bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep-disordered breathing in heart failure
Authors: Jackson Gregory R. , Durland Justin , Hoyland Frank 
Published: February 2024

Purpose of review
This review addresses the evolving intersection of sleep-disordered breathing (SDB) and heart failure, a topic of increasing clinical significance due to the high prevalence of SDB in heart failure patients and its impact on morbidity and mortality. It reflects recent advancements in diagnostic methodologies and therapeutic strategies. It emphasizes the need for heightened awareness among healthcare providers about the complex relationship between SDB and various forms of heart failure.

Recent findings
Recent studies underscore the high incidence of SDB in heart failure patients, varying with the cause of heart failure. Emerging diagnostic tools, including home sleep tests and advanced inpatient screening methods, have improved the early detection and accurate diagnosis of SDB. Novel treatment modalities, like hypoglossal and phrenic nerve stimulation, are promising, especially where conventional therapies are inadequate. The review also discusses the complexities of managing SDB in the context of different heart failure subtypes.

Summary
Findings from recent literature suggest that improved screening, diagnosis, and innovative treatment of SDB in heart failure patients can reduce morbidity, mortality, and healthcare costs. This review emphasizes the need for personalized treatment approaches tailored to individual patient profiles, highlighting the potential of new technologies and multidisciplinary strategies in clinical practice.
Oleic acid-PPARγ-FABP4 loop fuels cholangiocarcinoma colonization in lymph node metastases microenvironment
Authors: Zhang Honghua , Zhu Ke , Zhang Rui , Guo Yabin , Wang Jin , Liu Chaoqun , Lu Xinjun , Zhou Ziyu , Wu Wenrui , Zhang Fapeng , Song Zhixiao , Lin Shusheng , Yang Caini , Li Xiuxian , Liu Yang , Tang Qibin , Yu Xianhuan , Xu Leibo , Liu Chao 
Published: February 2024

Background and Aims:
Lymph node metastasis is a significant risk factor for patients with cholangiocarcinoma, but the mechanisms underlying cholangiocarcinoma colonization in the lymph node microenvironment remain unclear. We aimed to determine whether metabolic reprogramming fueled the adaptation and remodeling of cholangiocarcinoma cells to the lymph node microenvironment.

Approach and Results:
Here, we applied single-cell RNA sequencing of primary tumor lesions and paired lymph node metastases from patients with cholangiocarcinoma and revealed significantly reduced intertumor heterogeneity and syntropic lipid metabolic reprogramming of cholangiocarcinoma after metastasis to lymph nodes, which was verified by pan-cancer single-cell RNA sequencing analysis, highlighting the essential role of lipid metabolism in tumor colonization in lymph nodes. Metabolomics and in vivo CRISPR/Cas9 screening identified PPARγ as a crucial regulator in fueling cholangiocarcinoma colonization in lymph nodes through the oleic acid-PPARγ-fatty acid–binding protein 4 positive feedback loop by upregulating fatty acid uptake and oxidation. Patient-derived organoids and animal models have demonstrated that blocking this loop impairs cholangiocarcinoma proliferation and colonization in the lymph node microenvironment and is superior to systemic inhibition of fatty acid oxidation. PPARγ-regulated fatty acid metabolic reprogramming in cholangiocarcinoma also contributes to the immune-suppressive niche in lymph node metastases by producing kynurenine and was found to be associated with tumor relapse, immune-suppressive lymph node microenvironment, and poor immune checkpoint blockade response.

Conclusions:
Our results reveal the role of the oleic acid-PPARγ-fatty acid–binding protein 4 loop in fueling cholangiocarcinoma colonization in lymph nodes and demonstrate that PPARγ-regulated lipid metabolic reprogramming is a promising therapeutic target for relieving cholangiocarcinoma lymph node metastasis burden and reducing further progression.
Incidence and characteristics of neovascular age-related macular degeneration with over a 12-month remission after three monthly aflibercept administration: 60 months results of a pro re nata regimen.
Authors: Kikushima Wataru , Sakurada Yoichi , Fukuda Yoshiko , Matsubara Mio , Yoneyama Seigo , Shijo Taiyo , Sugiyama Atsushi , Kotoda Yumi , Kashiwagi Kenji 
Published: February 2024

Abstract

Purpose:
To investigate the characteristics of patients with over a 12-month remission after three monthly intravitreal aflibercept injections (IVA) followed by a pro re nata regimen for exudative age-related macular degeneration (AMD).

Methods:
One-hundred and forty-four eyes with exudative AMD were included. All patients received three monthly IVA as a loading dose, followed by an as-needed regimen for 60 months. Patients were classified into the remission and recurrence groups depending on the presence or absence of a 12-month remission. ARMS2 A69S and CFH I62V were genotyped in all cases.

Results:
During the study, 82 eyes (56.9%) showed 12 months or more remission at least once. The cumulative incidence rate of a 12-month remission showed a plateau pattern and converged to 60% (y=-166.26x-2.172+0.6, R2=0.8168). Patients in the remission group were younger than those in the recurrence group (p<0.001) and had less risk allele frequency of the ARMS2 gene than the recurrence group (p<0.001). The longer the remission interval was prolonged, the better visual acuity was achieved at the 60-month visit (p<0.001).

Conclusion:
Fifty-seven percent of patients showed a 12-month remission or more at least once during a 60-month follow-up, suggesting that patients with no reactivation can prolong the treatment interval.
Black and Hispanic Representation Declined After Increased Degree Requirements for Physician Assistants
Authors: Herring Jordan , Brantley Erin , Ritsema Tamara S. , Luo Qian , Straker Howard , Salsberg Ed 
Published: February 2024

Introduction
The physician assistant (PA) profession is one of the least racially and ethnically diverse health professions requiring advanced education. New PA graduates are even less diverse than the current PA workforce and less diverse than professions requiring doctoral degrees. Between 1995 and 2020, the percent of all PA graduates that were Black individuals fell from 7% to 3.1%, while Hispanic representation increased from 4.5% to 7.9%.

Methods
Using the federal Integrated Postsecondary Education Data System, we examine the impact of transitions to master’s degrees for PAs on Black and Hispanic representation between 1995 and 2020, using individual universities as the unit of analysis.

Results
After adjusting for state and year effects, PA programs that transitioned from bachelor’s to master’s degrees experienced a 5.3% point decline in Black representation and a 3.8% point decline in Hispanic representation. Relative to the already low proportions of Black and Hispanic graduates in PA programs, these declines are significant.

Discussion
Steps should be taken to ensure that underrepresented populations have greater access to PA education.
Lesbian, Gay, Bisexual, Transgender, Queer, Plus Curriculum in Physician Assistants/Associate Education: A Call to Action
Authors: Lechien Nathan M. , Dempsey Shea A. 
Published: February 2024

Abstract
Healthcare avoidance of the LGBTQIA+ community is growing, in part, due to a knowledge gap in medical learners on LGBTQIA+-related topics. Barriers of including LGBTQIA+ topics in medical education include perceived lack of applicability and preceptor knowledge gaps. Advocating for a weave-like integration approach, topics such as personal biases, hormone replacement therapy, STI prevention, and health inequities should be included. It is imperative that PA educators use this call to action to avoid perpetuating the cultural incompetence of new graduate PAs.
Trends in PubMed-Indexed Research in Matched Urology Applicants: A Cross-Sectional Analysis of the 2017 to 2021 Match Cycles
Authors: Hinojosa-Gonzalez David E. , Kronstedt Shane , Saffati Gal , Corsi Nicholas , Wintner Anton , Zlatev Dimitar , Mayer Wesley A. , Korets Ruslan , Eisner Brian H. 
Published: February 2024

Purpose:
Urology is one of the most competitive specialties for residency matches in the United States. Data reported by the American Urological Association from match cycles spanning 2014 to 2021 reveal a median of 0.34% (0%-3%) of unfilled spots, a median of 1.48 (1.28-1.87) applicants per position, and a median of 75% (63%-87%) match rate. Recent research has shown that program directors value applicants' research highly. We sought to assess the research productivity of matched urology residency applicants, identify trends in research volume over time, and investigate the potential correlation between research output and program ranking.

Materials and Methods:
Doximity Urology program ranking list from the 2017 to 2021 match cycles was sorted by reputation, extracted, and populated using each program's official website resident roster, including name, medical school, postgraduate year, and additional degrees. Rosters were crossed-checked against social media posts from the official accounts. Each identified urology resident was queried in PubMed. Journal ranking was determined through Scimagojr; top-quartile journals were classified as Q1.

Results:
In total 131 of 145 programs were identified, and 1605 matched applicants spanning the 2017 to 2021 match cycles. The mean and median total publications were 2.44 and 1, respectively, and 2.17 and 1 when excluding case reports. 64.2% of applicants had at least one publication, and 42.2% had at least one urological publication. Applicants matching into higher-ranked programs had more research and urological research. Multivariable regression analysis revealed that Q1 research (β 2.38) and urology research (β 2.33) significantly affected rank. Match cycle analysis revealed an increase in total and urology-focused research, whereas regression analysis demonstrated significant increases in total publications (β 0.019) per cycle.

Conclusion:
Overall research, urology-focused research, first authorship, and publication in higher-ranked journals play an essential role in the urology match.
Ankyloglossia, a Contributor to Pelvic Pain: A Case Report
Authors: Guan Jennifer 
Published: February 2024

Background:
Ankyloglossia is a congenital condition of the tongue in which the lingual frenulum is shortened, causing restrictions in the mobility of the tongue. Improper tongue mechanics have an impact on breathing, and impairments can cause a strain on the diaphragm, muscles of the head and neck, as well as the pelvic floor via the connective tissue and fascia. Evidence is largely lacking for the impact ankyloglossia has on pelvic floor function and pain.

Case Description:
The patient is a 31-year-old woman who reported primary dyspareunia, with significant exacerbation of symptoms postpartum. Six months after the physical therapy initial evaluation she was diagnosed with ankyloglossia, with the frenotomy performed 1 month later.

Outcomes:
The connective tissue restrictions, muscular restrictions, and myofascial trigger points were addressed via manual therapy. Her planned home exercise program was focused on down-training and breathing. She was initially improving at a slower rate than patients with similar symptoms and history. The first time she attempted intercourse following the frenotomy, she noticed a marked difference in her dyspareunia symptoms and her ability to relax her pelvic floor voluntarily.

Discussion:
The impact ankyloglossia had on the patient's pelvic floor was missed and her slow progress was attributed solely to other factors. Asking the proper patient history questions and understanding the potential impact that ankyloglossia can have on pelvic floor function can help physical therapists identify an easily missed underlying contributor for pelvic pain.
Diagnosis and management of immune mediated liver injury from checkpoint inhibitors
Authors: Likhitsup Alisa , Fontana Robert J. 
Published: February 2024

Purpose of review
The aim is to summarize the latest data on the incidence, clinical manifestations, and management of immune- mediated liver injury from checkpoint inhibitors (ILICI).

Recent findings
ILICI develops in 10–15% of oncology patients receiving immunotherapy with most having asymptomatic serum aminotransferase and/or alkaline phosphatase elevations. Most grade 1–2 ILICI patients improve with drug discontinuation and/or short-term oral corticosteroids. In contrast, the 2–3% with grade 3/4 hepatotoxicity frequently require oral or intravenous corticosteroids and some are hospitalized to initiate further immunosuppression with mycophenolate mofetil or azathioprine. Liver biopsy is generally reserved for patients with atypical features or those with severe hepatotoxicity who fail to respond to treatment. Up to 3% of ILICI patients with a cholestatic profile have MRI evidence of intra or extrahepatic cholangitis that responds poorly to immunosuppression. Most ILICI patients improve during follow-up and liver-related death is very uncommon (<1%). Up to 30% of rechallenged ILICI patients develop recurrent hepatotoxicity with a shorter latency.

Summary
ILICI is increasingly encountered by gastroenterologists evaluating oncology patients with abnormal liver biochemistries. A stepwise approach to exclude viral hepatitis, alcohol, hepatic metastases, and pancreaticobiliary disease is recommended. The majority of ILICI patients fully recover with ICI discontinuation and short-term corticosteroids or a second line immunosuppressant.
Convergent construct validity of the Brazilian version of the Houghton scale
Authors: Secco Milena Zavatini , Balbi Larissa Lavoura , Pereira Maira Stéfanie de Castro , Santos Costa Wilker , Barros Ana Regina de Souza Bavaresco , Registro Fonseca Marisa de Cássia 
Published: February 2024

Background:
After lower limb amputations, a decrease in gait capacity, even with prostheses, is common and persistent. Functional ability involves multiple constructs; therefore, several outcome measures, such as performance tests or self-report questionnaires, should be used to evaluate people with amputation who use prostheses.

Objective:
To analyze the convergent construct validity of the Brazilian version of the Houghton scale in a sample of lower limb prosthesis users.

Methods:
Volunteers selected were older than 18 years with any level of lower limb amputation and prosthesis use for at least 6 months. In this study, evidence of construct validity of the Houghton scale was established by the Spearman rho correlation with the Brazilian translation of the Prosthetic Limb Users Survey of Mobility and with the Physical Function (PF) and Emotional Well-being subdomains of the Medical Outcomes Study 36-Short Form Health Survey.

Results:
Seventy-one volunteers were recruited for the study. The sample consisted mainly of men (70.4%) with a mean age of 50 ± 12 years. The primary cause of amputation was traumatic (53.5%), and most participants (54.9%) had a transtibial amputation. The Houghton questionnaire correlated strongly with the Brazilian translation of the Prosthetic Limb Users Survey of Mobility questionnaire (rho: 0.74, p < 0.01) and weakly with the PF and Emotional Well-being of the 36-Short Form Health Survey (rho: 0.06 and rho: 0.22, respectively, p > 0.05).

Conclusion:
This study showed evidence of convergent construct validity of the Houghton questionnaire to measure and classify functional use of lower limb prostheses, with great value to clinical practice. Additional work is needed to assess other measurement properties in different samples.
Hemangioma of the Ilium Simulating Bone Metastasis on 18F-PSMA-1007 PET/CT
Authors: Dong Aisheng , Nian Shensheng , Bai Yushu , Zuo Changjing 
Published: February 2024

Abstract
A 64-year-old man was referred for 18F-PSMA-1007 PET/CT scan for initial staging of biopsy-proved prostate adenocarcinoma. 18F-PSMA-1007 PET/CT showed focal intense 18F-PSMA-1007 of the prostate adenocarcinoma and a focal intense activity with SUVmax of 10.5 in the left ilium. The 18F-PSMA-1007–avid iliac bone lesion corresponded to a hemangioma, which was initially detected on pelvic MRI 13 months ago and remained stable in size. This case indicates that hemangioma should be included in the differential diagnosis of PSMA-avid iliac bone lesions.
FDG Uptake Caused by Right Varicocele
Authors: Deng Jia , Sun Yuanyuan , He Renjie , Cai Liang , Chen Yue 
Published: February 2024

Abstract
A 67-year-old man underwent 18F-FDG PET/CT for lung cancer staging. Interestingly, the PET scan revealed strip-shaped FDG uptake in the right inguinal contoured area, which was later confirmed as a right varicocele through ultrasound imaging.
Elevated FAPI Activity in an Adult Brodie Abscess
Authors: Xie Yang , Tang Wenxin , Liu Huipan , Wang Yudi , Chen Yue 
Published: February 2024

Abstract
We report an adult Brodie abscess with elevated activity of 18F-FDG and 68Ga-FAPI (fibroblast activating protein inhibitor), mimicking bone metastasis. Our case illustrates that Brodie abscess should also be contemplated in the differential diagnosis of osteolytic lesions with increased 68Ga-FAPI uptake.
Uptake of 99mTc-DTPA in Bone Metastases From Follicular Thyroid Carcinoma
Authors: Liang Zhiying , Li Wei 
Published: February 2024

Abstract
A 53-year-old man with follicular thyroid carcinoma (FTC) was referred for renal scintigraphy using 99mTc-DTPA to assess the kidney function. Unexpectedly, the images showed an abnormal uptake of radiotracer in the right pelvic region. It corresponded to the site of metastasis in the right ilium revealed on 131I SPECT/CT images. The biopsy pathology of the ilium lesion demonstrated follicular thyroid cancer.
What Do You See? Signature Pedagogy in Continuous Electroencephalography Teaching
Authors: Fernandez Andres , Asoodar Maryam , van Kranen-Mastenbroek Vivianne , Majoie Marian , Balmer Dorene 
Published: February 2024

Purpose:
Electroencephalography (EEG) is commonly used in neurology, but there is variability in how neurologists interpret EEGs, potentially from variability in EEG teaching. Little is known about how EEG teaching is done to prepare neurologists for professional practice.

Methods:
We interviewed a group of EEG experts to characterize their teaching practices around continuous EEG (cEEG). We used signature pedagogy as a framework to analyze and interpret the data.

Results:
We identified pervasive and characteristic forms of cEEG teaching. Teaching is based on apprenticeship, relying on “learning by doing” in the context of real-life clinical practice. There are habitual steps that learners take to anchor teaching, which typically occurs during rounds. There is a common language and core knowledge that trainees need to master early in their training.

Conclusions:
There are pervasive characteristic forms of cEEG teaching. These findings can help facilitate instructional design and implementation of complementary or enhanced cEEG teaching practices.
Safety of Same-Day Discharge after Bariatric Surgery: Retrospective 6-Year North American Analysis
Authors: Bharani Tina , Tavakkoli Ali , Tsai Thomas C , Robinson Malcolm K , Sheu Eric G 
Published: February 2024

BACKGROUND:
With increasing implementation of Enhanced Recovery After Surgery protocols and rising demand for inpatient hospital beds accentuated by COVID-19, there has been interest in same-day discharge (SDD) for bariatric surgery. The aim of this study was to determine the national trends, safety profile, and risk factors for complications of SDD for minimally invasive bariatric surgery.

STUDY DESIGN:
We analyzed the MBSAQIP database from 2016 to 2021 to characterize trends in SDD for minimally invasive bariatric operation. Multivariate logistic regression was performed on preoperative patient characteristics predictive of increased complications associated with SDD. A comparative analysis of postoperative outcomes within 30 days was performed for SDD and admission after 1:1 nearest neighbor propensity score matching for patient demographics and preoperative comorbidities.

RESULTS:
SDD increased from 2.4% in 2016 to 7.4% in 2021. Major preoperative factors associated with increased complications for SDD included Black race, history of MI, renal insufficiency, deep vein thrombosis, and smoking. SDD for Roux-en-Y gastric bypass had 72% increased risk of postoperative complications compared with sleeve gastrectomy. The overall major complications were lower in SDD cohort vs admission cohort (odds ratio [OR] 0.62, p < 0.01). However, there was a significant increase in deaths within 30 days (OR 2.11, p = 0.01), cardiac arrest (OR 2.73; p < 0.01), and dehydration requiring treatment (OR 1.33; p < 0.01) in SDD cohort compared with admission cohort.

CONCLUSIONS:
Nationally, there has been a rise in SDD for bariatric operation from 2016 to 2021. Matched analysis demonstrates that SDD is associated with a significantly higher mortality rate. Additionally, the risk of complications with SDD is higher for RYGB compared with sleeve gastrectomy. Therefore, further studies are required to appropriately select patients for whom bariatric surgery can be safely performed as an outpatient.
Extracellular vesicles alter trophoblast function in pregnancies complicated by COVID-19
Authors: Golden Thea N. , Mani Sneha , Linn Rebecca L. , Leite Rita , Trigg Natalie A. , Wilson Annette , Anton Lauren , Mainigi Monica , Conine Colin C. , Kaufman Brett A. , Strauss Jerome F. , Parry Samuel , Simmons Rebecca A. 
Published: February 2024

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and resulting coronavirus disease (COVID-19) causes placental dysfunction, which increases the risk of adverse pregnancy outcomes. While abnormal placental pathology resulting from COVID-19 is common, direct infection of the placenta is rare. This suggests that pathophysiology associated with maternal COVID-19, rather than direct placental infection, is responsible for placental dysfunction and alteration of the placental transcriptome. We hypothesized that maternal circulating extracellular vesicles (EVs), altered by COVID-19 during pregnancy, contribute to placental dysfunction. To examine this hypothesis, we characterized maternal circulating EVs from pregnancies complicated by COVID-19 and tested their effects on trophoblast cell physiologyin vitro. We found that the gestational timing of COVID-19 is a major determinant of circulating EV function and cargo.In vitrotrophoblast exposure to EVs isolated from patients with an active infection at the time of delivery, but not EVs isolated from Controls, altered key trophoblast functions including hormone production and invasion. Thus, circulating EVs from participants with an active infection, both symptomatic and asymptomatic cases, can disrupt vital trophoblast functions. EV cargo differed between participants with COVID-19 and Controls, which may contribute to the disruption of the placental transcriptome and morphology. Our findings show that COVID-19 can have effects throughout pregnancy on circulating EVs and circulating EVs are likely to participate in placental dysfunction induced by COVID-19.