bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron regulation and absorption in athletes: contemporary thinking and recommendations
Authors: Peeling Peter , McKay Alannah 
Published: July 2023

Purpose of review
This review examines recent developments in our understanding of iron regulation/absorption around exercise, with specific attention paid towards the female athlete.

Recent findings
Building on the well accepted knowledge that hepcidin concentrations increase in the 3–6 h period following an acute bout of exercise, recent studies have shown that this links to a reduced fractional iron absorption from the gut during feedings provided 2 h postexercise. Further, a window of enhanced iron absorption has recently been identified to occur 30 min either side of exercise commencement/completion, which allows for strategic iron intake to optimize absorption around exercise. Finally, there is burgeoning evidence to show that iron status and iron regulation change throughout the menstrual cycle and with hormonal contraceptive use, which could have implications for iron status in female athletes.

Summary
Exercise can affect iron regulatory hormone activity, which subsequently impairs iron absorption, potentially contributing to the high rates of iron deficiency seen in athletes. Future research should continue to examine strategies to optimize iron absorption, with consideration to the timing, mode and intensity of exercise, the time of day, and in females, the menstrual cycle/menstrual status.
Medical management of hypertriglyceridemia in pancreatitis
Authors: Gligorijevic Nikola , Stefanovic-Racic Maja , Kershaw Erin E. 
Published: July 2023

Purpose of review
Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) should be considered in all cases of acute pancreatitis and triglyceride levels measured early, so that appropriate early and long-term treatment can be initiated.

Recent findings
In most cases of HTG-AP, conservative management (nothing by mouth, intravenous fluid resuscitation and analgesia) is sufficient to achieve triglyceride levels less than 500 mg/dl. Intravenous insulin and plasmapheresis are sometimes used, although prospective studies showing clinical benefits are lacking. Pharmacological management of hypertriglyceridemia (HTG) should start early and target triglyceride levels of less than 500 mg/dl to reduce the risk or recurrent acute pancreatitis. In addition to currently used fenofibrate and omega-3 fatty acids, several novel agents are being studied for long-term treatment of HTG. These emerging therapies focus mainly on modifying the action of lipoprotein lipase (LPL) through inhibition of apolipoprotein CIII and angiopoietin-like protein 3. Dietary modifications and avoidance of secondary factors that worsen triglyceride levels should also be pursued. In some cases of HTG-AP, genetic testing may help personalize management and improve outcomes.

Summary
Patients with HTG-AP require acute and long-term management of HTG with the goal of reducing and maintaining triglyceride levels to less than 500 mg/dl.
Posttraumatic Stress and Alexithymia
Authors: Putica Andrea , O'Donnell Meaghan L. , Agathos James , Felmingham Kim L. , Krug Isabel , Van Dam Nicholas T. 
Published: July 2023

AbstractThere is a demonstrated association between alexithymia and posttraumatic stress disorder (PTSD). However, work has largely focused on male-dominant, high-risk occupation populations. We aimed to explore the relationship between posttraumatic stress (PTS) and alexithymia among 100 trauma-exposed female university students. Participants completed a Life Events Checklist, the PTSD Checklist for theDiagnostic and Statistical Manual of Mental Disorders (Fifth Edition)(PCL-5), and the Toronto Alexithymia Scale (TAS-20). Multiple regressions were run to examine whether alexithymia was associated with each of the PCL-5 subscales. The TAS-20 total scores were associated with total PTS scores, β = 0.47,t(99)= 5.22,p< 0.001. On a subscale level, Difficulty in Identifying Feelings (DIF) was positively associated (β = 0.50 to 0.41) with all PCL-5 subscales except for Avoidance. Our results align with research showing that for women, the DIF subscale is most strongly associated with PTS, in contrast with the literature on male samples, showing strongest associations with the Difficulties in Describing Feelings subscale, suggesting sex differences in associations between PTS and alexithymia. Our study supports the universality of the associations between alexithymia and PTS.
Negative pressure wound therapy: Where are we in 2022?
Authors: Quacinella Michael A. , Yong Taylor M. , Obremskey William T. , Stinner Daniel J. 
Published: July 2023

Summary:
The use of negative pressure wound therapy (NPWT) continues to be an important tool for surgeons. As the use and general acceptance of NPWT have grown, so have the indications for its use. These indications have expanded to include soft tissue defects in trauma, infection, surgical wound management, and soft tissue grafting procedures. Many adjuvants have been engineered into newer generations of NPWT devices such as wound instillation of fluid or antibiotics allowing surgeons to further optimize the wound healing environment or aid in the eradication of infection. This review discusses the recent relevant literature on the proposed mechanisms of action, available adjuvants, and the required components needed to safely apply NPWT. The supporting evidence for the use of NPWT in traumatic extremity injuries, infection control, and wound care is also reviewed. Although NPWT has a low rate of complication, the surgeon should be aware of the potential risks associated with its use. Furthermore, the expanding indications for the use of NPWT are explored, and areas for future innovation and research are discussed.
Improving Postpartum Depression Screening in the NICU: Partnering with Students to Improve Outreach
Authors: Brady Sinead , Steinwurtzel Rochelle , Kim Rachel , Abascal Elena , Lane Mariellen , Brachio Sandhya 
Published: July 2023

Introduction:
Infants born to mothers with postpartum depression (PPD) are at risk for adverse developmental outcomes. Mothers of premature infants are 40% more likely to develop PPD when compared with the general population. Current published studies on implementing PPD screening in the Neonatal Intensive Care Unit (NICU) do not comply with the American Academy of Pediatrics (AAP) guideline, which recommends multiple screening points in the first year postpartum and includes partner screening. Our team implemented PPD screening that follows the AAP guideline and includes partner screening for all parents of infants admitted to our NICU beyond 2 weeks of age.

Methods:
The Institute For Healthcare Improvement Model for Improvement was the framework for this project. Our initial intervention bundle included provider education, standardized identification of parents to be screened, and bedside screening performed by the nurse with social work follow-up. This intervention transitioned to weekly screening by phone by health professional students and the use of the electronic medical record for notification of team members of screening results.

Results:
Under the current process, 53% of qualifying parents are screened appropriately. Of the parents screened, 23% had a positive Patient Health Questionnaire-9 requiring referral for mental health services.

Conclusions:
Implementing a PPD screening program that complies with the AAP standard is feasible within a Level 4 NICU. Partnering with health professional students greatly improved our ability to screen parents consistently. Given the high percentage of parents with PPD uncovered with appropriate screening, this type of program has a clear need within the NICU.
Brain-heart interactions in novice meditation practitioners during breath focus and an arithmetic task
Authors: Soriano Javier R. , Rodriguez-Larios Julio , Varon Carolina , Castellanos Nazareth , Alaerts Kaat 
Published: July 2023

ABSTRACTObjectivesThe study of neural and visceral oscillatory activities reveals that both subsystems and their interactions influence human cognition. In particular, cardiac and neural changes during self-regulation processes can be studied through a comparison of stress-inducing procedures and meditation practices.MethodsIn this study, we investigate the characteristic profiles of neural-cardiac interactions during a stress-inducing arithmetic task and a breath focus meditation period in a sample of 21 young participants (10 women, age range 20-29) with no prior experience in meditation practices. Using recordings of electroencephalography (EEG) and electrocardiography (ECG), we assessed instantaneous cross-frequency relationships between the alpha neural band and heart rate in both conditions.ResultsOur results indicate significant heart rate and alpha frequency decelerations during breath focus compared to the stress-inducing task. Regarding alpha: heart rate cross-frequency relationships, the stress-inducing arithmetic task exhibited ratios of smaller magnitude than the breath focus task, including a higher incidence of the specific 8:1 cross-frequency relationship, compared to the breath-focus task, proposed to enable cross-frequency coupling among neural and cardiac rhythms during mild cognitive stress. The change in cross-frequency relationships were mostly driven by changes in heart rate frequency between the two tasks, as indicated through surrogate data analyses.ConclusionsOur results provide novel evidence that stress responses and changes during meditation practices can be better characterized by integrating physiological markers and, more crucially, their interactions. Together, this physiologically comprehensive approach can aid in guiding interventions such as physiology modulation protocols (biofeedback and neurofeedback) for emotion and stress-regulation.
Social Capital Associates with Cognitive Health, Oral Health and Epigenetic Age Deceleration: A Cross-sectional Analysis of the Canadian Longitudinal Study on Aging (CLSA)
Authors: Liang A , Gomaa N 
Published: July 2023

AbstractObjectivesTo quantify the association of social capital, defined as social relationships and networks, with cognitive health, oral inflammation, and epigenetic aging.MethodsWe used data from the Canadian Longitudinal Study on Aging (CLSA) (n=1,479; ages 45-85 years), categorizing social capital as structural and cognitive capital. Oral inflammation was determined as the presence of gum bleeding. Epigenetic aging was computed as the difference between chronological age and DNA methylation age. Multivariable regression models adjusted for covariates were used.ResultsHigher structural social capital was associated with decelerated epigenetic aging and better cognitive health outcomes. Higher cognitive social capital was also associated with better cognitive outcomes and less oral inflammation.ConclusionEnhancing social capital may contribute to better clinical and biological outcomes around aging.Visual Abstract
ESQmodel: biologically informed evaluation of 2-D cell segmentation quality in multiplexed tissue images
Authors: Lee Eric , Lee Dongkyu , Fan Wayne , Lytle Andrew , Fu Yuxiang ,   IMAXT Consortium, Scott David W. , Steidl Christian , Aparicio Samuel , Roth Andrew 
Published: July 2023

AbstractMotivationSingle cell segmentation is critical in the processing of spatial omics data to accurately perform cell type identification and analyze spatial expression patterns. Segmentation methods often rely on semi-supervised annotation or labeled training data which are highly dependent on user expertise. To ensure the quality of segmentation, current evaluation strategies quantify accuracy by assessing cellular masks or through iterative inspection by pathologists. While these strategies each address either the statistical or biological aspects of segmentation, there lacks an unified approach to evaluating segmentation accuracy.ResultsIn this paper, we present ESQmodel, a Bayesian probabilistic method to evaluate single cell segmentation using expression data. By using the extracted cellular data from segmentation and a prior belief of cellular composition as input, ESQmodel computes per cell entropy to assess segmentation quality by how consistent cellular expression profiles match with cell type expectations.Availability and implementationSource code is available on Github at:https://github.com/Roth-Lab/ESQmodelunder the MIT license.
The impact of digital health insurance for low-income women in Kenya
Authors: de Groot R. , Abajobir A. , Wainaina C. , Sidze E. , Pradhan M. , Janssens W. 
Published: July 2023

AbstractObjectiveThis study evaluates how a subsidized, mobile phone-based health insurance program affected insurance uptake, healthcare utilization and health expenditures for low-income women and their family members in Western Kenya. The program, targeting pregnant women and mothers of children below age four, addressed both demand- and supply-side constraints, providing subsidies through mobile money and support in digital registration while upgrading selected facilities and digitally training community health workers.MethodsThe research was based on a cluster-RCT conducted between 2019 and 2021 in 24 villages in Kakamega County. After a baseline survey, 240 households (more than 1,300 individuals) were interviewed every week during 18 months to collect detailed financial and health data while the program was rolled out in the treatment communities, moving to phone-based interviewing after the onset of COVID-19.ResultsThe intervention had a significant impact on individual insurance uptake of 65.8 percentage points (from a baseline control mean 18.9 percent). We find weak positive impacts on formal healthcare utilization, and substantial increases in financial coverage of medical costs and associated reductions in out-of-pocket expenditures, particularly for medicines. Results are strongest for women, young children and individuals living closest to the clinics. Dynamic analyses show that impacts become increasingly pronounced over time, suggesting that women may need some time to get used to the digital insurance scheme.ConclusionThe program not only reduced the costs of enrolment, but also eliminated other (administrative, logistical, trust) barriers. The introduction of the scheme by trusted local agents, the hands-on assistance with the digital registration procedures at women’s homes, and support in retrieving the necessary documentation such as children’s birth certificates, have likely all contributed to the high enrolment rates, thereby improving access to good-quality care. Digital insurance has the potential to substantially enhance universal health coverage and financial protection for poor households.
Observational study of effects of HIV Acquisition and Antiretroviral Treatment on Biomarkers of Systemic Immune Activation
Authors: Kosmider Ewelina , Wallner Jackson , Gervassi Ana , Bender Ignacio Rachel A , Pinto-Santini Delia , Gornalusse German , Pandey Urvashi , Hladik Florian , Edlefsen Paul T. , Lama Javier R. , Duerr Ann C. , Frenkel Lisa M. 
Published: July 2023

ABSTRACTObjectiveAssess whether biomarkers of systemic inflammation are associated with HIV acquisition or with the timing of ART initiation (“immediate”, at diagnosis, versus “deferred”, at 24 weeks postdiagnosis) in men-who-have-sex-with-men (MSM) and transgender women.DesignA retrospective study comparing inflammatory biomarkers in participants’ specimens collected before and after ≥2 years of effective ART.MethodsInflammatory biomarkers were measured in four longitudinally collected plasma specimens, including two plasma specimens collected from each participant before and two after HIV acquisition and confirmed ART-suppression. Biomarkers were quantified by enzyme-linked immuno-assay or Meso Scale Discovery. Statistical measures compared intra-participant and between-group changes in biomarkers.ResultsAcross 50 participants, the levels of C-reactive protein (CRP), monocyte chemo-attractant protein-1, tumor necrosis factor-α and interferon gamma-induced protein-10 significantly increased while leptin and lipopolysaccharide binding protein (LBP) significantly decreased following HIV infection. Randomization to deferred-ART initiation was associated with greater increases in CRP and no decreases in LBP. Multiple biomarkers varied significantly within participants’ two pre-infection or two post-ART-suppression specimens.ConclusionsAcquisition of HIV appeared to induce systemic inflammation, with elevation of biomarkers previously associated with infections and cardiovascular disease. Initiation of ART during the early weeks of infection tempered the increase in pro-inflammatory biomarkers compared to those who delayed ART for ∼24 weeks after HIV diagnosis, perhaps because immediate-ART limited the size of the HIV reservoir or limited immune dysregulation. Some but not all biomarkers appeared sufficiently stable to assess intraparticipant changes over time. Given that pro-inflammatory biomarkers predict multiple co-morbidities, our findings suggest that immediate-ART initiation may improve health outcomes.
Genome-wide Association Clustering Meta-analysis in European and Chinese Datasets for Systemic Lupus Erythematosus identifies new genes
Authors: Saeed Mohammad 
Published: July 2023

AbstractGenome-wide association studies (GWAS) face multiple challenges in order to identify reliable susceptibility genes for complex disorders, such as Systemic lupus erythematosus (SLE). These include high false positivity due to number of SNPs genotyped, false negativity due to statistical corrections and the proportional signals problem. Association clustering methods, by reducing the testing burden, have increased power than single variant analysis. Here, OASIS, a locus-based test, and its novel statistic, the OASIS locus index (OLI), is applied to European (EU) and Chinese (Chi) SLE GWAS to identify common significant non-HLA, autosomal genes. Six SLE dbGAP GWAS datasets, 4 EU and 2 Chi involving 19,710 SLE cases and 30,876 controls were analyzed. OLI is defined as the product of maximum −logP at a locus with the ratio of actual to predicted number of significant SNPs and compared against the standard P-value using Box plots and Wilcoxon Signed Rank Test. OLI outperformed the standard P-value statistic in detecting true associations (Wilcoxon Signed Test Z= - 4.11, P<1×10−4). Top non-HLA significant loci, common in both ethnicities were 2q32.2 (STAT4, rs4274624, P=9.7×10−66), 1q25.3 (SMG7, rs41272536, P=3.5×10−52), 7q32.1 (IRF5, rs35000415, P=1.9×10−45), 8p23.1 (BLK, rs2736345, P=1.5×10−25) and 6q23.3 (TNFAIP3, rs5029937, P=4.4×10−24). Overall, OASIS identified 19 highly significant and 16 modestly significant (P>10−8) non-HLA SLE associated genes common to EU and Chi ethnicities. Interaction of these 35 genes elucidated important SLE pathways viz NOD, TLR, JAK-STAT and RIG-1. OASIS aims to advance GWAS by rapid and cost-effective identification of genes of modest significance for complex disorders.Key MessagesGWAS are challenged by risk genes of modest effect.OASIS, a clustering algorithm, can help identify genes of modest significance for complex disorders such SLE, rapidly and cost-effectively using publicly available GWAS datasets.This meta-analysis identified 35 genes common to both European and Chinese populations.Interaction of these genes identify major SLE pathways to be NOD, TLR, JAK-STAT and RIG-1.
Reliability and Performance of the IRRAflow® System for Intracranial Lavage and Evacuation of Hematomas - A Technical Note
Authors: Haldrup Mette , Nazari Mojtaba , Gu Chenghao , Rasmussen Mads , Dyrskog Stig , Simonsen Claus Ziegler , Grønhøj Mads , Poulsen Frantz Rom , Rehman Naveed Ur , Korshoej Anders Rosendal 
Published: July 2023

AbstractBackgroundIntraventricular hemorrhage (IVH) is a severe condition with poor outcomes and high mortality. IRRAflow®(IRRAS AB) is a new technology introduced to accelerate IVH clearance by minimally invasive wash-out. The IRRAflow®system performs active and controlled intracranial irrigation and aspiration with physiological saline, while simultaneously monitoring and maintaining a stable intracranial pressure (ICP). We addressed important aspects of the device implementation and intracranial lavage.MethodTo allow versatile investigation of multiple device parameters, we designed anex vivolab setup. We evaluated 1) compatibility between the IRRAflow®catheter and the Silverline f10 bolt (Spiegelberg), 2) the physiological and hydrodynamic effects of varying the IRRAflow®settings, 3) the accuracy of the IRRAflow®injection volumes, and 4) the reliability of the internal ICP monitor of the IRRAflow®.ResultsThe IRRAflow®catheter was not compatible with Silverline bolt fixation, which was associated with leakage and obstruction. Design space exploration of IRRAflow®settings revealed that a balanced saline influx and efflux required adjustments of the drainage bag to adapt to different irrigation rates. High irrigation rates could be compensated by lowered drain bag height and vice versa. Appropriate settings included irrigation rate 20 ml/h with a drainage bag height at 0 cm, irrigation rate 90 ml/h with a drainage bag height at 19 cm and irrigation rate 180 ml/h with a drainage bag height at 29 cm. We found the injection volume performed by the IRRAflow®to be stable and reliable, while the internal ICP monitor was compromised in several ways due to the proximal location of the pressure sensor within the cassette of the device rather than within the parenchyma of the brain. Furthermore, we observed a significant mean drift difference of 3.16 mmHg (variance 0.4, p=0.05) over a 24-hour test period with a mean 24-hour drift of 3.66 mmHg (variance 0.28) in the pressures measured by the IRRAflow®compared to 0.5 mmHg (variance 1.12) in the Raumedic measured pressures.ConclusionBolting of the IRRAflow®catheter using the Medtronic Silverline® bolt is not recommendable. Increased irrigation rates are recommendable followed by a decrease in drainage bag level. ICP measurement using the IRRAflow®device was unreliable and should be accompanied by a control ICP monitor device in clinical settings.