bluuebunny/crossref_metadata_2025_split huggingface dataset:
Triglyceride-rich lipoprotein remnants, low-density lipoproteins, and risk of coronary heart disease: a UK Biobank study
Authors: Björnson Elias , Adiels Martin , Taskinen Marja-Riitta , Burgess Stephen , Rawshani Aidin , Borén Jan , Packard Chris J 
Published: June 2023

Abstract

Aims
The strength of the relationship of triglyceride-rich lipoproteins (TRL) with risk of coronary heart disease (CHD) compared with low-density lipoprotein (LDL) is yet to be resolved.

Methods and results
Single-nucleotide polymorphisms (SNPs) associated with TRL/remnant cholesterol (TRL/remnant-C) and LDL cholesterol (LDL-C) were identified in the UK Biobank population. In a multivariable Mendelian randomization analysis, TRL/remnant-C was strongly and independently associated with CHD in a model adjusted for apolipoprotein B (apoB). Likewise, in a multivariable model, TRL/remnant-C and LDL-C also exhibited independent associations with CHD with odds ratios per 1 mmol/L higher cholesterol of 2.59 [95% confidence interval (CI): 1.99–3.36] and 1.37 [95% CI: 1.27–1.48], respectively. To examine the per-particle atherogenicity of TRL/remnants and LDL, SNPs were categorized into two clusters with differing effects on TRL/remnant-C and LDL-C. Cluster 1 contained SNPs in genes related to receptor-mediated lipoprotein removal that affected LDL-C more than TRL/remnant-C, whereas cluster 2 contained SNPs in genes related to lipolysis that had a much greater effect on TRL/remnant-C. The CHD odds ratio per standard deviation (Sd) higher apoB for cluster 2 (with the higher TRL/remnant to LDL ratio) was 1.76 (95% CI: 1.58–1.96), which was significantly greater than the CHD odds ratio per Sd higher apoB in cluster 1 [1.33 (95% CI: 1.26–1.40)]. A concordant result was obtained by using polygenic scores for each cluster to relate apoB to CHD risk.

Conclusion
Distinct SNP clusters appear to impact differentially on remnant particles and LDL. Our findings are consistent with TRL/remnants having a substantially greater atherogenicity per particle than LDL.
Stroke in patients with heart failure and reduced or preserved ejection fraction
Authors: Yang Mingming , Kondo Toru , Butt Jawad H , Abraham William T , Anand Inder S , Desai Akshay S , Køber Lars , Packer Milton , Pfeffer Marc A , Rouleau Jean L , Sabatine Marc S , Solomon Scott D , Swedberg Karl , Zile Michael R , Jhund Pardeep S , McMurray John J V 
Published: June 2023

Abstract

Aims
Stroke is an important problem in patients with heart failure (HF), but the intersection between the two conditions is poorly studied across the range of ejection fraction. The prevalence of history of stroke and related outcomes were investigated in patients with HF.

Methods and results
Individual patient meta-analysis of seven clinical trials enrolling patients with HF with reduced (HFrEF) and preserved ejection fraction (HFpEF). Of the 20 159 patients with HFrEF, 1683 (8.3%) had a history of stroke, and of the 13 252 patients with HFpEF, 1287 (9.7%) had a history of stroke. Regardless of ejection fraction, patients with a history of stroke had more vascular comorbidity and worse HF. Among those with HFrEF, the incidence of the composite of cardiovascular death, HF hospitalization, stroke, or myocardial infarction was 18.23 (16.81–19.77) per 100 person-years in those with prior stroke vs. 13.12 (12.77–13.48) in those without [hazard ratio 1.37 (1.26–1.49), P &lt; 0.001]. The corresponding rates in patients with HFpEF were 14.16 (12.96–15.48) and 9.37 (9.06–9.70) [hazard ratio 1.49 (1.36–1.64), P &lt; 0.001]. Each component of the composite was more frequent in patients with stroke history, and the risk of future stroke was doubled in patients with prior stroke. Among patients with prior stroke, 30% with concomitant atrial fibrillation were not anticoagulated, and 29% with arterial disease were not taking statins; 17% with HFrEF and 38% with HFpEF had uncontrolled systolic blood pressure (≥140 mmHg).

Conclusion
Heart failure patients with a history of stroke are at high risk of subsequent cardiovascular events, and targeting underutilization of guideline-recommended treatments might be a way to improve outcomes in this high-risk population.
Increased knowledge levels of patients with diabetes in resource-limited communities after receiving peer-led education
Authors: Kobayashi Nobuyuki , Tanimura Chika , Aoto Haruka , Nagata Abir , Otani Shinji , Tokushima Yasuko , Fukada Mika , Morita Tetsuji , Inoue Kazuoki , Kageyama Seiji 
Published: June 2023

Abstract
Diabetes self-management education through peer support has been beneficial, especially in regions with limited medical resources. Studying the effects of education offered by trained peers of patients will facilitate tailoring the peer-led education programs to the regions’ specific needs. Here, we evaluated changes in diabetes-related indicators in Filipino patients who received a peer-led education. We used data on 23 patients (age, 67.83 ± 6.69 years; 82.6% female) who participated in all five surveys performed every 6 months from March 2017 to March 2019. After the second survey until the end of this study, the participants were educated in diabetes self-management by their 13 peers who previously had received the training in diabetes self-management. Participants’ knowledge of diabetes and the related ‘cause, risk factors, nature of diabetes and complications’ subindicator were greater on all surveys after starting the peer-led education compared with those on the second survey (i.e. before starting the education); these values did not differ between the first two surveys. Because increasing patients’ knowledge can enhance their ability to self-manage their disease and thus improve their quality of life, strategies to expand patients’ knowledge about diabetes should be included when organizing peer-led education in regions with limited medical resources.
Stratified genome-wide association analysis of type 2 diabetes reveals subgroups with genetic and environmental heterogeneity
Authors: Christiansen Colette E , Arathimos Ryan , Pain Oliver , Molokhia Mariam , Bell Jordana T , Lewis Cathryn M 
Published: June 2023

Abstract
Type 2 diabetes (T2D) is a heterogeneous illness caused by genetic and environmental factors. Previous genome-wide association studies (GWAS) have identified many genetic variants associated with T2D and found evidence of differing genetic profiles by age-at-onset. This study seeks to explore further the genetic and environmental drivers of T2D by analyzing subgroups on the basis of age-at-onset of diabetes and body mass index (BMI). In the UK Biobank, 36 494 T2D cases were stratified into three subgroups, and GWAS was performed for all T2D cases and for each subgroup relative to 421 021 controls. Altogether, 18 single nucleotide polymorphisms were significantly associated with T2D genome-wide in one or more subgroups and also showed evidence of heterogeneity between the subgroups (Cochrane’s Q P &lt; 0.01), with two SNPs remaining significant after multiple testing (in CDKN2B and CYTIP). Combined risk scores, on the basis of genetic profile, BMI and age, resulted in excellent diabetes prediction [area under the ROC curve (AUC) = 0.92]. A modest improvement in prediction (AUC = 0.93) was seen when the contribution of genetic and environmental factors was evaluated separately for each subgroup. Increasing sample sizes of genetic studies enables us to stratify disease cases into subgroups, which have sufficient power to highlight areas of genetic heterogeneity. Despite some evidence that optimizing combined risk scores by subgroup improves prediction, larger sample sizes are likely needed for prediction when using a stratification approach.
Cefixime–tellurite-deoxycholate tryptic soy broth (CTD-TSB), a selective enrichment medium, for enhancing isolation ofEscherichia albertiifrom wild raccoon fecal samples
Authors: Xu Bingting , Hatanaka Noritoshi , Awasthi Sharda Prasad , Tekehira Keiji , Hinenoya Atsushi , Yamasaki Shinji 
Published: June 2023

AbstractAimThe aim of this study was to develop a selective enrichment broth for efficient isolation of Escherichia albertii.Methods and ResultsA total of 412 raccoon rectal swabs suspended in PBS (phosphate-buffered saline) were tested by a real-time PCR to quantify the number of E. albertii followed by its isolation. The number of E. albertii in the PBS suspension strongly affected the isolation rate (1.2%–89%), which notably dropped (≤33%) when the number was &lt;4 log10 CFU ml−1. However, enrichment of PBS suspension containing raccoon feces in tryptic soy broth containing cefixime, tellurite, and deoxycholate (CTD-TSB), the selective medium developed in this study, remarkably improved the isolation efficiency (up to 48%) of E. albertii.ConclusionsCTD-TSB is a useful enrichment culture medium for E. albertii and contributes to increase its isolation rate.
Potential bias and lack of generalizability in electronic health record data: reflections on health equity from the National Institutes of Health Pragmatic Trials Collaboratory
Authors: Boyd Andrew D , Gonzalez-Guarda Rosa , Lawrence Katharine , Patil Crystal L , Ezenwa Miriam O , O’Brien Emily C , Paek Hyung , Braciszewski Jordan M , Adeyemi Oluwaseun , Cuthel Allison M , Darby Juanita E , Zigler Christina K , Ho P Michael , Faurot Keturah R , Staman Karen L , Leigh Jonathan W , Dailey Dana L , Cheville Andrea , Del Fiol Guilherme , Knisely Mitchell R , Grudzen Corita R , Marsolo Keith , Richesson Rachel L , Schlaeger Judith M 
Published: June 2023

Abstract
Embedded pragmatic clinical trials (ePCTs) play a vital role in addressing current population health problems, and their use of electronic health record (EHR) systems promises efficiencies that will increase the speed and volume of relevant and generalizable research. However, as the number of ePCTs using EHR-derived data grows, so does the risk that research will become more vulnerable to biases due to differences in data capture and access to care for different subsets of the population, thereby propagating inequities in health and the healthcare system. We identify 3 challenges—incomplete and variable capture of data on social determinants of health, lack of representation of vulnerable populations that do not access or receive treatment, and data loss due to variable use of technology—that exacerbate bias when working with EHR data and offer recommendations and examples of ways to actively mitigate bias.
Current Practices in Anticoagulation Management for Patients Undergoing Percutaneous Image-guided Breast Procedures
Authors: Brown Theodore , Schafer Leah , Qureshi Muhammad Mustafa , Freer Phoebe , Niell Bethany L , Yeh Eren D , Moy Linda , Fishman Michael D C , Slanetz Priscilla J 
Published: June 2023

Abstract

Objective
Given variability in how practices manage patients on antithrombotic medications, we undertook this study to understand the current practice of antithrombotic management for patients undergoing percutaneous breast and axillary procedures.

Methods
A 20-item survey with multiple-choice and write-in options was emailed to 2094 active North American members of the Society of Breast Imaging (SBI) in March 2021. Data were collected anonymously and analyzed quantitatively, with free-text responses categorized by themes.

Results
Three-hundred twenty-six of 2094 members (15.6%) completed the survey. Eighty-seven percent (274/313) reported having a policy for managing antithrombotic medications. Fifty-nine percent (185/312) reported routinely withholding medications before biopsy, more commonly in the Northeast and South (P = 0.08). Withholding of medications did not vary by lesion location (182/308, 59%, breast vs 181/308, 58.7%, axillary; P = 0.81). Respondents were statistically more likely to withhold medications if using a vacuum-assisted device for all classes of antithrombotic medications (P &lt; 0.001). Up to 50.2% (100/199) on warfarin and 33.6% (66/196) on direct oral anticoagulants had medications withheld more stringently than guidelines suggest.

Conclusion
Based on a survey of SBI members, breast imaging practices vary widely in antithrombotic management for image-guided breast and axillary procedures. Of the 60% who withhold antithrombotic medications, a minority comply with recommended withhold guidelines, placing at least some patients at potential risk for thrombotic events. Breast imaging radiologists should weigh the risks and benefits of withholding these medications, and if they elect to withhold should closely follow evidence-based guidelines to minimize the risks of this practice.
Developing a Program for Advanced Physical Therapist Practice in Amputation Care
Authors: Crunkhorn Andrea E , Campbell Stuart M , Lutz Laurie L 
Published: June 2023

ABSTRACT

Introduction
Over the past 20 years, military medicine made great strides in the medical management of traumatically injured patients. Significant advancements were made in the treatment and rehabilitation after limb loss. These advancements can be attributed to the large number of complex patients presenting to military treatment facilities and the demand for medical professionals to provide care to patients with complex injuries and multiple traumatic amputations. The concern now is to maintain the skills needed to be prepared for the next conflict. To meet this demand, the Extremity Trauma and Amputation Center of Excellence (EACE) initiated the documentation of knowledge, skills, and abilities (KSAs) to ensure that the skill sets needed to treat this unique population are not lost. The EACE developed KSAs to sustain advanced clinical practice for physical therapists, occupational therapists, and prosthetists and is in the process of developing KSAs for orthotists and physical medicine physicians. The learning objectives [terminal and enabling learning objectives (TLOs and ELOs)] derived from each set of KSAs will drive curricula development for enduring education, residencies, and fellowships. This article describes the KSAs and learning objectives for advanced physical therapist competencies in amputation care.

Methods
Clinical subject matter experts (SMEs) convened from the Department of Defense (DoD) Advanced Rehabilitation Centers (ARCs) to draft the initial KSAs. All experts had specific expertise in treating individuals with highly complex lower and upper limb amputation. In a quasi-Delphi methodology, the initial draft KSAs underwent five cycles of review and comment by an additional 15 DoD, Veterans Affairs, and civilian institution experts from clinical practice, education, and research. The consensus KSAs were then transcribed into learning objectives with collaboration between clinical subject matter experts and doctoral-level educators.

Results
The final program document has 21 instructional modules with 30 TLOs and 157 ELOs.

Conclusion
The KSAs and the learning objectives describe the skills expected of an advanced practice physical therapist treating patients with traumatic limb loss. Weaknesses of this document include the focus on traumatic amputation and military specific needs. However, many of the central advanced practices are universal to all physical therapists working in amputation. Thus, this document should serve as a starting point and can evolve to include dysvascular, oncology, and other etiologies. To our knowledge, this is the first paper to describe the KSAs for the advanced practice physical therapist working with traumatic limb loss population. This work will form the framework for physical therapist advanced practice training programs.
Aberration of gravitational waveforms by peculiar velocity
Authors: Bonvin Camille , Cusin Giulia , Pitrou Cyril , Mastrogiovanni Simone , Congedo Giuseppe , Gair Jonathan 
Published: June 2023

ABSTRACT
One key prediction of General Relativity is that gravitational waves are emitted with two independent polarizations. Any observation of extra polarization mode, spin-1 or spin-0, is consequently considered a smoking gun for deviations from General Relativity. In this paper, we show that the velocity of merging binaries with respect to the observer gives rise to spin-1 polarization in the observer frame even in the context of General Relativity. These are pure projection effects, proportional to the plus and cross polarizations in the source frame, hence they do not correspond to new degrees of freedom. We demonstrate that the spin-1 modes can always be rewritten as pure spin-2 modes coming from an aberrated direction. Since gravitational waves are not isotropically emitted around binary systems, this aberration modifies the apparent orientation of the binary system with respect to the observer: the system appears slightly rotated due to the source velocity. Fortunately, this bias does not propagate to other parameters of the system (and therefore does not spoil tests of General Relativity), since the impact of the velocity can be fully reabsorbed into new orientation angles.
Long-term cryopreservation of potassium bromate positive assay controls for measurement of oxidatively damaged DNA by the Fpg-modified comet assay: results from the hCOMET ring trial
Authors: Møller Peter , Azqueta Amaya , Rodriguez-Garraus Adriana , Bakuradze Tamara , Richling Elke , Bankoglu Ezgi Eyluel , Stopper Helga , Claudino Bastos Victoria , Langie Sabine A S , Jensen Annie , Ristori Sara , Scavone Francesca , Giovannelli Lisa , Wojewódzka Maria , Kruszewski Marcin , Valdiglesias Vanessa , Laffon Blanca , Costa Carla , Costa Solange , Paulo Teixeira João , Marino Mirko , Del Bo’ Cristian , Riso Patrizia , Zheng Congying , Shaposhnikov Sergey , Collins Andrew 
Published: June 2023

Abstract
The formamidopyrimidine DNA glycosylase (Fpg)-modified comet assay is widely used for the measurement of oxidatively generated damage to DNA. However, there has not been a recommended long-term positive control for this version of the comet assay. We have investigated potassium bromate as a positive control for the Fpg-modified comet assay because it generates many Fpg-sensitive sites with a little concurrent generation of DNA strand breaks. Eight laboratories used the same procedure for the treatment of monocytic THP-1 cells with potassium bromate (0, 0.5, 1.5, and 4.5 mM) and subsequent cryopreservation in a freezing medium consisting of 50% foetal bovine serum, 40% RPMI-1640 medium, and 10% dimethyl sulphoxide. The samples were analysed by the Fpg-modified comet assay three times over a 3-year period. All laboratories obtained a positive concentration–response relationship in cryopreserved samples (linear regression coefficients ranging from 0.79 to 0.99). However, there was a wide difference in the levels of Fpg-sensitive sites between the laboratory with the lowest (4.2% Tail DNA) and highest (74% Tail DNA) values in THP-1 cells after exposure to 4.5 mM KBrO3. In an attempt to assess sources of inter-laboratory variation in Fpg-sensitive sites, comet images from one experiment in each laboratory were forwarded to a central laboratory for visual scoring. There was high consistency between measurements of %Tail DNA values in each laboratory and the visual score of the same comets done in the central laboratory (r = 0.98, P &lt; 0.001, linear regression). In conclusion, the results show that potassium bromate is a suitable positive comet assay control.
Laparoscopic resection for pedunculated focal nodular hyperplasia of the liver during pregnancy
Authors: Akaguma Ai , Ishii Takamichi , Uchida Yoichiro , Chigusa Yoshitsugu , Ueda Yusuke , Mandai Masaki , Mogami Haruta 
Published: June 2023

Abstract
Focal nodular hyperplasia (FNH) is the second most common intrahepatic benign mass lesion; however, extremely rarely, FNH grows in an exophytic manner. It is unclear whether pedunculated FNH can be managed in the same way as intrahepatic FNH. A 35-year-old female presented with right upper quadrant pain, and dynamic enhanced computed tomography revealed an exophytic hyperdense mass lesion originating from the liver, suggesting a pedunculated FNH. Shortly thereafter, she conceived. Since there was a history of acute abdomen, as well as the possibility of torsion of the mass or sudden massive bleeding during pregnancy, laparoscopic resection was performed at 17 weeks of gestation. Her postoperative and pregnancy course was uneventful, and she delivered a baby by cesarean section at 41 weeks of gestation. Our case suggests that pedunculated FNH, unlike typical intrahepatic FNH, may be better managed by laparoscopic surgery during pregnancy, resulting in favorable maternal and fetal outcomes.
Fecal incontinence as the sole presentation of focal epilepsy; a case report
Authors: Al-Ameri Laith T , Hameed Ekhlas K , Maroof Bilal S , Al-Momen Hayder 
Published: June 2023

Abstract
Focal epilepsy is a surge in brain activity arising from a localised area of the cerebral cortex; it can be sub-classified in different categories including motor, sensory, autonomic and cognitive subtypes. A clinical case report of a 11-year-old girl was diagnosed with frequent fecal incontinence four or more times daily for more than two months. An electroencephalogram (EEG) study suggested a prominent interictal spike and sharp wave discharge on the left hemisphere, mainly at the frontotemporal region without loss of consciousness or even speech disruption. This could be due to the normal EEG study of the dominant hemisphere. A magnetic resonance imaging study was done to exclude space-occupying lesions or focal lesions of the left hemisphere of the brain. An impression was made with abnormal EEG showing focal epileptiform activity as a final diagnosis. The patient was treated with Leviteracetam anti-epileptic drug 250 mg twice daily with significant clinical improvement at a 3-month follow-up.
MOYAMOYA disease in an adolescent with HIV-1
Authors: Pereira Noella Maria Delia , Gabhale Yashwant R , Lala Mamatha M , Dere Harshad , Ghildiyal Radha 
Published: June 2023

Abstract
Moyamoya disease has been reported in both children and adults with HIV-1. Most cases reported in children were found to have unsuppressed viral loads and low CD4 counts. Although the aetiology of the disease is largely unknown, a few studies have postulated cytokine imbalance and immune activation as possible causes. Intimal staining of the involved cerebral arteries have revealed transmembrane glycoprotein of HIV-gp 41. We present the case of an 18-year-old boy with congenitally acquired HIV-1 who presented with right hemiparesis at the age of 12 years and was found to have Moyamoya disease on neuroimaging. His CD4 count has always been low (&lt;100 cells/cumm) in spite of being virally suppressed. He was started on anti-retroviral therapy at 5 and half years of age and he was continued on the same. He was treated conservatively and he continues to have residual right hemiparesis.