bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Ventricular Assist Device: Review of Antimicrobial Prophylaxis Strategies and Incidence of Infections at a Tertiary Care Center 12-Year Experience
Authors: Mendoza Maria Alejandra , Ranganath Nischal , Garcia Bismarck Bisono , Stevens Ryan W , Lahr Brian , O’Horo John , Stulak John , Shah Aditya 
Published: September 2023

Abstract

Background
Left ventricular assist devices (LVAD) have an associated infection rate of 13%–80% postimplant. An optimal strategy for surgical infection prophylaxis (SIP) at the time of implantation has not been well defined. We aimed to evaluate the different LVAD implantation antibiotic prophylaxis regimens as well as the incidence of LVAD infection at our institution.

Methods
We performed a single-center, retrospective study of patients who underwent LVAD implantation between February 2007 and June 2019. The primary outcome was the incidence of LVAD infection (LVADI), within 3 months and 1 year of placement, between patients who received expanded or narrow-spectrum regimens for SIP. We assessed outcomes using Kaplan-Meier, time-to-first event. We used a noninferiority analysis, which was established if the narrow-spectrum event rate was no more than 5% greater than the expanded-spectrum event rate.

Results
We included 399 patients, 305 (76.4%) patients received narrow-spectrum SIP, whereas the remaining 94 (23.6%) patients received the expanded-spectrum regimen. Statistical noninferiority of the narrow spectrum to the multiple drug regimen was demonstrated at both time points, and statistical superiority of the narrow-spectrum group across 12-month follow up was further evident (P = .037).

Conclusions
We report evidence supporting noninferiority, or even superiority, of the narrow-spectrum over expanded-spectrum antimicrobial prophylaxis strategy with respect to LVADI. These findings support data-driven antimicrobial prophylaxis strategies.
Biological and Clinical Implications of the Vascular Endothelial Growth Factor Coreceptor Neuropilin-1 in Human Immunodeficiency Virus
Authors: Schnittman Samuel R , Kolossváry Márton , Beck-Engeser Gabriele , Fitch Kathleen V , Ambayec Gabrielle C , Nance Robin M , Zanni Markella V , Diggs Marissa , Chan Fay , McCallum Sara , Toribio Mabel , Bamford Laura , Fichtenbaum Carl J , Eron Joseph J , Jacobson Jeffrey M , Mayer Kenneth H , Malvestutto Carlos , Bloomfield Gerald S , Moore Richard D , Umbleja Triin , Saag Michael S , Aberg Judith A , Currier Judith S , Delaney Joseph A C , Martin Jeffrey N , Lu Michael T , Douglas Pamela S , Ribaudo Heather J , Crane Heidi M , Hunt Peter W , Grinspoon Steven K 
Published: September 2023

Abstract
Plasma vascular endothelial growth factor (VEGF) coreceptor neuropilin-1 (NRP-1) had the largest association with coronary plaque in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) proteomics analysis. With little known about NRP-1 in people with human immunodeficiency virus (PWH), we explored its relation to other proteins in REPRIEVE and validated our findings through a Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) case-cohort study by assessing its relation to host factors and incident cardiovascular disease and cancer. Within REPRIEVE, NRP-1 was associated with proteins involved in angiogenesis, signal transduction, immunoregulation, and cell migration/adhesion. Within CNICS, NRP-1 was associated with key host factors, including older age and male sex. NRP-1 was associated with an increased hazard of multiple cancers but a decreased prostate cancer risk. Finally, NRP-1 was most strongly associated with mortality and type 2 myocardial infarction. These data suggest that NRP-1 is part of a clinically relevant immunoregulatory pathway related to multiple comorbidities in PWH.
Clinical Trials Registration. NCT02344290.
Sex differences of brain cortical structure in major depressive disorder
Authors: Mou Jingping , Zheng Ting , Long Zhiliang , Mei Lan , Wang Yuting , Yuan Yizhi , Guo Xin , Yang Hongli , Gong Qiyong , Qiu Lihua 
Published: September 2023

Abstract

Background
Major depressive disorder (MDD) has different clinical presentations in males and females. However, the neuroanatomical mechanisms underlying these sex differences are not fully understood.

Objective
The purpose of present study was to explore the sex differences in brain cortical thickness (CT) and surface area (SA) of MDD and the relationship between these differences and clinical manifestations in different gender.

Methods
High-resolution T1-weighted images were acquired from 61 patients with MDD and 61 healthy controls (36 females and 25 males, both). The sex differences in CT and SA were obtained using the FreeSurfer software and compared between every two groups by post hoc test. Spearman correlation analysis was also performed to explore the relationships between these regions and clinical characteristics.

Results
In male patients with MDD, the CT of the right precentral was thinner compared to female patients, although this did not survive Bonferroni correction. The SA of several regions, including right superior frontal, medial orbitofrontal gyrus, inferior frontal gyrus triangle, superior temporal, middle temporal, lateral occipital gyrus, and inferior parietal lobule in female patients with MDD was smaller than that in male patients (P &lt; 0.01 after Bonferroni correction). In female patients, the SA of the right superior temporal (r = 0.438, P = 0.008), middle temporal (r = 0.340, P = 0.043), and lateral occipital gyrus (r = 0.372, P = 0.025) were positively correlated with illness duration.

Conclusion
The current study provides evidence of sex differences in CT and SA in patients with MDD, which may improve our understanding of the sex-specific neuroanatomical changes in the development of MDD.
Female sexual dysfunction in undergraduate medical education: a survey of U.S. medical students
Authors: Goddard Brian , Brucker Benjamin 
Published: September 2023

Abstract

Background
Physicians often report low levels of confidence in diagnosing and treating female sexual dysfunction (FSD), which may stem from inadequate education and exposure to the topic.

Aim
The study sought to determine the extent to which FSD is covered in undergraduate medical education and evaluate student comfort with the topic and familiarity with treatments.

Methods
We created a novel, 50-question survey to be administered online to any current U.S. medical student. Obstetrician-gynecologist clerkship directors at 146 U.S. medical schools were contacted and asked to invite any current student at their school to participate. A link to the electronic REDCap (Research Electronic Data Capture) survey was distributed to eligible students via the clerkship directors. The survey collected data regarding (1) coverage of FSD and male sexual dysfunction (MSD) in preclinical and clinical curricula, (2) student self-ratings of comfort in hypothetical scenarios in which a patient exhibits symptoms of FSD or MSD, and (3) student familiarity with treatments for FSD and MSD.

Outcomes
Outcomes included the proportion of students reporting that their school covered FSD/MSD in its preclinical/clinical curriculum, the mean comfort ratings for each of the FSD and MSD scenarios, and the proportion of students indicating knowledge of various FSD and MSD treatments.

Results
A smaller proportion of students (N = 236) reported receiving instruction in FSD (58.5%) compared with MSD (78.4%) in their preclinical curriculum (P &lt; .001). Students’ average self-ratings of comfort in the sexual dysfunction scenarios were significantly lower for patients with symptoms of FSD compared with MSD (P &lt; .001). Students had higher average self-ratings of confidence in FSD scenarios if their intended specialty was obstetrician-gynecologist (P = .003), if their school included FSD in its clinical curriculum (P = .01), and if they had ever participated in the care of a patient with FSD (P = .006).

Clinical Implications
There are important gaps in the coverage of FSD in undergraduate medical education that may be mitigated through improvements to curriculum and increased exposure to patients with FSD.

Strengths and Limitations
This is the first study, to our knowledge, to directly survey medical students regarding their educational experience and comfort with FSD. Our study was limited by a small sample size, the use of a novel and nonvalidated questionnaire, and the potential for bias given our sampling method.

Conclusion
Medical schools must work toward improving instruction in FSD for their students to address these disparities and improve students’ comfort with the topic.
Phenomenology and psychiatric correlates of pseudocataplexy
Authors: Menchetti Marco , Biscarini Francesco , Sallemi Giombattista , Antelmi Elena , Franceschini Christian , Vandi Stefano , Neccia Giulia , Baldini Valentina , Plazzi Giuseppe , Pizza Fabio 
Published: September 2023

Abstract

Study Objectives
Pseudocataplexy is a rare functional neurological disorder that mimics cataplexy, pathognomonic for narcolepsy type 1 (NT1). We describe the psychiatric comorbidity and personality traits of patients with pseudocataplexy versus NT1 cases.

Methods
The case–control observational study enrolled consecutive patients with pseudocataplexy and a control group of age-matched consecutive NT1 patients. The diagnostic work-up included a structured interview, 48-hour polysomnography, multiple sleep latency test, cataplexy provoking test, and hypocretin-1 measurement in cerebrospinal fluid. All participants were administered Beck Depression Inventory, State-Trait Anxiety Inventory, Patient Health Questionnaire-15 (PHQ-15), Personality Inventory for DSM-5 brief form, and quality-of-life (QoL) measurement by 36-item Short Form health survey (SF-36).

Results
Fifteen patients with pseudocataplexy and 30 with NT1 were included. Despite the suspicion of possible cataplexy, none of the pseudocataplexy participants fulfilled international diagnostic criteria for NT1. Pseudocataplexy patients presented higher rates of moderate state anxiety (40% vs. 10%, p = 0.018), medium level of somatic symptoms, defined by PHQ-15 score &gt; 10 (66.7% vs. 16.7%, p = 0.003), and a trend towards moderate-to-severe depressive symptoms (33.3% vs. 10%, p = 0.054) compared to NT1. No significant differences in personality traits emerged. Pseudocataplexy patients had worse QoL profiles in almost all SF-36 domains including physical (mean ± SD: 37.7 ± 9.88 vs. 51.13 ± 7.81, p &lt; 0.001) and mental (mean ± SD: 33.36 ± 12.69 vs.42.76 ± 11.34, p = 0.02) summary scores.

Conclusions
Patients with pseudocataplexy present more severe psychiatric symptoms and a lower QoL profile in comparison with patients with NT1. The severe somatoform and affection impairment in pseudocataplexy may explain the poorer QoL and should require a tailored therapeutic approach.
Longitudinal sleep multi-trajectories from age 1 to 5.5 years and their early correlates: results from the Étude Longitudinale Française depuis l’Enfance birth cohort study
Authors: Kim Mihyeon , Saade Danielle , Dufourg Marie-Noëlle , Charles Marie-Aline , Plancoulaine Sabine 
Published: September 2023

Abstract

Study Objectives
To identify sleep multi-trajectories in children from age 1 to 5.5 years and their early correlates.

Methods
We collected early family, maternal, and child characteristics, including children’s nighttime sleep duration (NSD) and daytime sleep duration (DSD), night waking (NW), and sleep-onset difficulties (SOD), by parental phone interviews at age 2 months and 1-, 2-, 3.5-, and 5.5 years. Group-based multi-trajectory modeling identified sleep multi-trajectory groups. Multinomial logistic regression assessed associations with early factors.

Results
We identified five distinct sleep multi-trajectory groups for NSD, DSD, NW, and SOD in 9273 included children. The “Good sleepers” (31.6%) and “Long sleepers” (31.0%) groups had low NW and SOD prevalence and shorter NSD but longer DSD in “Good sleepers” than in “Long sleepers.” The “Good sleepers but few SOD” group (10.3%) had long NSD and DSD but a SOD peak at age 3.5 years; the “Improving NW and SOD” group (9.6%) showed short but rapidly increasing NSD to a plateau and high but decreasing NW and SOD; the “Persistent NW and SOD” group (17.5%) had persistent high NW and SOD. Maternal depression during pregnancy and sleep habits at age 1 (e.g. parental presence or feeding to fall asleep, sleeping at least part of the night away from own bed) were common risk factors associated with the most disordered sleep multi-trajectory groups.

Conclusions
We identified distinct sleep multi-trajectory groups and early life-associated factors in preschoolers. Most of the factors associated with the most sleep-disordered multi-trajectory groups are likely modifiable and provide clues for early prevention interventions.
Circadian misalignment alters resting-state functional connectivity of the salience network in rotating shift workers
Authors: Kim Sun-Young , Lee Kyung Hwa , Lee Ha Young , Jeon Jeong Eun , Park Cho Won , Shin Jiyoon , Seo Min Cheol , Jeon Sehyun , Kim Seog Ju , Lee Yu Jin 
Published: September 2023

Abstract

Study Objectives
This study compared resting-state functional connectivity (rsFC) of the salience network (SN) between rotating shift workers (RSWs) and controls. Furthermore, we examined whether rsFC of the SN was correlated with sleep, emotion, cognition, and attention.

Methods
The 60 RSWs and 57 controls enrolled in this study completed self-report questionnaires and sleep diaries to assess subjective sleep quality, and polysomnography and actigraphy to evaluate objective sleep and 24-hour rest-activity rhythm parameters. The participants also underwent resting-state functional magnetic resonance imaging and structural T1 scans. We performed a seed-based rsFC analysis of the SN using the anterior cingulate cortex (ACC) and anterior insula (AI) as seed regions. Furthermore, AI and ACC rsFC were compared in RSWs and controls, and we analyzed correlations between rsFC and variables of interest showing significant group differences.

Results
Compared with controls, RSWs showed reduced rsFC between the ACC and right insula, and increased rsFC of the ACC with the left occipital lobe and right superior frontal gyrus extending to the supplementary motor area (SFG/SMA). Moreover, RSWs showed reduced rsFC between the right AI and right superior parietal lobule (SPL). Finally, rsFC between the ACC and right AI was correlated with 24-hour rest-activity rhythmicity.

Conclusions
Although RSWs did not show sleep disturbance, emotional distress, cognitive impairment, or attention deficits, alterations of right insula, left occipital lobe, right SFG/SMA, and right SPL rsFC in the SN indicate that impairments in salience detection and top-down attentional control may emerge in shift workers over time.
LcMYB106 suppresses monoterpene biosynthesis by negatively regulating LcTPS32 expression in Litsea cubeba
Authors: Zhao Yunxiao , Chen Yicun , Gao Ming , Wu Liwen , Wang Yangdong 
Published: September 2023

Abstract
Litsea cubeba, the core species of the Lauraceae family, is valuable for the production of essential oils due to its high concentration of monoterpenes (90%). The key monoterpene synthase and metabolic regulatory network of monoterpene biosynthesis have provided new insights for improving essential oil content. However, there are few studies on the regulation mechanism of monoterpenes in L. cubeba. In this study, we investigated LcTPS32, a member of the TPS-b subfamily, and identified its function as an enzyme for the synthesis of monoterpenes, including geraniol, α-pinene, β-pinene, β-myrcene, linalool and eucalyptol. The quantitative real-time PCR analysis showed that LcTPS32 was highly expressed in the fruits of L. cubeba and contributed to the characteristic flavor of its essential oil. Overexpression of LcTPS32 resulted in a significant increase in the production of monoterpenes in L. cubeba by activating both the MVA and MEP pathways. Additionally, the study revealed that LcMYB106 played a negative regulatory role in monoterpenes biosynthesis by directly binding to the promoter of LcTPS32. Our study indicates that LcMYB106 could serve as a crucial target for metabolic engineering endeavors, aiming at enhancing the monoterpene biosynthesis in L. cubeba.
PFKFB3‐driven vascular smooth muscle cell glycolysis promotes vascular calcification via the altered FoxO3 and lactate production
Authors: Chen Jiaxin , Yu Hongjiao , Tan Xiao , Mok Simon Wing Fai , Xie Yuchen , Wang Yueheng , Jiang Xueyan , Macrae Vicky E. , Lan Lan , Fu Xiaodong , Zhu Dongxing 
Published: September 2023

AbstractA link between increased glycolysis and vascular calcification has recently been reported, but it remains unclear how increased glycolysis contributes to vascular calcification. We therefore investigated the role of PFKFB3, a critical enzyme of glycolysis, in vascular calcification. We found that PFKFB3 expression was upregulated in calcified mouse VSMCs and arteries. We showed that expression of miR‐26a‐5p and miR‐26b‐5p in calcified mouse arteries was significantly decreased, and a negative correlation between Pfkfb3 mRNA expression and miR‐26a‐5p or miR‐26b‐5p was seen in these samples. Overexpression of miR‐26a/b‐5p significantly inhibited PFKFB3 expression in VSMCs. Intriguingly, pharmacological inhibition of PFKFB3 using PFK15 or knockdown of PFKFB3 ameliorated vascular calcification in vD3‐overloaded mice in vivo or attenuated high phosphate (Pi)‐induced VSMC calcification in vitro. Consistently, knockdown of PFKFB3 significantly reduced glycolysis and osteogenic transdifferentiation of VSMCs, whereas overexpression of PFKFB3 in VSMCs induced the opposite effects. RNA‐seq analysis and subsequent experiments revealed that silencing of PFKFB3 inhibited FoxO3 expression in VSMCs. Silencing of FoxO3 phenocopied the effects of PFKFB3 depletion on Ocn and Opg expression but not Alpl in VSMCs. Pyruvate or lactate supplementation, the product of glycolysis, reversed the PFKFB3 depletion‐mediated effects on ALP activity and OPG protein expression in VSMCs. Our results reveal that blockade of PFKFB3‐mediated glycolysis inhibits vascular calcification in vitro and in vivo. Mechanistically, we show that FoxO3 and lactate production are involved in PFKFB3‐driven osteogenic transdifferentiation of VSMCs. PFKFB3 may be a promising therapeutic target for the treatment of vascular calcification.
New therapies in anti-MDA5 antibody-positive dermatomyositis
Authors: Yasui Masahiro , Iwamoto Taro , Furuta Shunsuke 
Published: September 2023

Purpose of review
This review focuses on treatments for anti-MDA5 antibody-positive dermatomyositis (MDA5-DM), which is a subgroup of dermatomyositis and characterized by frequent rapidly progressive interstitial lung disease and the high mortality rate. Despite conventional immunosuppressive therapies, there are still refractory cases. Newer treatment options are needed.

Recent findings
The triple combination therapy (high-dose glucocorticoids, calcineurin inhibitor, and intravenous cyclophosphamide) improved patient survival compared to high-dose glucocorticoids and step-wise addition of the immunosuppressants. The triple therapy now has been widely used, but there are still refractory cases. In addition to the conventional-type immunosuppressants, recently the efficacy of Janus kinase inhibitors, biologic agents such as rituximab, plasma exchange, and polymyxin B perfusion for refractory MDA5-DM patients have been reported. However, the majority of those reports regarding new treatments are limited to case series, retrospective studies, and small single-arm studies. Adding antifibrotic drugs to immunosuppressive therapies might have some ancillary benefits.

Summary
Several new therapies for MDA5-DM patients have emerged, although the optimal use of those therapies is still unknown. Further research and evidence accumulation will be needed. It is also noted that the intensive immunosuppressive therapies are associated with the higher infection risk.
Pathologic Nodal Staging Before SBRT for Early-stage NSCLC Does Not Impact Overall Survival
Authors: Cantrell James N. , Acharya Pawan , Vesely Sara K. , Gunter Tyler C. 
Published: September 2023

Objective:
Stereotactic body radiation therapy (SBRT) for early-stage non–small cell carcinoma of the lung (NSCLC) is increasingly utilized. We sought to assess overall survival (OS) for early-stage NSCLC patients receiving SBRT depending on staging method.

Methods:
Early-stage NSCLC patients treated with definitive SBRT were identified in the National Cancer Database (NCDB), and OS was determined based on method of staging. Patient, disease, and treatment characteristics were also analyzed.

Results:
A total of 12,106 patients were included; 865 (7%) received invasive staging (nodal sampling, NS) and 11,241 (93%) had no nodal sampling (NNS). From this larger dataset, a propensity score matching (1:1 without replacement) was performed, which yielded 839 patients for each group (NNS and NS). With a median follow-up time of 3.12 years, median survival for all patients included in the matched dataset was 2.75 years (95% CI: 2.55-2.93 y), with 2- and 5-year OS estimated at 63.9% and 25.7%, respectively. In a multivariable analysis on matched data, there was no difference in mortality risk between the NNS and NS groups (hazard ratio=1.08, 95% CI: 0.94-1.24, P=0.25). Negative prognostic factors identified in the multivariable analysis of the matched data included: age more than 65, male sex, Charlson-Deyo Score ≥1, and tumor size ≥3 cm.

Conclusions:
SBRT use in early-stage NSCLC steadily increased over the study period. Most patients proceeded to SBRT without nodal staging, conflicting with National Comprehensive Cancer Network (NCCN) guidelines which recommend pathologic mediastinal lymph node evaluation for all early-stage NSCLC cases, except stage IA. Our findings suggest similar OS in patients with early-stage NSCLC treated with SBRT irrespective of nodal staging. Furthermore, we highlight patient-related, disease-related, and treatment-related prognostic factors to consider when planning therapy for these patients.
Cost-Effectiveness of New Quadruple Therapy Compared With Standard Treatment for Patients With Heart Failure in China
Authors: Huang Yun , Zhou Hua , Fang Chongbo , Ma Lili , Zhang Yuyu , Rong Weibo , Liu Xiaoli , Ye Honghua 
Published: September 2023

Abstract:
This study aimed to compare the cost-effectiveness of the new quadruple therapy regimen of adding sodium-glucose–linked transporter 2 (SGLT2) inhibitors, with standard treatment for patients with heart failure (HF) in China. From the payer's perspective, the dates of cardiovascular event recurrences were extracted from a meta-analysis including 6 trials, combined with the treatment cost for patients with HF in China to construct a Markov model. The outcomes included per capita medical costs and incremental cost-effectiveness ratio, using quality-adjusted life years (QALYs) data. Single-factor, probability sensitivity analysis, and scenario analysis were used to explore the potential uncertainties of the model. The per capita costs of the new quadruple therapy regimen and standard treatment were $87441.26 and $87087.54, respectively. The new regimen was associated with a mean of 21.44 QALYs gained, compared with 18.60 QALYs gained with the standard treatment. The incremental cost-effectiveness ratio was $124.03 per QALY gained. The sensitivity analysis revealed that changes in the parameters within the set range did not affect the model results. In China, compared with standard treatment, the new quadruple therapy regimen with SGLT2 inhibitors reduce the frequency of cardiovascular events among patients with HF, and it has economic advantages.