bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Autonomic Activation with traumatic reminder challenges in posttraumatic stress disorder: A co‐twin control study
Authors: Perez Alday Erick A. , Da Poian Giulia , Levantsevych Oleksiy , Murrah Nancy , Shallenberger Lucy , Alkhalaf Mhmtjamil , Haffar Ammer , Kaseer Belal , Ko Yi‐An , Goldberg Jack , Smith Nicholas , Lampert Rachel , Bremner J. Douglas , Clifford Gari D. , Vaccarino Viola , Shah Amit J. 
Published: August 2022

AbstractPost‐traumatic stress disorder (PTSD) has been associated with cardiovascular disease (CVD), but the mechanisms remain unclear. Autonomic dysfunction, associated with higher CVD risk, may be triggered by acute PTSD symptoms. We hypothesized that a laboratory‐based trauma reminder challenge, which induces acute PTSD symptoms, provokes autonomic dysfunction in a cohort of veteran twins. We investigated PTSD‐associated real‐time physiologic changes with a simulation of traumatic experiences in which the twins listened to audio recordings of a one‐minute neutral script followed by a one‐minute trauma script. We examined two heart rate variability metrics: deceleration capacity (DC) and logarithmic low frequency (log‐LF) power from beat‐to‐beat intervals extracted from ambulatory electrocardiograms. We assessed longitudinal PTSD status with a structured clinical interview and the severity with the PTSD Symptoms Scale. We used linear mixed‐effects models to examine twin dyads and account for cardiovascular and behavioral risk factors. We examined 238 male Veteran twins (age 68 ± 3 years old, 4% black). PTSD status and acute PTSD symptom severity were not associated with DC or log‐LF measured during the neutral session, but were significantly associated with lower DC and log‐LF during the traumatic script listening session. Long‐standing PTSD was associated with a 0.38 (95% confidence interval, −0.83,‐0.08) and 0.79 (−1.30,‐0.29) standardized unit lower DC and log‐LF, respectively, compared to no history of PTSD. Traumatic reminders in patients with PTSD lead to real‐time autonomic dysregulation and suggest a potential causal mechanism for increased CVD risk, based on the well‐known relationships between autonomic dysfunction and CVD mortality.
Parenting young adults across social class: A review and synthesis
Authors: van Stee Elena G. 
Published: August 2022

AbstractResearch on parental involvement has traditionally focused on social class differences in parenting behavior throughout early childhood and K‐12 schooling. Yet there is mounting evidence that similar class divides persist as children exit high school and progress through young adulthood. This review examines parents' roles in young adults' lives, focusing on class differences in non‐financial forms of involvement. These processes are often hidden from public view and have received less attention in prior reviews. Beginning with the transition out of high school, I discuss current research on parents' roles in relation to five traditional young adult milestones: finishing school, finding a job, leaving the family home, getting married, and becoming a parent (Furstenberg, 2010). The findings underscore that understanding the transition to adulthood requires understanding young adults' relationships with parents.
Investigation of scan delays for CT evaluation of inner wall layering and peak enhancement of the canine stomach and small intestine using a 20 second fixed‐injection‐duration and bolus tracking technique
Authors: Siow Jia Wen , Chau Jennifer , Podadera Juan M. , Makara Mariano 
Published: August 2022

AbstractMany gastrointestinal diseases affect the mucosal layer, suggesting that on computed tomography (CT) examination, detection of consistent inner wall layering of the gastrointestinal tract may aid in detection of disease. Changes in wall enhancement can also characterise specific diseases and provide prognostic information. The objectives of this mixed retrospective and prospective analytical study were therefore to identify the scan delays for peak detection of canine stomach and small intestinal inner wall layering and enhancement when using a 20 s fixed‐injection‐duration and bolus tracking technique. For each patient, 700 mg I/kg iohexol was administered intravenously. Bolus tracking was used to determine aortic arrival. Diagnostic scans were performed after a post‐aortic arrival scan delay. Postcontrast CT series were grouped according to post‐aortic arrival scan delay: 5 s (n = 17), 10 s (n = 18), 15 s (n = 23), 20 s (n = 10), 25 s (n = 6), 30 s (n = 14), 35 s (n = 17), 40 s (n = 24), and 180 s (n = 60). The stomach and small intestine were assessed for the presence of a contrast‐enhancing inner wall layer and wall enhancement. Statistical modeling showed that the scan delays for peak inner wall layering and enhancement were 10 and 15 s for the small intestine, respectively, and 40 s for the stomach. For the injection protocol used in this study, assessment of the canine gastrointestinal tract may use scan delays of 10–15 s and 40 s.
Association Between Nondominant Leg-Side Hip Internal Rotation Restriction and Low Back Pain in Male Elite High School Soft Tennis Players
Authors: Tanabe Toru , Watabu Takumi , Miaki Hiroichi , Kubo Naoyuki , Inaoka Pleiades Tiharu , Sugano Tomonari , Mizuno Katsunori 
Published: August 2022

Context: The incidence of low back pain (LBP) is high among high school male soft tennis players. In some sports for which the rotational component of the body is important, an association between restricted hip internal rotation of the nondominant leg and LBP has been reported; however, whether this association holds in soft tennis is unknown. Therefore, this study aimed to evaluate the association between hip internal rotation, hip external rotation, hamstring flexibility, iliopsoas flexibility, and LBP incidence. Design: This study was designed as a cross-sectional study, conducted at a sports training center. Methods: Participants comprised 113 male elite high school soft tennis players (age: 16.1 [0.7] y) from 9 elite-level teams. The main outcome measures were the hip internal and external rotation range of motion, hamstring flexibility on the straight leg raise test, and iliopsoas flexibility on the Thomas test. Multiple logistic regression analysis was performed to examine the influence of main outcomes on LBP incidence in the past 1 year. Results: A total of 35 participants had LBP (LBP group); 78 participants did not have LBP (non-LBP group). Multiple logistic regression analysis revealed that the odds ratio for height was 1.08 (95% confidence interval, 1.00–1.16; P = .043) and for the hip internal rotation range of motion in the nondominant leg was 0.90 (95% confidence interval, 0.85–0.95; P < .001), indicating significant associations with LBP. Conclusion: Hip internal rotation range of motion in the nondominant leg and height were crucial factors related to LBP in male elite high school soft tennis players.
Physical activity paradox: could inflammation be a key factor?
Authors: Feinberg Joshua Buron , Møller Anne , Siersma Volkert , Bruunsgaard Helle , Mortensen Ole Steen 
Published: August 2022

ObjectiveThe aim of this study was to test the extent to which physical activity performed during work and leisure is associated with systemic inflammation.MethodsData regarding job history and high-sensitivity C reactive protein (hs-CRP) levels, as well as potential confounders, came from the Copenhagen Aging and Midlife Biobank. The participants’ self-reported job history was combined with a job exposure matrix to give a more valid assessment of cumulated occupational physical activity compared with conventional self-reported activity. Occupational physical activity was measured as cumulative ton-years (lifting 1000 kg each day for a year). Current leisure time physical activity was self-reported into four different categories. We analysed the association between occupational physical activity, current leisure time physical activity and hs-CRP level in a multivariable linear regression model with adjustment for age, sex, smoking history, number of chronic diseases, body mass index and alcohol.ResultsIn unadjusted analysis, higher occupational physical activity was associated with increased hs-CRP levels, while higher leisure time physical activity was associated with lower hs-CRP levels. In adjusted analysis, lower leisure time physical activity resulted in 12% higher hs-CRP levels while higher occupational physical activities showed a 6% increase in hs-CRP. When we analysed occupational and leisure time physical activity as continuous variables, only leisure time physical activity affected hs-CRP.ConclusionThis study indicates that the relationship between physical activity and hs-CRP depends on the setting of physical activity, with lower hs-CRP related to leisure time physical activity and higher hs-CRP related to occupational physical activity. The results suggest that systemic inflammation may explain the physical activity paradox.
Integrated metagenomic and metabolomic analysis reveals distinct gut-microbiome-derived phenotypes in early-onset colorectal cancer
Authors: Kong Cheng , Liang Lei , Liu Guang , Du Lutao , Yang Yongzhi , Liu Jianqiang , Shi Debing , Li Xinxiang , Ma Yanlei 
Published: August 2022

ObjectiveThe incidence of early-onset colorectal cancer (EO-CRC) is steadily increasing. Here, we aimed to characterise the interactions between gut microbiome, metabolites and microbial enzymes in EO-CRC patients and evaluate their potential as non-invasive biomarkers for EO-CRC.DesignWe performed metagenomic and metabolomic analyses, identified multiomics markers and constructed CRC classifiers for the discovery cohort with 130 late-onset CRC (LO-CRC), 114 EO-CRC subjects and age-matched healthy controls (97 LO-Control and 100 EO-Control). An independent cohort of 38 LO-CRC, 24 EO-CRC, 22 LO-Controls and 24 EO-Controls was analysed to validate the results.ResultsCompared with controls, reduced alpha-diversity was apparent in both, LO-CRC and EO-CRC subjects. Although common variations existed, integrative analyses identified distinct microbiome–metabolome associations in LO-CRC and EO-CRC.Fusobacterium nucleatumenrichment and short-chain fatty acid depletion, including reduced microbial GABA biosynthesis and a shift in acetate/acetaldehyde metabolism towards acetyl-CoA production characterises LO-CRC. In comparison, multiomics signatures of EO-CRC tended to be associated with enrichedFlavonifractor plautiand increased tryptophan, bile acid and choline metabolism. Notably, elevated red meat intake-related species, choline metabolites and KEGG orthology (KO) pldB and cbh gene axis may be potential tumour stimulators in EO-CRC. The predictive model based on metagenomic, metabolomic and KO gene markers achieved a powerful classification performance for distinguishing EO-CRC from controls.ConclusionOur large-sample multiomics data suggest that altered microbiome–metabolome interplay helps explain the pathogenesis of EO-CRC and LO-CRC. The potential of microbiome-derived biomarkers as promising non-invasive tools could be used for the accurate detection and distinction of individuals with EO-CRC.
Neuropathology and emerging biomarkers in corticobasal syndrome
Authors: Koga Shunsuke , Josephs Keith A , Aiba Ikuko , Yoshida Mari , Dickson Dennis W 
Published: August 2022

Corticobasal syndrome (CBS) is a clinical syndrome characterised by progressive asymmetric limb rigidity and apraxia with dystonia, myoclonus, cortical sensory loss and alien limb phenomenon. Corticobasal degeneration (CBD) is one of the most common underlying pathologies of CBS, but other disorders, such as progressive supranuclear palsy (PSP), Alzheimer’s disease (AD) and frontotemporal lobar degeneration with TDP-43 inclusions, are also associated with this syndrome.In this review, we describe common and rare neuropathological findings in CBS, including tauopathies, synucleinopathies, TDP-43 proteinopathies, fused in sarcoma proteinopathy, prion disease (Creutzfeldt-Jakob disease) and cerebrovascular disease, based on a narrative review of the literature and clinicopathological studies from two brain banks. Genetic mutations associated with CBS, includingGRNandMAPT, are also reviewed. Clinicopathological studies on neurodegenerative disorders associated with CBS have shown that regardless of the underlying pathology, frontoparietal, as well as motor and premotor pathology is associated with CBS. Clinical features that can predict the underlying pathology of CBS remain unclear. Using AD-related biomarkers (ie, amyloid and tau positron emission tomography (PET) and fluid biomarkers), CBS caused by AD often can be differentiated from other causes of CBS. Tau PET may help distinguish AD from other tauopathies and non-tauopathies, but it remains challenging to differentiate non-AD tauopathies, especially PSP and CBD. Although the current clinical diagnostic criteria for CBS have suboptimal sensitivity and specificity, emerging biomarkers hold promise for future improvements in the diagnosis of underlying pathology in patients with CBS.
067 One Health: Clinical characteristics of spontaneously-arising feline LGI1- autoantibody limbic encephalitis in a large international cohort
Authors: Binks Sophie , Crawford Abbe H , Woodhall Mark , Fower Andrew , Syme Hattie , Kennedy Lorna J , Waters Patrick , Davison Lucy , Irani Sarosh , Pakozdy Akos 
Published: August 2022

IntroductionLeucine-rich glioma-inactivated 1 (LGI1) is one of the most common surface neuronal autoantigens associated with autoimmune limbic encephalitis (LE) in humans, with hallmarks of personality change, amnesia and seizures. Recently, these autoantibodies were described in domestic cats with LE, likewise with a distinctive phenotype of behavioural change and orofacial seizures.MethodsUsing a feline-specific cell-based assay for LGI1-autoantibodies, we tested serum from 123 cats with neurological signs, submitted by veterinary surgeons across Europe. Clinical presentation, investiga- tions, management and outcomes were captured by questionnaire and review of medical records.Results56 samples were positive for LGI1-autoantibodies. The median age was 45 months and 34/54 (63%) were female. Most (44/56, 79%) had LE but other clinical syndromes included epilepsy, encephalopathy and feline hyperesthesia syndrome. Focal seizures without generalisation were reported in 42/51 (82%) compared to 25/47 (53%) in seronegative cats (p=0.02). Among seropositive cats, MRI abnormalities were identified in 23/42 (55%), adverse drug reactions in 7/50 (14%), and 8/51 (16%) were euthanised due to refractory seizures or status epilepticus.ConclusionMany features are common to humans and cats with LGI1-autoantibodies. Feline patients represent a naturally-occurring disease model and an opportunity to benefit health in both species via a bi-directional translational model.
120 UK multiple sclerosis registries project: disease modifying treatment durability
Authors: Froud Joseph , John Freddie St , Willis Mark , Anderson Valerie , Uzochukwu Emeka , Thomas Ray Wynford- , Harding Katharine , Tallantyre Emma , Robertson Neil ,   et al
Published: August 2022

BackgroundReal-world, long-term adherence and effectiveness data is vital to complement our under- standing of therapies, which is often based on short-term clinical trials. Here we explored disease modifying therapy (DMT) durability in a UK-wide cohort of people with Multiple Sclerosis (pwMS).MethodsIn this cohort study, which included 4,415 pwMS from 10 UK MS centres, 6,960 DMT prescrip- tions were included in the analysis (mean 1.7, range 1-6 per patient). Prescriptions without accurate start dates were excluded (n=90). Kaplan-Meier survival analysis was used to model DMT persistence (days from prescription start to stop), which was used to calculate 2, 5 and 10-year durability (% of prescrip- tions continuing).ResultsTwo-year durability was highest for immune reconstitution therapies cladribine (98%), ocrelizumab (96%), and alemtuzumab (95%). Oral therapies fingolimod (74%) and dimethyl fumarate (73%), and intravenous natalizumab (78%) shared similar durability. Injectable therapies glatiramer acetate (51%) and interferon (55%), had lowest durability. Potential confounding factors include variable date of DMT licensing, change in DMT algorithms over time and increasing DMT options.ConclusionThis multi-centre study has revealed highly variable durability between DMTs over time, which may impact real-world effectiveness. These results may inform DMT clinical decision-making and improve outcomes for pwMS.
138 Done in 16 Seconds: extracting research ready data from NHS clinical letters
Authors: Middleton Rod , Witts James , Craig Elaine , Tuite-Dalton Katherine , Rodgers Jeff , Nicholas Richard ,   UK MS Register Research Group
Published: August 2022

BackgroundLetters dictated by healthcare professionals in routine patient care form an invaluable dataset but are difficult to access and interpret. The UK MS Register (UKMSR) previously outlined (ABN2019) usage of Natural Language Processing Algorithms (NLP-A) to harvest and transform written language into analysable data in databases. We expanded the variables captured, increased the number of donating hospitals and compared the results to the previous NLP-A.AimApply the new NLP-A to a random letter selection and evaluate output and results.MethodsA random, seeded, selection algorithm chose 100 letters from a corpus of 2690 consented in/outpatient letters from 13 Trusts. Letters were reviewed by human domain experts for Date Of Birth, NHS Number, Gender, Clinic Date, Postcode, MS Type and Expanded Disability Status Score (EDSS). NLP-A was applied and assessment made against the same variables.ResultsRun time was 15.4s, Sensitivity and Specificity > 98% in all cases except Clinic Date (Sensitivity 87%, Specificity 20%), MSType (Sensitivity 84%, Specificity 98%) and Postcode (Sensitivity 100%, Specificity 66%). Low specificity in Clinic Date illustrates disagreement on criteria between reviewer and NLP-A. These results represent a 5% increase (in common variables) in Sensitivity and Specificity over the 2019 algorithm.ConclusionWe have improved the ability to accurately and rapidly identify required variables from the UKMSR minimum dataset using NLP-A. We are continuing to implement this on a widespread basis in the UKMSR.
197 Checkpoint inhibitor associated neuritis a novel pathological entity
Authors: Brown Rachel , Kapoor Mahima , Compton Laura , Shaw Heather , Jaunmuktanee Zane , Turajlic Samra , Rees Jeremy , Brandner Sebastian , Lunn Michael , Carr Aisling 
Published: August 2022

Checkpoint inhibitor immunotherapy has revolutionised cancer treatment. However, immunotoxicity due to dysregulated immune control can affect a range of non-cancer tissues causing dermatitis, colitis and endocrinopathies in up to 80% of exposed patients. Peripheral nerve neurotoxicity is rare (<5%) and described as GBS-like or CIDP-like in published case series.Here we present two cases of checkpoint inhibitor associated peripheral neuropathy suggesting this neuritis is a novel pathological entity.Case 155-year-old man treated with nivolumab and ipilimumab for renal cell carcinoma developed painful sensory predominant neuropathy after cycle 1. Gait impairment led to discontinuation by cycle3. NCS revealed axonal loss and conduction slowing but no demyelinating features. He was treated with IVIg without response.Case 255-year-old woman with metastatic melanoma was treated with pembrolizumab for 16 months without complication. Within weeks of change to nivolumab she developed painful neuropathic symptoms causing difficulty walking. Neurophysiology was similar to case 1 but she improved to normal with high dose corticosteroids over 4 months.Both sural nerve biopsies showed active large fibre degeneration with diffuse, predominantly T cell inflam- matory infiltrate. No malignant cells. No evidence of a primary demyelinating pathology.This novel inflammatory neuropathy warrants recognition due to alternative treatment response.
Extended interval dosing of ocrelizumab reduces risk of developing hypogammaglobulinaemia
Authors: Allen Christopher , Russell Melanie , Pendlebury Jessica , Vollmer Brandi , Moswela Olivia , Raza Pranee-Ta , Garjani Afagh , Abdel-Fahim Rasha , Tallantyre Emma , Evangelou Nikos 
Published: August 2022

IntroductionDisruption to clinical services, triggered by the COVID-19 pandemic, led to extended intervals between ocrelizumab treatments for some patients.ObjectivesTo assess the rates of developing low immunoglobulin levels and timing of CD19+ B-cell count repopulation in a real-world clinical population. To assess for evidence of clinical or radiological MS disease activity with extended interval dosing of ocrelizumab.MethodsWe audited 712 patients given ocrelizumab by our seven clinical services. All monitoring of immunoglobulin levels and CD19+ cell counts were recorded. Disease activity was defined as on treatment clinical relapse, radiological activity, and EDSS progression.ResultsLow immunoglobulin levels developed in 102 patients, the odds ratio for developing hypogam- maglobulinaemia comparing extended to standard interval dosing was 0.42 (CI 0.22-0.81). Disease activity included 20 participants with clinical relapses and 72 with new MRI lesions. There was no evidence of excess clinical or radiological disease activity on switching to extended interval dosing. 38 had EDSS progression, giving an odds ratio comparing extended to standard interval dosing of 0.77 (CI 0.38-1.56).ConclusionsThis real-world data of extended interval dosing of ocrelizumab indicates lower rates of hypogammaglobulinaemia and no detrimental effect on short-term treatment efficacy.
Improving compliance with the duty of candour: 5-year experience within an endoscopy department
Authors: Berry Philip , Kotha Sreelakshmi , Demartino Sabina , Tritto Giovanni 
Published: August 2022

Abstract

Background and aims
Duty of candour (DoC) is the requirement for timely and transparent disclosure after significant healthcare-related harm. We describe the experience of DoC following patient safety incidents (PSI) related to endoscopy, and offer reflections on improving compliance across other areas of clinical medicine.

Methods
PSI notified on an electronic reporting system (DATIX) from January 2015 to June 2021 were identified. Details of the procedure, level of harm and evidence of both verbal and written DoC were collected and analysed.

Results
33 PSI were notified on DATIX. A verbal apology was documented in 23 cases (70%) and a written notification was offered or sent to in 20 (61%). Verbal apologies were timely, while written DoC was delayed. PSI reporting and verbal DoC increased over this period. Patients or families were invited to present questions for investigation in all 20 with written DoC. There were two claims for compensation during this period.

Conclusion
DoC remains challenging for clinicians and patient safety teams 8 years after its inception. Improved compliance requires promotion by clinical leaders and high levels of awareness among clinical and nursing staff, a culture of openness and importantly, sustained administrative support to ensure that downstream actions are not overlooked.