bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bupropion and varenicline administration reversed depressive behavior induced by acetamiprid exposure in mice: the role of nAChRs in depression
Authors: Mesripour Azadeh , Soltani Leila , Aliomrani Mehdi 
Published: January 2024

Abstract
Acetamiprid (ACE), is a popular neonicotinoid pesticide, that has a high affinity for mammalian nicotinic acetylcholine receptors (nAChRs). Therefore, ACE might induce depressive effects by perturbing the cholinergic system in mammalian. The aim of this study was to evaluate the effects of ACE exposure on depressive-like behaviors and grip strength (GS) in mice. Also the possible role of nAChR activation in depression was assessed by varenicline, and bupropion. Male Swiss mice (27 ± 2 g) were daily exposed to ACE by gavage (0.1, 1, 5 mg/kg), behavioral tests took place after 3 h, 7 days and 15 days, the subacute ACE (0.1 mg/kg) exposure was assessed after 30 days. Varenicline (0.5 mg/kg) or bupropion (4 mg/kg) were injected intraperitoneally 30 min prior exposure to (1 mg/kg) ACE. The locomotor activity, forced swimming test (FST), and sucrose preference (SP) test were assessed. After a week ACE dose dependently increased the immobility time during FST, and after 15 days’ depressive behavior was observed equally for ACE (0.1–5 mg/kg). The subacute exposure (0.1 mg/kg) significantly increased the immobility time, SP also declined that revealed anhedonia. These behavioral changes showed that ACE can initiate depressive effects. The changes in locomotor activity were not significant. GS significantly reduced following a week of exposure to ACE (1–5 mg/kg) that indicated neurotoxicity. These effects were antagonized by bupropion or varenicline, thus ACE effect on nAChRs was essential in initiating the depressive behavior.
Highlights ACE induced depressive behavior in mice dose dependently ACE exposure reduced mice grip strength ACE neurotoxicity was reversed by bupropion or varenicline nAChRs over activity is involved in ACE neurotoxicity in mice
Exploring workplace barriers faced by breastfeeding mothers who are PAs
Authors: Nourse Lindsay 
Published: January 2024

ABSTRACT

Objectives:
To explore physician associate/assistant (PA) mothers' breastfeeding intention, duration, as well as workplace barriers for breastfeeding among working PA mothers and to determine if specialty has an effect on breastfeeding duration.

Methods:
A cross-sectional online survey was administered to PA mothers who had at least one biological child while a PA student or practicing as a PA. Study participants were recruited through the American Academy of Physician Associates' special interest group, PA Moms.

Results:
The 545 participants reported a breastfeeding goal of 12 months in 76.8% of births. Breastfeeding rates among participants were 96.3% at birth, 83.8% at age 3 months, 78.1% at age 6 months, and 54.8% at age 12 months. Exclusive breastfeeding rates were 77.9% at birth, 75% at age 3 months, and 42.6% at age 6 months. Workplace support from colleagues and support staff was associated with longer exclusive breastfeeding duration and any breastfeeding duration. Adequate time and place for expression of breastmilk and support from supervising or collaborating physicians were associated with longer duration of breastfeeding. Specialty had a statistically significant effect on exclusive breastfeeding duration.

Conclusions:
PA mothers failed to meet their breastfeeding goals, despite high initiation rates. Dedicated time and space to express breastmilk and workplace support may significantly improve PA mothers' breastfeeding duration.
Diversity of PA cohorts during the evolution to an entry-level master's degree
Authors: Young Peter A. , Griffith Cynthia F. , Ticknor Iesha L. , McElroy-Brooklyn Jameka , DiRuggiero Douglas , Bae Gordon H. , Froman Richard , Kayingo Gerald 
Published: January 2024

ABSTRACT

Objective:
This study evaluated the racial and ethnic diversity of physician associate/assistant (PA) graduating cohorts during the profession's transition from a standard undergraduate degree to an entry-level master's degree.

Methods:
Using all existing program reports from the Physician Assistant Education Association (1985-2019), we explored potential associations between changes in tuition, degree types offered, and racial/ethnic makeup of graduating cohorts.

Results:
We observed a strong negative association between Black students and graduates versus increasing tuition and the rise of master's level programs.

Conclusions:
More equitable opportunities for joining the PA profession may be needed.
Reporting of Facet Joint Inflammation in Lumbar Spine MRI Studies in Patients With low Back Pain
Authors: Acosta Julbe José I. , Gottreich Julia R. , Ermann Joerg , Isaac Zacharia , DeFilipp Miriam , Andrew Michael N. , Chang Yuchiao , Zampini Jay M. , Katz Jeffrey N. , Mandell Jacob C. 
Published: January 2024

Study design:Retrospective.Objective:We aimed to assess the frequency of facet joint inflammatory features noted in routine radiology reports of lumbar spine Magnetic Resonance Imaging (MRI) studies among patients with chronic low back pain.Summary of Background Data:Facet joint arthropathy is one of the most common causes of chronic low back pain. It may encompass various inflammatory imaging characteristics, such as facet joint effusion, bone marrow edema, and soft tissue edema. The extent to which radiology reports mention inflammatory features of the lumbar facet joints and the accuracy of these reports has not been investigated.Methods:We performed a chart review on 49 subjects with previous facet-related interventions (i.e., medial branch blocks or intra-articular facet joint injection) and MRI available in the medical record. One senior musculoskeletal radiologist and a musculoskeletal radiology fellow graded the inflammatory features using a published facet joint inflammation grading system (gold standard). We identified the inflammatory markers mentioned in the radiology reports and calculated the sensitivity and positive predictive value of the radiology reports compared with gold standard readings.Results:Compared with the gold standard, the sensitivity of radiology reports for facet joint effusion, bone marrow, and soft tissue edema ranged from 6% to 22%, and the positive predictive value ranged from 25% to 100%. L4/5 had the highest number of cases with inflammatory features noted on the reports.Conclusion:Inflammatory findings, such as facet joint effusion, bone marrow edema, and soft tissue edema, are not commonly identified in radiology reports. Further investigations are needed to determine the clinical importance of MRI-detected lumbar facet joint inflammatory features as a potential mechanism of nociception and as a predictor of outcomes following injections or other therapies.
Evaluating Prognostic Bias of Critical Illness Severity Scores Based on Age, Sex, and Primary Language in the United States: A Retrospective Multicenter Study
Authors: Liu Xiaoli , Shen Max , Lie Margaret , Zhang Zhongheng , Liu Chao , Li Deyu , Mark Roger G. , Zhang Zhengbo , Celi Leo Anthony 
Published: January 2024

OBJECTIVES:
Although illness severity scoring systems are widely used to support clinical decision-making and assess ICU performance, their potential bias across different age, sex, and primary language groups has not been well-studied.

DESIGN, SETTING, AND PATIENTS:
We aimed to identify potential bias of Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) IVa scores via large ICU databases.

SETTING/PATIENTS:
This multicenter, retrospective study was conducted using data from the Medical Information Mart for Intensive Care (MIMIC) and eICU Collaborative Research Database. SOFA and APACHE IVa scores were obtained from ICU admission. Hospital mortality was the primary outcome. Discrimination (area under receiver operating characteristic [AUROC] curve) and calibration (standardized mortality ratio [SMR]) were assessed for all subgroups.

INTERVENTIONS:
Not applicable.

MEASUREMENTS AND MAIN RESULTS:
A total of 196,310 patient encounters were studied. Discrimination for both scores was worse in older patients compared with younger patients and female patients rather than male patients. In MIMIC, discrimination of SOFA in non-English primary language speakers patients was worse than that of English speakers (AUROC 0.726 vs. 0.783, p < 0.0001). Evaluating calibration via SMR showed statistically significant underestimations of mortality when compared with overall cohort in the oldest patients for both SOFA and APACHE IVa, female patients (1.09) for SOFA, and non-English primary language patients (1.38) for SOFA in MIMIC.

CONCLUSIONS:
Differences in discrimination and calibration of two scores across varying age, sex, and primary language groups suggest illness severity scores are prone to bias in mortality predictions. Caution must be taken when using them for quality benchmarking and decision-making among diverse real-world populations.
Antibiotic resistance in Helicobacter pylori among children and adolescents in East Asia: A systematic review and meta-analysis
Authors: Zhou Yuhang , Zhang Yanli , Du Shiyu 
Published: January 2024

Abstract

Background:
In East Asia, Helicobacter pylori (H. pylori) infection and related diseases are common, primarily during childhood and adolescence. The rates of primary antibiotic resistance in H. pylori among East Asian children and adolescents have not been extensively explored; few relevant systematic reviews or meta-analyses have been conducted. We evaluated the rates of antibiotic resistance in H. pylori among East Asian children and adolescents, with the goal of facilitating individualized treatment recommendations.

Methods:
We searched PubMed, Embase, and the Cochrane Library for studies in any language published up to February 2023 that explored antibiotic resistance in H. pylori among East Asian children and adolescents. We used MeSH and non-MeSH terms related to the topic, including terms related to children, adolescents, antibiotic resistance, H. pylori, and nations or regions. Additionally, we reviewed the reference lists of relevant articles. Studies that matched our strict predefined eligibility criteria were included in the screening process. Using established assessment methods, we evaluated the quality of the included studies.

Results:
We identified 15 observational studies involving 4831 H. pylori isolates, all published between 2001 and 2022. There was substantial primary antibiotic resistance in H. pylori isolates from East Asian children and adolescents. The rates of primary resistance were 51% (95% confidence interval [CI]: 40–62%) for metronidazole; 37% (95% CI: 20–53%) for clarithromycin; 19% (95% CI: 11–28%) for levofloxacin; and less than 3% each for amoxicillin, tetracycline, and furazolidone. Subgroup analysis revealed a prominent increase in metronidazole resistance over time. Clarithromycin and levofloxacin resistance rates fluctuated between 2005 and 2015, then remained stable; other antibiotic resistance rates were generally stable. Metronidazole, clarithromycin, and levofloxacin resistance rates were significantly higher in the Chinese mainland than in other East Asian regions. The rates of dual and multiple antibiotic resistance were 28% (95% CI: 21–36%) and 10% (95% CI: 7–14%), highlighting the potential for diverse resistance patterns.

Conclusions:

H. pylori isolates from East Asian children and adolescents exhibit high levels of metronidazole and clarithromycin resistance, particularly in the Chinese mainland. The non-negligible rates of dual and multiple resistance highlight the complexity of this problem.

Registration:
PROSPERO, No. CRD42023402510.
Tofacitinib Is Associated With Increased Risk of Postoperative Venous Thromboembolism in Patients With Ulcerative Colitis
Authors: Russell Tara A. , Banerjee Sudeep , Lipman Jeremy , Holubar Stefan D. , Hull Tracy , Steele Scott R. , Lightner Amy L. 
Published: January 2024

BACKGROUND:
In 2019, the Food and Drug Administration issued a black box warning for increased risk of venous thromboembolism in rheumatoid arthritis patients exposed to tofacitinib. There is limited data regarding the postoperative venous thromboembolism risk in ulcerative colitis patients exposed to tofacitinib.

OBJECTIVE:
To assess if preoperative exposure to tofacitinib is associated with increased odds of postoperative venous thromboembolism.

DESIGN:
Retrospective review.

SETTINGS:
Tertiary academic medical center.

PATIENTS:
Consecutive patients exposed to tofacitinib within 4 weeks prior to total abdominal colectomy or total proctocolectomy, with or without ileostomy, from 2014 to 2021, matched 1:2 for tofacitinib exposure or no exposure.

INTERVENTION:
Tofacitinib exposure versus no exposure.

MAIN OUTCOME MEASURES:
Ninety-day postoperative venous thromboembolism rate.

RESULTS:
Forty-two patients with tofacitinib exposure and 84 case-matched patients without tofacitinib exposure underwent surgery for medically-refractory ulcerative colitis. Nine (22.0%) tofacitinib exposed patients, and 7 (8.5%) unexposed patients, were diagnosed with a venous thromboembolism within 90-days of surgery. In univariate logistic regression, patients exposed to tofacitinib had 3.01 times increased odds of developing a venous thromboembolism within 90-days following surgery compared to unexposed (p = 0.04, 95% CI 1.03-8.79). Other venous thromboembolism risk factors were not significantly associated with venous thromboembolisms. Venous thromboembolisms in both groups were most commonly portomesenteric vein thromboses (66.7% in tofacitinib exposed and 42.9% in unexposed) and were diagnosed at a mean of 23.2 days (range, 3-90 days) postoperatively in the tofacitinib exposed and 7.9 days (1 to 19 days) in the unexposed groups, respectively. There were no statistically significant differences in location or timing between the 2 groups.

LIMITATIONS:
Retrospective nature of the study and associated biases. Reliance on clinically diagnosed venous thromboembolisms may underreport true incidence rate.

CONCLUSIONS:
Tofacitinib exposure prior to surgery for medically-refractory ulcerative colitis is associated with 3 times increased odds of venous thromboembolism as compared to patients without tofacitinib exposure. See Video Abstract.
Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study
Authors: Astudillo Yaritzy , Kibrom Sara , Pereira Tanya , Solomon Sonia , Krishnan Sankaran , Samsonov Dmitry 
Published: January 2024

Objective:
Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents.

Methods:
Adolescents, aged 12–18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child.

Results:
Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative (P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) (P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively.

Conclusion:
Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.
Salt sensitivity risk derived from nocturnal dipping and 24-h heart rate predicts long-term blood pressure reduction following renal denervation
Authors: Sesa-Ashton Gianni , Carnagarin Revathy , Nolde Janis M. , Muente Ida , Lee Rebecca , Macefield Vaughan G. , Dawood Tye , Sata Yusuke , Lambert Elisabeth A. , Lambert Gavin W. , Walton Antony , Kiuchi Marcio G. , Esler Murray D. , Schlaich Markus P. 
Published: January 2024

Background:
Renal denervation (RDN) has been consistently shown in recent sham-controlled clinical trials to reduce blood pressure (BP). Salt sensitivity is a critical factor in hypertension pathogenesis, but cumbersome to assess by gold-standard methodology. Twenty-four-hour average heart rate (HR) and mean arterial pressure (MAP) dipping, taken by ambulatory blood pressure monitoring (ABPM), stratifies patients into high, moderate, and low salt sensitivity index (SSI) risk categories.

Objectives:
We aimed to assess whether ABPM-derived SSI risk could predict the systolic blood pressure reduction at long-term follow-up in a real-world RDN patient cohort.

Methods:
Sixty participants had repeat ABPM as part of a renal denervation long-term follow-up. Average time since RDN was 8.9 ± 1.2 years. Based on baseline ABPM, participants were stratified into low (HR < 70 bpm and MAP dipping > 10%), moderate (HR ≥70 bpm or MAP dipping ≤ 10%), and high (HR ≥ 70 bpm and MAP dipping ≤ 10%) SSI risk groups, respectively.

Results:
One-way ANOVA indicated a significant treatment effect (P = 0.03) between low (n = 15), moderate (n = 35), and high (n = 10) SSI risk with systolic BP reduction of 9.6 ± 3.7 mmHg, 8.4 ± 3.5 mmHg, and 28.2 ± 9.6 mmHg, respectively. Baseline BP was not significantly different between SSI Risk groups (P = 0.18). High SSI risk independently correlated with systolic BP reduction (P = 0.02).

Conclusions:
Our investigation indicates that SSI risk may be a simple and accessible measure for predicting the BP response to RDN. However, the influence of pharmacological therapy on these participants is an important extraneous variable requiring testing in prospective or drug naive RDN cohorts.
Inverse association between obesity and aortic pressure augmentation is attenuated in women: the Wakuya study
Authors: Tagawa Kaname , Tsuru Yusuke , Yokoi Katsumi , Aonuma Takanori , Hashimoto Junichiro 
Published: January 2024

Objective:
Pressure wave reflection predicts cardiovascular events in the general population. Obesity is negatively associated with pressure wave reflection. Muscular arterial diameter (responsible for pressure wave reflection) increases with obesity, and obesity-dependent dilation of muscular arteries is attenuated in women compared with men. We investigated the sex differences in the cross-sectional relationship between obesity and pressure wave reflection in a general population cohort.

Methods:
Tonometric pressure waveforms were recorded in 928 adults (mean age, 56 ± 10 years) to estimate the aortic augmentation index. The BMI was calculated using height and body weight, and waist circumference was recorded at the umbilical level.

Results:
Aortic augmentation index was significantly higher in women than in men. Indices of obesity (BMI and waist circumference) were negatively correlated with the aortic augmentation index in both men and women, even after adjusting for mean arterial pressure (both P < 0.001). Sex and BMI had no synergistic effect on the aortic augmentation index. However, when waist circumference was substituted for BMI, sex and waist circumference had a reciprocal influence on decreasing the aortic augmentation index independent of age, mean arterial pressure, diabetes, and hyperlipidemia (interaction, P = 0.045).

Conclusion:
The negative correlation between overweight/obesity and aortic pressure augmentation from peripheral wave reflection is inhibited in women more than in men. Sex differences in aortic pressure augmentation are greater in individuals with central (abdominal) obesity than in those with general obesity.
Comparison of cuff inflation and cuff deflation brachial sphygmomanometry with intra-arterial blood pressure as reference
Authors: Celler Branko G. , Yong Andy , Rubenis Imants , Butlin Mark , Argha Ahmadreza , Rehan Rajan , Avolio Alberto 
Published: January 2024

Conventional sphygmomanometry with cuff deflation is used to calibrate all noninvasive BP (NIBP) instruments and the International Standard makes no mention of calibrating methods specifically for NIBP instruments, which estimate systolic and diastolic pressure during cuff inflation rather than cuff deflation. There is however increasing interest in inflation-based NIBP (iNIBP) instruments on the basis of shorter measurement time, reduction in maximal inflation pressure and improvement in patient comfort and outcomes.
However, we have previously demonstrated that SBP estimates based on the occurrence of the first K1 Korotkoff sounds during cuff deflation can underestimate intra-arterial SBP (IA-SBP) by an average of 14 ± 10 mmHg.
In this study, we compare the dynamics of intra-arterial blood pressure (IABP) measurements with sequential measurement of Korotkoff sounds during both cuff inflation and cuff deflation in the same individual. In 40 individuals aged 64.1 ± 9.6 years (range 36–86 years), the overall dynamic responses below the cuff were similar, but the underestimation error was significantly larger during inflation than deflation, increasing from 14 ± 10 to 19 ± 12 mmHg (P < 0.0001).
No statistical models were found which could compensate for this error as were found for cuff deflation. The statistically significant BP differences between inflation and deflation protocols reported in this study suggest different behaviour of the arterial and venous vasculature between arterial opening and closing which warrant further investigation, particularly for iNIBP devices reporting estimates during cuff inflation. In addition, measuring Korotkoff sounds during cuff inflation represents significant technical difficulties because of increasing pump motor noise.
Enhancing inverted internal limiting membrane flap stability in macular hole retinal detachment by the “viscoelastic agent pool” technique
Authors: Fan Yuanyuan , Chen Lifeng , Wu Mengai , Lin Li , Li Haidong , Zheng Bin Bin 
Published: January 2024

Purpose:
To evaluate the surgical anatomical and functional results of “viscoelastic agent pool” technique-assisted stability of inverted internal limiting membrane (ILM) flap in macular hole retinal detachment (MHRD).

Methods:
The innovative surgical technique was carried out on 10 patients with MHRD. The primary outcomes included best corrected visual acuity (BCVA) after surgery, rate of closure of MH, retinal reattachment, and occurrence of complications.

Results:
The mean age of the individuals was 67.70±8.75 (range, 55–84) years; mean axial length, 29.34±1.53 (range, 27.10–30.93) mm; mean corrected MH diameter, 685.30± 345.65 (range, 172–1325) μm; and average follow-up period, 6.01±1.71 (range, 3.10–8.4) months. In six eyes (60%), the postoperative BCVA showed improvement. All patients had MH closure, and the retinal reattachment rate was 100%. No postoperative complications were noted.

Conclusions:
The "Viscoelastic agent pool" technique, an innovative surgical approach designed to enhance the stability of the ILM flap, serves as an effective adjunctive procedure for the inverted ILM flap technique. It presents a viable option for patients with MHRD.