bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence of Cognitive Impairment Among Medicare Beneficiaries Who Use Outpatient Physical Therapy
Authors: Miller Matthew J , Cenzer Irena , Barnes Deborah E , Kelley Amy S , Covinsky Kenneth E 
Published: August 2023

Abstract

Objective
The objective of this study was to estimate the prevalence of cognitive impairment (including cognitive impairment no dementia [CIND] and dementia) among Medicare fee-for-service beneficiaries who used outpatient physical therapy and to estimate the prevalence of cognitive impairment by measures that are relevant to rehabilitation practice.

Methods
This cross-sectional analysis included 730 Medicare fee-for-service beneficiaries in the 2016 wave of the Health and Retirement Study with claims for outpatient physical therapy. Cognitive status, our primary variable of interest, was categorized as normal, CIND, or dementia using a validated approach, and population prevalence of cognitive impairment (CIND and dementia) was estimated by sociodemographic variables and Charlson comorbidity index score. Age-, gender- (man/woman), race-/ethnicity-adjusted population prevalence of CIND and dementia were also calculated for walking difficulty severity, presence of significant pain, self-reported fall history, moderate-vigorous physical activity (MVPA) ≤1×/week, and sleep disturbance frequency using multinomial logistic regression.

Results
Among Medicare beneficiaries with outpatient physical therapist claims, the prevalence of any cognitive impairment was 20.3% (CIND:15.2%, dementia:5.1%). Cognitive impairment was more prevalent among those who were older, Black, had lower education attainment, or higher Charlson comorbidity index scores. The adjusted population prevalence of cognitive impairment among those who reported difficulty walking across the room was 29.8%, difficulty walking 1 block was 25.9%, difficulty walking several blocks was 20.8%, and no difficulty walking was 16.3%. Additionally, prevalence of cognitive impairment among those with MVPA ≤1×/week was 27.1% and MVPA &gt;1×/week was 14.1%. Cognitive impairment prevalence did not vary by significant pain, self-reported fall history, or sleep disturbance.

Conclusion
One in 5 older adults who use outpatient physical therapist services have cognitive impairment. Furthermore, cognitive impairment is more common in older physical therapist patients who report worse physical function and less physical activity.

Impact
Physical therapists should consider cognitive screening for vulnerable older adults to inform tailoring of clinical practice toward a patient’s ability to remember and process rehabilitation recommendations.
Behavioral Response to Catecholamine Depletion in Individuals With Schizophrenia and Healthy Volunteers
Authors: Suker Samir , Mihov Yoan , Wolf Andreas , Mueller Stefanie V , Hasler Gregor 
Published: August 2023

Abstract

Background and Hypothesis
Dysfunction of the dopamine system is the leading neurobiological hypothesis of schizophrenia. In this study, we tested this hypothesis in the context of aberrance salience theory of delusions using catecholamine depletion. We hypothesized that acute dopamine depletion improves both positive symptoms and salience attribution in individuals with schizophrenia.

Study Design
Catecholamine depletion was achieved by oral administration of alpha-methyl-para-tyrosine (AMPT) in 15 individuals with schizophrenia and 15 healthy volunteers. The study design consisted of a randomized, double-blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were the Scale for the Assessment of Positive Symptoms and the Salience Attribution Test.

Study Results
Catecholamine depletion transiently reduced specific psychotic symptoms in symptomatic individuals with schizophrenia, namely delusions and positive formal thought disorder (interaction treatment-by-timepoint, P = .013 and P = .010, respectively). We also found trends for catecholamine depletion to increase relevant bias and adaptive salience in participants with schizophrenia while decreasing them in healthy controls (interaction group-by-treatment, P = .060 and P = .089, respectively). Exploratory analyses revealed that in participants with schizophrenia, higher relevant bias at 3 hours after the end of AMPT treatment corresponded to lower delusional symptoms (Spearman’s rho = −0.761, P = .001).

Conclusions
This study suggests that the relationship between dopamine hyperactivity and delusional symptoms in schizophrenia is mediated by impaired attribution of salience to reward-predicting stimuli.
Authoritarian Othering Back and Feminist Subversion: Rethinking Transnational Feminism in Russia and Serbia
Authors: Bias Leandra 
Published: August 2023

Abstract
This article examines the effect of rising authoritarianism on Russian and Serbian feminists. In both cases, regimes rely on what I term “Othering back.” Using “gender ideology” as a proxy for Western imperialism, they reappropriate postcolonial frames to reject democratization and human rights. In such a context, the critical argument that transnational feminism is an exercise of Western Othering to reify power relations no longer resonates with feminists on the ground. To them it dangerously resonates with their own regime’s discourse. The article first traces how the regimes conduct authoritarian Othering back. Based on interpretive discourse analysis, applied to sixty-nine interviews, it then shows how Russian and Serbian feminists make sense of this political environment and the new strategies they derive from their interpretation: the need for discursive subversion that articulates alternative imaginaries of transnational feminism that cannot be reappropriated by the regime.
2-Chloro-3,7,8-tribromodibenzofuran as a new environmental pollutant inducing atypical ultrasonic vocalization in infant mice
Authors: Kimura Eiki , Suzuki Go , Uramaru Naoto , Kakeyama Masaki , Maekawa Fumihiko 
Published: August 2023

Abstract
Epidemiological and experimental studies indicate that maternal exposure to environmental pollutants impairs the cognitive and motor functions of offspring in humans and laboratory animals. Infant ultrasonic vocalizations (USVs), the communicative behavior of pups toward caregivers, are impaired in rodent models of neurodevelopmental disorders, suggesting a useful method to evaluate the developmental neurotoxicity of environmental pollutants. Therefore, we investigated USVs emitted by mouse pups of dams exposed to 2-chloro-3,7,8-tribromodibenzofuran (TeXDF) and 1,2,3,7,8-pentabromodibenzofuran (PeBDF), which are detected in the actual environment. The USV duration and number in the pups born to dams administered with TeXDF 40 μg/kg body weight (b.w.), but not 8 μg/kg b.w., on gestational day (GD) 12.5, were significantly lower than those in the corresponding pups on postnatal days 3–9. Conversely, there was no statistical change in the USVs emitted by the pups of dams administered with PeBDF 35 or 175 μg/kg b.w. on GD 12.5. To examine whether maternal exposure leads to behavioral impairments in adulthood, we analyzed exploratory behaviors in a novel environment using IntelliCage, a fully automated testing apparatus for group-housed mice. Neither TeXDF nor PeBDF exposure induced significant differences in offspring exploration. Considered together, our findings revealed that TeXDF induces atypical USV emission in infant mice, suggesting the importance of further studies on the risk assessment of mixed brominated/chlorinated dibenzo-p-dioxins and dibenzofurans.
Involvement of functional senescence in efavirenz-induced toxicity in fruit fly
Authors: Iorjiim Walter Mdekera , Omale Simeon , Ede Samuel , Ugokwe Chinelo Vera , Alemika Taiwo Emmanuel 
Published: August 2023

AbstractBackgroundWe aimed in this article to assess the likeliness of efavirenz to induce functional senescence in Drosophila melanogaster (fruit fly).MethodsTen different concentrations of EFV were mixed with fly food and fed to 3-day-old flies orally for a 7 day LC50 calculation. Drug concentrations from LC50 were selected for a 28 day survival to determine the duration of treatment for behavioral and biochemical assays. A 5day feeding plan was used to investigate the effects of the drug on organismal, neuromuscular, reproductive, and metabolic senescence. An in silico study was executed to decipher a molecular interaction of Drosophila enzymes glutathione-s-transferase (GST) or acetylcholinesterase (AChE) with EFV.ResultsThe calculated LC50 of EFV was 118 mg/10-g fly diet. The test drug induced a significant (P &lt; 0.05) increase in fly mortality, climbing difficulty, and procreative deficits after a 5 day oral exposure. Similarly, there were significant (P &lt; 0.05) biochemical alterations, which suggested in vivo biochemical damage against total thiols (T-SH), SOD (superoxide dismutase), CAT (catalase), GST, AChE, and MDA (malondialdehyde) in the test flies compared to the control groups. In silico study revealed a significantly (P &lt; 0.05) higher binding energy between EFV and the active amino acids of fly AChE and GST when compared to the substrates or standard inhibitors respectively.ConclusionEFV exhibited ecotoxic potentials evidenced by age-related deficits in the fly’s functional integrity such as sluggish movement, procreative deficiency, increased mortality, and oxidant-antioxidant inequality. Results from in silico study suggested antagonism against GST and AChE activities as a likely mechanism of EFV-induced toxicity in the fruit fly.
Disseminated Bacillus Calmette–Guérin infection: role of imaging in the evaluation of complications
Authors: Rajabi Ardeshir , Pouladfar Gholamreza , Dehghan Yasamin , Jafarpour Zahra , Dehghan Alireza 
Published: August 2023

Abstract

Background
The Bacillus Calmette–Guerin (BCG) vaccine is generally used to prevent tuberculosis, particularly meningeal and miliary types, in childhood. This vaccine can rarely cause complications of varying severity, ranging from localized disease to a severe diffuse type known as disseminated BCG infection. Imaging modalities play an important role in the evaluation of different complications of disseminated BCG infection. This study aimed to assess and describe the imaging findings of disseminated BCG infection in order to help clinicians diagnose this life-threatening infection more accurately.

Methods
This retrospective study was performed on 44 hospitalized children diagnosed with disseminated BCG infection. The results of radiographs, sonography, computerized tomography (CT) scan and magnetic resonance imaging were compiled in a checklist and were then assessed by a radiology resident and a board-certificated radiologist. The radiological findings from various imaging modalities were presented descriptively and the frequency of different parameters was reported.

Results
Axillary lymphadenopathy at the vaccinated side was frequent and was often associated with abscesses. However, abscesses in other body regions were uncommon. The most common abdominal imaging findings were enlarged liver and spleen accompanied by multiple hypoechoic and hypodense nodules on ultrasound and CT scans, respectively. Furthermore, diffuse or multifocal pulmonary opacities were the most frequent findings on chest X-rays and CT scans.

Conclusion
Characteristic imaging findings of disseminated BCG infection play a vital role in the early diagnosis of this infection. The study findings demonstrated the importance of radiological imaging in the diagnosis and evaluation of the complications of disseminated BCG infection.
A novel role of RNase L in the development of nonalcoholic steatohepatitis
Authors: Chen Guanmin , Zhao Xiaotong , Dankovskyy Maksym , Ansah‐Zame Abigail , Alghamdi Uthman , Liu Danting , Wei Ruhan , Zhao Jianjun , Zhou Aimin 
Published: August 2023

AbstractNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and affects about 25% of the population globally. NAFLD has the potential to cause significant liver damage in many patients because it can progress to nonalcoholic steatohepatitis (NASH) and cirrhosis, which substantially increases disease morbidity and mortality. Despite the key role of innate immunity in the disease progression, the underlying molecular and pathogenic mechanisms remain to be elucidated. RNase L is a key enzyme in interferon action against viral infection and displays pleiotropic biological functions such as control of cell proliferation, apoptosis, and autophagy. Recent studies have demonstrated that RNase L is involved in innate immunity. In this study, we revealed that RNase L contributed to the development of NAFLD, which further progressed to NASH in a time‐dependent fashion after RNase L wild‐type (WT) and knockout mice were fed with a high‐fat and high‐cholesterol diet. RNase L WT mice showed significantly more severe NASH, evidenced by widespread macro‐vesicular steatosis, hepatocyte ballooning degeneration, inflammation, and fibrosis, although physiological and biochemical data indicated that both types of mice developed obesity, hyperglycemia, hypercholesterolemia, dysfunction of the liver, and systemic inflammation at different extents. Further investigation demonstrated that RNase L was responsible for the expression of some key genes in lipid metabolism, inflammation, and fibrosis signaling. Taken together, our results suggest that a novel therapeutic intervention for NAFLD may be developed based on regulating the expression and activity of RNase L.
Exploring plagiarism
Authors: Hilliard Wanda , Hobbs Stacy , Jimenez Rosalinda 
Published: August 2023

Abstract:
Plagiarism is a common issue in academic and professional communities. This article discusses ways to avoid plagiarism by identifying valuable resources, such as appropriate paraphrasing, creative work organizing, and new technology. Understanding copyright law safeguards is critical to avoiding plagiarism.
Predictors of Low Risk for Delirium during Anesthesia Emergence
Authors: Dragovic Srdjan , Schneider Gerhard , García Paul S. , Hinzmann Dominik , Sleigh Jamie , Kratzer Stephan , Kreuzer Matthias 
Published: August 2023

Background
Processed electroencephalography (EEG) is used to monitor the level of anesthesia, and it has shown the potential to predict the occurrence of delirium. While emergence trajectories of relative EEG band power identified post hoc show promising results in predicting a risk for a delirium, they are not easily transferable into an online predictive application. This article describes a low-resource and easily applicable method to differentiate between patients at high risk and low risk for delirium, with patients at low risk expected to show decreasing EEG power during emergence.

Methods
This study includes data from 169 patients (median age, 61 yr [49, 73]) who underwent surgery with general anesthesia maintained with propofol, sevoflurane, or desflurane. The data were derived from a previously published study. The investigators chose a single frontal channel, calculated the total and spectral band power from the EEG and calculated a linear regression model to observe the parameters’ change during anesthesia emergence, described as slope. The slope of total power and single band power was correlated with the occurrence of delirium.

Results
Of 169 patients, 32 (19%) showed delirium. Patients whose total EEG power diminished the most during emergence were less likely to screen positive for delirium in the postanesthesia care unit. A positive slope in total power and band power evaluated by using a regression model was associated with a higher risk ratio (total, 2.83 [95% CI, 1.46 to 5.51]; alpha/beta band, 7.79 [95% CI, 2.24 to 27.09]) for delirium. Furthermore, a negative slope in multiple bands during emergence was specific for patients without delirium and allowed definition of a test for patients at low risk.

Conclusions
This study developed an easily applicable exploratory method to analyze a single frontal EEG channel and to identify patterns specific for patients at low risk for delirium.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Understanding Geospatial Trends in Lumbar Fusion Incidence and Technique in Medicare Populations
Authors: Peterman Nicholas , Shivdasani Krishin , Naik Anant , Yeo Eunhae , Simon Joshua , Garst Jonathan , Moawad Christina , Stauffer Catherine , Kaptur Bradley , Arnold Paul M. 
Published: August 2023

Study Design.
Retrospective study with epidemiologic analysis of public Medicare data.

Objective.
This study seeks to utilize geospatial analysis to identify distinct trends in lumbar fusion incidence and techniques in Medicare populations.

Summary of Background Data.
With an aging population and new technologies, lumbar fusion is an increasingly common procedure. There is controversy, however, regarding which indications and techniques achieve optimal outcomes, leading to significant intersurgeon variation and potential national disparities in care.

Materials and Methods.
Medicare billing datasets were supplemented with Census Bureau socioeconomic data from 2013 to 2020. These databases listed lumbar fusions billed to Medicare by location, specialty, and technique. Hotspots and coldspots of lumbar fusion incidence and technique choice were identified with county-level analysis and compared with Mann-Whitney U. A linear regression of fusion incidence and a logistic regression of lumbar fusion hotspots/coldspots were also calculated.

Results.
Between 2013 and 2020, 624,850 lumbar fusions were billed to Medicare. Lumbar fusion hotspots performed fusions at nearly five times the incidence of coldspots (101.6–21.1 fusions per 100,000 Medicare members) and were located in the Midwest, Colorado, and Virginia while coldspots were in California, Florida, Wisconsin, and the Northeast. Posterior and posterolateral fusion were the most favored techniques, with hotspots in the Northeast. Combined posterior and posterolateral fusion and posterior interbody fusion was the second most favored technique, predominantly in Illinois, Missouri, Arkansas, and Colorado.

Conclusions.
The geographic distribution of lumbar fusions correlates with variations in residency training, fellowship, and specialty. The geospatial patterning in both utilization and technique reflects a lack of consensus in the application of lumbar fusion. The strong variance in utilization is a potentially worrying finding that could suggest that the nonstandardization of lumbar fusion indication has led to both overtreatment and undertreatment across the nation.

Level of Evidence.
Level 3—retrospective.
Improved understanding of the respiratory drive pathophysiology could lead to earlier spontaneous breathing in severe acute respiratory distress syndrome
Authors: Petitjeans Fabrice , Leroy Sandrine , Pichot Cyrille , Ghignone Marco , Quintin Luc , Longrois Dan , Constantin Jean-Michel 
Published: August 2023

Optimisation of the respiratory drive, as early as possible in the setting of severe acute respiratory distress syndrome (ARDS) and not its suppression, could be a new paradigm in the management of severe forms of ARDS. Severe ARDS is characterised by tachypnoea and hyperpnoea, a consequence of a high respiratory drive. Some patients require endotracheal intubation, controlled mechanical ventilation (CMV) and paralysis to prevent overt ventilatory failure and self-inflicted lung injury. Nevertheless, intubation, CMV and paralysis do not address per se the high respiratory drive, they only suppress it. Optimisation of the respiratory drive could be obtained by a multimodal approach that targets attenuation of fever, agitation, systemic and peripheral acidosis, inflammation, extravascular lung water and changes in carbon dioxide levels. The paradigm we present, based on pathophysiological considerations, is that as soon as these factors have been controlled, spontaneous breathing could resume because hypoxaemia is the least important input to the respiratory drive. Hypoxaemia could be handled by combining positive end-expiratory pressure (PEEP) to prevent early expiratory closure and low pressure support to minimise the work of breathing (WOB). ‘Cooperative’ sedation with alpha-2 agonists, supplemented with neuroleptics if required, is the pharmacological adjunct, administered immediately after intubation as the first-line sedation regimen during the multimodal approach. Given relative contraindications (hypovolaemia, auriculoventricular block, sick sinus syndrome), alpha-2 agonists can help attenuate or moderate fever, increased oxygen consumption VO2, agitation, high cardiac output, inflammation and acidosis. They may also help to preserve microcirculation, cognition and respiratory rhythm generation, thus promoting spontaneous breathing. Returning the physiology of respiratory, ventilatory, circulatory and autonomic systems to normal will support the paradigm of optimised respiratory drive favouring early spontaneous ventilation, at variance with deep sedation, extended paralysis, CMV and use of the prone position as therapeutic strategies in severe ARDS.

GLOSSARY
Glossary and Abbreviations_SDC, http://links.lww.com/EJAIC/A55
Comparison of two objective methods for measuring postoperative toric intraocular lens orientation under the natural pupil
Authors: Jiang Yuanfeng , Gao Yichen , Yang Jun , Chen Xiteng , Zhao Fangyu , Li Meisa , Lin Song , Bu Shaochong , Tian Fang 
Published: August 2023

Purpose:
To evaluate and compare the accuracy of iTrace and CASIA2 in measuring the postoperative orientation of toric intraocular lens (IOL) without mydriasis.

Setting:
Tianjin Medical University Eye Hospital, Tianjin, China.

Design:
Prospective cohort study.

Methods:
Patients with SN6AT toric IOLs implanted after cataract surgery were enrolled. 1 month after surgery, the toric IOL orientation were measured by iTrace and CASIA2 in non-mydriatic, semi-dark conditions. Then, the toric axis was directly reviewed using the slit-lamp under full mydriasis. Axis measurement differences between each of the 2 devices and the slit-lamp, described as their relative differences (RDs), were calculated and compared. The percentage of RDs within 5 degrees, within 10 degrees and greater than 30 degrees were analyzed.

Results:
77 eyes of 70 patients were included. Generally, the mean toric axis measurement RDs of CASIA2 and iTrace were 9.24 ± 10.53 degrees and 13.89 ± 15.47 degrees respectively (P = .04). For CASIA2 (72 eyes), 54.17% (39), 72.22% (52), and 4.17% (3) of eyes had RDs within 5 degrees, within 10 degrees and greater than 30 degrees, compared with 40.00% (28), 61.43% (43) and 12.86% (9) for iTrace (70 eyes). The 95% limits of agreements of CASIA2 with slit-lamp was narrower than that of iTrace with slit-lamp. The median RD of CASIA2 was significantly smaller in eyes with pupil ≥4 mm under dark condition compared with eyes with pupil <4 mm (P = .03).

Conclusions:
CASIA2 demonstrates greater precision in measuring toric IOL orientation under non-mydriatic conditions compared with iTrace. Moreover, the accuracy of CASIA2 is enhanced in cases of pupil >4 mm.