bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional interventions in treating menopause-related sleep disturbances: a systematic review
Authors: Polasek Dominik , Santhi Nayantara , Alfonso-Miller Pamela , Walshe Ian H , Haskell-Ramsay Crystal F , Elder Greg J 
Published: September 2023

Abstract

Context
Sleep disturbances are a core symptom of menopause, which refers to the permanent cessation of menstrual periods. Nutritional interventions may alleviate menopause-related sleep disturbances, as studies have shown that certain interventions (eg, tart cherry juice, or tryptophan-rich foods) can improve relevant aspects of sleep.

Objective
The aim of this systematic review was to examine the effect of nutritional interventions for menopause-related sleep disturbances, in order to inform the subsequent development of specific interventional trials and assess their potential as a treatment for menopause-related sleep disturbances.

Data Sources
Published studies in English were located by searching PubMed and PsycArticles databases (until September 15, 2022).

Data Extraction
Following full-text review, a final total of 59 articles were included. The search protocol was performed in accordance with PRISMA guidelines.

Data Analysis
A total of 37 studies reported that a nutritional intervention improved some aspect of sleep, and 22 studies observed no benefit. Most (n = 24) studies recruited postmenopausal women, 18 recruited menopausal women, 3 recruited perimenopausal women, and 14 recruited women from multiple groups. The majority of the studies were of low methodological quality. Due to the heterogeneity of the studies, a narrative synthesis without meta-analysis is reported.

Conclusion
Despite the large heterogeneity in the studies and choice of intervention, the majority of the identified studies reported that a nutritional intervention did benefit sleep, and that it is mainly subjective sleep that is improved. More high-quality, adequately powered, randomized controlled trials of the identified nutritional interventions are necessary.

Systematic Review Registration
PROSPERO registration no. CRD42021262367.
Transition luminosities of Galactic black hole transients with Swift/XRT and NICER/XTI observations
Authors: Wang Sili , Kawai Nobuyuki , Shidatsu Megumi , Matsuoka Yoshiki 
Published: September 2023

AbstractThe X-ray spectral state transitions of Galactic black hole transients (GBHTs) are often linked to the changes in the mass accretion rate. A narrow distribution of transition luminosity in terms of the Eddington ratio has been found in previous studies of GBHTs based on RXTE data (Maccarone, 2003, A&A, 409, 697; Vahdat Motlagh et al., 2019, MNRAS, 485, 2744) and this Eddington ratio at the transition is often used in recent studies with instruments such as Swift/XRT and NICER/XTI, covering soft energies below 1 to 10 keV. However, the X-ray states characterized by spectral parameters may have different definitions depending on the energy ranges adopted in the spectral analysis, leaving the question of whether the distribution of transition luminosity obtained with RXTE remains the same when we use the instruments covering softer energy bands. In this work, we investigated the X-ray state evolutions and the variations of luminosities of eight outbursts of seven GBHTs. We found that the bolometric luminosity of the power-law component was tightly constrained to $\sim\! 1.3\%$ Eddington luminosity at index transition when the photon index starts to decrease towards the hard state, which is consistent with the previous RXTE results (Vahdat Motlagh et al. 2019, MNRAS, 485, 2744; Kalemci et al. 2013, ApJ, 779, 95). Moreover, the tightest clustering was found to be the power-law luminosity right after the start of disk recession, with a mean logarithmic Eddington ratio of −1.84 ± 0.28. In addition, our results suggest that the disk recession starts after the bolometric disk luminosity drops below 1% Eddington luminosity.
Stomatal opening efficiency is controlled by cell wall organization in Arabidopsis thaliana
Authors: Keynia Sedighe , Jaafar Leila , Zhou You , Anderson Charles T , Turner Joseph A 
Published: September 2023

Abstract
Stomatal function in plants is regulated by the nanoscale architecture of the cell wall and turgor pressure, which together control stomatal pore size to facilitate gas exchange and photosynthesis. The mechanical properties of the cell wall and cell geometry are critical determinants of stomatal dynamics. However, the specific biomechanical functions of wall constituents, for example, cellulose and pectins, and their impact on the work required to open or close the stomatal pore are unclear. Here, we use nanoindentation in normal and lateral directions, computational modeling, and microscopic imaging of cells from the model plant Arabidopsis thaliana to investigate the precise influences of wall architecture and turgor pressure on stomatal biomechanics. This approach allows us to quantify and compare the unique anisotropic properties of guard cells with normal composition, lower cellulose content, or alterations in pectin molecular weight. Using these data to calculate the work required to open the stomata reveals that the wild type, with a circumferential-to-longitudinal modulus ratio of 3:1, is the most energy-efficient of those studied. In addition, the tested genotypes displayed similar changes in their pore size despite large differences in wall thickness and biomechanical properties. These findings imply that homeostasis in stomatal function is maintained in the face of varying wall compositions and biomechanics by tuning wall thickness.
Extra-osseous manifestations in chronic recurrent multifocal osteomyelitis: a retrospective study
Authors: Robert Marie , Giolito Anna , Reumaux Heloise , Rossi-Semerano Linda , Guillemin Claire , Biarrotte Louis , Leguevaques Damia , Belot Alexandre , Duquesne Agnès , Frachette Cécile , Laurent Audrey , Desjonquères Marine , Larbre Jean-Paul , Galeotti Caroline , Koné-Paut Isabelle , Dusser Perrine 
Published: September 2023

Abstract

Objectives
Extra-osseous (EO) manifestations are poorly characterized in chronic recurrent multifocal osteomyelitis (CRMO). This study aimed to further define the frequency, characteristics and treatment of EO events in CRMO and whether different phenotypes can be distinguished and benefit from special management.

Methods
This multicentre retrospective study included CRMO patients followed in several paediatric rheumatology departments in France between 2015 and 2022. EO manifestations were defined as skin lesions, gastrointestinal manifestations, arthritis, enthesitis, sacroiliitis, uveitis, vasculitis and fever. At the last visit, the physician defined CRMO as active in the presence of clinical manifestations including both osseous and EO symptoms.

Results
We included 133 patients; 87 (65.4%) were girls and the median age at first symptoms was 9.0 years (interquartile range 7.0–10.0). EO manifestations were described in 90 (67.7%) patients, with a predominance of skin lesions [n = 51/90 (56.7%)], followed by sacroiliitis [n = 38/90 (42.2%)], enthesitis [n = 21/90 (23.3%)], arthritis [n = 14/90 (15.6%)] and gastrointestinal manifestations [n = 6/90 (6.7%)]. The use of non-steroidal anti-inflammatory drugs and bisphosphonates did not differ by the presence or not of EO manifestations. Biologics were taken more frequently by patients with than without EO manifestations (P &lt; 0.001); TNF inhibitors were used in 33 (36.7%) EO-positive patients. Under this treatment, 18 (54.5%) patients achieved complete remission of osseous and EO manifestations. At the last visit, more EO+ than EO− patients were on treatment (P = 0.009), with active disease in 58 (64.4%) patients.

Conclusion
The analysis of EO manifestations in CRMO delineates two groups of patients in terms of severity and treatments used. Our study opens up new pathophysiological leads that may underlie the wide range of CRMO phenotypes.
Pathology-based radiation dose in computed tomography: investigation of the effect of lung lesions on water-equivalent diameter, CTDIVol and SSDE in COVID-19 patients
Authors: Mohammadbeigi Ahmad , Shouraki Jalal Kargar , Ebrahiminik Hojat , Nouri Majid , Bagheri Hamed , Moradi Hamid , Azizi Ahmad , Fadaee Narges , Soltanzadeh Taher , Moghimi Yousef 
Published: September 2023

Abstract
Lung lesions can increase the CT number and affect the water-equivalent diameter (Dw), Dw-based conversion factor (CFw), and Dw-based size-specific dose estimate (SSDEw). We evaluated the effect of COVID-19 lesions and total severity score (TSS) on radiation dose considering the effect of automatic tube current modulation (ATCM) and fixed tube current (FTC). A total of 186 chest CT scans were categorised into five TSS groups, including healthy, minimal, mild, moderate and severe. The effective diameter (Deff), Dw, CFw, Deff-based conversion factor (CFeff), volume computed tomography dose index (CTDIVol), pathological dose impact factor (PDIF) 1 and SSDEw were calculated. TSS was correlated with Dw (r = 0.29, p-value = 0.001), CTDIVol (ATCM) (r = 0.23, p = 0.001) and PDIF (r = − 0.51, p-value = 0.001). $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC) was significantly different among all groups. $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) was greater for moderate (13%) and mild (14%) groups. Increasing TSS increase the Dw and causes a decrease in CFw and $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC), and can increase $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) in some Dw ranges.
Prevalence of central sleep apnea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data
Authors: Graco Marnie , Ruehland Warren R , Schembri Rachel , Churchward Thomas J , Saravanan Krisha , Sheers Nicole L , Berlowitz David J 
Published: September 2023

Abstract

Study Objectives
Over 80% of people with tetraplegia have sleep-disordered breathing (SDB), but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnea (CSA) in tetraplegia and the contributions of central, obstructive, and hypopnea respiratory events to SDB summary indices in tetraplegia.

Methods
Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (Central Apnea Index [CAI] ≥ 5 and more central than obstructive apneas) and Any CSA (CAI ≥ 5) was estimated. Prevalence of sleep-related hypoventilation (SRH) was estimated in a clinical sub-cohort.

Results
Respiratory events were primarily hypopneas (71%), followed by obstructive (23%), central (4%), and mixed apneas (2%). As severity increased, the relative contribution of hypopneas and central apneas decreased, while that of obstructive apneas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. SRH was identified in 26% (26/113) of the clinical sub-cohort.

Conclusions
This is the largest study to characterize SDB in tetraplegia. It provides strong evidence that obstructive sleep apnea is the predominant SDB type; 9–18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4%–8%, significantly lower than previously reported.
Glymphatic system dysfunction in restless legs syndrome: evidenced by diffusion tensor imaging along the perivascular space
Authors: Park Kang Min , Kim Keun Tae , Lee Dong Ah , Motamedi Gholam K , Cho Yong Won 
Published: September 2023

Abstract

Study Objectives
There is growing evidence pointing at glymphatic system dysfunction in diseases with circadian disruption, such as sleep disorders. Lower diffusivity in the direction of perivascular space has been shown in several neurological and sleep-related disorders; however, its role in restless legs syndrome (RLS) is unclear. We hypothesized that similarly, in RLS the diffusivity in glymphatic system is decreased. Here, we aimed to evaluate glymphatic system functionality in patients with RLS, compare it to healthy controls, and analyze the correlation between its function and clinical characteristics.

Methods
Sixty-nine patients with primary RLS and 51 healthy controls were recruited at a tertiary hospital. All participants underwent diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI) using a 3T MRI scanner, and the DTI along the perivascular space (DTI-ALPS) index was calculated using DTI data. We compared the DTI-ALPS index between the patients with RLS and healthy controls. We also conducted the correlation analysis between the DTI-ALPS index and clinical characteristics, including age, age of onset, symptom duration, and RLS severity.

Results
DTI-ALPS index differed significantly between the patients with RLS and healthy controls; the DTI-ALPS index in the patients with RLS was lower than that in the healthy controls (1.48 vs. 0.60, p = 0.008). There was no significant correlation between the DTI-ALPS index and clinical characteristics.

Conclusion
A significantly lower DTI-ALPS index in patients with RLS suggests that the glymphatic system function is impaired in patients with RLS.
Preconditioning Concepts for the Therapeutic Use of Extracellular Vesicles Against Stroke
Authors: Haupt Matteo , Gerner Stefan T , Huttner Hagen B , Doeppner Thorsten R 
Published: September 2023

Abstract
Various preclinical stroke models have demonstrated the neuroprotective effects of extracellular vesicles (EVs) obtained from several types of cells, including neurons, astrocytes, microglia, neuronal progenitor cells, bone marrow stem cells, and mesenchymal stem cells. EVs interfere with key mechanisms in stroke pathophysiology such as cell death, neuroinflammation, autophagy, and angiogenesis. The mode of action and efficacy depend on the specific EV content, including miRNAs, proteins, and lipids, which can be modified through (I) bioengineering methods, (II) choice of source cells, and (III) modification of the source cell environment. Indeed, modifying the environment by preconditioning the EV-secreting cells with oxygen-glucose deprivation or medium modification revealed superior neuroprotective effects in stroke models. Although the concept of preconditioned EVs is relatively novel, it holds promise for the future treatment of ischemic stroke. Here, we give a brief overview about the main mechanisms of EV-induced neuroprotection and discuss the current status of preconditioning concepts for EV-treatment of ischemic stroke.
Neurotrophic keratitis: inflammatory pathogenesis and novel therapies
Authors: Wajnsztajn Denise , Faraj Lana A. , Sanchez-Tabernero Sara , Solomon Abraham 
Published: September 2023

Purpose of review
Neurotrophic keratitis is a rare degenerative disease characterized by decrease or absence of corneal sensation. Neurotrophic keratitis varies from mild forms with mild epitheliopathy to severe manifestations such as corneal ulceration, melting and perforation that can lead to irreversible visual loss. The cause of neurotrophic keratitis comprises a long list of diseases, medications, congenital or genetic conditions as well as trauma. The mechanism of neurotrophic keratitis is complex and multifactorial and its understanding is crucial to better address the treatment strategies. We aimed to review neurotrophic keratitis pathology, mechanisms and management.

Recent findings
Corneal nerves are critical for the homeostasis of a healthy ocular surface. The lack of nerve-derived neuromediators and corneal-released neuropeptides, neuro-trophins and neurotrophic factors in neurotrophic keratitis leads to a decrease in trophic supply to corneal cells in addition to a decrease in afferent signaling to the brain. This results in pathological tear secretion, decreased blinking rate, corneal healing along with ocular surface and corneal inflammation. Lately, nerve growth factor in special gained emphasis as a treatment strategy targeting the disease mechanism rather than its manifestations. Other therapies, including surgical interventions, are in the pipeline of neurotrophic keratitis management. However, there are still no proper therapeutic guidelines and neurotrophic keratitis treatment remains challenging.

Summary
Neurotrophic keratitis may have a devastating outcome and treatment is still challenging. Understanding the disease pathology may assist in the development of new treatment strategies. Prompt disease recognition and immediate intervention are key factors to promote corneal healing and avoid further deterioration.
How Often Do Patients Presenting With Severe Adolescent Idiopathic Scoliosis Have Underlying Hip Dysplasia?
Authors: Taylor Tristen N. , Bridges Callie S. , Duruewuru Anthony T. , Sher Andrew C. , Rosenfeld Scott B. , Smith Brian G. , Kan J. Herman 
Published: September 2023

Introduction:
Adolescent idiopathic scoliosis radiographic screening will often include the hips. The purpose of this study is to evaluate the prevalence of hip dysplasia by lateral center edge angle (LCEA) on scoliosis radiographs in patients presenting with severe range (>45 deg) idiopathic curves.

Methods:
We reviewed 200 consecutive patients (400 hips) with idiopathic scoliosis with major coronal curves ≥45 degrees between October 2009 and October 2022. The presenting scoliosis radiograph PA were reviewed for the following variables: major coronal curve direction, coronal balance, and lateral center edge angles. An LCEA value ≤18 was considered dysplastic. To assess potential measurement variability related to parallax of the scoliosis radiographs, the intermodality intraclass correlation coefficient (ICC) was measured from a subset of 20 hip LCEA values from patients with both scoliosis and pelvis radiographs.

Results:
A total of 200 patients [mean age: 13.6 (1.8) years; Female: 79%] were reviewed. The mean major curve (SD) was 58.6 degrees (11.4 deg). Overall 19% (37/200) patients or 11% (43/400) of hips had hip dysplasia. Of the dysplastic hips, 16% (6/43, P<0.001) were bilateral and 57% (21/43, P=0.04) were right sided. There was no association between dysplastic hip laterality and ipsilateral or contralateral coronal balance (P=0.26) or curve direction (P=0.49). The interobserver ICC for assessment of LCEA on scoliosis radiographs was 0.85, and the intermodality ICC between pelvic and scoliosis radiographs was 0.78.

Conclusion:
Hip dysplasia was present in 19% of patients presenting with large major curves, and many of these patients had right sided hip dysplasia. There was no association between hip dysplasia laterality and the patient’s major curve direction or coronal balance. There was good intermodality reliability (ICC=0.78) between LCEA values in patients who had both scoliosis and pelvis radiographs, and good inter-rater reliability between raters. Radiographic interpretation of adolescent idiopathic scoliosis should focus not only on the description of the curve and ruling out underlying segmentation anomalies but should also include critical assessment of the hips to exclude co-existing hip dysplasia.

Level of Evidence:
Therapeutic study—level IV
Socioeconomic Influence on Cervical Fusion Outcomes
Authors: Touponse Gavin , Theologitis Marinos , Beach Isidora , Rangwalla Taiyeb , Li Guan , Zygourakis Corinna 
Published: September 2023

Study Design:
A retrospective observational study.

Objective:
The aim of this study was to compare postoperative outcomes following cervical fusion based on socioeconomic status (SES) variables including race, education, net worth, and homeownership status.

Summary of Background Data:
Previous studies have demonstrated the effects of patient race and income on outcomes following cervical fusion procedures. However, no study to date has comprehensively examined the impact of multiple SES variables. We hypothesized that race, education, net worth, and homeownership influence important outcomes following cervical fusion.

Materials and Methods:
Optum’s de-identified Clinformatics Data Mart (CDM) database was queried for patients undergoing first-time inpatient cervical fusion from 2003 to 2021. Patient demographics, SES variables, and the Charlson comorbidity index were obtained. Primary outcomes were hospital length of stay and 30-day rates of reoperation, readmission, and postoperative complications. Secondary outcomes included postoperative emergency room visits, discharge status, and total hospital charges.

Results:
A total of 111,914 patients underwent cervical spinal fusion from 2003 to 2021. Multivariate analysis revealed that after controlling for age, sex, and Charlson comorbidity index, Black race was associated with a higher rate of 30-day readmissions [odds ratio (OR): 1.11, 95% CI: 1.03–1.20]. Lower net worth (vs. >$500K) and renting (vs. owning a home) were significantly associated with both higher rates of 30-day readmissions (OR: 1.29, 95% CI: 1.17–1.41; OR: 1.34, 95% CI: 1.22–1.49), and emergency room visits (OR: 1.29, 95% CI: 1.18–1.42; OR: 1.11, 95% CI: 1.00–1.23). Lower net worth (vs. >$500K) was also associated with increased complications (OR: 1.22, 95% CI: 1.14–1.31).

Conclusion:
Socioeconomic variables, including patient race, education, and net worth, influence postoperative metrics in cervical spinal fusion surgery. Future studies should focus on developing and implementing targeted interventions based on patient SES to reduce disparity.
Evaluating Leadership Development Competencies of Clinicians to Build Health Equity in America
Authors: Henry Ellison , Chandler Caroline , Laux Jeff , Noble Cheryl C. , Corbie Giselle , Fernandez Claudia S. P. , Dave Gaurav 
Published: September 2023

Introduction:
To achieve more equitable health, health care must be grounded in an understanding of social determinants of health. Clinicians need hands-on, equity-centered training in interdisciplinary settings where they can further develop leadership skills and apply learnings in real-time. The Clinical Scholars program trained five cohorts of health care professionals in 25 leadership development competencies to contribute toward advancing health equity within the organizations and communities where they work. This study describes the self-reported ratings of three dimensions of competencies within four domains.

Methods:
Data from 169 Fellows were collected at three time-points during the three-year training program using Qualtrics and Research Electronic Data Captrue software. Analysis was conducted in R and included descriptive statistics, fitting a linear mixed-effects model using random intercepts, and paired-sample t tests to assess significance between baseline and endpoint ratings.

Results:
We found improved ratings over time for each of the three competency dimensions (knowledge, self-efficacy, use) and significant differences in ratings from baseline to endpoint, by domain (personal, interpersonal, organizational, community, and systems).

Discussion:
These findings support the effectiveness of an equity-centered leadership development curriculum in training health care professionals to address health challenges in their communities and organizations, thereby furthering the broader goal of achieving more equitable health for all.