bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nationwide cardiovascular risk categorization: applying the European Society of Cardiology guidelines to the Swedish National Diabetes Register
Authors: Eliasson Björn , Ekelund Jan , Holmberg Cecilia Nagorny , Wolden Michael Lyng , Matthiessen Kasper Sommer , James Stefan 
Published: December 2022

Abstract

Aims
The 2021 European Society of Cardiology (ESC) guidelines recommend that patients with type 2 diabetes (T2D) with a very high cardiovascular disease (CVD) risk receive cardiovascular (CV)-protective glucose-lowering medication (glucagon-like peptide-1 receptor agonists or sodium–glucose co-transporter-2 inhibitors). This analysis compared previous prescribing practices with the ESC recommendations.

Methods and results
Patients in the Swedish National Diabetes Register (NDR) with T2D, aged 18–90 years, not receiving CV-protective glucose-lowering medication in 2017 were identified, and the ESC criteria for very high CVD risk were applied. The composite outcome of major adverse CV events (MACEs; defined as CV death, non-fatal stroke or non-fatal myocardial infarction) during 2017 was calculated, and the number of MACE avoided with semaglutide, an example of a CV-protective glucose-lowering medication, was estimated for patients with a certain CV risk score. Of the 320 028 patients in the NDR with T2D who were not receiving CV-protective glucose-lowering medication, 129 512 patients had a very high CVD risk. Patients with a very high CVD risk had a high incidence of MACE (75.4 events/1000 person-years), which was higher in those with atherosclerotic CVD (ASCVD) with and without elevated glycated haemoglobin (&gt;9%; 136.5 and 90.8 events/1000 person-years, respectively). If patients with a very high CVD risk, according to the ESC, and ASCVD received semaglutide, 803 MACE may have been avoided in 2017.

Conclusions
This analysis highlights differences between previous prescribing practices in Sweden and the 2021 ESC guidelines and offers strategies to prioritize CV-protective glucose-lowering medication for patients who would benefit most.
Longitudinal Associations Between Loneliness and &#x2028;Self-Rated Health Among Black and White Older Adults
Authors: Sol Ketlyne , Brauer Simon , Antonucci Toni C 
Published: December 2022

AbstractObjectivesThis study examined the longitudinal association between loneliness and self-rated health (SRH), and whether there were race differences between non-Hispanic Black and White adults in these associations.MethodA total of 1,407 participants were drawn Social Relations Study, a regional study of social relations across the life span with 3 waves of data collection in 1992, 2005, and 2015 (Wave 1, W1: Mage = 50.28, 28% Black, 59% women). Cross-lagged structural equation models examined the association between loneliness and SRH over 3 waves. We adjusted for baseline age, gender, social network size, and depressive symptoms.ResultsThere were no race differences in loneliness at any wave. Loneliness W1 was associated with Loneliness W2; Loneliness W2 was associated with Loneliness W3. We had similar findings for associations among SRH. However, only one of the cross-lagged paths was significant. Worse SRH W2 was associated with more Loneliness W3. The only path that varied across race was in the association between SRH W2 and Loneliness W3, and this path was significant only in Whites.DiscussionFindings indicate that worse SRH at later midlife may increase risk for loneliness in later life, particularly for Whites. As a valid indicator of health, SRH can be used in the body of research on health correlates of loneliness as adults age. Use of the current sample of Black and White adults provides nuanced understanding in the ways in which racially diverse adults experience loneliness and should be useful in refining and developing culturally competent interventions for older adults.
The trade-off function of photorespiration in a changing environment
Authors: Hernandez Jakob Sebastian , Nägele Thomas 
Published: December 2022

Abstract
The photorespiratory pathway in plants comprises metabolic reactions distributed across several cellular compartments. It emerges from the dual catalytic function of Rubisco, i.e. ribulose-1,5-bisphosphate carboxylase/oxygenase. Rubisco either carboxylates or oxygenates ribulose-1,5-bisphosphate. Carboxylation reactions produce 3-phosphoglycerate molecules which are substrates for the central carbohydrate metabolism. However, oxygenation reactions additionally form 2-phosphoglycolate molecules which are (i) substrate for a multicompartmental recovery process, and (ii) inhibit several enzymes of the Calvin–Benson–Bassham cycle. Here, an approach of structural kinetic modelling is presented to investigate the extent of stabilization of the Calvin–Benson–Bassham cycle and carbohydrate metabolism by photorespiration. This method is based on a parametric representation of the Jacobian matrix of a metabolic system which offers a robust strategy for handling uncertainties associated with in vitro kinetic constants. Our findings indicate that oxygenation of ribulose-1,5-bisphosphate by Rubisco significantly stabilizes the Calvin–Benson–Bassham cycle. Hence, a trade-off function of photorespiration is suggested which reduces carbon assimilation rates but simultaneously stabilizes metabolism by increasing plasticity of metabolic regulation within the chloroplast. Furthermore, our analysis indicates that increasing carbon flux towards sucrose biosynthesis has a stabilizing effect. Finally, our findings shed light on the role of a multicompartmental metabolic pathway in stabilizing plant metabolism against perturbation induced by a dynamic environment.
Association of longer telomere length in cancer cells and cancer-associated fibroblasts with worse prognosis
Authors: Matsuda Yoko , Ye Juanjuan , Yamakawa Keiko , Mukai Yuri , Azuma Kazuki , Wu Linxuan , Masutomi Kenkichi , Yamashita Taro , Daigo Yataro , Miyagi Yohei , Yokose Tomoyuki , Oshima Takashi , Ito Hiroyuki , Morinaga Soichiro , Kishida Takeshi , Minamoto Toshinari , Kojima Motohiro , Kaneko Shuichi , Haba Reiji , Kontani Keiichi , Kanaji Nobuhiro , Okano Keiichi , Muto-Ishizuka Mariko , Yokohira Masanao , Saoo Kousuke , Imaida Katsumi , Suizu Futoshi 
Published: December 2022

Abstract

Background
Telomere dysfunction has been reported to be directly involved in carcinogenesis owing to chromosomal instability and immortalization; however, the clinicopathological significance of telomeres remains controversial. We have shown that telomere shortening occurs in normal-appearing duct cells at initiation and then continues during the progression of pancreatic cancer. In this study, we determined the clinicopathological and prognostic value of telomere length (TL) in cancer progression.

Methods
TL in both cancer cells and cancer-associated fibroblasts (CAFs) was analyzed by high-throughput quantitative fluorescence in situ hybridization using a previously reported cohort comprising 1434 cases of adenocarcinoma (ADC), squamous cell carcinoma (SCC), adenosquamous carcinoma, hepatocellular carcinoma, and renal cell carcinoma (RCC), which are known cancers with a statistically significantly low incidence of alternative lengthening of telomeres. Cases were divided into 2 groups as follows: longer and shorter telomeres, according to the median TL of cancer cells and CAFs. The statistical significance of TL in cancer cells and CAFs on clinicopathological characteristics and prognosis was analyzed.

Results
There was a close association between TL in cancer cells and CAFs. Longer telomeres in cancer cells and CAFs were associated with aggressive features such as advanced stage, high mitosis score and nuclear score, poorly differentiated cancer, and desmoplastic stroma in ADC. Furthermore, a longer TL was an independent prognostic factor for ADC, SCC, and RCC.

Conclusions
Longer telomeres are associated with worse prognosis in ADC, SCC, and RCC. Thus, TL is a novel biomarker for the diagnosis of aggressive cancers with poor prognoses.
Challenges in research approaches to the ‘just energy transition’ in legal studies and other branches of the social sciences
Authors: Muinzer Thomas L 
Published: December 2022

Abstract
The ‘just energy transition’ (JET) is a concept that is starting to pervade climate and energy scholarship to a greater and greater degree at present. It is often difficult, however, to interpret clearly and precisely what this increasingly common term is intended to mean. This study explores the JET as a scholarly concept and as a compound discursive term, identifying problems that arise in research and scholarship where semantic and associated analytical precision is lacking or unclear. Such problems include the disruption of the ability to construct scholarly hypotheses and theories that allow testable propositions to be utilized with reference to the term. The study argues that these outcomes should be guarded against in legal studies, and in any branch of the social sciences that seeks to integrate JET considerations meaningfully into serious research. It is also argued that elements of the sorts of difficulties under review in relation to the JET exist in a more developed condition within the field of Energy Justice (EJ). The study draws upon the juxtaposition of JET–EJ scholarship in order to throw into relief a range of issues that JET studies should guard against.
Trichodermaroot colonization in maize triggers epigenetic changes in genes related to the jasmonic and salicylic acid pathways that prime defenses againstColletotrichum graminicolaleaf infection
Authors: Agostini Romina B , Ariel Federico , Rius Sebastián P , Vargas Walter A , Campos-Bermudez Valeria A 
Published: December 2022

AbstractBeneficial interactions between plant roots and Trichoderma species lead to both local and systemic enhancements of the plant immune system through a mechanism known as priming of defenses. Previously, we have reported a number of genes and proteins that are differentially regulated in distant tissues of maize plants following inoculation with Trichoderma atroviride. To further investigate the mechanisms involved in the systemic activation of plant responses, here we have further evaluated the regulatory aspects of a selected group of genes when priming is triggered in maize plants. Time-course experiments from the beginning of the interaction between T. atroviride and maize roots followed by leaf infection with Colletotrichum graminicola allowed us to identify a gene set regulated by priming in the leaf tissue. In the same experiment, phytohormone measurements revealed a decrease in jasmonic acid concentration while salicylic acid increased at 2 d and 6 d post-inoculation. In addition, chromatin structure and modification assays showed that chromatin was more open in the primed state compared with unprimed control conditions, and this allowed for quicker gene activation in response to pathogen attack. Overall, the results allowed us to gain insights on the interplay between the phytohormones and epigenetic regulatory events in the systemic and long-lasting regulation of maize plant defenses following Trichoderma inoculation.
Astraeus VII: the environmental-dependent assembly of galaxies in the Epoch of Reionization
Authors: Legrand Laurent , Dayal Pratika , Hutter Anne , Gottlöber Stefan , Yepes Gustavo , Trebitsch Maxime 
Published: December 2022

ABSTRACT
Using the astraeus (seminumerical rAdiative tranSfer coupling of galaxy formaTion and Reionization in N-body dark matter simUlationS) framework, we explore the impact of environmental density and radiative feedback on the assembly of galaxies and their host haloes during the Epoch of Reionization. The astraeus framework allows us to study the evolution of galaxies with masses ($10^{8.2}\,\rm M_\odot \lt M_{\rm h}\lt 10^{13}\,\rm M_\odot$) in a wide variety of environment [−0.5 &lt; log (1 + δ) &lt; 1.3 averaged over (2 cMpc)3]. We find that: (i) there exists a mass- and redshift- dependent ‘characteristic’ environment [${\rm log}\, (1+\delta _a(M_{\rm h}, z)) = 0.021\times (M_{\rm h}/\rm M_\odot)^{0.16} + 0.07 z -1.12$, up to $z$ ∼ 10] at which galaxies are most efficient at accreting dark matter, e.g at a rate of $0.2{{\ \rm per\ cent}}$ of their mass every Myr at $z$ = 5; (ii) the number of minor and major mergers and their contributions to the dark matter assembly increases with halo mass at all redshifts and is mostly independent of the environment; (iii) at $z$ = 5 minor mergers contribute slightly more (by up to $\sim 10{{\ \rm per\ cent}}$) to the dark matter assembly while for the stellar assembly, major mergers dominate the contribution from minor mergers for $M_{\rm h}\lesssim 10^{11.5}\rm\, M_\odot$ galaxies; (iv) radiative feedback quenches star formation more in low-mass galaxies ($M_{\rm h}\lesssim 10^{9.5}\rm\, M_\odot$) in over-dense environments [log(1 + δ) &gt; 0.5]; dominated by their major branch, this yields star formation histories biased towards older ages with a slower redshift evolution.
Discovery of clinical and demographic determinants of symptom burden in primary brain tumor patients using network analysis and unsupervised clustering
Authors: Bergsneider Brandon H , Vera Elizabeth , Gal Ophir , Christ Alexa , King Amanda L , Acquaye Alvina , Choi Anna , Leeper Heather E , Mendoza Tito , Boris Lisa , Burton Eric , Lollo Nicole , Panzer Marissa , Penas-Prado Marta , Pillai Tina , Polskin Lily , Wu Jing , Gilbert Mark R , Armstrong Terri S , Celiku Orieta 
Published: December 2022

AbstractBackgroundPrecision health approaches to managing symptom burden in primary brain tumor (PBT) patients are imperative to improving patient outcomes and quality of life, but require tackling the complexity and heterogeneity of the symptom experience. Network Analysis (NA) can identify complex symptom co-severity patterns, and unsupervised clustering can unbiasedly stratify patients into clinically relevant subgroups based on symptom patterns. We combined these approaches in a novel study seeking to understand PBT patients’ clinical and demographic determinants of symptom burden.MethodsMDASI-BT symptom severity data from a two-institutional cohort of 1128 PBT patients were analyzed. Gaussian Graphical Model networks were constructed for the all-patient cohort and subgroups identified by unsupervised clustering based on co-severity patterns. Network characteristics were analyzed and compared using permutation-based statistical tests.ResultsNA of the all-patient cohort revealed 4 core dimensions that drive the overall symptom burden of PBT patients: Cognitive, physical, focal neurologic, and affective. Fatigue/drowsiness was identified as pivotal to the symptom experience based on the network characteristics. Unsupervised clustering discovered 4 patient subgroups: PC1 (n = 683), PC2 (n = 244), PC3 (n = 92), and PC4 (n = 109). Moderately accurate networks could be constructed for PC1 and PC2. The PC1 patients had the highest interference scores among the subgroups and their network resembled the all-patient network. The PC2 patients were older and their symptom burden was driven by cognitive symptoms.ConclusionsIn the future, the proposed framework might be able to prioritize symptoms for targeting individual patients, informing more personalized symptom management.
Deep Brain Stimulator Device Infection: The Mayo Clinic Rochester Experience
Authors: Tabaja Hussam , Yuen Jason , Tai Don Bambino Geno , Campioli Cristina Corsini , Chesdachai Supavit , DeSimone Daniel C , Hassan Anhar , Klassen Bryan T , Miller Kai J , Lee Kendall H , Mahmood Maryam 
Published: December 2022

Abstract

Background
Deep brain stimulator (DBS)–related infection is a recognized complication that may significantly alter the course of DBS therapy. We describe the Mayo Clinic Rochester experience with DBS-related infections.

Methods
This was a retrospective study of all adults (≥18 years old) who underwent DBS-related procedures between 2000 and 2020 at the Mayo Clinic Rochester.

Results
There were 1087 patients who underwent 1896 procedures. Infection occurred in 57/1112 (5%) primary DBS implantations and 16/784 (2%) revision surgeries. The median time to infection (interquartile range) was 2.1 (0.9–6.9) months. The odds of infection were higher with longer operative length (P = .002), higher body mass index (BMI; P = .006), male sex (P = .041), and diabetes mellitus (P = .002). The association between infection and higher BMI (P = .002), male sex (P = .016), and diabetes mellitus (P = .003) remained significant in a subgroup analysis of primary implantations but not revision surgeries. Infection was superficial in 17 (23%) and deep in 56 (77%) cases. Commonly identified pathogens were Staphylococcus aureus (65%), coagulase-negative staphylococci (43%), and Cutibacterium acnes (45%). Three device management approaches were identified: 39 (53%) had complete device explantation, 20 (27%) had surgical intervention with device retention, and 14 (19%) had medical management alone. Treatment failure occurred in 16 (23%) patients. Time-to-event analysis showed fewer treatment failures with complete device explantation (P = .015). Only 1 individual had complications with brain abscess at failure.

Conclusions
Primary DBS implantations had higher rates of infection compared with revision surgeries. Complete device explantation was favored for deep infections. However, device salvage was commonly attempted and is a reasonable approach in select cases given the low rate of complications.
Evaluating Predictive Value of Surgical Resected Proximal Bone Margins in Diabetic Foot Osteomyelitis With Clinical Outcomes at 1 Year
Authors: Weng Bruce , Oskooilar Yasmin , Zakhary Bishoy , Chiu Chiao An , Wu Patrick , Mulligan Nikki , Sutjita Made 
Published: December 2022

Abstract

Background
Osteomyelitis of the diabetic foot remains a significant complication that may result in the need for amputation. Proximal surgical margin histopathology after limb-sparing amputation could be used to guide antimicrobial duration and prognostic management but remains debatable. Here we evaluate if negative proximal bone margins predict outcomes of diabetic foot osteomyelitis at 1 year.

Methods
A retrospective study assessed adults with diabetes undergoing limb-sparing foot amputations from September 2016 to September 2019. Patients required histopathology confirmation of osteomyelitis, proximal margin histopathology report, and documented electronic medical record follow-up through 12 months. The primary outcome evaluated if no further amputation at the same site was required in the following 12 months.

Results
Of 92 patients, 57 (61.9%) had pathology-confirmed negative margins for osteomyelitis. Patients with negative margins required less frequent subsequent amputations at the same site within 12 months compared to positive margins (86.0% vs 65.7%; P = .003). Antibiotic duration was shorter in patients with negative margins (mean, 18 vs 30 days; P = .001). Negative-margin patients also noted lower rates of readmission at 12 months (26.3% vs 51.4%; P = .015) for site-specific complications. Staphylococcus aureus was more predominant in patients with positive versus negative margins (57.1% vs 29.8%; P = .017).

Conclusions
Negative proximal bone margin by histopathology was associated with lower frequency of further amputations at the index surgical site within 12 months. This group also received shorter courses of antibiotic therapy. It was also associated with lower rates of readmission at 12 months for surgical-site complications. Proximal margin histopathology results potentially can be integrated to guide antimicrobial duration and decrease the frequency of further amputation at the original site.
Cost modelling incorporating procalcitonin for the risk stratification of febrile infants ≤60 days old
Authors: Dionisopoulos Zachary , Strumpf Erin , Anderson Gregory , Guigui Andre , Burstein Brett 
Published: December 2022

Abstract

Objectives
Procalcitonin testing is recommended to discriminate febrile young infants at risk of serious bacterial infections (SBI). However, this test is not available in many clinical settings, limited largely by cost. This study sought to evaluate contemporary real-world costs associated with the usual care of febrile young infants, and estimate impact on clinical trajectory and costs when incorporating procalcitonin testing.

Methods
We assessed hospital-level door-to-discharge costs of all well-appearing febrile infants aged ≤60 days, evaluated at a tertiary paediatric hospital between April/2016 and March/2019. Emergency Department and inpatient expense data for usual care were obtained from the institutional general ledger, validated by the provincial Ministry of Health. These costs were then incorporated into a probabilistic model of risk stratification for an equivalent simulated cohort, with the addition of procalcitonin.

Results
During the 3-year study period, 1168 index visits were included for analysis. Real-world median costs-per-infant were the following: $3266 (IQR $2468 to $4317, n=93) for hospitalized infants with SBIs; $2476 (IQR $1974 to $3236, n=530) for hospitalized infants without SBIs; $323 (IQR $286 to $393, n=538) for discharged infants without SBIs; and, $3879 (IQR $3263 to $5297, n=7) for discharged infants subsequently hospitalized for missed SBIs. Overall median cost-per-infant of usual care was $1555 (IQR $1244 to $2025), compared to a modelled cost of $1389 (IQR $1118 to $1797) with the addition of procalcitonin (10.7% overall cost savings; $1,816,733 versus $1,622,483). Under pessimistic and optimistic model assumptions, savings were 5.9% and 14.9%, respectively.

Conclusions
Usual care of febrile young infants is variable and resource intensive. Increased access to procalcitonin testing could improve risk stratification at lower overall costs.
Perceived barriers to the provision of adolescent confidential care in a tertiary care setting
Authors: Agostino Holly , Burstein Brett 
Published: December 2022

Abstract

Objective
Adolescents are more likely to seek care and disclose sensitive health information if confidentiality is assured. Little is known regarding the provision of confidential care to adolescents in the hospital setting. We sought to understand confidentiality practices and barriers for adolescents cared for in a tertiary hospital setting.

Methods
This was a cross-sectional survey of all Emergency Department (ED), hospitalist, and resident physicians at a tertiary paediatric hospital from May/2019 to July/2019. Participants were asked multiple choice questions regarding practices, comfort, and barriers to confidential care.

Results
Response rate was 91% (n = 72/79; 26 ED, 14 hospitalists, 32 residents). Overall, 47% of respondents doubted that confidential care was being consistently provided to adolescents. Fifty-eight per cent of attendings and 31% of residents reported usually/always offering confidential care. Factors most reported to influence the provision of confidential care were chief complaint (75%), time of visit (45%), and patient age (25%). Barriers to the quantity or quality of confidential care were identified by 89%, most commonly including time constraints (21%), perceived parental resistance (26%), lack of private space (26%), and the belief that confidentiality is not necessary for all adolescent encounters (34%). Forty per cent of respondents reported breaching confidentially and discussing sensitive topics with adolescents in front of family members. Overall, only 45% felt they had received adequate training on how best to deliver confidential care, and 75% reported a desire for additional training.

Conclusion
Results suggest inadequate provision of confidential care in a tertiary teaching hospital, with several potentially modifiable barriers.