bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial Stewardship for Ventilator Associated Pneumonia in Intensive Care (the ASPIC trial): study protocol for a randomised controlled trial
Authors: Foucrier Arnaud , Roquilly Antoine , Bachelet Delphine , Martin-Loeches Ignacio , Bougle Adrien , Timsit Jean-François , Montravers Philippe , Zahar Jean-Ralph , Eloy Philippine , Weiss Emmanuel 
Published: February 2023

IntroductionVentilator-associated pneumonia (VAP) remains the leading cause of infections treated in the intensive care units (ICU). In a personalised care approach, we hypothesise that the duration of treatment of VAP can be reduced in function of the response to treatment.Methods and analysisThe Antimicrobial Stewardship for Ventilator-Associated Pneumonia in Intensive Care (ASPIC) trial is a pragmatic national multicentre, phase III, non-inferiority, comparative randomised (1:1) single-blinded clinical trial. Five hundred and ninety adult patients hospitalised in 24 French ICU with a microbiologically confirmed first episode of VAP that received appropriate empirical antibiotic therapy will be included. They will be randomly allocated to standard management with duration of appropriate antibiotic fixed for 7 days according to international guidelines or antimicrobial stewardship based on daily clinical assessment of clinical cure. The assessment of clinical cure will be repeated daily until at least three criteria of clinical cure are met, allowing the discontinuation of antibiotic therapy in experimental group. The primary endpoint is a composite endpoint combining of all-cause mortality measured at day 28, treatment failure or new episode of microbiologically confirmed VAP until day 28.The aim of the study is to demonstrate that a strategy to reduce the duration of antibiotic therapy for VAP based on clinical assessment is safe could lead to changes in practice as part of a personalised therapeutic approach, by reducing exposure to antibiotics and their side effects.Ethics and disseminationThe ASPIC trial has been approved by the French regulatory agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM; EUDRACT number 2021-002197-78, 19 August 2021) and an independent ethics committee the Comité de Protection des Personnes Ile-de-France III (CNRIPH : 21.03.25.60729, 10 October 2021) for the study protocol (version ASPIC−1.3; 03 September 2021) for all study centres. Participant recruitment is scheduled to begin in 2022. Results will be published in international peer-reviewed medical journals.Trial registration numberNCT05124977.
Association between frailty, chronic conditions and socioeconomic status in community-dwelling older adults attending primary care: a cross-sectional study using practice-based research network data
Authors: Mangin Dee , Lawson Jennifer , Risdon Cathy , Siu Henry Yu-Hin , Packer Tamar , Wong Sabrina T , Howard Michelle 
Published: February 2023

ObjectivesFrailty is a multidimensional syndrome of loss of reserves in energy, physical ability, cognition and general health. Primary care is key in preventing and managing frailty, mindful of the social dimensions that contribute to its risk, prognosis and appropriate patient support. We studied associations between frailty levels and both chronic conditions and socioeconomic status (SES).DesignCross-sectional cohort studySettingA practice-based research network (PBRN) in Ontario, Canada, providing primary care to 38 000 patients. The PBRN hosts a regularly updated database containing deidentified, longitudinal, primary care practice data.ParticipantsPatients aged 65 years or older, with a recent encounter, rostered to family physicians at the PBRN.InterventionPhysicians assigned a frailty score to patients using the 9-point Clinical Frailty Scale. We linked frailty scores to chronic conditions and neighbourhood-level SES to examine associations between these three domains.ResultsAmong 2043 patients assessed, the prevalence of low (scoring 1–3), medium (scoring 4–6) and high (scoring 7–9) frailty was 55.8%, 40.3%, and 3.8%, respectively. The prevalence of five or more chronic diseases was 11% among low-frailty, 26% among medium-frailty and 44% among high-frailty groups (χ2=137.92, df 2, p<0.001). More disabling conditions appeared in the top 50% of conditions in the highest-frailty group compared with the low and medium groups. Increasing frailty was significantly associated with lower neighbourhood income (χ2=61.42, df 8, p<0.001) and higher neighbourhood material deprivation (χ2=55.24, df 8, p<0.001).ConclusionThis study demonstrates the triple disadvantage of frailty, disease burden and socioeconomic disadvantage. Frailty care needs a health equity approach: we demonstrate the utility and feasibility of collecting patient-level data within primary care. Such data can relate social risk factors, frailty and chronic disease towards flagging patients with the greatest need and creating targeted interventions.
Diagnostic value of intereye difference metrics for optic neuritis in aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders
Authors: Oertel Frederike Cosima , Zimmermann Hanna G , Motamedi Seyedamirhosein , Chien Claudia , Aktas Orhan , Albrecht Philipp , Ringelstein Marius , Dcunha Anitha , Pandit Lekha , Martinez-Lapiscina Elena H , Sanchez-Dalmau Bernardo , Villoslada Pablo , Palace Jacqueline , Roca-Fernández Adriana , Leite Maria Isabel , Sharma Srilakshmi M , Leocani Letizia , Pisa Marco , Radaelli Marta , Lana-Peixoto Marco Aurélio , Fontenelle Mariana Andrade , Havla Joachim , Ashtari Fereshteh , Kafieh Rahele , Dehghani Alireza , Pourazizi Mohsen , Marignier Romain , Cobo-Calvo Alvaro , Asgari Nasrin , Jacob Anu , Huda Saif , Mao-Draayer Yang , Green Ari J , Kenney Rachel , Yeaman Michael R , Smith Terry J , Cook Lawrence , Brandt Alexander U , Paul Friedemann , Petzold Axel 
Published: February 2023

BackgroundThe novel optic neuritis (ON) diagnostic criteria include intereye differences (IED) of optical coherence tomography (OCT) parameters. IED has proven valuable for ON diagnosis in multiple sclerosis but has not been evaluated in aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders (AQP4+NMOSD). We evaluated the diagnostic accuracy of intereye absolute (IEAD) and percentage difference (IEPD) in AQP4+NMOSD after unilateral ON >6 months before OCT as compared with healthy controls (HC).MethodsTwenty-eight AQP4+NMOSD after unilateral ON (NMOSD-ON), 62 HC and 45 AQP4+NMOSD without ON history (NMOSD-NON) were recruited by 13 centres as part of the international Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica study. Mean thickness of peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell and inner plexiform layer (GCIPL) were quantified by Spectralis spectral domain OCT. Threshold values of the ON diagnostic criteria (pRNFL: IEAD 5 µm, IEPD 5%; GCIPL: IEAD: 4 µm, IEPD: 4%) were evaluated using receiver operating characteristics and area under the curve (AUC) metrics.ResultsThe discriminative power was high for NMOSD-ON versus HC for IEAD (pRNFL: AUC 0.95, specificity 82%, sensitivity 86%; GCIPL: AUC 0.93, specificity 98%, sensitivity 75%) and IEPD (pRNFL: AUC 0.96, specificity 87%, sensitivity 89%; GCIPL: AUC 0.94, specificity 96%, sensitivity 82%). The discriminative power was high/moderate for NMOSD-ON versus NMOSD-NON for IEAD (pRNFL: AUC 0.92, specificity 77%, sensitivity 86%; GCIP: AUC 0.87, specificity 85%, sensitivity 75%) and for IEPD (pRNFL: AUC 0.94, specificity 82%, sensitivity 89%; GCIP: AUC 0.88, specificity 82%, sensitivity 82%).ConclusionsResults support the validation of the IED metrics as OCT parameters of the novel diagnostic ON criteria in AQP4+NMOSD.
Anti-Argonaute antibodies as a potential biomarker in NMOSD
Authors: Carta Sara , Le Duy Do , Rogemond Veronique , Derache Nathalie , Chaumont Hugo , Fromont Agnès , Cabasson Sebastien , Boudot de la Motte Marine , Honnorat Jerome , Marignier Romain 
Published: February 2023

Background and objectivesNeuromyelitis optica spectrum disorders (NMOSDs) are a group of diseases mainly characterised by recurrent optic neuritis and/or myelitis. Most cases are associated with a pathogenic antibody against aquaporin-4 (AQP4-Ab), while some patients display autoantibodies targeting the myelin oligodendrocyte glycoprotein (myelin oligodendrocyte glycoprotein antibodies (MOG-Abs)). Anti-Argonaute antibodies (Ago-Abs) were first described in patients with rheumatological conditions and were recently reported as a potential biomarker in patients with neurological disorders. The aims of the study were to investigate if Ago-Abs can be detected in NMOSD and to evaluate its clinical usefulness.MethodsSera from patients prospectively referred to our centre with suspected NMOSD were tested for AQP4-Abs, MOG-Abs and Ago-Abs with cell-based assays.ResultsThe cohort included 104 prospective patients: 43 AQP4-Abs-positive cases, 34 MOG-Abs positive cases and 27 double-negative patients. Ago-Abs were detected in 7 of 104 patients (6.7%). Clinical data were available for six of seven patients. The median age at onset of patients with Ago-Abs was 37.5 [IQR 28.8–50.8]; five of six patients tested positive also for AQP4-Abs. Clinical presentation at onset was transverse myelitis in five patients, while one presented with diencephalic syndrome and experienced a transverse myelitis during follow-up. One case presented a concomitant polyradiculopathy. Median EDSS score at onset was 7.5 [IQR 4.8–8.4]; median follow-up was 40.3 months [IQR 8.3–64.7], and median EDSS score at last evaluation was 4.25 [IQR 1.9–5.5].ConclusionAgo-Abs are present in a subset of patients with NMOSD and, in some cases, represent the only biomarker of an autoimmune process. Their presence is associated with a myelitis phenotype and a severe disease course.
Folic acid protects against age-associated apoptosis and telomere attrition of neural stem cells in senescence-accelerated mouse prone 8
Authors: Li Zhenshu , Cai Ke , Sun Yue , Zhou Dezheng , Yan Jing , Luo Suhui , Huang Guowei , Gao Yuxia , Li Wen 
Published: February 2023

Folic acid (FA) could improve cognitive performance and attenuate brain cell injury in the aging brain; FA supplementation is also associated with inhibiting neural stem cell (NSC) apoptosis. However, its role in age-associated telomere attrition remains unclear. We hypothesized that FA supplementation attenuates age-associated apoptosis of NSCs in mice via alleviating telomere attrition in senescence-accelerated mouse prone 8 (SAMP8). In this study, 4-month-old male SAMP8 mice were assigned equal numbers to four different diet groups ( n = 15). Fifteen age-matched senescence-accelerated mouse resistant 1 mice, fed with the FA-normal diet, were used as the standard aging control group. After FA treatment for 6 months, all mice were sacrificed. NSC apoptosis, proliferation, oxidative damage, and telomere length were evaluated by immunofluorescence and Q-fluorescent in situ hybridization. The results showed that FA supplementation inhibited age-associated NSC apoptosis and prevented telomere attrition in the cerebral cortex of SAMP8 mice. Importantly, this effect might be explained by the decreased levels of oxidative damage. In conclusion, we demonstrate it may be one of the mechanisms by which FA inhibits age-associated NSC apoptosis by alleviating telomere length shortening.
Feasibility of the observation of a heavy scalar through the fully hadronic final state at the LHeC
Authors: Malwa Elias , Kumar Mukesh , Mellado Bruce , Ruan Xifeng 
Published: February 2023

AbstractThe proposed future Large Hadron electron collider provides sufficient center of mass energies, $$\sqrt{s}$$

s

, to probe heavy particles decaying into $$W^\pm (Z)-$$

W
±

(
Z
)

-

boson of mass $$>2m_W$$

>
2

m
W

$$(2m_Z)$$

(
2

m
Z

)

. In this work we present a study to produce one such heavy CP even scalar H of mass $$2m_h< m_H < 2 m_t$$

2

m
h

<

m
H

<
2

m
t

through charged-current production mode where $$H \rightarrow W^+W^-$$

H
→

W
+

W
-

, where hadronic decay of $$W^\pm -$$

W
±

-

boson is considered to reconstruct $$m_H$$

m
H

. Due to the presence of missing energy and forward jet in this channel, it is challenging to reconstruct $$m_H$$

m
H

with above final state and thus we employed three different reconstruction methods and discuss the significance of each one. For this analysis we consider a benchmark value of $$m_H = 270$$

m
H

=
270

GeV and $$\sqrt{s} \approx 1.3$$

s

≈
1.3

TeV with an assumed luminosity of 1 ab$$^{-1}$$

-
1

.
$$AdS_5$$ vacua and holographic RG flows from 5D $$N=4$$ gauged supergravity
Authors: Karndumri Parinya 
Published: February 2023

AbstractWe study five-dimensional $$N=4$$

N
=
4

gauged supergravity coupled to five vector multiplets with $$SO(2)_D\times SO(3)\times SO(3)$$

S
O

(
2
)

D

×
S
O

(
3
)

×
S
O

(
3
)

gauge group. There are four supersymmetric $$AdS_5$$

A
d

S
5

vacua in the truncation to $$SO(2)_{\text {diag}}$$

S
O

(
2
)

diag

invariant scalars. Two of these vacua preserve the full $$N=4$$

N
=
4

supersymmetry with $$SO(2)_D\times SO(3)\times SO(3)$$

S
O

(
2
)

D

×
S
O

(
3
)

×
S
O

(
3
)

and $$SO(2)_D\times SO(3)_{\text {diag}}$$

S
O

(
2
)

D

×
S
O

(
3
)

diag

symmetries. These have an analogue in $$N=4$$

N
=
4

gauged supergravity with $$SO(2)\times SO(3)\times SO(3)$$

S
O
(
2
)
×
S
O
(
3
)
×
S
O
(
3
)

gauge group. The other two $$AdS_5$$

A
d

S
5

vacua preserve only $$N=2$$

N
=
2

supersymmetry with $$SO(2)_{\text {diag}}\times SO(3)$$

S
O

(
2
)

diag

×
S
O

(
3
)

and $$SO(2)_{\text {diag}}$$

S
O

(
2
)

diag

symmetry. The former has an analogue in the previous study of $$SO(2)_D\times SO(3)$$

S
O

(
2
)

D

×
S
O

(
3
)

gauge group while the latter is a genuinely new $$N=2$$

N
=
2

$$AdS_5$$

A
d

S
5

vacuum. These vacua should be dual to $$N=2$$

N
=
2

and $$N=1$$

N
=
1

superconformal field theories (SCFTs) in four dimensions with different flavour symmetries. We give the full scalar mass spectra at all of the $$AdS_5$$

A
d

S
5

critical points which provide information on conformal dimensions of the dual operators. Finally, we study holographic RG flows interpolating between these $$AdS_5$$

A
d

S
5

vacua and find a new class of solutions. In addition to the RG flows from the trivial $$SO(2)_D\times SO(3)\times SO(3)$$

S
O

(
2
)

D

×
S
O

(
3
)

×
S
O

(
3
)

$$N=4$$

N
=
4

critical point, at the origin of the scalar manifold, to all the other critical points, there is a family of RG flows from the trivial $$N=4$$

N
=
4

critical point to the new $$SO(2)_{\text {diag}}$$

S
O

(
2
)

diag

$$N=2$$

N
=
2

critical point that pass arbitrarily close to the $$SO(2)_D\times SO(3)_{\text {diag}}$$

S
O

(
2
)

D

×
S
O

(
3
)

diag

$$N=4$$

N
=
4

critical point.
Analytical expressions for pulse profile of neutron stars in plasma environments
Authors: Briozzo Gastón , Gallo Emanuel 
Published: February 2023

AbstractWe present an analytical study of light curves of slowly rotating radio pulsars with emphasis on the chromatic effects derived from the presence of a plasma environment; analyzing the effects of the compactness, the metric model, and the electronic plasma density profile. After doing a numerical integration of the trajectories and luminosity curves of pulsars for different spherically symmetric metrics representing the exterior region of the pulsar, we generalize the approximate Beloborodov formula in order to include plasma corrections, obtaining simple analytical expressions for the trajectories and the observed flux and significantly simplifying the calculation of the pulse profiles by a drastic reduction of their computational cost. We study the errors committed by our approximation, comparing the numerical and analytical procedures. We also show how to use the new formalism to model the flux coming from different emission caps, not necessarily circular or antipodal and including the case of ring-shaped hot spots. Finally, we extend the classification introduced by Beloborodov to the case of two distinguishable, non-antipodal, finite size emission caps, showing the respective classification maps and some of the characteristic pulse profiles.
The Relationship of Patient Characteristics and Prolonged Pain after Treatment of Carpometacarpal Joint Arthritis of the Thumb
Authors: ARASEGAWA Yoshito , MURAMATSU Keiichi , INOUE Kiyotaka , UEDA Takeshi , JYOUICHI Kouhei , KINOSHITA Daisuke 
Published: February 2023

Background: The carpometacarpal (CMC) joint of the thumb is the second most common site of osteoarthritis in the hand. Clinical severity stage of CMC joint arthritis has not been correlated with the pain level of the patient. Recently, the association of joint pain with patient psychological factor, such as depression or case-specific personality, has been investigated. This study was designed to determine the impact of psychological factors to residual pain after treatment of CMC joint arthritis, using pain catastrophizing scale (PCS) and the Yatabe–Guilford (YG) personality test. Methods: Twenty-six patients (7 males and 19 females) with 26 hands were included. Thirteen patients classified as Eaton stage 3 underwent suspension arthroplasty and 13 patients as Eaton stage 2 underwent conservative treatment using a custom fitted orthosis. Clinical evaluation was assessed using Visual Analogue Scale (VAS) and the quick Disabilities of the Arm, Shoulder and Hand Questionnaire Score (QuickDASH) at initial evaluation, at 1 month and at 3 months after treatment. We compared both groups using the PCS and YG test. Results: The PCS showed significant difference in the VAS scores only at initial evaluation in both surgical and conservative treatment. There was a significant difference in VAS at 3 months between the two groups in both surgical and conservative treatment and in QuickDASH at 3 months in conservative treatment. Conclusions: The YG test has been used mainly in psychiatry. Although this test has not yet been used worldwide, its usefulness has been recognised and applied clinically, especially in Asia. Patient characteristics are strongly associated with residual pain of the CMC joint arthritis of the thumb. The YG test is a useful tool to analyse pain-related patient characteristics and can be utilised to determine the therapeutic modalities and most effective rehabilitation programme for pain control. Level of Evidence: Level III (Therapeutic)
Retrospective Comparative Study of Clinical Outcomes and Cost-Effectiveness with Bone Substitutes on Volar Locking Plate Fixation of Unstable Distal Radial Fractures in the Elderly
Authors: MORI Yusuke , TAKEGAMI Yasuhiko , TOKUTAKE Katsuhiro , OKA Yoshiharu , IMAGAMA Shiro 
Published: February 2023

Background: This multicenter retrospective study aimed to compare clinical outcomes and cost-effectiveness with bone substitutes on volar locking plate (VLP) fixation of unstable distal radial fractures (DRF) in the elderly. Methods: The data of 1,980 patients of ≥65 years of age who underwent surgery for the DRF with a VLP in 2015–2019 were extracted from a database (named TRON). Patients lost to follow-up or who received autologous bone grafting were excluded. The patients (n = 1,735) were divided into the VLP fixation alone (Group VLA) and VLP fixation with bone substitutes (Group VLS). Propensity score matching of background characteristics (ratio, 4:1) was performed. The modified Mayo wrist scores (MMWS) were evaluated as clinical outcomes. The implant failure rate, bone union rate, volar tilt (VT), radial inclination (RI), ulnar variance (UV) and distal dorsal cortical distance (DDD) were evaluated as radiologic parameters. We also compared the initial surgery cost and total cost for each group. Results: After matching, the backgrounds of Groups VLA (n = 388) and VLS (n = 97) were not significantly different. The MMWS values of the groups were not significantly different. Radiographic evaluation revealed no implant failure in either group. Bone union was confirmed in all patients in both groups. The VT, RI, UV and DDD values of the groups were not significantly different. The initial surgery cost and total cost in the VLS group were significantly higher than those in the VLA group ($3,515 vs. $3,068, p < 0.001). Conclusions: In patients of ≥65 years of age with DRF, the clinical and radiological outcomes of VLP fixation with bone substitutes did not differ from those of VLP fixation alone, yet the additional use of bone augmentation was associated with higher medical costs. The indications for bone substitutes should be more strictly considered in the elderly with DRF. Level of Evidence: Level IV (Therapeutic)
Modified Thompson–Littler Method for Chronic Instability of the Proximal Interphalangeal Joint: A Report of Two Cases
Authors: MATSUO Tomoki , SUZUKI Taku , KIMURA Hiroo , IWAMOTO Takuji 
Published: February 2023

A 40-year-old patient and a 45-year-old patient presented with chronic dorsal and lateral subluxation of the proximal interphalangeal (PIP) joint of the little finger and underwent surgeries. Through a dorsal approach, the ulnar lateral band was transected and transferred to the radial side through the volar side of the PIP joint. The transferred lateral band and the remnant of the radial collateral ligament were secured with an anchor on the radial side of the proximal phalanx. Satisfactory results were obtained without the loss of flexion and recurrence of subluxation of the finger. This method enabled the correction of both dorsal and lateral instability of the PIP joint through a dorsal incision. The modified Thompson–Littler technique was useful for chronic instability of the PIP joint.– Level of Evidence: Level V (Therapeutic)