bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors related to medication adherence in patients with hypertension in Iran: a systematic review study
Authors: Maleki Golara , Norian Rohollah , Moeini Babak , Barati Majid , Maleki Shahnaz , Afshari Maryam 
Published: September 2023

Objectives
This study aimed to review the available studies of the factors in Iranian hypertensive patients’ adherence to drug treatment.

Methods
Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO.

Results
The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients’ satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient’s blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action.

Conclusion:
It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment
Central blood pressure obtained by cuff-based oscillometry as a determinant of left ventricular hypertrophy in hypertensive patients
Authors: Abdelmegid Mohamed Aboel-Kassem F. , Fouad Doaa A. , Beshay Nardeen W.M. , Mahran Dalia G. , Shams-eddin Hamdy 
Published: September 2023

Objective
Limited and conflicting data have been reported on the prognostic relevance of central blood pressure (CBP) compared with brachial blood pressure (BP) in the anticipation of hypertension-mediated organ damage and the majority of data derived using applanation tonometry with its known complexities. The objective of the present study was to investigate the diagnostic factors of left ventricular hypertrophy (LVH) with a special highlight on the utility of non-invasive oscillometric CBP measurement and derived hemodynamic indices compared to brachial BP as indicators of LVH.

Methods
This cross-sectional study included 300 hypertensive patients (mean age 55.3 years, 61.3% female, 51.7% obese) with a mean duration of hypertension was 5.8 years. They underwent measurement of brachial BP, using a mercury sphygmomanometer, and CBP, using a Mobil-O-Graph, alongside the determination of left ventricular (LV) mass by two-dimensional transthoracic echocardiography. LVH and LV geometric patterns were defined by LV mass index/height2.7 and relative wall thickness.

Results
Bivariate then multivariate analysis showed that age, BMI, central systolic BP (SBP), and pulse wave velocity (PWV) were significant determinants of LVH and optimally controlled brachial BP was a significant negative determinant for LVH. Central SBP had an acceptable diagnostic performance to determine LVH in patients with hypertension (AUC = 0.722, 95% confidence interval: 0.618–0.824, SE = 0.21, P-value <0.001). Using one-way ANOVA, a comparison of means among age groups showed that the steady increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.

Conclusion
Estimated central SBP using Mobil-O-Graph showed a significantly higher correlation to LVH than brachial SBP values. The consistent increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.
Screening for orthostatic hypotension in the geriatric population in a real-world primary care setting reduces prescribed antihypertensive medications
Authors: Kaye Matthew G. , Rutowski James , Aftab Hamza , Pandey Rohan , Khan Raheel , Kalot Mohamad A. , Anand Renata , Graham Susan P. 
Published: September 2023

Background
To determine if outpatient screening for orthostatic hypotension (OH) in the geriatric population results in fewer prescribed antihypertensive medications and if a relationship exists between OH and specific pharmacologic classes of antihypertensive medications.

Materials and methods
Patients ≥ 65 years were screened for OH, defined as a decrease in systolic blood pressure (SBP) ≥ 20 mm Hg or a decrease in diastolic blood pressure (DBP) ≥ 10 mm Hg after standing for 3 minutes. Sitting blood pressure (BP) was measured after patients had been seated quietly in an exam room. Patients then stood for approximately 3 minutes at which time standing BP was recorded.

Results
OH prevalence was 18%. Standing DBP was significantly different between the two groups (70 mmHg ± 18, 80 mmHg ± 13, P = 0.007). Compared to patients without OH, patients with OH were more likely to have been previously prescribed beta-blockers (56% vs. 32%, P = 0.056) and potassium-sparing diuretics (11% vs. 1%, P = 0.026). Physicians discontinued an antihypertensive medication more often in patients who screened positive for OH than in to those who did not (17% vs. 4%, P = 0.037). Calcium channel blockers were the most frequently discontinued class of medication.

Conclusion
Asymptomatic OH is prevalent in geriatric patients. Screening for OH may lead to de-escalation of antihypertensive regimen and a reduction in polypharmacy. Positive screening for OH was associated with de-prescribing of antihypertensive medications. Prior use of beta-blockers and potassium-sparing diuretics was most largely associated with OH.
Bidirectional association between non-alcoholic fatty liver disease and fatty pancreas: a systematic review and meta-analysis
Authors: Wongtrakul Wasit , Untaaveesup Suvijak , Pausawadi Nonthalee , Charatcharoenwitthaya Phunchai 
Published: September 2023

Background
Accumulating evidence suggests a potential relationship between non-alcoholic fatty liver disease (NAFLD) and fatty pancreas, as both conditions are associated with fat deposition in the liver and pancreas, respectively. The meta-analysis aimed to investigate the bidirectional association between NAFLD and fatty pancreas, as well as their respective effects on disease severity.

Methods
A systematic search of the EMBASE and MEDLINE databases, from inception to August 2022, was conducted to identify observational studies examining the association between NAFLD and fatty pancreas, as well as their impact on disease severity. The pooled odds ratio (OR) with a 95% confidence interval (CI) was estimated using a random-effects model.

Results
Our analysis included 26 case-control or cross-sectional studies, comprising 67,803 participants. We observed a significant association between NAFLD and an increased odds of having fatty pancreas (OR, 6.18; 95% CI, 4.49–8.51; I2
= 92%). Similarly, fatty pancreas was significantly associated with an increased odds of having NAFLD (OR, 9.56; 95% CI, 5.09–17.95; I2
= 83%). Furthermore, the presence of fatty pancreas was associated with a 1.75-fold increased risk of severe NAFLD based on ultrasonographic classification (95% CI, 1.46–2.10; I2
= 0%). Among NAFLD patients, the coexistence of fatty pancreas was associated with a trend towards increased odds of having non-alcoholic steatohepatitis (OR, 3.52; 95% CI, 0.65–18.93; I2
= 82%) and advanced fibrosis (OR, 2.47; 95% CI, 0.52–11.80; I2
= 76%).

Conclusion
This meta-analysis discloses a bidirectional association between NAFLD and fatty pancreas, emphasizing the importance of understanding the intricate relationship between these two conditions.
Evaluation of treatment response by Hopkins criteria on18F FDG PET-CT in patients of non-small cell lung cancer and its comparison with PERCIST response criteria
Authors: Dang Shreya , Shivdasani Divya , Pereira Melvika , Singh Natasha , Rungta Rachita , Roy Debdip , Kesariya Jugal 
Published: September 2023

Aim
To assess treatment response on FDG PET-CT in NSCLC patients by visual Hopkins score compared to PERCIST criteria and its potential for prognostication (or its correlation with survival).

Methods
Forty-four NSCLC patients with baseline and post-treatment FDG PET-CT scans were included, and interpreted using Hopkins and PERCIST criteria classifying patients into responders and non-responders. PERCIST-based CMR and PMR, and Hopkins Scores 1,2,3 were classified responders. PERCIST-based SD and PD and Hopkins scores 4,5 were classified as non-responders. Patients were followed upto 24 months after treatment completion. Cohen kappa for inter-criteria agreement and Kaplan Meir curve for overall survival (OS) analysis done.

Results
Out of 44 patients, PERCIST classified 27 (61.3%) as responders and 17 (38.6%) as non-responders, whereas Hopkins classified 12 patients (27.3%) as responders and 32 (72.7%) as non-responders. Inter-criteria agreement was low (kappa=0.19) with discordance in 45.5% of patients. Eighteen of 20 discordant cases were non-responders on Hopkins and responders on PERCIST, of which 88.8% were non-responders on follow-up as predicted by Hopkins. PERCIST responders had OS of 96.4% and 64.3% at 9 and 24 months, respectively, while non-responders OS was 93.5% and 40.2% at 9 and 24 months, respectively (P-value = 0.049). However, responders on Hopkins had OS of 100% at 24 months, whereas non-responders had OS of 93.5% and 51.5% at 9 and 24 months, respectively (P-value = 0.232).

Conclusion
Semi-quantitative PERCIST and visual Hopkins criteria show low inter-criteria agreement, with visual criteria better-predicting survival in patients of NSCLC.
Brown adipose tissue: can it keep us slim? A discussion of the evidence for and against the existence of diet-induced thermogenesis in mice and men
Authors: Nedergaard Jan , von Essen Gabriella , Cannon Barbara 
Published: September 2023

The issue under discussion here is whether a decrease in the degree of UCP1 activity (and brown adipose tissue activity in general) could be a cause of obesity in humans. This possibility principally requires the existence of the phenomenon of diet-induced thermogenesis. Obesity could be a consequence of a reduced functionality of diet-induced thermogenesis. Experiments in mice indicate that diet-induced thermogenesis exists and is dependent on the presence of UCP1 and thus of brown adipose tissue activity. Accordingly, many (but not all) experiments indicate that in the absence of UCP1, mice become obese. Whether similar mechanisms exist in humans is still unknown. A series of studies have indicated a correlation between obesity and low brown adipose tissue activity, but it may be so that the obesity itself may influence the estimates of brown adipose tissue activity (generally glucose uptake), partly explaining the relationship. Estimates of brown adipose tissue catabolizing activity would seem to indicate that it may possess a capacity sufficient to help maintain body weight, and obesity would thus be aggravated in its absence.
This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part II)’.
Questioning the foundations of the gut microbiota and obesity
Authors: Dalby Matthew J. 
Published: September 2023

The role of the gut microbiota in determining body fatness has been a prominent area of research and has received significant public attention. Based largely on animal studies, recent attempts to translate these findings into interventions in humans have not been successful. This review will outline the key mouse research that initiated this area of study, examine whether those results warranted the initial enthusiasm and progress into human studies, and examine whether later follow-up research supported earlier conclusions. It will look at whether the absence of a gut microbiota protects germ-free mice from obesity, whether microbiota can transfer obesity into germ-free mice, the evidence for the role of immune system activation as a causal mechanism linking the gut microbiota to body weight, and consider the evidence for effects of individual bacterial species. Finally, it will examine the outcomes of randomized controlled trials of microbiota transfer in human participants that have not shown effects on body weight. With a more critical reading, early studies did not show as large an effect as first appeared and later research, including human trials, has failed to support a role of the gut microbiota in shaping body weight.
This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part II)’.
Obesity and psychological distress
Authors: Steptoe Andrew , Frank Philipp 
Published: September 2023

The relationship between high body weight and mental health has been studied for several decades. Improvements in the quality of epidemiological, mechanistic and psychological research have brought greater consistency to our understanding of the links. Large-scale population-based epidemiological research has established that high body weight is associated with poorer mental health, particularly depression and subclinical depressive symptoms. There is some evidence for bidirectional relationships, but the most convincing findings are that greater body weight leads to psychological distress rather than the reverse. Particular symptoms of depression and distress may be specifically related to greater body weight. The psychological stress induced by weight stigma and discrimination contributes to psychological distress, and may in turn handicap efforts at weight control. Heightened systemic inflammation and dysregulation of the hypothalamic-pituitary-adrenal axis are biological mechanisms that mediate in part the relationship of greater body weight with poorer mental health. Changing negative societal attitudes to high body weights would improve the wellbeing of people living with obesity, and promote more effective weight-inclusive attitudes and behaviours in society at large, particularly in healthcare settings.
This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part II)’.
Food insecurity as a cause of adiposity: evolutionary and mechanistic hypotheses
Authors: Bateson Melissa , Pepper Gillian V. 
Published: September 2023

Food insecurity (FI) is associated with obesity among women in high-income countries. This seemingly paradoxical association can be explained by the insurance hypothesis, which states that humans possess evolved mechanisms that increase fat storage to buffer against energy shortfall when access to food is unpredictable. The evolutionary logic underlying the insurance hypothesis is well established and experiments on animals confirm that exposure to unpredictable food causes weight gain, but the mechanisms involved are less clear. Drawing on data from humans and other vertebrates, we review a suite of behavioural and physiological mechanisms that could increase fat storage under FI. FI causes short-term hyperphagia, but evidence that it is associated with increased total energy intake is lacking. Experiments on animals suggest that unpredictable food causes increases in retained metabolizable energy and reductions in energy expenditure sufficient to fuel weight gain in the absence of increased food intake. Reducing energy expenditure by diverting energy from somatic maintenance into fat stores should improve short-term survival under FI, but the trade-offs potentially include increased disease risk and accelerated ageing. We conclude that exposure to FI plausibly causes increased adiposity, poor health and shorter lifespan.
This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part II)’.
Statistical Analysis Plan for the Primary and Selected Secondary Endpoints in the ENHANCED-SPS Study
Authors: Balzer Laura B. , Kabami Jane ,   the ENHANCED-SPS Study Team
Published: September 2023

AbstractThis document provides the statistical analytic plan (SAP) for the ENHANCED-SPS study, a cluster randomized trial to evaluate the effects of peer-led, multicomponent intervention on viral suppression and other care outcomes among pregnant and breastfeeding women with HIV in South Western Uganda (Clinicaltrials.gov:NCT04122144). The SAP was locked prior to unblinding and effect estimation. This SAP was embargoed until August 31, 2023 when it was submitted to medRxiv.
Direct Antigen Presentation is the Canonical Pathway of Cytomegalovirus CD8 T-cell Priming Regulated by Balanced Immune Evasion Mounting a Strong Antiviral Response
Authors: Büttner Julia K. , Becker Sara , Fink Annette , Brinkmann Melanie M. , Holtappels Rafaela , Reddehase Matthias J. , Lemmermann Niels A. 
Published: September 2023

AbstractCD8 T cells are the main antiviral effectors of the adaptive immune response to cytomegaloviruses (CMVs) in confining acute infection and in long-term surveillance of latent infection. An unresolved issue of debate, with diametrically opposite conclusions, is the mechanism by which CMV-specific naïve CD8 T cells are primed. The idea of priming by antigen cross-presentation through uninfected professional antigen presenting cells taking up viral proteins derived from infected cells was based on the observation that the net response is not improved when direct presentation is enhanced by deletion of viral ‘immune evasion’ genes affecting the classical MHC class-I pathway of antigen presentation. Redundance of priming mechanisms has been demonstrated by experimental models in which either pathway has been rendered inaccessible, so that both pathways are, in principle, capable of priming CD8 T cells. For studying CMV-specific priming in the normal host competent in both antigen presentation pathways, we took the novel approach to enhance instead of delete immune evasion protein expression. Surprisingly, the net magnitude of the CD8 T-cell response in the regional lymph node draining a local site of infection was identical for the contrasts of reduced or enhanced direct antigen presentation. At first glance, this may lead one to conclude that direct presentation plays no role in priming. This interpretation, however, is incompatible with the finding that an intermediate extent of direct antigen presentation, as it exists for wild-type virus, resulted in the best CD8 T-cell response. Our findings thus revealed an essential positive role of a balanced viral immune evasion in mounting a strong antiviral immune response. This novel insight sheds a completely new light on the acquisition of viral immune evasion genes during virus-host co-evolution.
Single-B cell analysis correlates high-lactate secretion with stress and increased apoptosis
Authors: Bucheli Olivia T.M. , Rodrigues Daniela , Portmann Kevin , Linder Aline , Thoma Marina , Halin Cornelia , Eyer Klaus 
Published: September 2023

AbstractWhile cellular metabolism was proposed to be a driving factor of the activation and differentiation of B cells and the function of the resulting antibody-secreting cells (ASCs), the study of correlations between cellular metabolism and functionalities has been difficult due to the absence of technologies enabling the parallel measurement. Herein, we performed single-cell transcriptomics and introduced a direct concurrent functional and metabolic flux quantitation of individual murine B cells. Our transcriptomic data identified lactate metabolism as dynamic in ASCs, but antibody secretion did not correlate with lactate secretion rates (LSRs). Instead, our study of all splenic B cells during an immune response linked increased lactate metabolism with acidic intracellular pH and the upregulation of apoptosis. T cell-dependent responses increased LSRs, and added TLR4 agonists affected the magnitude and boosted LSRhighB cellsin vivo, while resulting in only a few immunoglobulin-G secreting cells (IgG-SCs). Therefore, our observations indicated that LSRhighcells were not differentiating into IgG-SCs, and were rather removed due to apoptosis.
Multidimensional analysis of preoperative patient-reported outcomes identifies distinct phenotypes in patients booked for total knee arthroplasty: Secondary analysis of the SHARKS registry in a metropolitan hospital department
Authors: McGill Raquel , Scholes Corey , Torbey Stephen , Calabro Lorenzo 
Published: September 2023

AbstractBackgroundTraditional research on total knee arthroplasty (TKA) relies on preoperative patient-reported outcome measures (PROMs) to predict postoperative satisfaction. We aim to identify distinct patient phenotypes among TKA candidates, and investigate their correlations with patient characteristics.MethodsBetween 2017-2021, 389 patients with 450 primary knee cases at a metropolitan public hospital were enrolled in a clinical quality registry. Demographics, clinical data, and the Veterans Rand 12 (VR-12) and Oxford Knee Score (OKS) were collected. Imputed data were utilised for the primary analysis, employing k-means clustering to identify four phenotypes. ANOVA assessed differences in scores between clusters, and nominal logistic regression determined relationships between phenotypes and patient age, sex, body mass index, and laterality.ResultsThe sample comprised 389 patients with 450 primary knees. Phenotype 4 (Mild symptoms with good mental health) exhibited superior physical function and overall health. In contrast, patients in phenotype 2 (Severe symptoms with poor mental health) experienced the most knee pain and health issues. Phenotype 1 (Moderate symptoms with good mental health) reported high mental health scores despite knee pain and physical impairment. Patient characteristics significantly correlated with phenotypes; those in the Severe symptoms with poor mental health phenotype were more likely to be younger, female, have a higher BMI, and bilateral osteoarthritis (P<0.05).ConclusionsThis multidimensional analysis identified TKA patient phenotypes based on common PROMs, revealing associations with patient demographics. This approach has the potential to inform prognostic models, enhancing clinical decision-making and patient outcomes in joint replacement.Significance and InnovationsThis study leverages the power of machine learning to simultaneously analyse multiple patient-reported outcome measures, which is not utilised in traditional research in total knee arthroplastyFour distinct phenotypes were identified, and they demonstrated significant associations with patient demographicsThis method has potential for developing prognostic models in joint replacement, with the ability to improve clinical decision-making and patient outcomes.