bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the saliva microbiome in patients with immunoglobulin G4–related disease
Authors: Yamamoto Motohisa , Aochi Satsuki , Uehara Masaaki 
Published: April 2023

ABSTRACT

Objectives
This article aims to investigate the saliva microbiome in patients with immunoglobulin G4–related disease (IgG4RD) compared with primary Sjögren’s syndrome (SS).

Methods
Saliva samples were collected from 11 IgG4RD and 11 SS patients who visited IMSUT Hospital, The Institute of Medical Science, The University of Tokyo. Deoxyribonucleic acid (DNA) was extracted from the samples, and primers were used to amplify the V3–V4 regions of bacterial and archaeal 16S ribosomal RNA (rRNA) genes, which was then analysed by paired-end sequencing. Amplicon reads were processed using QIIME2 to generate representative sequences. The Greengenes database was used to identify the bacterial flora in each sample and compare them between groups.

Results
The IgG4RD and SS groups exhibited differences in bacterial diversity. Cluster analyses of attributed classification groups by species and disease showed that IgG4RD and SS cases formed individual clusters. Significant differences in relative abundance between IgG4RD and SS were observed for the following organisms: Mogibacterium (P = .0051), Solobacterium moorei (P = .0195), Slackia (P = .0356), and Moryella (P = .0455).

Conclusions
Salivary microbiome analysis of IgG4RD and SS patients revealed significantly higher relative proportions of Mogibacterium, S. moorei, Slackia, and Moryella bacteria in IgG4RD compared with SS.
The Association Between Tobacco and Cannabis Use and the Age of Onset of Depression and Anxiety Symptoms: Among Adolescents and Young Adults
Authors: Bataineh Bara S , Wilkinson Anna V , Sumbe Aslesha , Clendennen Stephanie L , Chen Baojiang , Messiah Sarah E , Harrell Melissa B 
Published: April 2023

Abstract

Introduction
No studies have prospectively explored the association between the use of tobacco or cannabis use and the age of onset of depressive or anxiety symptoms, and no studies have identified the peak ages and ranges of onset of these symptoms among tobacco and/or cannabis users.

Aims and Methods
This is a secondary analysis of Texas Adolescent Tobacco and Marketing Surveillance System data, waves 9–14 (2019–20121). Participants were in 10th grade, 12th grade, and 2 years post-high school (HS) at baseline (wave 9). Interval-censoring multivariable Cox proportional hazards models were fit to assess differences in the estimated age of onset of depression and anxiety by tobacco and cannabis use while adjusting for covariates.

Results
We found that lifetime or ever cigarette, e-cigarette, and cannabis use had an increased risk of an earlier age of onset of depressive and anxiety symptoms across the three cohorts, and the youngest cohort was the most differentially impacted by substance use. Between ages 18 to 19 years in the 10th-grade cohort, between ages 20 to 21 years in the 12th-grade cohort, and between ages 22 to 23 years in the post-HS cohort, the estimated hazard function (or cumulative incidence) for reporting depressive and anxiety symptoms almost doubled among lifetime cigarette, e-cigarette, and cannabis users.

Conclusions
Tobacco and cannabis users should be screened for mental health problems at an earlier age, especially those aged 18 years and younger, and provided with age- and culturally appropriate resources to prevent or delay the onset of anxiety and/or depression symptoms.

Implications
The study’s findings indicate that tobacco and cannabis use is directly linked to the early onset of depressive and anxiety symptoms among youth. This highlights the significance of early screening and substance use interventions, particularly for youth aged 18 years and younger, as they are disproportionately affected by both substance use and mental health problems. School-based interventions that are age- and culturally appropriate hold promise as they enable youth to seek professional help early, and in a supportive environment. Intervening early in substance shows promise in reducing the likelihood of developing mental health problems at a young age.
Effects of intermittent fasting on cognitive health and Alzheimer’s disease
Authors: Elias Alby , Padinjakara Noushad , Lautenschlager Nicola T 
Published: April 2023

AbstractObjectiveCaloric restriction by intermittent fasting produces several metabolic changes, such as increased insulin sensitivity and use of ketone bodies as energy sources. In humans, intermittent fasting has been studied in hypertension, diabetes, and related conditions, but, to date, not as a strategy to reduce the risk of emergent dementia. In this scoping review, the relevance of intermittent fasting as a potential preventive intervention for Alzheimer’s dementia is explored.BackgroundThe beneficial effects of calorie restriction have been documented in animals and humans. Decreased oxidative stress damage and attenuated inflammatory responses are associated with intermittent fasting. These changes have a favorable impact on the vascular endothelium and stress-induced cellular adaptation.ResultsPhysiological alterations associated with fasting have profound implications for pathological mechanisms associated with dementias, particularly Alzheimer’s disease. Compared with ad libitum feeding, caloric restriction in animals was associated with a reduction in β-amyloid accumulation, which is the cardinal pathological marker of Alzheimer’s disease. Animal studies have demonstrated synaptic adaptations in the hippocampus and enhanced cognitive function after fasting, consistent with these theoretical frameworks. Furthermore, vascular dysfunction plays a crucial role in Alzheimer’s disease pathology, and intermittent fasting promotes vascular health.ConclusionsThese observations lead to a hypothesis that intermittent fasting over the years will potentially reverse or delay the pathological process in Alzheimer’s disease.
Anaplasmosis in Pennsylvania: Clinical Features, Diagnosis, and Outcomes of Patients Diagnosed With Anaplasma phagocytophilum Infection at Hershey Medical Center From 2008 to 2021
Authors: Ingram David , Joseph Betsy , Hawkins Stephanie , Spain James 
Published: April 2023

Abstract
Anaplasmosis is an emerging infection in the United States and in particular, Pennsylvania. We highlight the abrupt rise in cases of anaplasmosis in the past decade in the state of Pennsylvania with the hope of increasing clinician awareness. We identified a cohort of 61 patients diagnosed with anaplasmosis at our institution as well as cases reported to the Department of Health. From our review, we identified not only an increase in cases over time but what appears to be an expansion further into central and western Pennsylvania over time.
Petrogenesis of Mantle-Hosted Granitoids from the Samail Ophiolite
Authors: Angelo Tiago Valim , Spencer Christopher J , Cavosie Aaron J , Thomas Robert , Li Hong-Yan 
Published: April 2023

Abstract
Granitoids with evolved chemical signatures, intruding both oceanic crustal rocks and mantle peridotite, are well known in the Samail supra-subduction ophiolite of Oman and United Arab Emirates. The former are metaluminous tonalites and trondhjemites have positive εNd, relatively low δ18O values, resemble ridge ‘tholeiitic’ granitoids with MORB-like affinity, and formed by fractionation of basalt/gabbro or anatexis of oceanic crust. In contrast, the mantle-hosted granitoids are peraluminous, with negative εNd and high δ18O values. They can be modeled as having formed by mixing between partial melts of metabasalt and metasedimentary rocks with minimal mantle contribution. The mantle-hosted granitoids resemble typical peraluminous S-type granitoids (e.g. Himalaya, Variscan, Lachlan) but are compositionally distinct in having notably scattered data values of K2O, Na2O, CaO, Rb/Sr, relatively higher silica and, lower (Al2O3 + FeO + MgO + TiO2 wt%) and Th/Yb as compared to typical S-types. The mantle-hosted granitoids mainly originate from the subducted slab, and mostly intruded mantle peridotite in the lithospheric mantle, with no apparent association with the overriding oceanic plate and little interaction (e.g. assimilation) with the mantle. While the specific controls on geochemical variations remain speculative, results from this study show that the Samail mantle-hosted S-type granitoids are compositionally distinct from classic S-type granitoids formed in orogenic belts. While global S-type granitoids may be mineralogically similar, the Samail mantle-hosted granitoids preserve different geochemical signatures, reflecting their formation in distinct tectonic setting, including the mantle.
Sidestepping the Frege–Geach Problem
Authors: Bex-Priestley Graham , Gamester Will 
Published: April 2023

AbstractHybrid expressivists claim to solve the Frege–Geach problem by offloading the explanation of the logico-semantic properties of moral sentences onto the belief-components of hybrid states they express. We argue that this strategy is undermined by one of hybrid expressivism's own commitments: That the truth of the belief-component is neither necessary nor sufficient for the truth of the hybrid state it composes. We articulate a new approach. Instead of explaining head-on what it is for, say, a pair of moral sentences to be inconsistent, expressivists should ‘sidestep’ and explain what it is to think that a pair of moral sentences is inconsistent. To think so is to think they cannot both be true—a modal notion. Since expressivists have given accounts of such modals, we illustrate how sentences like ‘‘‘lying is wrong’’ and ‘‘lying is not wrong’’ are inconsistent’ express sensible—and rationally compelling—states of mind.
Two Neuroanatomical Signatures in Schizophrenia: Expression Strengths Over the First 2 Years of Treatment and Their Relationships to Neurodevelopmental Compromise and Antipsychotic Treatment
Authors: du Plessis Stefan , Chand Ganesh B , Erus Guray , Phahladira Lebogang , Luckhoff Hilmar K , Smit Retha , Asmal Laila , Wolf Daniel H , Davatzikos Christos , Emsley Robin 
Published: April 2023

Abstract

Background and Hypothesis
Two machine learning derived neuroanatomical signatures were recently described. Signature 1 is associated with widespread grey matter volume reductions and signature 2 with larger basal ganglia and internal capsule volumes. We hypothesized that they represent the neurodevelopmental and treatment-responsive components of schizophrenia respectively.

Study Design
We assessed the expression strength trajectories of these signatures and evaluated their relationships with indicators of neurodevelopmental compromise and with antipsychotic treatment effects in 83 previously minimally treated individuals with a first episode of a schizophrenia spectrum disorder who received standardized treatment and underwent comprehensive clinical, cognitive and neuroimaging assessments over 24 months. Ninety-six matched healthy case–controls were included.

Study Results
Linear mixed effect repeated measures models indicated that the patients had stronger expression of signature 1 than controls that remained stable over time and was not related to treatment. Stronger signature 1 expression showed trend associations with lower educational attainment, poorer sensory integration, and worse cognitive performance for working memory, verbal learning and reasoning and problem solving. The most striking finding was that signature 2 expression was similar for patients and controls at baseline but increased significantly with treatment in the patients. Greater increase in signature 2 expression was associated with larger reductions in PANSS total score and increases in BMI and not associated with neurodevelopmental indices.

Conclusions
These findings provide supporting evidence for two distinct neuroanatomical signatures representing the neurodevelopmental and treatment-responsive components of schizophrenia.
Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians
Authors: McKinley Kenneth W. , Tran Jennifer Q. , Chamberlain James M. , Berkowitz Deena D. 
Published: April 2023

ABSTRACT

Objective:
To determine if there was a clinically important difference (15 minutes or more) in length of stay (LOS) for low-acuity pediatric ED patients treated by PAs compared with those treated by pediatricians.

Methods:
Between July 2017 and February 2020, shifts were identified that had shared PA and pediatrician staffing in the low-acuity care area for a large, urban ED. LOS was collected for every patient during the 6 hours of overlap for each shift. Using a paired analysis, we calculated the difference in mean LOS for these shifts.

Results:
Mean shift LOS for children seen by PAs (160.1 minutes, SD: 48.6) was 10.1 minutes longer (95% CI: 6.1, 14.1) than mean shift LOS for children seen by pediatricians (150 minutes, SD: 47.3).

Conclusions:
No clinically important difference in LOS was found for low-acuity children treated by PAs compared with those treated by pediatricians in a large, urban ED.
A Faculty Toolkit to Pilot Next Generation NCLEX-Style Exam Items in a Prelicensure Curriculum
Authors: Davis Rebecca G. 
Published: April 2023

Abstract
With the implementation of Next Generation NCLEX (NGN), many prelicensure nurse faculty feel unprepared to create examination items in the formats proposed. These formats are designed to meaningfully evaluate clinical judgment while providing learners experience with the NGN assessment format prior to their sitting for the licensure examination. This article presents one program’s pilot of NGN-style exam items in three clinical courses. Resources created for faculty to successfully implement the pilot items, outcomes of the pilot, and future plans for full implementation are discussed.
Implementing the AAOS Guidelines for Screening of Developmental Dysplasia of the Hip Before the Age of 6 Months in Taiwan
Authors: Hsu Kuei-Hsiang , Chang Wen-Chieh , Feng Chi-Kuang , Su Yu-Ping 
Published: April 2023

Background:
The prevalence of developmental dysplasia of the hip (DDH) has been considered to be low in East Asia, but this may be incorrect because of inconsistent diagnostic definitions and testing criteria. In 2015, the AAOS released guidelines for systematic screening for DDH in newborns. We implemented these guidelines and compared DDH incidence and outcomes before and after their implementation.

Methods:
We used a historic comparison cohort of newborns with DDH between July 2015 and May 2017 before guideline implementation (the preguideline group); their data were retrieved using electronic medical records. In this group, the newborns received general hip screening without systemic follow-up. The postguideline group included newborns who were screened for hip dysplasia and followed up per the AAOS guidelines between July 2017 and May 2019. Their data were prospectively collected. The primary outcome in the postguideline group was DDH incidence. Other outcomes included rates of referral, surgery, and complications, and DDH prognosis.

Results:
The preguideline and postguideline groups included 3534 and 2663 newborns, respectively, of whom 49 (1.1%) and 225 (8.4%), respectively, were referred to the pediatric orthopaedic clinic enrolled. In the postguideline group, 35 patients were diagnosed as having DDH (incidence: 1.3%, 95% CI: 0.8%–1.9%). Both the incidence and referral rates were significantly higher in the postguideline group than in the preguideline group. Furthermore, the mean age at referral was 6.7±10.06 months and 0.9±0.25 months in the preguideline and postguideline groups, respectively, indicating a potential for early treatment in the postguideline group. Finally, the female sex was identified as a risk factor for residual hip dysplasia at 6 months of age.

Conclusion:
DDH incidence in East Asia seems comparable to that in Western countries. Implementing the AAOS guidelines increased the diagnosis rate and opportunity for early treatment initiation, thus potentially avoiding surgical intervention. Nevertheless, residual DDH may be detected in some patients at 6 months of age, particularly in female infants.

Level of Evidence:
Level IV.
Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy
Authors: Dearborn Logan C , Hazlehurst Marnie F , Loftus Christine T , Szpiro Adam A , Carroll Kecia N , Moore Paul E , Adgent Margaret A , Barrett Emily S , Nguyen Ruby HN , Sathyanarayana Sheela , LeWinn Kaja Z , Bush Nicole R , Kaufman Joel D , Karr Catherine J 
Published: April 2023

Background:
Infants experiencing bronchiolitis are at increased risk for asthma, but few studies have identified modifiable risk factors. We assessed whether early life air pollution influenced child asthma and wheeze at age 4–6 years among children with a history of bronchiolitis in the first postnatal year.

Methods:
Children with caregiver-reported physician-diagnosed bronchiolitis were drawn from ECHO-PATHWAYS, a pooled longitudinal cohort from six US cities. We estimated their air pollution exposure from age 1 to 3 years from validated spatiotemporal models of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). Caregivers reported children’s current wheeze and asthma at age 4–6 years. We used modified Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for child, maternal, and home environmental factors. We assessed effect modification by child sex and maternal history of asthma with interaction models.

Results:
A total of 224 children had caregiver-reported bronchiolitis. Median (interquartile range) 2-year pollutant concentrations were 9.3 (7.8–9.9) µg/m3 PM2.5, 8.5 (6.4–9.9) ppb NO2, and 26.6 (25.6–27.7) ppb O3. RRs (CI) for current wheeze per 2-ppb higher O3 were 1.3 (1.0–1.7) and 1.4 (1.1–1.8) for asthma. NO2 was inversely associated with wheeze and asthma whereas associations with PM2.5 were null. We observed interactions between NO2 and PM2.5 and maternal history of asthma, with lower risks observed among children with a maternal history of asthma.

Conclusion:
Our results are consistent with the hypothesis that exposure to modest postnatal O3 concentrations increases the risk of asthma and wheeze among the vulnerable subpopulation of infants experiencing bronchiolitis.
Prevalence and Factors Associated With Delayed Puberty Among Adolescents on Boosted Protease Inhibitor–based Second-line Antiretroviral Therapy: A Cross-sectional Study at a Pediatric Infectious Diseases Clinic in Uganda
Authors: Nakiddu Nana Jacqueline , Bakeera-Kitaka Sabrina , Musoke Philippa 
Published: April 2023

Background:
Delayed puberty is a recognized phenomenon among children living with HIV type 1 infection but has not been widely reported among adolescents on second-line or newer treatments in high burden settings. The study aimed to determine the prevalence of, and factors associated with delayed puberty among adolescents on boosted protease inhibitor-based second-line antiretroviral therapy (ART) in Uganda.

Methods:
Between December 2017 and May 2018, we conducted a cross-sectional study among adolescents living with HIV (ALWHIV) 10–19 years of age on atazanavir- and lopinavir-based regimens at the Paediatric Infectious Diseases Clinic, Kampala. Participants were on ART for at least 3 months and had a recent viral load. Sociodemographics, clinical measurements: body mass index for age Z score, height for age Z score, Tanner staging were collected. ART history was extracted from medical records. The outcome was delayed puberty defined as absence of signs of breast development in a girl 13 years of age or a testicular volume of less than 4 mL in a boy 14 years of age by Tanner staging, or an age for Tanner staging which was at least 2 standard deviations above the expected mean.

Results:
Among 230 perinatally infected ALWHIV participants, 14.7 ± 3.1 years of age were included, 54.9% were female, 5.2% were wasted and the median duration on ART was 9.5 years (interquartile range 7.3–11.7). The prevalence of delayed puberty was 8.7% (10.4% females, 6.7% males). Overall mean age estimates at different Tanner stages by sex were significantly higher than reference populations. Age at ART initiation (adjusted odds ratio 1.37, 95% confidence interval: 1.06–1.77) and body mass index for age Z score (adjusted odds ratio: 7.63, 95% confidence interval: 1.80–32.38) were associated with delayed puberty.

Conclusions:
Timely initiation of ART and nutritional monitoring could optimize body weight and consequently, normal puberty for ALWHIV. Longitudinal studies could establish biological diagnoses and guide treatment of delayed puberty in this population.
Benefits and Challenges of Transitioning Occupational Health to an Enterprise Electronic Health Record
Authors: Isakari Marcia , Sanchez Arthur , Conic Rosalynn , Peretti Jacqueline , Saito Kenji , Sitapati Amy M. , Millen Marlene , Longhurst Christopher 
Published: April 2023

Objective
Occupational health (OH) documentation has traditionally been separate from health system electronic health records (EHRs), but this can create patient safety and care continuity challenges. Herein, we describe outcomes and challenges of such integration including how one health system managed compliance with laws, regulations, and ethical principles concerning digital privacy.

Methods
Occupational health integration with the enterprise EHR at the University of California San Diego Health was started in June 2021 and completed in December 2021.

Results
Integrating with the enterprise EHR allowed for a secure telehealth system, faster visit times, digitization of questionnaires medical clearance forms, and improved reporting capabilities.

Conclusions
Integration and interoperability are fundamental building blocks to any OH EHR solution and will allow for evaluation of worker population trends, and targeted interventions to improve worker health status.
Interventions for sustainable surgery: a systematic review
Authors: Lam Kyle , Gadi Nishita , Acharya Amish , Winter Beatty Jasmine , Darzi Ara , Purkayastha Sanjay 
Published: April 2023

Objective:
To systematically evaluate interventions designed to improve the sustainability of surgical practice with respect to their environmental and financial impact.

Background:
Surgery contributes significantly to emissions attributed to healthcare due to its high resource and energy use. Several interventions across the operative pathway have, therefore, been trialed to minimize this impact. Few comparisons of the environmental and financial effects of these interventions exist.

Materials and methods:
A search of studies published up to 2nd February 2022 describing interventions to increase surgical sustainability was undertaken. Articles regarding the environmental impact of only anesthetic agents were excluded. Data regarding environmental and financial outcomes were extracted with a quality assessment completed dependent upon the study design.

Results:
In all, 1162 articles were retrieved, of which 21 studies met inclusion criteria. Twenty-five interventions were described, which were categorized into five domains: ‘reduce and rationalize’, ‘reusable equipment and textiles’, ‘recycling and waste segregation’, ‘anesthetic alternatives’, and ‘other’. Eleven of the 21 studies examined reusable devices; those demonstrating a benefit reported 40–66% lower emissions than with single-use alternatives. In studies not showing a lower carbon footprint, the reduction in manufacturing emissions was offset by the high environmental impact of local fossil fuel-based energy required for sterilization. The per use monetary cost of reusable equipment was 47–83% of the single-use equivalent.

Conclusions:
A narrow repertoire of interventions to improve the environmental sustainability of surgery has been trialed. The majority focuses on reusable equipment. Emissions and cost data are limited, with longitudinal impacts rarely investigated. Real-world appraisals will facilitate implementation, as will an understanding of how sustainability impacts surgical decision-making.