bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Major Cardiovascular Events in Adult Sepsis Survivors: A Population-Based Cohort Study*
Authors: Angriman Federico , Rosella Laura C. , Lawler Patrick R. , Ko Dennis T. , Martin Claudio M. , Wunsch Hannah , Scales Damon C. ,   on behalf of the Sepsis Canada Network
Published: February 2023

OBJECTIVES:
To describe risk factors for major cardiovascular events in adults following hospital discharge after sepsis.

DESIGN:
Population-based cohort study.

SETTING:
Ontario, Canada (2008–2017).

PATIENTS:
Adult patients (age 18 yr or older) who survived a first sepsis hospitalization without preexisting cardiovascular disease.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary composite outcome was myocardial infarction, stroke, or cardiovascular death up to 5 years following hospital discharge. We used cause-specific Cox proportional hazards models that accounted for the competing risk of noncardiovascular death to describe factors associated with major cardiovascular events. We identified 268,259 adult patients without cardiovascular disease (median age, 72 yr), of whom 10.4% experienced a major cardiovascular event during a median follow-up of 3 years. After multivariable adjustment, age (hazard ratio [HR], 1.53 for every 10 yr; 95% CI, 1.51–1.54), male sex (HR, 1.23; 95% CI, 1.20–1.26), diabetes mellitus (HR, 1.24; 95% CI, 1.21–1.27), hypertension (HR, 1.34; 95% CI, 1.30–1.38), prevalent atrial fibrillation (HR, 1.46; 95% CI, 1.40–1.52), and chronic kidney disease (HR, 1.11; 95% CI, 1.06–1.16) were associated with major cardiovascular events during long-term follow-up. Sepsis characteristics such as site of infection (pneumonia vs other: HR, 1.09; 95% CI, 1.05–1.12), septic shock (HR, 1.08; 95% CI, 1.05–1.11), and renal replacement therapy (HR, 1.51; 95% CI, 1.38–1.64) were also associated with subsequent cardiovascular events. In an analysis restricting to patients with troponin values measured during the hospitalization (26,400 patients), an elevated troponin was also associated with subsequent cardiovascular events (HR, 1.23; 95% CI, 1.13–1.33).

CONCLUSIONS:
Classic cardiovascular risk factors, comorbid conditions, and characteristics of the sepsis episode were associated with a higher hazard of major cardiovascular events in adult sepsis survivors. These findings may inform enrichment strategies for future studies.
Cerebrovascular Pressure Reactivity Has a Strong and Independent Association With Outcome in Children With Severe Traumatic Brain Injury*
Authors: Smith Claudia A. , Rohlwink Ursula K. , Mauff Katya , Thango Nqobile S. , Hina Thembani S. , Salie Shamiel , Enslin Johannes M. N. , Figaji Anthony A. 
Published: February 2023

OBJECTIVES:
To examine cerebrovascular pressure reactivity index (PRx) in a large cohort of children with severe traumatic brain injury (sTBI) in association with physiologic variables and outcome.

DESIGN:
Retrospective observational cohort study.

SETTING:
Red Cross War Memorial Children’s Hospital in Cape Town, South Africa.

PATIENTS:
Pediatric (≤ 14 yr old) sTBI patients with intracranial pressure (ICP) monitoring (postresuscitation Glasgow Coma Score [Glasgow Coma Scale (GCS)] of ≤ 8).

MEASUREMENTS AND MAIN RESULTS:
Data were analyzed from ICM+ files sampled at 100Hz. PRx (a mathematical indicator of pressure reactivity) was calculated as a moving correlation coefficient between ICP and mean arterial pressure (MAP) as previously described. Associations between PRx, age, GCS, ICP, MAP, and cerebral perfusion pressure (CPP) were examined with summary measures and correlation analysis using high-frequency data. Associations between PRx and mortality/outcome were examined with multivariable logistic regression analysis and the prognostic ability of PRx with receiver operating characteristic (ROCs) curves. The dataset included over 1.7 million minutes (28,634 hr) of MAP and ICP data in 196 children. The series mortality was 10.7% (21/196), and unfavorable outcome 29.6% (58/196). PRx had a moderate positive correlation with ICP (r = 0.44; p < 0.001), a moderate negative correlation with CPP (r = -0.43; p < 0.001), and a weak negative correlation with MAP (r = –0.21; p = 0.004). PRx was consistently higher in patients with poor outcome and had a strong, independent association with mortality (ROC area under the curve = 0.91). A PRx threshold of 0.25 showed the best predictive ability for mortality.

CONCLUSIONS:
This is the largest cohort of children with PRx analysis of cerebrovascular reactivity to date. PRx had a strong association with outcome that was independent of ICP, CPP, GCS, and age. The data suggest that impaired autoregulation is an independent factor associated with poor outcome and may be useful in directing clinical care.
Risk and incidence of breast cancer in transgender individuals: a systematic review and meta-analysis
Authors: Corso Giovanni , Gandini Sara , D’Ecclesiis Oriana , Mazza Manuelita , Magnoni Francesca , Veronesi Paolo , Galimberti Viviana , La Vecchia Carlo 
Published: February 2023

Background and aims
The risk of developing breast cancer in transgender individuals [male-to-female (MtF) or female-to-male (FtM)] is still inadequately quantified. We aimed to evaluate the impact of breast cancer in this population.

Methods
We conducted a systematic literature search and review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines through the PUBMED and SCOPUS databases. We identified six cohort studies (for both populations) plus 35 case reports. Incidence and breast cancer risk quantification were the main outcomes considered.

Results
FtM individuals had a higher risk of developing breast cancer in comparison to cisgender men [standardized incidence ratio (SIR) = 63.4; 95% confidence interval (CI), 32.2–124.9] but a lower risk than cisgender women (SIR = 0.42; 95% CI, 0.07–2.41). Similarly, MtF individuals were at higher risk of developing breast cancer in comparison to cisgender men (SIR = 22.5; 95% CI, 5.54–91.8) and at lower risk than cisgender women (SIR = 0.30; 95% CI, 0.22–0.42).

Conclusion
In this systematic study and meta-analysis, we identified that FtM and MtF individuals are at substantially higher risk of developing breast cancer in comparison to cisgender men, though at lower risk than cisgender women. These individuals, in the absence of defined guidelines for breast cancer prevention, should periodically undergo breast or chest examinations.
IMMEDIATE VITRECTOMY vs TAP AND INJECT IN EYES WITH ACUTE POSTCATARACT ENDOPHTHALMITIS AND VISUAL ACUITY ≥HM
Authors: Sen Alok C. , Mehta Sonali M. , Sule Ashita , More Amruta V. , Shetty Sachin B. , Singh Jayanti , Tripathi Shubhi , Agrawal Rupesh , Talwar Dinesh 
Published: February 2023

Purpose:
To compare the outcomes of immediate pars plana vitrectomy (PPV) and tap and inject in eyes with postcataract surgery endophthalmitis.

Methods:
Patients presenting with acute postcataract surgery endophthalmitis and visual acuity between ≥ hand movement and <6/18 were randomized to receive either PPV (Group A) or tap and inject (Group B).

Results:
There were 26 and 31 eyes in Group A and Group B, respectively. The final mean visual acuity at 6 weeks [0.14 (Snellen equivalent 6/7.5) versus 0.22 (Snellen equivalent 6/9.5) LogMAR in Groups A and B, respectively; P = 0.2] was similar. However, eyes in Group A had significantly greater mean letter gain in vision compared with Group B (66.36 vs. 43.36, P = 0.02), and more eyes in Group A (88%) than in Group B (65%) attained a visual acuity of ≥ 6/18 (P = 0.06). Eyes in Group B needed more reinterventions including delayed vitrectomy after tap and inject than those in Group A (39% vs. 8%; P = 0.09). On subgroup analysis, the mean visual acuity at the final follow-up was significantly better in the immediate PPV group compared with the delayed PPV group (P = 0.04).

Conclusion:
PPV resulted in earlier recovery, lesser interventions, and greater change in visual acuity than tap and inject in eyes with postcataract surgery endophthalmitis presenting with visual acuity of ≥HM.
Prognostic Factors of Pretreatment Magnetic Resonance Imaging for Predicting Clinical Outcome in Patients With Parotid Gland Cancer
Authors: Ando Tomohiro , Kato Hiroki , Shibata Hirofumi , Ogawa Takenori , Noda Yoshifumi , Hyodo Fuminori , Matsuo Masayuki 
Published: February 2023

Purpose
This study aimed to assess the utility of pretreatment magnetic resonance imaging (MRI) in predicting the clinical outcomes of patients with parotid gland cancer.

Methods
A total of 43 patients with histopathologically confirmed primary parotid gland cancer, who underwent pretreatment MRI, were enrolled in this study. All images were retrospectively reviewed, and MRI features were evaluated as possible prognostic factors influencing the progression-free survival (PFS) using the Kaplan-Meier method and Cox proportional hazards regression model. Cox regression analysis was used to estimate the hazard ratios (HRs) with 95% confidence interval (95% CI) values.

Results
Kaplan-Meier survival analysis showed that old age (>73 years, P < 0.01), large maximum tumor diameter (>33 mm, P < 0.01), low apparent diffusion coefficient value (≤1.29 ×10−3 mm2/s, P < 0.01), ill-defined margin (P < 0.01), skin invasion (P < 0.01), regional nodal metastasis (P < 0.01), heterogeneous enhancement (P < 0.05), and high signal intensity ratio on gadolinium-enhanced fat-suppressed T1-weighted images (>2.017, P < 0.05) were significant predictors of worse PFS. Cox proportional hazards regression analysis revealed that regional nodal metastasis (HR, 32.02; 95% CI, 6.42–159.84; P < 0.01) and maximum tumor diameter (HR, 1.04; 95% CI, 1.01–1.08; P < 0.05) were independent predictors of PFS.

Conclusion
Pretreatment MRI parameters could be prognostic factors of patients with parotid gland cancer. In particular, the maximum tumor diameter and regional nodal metastasis, which were closely associated with T and N classifications, were important prognostic factors in predicting the PFS.
Can 3-Phase Computed Tomography Urography Be Used to Characterize Adrenal Nodules? Results in 145 Patients
Authors: Franco Felipe B. , Souza Daniel A.T. , Glazer Daniel I. , Ali Naiim S. , Mayo-Smith William W. 
Published: February 2023

Objective
The aim of the study is to determine whether computed tomography (CT) urography (CTU) can characterize incidental adrenal nodules.

Methods
This retrospective cohort study was performed at an academic medical center. Patients were identified by free text search of CTU reports that contained the terms “adrenal mass” “adrenal nodule” and “adrenal lesion.” Computed tomography urography technique consisted of unenhanced images and postcontrast images obtained at 100 seconds and 15 minutes. The final cohort included 145 patients with 151 adrenal nodules. Nodules were considered lipid-rich adenomas or myelolipomas based on unenhanced imaging characteristics. Absolute and relative washout values were calculated for the remaining nodules, using a cutoff of 60% and 40%, respectively, to diagnose adenomas. Reference standard for lipid-poor adenomas and malignant nodules was histopathology or imaging/clinical follow-up. Mann-Whitney U test was used for comparison of continuous variables, and Fisher exact test was used for categorical variables.

Results
One hundred nodules were lipid-rich adenomas and 3 were myelolipomas. Forty-eight nodules were indeterminate at unenhanced CT, corresponding to 39 lipid-poor adenomas and 9 malignant nodules based on reference standards. Both absolute and relative washout correctly characterized 71% of nodules (34/48), with a sensitivity of 67% and specificity of 89%. Overall, 91% of all adrenal nodules (137/151) were correctly characterized by CTU alone. Lipid-poor adenomas were smaller than malignant nodules (P < 0.01) and were lower in attenuation on unenhanced and delayed images (P < 0.01).

Conclusions
Adrenal nodules detected at 3-phase CTU can be accurately characterized, potentially eliminating the need for subsequent adrenal protocol CT or magnetic resonance imaging.
Isolated Sixth Nerve Palsies in a Child With Familial Hemophagocytic Lymphohistiocytosis Type 2
Authors: Chiang Homer H. , Fernandez-Pol Sebastian , Bae Gordon H. , Rieger Kerri E. , Dahmoush Hisham M. , Beres Shannon J. 
Published: February 2023

Abstract:
A previously healthy 2-year-old boy presented with a left sixth cranial nerve palsy. There was a family history of multiple sclerosis and optic neuritis. Neuroimaging showed multiple foci of T2/FLAIR hyperintense signal abnormality in both cerebral hemispheres and in the brainstem. The initial diagnosis was suspicious for demyelinating disease. However, there was no clinical improvement after a course of corticosteroids, and there was no change in his follow-up MRI. He later developed bilateral sixth nerve palsies, with esotropia addressed with bilateral medial rectus botulinum toxin injections. A brain biopsy was planned. However, his 3-month-old sister was separately admitted for fever and pancytopenia. She had markedly elevated ferritin, D-dimer, triglycerides, sIL-2R, CXCL9, and IL-18 and low fibrinogen. Her bone marrow biopsy showed hemophagocytosis. Genetic testing of both siblings revealed biallelic mutations in the PRF1 locus. The final diagnosis of familial hemophagocytic lymphohistiocytosis Type 2 was made. Both siblings underwent chemotherapy. The boy's sixth nerve palsies and MRI abnormalities resolved. Both siblings then went on to undergo bone marrow transplant.
The effect of sensorineural hearing loss on central auditory processing of signals in noise in older adults
Authors: Gürkan Selhan , Mungan Durankaya Serpil 
Published: February 2023

Objectives
The study aimed to explore the effect of sensorineural hearing loss on the central auditory processing of signals in noise using cortical auditory evoked potentials (CAEPs) in a cohort of older adults.

Design
Three groups of individuals participated in the study. Each group included 33 older adults with normal hearing, those with mild hearing loss and those with moderate hearing loss. N1-P2 peaks of CAEPs by speech stimuli in silent conditions and with varying sound pressure levels of background noise were recorded. CAEP latencies, amplitudes and relative changes in CAEP amplitudes as a function of decreasing signal-to-noise ratios (SNR) in three groups were analyzed using the mixed analysis of variance method.

Results
There was a significant main effect of SNR on all CAEP components, as well as significant main effects of hearing status on N1 latencies, amplitudes and relative changes in N1 amplitudes. A significant interaction was found between hearing status and SNR for relative changes in N1 amplitudes. The normal hearing group differed from both the mild and moderate hearing loss groups in terms of relative changes in N1 amplitudes at SNR 10 dB.

Conclusion
The results showed decreased amplitudes and increased latencies for N1-P2 response as the SNR of CAEP stimuli was lowered. The degree of reduction in the N1 amplitudes of the older people with normal hearing resulting from the increase in the background noise level was greater than those in their sensorineural hearing-impaired counterparts, providing evidence for decreased central inhibition for individuals with age-related hearing loss.
Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: A non-randomized controlled trial
Authors: Van de Winckel Ann , Carpentier Sydney T. , Deng Wei , Zhang Lin , Philippus Angela , Monden Kimberley R. , Battaglino Ricardo , Morse Leslie R. 
Published: February 2023

AbstractImportanceThe manuscript proposes the feasibility and potential of a remote Qigong intervention to reduce neuropathic pain in adults with spinal cord injury (SCI)-related neuropathic pain.ObjectiveWe determined the feasibility and estimates of efficacy of a remotely delivered Qigong intervention in adults with SCI-related neuropathic pain.DesignThis is a non-randomized controlled trial with outcomes assessed at baseline-, 6- and 12-weeks of Qigong practice, and at 6-weeks and 1-year follow-up.SettingCompletely remote clinical trial.ParticipantsAdults with SCI-related neuropathic pain, with SCI ≥3 months, with complete or incomplete SCI, and highest neuropathic pain level of >3 on the Numeric Pain Rating Scale (NPRS). We used nationwide volunteer sampling.We recruited 23 adults with chronic SCI (7/2021-2/2022). Eighteen participants started the study and completed all study components, including the 6-week follow-up. Twelve participants completed the 1-year follow-up assessment.InterventionParticipants practiced the Spring Forest Qigong™ “Five Element Healing Movements” with an online video by combining movement with kinesthetic imagery, at least 3x/week for 12 weeks.Main Outcome(s) and Measure(s)To address the feasibility outcome and track adherence, the website automatically monitored the days and duration that the Qigong video was played. Self-report neuropathic pain intensity and SCI-related symptoms such as spasms, functional performance, mood, and body appreciation were also collected.ResultsEighteen participants, 60±12 years of age, 15±11 years post-SCI had a highest baselineneuropathic painof 7.94±2.33 on the NPRS, which was reduced to 4.17±3.07 after 12 weeks of Qigong practice (Cohen’sd=1.75). This pain relief remained at 6-week and 1-year follow-ups. Participants reported reduced spasm frequency (change score 1.17±1.20,d=0.98) and severity (0.72±1.02,d=0.71), and reduced interference of neuropathic pain on mood (3.44±2.53,d=1.36), sleep (3.39±2.40,d=1.41), and daily activities (3.17±2.77,d=1.14). They had a greater ability to perform functional activities (Patient Specific Functional Scale, 6.68±3.07,d=2.18) and had improved mood (Patient Health Questionnaire-9, 2.33±3.31,d=0.70).Conclusions and RelevanceOur preliminary data demonstrate the feasibility of Qigong practice in adults with SCI-related neuropathic pain and promising results of neuropathic pain relief and improvement in SCI-related symptoms after Qigong practice.Trial Registration (this manuscript refers to the quasi-experimental substudy)CREATION: A Clinical Trial of Qigong for Neuropathic Pain Relief in Adults with Spinal Cord Injury,NCT04917107,https://www.clinicaltrials.gov/ct2/show/NCT04917107.
Neurexin 3 is Essential for the Specific Wiring of a Color Pathway in the Mammalian Retina
Authors: Kunze Vincent P , Angueyra Juan M , Ball John M , Thomsen Michael B , Li Xiaoyi , Sabnis Adit , Nadal-Nicolás Francisco M , Li Wei 
Published: February 2023

AbstractPrecise wiring within sensory systems is critical for the accurate transmission of information. In the visual system, S-cone photoreceptors specialize in detecting short-wavelength light, crucial to color perception and environmental cue detection. S-cones form specific synapses with S-cone bipolar cells (SCBCs), a connection that is remarkably consistent across species. Yet, the molecular mechanisms guiding this specificity remain unexplored. To address this, we used the cone-dominant ground squirrel for deep-sequencing of cone subtype transcriptomes and identifiedNrxn3as an essential molecule for the S-cone to SCBC synapse. Using transgenic mouse models, we further examined the role ofNrxn3in S-cones and discovered a significant reduction of SCBC connections in the absence ofNrxn3. This finding extends the known functions of neurexins, typically associated with synapse regulation, by highlighting their essential role in a specific synaptic connection for the first time. Moreover, the differentially expressed genes identified here pave the way for further investigations into the unique functions of cone subtypes.
Ancient hybridization leads to the repeated evolution of red flowers across a monkeyflower radiation
Authors: Short Aidan W. , Streisfeld Matthew A. 
Published: February 2023

AbstractThe re-use of old genetic variation can promote rapid diversification in evolutionary radiations, but in most cases, the historical events underlying this divergence are not known. For example, ancient hybridization can generate new combinations of alleles that sort into descendant lineages, potentially providing the raw material to initiate divergence. In theMimulus aurantiacusspecies complex, there is evidence for widespread gene flow among members of this radiation. In addition, allelic variation in theMaMyb2gene is responsible for differences in flower color between the closely related ecotypes of subspeciespuniceus, contributing to reproductive isolation by pollinators. Previous work suggested thatMaMyb2was introgressed into the red-flowered ecotype ofpuniceus. However, additional taxa within the radiation have independently evolved red flowers from their yellow-flowered ancestors, raising the possibility that this introgression had a more ancient origin. In this study, we used repeated tests of admixture from whole-genome sequence data across this diverse radiation to demonstrate that there has been both ancient and recurrent hybridization in this group. However, most of the signal of this ancient introgression has been removed due to selection, suggesting that widespread barriers to gene flow are in place between taxa. Yet, a roughly 30 kb region that contains theMaMyb2gene is currently shared among the red-flowered taxa. Patterns of admixture, sequence divergence, and extended haplotype homozygosity across this region confirm a history of ancient hybridization, where functional variants have been preserved due to positive selection in red-flowered taxa but lost in their yellow-flowered counterparts. The results of this study reveal that selection against gene flow can reduce genomic signatures of ancient hybridization, but that historical introgression can provide essential genetic variation that facilitates the repeated origins of phenotypic traits between lineages.
Orthographic deficits but typical visual perceptual processing in Chinese adults with reading disability
Authors: Yan Xiaohui , Chen Jing , Fu Yang , Wu Yu , Ku Yixuan , Cao Fan 
Published: February 2023

AbstractVisual orthographic deficits have been reported as one of the core deficits in reading disability (RD), however, whether the deficits are orthographic-specific or domain general in all visual processing is still in debate. Hereby, we conducted an fMRI and an EEG study to examine visual orthographic deficits in Chinese adults with RD. In the fMRI study, we found that there was reduced brain activation in the left inferior temporal gyrus and right cuneus gyrus in orthographic processing (lexical minus perceptual), but not in visual perceptual processing (perceptual minus null) in adults with RD, suggesting orthographic-specific deficits. In the EEG study, adults with RD showed typical visual binding as indicated by intermodulation SSVEPs (steady-state visual-evoked potentials) for both real and pseudo characters, suggesting normal neural phase locking in the visual modality. These results consistently suggest orthographic specific deficits but normal visual perceptual processing in adults with RD, deepening our understanding of the underlying deficits associated with RD.