: 0.56–0.91). The increased risk was only observed among current fluoxetine users. Conclusions: Fluoxetine therapy was associated with an increased risk of UGIB in a dose–response manner among older adults.
Expert patients leading activities on social justice: towards patient-centered education
Authors: Feijoo-Cid Maria , Arreciado Marañón Antonia , Fernández-Cano María Isabel , García-Sierra Rosa María 
Published: December 2023

Background Social justice is recognized by reputable international organizations as a professional nursing value. However, there are serious doubts as to whether it is embodied in Catalan nursing education. Objectives To explore what nursing students take away from two teaching activities led by expert patients (one presentation and three expert patient illness narratives) on the topics of social justice, patient rights, and person-centered care. Research design Qualitative study using a content analysis approach. The research plan included (1) think-pair-share activities (additional faculty-assisted presentation and three faculty-assisted, semi-structured scripted narratives); (2) paired reflections; (3) focus groups; and (4) content analysis of paired reflections and focus groups. Participants and research context Fourth-year nursing degree students at the Autonomous University of Barcelona (UAB), Spain. Convenience sampling was used. Ethical considerations The UAB Research Ethics Committee did not deem it necessary to apply any specific measures. We fully explained to patients that they could decide what medical information they would share with the students that was relevant to their learning, and we provided students with guidelines about patient confidentiality, dignity, and respect. Findings/results The students engaged in reflection about their education (recognizing that it had been centered on the professional and not the patient) and their relationship with the patient, in which they reproduced low-involvement patient care by modeling behaviors of their nurse educator. Moreover, they valued a person-centered care model with an emphasis on the emotional part but left out decision-making as an individual right of people. Conclusions The think-pair-share activities were useful to spark self-reflection among students, who identified aspects to change in their own practice, and reflected about their own education process, both of which promote change.
Virtual 3D Simulation Technology for Interprofessional Team Training
Authors: Rash Isabelle , Shi Kevin , Sussel Robyn , Smith Richard , Thompson Spencer , Cai Edward , Nguyen Tu Dat , Cheng Julia , Gong Wenyi , Farahmand Sahar , Mehrnoush Vahid , Hosseinzadeh Shahriar , Qayumi Karim 
Published: December 2023

Background In the hospital, interprofessional team members must work collaboratively. That creates a gap in medical practice, particularly in a hectic emergency that may lead to medical errors, with associated ethical, legal, and financial consequences. Mannequin-based simulation can be a solution to bridge this gap in team training. While mannequin-based simulations are effective as a synchronous method, they are expensive, time and space-bound, use hospital resources, and require the whole team to be present. Objective To develop a prototype of a 3D virtual simulation emergency room (ER) environment for interprofessional team training. And to assess the usability of the prototype in a simulation environment for team training using a clinical scenario. Methods Tools and technologies used for this prototype included the Unity platform, C# programming language, and Photon Voice 2. With 3DS Max, we modified and created 3d assets in the ER simulation room. Adobe XD was used to create interactive prototype iterations. Clinical cases were developed with simple algorithms to prove the concepts. We used complex algorithms with Artificial Intelligence and Machine Learning capabilities for the final product. We conducted two usability tests (n = 10, n = 9) using a think-aloud method, a semi-structured follow-up interview, and a survey. Results A prototype was built to achieve asynchronous team training with easy user access from anywhere in the world. The prototype, which includes voice communication and control of the avatars by players from a distance, supported the usability of the technology for asynchronous team training in health education. Conclusions CyberPatientER can be used as an additional tool to support team training and communication skills in the health education and healthcare environment.
Emotions and Narrative Reappraisal Strategies of Users of Breast Cancer Screening: Reconstructing the Past, Passing Through the Present, and Predicting Emotions
Authors: Martino Maria Luisa , Lemmo Daniela , Donizzetti Anna Rosa , Bianchi Marcella , Freda Maria Francesca , Caso Daniela 
Published: December 2023

Emotional forecasting, meaning how a person anticipates feeling as a consequence of their choices, drives healthcare decision-making. Research, however, suggests that people often do not fully anticipate or otherwise grasp the future emotional impacts of their decisions. Emotional reappraisal strategies, such as putting emotions into words and sharing emotions with others, may mitigate potential undesirable effects of emotions on decision-making. The use of such strategies is important for consequential decisions, such as obtaining timely mammography screening for breast cancer, whereby earlier diagnosis may impact the success of treatment. In this study, we explored the use of emotional reappraisal strategies for decision-making regarding breast cancer screening attendance among women aged 50–69 years. Data were collected through semi-structured interviews following mammography with a reflexive thematic methodological approach employed for analysis. Results shed light on how participants’ emotional response narratives were reconstructed before the mammography, felt during the mammography, and forecasted while awaiting the results. Future research should consider how individuals experience and manage their emotions as they access breast screening services.
Narrative Medicine in Hospice and Palliative Care: A Longitudinal Fellowship Curriculum Pilot
Authors: Paul Trisha K. , Aglio Taylor , Dalgo Austin , Kaye Erica C. 
Published: December 2023

Introduction Growing evidence suggests that clinician exposure to narrative medicine (NM) may help bolster resilience and mitigate burnout. The value of formal longitudinal training in NM for hospice and palliative medicine (HPM) trainees remains understudied. Methods A 1-year longitudinal NM curriculum for HPM fellows was pilot-tested for feasibility, acceptability, and exploratory impact. Six monthly 45-minute sessions included reading literature, reflective writing, and sharing creative work. Quantitative and qualitative data were collected through a pre-intervention survey and post-intervention survey administered immediately upon completion of the curriculum. Longitudinal impact was assessed with a post-intervention survey administered three months after completion of the curriculum. Results All HPM fellows (n = 6) attended at least 5/6 sessions during the 1-year pilot, suggesting intervention feasibility. Participant engagement and self-reported comfort with NM exercises supported intervention acceptability. Post-intervention, participants described the positive influence of NM practice on their clinical practice and stated an intention to integrate NM skills in their future HPM careers. Three months following the intervention, participants had a sustained increase in their comfort level with NM. All participants felt that the NM sessions had been relevant to their life as HPM fellows and anticipated using NM moving forward in their practice of HPM. Discussion This novel NM curriculum was feasible and acceptable to implement in a 1-year HPM fellowship. Longitudinal impact showed sustained increase in trainee comfort and interest in using NM in their future clinical practice.