bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of intravenous iron repletion in patients with heart failure: a systematic review and meta-analysis
Authors: Vukadinović Davor , Abdin Amr , Emrich Insa , Schulze P. Christian , von Haehling Stephan , Böhm Michael 
Published: April 2023

Abstract
Introduction
AFFIRM-AHF and IRONMAN demonstrated lower rates of the combined endpoint recurrent heart failure (HF) hospitalizations and cardiovascular death (CVD) using intravenous (IV) ferric carboxymaltose (FCM) and ferric derisomaltose (FDI), respectively in patients with HF and iron deficiency (ID) utilizing prespecified COVID-19 analyses.

Material and methods
We meta-analyzed efficacy, between trial heterogeneity and data robustness for the primary endpoint and CVD in AFFIRM-AHF and IRONMAN. As sensitivity analysis, we analyzed data from all eligible exploratory trials investigating FCM/FDI in HF.

Results
FCM/FDI reduced the primary endpoint (RR = 0.81, 95% CI 0.69–0.95, p = 0.01, I2 = 0%), with the number needed to treat (NNT) being 7. Power was 73% and findings were robust with fragility index (FI) of 94 and fragility quotient (FQ) of 0.041. Effects of FCM/FDI were neutral concerning CVD (OR = 0.88, 95% CI 0.71–1.09, p = 0.24, I2 = 0%). Power was 21% while findings were fragile with reverse FI of 14 and reversed FQ of 0.006. The sensitivity analysis from all eligible trials (n = 3258) confirmed positive effects of FCM/FDI on the primary endpoint (RR = 0.77, 95% CI 0.66–0.90, p = 0.0008, I2 = 0%), with NNT being 6. Power was 91% while findings were robust (FI of 147 and FQ of 0.045). Effect on CVD was neutral (RR = 0.87, 95% CI 0.71–1.07, p = 0.18, I2 = 0%). Power was 10% while findings were fragile (reverse FI of 7 and reverse FQ of 0.002). Rate of infections (OR = 0.85, 95% CI 0.71–1.02, p = 0.09, I2 = 0%), vascular disorder (OR = 0.84, 95% CI 0.57–1.25, p = 0.34, I2 = 0%) and general or injection-site related disorders (OR = 1.39, 95% CI 0.88–1.29, p = 0.16, I2 = 30%) were comparable between groups. There was no relevant heterogeneity (I2 > 50%) between the trials for any of the analyzed outcomes.

Conclusions
Use of FCM/FDI is safe and reduces the composite of recurrent HF hospitalizations and CVD, while effects on CVD alone are based on available level of data indeterminate. Findings concerning composite outcomes exhibit a high level of robustness without heterogeneity between trials with FCM and FDI.

Graphical Abstract
Iodine intake assessment in the staff of a Porto region university (Portugal): the iMC Salt trial
Authors: Machado Ana , Gonçalves Carla , Moreira Pedro , Pinho Olívia , Padrão Patrícia , Silva-Santos Tânia , Rodrigues Micaela , Norton Pedro , Bordalo Adriano A. 
Published: April 2023

Abstract
Purpose
Iodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population.

Methods
The population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24–69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell–Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt.

Results
The mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%.

Conclusion
This study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups.
Characterisation and differential diagnosis of neurological complications in adults with phenylketonuria: literature review and expert opinion
Authors: Merkel Martin , Berg Daniela , Brüggemann Norbert , Classen Joseph , Mainka Tina , Zittel Simone , Muntau Ania C. 
Published: April 2023

Abstract
Objective
Phenylketonuria (PKU) is a rare inherited metabolic disorder characterised by elevated phenylalanine (Phe) concentrations that can exert neurotoxic effects if untreated or upon treatment discontinuation. This systematic review supported by expert opinion aims to raise awareness among the neurological community on neurological complications experienced by adults with PKU (AwPKU).

Methods
The PubMed database was searched for articles on neurological signs and symptoms in AwPKU published before March 2022. In addition, two virtual advisory boards were held with a panel of seven neurologists and two metabolic physicians from Germany and Austria. Findings are supported by three illustrative patient cases.

Results
Thirty-nine articles were included. Despite early diagnosis and treatment, neurological signs and symptoms (e.g. ataxia, brisk tendon reflexes, tremor, visual impairment) can emerge in adulthood, especially if treatment has been discontinued after childhood. In PKU, late-onset neurological deficits often co-occur with cognitive impairment and psychiatric symptoms, all of which can be completely or partially reversed through resumption of treatment.

Conclusion
Ideally, neurologists should be part of the PKU multidisciplinary team, either to bring lost to follow-up patients back to clinic or to manage symptoms in referred patients, considering that symptoms are often reversible upon regaining metabolic control. The current findings have been combined in a leaflet that will be disseminated among neurologists in Germany and Austria to create awareness.
Adaptability of the load sharing between the longissimus and components of the multifidus muscle during isometric trunk extension in healthy individuals
Authors: Tier Louise , Salomoni Sauro E. , Hug François , Besomi Manuela , Hodges Paul W. 
Published: April 2023

Abstract
Purpose
Redundancy of the musculoskeletal system implies multiple strategies are theoretically available to coordinate back extensor muscles. This study investigated whether coordination between back muscles during a tightly constrained isometric trunk extension task varies within and between individuals, and whether this changes following brief exposure to activation feedback of a muscle.

Methods
Nine healthy participants performed three blocks of two repetitions of ramped isometric trunk extension in side-lying against resistance from 0–30% of maximum voluntary contraction over 30 s (force feedback). Between blocks, participants repeated contractions with visual feedback of electromyography (EMG) from either superficial (SM) or deep multifidus (DM), in two conditions; ‘After SM’ and ‘After DM’. Intramuscular EMG was recorded from SM, DM, and longissimus (LG) simultaneously with shear wave elastography (SWE) from SM or DM.

Results
In the ‘Natural’ condition (force feedback only), group data showed incremental increases in EMG with force, with minor changes in distribution of activation between muscles as force increased. SM was the most active muscle during the ‘Natural’ condition, but with DM most active in some participants. Individual data showed that coordination between muscles differed substantially between repetitions and individuals. Brief exposure to EMG feedback altered coordination. SWE showed individual variation, but findings differed from EMG.

Conclusion
This study revealed substantial variation in coordination between back extensor muscles within and between participants, and after exposure to feedback, in a tightly constrained task. Shear modulus revealed similar variation, but with an inconsistent relationship to EMG. These data highlight highly flexible control of back muscles.
Sense of coherence and its context with demographics, psychological aspects, lifestyle, complementary and alternative medicine and lay aetiology
Authors: Bargehr B. , Fischer von Weikersthal L. , Junghans C. , Zomorodbakhsch B. , Stoll C. , Prott F.-J. , Fuxius S. , Micke O. , Hübner J. , Büntzel J. , Hoppe C. 
Published: April 2023

Abstract
Purpose
For patients with a cancer diagnosis, coping abilities are of high importance. Cancer patients with a high sense of coherence may cope better. The purpose of this study is to learn more about the correlation of sense of coherence and different aspects, such as demographics, psychological factors, lifestyle, complementary and alternative medicine (CAM) and lay aetiology.

Methods
A prospective cross-sectional study was performed in ten cancer centres in Germany. The questionnaire consisted of ten sub-items, collecting information about sense of coherence, demographics, general life satisfaction, resilience, spirituality, self-efficacy, physical activity and sports, nutrition, CAM methods and cancer causes.

Results
As many as 349 participants were evaluable. The mean sense of coherence score was M = 47.30. Significant associations were shown for sense of coherence and financial situation (r = 0.230, p < 0.001), level of education (r = 0.187, p < 0.001), marital status (η = 0.177, p = 0.026) and time interval since diagnosis (r = − 0.109, p = 0.045). Sense of coherence and resilience correlated on a high level, as well as spirituality, self-efficacy and general life satisfaction (r = 0.563, r = 0.432, r = 0.461, r = 0.306, p’s < 0.001).

Conclusion
Several aspects, such as demographics and psychological factors, have a great influence on the sense of coherence. To help patients to cope better, physicians should try to strengthen sense of coherence, resilience and self-efficacy and, at the same time, consider patients’ individual background such as level of education, financial capacity and emotional support by family members.
Sequential repeated tibial tubercle osteotomy in a two-stage exchange strategy: a superior approach to treating a chronically infected knee arthroplasty?
Authors: Corona Pablo S. , Pérez Marta , Vicente Matías , Pujol Oriol , Amat Carles , Carrera Lluís 
Published: April 2023

Abstract
Purpose
Surgical approach can impact the reliability of the debridement after a chronic total knee periprosthetic joint infection (PJI), a factor of utmost importance to eradicate the infection. The most adequate knee surgical approach in cases of PJI is a matter of debate. The purpose of this study was to determine the influence of performing a tibial tubercle osteotomy (TTO) in a two-stage exchange protocol for knee PJI treatment.

Methods
Retrospective cohort study examining patients managed with two-stage arthroplasty due to chronic knee PJI (2010–2019). Performance and timing of the TTO were collected. Primary end-point was infection control with a minimum FU of 12 months and according to internationally accepted criteria. Correlation between TTO timing and reinfection rate was reviewed.

Results
Fifty-two cases were finally included. Overall success (average follow-up: 46.2 months) was 90.4%. Treatment success was significantly higher among cases addressed using TTO during the second stage (97.1% vs. 76.5%, pvalue 0.03). Only 4.8% of the patients relapsed after performing a sequential repeated TTO, that is, during both first and second stages, compared to 23.1% cases in which TTO was not done (p value 0.28). No complications were observed among patients in the TTO group with a significant decrease in soft tissue necrosis (p: 0.052).

Conclusion
Sequential repeated tibial tubercle osteotomy during a two-stage strategy is a reasonable option and offers high rates of infection control in complex cases of knee PJI with a low rate of complications.
Subcortical language localization using sign language and awake craniotomy for dominant posterior temporal glioma resection in a hearing-impaired patient
Authors: Lau Ruth , Malhotra Armaan K , McAndrews Mary Pat , Kongkham Paul 
Published: April 2023

AbstractIntraoperative direct cortical stimulation (DCS) is the gold standard technique to maximize the extent of resection of tumors located in eloquent areas. To date, there are three cases reported of awake mapping for language centers in deaf patients who could communicate only with sign language. We present the case of DCS in a deaf patient who could communicate vocally, native to American Sign Language and English, that underwent intraoperative awake mapping. DCS showed similar disruption of expressive phonology to both pictorial and gestural stimuli, confirming that sign language follows the same pattern as oral language.
Robust state and protection-level estimation within tightly coupled GNSS/INS navigation system
Authors: Liu Shuchen , Wang Kaizheng , Abel Dirk 
Published: April 2023

AbstractIn autonomous applications for mobility and transport, a high-rate and highly accurate vehicle-state estimation is achieved by fusing measurements of global navigation satellite systems (GNSS) and inertial sensors. The state estimation and its protection-level generation often suffer from satellite-signal disturbances in urban environments and subsequent poor parametrization of the satellite observables. Thus, we propose an innovative scheme involving an extended H∞ filter (EHF) for robust state estimation and zonotope for the protection-level generation. This scheme is shown as part of a tightly coupled navigation system based on an inertial navigation system and aided by the GPS/Galileo dual-constellation satellite navigation system. Specifically, GNSS pseudorange and deltarange observables are utilized. The experimental results of post-processing a real-world dataset show significant advantages of EHF against a conventional extended Kalman filter regarding the navigation accuracy and robustness under various GNSS measurement parametrizations and environmental circumstances. The zonotope-based protection-level calculation is proven valid, computationally affordable, and feasible for real-time implementations.
Genetische Diagnostik der Epilepsien: Empfehlung der Kommission Epilepsie und Genetik der Deutschen Gesellschaft für Epileptologie (DGfE)
Authors: Boßelmann Christian , Borggräfe Ingo , Fazeli Walid , Klein Karl-Martin , Kluger Gerhard J. , Müller-Schlüter Karen , Neubauer Bernd A. , von Spiczak Sarah , Steinbeis von Stülpnagel Celina , Weber Yvonne , Lemke Johannes R. , Wolking Stefan , Krey Ilona 
Published: April 2023

ZusammenfassungDie genetische Diagnostik bei an Epilepsie erkrankten Personen ist inzwischen weit verbreitet und unstrittig sinnhaft geworden. Die Kenntnis einer genetischen Ätiologie kann die Identifikation der Diagnose, genetische Beratung, Therapie und Prognoseeinschätzung der Grunderkrankung maßgeblich unterstützen. Methoden der Hochdurchsatz-Sequenzierung erlauben inzwischen eine rasche, umfassende und kosteneffektive Diagnostik. Diese aktuellen Empfehlungen der Kommission „Epilepsie und Genetik“ der Deutschen Gesellschaft für Epileptologie (DGfE) bauen auf den Empfehlungen der International League Against Epilepsie (ILAE) Commission on Genetics auf. Wir bieten einen praxisnahen Überblick über die Indikationsstellung, praktische Umsetzung, Befundbewertung, und Möglichkeiten der Präzisionsmedizin.
Nutrient fluxes via litterfall in silver birch (Betula pendula Roth) stands growing on post-arable soils
Authors: Jonczak Jerzy , Oktaba Lidia , Chojnacka Aleksandra , Pawłowicz Edyta , Kruczkowska Bogusława , Oktaba Jarosław , Słowińska Sandra 
Published: April 2023

AbstractThe purpose of this study was to evaluate the importance of litterfall as a link in biogeochemical cycling of certain elements (C, N, P, K, Ca, Mg, Fe, Mn, Cu, and Zn) in silver birch stands growing on post-arable soils under temperate climatic conditions (Poland). The study covered three stands on sandy soils (21, 29, and 40 years old) and three on loamy soils (15, 33, and 41 years old). Litterfall was collected during 2020–2021 and analysed using standard procedures. Elemental contents were determined also in green leaves collected from the tree crowns in early summer to determine intensity of retranslocation. The total litterfall production varied from 2576 to 5293 kg ha−1, depending on the stand and year. These values are typical of temperate forests. Litterfall production was positively correlated with stand age. Leaves made up the major fraction, followed by twigs. Silver birch litterfall was generally rich in nutrients compared to many other tree species typical for temperate climatic zone. Nutrient fluxes to the soil were in the upper limits reported in the literature. It may partially be an effect of the post-arable history of these stands. Large fluxes of nutrients to the soil via litterfall are important in the context of the high nutritional demands of the studied tree species. This study also showed that silver birch strongly retranslocates N, P, and K from senescing leaves, whereas Ca, Mg, Fe, Mn, Cu, and Zn are accumulated in these organs.
Using Observed and Modelled Heat Fluxes for Improved Extrapolation of Wind Distributions
Authors: Floors Rogier , Troen Ib , Peña Alfredo 
Published: April 2023

AbstractModelling the horizontal and vertical variation of wind speed is crucial for wind energy applications. A model frequently used for this purpose is part of the Wind Atlas Analysis and Application program (WAsP). Here, we modify the model in WAsP to account for local atmospheric stability parameters. Atmospheric stability effects are treated by using the impact of a temperature scale on the geostrophic drag law and the diabatic logarithmic wind profile. Using this approach, wind-direction dependent mean and standard deviation of a surface-layer temperature scale and a mean boundary-layer height scale can be obtained from either numerical weather prediction model output or observations to improve vertical extrapolations of Weibull wind speed distribution parameters. The modified atmospheric stability model is validated at six flat sites in northwestern Europe. The surface-layer temperature scale is available from sonic anemometer measurements at three of the sites. At all sites the temperature scale is also estimated from reanalysis data and from mesoscale model output. The modified model improves the aggregated estimations of power density distributions when extrapolating to nearby locations from 5.2 to 3%, when using the temperature scale derived from either observations or mesoscale/reanalysis output compared to the current model.
Landscape genomics reveals signals of climate adaptation and a cryptic lineage in Arthropodium fimbriatum
Authors: Jordan Rebecca , Price Meridy , Harrison Peter A. , Prober Suzanne M. , Vaillancourt René E. , Steane Dorothy 
Published: April 2023

AbstractHabitat loss and fragmentation are critical threats to biodiversity. Consequent decreases in population size and connectivity can impact genetic diversity and, thus, future adaptability and resilience to environmental change. Understanding landscape patterns of genetic diversity, including patterns of adaptive variation, can assist in developing conservation strategies that maximise population persistence and adaptability in the face of environmental change. Using a reduced-representation genomic approach, we investigated genetic diversity, structure, and adaptive variation across an aridity gradient in the woodland forb Arthropodium fimbriatum. Moderate levels of genetic diversity (HS = 0.14–0.23) were found in all 13 sampled provenances. Inbreeding varied among provenances (FIS = 0.08–0.42) but was not associated with estimated population size. Four genetic clusters were identified, including one highly differentiated cluster. Higher pairwise FST (0.23–0.42) between the three provenances of this cluster and the remaining 10 provenances (pairwise FST between 10 provenances 0.02–0.32) suggested two highly divergent lineages or potentially a cryptic species. After excluding the three highly differentiated populations, outlier and genotype-environment association analysis identified 275 putatively adaptive loci suggesting genomic signatures of climate adaptation in A. fimbriatum is primarily associated with changes in aridity. Combined, these results suggest that all provenances have conservation value, contributing to the maintenance of genetic diversity and adaptive variation in this species. The uncovering of a potential cryptic taxon highlights the power of genomics approaches in conservation genetics and the importance of understanding the role of landscape variation shaping genetic variation to effectively define conservation management units in an era of rapid biodiversity decline.
What is the role of puberty in the development of islet autoimmunity and progression to type 1 diabetes?
Authors: Peltonen Essi J. , Veijola Riitta , Ilonen Jorma , Knip Mikael , Niinikoski Harri , Toppari Jorma , Virtanen Helena E. , Virtanen Suvi M. , Peltonen Jaakko , Nevalainen Jaakko 
Published: April 2023

AbstractIn many populations, the peak period of incidence of type 1 diabetes (T1D) has been observed to be around 10–14 years of age, coinciding with puberty, but direct evidence of the role of puberty in the development of T1D is limited. We therefore aimed to investigate whether puberty and the timing of its onset are associated with the development of islet autoimmunity (IA) and subsequent progression to T1D. A Finnish population-based cohort of children withHLA-DQB1-conferred susceptibility to T1D was followed from 7 years of age until 15 years of age or until a diagnosis of T1D (n = 6920). T1D-associated autoantibodies and growth were measured at 3- to 12-month intervals, and pubertal onset timing was assessed based on growth. The analyses used a three-state survival model. IA was defined as being either positive for islet cell antibodies plus at least one biochemical autoantibody (ICA + 1) or as being repeatedly positive for at least one biochemical autoantibody (BC1). Depending on the IA definition, either 303 (4.4%, ICA + 1) or 435 (6.3%, BC1) children tested positive for IA by the age of 7 years, and 211 (3.2%, ICA + 1)) or 198 (5.3%, BC1) developed IA during follow-up. A total of 172 (2.5%) individuals developed T1D during follow-up, of whom 169 were positive for IA prior to the clinical diagnosis. Puberty was associated with an increase in the risk of progression to T1D, but only from ICA + 1-defined IA (hazard ratio 1.57; 95% confidence interval 1.14, 2.16), and the timing of pubertal onset did not affect the association. No association between puberty and the risk of IA was detected. In conclusion, puberty may affect the risk of progression but is not a risk factor for IA.