bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care for older adults living with dementia in the emergency department: a systematic review and meta-synthesis of care partner roles and perspectives
Authors: Jelinski Dana , Fernandes Brooklynn , Reich Krista , Lang Eddy , Holroyd-Leduc Jayna , Goodarzi Zahra 
Published: January 2025

ObjectiveCare partners play a vital role in supporting persons living with dementia (PLWD) in using medical services. We conducted a meta-synthesis to explore care partner perspectives of ED care for PLWD, as well as healthcare provider (HCP) perceptions of care partner roles within the ED, to identify care gaps and facilitators across the ED continuum.MethodsMEDLINE, PsycINFO and Embase databases were searched from inception to 8 May 2023. Grey literature was also searched. Articles were included if they reported on care partner roles or experiences regarding care delivery for PLWD in the ED, either from the perspective of care partners or HCPs. A charting exercise was used to categorise the primary focus and outcomes of the articles selected for inclusion. A second charting exercise was used to derive overarching themes based on care partner roles in ED care for PLWD, and care partner perspectives surrounding barriers and facilitators to care.Results16 articles were included. Important barriers and facilitators to care for PLWD were identified and organised according to the timepoint of the visit (pre-ED, during a visit and post-ED). Key care gaps and barriers to care included: gaps in primary care access and care planning, ED environment and organisational processes, deficits in communication regarding patient care, lack of care partner involvement in clinical decisions, and difficulties with discharge transitions and follow-up care. Key facilitators to care included: clinical information provided by care partners, care coordination, and care partner support and engagement.ConclusionThese findings can aid in developing dementia-friendly EDs by informing policy and practices, as well as environmental modifications. Future studies should focus on the feasibility and effectiveness of interventions targeted towards EDs and primary care settings. Engagement of care partners in these intervention studies will be critical to their success.
Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review
Authors: Kjeken Ingvild , Bordvik Daniel Huseby , Osteras Nina , Haugen Ida K , Aasness Fjeldstad Kristine , Skaalvik Ingrid , Kloppenburg Margreet , Kroon Féline P B , Tveter Anne Therese , Smedslund Geir 
Published: January 2025

BackgroundWe aimed to update the 2018 systematic literature review on the efficacy and safety of treatments for hand osteoarthritis (OA), which was based on 126 studies.MethodsWe performed a systematic literature search on randomised controlled trials from June 2017 up to 31 December 2023. Risk of bias was assessed using the RoB2 tool. Meta-analyses of previous and new studies regarding the efficacy for pain, function, grip strength and OMERACT/OARSI responders were performed. Certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool.ResultsSixty-five new studies were included. For non-pharmacological interventions, there was low-certainty evidence for a small long-term effect of hand exercises and a moderate long-term effect of thumb orthoses for pain, and moderate-certainty evidence that assistive devices had a moderate long-term effect on function. Concerning pharmacological interventions, there was low-certainty evidence for a moderate short-term effect of oral non-steroidal anti-inflammatory drugs (NSAIDs) on pain, high- and moderate-certainty evidence for a small short-term effect of topical NSAIDs and oral glucocorticoids on function, respectively, and low-certainty evidence that oral glucocorticoids had a small short-term effect on function. Further, there was low-certainty evidence that methotrexate had a small long-term effect on pain. The heterogeneity of studies did not allow for any meta-analyses on surgery.ConclusionThe results largely support current treatment recommendations. However, there is a lack of interventions that efficiently improve grip strength, and the evidence for most current treatments is still limited. To better understand action mechanism of different treatments, future trials should include hand OA subtyping and be powered for subgroup analyses.
STABLE REDUCED HIP AFTER OPEN REDUCTION IN DEVELOPMENTAL DYSPLASIA OF THE HIP
Authors: Maleki Arash , Qoreishy Mohamad , Tajik Katayoon , Valinejad Ghazal , Tahririan Mohammad Ali 
Published: January 2025

Introduction: Developmental dysplasia of the hip (DDH) has a wide spectrum of conditions and treatment plans. Our aim in this study is to investigate related and controllable factors that can lead to secondary redislocation, and use them to foresee a concomitant pelvic osteotomy requirement. Methods: This is a retrospective case-control study on DDH cases reduced via an anterior approach without pelvic osteotomy in our orthopedics hospital from 2019 to 2021. After 24 months, we compared clinical and radiological findings between the failure and successful groups. Results: We reduced 49 hips (38 cases) using an anterior approach without osteotomy. The success rate was 89.8% (five cases re-dislocated), which is accountable for favorable odds. We found no statistically significant correlation between re-dislocation and bilaterality ([Formula: see text] = 0.64), gender ([Formula: see text] = 0.27) or age ([Formula: see text] = 0.82), or the AI before reduction ([Formula: see text] = 0.19). Conclusion: When the reduction has a wide safe zone in the operating room, the reduction of the hip without osteotomy can have satisfactory results, so based on the findings of our study, invasive procedures such as osteotomy will not be necessary if the hip is stable after the open reduction in the operating room.
Caffeine Promotes Adipocyte Autophagy Through the AMPK/SIRT1 Signaling Pathway and Improves High‐Fat Diet–Induced Obesity and Leptin Resistance
Authors: Yinghao Wang , Wenyuan Peng , Chunfeng Li , Jingning Yu , Jun Sheng , Chengting Zi , Xiaoyun Wu 
Published: January 2025

Purpose: Caffeine has been widely studied for its lipid‐lowering and blood‐glucose–lowering effects. This study aimed to investigate whether caffeine can regulate adipocyte autophagy through the AMPK/SIRT1 signaling pathway, both in vivo and in vitro, thereby exerting a hypoglycemic effect.Method: Western blot analysis was conducted to assess changes in the expression levels of FASN, ACC, pACC, SIRT1, LC3II/I, and pAMPKα in 3T3‐L1 cells following caffeine treatment. The size of the lipid droplets was evaluated using Oil Red O staining. Mito Tracker Red and qRT‐PCR were employed to quantify the number of mitochondria in the cells. Six‐week‐old C57BL/6J mice were divided into three groups: control, high‐fat diet (HFD), and HFD + caffeine. After 11 weeks of feeding, insulin resistance was assessed using insulin tolerance and glucose tolerance tests. The expression levels of AMPKα, SIRT1, PPARγ, P62, and LC3II/I in the adipose tissue of each group were measured using Western Blotting. Serum levels of triglycerides (TG), total cholesterol (TC), and leptin were determined by Elisa. Finally, hematoxylin and eosin (HE) staining was performed to observe the size of adipocytes in visceral adipose tissue.Results: Caffeine significantly inhibits the expression of proteins associated with fat synthesis and reduces lipid droplet size in 3T3‐L1 cells. In addition, caffeine robustly activates the AMPK/SIRT1 signaling pathway in 3T3‐L1 cells, promoting autophagy and enhancing mitochondrial biogenesis. In animal models, caffeine effectively attenuates weight gain and insulin resistance induced by a HFD while reducing serum TG and TC levels. Furthermore, caffeine suppresses leptin resistance and mitigates the increased food intake associated with a HFD. Notably, caffeine enhances AMPKα phosphorylation levels and SIRT1 expression in visceral fat, facilitating adipocyte autophagy and reducing lipid accumulation. At the cellular level, caffeine significantly promotes mitochondrial biogenesis.Conclusion: Caffeine enhances autophagy in adipocytes by activating the AMPK/SIRT1 signaling pathway of adipocytes, contributing to antiobesity effects and improving insulin resistance.
Chronic Cigarette Smoke Exposure Masks Pathological Features of Helicobacter pylori Infection While Promoting Tumor Initiation
Authors: Morris Maeve T. , Duncan Benjamin C. , Piazuelo M. Blanca , Olfert I. Mark , Xu Xiaojiang , Hussain Salik , Peek Richard M. , Busada Jonathan T. 
Published: January 2025

Abstract
Gastric cancer is the fifth most common cancer and the fifth leading cause of cancer deaths worldwide. Chronic infection by the bacterium Helicobacter pylori is the most prominent gastric cancer risk factor, but only 1% to 3% of infected individuals will develop gastric cancer. Cigarette smoking is another independent gastric cancer risk factor, and H. pylori–infected smokers are at a 2- to 11-fold increased risk of gastric cancer development, but the direct impacts of cigarette smoke (CS) on H. pylori pathogenesis remain unknown. In this study, male C57BL/6 mice were infected with H. pylori and began smoking within 1 week of infection. The mice were exposed to CS 5 days/week for 8 weeks. CS exposure had no notable impact on gross gastric morphology or inflammatory status compared with filtered-air (FA) exposed controls in mock-infected mice. However, CS exposure significantly blunted H. pylori–induced gastric inflammatory responses, reducing gastric atrophy and pyloric metaplasia development. Despite blunting these classic pathological features of H. pylori infection, CS exposures increased DNA damage within the gastric epithelial cells and accelerated H. pylori–induced dysplasia onset in the INS-GAS gastric cancer model. These data suggest that cigarette smoking may clinically silence classic clinical symptoms of H. pylori infection but enhance the accumulation of mutations and accelerate gastric cancer initiation.
Prevention Relevance: These findings suggest that cigarette smoking suppresses pathophysiological hallmarks of H. pylori infection while accelerating gastric carcinogenesis. Therefore, smokers should receive screening for H. pylori infection to reduce gastric cancer risk.
Epistaxis Versus Nonepistaxis Bleeding in Anticoagulated Patients With Atrial Fibrillation: Results From the ENGAGE AF‐TIMI 48 Trial
Authors: Semco Robert S. , Bergmark Regan W. , Murphy Sabina A. , Cange Abby L. , Unverdorben Martin , Chen Cathy Z. L. , Ruff Christian T. , Antman Elliott M. , Giugliano Robert P. , Bergmark Brian A. 
Published: January 2025

Background
Epistaxis is common with antithrombotic therapy and is often troublesome to patients, yet its frequency, severity, and outcomes are poorly characterized.

Methods and Results

Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation–Thrombolysis in Myocardial Infarction 48 (ENGAGE AF‐TIMI 48) randomized 21 105 patients with atrial fibrillation and CHADS2 risk score ≥2 to higher‐dose edoxaban regimen (60 mg daily, dose‐reduced to 30 mg), lower‐dose edoxaban regimen (30 mg, dose reduced to 15 mg, daily), or warfarin. Bleeds were adjudicated using International Society on Thrombosis and Haemostasis criteria. Patients with intracranial hemorrhage during follow‐up were excluded; those with >1 bleeding event were categorized according to their most severe event. The safety cohort with interval censoring during drug interruption was analyzed. Proportions were compared using Pearson's chi‐square test and treatment arms were compared using a Cox proportional hazards model. Among 5247 patients with a bleeding event, 1008 (19.2%) had epistaxis and 4239 (80.8%) had nonepistaxis bleeding. Epistaxis events were less severe than nonepistaxis bleeds (International Society on Thrombosis and Haemostasis major: 3.2% versus 20.7%; clinically relevant nonmajor: 64.7% versus 60.1%; minor: 32.1% versus 19.2%;
P
<0.001). Permanent drug discontinuation was similar following epistaxis versus nonepistaxis bleeding in patients with major (59.4% versus 53.6%;
P
=0.52) or clinically relevant nonmajor (32.5% versus 33.3%;
P
=0.70) bleeding but was significantly higher in patients with minor epistaxis versus other minor bleeds (33.3% versus 23.9%;
P
=0.001). Compared with warfarin, higher‐dose edoxaban regimen had similar risk of epistaxis (hazard ratio [HR], 1.09 [95% CI, 0.95–1.26]), whereas lower‐dose edoxaban regimen conferred reduced risk (HR, 0.73 [95% CI, 0.62–0.86]).

Conclusions
Epistaxis was frequent, and despite being overall less severe than nonepistaxis bleeding, was associated with similar rates of anticoagulant discontinuation. Compared with warfarin, lower‐dose edoxaban regimen reduced the risk of epistaxis by 27% whereas higher‐dose edoxaban regimen had no effect.

Registration

URL:
https://clinicaltrials.gov
; Unique Identifier:
NCT00781391
.
Excessive Supraventricular Ectopic Activity in Patients With Acute Ischemic Stroke Is Associated With Atrial Fibrillation Detection Within 24 Months After Stroke: A Predefined Analysis of the MonDAFIS Study
Authors: Haeusler Karl Georg , Tütüncü Serdar , Fiessler Cornelia , Jawad‐Ul‐Qamar Muhammad , Kunze Claudia , Schurig Johannes , Dietzel Joanna , Krämer Michael , Petzold Gabor C. , Royl Georg , Helberg Torsten , Thomalla Götz , Nabavi Darius G. , Röther Joachim , Laufs Ulrich , Veltkamp Roland , Heuschmann Peter U. , Kirchhof Paulus , Olma Manuel C. , Endres Matthias 
Published: January 2025

Background
Excessive supraventricular ectopic activity (ESVEA) is regarded as a risk marker for later atrial fibrillation (AF) detection.

Methods and Results

The investigator‐initiated, prospective, open, multicenter MonDAFIS (Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke) study randomized 3465 patients with acute ischemic stroke without known AF 1:1 to usual diagnostic procedures for AF detection or additive Holter monitoring in hospital for up to 7 days, analyzed in a core laboratory. Secondary study objectives include the comparison of recurrent stroke, myocardial infarction, major bleeding, and all‐cause death within 24 months in patients with ESVEA (defined as ectopic supraventricular beats ≥480/day or atrial runs of 10–29 seconds or both) versus patients with newly diagnosed AF versus patients without ESVEA or AF (non‐ESVEA/AF), randomized to the intervention group. Overall, 1435 (84.8%) of 1714 patients randomized to the intervention group had analyzable study ECG monitoring of at least 48 hours' duration within the first 72 hours of monitoring. ESVEA was detected in 363 (25.3%) patients, while AF was first detected in 48 (3.3%) patients. Within 24 months, AF was newly detected in 67 (18.5%) patients with ESVEA versus 60 (5.9%) patients without ESVEA/AF‐ (
P
<0.001). The composite outcome at 24 months was not different between patients with ESVEA and patients without ESVEA/AF (15.2% versus 12.6%;
P
=0.242). All‐cause death was numerically higher in patients with ESVEA (6.6% versus 3.2%), but failed statistical significance (
P
=0.433) in multivariate analysis (including age, heart failure, stroke severity, and creatinine at baseline).

Conclusions
ESVEA in the acute phase of ischemic stroke or transient ischemic attack is associated with AF detection during follow‐up and therefore may be used to select patients for prolonged ECG monitoring.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02204267.
Sex Differences in the Association Between Cardiovascular Autonomic Neuropathy and Mortality in Patients With Type 2 Diabetes: The ACCORD Study
Authors: Zhou Ziwei , Huang Yiquan , Zhuang Xiaodong , Guo Yue , Xie Peihan , Xiong Zhenyu , Liu Menghui , Zhang Wenjing , Zhong Junqi , Li Yi , Liao Xinxue 
Published: January 2025

Background
Cardiovascular autonomic neuropathy (CAN) is a severe complication of type 2 diabetes. Significant sex‐related differences have been observed in type 2 diabetes consequences such as mortality. However, the effect of sex on the association between CAN and mortality in patients with type 2 diabetes is currently unknown.

Methods and Results

We assessed 7866 participants in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, including 4730 men and 3136 women. CAN was diagnosed using a combination of heart rate variability and QT interval index, which has 3 different definitions. There were 1364 cases of all‐cause mortality and 452 cases of cardiovascular disease mortality during a median follow‐up of 9.7 years. We used multivariable Cox regression models to assess the association between different CAN definitions and mortality. In women, various CAN measures were statistically significant associated with an increased risk of all‐cause mortality (CAN1: hazard ratio [HR], 1.64 [95% CI, 1.28–2.09]; CAN2: HR, 1.58 [95% CI, 1.17–2.15]; CAN3: HR, 1.78 [95% CI, 1.20–2.65]) and mortality (CAN1: HR, 2.25 [95% CI, 1.44–3.52]; CAN 2: HR, 2.22 [95% CI, 1.28–3.87]; CAN3: HR, 3.31 [95% CI, 1.67–6.57]). CAN was not significantly associated with mortality in men. A significant multiplicative interaction of CAN and sex was observed on both mortality outcomes (
P
<0.01).

Conclusions
Significant sex‐related differences were observed in CAN and its associated mortality. In terms of mortality risk prevention, CAN should be given greater consideration in women with type 2 diabetes.
Representation of Women in Atrial Fibrillation Ablation Randomized Controlled Trials: Systematic Review
Authors: Khaing Eh , Aroudaky Ahmad , Dircks Danielle , Almerstani Muaaz , Alziadin Nmair , Frankel Samuel , Hollenberg Benjamin , Limsiri Pattarawan , Schleifer William , Easley Arthur , Tsai Shane , Anderson Daniel , Windle John , Khan Faris , Haynatzki Gleb , Peeraphatdit Thoetchai , Goyal Neha , Dunbar Matos Christina L. , Naksuk Niyada 
Published: January 2025

Background
Sex inequality in randomized controlled trials (RCTs) related to cardiovascular disease has been observed. This study examined the proportion of women enrolled in atrial fibrillation (AF) ablation RCTs and the potential risks of underrepresentation of women.

Methods and Results

We systematically searched PubMed and Embase for AF ablation RCTs published from 2015 to 2022. Participant characteristics were compared among trials with higher and lower proportions of women. Of 147 AF ablation RCTs (30,055 participants), only 10 trials had enrolled women ≥50% of the total participants. Additionally, 42 trials (28.57%) excluded pregnant/breastfeeding women; 6 (4.1%) excluded reproductive‐age women without reliable birth control. The proportion of women in AF RCTs ranged from 9% to 71% (median 31.5%), whereas the median proportion of men was 67.7%. The rate of women included in the trials was stable from 2015 to 2022 (
P
=0.49). Study characteristics, including funding source, showed no correlation with the rate of inclusion of women. RCTs with a higher proportion of female participants enrolled older patients with AF, had a higher prevalence of hypertension but less persistent AF, and smaller left atrium size (
P
<0.05 for all). Biological sex was evaluated as a risk factor or in a subgroup analysis in 28 RCTs; 10.7% of these trials observed the implication of sex on their results.

Conclusion
Women were underrepresented in contemporary AF ablation RCTs. Additionally, women enrolled in AF RCTs were likely to have more comorbidities but less advanced AF, limiting the applicability of the results to women with AF.
Mechanical Circulatory Support in Patients Without Cardiogenic Shock Undergoing Percutaneous Coronary Intervention
Authors: Miller P. Elliott , Gordon Aliza S. , Liu Ying , Ahmad Tariq , Bromfield Samantha G. , Girotra Saket , Davila Carlos D. , Crawford Geoffrey , Whitney John , Desai Nihar R. 
Published: January 2025

Background
The use of mechanical circulatory support devices for high‐risk percutaneous coronary intervention (PCI) has increased over the past decade despite limited data of benefit. We sought to examine the association between intravascular microaxial left ventricular assist device (LVAD) versus intra‐aortic balloon pump use in patients without cardiogenic shock (CS) undergoing PCI.

Methods and Results

This retrospective study analyzed claims data from a large, insured population who underwent PCI without CS from April 1, 2016 to July 31, 2022. Using inverse probability treatment weighting, we assessed for the association between device type and clinical outcomes. The primary outcome was all‐cause mortality. Secondary outcomes included stroke, bleeding, incident dialysis, repeat revascularization, and total health care costs during the index admission and at 30 days. We identified 2879 patients without CS who underwent PCI with either an intra‐aortic balloon pump or microaxial LVAD. The mean±SD age was 68.2±12.5 years, and 27% (n=764) were women. After propensity weighting, intravascular LVAD use was not associated with a significant difference in either in‐hospital (odds ratio [OR] 1.30 [95% CI, 0.88–1.91];
P
=0.19) or 30‐day mortality (OR, 1.19 [95% CI, 0.84–1.69];
P
=0.33) compared with intra‐aortic balloon pump use. Compared with those receiving an intra‐aortic balloon pump, the mean total costs for the index admission ($96 716 versus $71 892;
P
<0.001) and at 30 days (+$16 671 [95% CI, $6639–$28 103];
P
=0.001) were significantly higher in those receiving an intravascular LVAD. There was no significant association between device type and stroke, bleeding, incident dialysis, and repeat revascularization at any time point (all
P
>0.05).

Conclusions
In patients without CS undergoing PCI, intravascular LVAD use was associated with higher costs but not associated with lower mortality. Randomized data are needed to improve device selection for patients without CS undergoing PCI.
Differentiation of Related Events in Hippocampus Supports Memory Reinstatement in Development
Authors: Varga Nicole L. , Roome Hannah E. , Molitor Robert J. , Martinez Lucia , Hipskind Elizabeth M. , Mack Michael L. , Preston Alison R. , Schlichting Margaret L. 
Published: January 2025

Abstract
Adults are capable of either differentiating or integrating similar events in memory based on which representations are optimal for a given situation. Yet how children represent related memories remains unknown. Here, children (7–10 years old) and adults formed memories for separate yet overlapping events. We then measured how successfully remembered events were represented and reinstated using fMRI. We found that children formed differentiated representations in the hippocampus—such that related events were stored as less similar to one another compared with unrelated events. Conversely, adults formed integrated representations, wherein related events were stored as more similar, including in medial prefrontal cortex. Furthermore, hippocampal differentiation among children and medial prefrontal cortex integration among adults tracked neocortical reinstatement of the specific features associated with the individual events. Together, these findings reveal that the same memory behaviors are supported by different underlying representations across development. Specifically, whereas differentiation underlies memory organization and retrieval in childhood, integration exhibits a protracted developmental trajectory.