bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between dual sensory impairment and dementia: A systematic review and meta-analysis
Authors: Yoshida Yuto , Hiratsuka Yoshimune , Umeya Reiko , Ono Koichi , Nakao Shintaro 
Published: January 2025

Background Sensory impairments have been linked to dementia. However, the impact of dual sensory impairment (DSI), combining both vision impairment and hearing impairment, on dementia has shown inconsistent results. Objective To systematically review the evidence on the association DSI and dementia. Methods A systematic literature search was conducted using MEDLINE, EMBASE, and the Cochrane Library databases. Included studies were prospective or retrospective cohort studies and a case-control study. The primary outcome was the onset of dementia or its various subtypes, including Alzheimer's disease (AD) and vascular dementia (VaD). Effect sizes, including hazard ratios (HRs), were pooled through a random-effects model. Results A total of 11 observational studies with 346,659 participants were included. DSI was significantly associated with the incidence of dementia compared to no sensory impairment (9 studies; HR: 1.46; 95% confidence interval [CI]: 1.29–1.65). Among subtypes of dementia, DSI was associated with AD onset (4 studies; HR: 2.07; 95% CI: 1.45–2.94); however, this association was not found in VaD (2 studies; HR: 1.65; 95% CI: 0.96–2.85). Conclusions These findings suggest that DSI is significantly associated with an increased risk of dementia. Further research is required to identify preventive strategies to decrease the incidence of dementia in individuals with sensory impairment.
Shielding properties of hybrid knitted fabrics: reflection and absorption
Authors: Arabuli Svitlana , Arabuli Arsenii , Kyzymchuk Olena , Tunakova Veronika , Bajzik Vladimir , Halavska Liudmyla 
Published: January 2025

Last decade a lot of research was done in the development and investigation of textile-based shielding materials against electromagnetic radiation. Still, there is a gap in understanding the effect of knitted structure (i.e., stitch type and shape) on shielding effectiveness by different shielding mechanisms: reflection and absorption. Seven knitted fabrics were produced on 8-gauge flat knitting machines, using 0.12 mm diameter stainless steel (SS) wire and 30 x 2 tex cotton yarn. The fabrics differ by the method of incorporation of conductive element (SS wire) into the knitted structure: separately and simultaneously with cotton yarn and used interloopings. The effect of stitch type (loop, float, or tuck) was studied as well. It was found that both the method of SS wire incorporation and the shape of its positioning in the knitted structure affect the EMR shielding effectiveness while only the method of SS wire incorporation determines the shielding mechanism: absorption or reflection. The half Milano rib knitted structures demonstrate the best shielding efficiency due to the additional floats behind held loops.
Artificial Intelligence for Cervical Spine Fracture Detection: A Systematic Review of Diagnostic Performance and Clinical Potential
Authors: Liawrungrueang Wongthawat , Cholamjiak Watcharaporn , Promsri Arunee , Jitpakdee Khanathip , Sunpaweravong Sompoom , Kotheeranurak Vit , Sarasombath Peem 
Published: January 2025

Study Design Systematic review. Objective Artificial intelligence (AI) and deep learning (DL) models have recently emerged as tools to improve fracture detection, mainly through imaging modalities such as computed tomography (CT) and radiographs. This systematic review evaluates the diagnostic performance of AI and DL models in detecting cervical spine fractures and assesses their potential role in clinical practice. Methods A systematic search of PubMed/Medline, Embase, Scopus, and Web of Science was conducted for studies published between January 2000 and July 2024. Studies that evaluated AI models for cervical spine fracture detection were included. Diagnostic performance metrics were extracted and included sensitivity, specificity, accuracy, and area under the curve. The PROBAST tool assessed bias, and PRISMA criteria were used for study selection and reporting. Results Eleven studies published between 2021 and 2024 were included in the review. AI models demonstrated variable performance, with sensitivity ranging from 54.9% to 100% and specificity from 72% to 98.6%. Models applied to CT imaging generally outperformed those applied to radiographs, with convolutional neural networks (CNN) and advanced architectures such as MobileNetV2 and Vision Transformer (ViT) achieving the highest accuracy. However, most studies lacked external validation, raising concerns about the generalizability of their findings. Conclusions AI and DL models show significant potential in improving fracture detection, particularly in CT imaging. While these models offer high diagnostic accuracy, further validation and refinement are necessary before they can be widely integrated into clinical practice. AI should complement, rather than replace, human expertise in diagnostic workflows.
Therapeutic alliance during trauma focused treatment in adolescent and young adult patients with PTSD
Authors: Grass Anne , Rosner Rita , Ciner Angelina , Renneberg Babette , Steil Regina 
Published: January 2025

Abstract

Background
Greater therapeutic alliance has been associated with an improved treatment outcome in various clinical populations. However, there is a lack of evidence for this association in posttraumatic stress disorder (PTSD) in young patients. We therefore investigated the development of the therapeutic alliance during Developmentally adapted cognitive processing therapy (D-CPT) in adolescents and young adults with PTSD following abuse to answer the question whether there was a connection between the therapeutic alliance and symptom reduction.

Methods
Weekly assessments of therapeutic alliance, rated by patients and their therapists, as well as PTSD symptom severity from a randomized controlled trial (RCT) of D-CPT were analyzed with multilevel modelling. The sample consisted of n = 39 patients aged 14–21 with a history of sexual and/or physical abuse.

Results
Therapeutic alliance increased during D-CPT. The ratings of the therapeutic alliance by patients and therapists were strongly correlated (r = .512, p < .01); however, at session level, there was a significant difference between the patients’ and their therapists’ alliance assessments. Patients with a higher perceived therapeutic alliance showed a greater reduction in self-reported symptoms over the course of therapy, compared to patients with lower alliance ratings. However, this only applied to the therapeutic alliance assessed by the patients.

Discussion
The therapeutic alliance plays a crucial role in D-CPT with young patients, contributing to a reduction in symptom severity over the course of treatment. It is essential that therapists prioritize the development of a strong alliance and seek feedback from their patients. The results suggest that patients’ perceptions, which often differ from therapists’ assessments, were more important in determining treatment success in the sample. Studies with larger samples sizes and additional independent ratings of alliance are needed to further examine the alliance-outcome link.

Trial registration
The trial was registered at the German Clinical Trial Registry, DRKS00004787, 18 March 2013, https://www.drks.de/DRKS00004787.
Time-dependent, patient-centered perceptions of quality measures for total joint arthroplasty: a cross-sectional, choice modeling study
Authors: Lemos Jacie L. , Welch Jessica M. , Amanatullah Derek F. , Shapiro Lauren M. , Harris Alex H. S. , Kamal Robin N. 
Published: January 2025

Abstract

Background
As value-based care arrangements continue to assess quality of care and costs, comprehensive and patient-centered definitions of quality of care are required. While patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), patient perceptions of quality paired with the phase of surgical care has not been described. The purpose of this study was to assess how TJA patients perceive measures of quality of care and assess if these perceptions change based on the phase of care.

Methods
Patients who had undergone a TJA within the past two years or had a scheduled TJA within the next 6 months completed a questionnaire designed using best-worst scaling, a method used to measure individuals’ priorities by asking participants to make repeated selections of the best and worst items in a series of subsets of items. Subanalyses were calculated to compare each phase of care (preoperative, short term postoperative, and long term postoperative).

Results
A total of 153 patients completed the questionnaire; 36 were preoperative, 55 were short term postoperative, and 62 were long term postoperative. Patients placed the highest value on improving activities of daily living (β = 1.03, CI = 0.90-1.16), decreasing pain (β = 0.65, CI = 0.53-0.76), and avoiding re-intervention (β = 0.64, CI = 0.52-0.76). Decreasing pain ranked as a higher priority preoperatively compared to short term postoperatively, and subsequently increased in priority again after 6 months. Avoiding reintervention was less important to patients preoperatively compared to postoperatively. Avoiding complications was more important to patients preoperatively compared to postoperatively.

Conclusions
Matching outcome assessments with how patients assess their quality of care throughout the TJA recovery process can inform phase-specific quality improvement initiatives and value definitions. Activities of daily living should be measured across phases of care and into long-term recovery. TJA value dashboards should align with these patient-driven perceptions of quality.

Level of evidence
Level III, cohort study.
The potential of a population register for addressing health inequities: an observational study using data linkage to improve breast cancer screening enrolment and participation in Indigenous Māori women in Aotearoa New Zealand
Authors: Aye Phyu Sin , Bartholomew Karen , Walsh Michael , Pritchard Kathy , Pierce Maree , Richards Jenny , Chambers Erin , Haggie Aroha , Solomon Jesse , Lord Gabrielle , Soloai Tiffany , Symons Lorraine , Tipene Roimata , Jansen Rawiri McKree 
Published: January 2025

Abstract

Background
Breast cancer screening in Aotearoa New Zealand (NZ) still has persistent inequitable coverage by ethnicity, especially for Indigenous Māori women. This project aimed to undertake systematic data linkage to identify and invite eligible Māori women to participate in breast screening.

Methods
This is a cross-sectional observational study conducted in Northern New Zealand between 1/01/2020 and 30/06/2021. The BreastScreen Aotearoa (BSA) register was linked with the primary care data to identify and invite eligible Māori women (aged 45–69 years) to breast screening, who were not currently enrolled in BSA, and who were enrolled in BSA but had not been screened or overdue for breast screening. Invitations were sent through invitation letters, text messages and phone calls. Enrolment to BSA and screening participation at 15 and 18 months from the project’s start date were reported.

Results
Through the data linkage, 2295 women who were not enrolled in BSA were identified eligible for breast screening. Approximately half (n = 1086) of the women were contactable within 5 contact attempts. Of these contactable, 345 (32%) women were enrolled in BSA, 421 (39%) were screened at 15 months, increasing to 441 (41%) at 18 months from the project start. Among women who were previously enrolled but never screened or overdue for screening, 1470 women were eligible. Their contact details were updated through the data linkage, which facilitated BSA to contact them successfully for breast screening. Consequently, 305 (21%) of these eligible were screened at 15 months, and increased to 332 (23%) at 18 months.

Conclusions
The data linkage approach has evidenced the benefit of a population register to facilitate equitable access to breast screening services. Further work is needed on choices of combined approaches for optimising screening uptake equitably.
Co-creation of a gender responsive TB intervention in Nigeria: a researcher-led collaborative study
Authors: Ugwu Chukwuebuka , Adekeye Oluwatoyosi , Ringwald Beate , Thomson Rachael , Chijioke-Akaniro Obioma , Anyaike Chukwuma , Squire S Bertel , Bimba John , Wingfield Tom 
Published: January 2025

Abstract

Background
In Nigeria, men constitute over half of the people notified with tuberculosis (TB), experience longer delays before reaching care, and are estimated to account for two thirds of people who miss out on care. The higher TB risk and burden in men has implications for the whole population and reaching them earlier with TB services will reduce onward transmission in households, communities, and workplaces. The absence of a comprehensive guidance and the lack of substantial empirical evidence on TB care approaches that are responsive to the needs of men in Nigeria exacerbates this problem. Therefore, this research aimed to co-create a gender-responsive intervention for men in peri-urban communities in Nigeria.

Methods
Our study utilised a researcher-led collaborative approach to engage local TB stakeholders including communities adversely affected by the disease to co-create a gender-responsive TB intervention. Between March and November 2022, we engaged 13 local TB stakeholders in a three-phase participatory intervention design process. This engagement involved two iterative cycles of Delphi research online, and an in-person workshop. In the first and second phases, participants described the potential impact of 15 listed interventions and prioritised combinations of nine interventions deemed to be effective in overcoming identified gendered barriers. Responses were analysed using a combination of qualitative framework approach, content analysis, and summary descriptive statistics assisted by NVivo software. Stakeholder consensus on a preferred intervention package was reached during the participatory workshop.

Results
Overall, participants prioritised approaches that sought to actively find and systematically screen men for TB including awareness creation as a crucial component. The stakeholders placed significant considerations on the synergy between interventions and their programmatic sustainability when making their final choices. Consequently, a complex intervention package comprising three components was developed. These included targeted awareness creation among men in communities; TB screening in male-dominated socio-cultural congregate settings; and the use of digital chest X-ray screening. Anticipated early outputs of this intervention included improved TB knowledge, increased care-seeking, reduced TB-related costs and TB stigma, and accelerated early diagnosis among men in Nigeria.

Conclusion
Leveraging the insights and experiences of local stakeholders through iterative engagements yielded consensus on a viable gender-responsive TB intervention.
Triglyceride-glucose index: carotid intima-media thickness and cardiovascular risk in a European population
Authors: Pavanello Chiara , Ruscica Massimiliano , Castiglione Sofia , Mombelli Giuliana Germana , Alberti Antonia , Calabresi Laura , Sirtori Cesare Riccardo 
Published: January 2025

Abstract

Background
The triglyceride-glucose (TyG) index is now widely recognized as a marker of insulin resistance and has been linked to the development and prognosis of atherosclerotic cardiovascular diseases (ASCVD) in numerous populations, particularly in the Eastern world. Although there are fewer reports from the Western world, and they are sometimes contradictory, the absence of definitive data on the relationship between a raised TyG index and cardiovascular risk suggested the opportunity of testing this biochemical marker against a well-established vascular marker such as the carotid intima media thickness (c-IMT).

Methods
Primary prevention patients were selected from a cohort of individuals who underwent c-IMT measurement between 1984 and 2018 at the Dyslipidemia Center at the ASST Grande Ospedale Metropolitano Niguarda in Milan, Italy. The TyG index was calculated as the Ln [fasting TG (mg/dL)×fasting glucose (mg/dL)/2]. Carotid ultrasonography was performed using echographic measurements of the far walls of the left and right common, internal carotids, and bifurcations. Patients were followed for up to 20 years with periodic evaluation of biochemical parameters. ASCVD events were monitored through hospital records, where all patients were regularly examined.

Results
The analysis included 3108 individuals with a mean age of 54.9 ± 13.1 years. Participants were generally non-obese, with an average BMI of 24.6 ± 3.5 Kg/m2. Among the women, 83.1% were postmenopausal. The mean TyG index was 8.65 ± 0.59. There was a significant association between the TyG index and all c-IMT measurements. Those in the highest TyG index quartiles had significantly higher IMTmean and IMTmax compared to those in the lower quartiles. These associations were consistent across all vascular sites examined and remained significant after adjusting for all potential confounders. Kaplan-Meier survival analysis revealed an increased incidence of ASCVD events in the two highest TyG index quartiles.

Conclusions
TyG index is a sensitive marker of risk in a European population with moderate ASCVD risk, as assessed by c-IMT measurements, in a large cohort of Lipid Clinic patients.
Uncovering the genetic basis of antiviral polyketide limocrocin biosynthesis through heterologous expression
Authors: Melnyk Sofiia , Stierhof Marc , Bratiichuk Dmytro , Fries Franziska , Müller Rolf , Rebets Yuriy , Luzhetskyy Andriy , Ostash Bohdan 
Published: January 2025

Abstract

Background

Streptomyces roseochromogenes NRRL 3504 produces clorobiocin, an aminocoumarin antibiotic that inhibits DNA replication. No other natural products have been isolated from this bacterium so far, despite the presence of a rich repertoire of specialized metabolite biosynthesis gene clusters (smBGCs) within its genome. Heterologous expression of smBGCs in suitable chassis speeds up the discovery of the natural products hidden behind these sets of genes.

Results
In this work we focus on one intriguing smBGC of NRRL 3504 bearing some similarity to gene clusters involved in production of manumycin family polyketides. Through heterologous expression in Streptomyces chassis strains S. albus Del14 and S. lividans ΔYA9, this smBGC (hereafter referred to as lim BGC) was shown to direct the production of unusual polyketide limocrocin (LIM) known for its ability to interfere with viral reverse transcriptases. The organization of lim BGC, data on the structures of revealed metabolites as well as manipulations of lim genes allowed us to put forward an initial hypothesis about a biosynthetic pathway leading to LIM. We provide initial data on two LIM derivatives as well as updated NMR spectra for the main product.

Conclusion
This study reveals the genetic control of biosynthesis of LIM that remained hidden for the last 70 years. This, in turn, opens the door to biological routes towards overproduction of LIM as well as generation of its derivatives.
Klebsiella pneumoniae-derived extracellular vesicles impair endothelial function by inhibiting SIRT1
Authors: Li Xinxin , Cui Jinghua , Ding Zanbo , Tian Ziyan , Kong Yiming , Li Linghai , Liu Yang , Zhao Wen , Chen Xueying , Guo Han , Cui Zhengshuo , Li Xinwei , Yuan Jing , Zhang Huina 
Published: January 2025

Abstract

Background
The potential role of Klebsiella pneumoniae (K.pn) in hypertension development has been emphasized, although the specific mechanisms have not been well understood. Bacterial extracellular vesicles (BEVs) released by Gram-negative bacteria modulate host cell functions by delivering bacterial components to host cells. Endothelial dysfunction is an important early event in the pathogenesis of hypertension, yet the impact of K.pn-secreted EVs (K.pn EVs) on endothelial function remains unclear. This study aimed to investigate the effects of K.pn EVs on endothelial function and to elucidate the underlying mechanisms.

Methods

K.pn EVs were purified from the bacterial suspension using ultracentrifugation and characterized by transmission electron microscopy nanoparticle tracking analysis, and EV marker expression. Endothelium-dependent relaxation was measured using a wire myograph after in vivo or ex vivo treatment with K.pn EVs. Superoxide anion production was measured by confocal microscopy and HUVEC senescence was assessed by SA-β-gal activity. SIRT1 overexpression or activator was utilized to investigate the underlying mechanisms.

Results
Our data showed that K.pn significantly impaired acetylcholine-induced endothelium-dependent relaxation and increased superoxide anion production in endothelial cells in vivo. Similarly, in vivo and ex vivo studies showed that K.pn EVs caused significant endothelial dysfunction, endothelial provocation, and increased blood pressure. Further examination revealed that K.pn EVs reduced the levels of SIRT1 and p-eNOS and increased the levels of NOX2, COX-2, ET-1, and p53 in endothelial cells. Notably, overexpression or activation of SIRT1 attenuated the adverse effects and protein changes induced by K.pn EVs on endothelial cells.

Conclusion
This study reveals a novel role of K.pn EVs in endothelial dysfunction and dissects the relevant mechanism involved in this process, which will help to establish a comprehensive understanding of K.pn EVs in endothelial dysfunction and hypertension from a new scope.
Evaluation of the effects of asymmetric lumbosacral transitional vertebra on pelvic morphology in dogs using ventrodorsal radiographs
Authors: Berg Jon Andre , Saevik Bente Kristin , Lingaas Frode , Trangerud Catrine 
Published: January 2025

Abstract

Background
A lumbosacral transitional vertebra (LTV) is a congenital anomaly of the caudal vertebral column. It has been associated with asymmetrical canine hip dysplasia (CHD) and cauda equina syndrome (CES) in German Shepherd dogs. This retrospective cross-sectional study aims to report the potential influence of asymmetric LTV on pelvic anatomy using ventrodorsal (VD) radiographs.

Results
The results are based on the evaluation of VD radiographs of 13,950 dogs from 14 breeds; an LTV was identified in 18.5%. The LTV segments were allotted into symmetrical (78.6%) and asymmetrical (21.4%) categories. An asymmetrical CHD grade was observed in 12.4% of the dogs, of which 39.7% had asymmetrical LTV. An asymmetric LTV was associated with an uneven sacroiliac joint length, in which the shortest sacroiliac joint is positioned more caudally, resulting in a reduced distance to the hip joint (P < 0.001). Rotation of the asymmetrical LTV segment about the long axis was associated with opposite pelvis rotation vertically (P < 0.001). Also, long-axis rotation of the asymmetric LTV segment was associated with an elevation of the pelvis (P < 0.001), promoting an asymmetrical CHD grade (P < 0.001).

Conclusions
This study suggests a compensatory mechanism for the sacroiliac joint related to an asymmetrical LTV. Counter-rotation between the pelvis and the LTV segment vertically may straighten the lower back. The asymmetrical LTV segment most likely affects the rotation of the pelvis and may indirectly promote an asymmetrical CHD grade.