bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dealing with requests for euthanasia in incompetent patients with dementia. Qualitative research revealing underexposed aspects of the societal debate
Authors: Coers Djura O , de Boer Marike E , Sizoo Eefje M , Smalbrugge Martin , Leget Carlo J W , Hertogh Cees M P M 
Published: January 2023

Abstract

Objectives
In the Netherlands, a case of euthanasia of an incompetent patient with dementia and an advance euthanasia directive (AED) caused great societal unrest and led to a petition signed by more than 450 physicians. In this paper, we investigate these physicians’ reasons and underlying motives for supporting the ‘no sneaky euthanasia’ petition, with the aim of gaining insight into the dilemmas experienced and to map out topics in need of further guidance.

Methods
Twelve in-depth interviews were conducted with physicians recruited via the webpage ‘no sneaky euthanasia’. General topics discussed were: reasons for signing the petition, the possibilities of euthanasia in incompetent patients and views on good end-of-life care. Data were interpreted using thematic content analysis and the framework method.

Results
Reasons for supporting the petition are dilemmas concerning ‘sneaky euthanasia’, the over-simplified societal debate, physicians’ personal moral boundaries and the growing pressure on physicians. Analysis revealed three underlying motives: aspects of handling a euthanasia request based on an AED, good end-of-life care and the doctor as a human being.

Conclusions
Although one of the main reasons for participants to support the petition was the opposition to ‘sneaky euthanasia’, our results show a broader scope of reasons. This includes their experience of growing pressure to comply with AEDs, forcing them to cross personal boundaries. The underlying motives are related to moral dilemmas around patient autonomy emerging in cases of decision-making disabilities in advanced dementia. To avoid uncertainty regarding patients’ wishes, physicians express their need for reciprocal communication.
Weight loss, visit-to-visit body weight variability and cognitive function in older individuals
Authors: Zonneveld Michelle H , Noordam Raymond , Sabayan Behnam , Stott David J , Mooijaart Simon P , Blauw Gerard J , Jukema J Wouter , Sattar Naveed , Trompet Stella 
Published: January 2023

AbstractObjectiveto investigate the association between variability and loss of body weight with subsequent cognitive performance and activities of daily living in older individuals.Designcross-sectional cohort study.SettingPROspective Study of Pravastatin in the Elderly at Risk, multicentre trial with participants from Scotland, Ireland and the Netherlands.Subjects4,309 participants without severe cognitive dysfunction (mean age 75.1 years, standard deviation (SD) = 3.3), at higher risk for cardiovascular disease (CVD).Methodsbody weight was measured every 3 months for 2.5 years. Weight loss was defined as an average slope across all weight measurements and as ≥5% decrease in baseline body weight during follow-up. Visit-to-visit variability was defined as the SD of weight measurements (kg) between visits. Four tests of cognitive function were examined: Stroop test, letter-digit coding test (LDCT), immediate and delayed picture-word learning tests. Two measures of daily living activities: Barthel Index (BI) and instrumental activities of daily living (IADL). All tests were examined at month 30.Resultsboth larger body weight variability and loss of ≥5% of baseline weight were independently associated with worse scores on all cognitive tests, but minimally with BI and IADL. Compared with participants with stable weight, participants with significant weight loss performed 5.83 seconds (95% CI 3.74; 7.92) slower on the Stroop test, coded 1.72 digits less (95% CI −2.21; −1.13) on the LDCT and remembered 0.71 pictures less (95% CI -0.93; −0.48) on the delayed picture-word learning test.Conclusionin older people at higher risk for CVD, weight loss and variability are independent risk-factors for worse cognitive function.
Invited Commentary: On the Mathematization of Epidemiology as a Socially Engaged Quantitative Science
Authors: Cartus Abigail R , Marshall Brandon D L 
Published: January 2023

Abstract
Ensuring that patients with opioid use disorder (OUD) have access to optimal medication therapies is a critical challenge in substance use epidemiology. Rudolph et al. (Am J Epidemiol. 2023;XXX(X):XXXX-XXXX) demonstrated that sophisticated data-adaptive statistical techniques can be used to learn optimal, individualized treatment rules that can aid providers in choosing a medication treatment modality for a particular patient with OUD. This important work also highlights the effects of the mathematization of epidemiologic research. Here, we define mathematization and demonstrate how it operates in the context of effectiveness research on medications for OUD using the paper by Rudolph et al. as a springboard. In particular, we address the normative dimension of mathematization and how it tends to resolve a fundamental tension in epidemiologic practice between technical sophistication and public health considerations in favor of more technical solutions. The process of mathematization is a fundamental part of epidemiology; we argue not for eliminating it but for balancing mathematization and technical demands equally with practical and community-centric public health needs.
Emulating a Target Trial Using Primary-Care Electronic Health Records: Sodium-Glucose Cotransporter 2 Inhibitor Medications and Hemoglobin A1c
Authors: Kalia Sumeet , Saarela Olli , O’Neill Braden , Meaney Christopher , Moineddin Rahim , Sullivan Frank , Greiver Michelle 
Published: January 2023

Abstract
Substantial effort has been dedicated to conducting randomized controlled experiments to generate clinical evidence for diabetes treatment. Randomized controlled experiments are the gold standard for establishing cause and effect. However, due to their high cost and time commitment, large observational databases such as those comprised of electronic health record (EHR) data collected in routine primary care may provide an alternative source with which to address such causal objectives. We used a Canadian primary-care data repository housed at the University of Toronto (Toronto, Ontario, Canada) to emulate a randomized experiment. We estimated the effectiveness of sodium-glucose cotransporter 2 inhibitor (SGLT-2i) medications for patients with diabetes using hemoglobin A1c (HbA1c) as a primary outcome and marker for glycemic control from 2018 to 2021. We assumed an intention-to-treat analysis for prescribed treatment, with analyses based on the treatment assigned rather than the treatment eventually received. We defined the causal contrast of interest as the net change in HbA1c (percent) between the group receiving the standard of care versus the group receiving SGLT-2i medication. Using a counterfactual framework, marginal structural models demonstrated a reduction in mean HbA1c level with the initiation of SGLT-2i medications. These findings provided effect sizes similar to those from earlier clinical trials on assessing the effectiveness of SGLT-2i medications.
Validation of Fespixon in Postoperative Scar Cosmesis Using Quantitative Digital Photography Analysis
Authors: Huang Tien-Ru , Chen Shyi-Gen , Chen Jui-Ching , Liu Shao-Cheng 
Published: January 2023

Abstract

Background
Unsightly scarring after surgery remains a dilemma. One of the challenges is the lack of objective scar assessment tools.

Objectives
This study aimed to evaluate the efficacy of a novel medicine, Fespixon, for prevention and/or alleviation of post–skin incision scarring. A second aim was to demonstrate the practicality of our digital image analysis system to see if this could serve as a sensitive tool to assess scar improvement.

Methods
A prospective, placebo-controlled trial involving patients with postoperative transverse scars was conducted. Each patient received a topical formulation of Fespixon on the left part of the scar and placebo cream on the right. In addition to recording the subjective modified Vancouver Scar Scale and visual analog scale scores, we utilized digital photography for monthly scar analysis, with CIELAB and hue serving as the colorimetric information, and with contrast, correlation, homogeneity, and entropy providing texture information.

Results
Forty-six participants (mean age, 52 years) were enrolled in the trial. All the parameters of subjective assessment showed superior results for the Fespixon-treated side, with significant differences in pigmentation, vascularity, pliability, height, itchiness, and patient satisfaction (P = .043, .013, .026, .002, .039, .012, respectively). The trends in color and texture showed increased relative difference ratios, with significant differences in most of the eigenvalues towards the Fespixon-treated side, including CIELAB-L* (P &lt; 0.001), hue-R,G,B (red, blue, green) values (P = .034, .001, .011), contrast (P &lt; 0.001), homogeneity (P &lt; 0.001), correlation (P = .011), and entropy (P &lt; 0.001).

Conclusions
We validated the efficacy of Fespixon for postoperative scar healing based not only on subjective assessments but also on objective quantitative analyses. The results also indicated that our digital photography quantitative analysis system is an ideal tool for quantification of scar appearance.

Level of Evidence: 3
Pollen characteristics used in determination and systematics of Quercus (Fagaceae): new data and verification of previous concepts
Authors: Tekleva Maria V , Polevova Svetlana , Naryshkina Natalia N 
Published: January 2023

Abstract
Quercus (oaks) is a large and important genus of woody angiosperms occurring in a wide range of environments and often occupying a dominant position in temperate forests of the Northern Hemisphere or being a minor component in some subtropical and tropical forests. A reliable determination of fossil dispersed oak pollen requires combined light, scanning electron (SEM) and transmission electron microscopy (TEM) studies and relevant comparative data on extant oak species. We provide SEM and TEM data on 22 extant Quercus spp., representing all sections of the genus. The main objectives of our study were to clarify the nature of the so-called geniculus, a characteristic equatorial bulge in the exine of the colpus found in many oak species, and to test previous hypotheses about the structural basic units of the exine in Quercus. Our ontogenetic study and oxidative experiment involving several Quercus spp. and one Trigonobalanus sp. resulted in a more accurate interpretation of the nature of the geniculus and exine elements, their different developmental states and, therefore, their more reliable application in the systematics and evolution of the genus Quercus and Fagaceae in general.
Grasping the opportunity: better behavioural diagnoses will lead to better treatments for stroke
Authors: Ward Nick 
Published: January 2023

Hensel et al. combine fMRI, rTMS and 3D hand movement analyses to test the contributions of contralesional motor cortex (M1) and anterior parietal sulcus (aIPS) to motor recovery post-stroke. The results reveal differential roles of M1 and aIPS in different aspects of recovered hand motor function, depending on interhemispheric connectivity.This scientific commentary refers to ‘Recovered grasping performance after stroke depends on interhemispheric frontoparietal connectivity’ by Hensel et al. (https://doi.org/10.1093/brain/awac157).
Genetic variation in the human olfactory receptor OR5AN1 associates with the perception of musks
Authors: Sato-Akuhara Narumi , Trimmer Casey , Keller Andreas , Niimura Yoshihito , Shirasu Mika , Mainland Joel D , Touhara Kazushige 
Published: January 2023

Abstract
Humans have significant individual variations in odor perception, derived from their experience or sometimes from differences in the olfactory receptor (OR) gene repertoire. In several cases, the genetic variation of a single OR affects the perception of its cognate odor ligand. Musks are widely used for fragrance and are known to demonstrate specific anosmia. It, however, remains to be elucidated whether the OR polymorphism contributes to individual variations in musk odor perception. Previous studies reported that responses of the human musk receptor OR5AN1 to a variety of musks in vitro correlated well with perceptual sensitivity to those odors in humans and that the mouse ortholog, Olfr1440 (MOR215-1), plays a critical role in muscone perception. Here, we took advantage of genetic variation in OR5AN1 to examine how changes in receptor sensitivity are associated with human musk perception. We investigated the functional differences between OR5AN1 variants in an in vitro assay and measured both perceived intensity and detection threshold in human subjects with different OR5AN1 genotypes. Human subjects homozygous for the more sensitive L289F allele had a lower detection threshold for muscone and found macrocyclic musks to be more intense than subjects homozygous for the reference allele. These results demonstrate that the genetic variation in OR5AN1 contributes to perceptual differences for some musks. In addition, we found that the more functional variant of OR5A1, a receptor involved in β-ionone perception, is associated with the less functional variant of OR5AN1, suggesting that the perceived intensities of macrocyclic musks and β-ionone are inversely correlated.
Asymptomatic hyperuricaemia in chronic kidney disease: mechanisms and clinical implications
Authors: Anders Hans-Joachim , Li Qiubo , Steiger Stefanie 
Published: January 2023

ABSTRACTAsymptomatic hyperuricaemia (HU) is considered a pathogenic factor in multiple disease contexts, but a causative role is only proven for the crystalline form of uric acid in gouty arthritis and urate nephropathy. Epidemiological studies document a robust association of HU with hypertension, cardiovascular disease (CVD) and CKD progression, but CKD-related impaired uric acid (UA) clearance and the use of diuretics that further impair UA clearance likely accounts for these associations. Interpreting the available trial evidence is further complicated by referring to xanthine oxidase inhibitors as urate-lowering treatment, although these drugs inhibit other substrates, so attributing their effects only to HU is problematic. In this review we provide new mechanistic insights into the biological effects of soluble and crystalline UA and discuss clinical evidence on the role of asymptomatic HU in CKD, CVD and sterile inflammation. We identify research areas with gaps in experimental and clinical evidence, specifically on infectious complications that represent the second common cause of death in CKD patients, referred to as secondary immunodeficiency related to kidney disease. In addition, we address potential therapeutic approaches on how and when to treat asymptomatic HU in patients with kidney disease and where further interventional studies are required.
ECCO Topical Review on Biological Treatment Cycles in Crohn’s Disease
Authors: Noor Nurulamin M , Sousa Paula , Bettenworth Dominik , Gomollón Fernando , Lobaton Triana , Bossuyt Peter , Casanova Maria Jose , Ding Nik S , Dragoni Gabriele , Furfaro Federica , van Rheenen Patrick F , Chaparro Maria , Gisbert Javier P , Louis Edouard , Papamichail Konstantinos 
Published: January 2023

AbstractThere are now a growing number of licensed biological therapies for patients with Crohn’s disease. However, there can be significant costs associated with long-term maintenance treatment, as well as some concerns about potential side-effects. As a result, there has been increasing interest in elective biological treatment discontinuation in selected patients, after a sustained period of remission. Following discontinuation, in cases of relapse, evidence to date has suggested that remission may often be regained by re-treatment with the same biological agent. Therefore, a concept has emerged in which cycles of biological therapy might be used. If this treatment strategy were to be applied in a subgroup of patients at low risk of relapse, cycling might allow a substantial number of patients to have a lower, overall therapeutic burden—ensuring decreased exposure to biological therapy but still enabling appropriate disease control.Currently, there remains uncertainty about the benefit–risk balance for using cycles of biological treatment for patients with Crohn’s disease. Accordingly, an expert panel was convened by the European Crohn’s and Colitis Organisation [ECCO] to review the published literature and agree a series of consensus practice points. The panel aimed to provide evidence-based guidance on multiple aspects of biological treatment discontinuation and cycling, including the risk of relapse after elective treatment discontinuation, predictors of probable relapse or remission, safety, patient preferences, and pharmacoeconomic aspects. Crucially, discussions about biological treatment discontinuation and cycling should be individualized, to enable shared decision-making by patients with their clinicians.
Ready or not, here I come: the significance of information about educational success for educational decisions
Authors: Larsen Kira Solveig 
Published: January 2023

Abstract
This study analyses the effect of the Educational Readiness Assessment (ERA)—a scheme that categorizes students in Denmark as either ‘ready’ or ‘not ready’ for upper secondary education—on educational decision-making. Because the ERA uses a grade-specific cut-off to determine readiness, it can be used in a fuzzy regression discontinuity design to estimate the causal effect of the ERA on educational decision-making. Inspired by the theory of Relative Risk Aversion (RRA), the study argues that non-service-class students respond to a negative signal by postponing the decision (not) to continue to upper secondary education, while service-class students proceed regardless of receiving a negative signal. Empirical results are mostly consistent with RRA. The policy implications of the results are that students do respond to information regarding the likelihood of educational success, but respond differently depending on their social class position.
Mixotrophy broadens the ecological niche range of the iron oxidizerSideroxydanssp. CL21 isolated from an iron-rich peatland
Authors: Cooper Rebecca E , Finck Jessica , Chan Clara , Küsel Kirsten 
Published: January 2023

AbstractSideroxydans sp. CL21 is a microaerobic, acid-tolerant Fe(II)-oxidizer, isolated from the Schlöppnerbrunnen fen. Since the genome size of Sideroxydans sp. CL21 is 21% larger than that of the neutrophilic Sideroxydans lithotrophicus ES-1, we hypothesized that strain CL21 contains additional metabolic traits to thrive in the fen. The common genomic content of both strains contains homologs of the putative Fe(II) oxidation genes, mtoAB and cyc2. A large part of the accessory genome in strain CL21 contains genes linked to utilization of alternative electron donors, including NiFe uptake hydrogenases, and genes encoding lactate uptake and utilization proteins, motility and biofilm formation, transposable elements, and pH homeostasis mechanisms. Next, we incubated the strain in different combinations of electron donors and characterized the fen microbial communities. Sideroxydans spp. comprised 3.33% and 3.94% of the total relative abundance in the peatland soil and peatland water, respectively. Incubation results indicate Sideroxydans sp. CL21 uses H2 and thiosulfate, while lactate only enhances growth when combined with Fe, H2, or thiosulfate. Rates of H2 utilization were highest in combination with other substrates. Thus, Sideroxydans sp. CL21 is a mixotroph, growing best by simultaneously using substrate combinations, which helps to thrive in dynamic and complex habitats.
Socioeconomic and Contextual Differentials in Memory Decline: A Cross-Country Investigation Between England and China
Authors: Cadar Dorina , Brocklebank Laura , Yan Li , Zhao Yaohui , Steptoe Andrew 
Published: January 2023

AbstractObjectivesAlthough cognitive functioning is strongly associated with biological changes in the brain during the aging process, very little is known about the role of sociocultural differentials between the western and eastern parts of the world. We examined the associations between individual socioeconomic markers (e.g., education, household wealth) and contextual levels characteristics (e.g., urbanicity) with memory performance and memory decline over up to 8 years of follow-up in England and China.MethodsThe analytical samples included participants aged 50+ from the English Longitudinal Study of Aging (n = 6,687) and the China Health and Retirement Longitudinal Study (n = 10,252). Mixed linear models were employed to examine the association between baseline individual socioeconomic markers (education, wealth) and contextual-level characteristics (urbanicity) on the change in memory over time.ResultsOur analyses showed that higher education and wealth were associated with better baseline memory in both England and China. Still, the impact of contextual-level characteristics such as urbanicity differed between the 2 countries. For English individuals, living in a rural area showed an advantage in memory, while the opposite pattern was observed in China. Memory decline appeared to be socioeconomically patterned by higher education, wealth, and urbanicity in China but not in England.DiscussionOur findings highlight substantial socioeconomic and contextual inequity in memory performance in both England and China, as well as in the rate of memory decline primarily in China. Public health strategies for preventing memory decline should target the socioeconomic gaps at the individual and contextual levels to protect those particularly disadvantaged.
Examining Satisfaction and Quality in Home- and Community-Based Service Programs in the United States: A Scoping Review
Authors: Bucy Taylor I , Mulcahy John F , Shippee Tetyana P , Fashaw-Walters Shekinah , Dahal Roshani , Duan Yinfei , Jutkowitz Eric 
Published: January 2023

Abstract

Background and Objectives
Long-term services and supports in the United States are increasingly reliant on home- and community-based services (HCBS). Yet, little is known about the quality of HCBS. We conducted a scoping review of the peer-reviewed literature to summarize HCBS consumer, provider, and stakeholder satisfaction with services as a means of assessing quality.

Research Design and Methods
We searched PubMed, OVID-MEDLINE, and SCOPUS to identify articles published from 2000 to 2021 that reported on studies describing a U.S.-based study population. Articles were grouped into 3 categories: drivers of positive consumer satisfaction, drivers of negative consumer satisfaction, and provider and stakeholder perspectives on satisfaction.

Results
Our final sample included 27 articles. Positive perceptions of quality and reported satisfaction with services were driven by consistent, reliable, and respectful care providers, and adoption of person-centered models of service delivery. Mistreatment of consumers, staff turnover, training, service interruptions, and unmet functional needs were drivers of negative consumer perceptions of quality. Support for caregivers and emphasis on training were identified by providers and stakeholders as important for providing satisfactory services.

Discussion and Implications
Multiple data challenges limit the ability to systematically evaluate HCBS program quality; however, studies examining single programs found that HCBS consumers are more satisfied and associate higher quality with easy-to-navigate programs and professional staff. Efforts to expand HCBS should also include requirements to systematically evaluate quality outcomes.