bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased racial disparities in sepsis mortality after an order set–driven initiative: An analysis of 8151 patients
Authors: Fernandez Olivera Maria L. , Pafford Carl , Lardaro Thomas , Roumpf Steven K. , Saysana Michele , Hunter Benton R. 
Published: January 2025

AbstractBackgroundSepsis is a leading cause of hospital mortality and there is evidence that outcomes vary by patient demographics including race and gender. Our objectives were to determine whether the introduction of a standardized sepsis order set was associated with (1) changes in overall mortality or early antibiotic administration or (2) changes in outcome disparities based on race or gender.MethodsPatients seen in the emergency department and admitted to the hospital with a diagnosis code of sepsis were identified and divided into a preintervention cohort seen during the 18 months prior to the initiation of a new sepsis order set and an intervention cohort seen during the 18 months after a quality initiative driven by introducing the order set. Associations between time period, race, gender, and mortality were assessed using univariate and multivariate logistic regression models. Other outcomes included early antibiotic administration (<3 h from arrival).ResultsOverall mortality was unchanged during the intervention period (7.8% vs. 7.2%) in both univariate (relative risk [RR] 1.08, 95% confidence interval [CI] 0.93–1.26) and multivariate logistic regression (RR 1.11, 95% CI 0.93–1.28) models. Although male gender tended to have higher mortality, there was no statistically significant association between gender and mortality in either cohort. In the multivariable model, Black race was associated with increased risk of death in the preintervention period (RR 1.41, 95% CI 1.02–1.94), but this association was not present in the intervention period. Patients of color also saw significantly more improvement in early antibiotic administration during the intervention period than White patients.ConclusionsAn order set–driven sepsis initiative was not associated with overall improved mortality but was associated with decreased racial disparities in sepsis mortality and early antibiotics.
Hypereosinophilia and Hypereosinophilic Syndromes: First Findings From a Nationwide Multicenter Cohort
Authors: Lefèvre Guillaume , Bleuse Séverine , Puyade Mathieu , Moulis Guillaume , Néel Antoine , Abisror Noémie , Baudet Antoine , Bonnotte Bernard , Dion Jérémie , Dossier Antoine , Grall Maximilien , Lifermann François , Limal Nicolas , Lioger Bertrand , Machelart Irène , Mohr Catherine , Outh Roderau , Queyrel‐Moranne Viviane , Slama Borhane , Tréfond Ludovic , Abou Chahla Wadih , Ackerman Félix , Belfeki Nabil , Berezne Alice , Blade Jean‐Sébastien , Bouderbala Mohammed Azzedine , Chebrek Safia , Cottin Vincent , De Almeida Sébastien , De Masson Adèle , Dezoteux Frédéric , Goulenok Tiphaine , Jachiet Vincent , Jouvray Mathieu , Latu Irina , Ledoult Emmanuel , Leurs Amélie , Lugosi Maxime , Martin Michael , Melboucy‐Belkhir Sara , Morati‐Hafsaoui Chafika , Quemeneur Thomas , Rohmer Julien , Roy‐Peaud Frédérique , Sanges Sébastien , Schleinitz Nicolas , Staumont‐Salle Delphine , Taillé Camille , Terriou Louis , Tieulie Nathalie , Koenga Japhete Darline Elenga , Schwarb Laurent , Panel Kewin , Kahn Jean‐Emmanuel , Groh Matthieu ,   the COHESion study group
Published: January 2025

ABSTRACTBackgroundHypereosinophilic syndromes (HES) are a heterogenous group of eosinophilic disorders. To date, only retrospective studies of limited sample‐size and/or follow‐up duration are available.MethodsThe COHESion study is a national prospective multicenter multidisciplinary cohort recruiting both adults or children with the spectrum of eosinophilic disorders (including reactive HE/HES [HE/HES‐R], idiopathic HES [HES‐I], lymphocytic HES [HES‐L], neoplastic HE/HES [HE/HES‐N], HE of unknown significance [HE‐US], as well as IgG4‐related disease [IgG4RD] or ANCA‐negative eosinophilic granulomatosis with polyangiitis [EGPA] overlaps). Patients are followed‐up yearly. All data about final diagnosis, organ involvement assessments, and outcome profiles in HES‐I were captured and analyzed centrally by HES expert centers.ResultsFrom May 2019 to November 2023, 779 patients were included. For this preliminary analysis, 550 cases were available for centralized review (mean ± SD age: 56 ± 18 years, 42% of female patients). The final diagnoses were HES‐I (47%), HE/HES‐R (16%), HE‐US (15%), HE/HES‐N (7%), HE/HES‐L (6%), IgG4RD (2%), and ANCA‐negative EGPA (7%). In the 258 HES‐I patients, outcome profiles were classified as follows: 16.3% had a “single‐flare” without further relapse, 28.3% had a “relapsing–remitting” disease when there was at least a 6‐month period free of symptoms between two flares, 46.1% had a “persistent disease” requiring continuous treatment to avoid relapses (9.3% remained unclassified because of insufficient follow‐up).ConclusionsThe COHESion cohort is the first nationwide prospective multicenter study collecting data on the full spectrum of HE/HES disorders. This preliminary analysis confirms that idiopathic HES patients have various outcome profiles, suggesting different underlying pathophysiological mechanisms and the need of patient‐specific management.Trial RegistrationClinicalTrials.gov identifier: NCT 04018118
Should adolescents and young adults with Hodgkin lymphoma be treated as children or adults?
Authors: Lew‐Derivry Lucille , Chevillon Florian , Brice Pauline , Bigenwald Camille , Landman‐Parker Judith , Leblanc Thierry , Boissel Nicolas , Cabannes‐Hamy Aurélie 
Published: January 2025

SummaryHodgkin lymphoma (HL) is one of the most common cancers in adolescents and young adults (AYA). Paediatric and adult therapeutic strategies diverge while sharing the common objective: maintaining optimal efficacy with less long‐term toxicity. However, few studies have compared the outcome of AYA treated according to one or the other approaches. Among the 148 patients aged 15–25 years, treated at Saint‐Louis Hospital for newly diagnosed HL between 2012 and 2018, 71 were treated according to an adult protocol and 77 were treated according to a paediatric one. The 5‐year overall survival (OS) and progression‐free survival (PFS) were, respectively, 100% and 85%, with no significant difference between treatment groups (85% in paediatric vs. 86% in adult, p = 0.7). Overall, the 5‐year PFS was 100% for early favourable stages and 78% for advanced stages. A higher risk of short‐term steroid and vincristine‐related toxicities was observed in paediatric regimen, whereas a higher risk of late toxicities was expected in adult regimen, due to higher anthracyclines, procarbazine, bleomycin and radiotherapy exposure. These results confirm the excellent outcome of AYA patients with HL, whatever the treatment strategies. They justify a tailor‐made therapeutic decision and highlight the importance of managing AYA patients in dedicated units with trained professionals.
Physiological change in ganglion cell inner plexiform layer and nerve fibre layer thickness over six years
Authors: Soh Zhi‐Da , Yu Marco , Chen Yanyan , Thakur Sahil , Lavanya Raghavan , Tham Yih Chung , Koh Victor , Aung Tin , Cheng Ching‐Yu 
Published: January 2025

AbstractBackgroundTo evaluate the 6‐year physiological rates‐of‐change in ganglion cell inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) thickness measured with optical coherence tomography.MethodsWe included 2202 out of 2661 subjects from the population‐based Singapore Chinese Eye Study who returned for follow‐up 6 years after baseline examination (follow‐up rate 87.7%). OCT scans with signal strength (SS) <6, imaging errors, and ocular pathologies were excluded. A linear mixed model was used to measure the rates‐of‐change in GCIPL and RNFL thickness. Time and difference between baseline and follow‐up scan SS were modelled as fixed effect. Baseline age, baseline measurement, gender, hypertensive medication, diabetes status, cardiovascular disease, smoking status, body mass index, spherical equivalent (SE), intraocular pressure and optic disc area were each analysed in an interaction term with time.ResultsThe adjusted mean rate‐of‐change in average GCIPL was −0.312 μm/year in males and −0.235 μm/year in females. Older age and thicker GCIPL thickness at baseline were associated with higher rates‐of‐change while females and more hyperopic SE were associated with lower rates‐of‐change. The adjusted mean rate‐of‐change in average RNFL was −0.374 μm, with higher rates‐of‐change in the vertical quadrants and no differences between genders. Older age and thicker RNFL thickness at baseline were associated with higher rates‐of‐change in average RNFL and RNFL thickness in the vertical quadrants, and vice versa for each unit increase in scan SS and SE.ConclusionOur population cohort provides data on physiological thinning of GCIPL and RNFL with age. Differentiating physiological changes in GCIPL and RNFL is important for more accurate clinical assessment.
Effectiveness and safety of iGlarLixi in people with type 2 diabetes not at target on basal insulin and oral antidiabetic therapy in a prospective observational trial
Authors: Seufert Jochen , Wiesner Tobias , Pegelow Katrin , Kenzler Julia , Pfohl Martin 
Published: January 2025

AbstractAimsThis study assessed efficacy and safety of the fixed ratio combination iGlarLixi 100/33 (insulin glargine 100 U/mL plus lixisenatide 33 μg/mL) in people with type 2 diabetes (PwT2D) in daily clinical practice.Materials and MethodsThis non‐interventional, multicentre, prospective, single‐arm 24‐week study documented PwT2D with an HbA1c of 7.5%–10.0%, currently treated with a basal insulin supported oral therapy (BOT) in German primary care facilities, after the physician had decided to change treatment to iGlarLixi 100/33, independent of study participation. Primary end‐point was the absolute change in HbA1c (%) from baseline.ResultsOf 93 participants included, 70 comprised the full analysis set for efficacy assessment. Approximately 24 weeks after switching to iGlarLixi 100/33 HbA1c (mean ± standard deviation) changed from 8.52 ± 0.82% by −0.74 ± 0.81% to 7.74 ± 0.76%, FPG from 174.3 ± 44.6 mg/dL (9.67 ± 2.48 mmol/L) by −32.9 ± 46.3 mg/dL (−1.83 ± 2.57 mmol/L) to 141.4 ± 34.1 mg/dL (7.85 ± 1.89 mmol/L) and body weight from 104.3 ± 22.5 kg by −3.0 ± 7.5 kg to 101.3 ± 21.6 kg (all p < 0.01). Furthermore, use of DPP4 inhibitors was significantly reduced from 34.8% to 6.8% of participants. Derived (from 7‐point self‐measured plasma glucose) time in range (TIR) increased and time above range (TAR) decreased after 24 weeks to target ranges (all p < 0.05). Flash glucose monitoring data of 20 patients showed similar patterns for TIR and TAR, respectively, and a reduction in time below range (p = 0.007). Hypoglycaemia events did not change significantly and were low in number. No severe hypoglycaemia was reported.ConclusionsModifying antiglycaemic treatment from a BOT regimen to iGlarLixi 100/33 in suboptimal controlled PwT2D in daily clinical practice improved glycaemic control without increasing hypoglycaemia and with favourable body weight change.
SARS‐COV‐2 Pre‐Exposure Prophylaxis With Tixagevimab‐Cilgavimab in Haematological, Immunocompromised Patients in the Omicron Era
Authors: Hoechstetter Manuela A. , Hollwich Eva‐Maria , Illner Doris , Pham Thu‐Trang , von Bergwelt‐Baildon Michael , Dreyling Martin , Wendtner Clemens‐Martin 
Published: January 2025

ABSTRACTBackgroundPre‐exposure prophylaxis with tixagevimab‐cilgavimab significantly reduced severe COVID‐19 outcomes in high‐risk individuals during the pre‐Omicron era (PROVENT trial). However, efficacy in patients with haematological malignancies (HM) was underreported. The rapid emergence of Omicron strains in 2021 showed reduced neutralizing activity in preclinical data, but real‐world data remains limited due to short follow‐up.Patients and MethodsWe aimed to evaluate the effectiveness and safety of tixagevimab‐cilgavimab in 86 HM patients during the early Omicron wave, including the BA.2, BA.5, and XBB.1 sublineages.These patients received PrEP between February and August 2022 due to impaired vaccine response (72%) and B‐cell depletion (46.5%). They were followed prospectively until April 2023, with a median follow‐up of 297 days.ResultsBreakthrough SARS‐CoV‐2 infections occurred in 32.6% of patients, with 22.1% within six months. Infections within six months were milder and shorter. B‐cell depletion within six (p = 0.035) and twelve months (p = 0.016) was identified as risk factor for breakthrough infections. No new safety events were reported.ConclusionOur data showed that tixagevimab‐cilgavimab prophylaxis effectively reduces severe COVID‐19 outcomes in patients with HM, particularly within the first six months, even during the Omicron era. However, those with recent B‐cell depletion (within 12 months) remained at high risk.
A house is more than a home: Why the law should discourage the shift to renting and the effects of the shift on nascent families
Authors: Sabbagh Lucas 
Published: January 2025

Abstract“Generation Rent” is a term that denotes the trend of young people renting as opposed to buying housing. This, in part, is due to rising housing prices. This Note seeks to look at the potential effects of private “pushes” for an increase in renting and in the private equity firm ownership of Single‐Family Rentals. There are many negative tradeoffs between renting and homeownership in relation to family wealth over a long term. Several proposed solutions to this problem include using Tax Deductions to encourage buying and using Eminent Domain to attack concentrated housing ownership.
Tree Lifespans in a Warming World: Unravelling the Universal Trade‐Off Between Growth and Lifespan in Temperate Forests
Authors: Liu Shuhui , Brienen Roel J. W. , Fan Chunyu , Hao Minhui , Zhao Xiuhai , Zhang Chunyu 
Published: January 2025

ABSTRACTTree growth and lifespan are key determinants of forest dynamics, and ultimately control carbon stocks. Warming and increasing CO2 have been observed to increase growth but such increases may not result in large net biomass gains due to trade‐offs between growth and lifespan. A deeper understanding of the nature of the trade‐off and its potential spatial variation is crucial to improve predictions of the future carbon sink. This study aims to identify key drivers of growth and lifespan, assess the universality of tree growth‐lifespan trade‐offs, explore the possible latitudinal patterns of trade‐off strengths and their determinants, and project growth and lifespan under future climate scenarios. We analyzed 21,193 trees of 69 species (48 included in further analysis) at 445 sites (417 included in further analysis) in temperate forests in northeastern China to estimate early growth rate and tree lifespan. We find that temperature and human pressure enhance tree growth and reduce lifespan, while altitude increases lifespan. We further find evidence for growth‐lifespan trade‐offs at all studied levels, that is, among trees, among species and communities, and within species and communities. Trade‐offs are stronger at colder, higher latitudes compared to warmer sites, because of larger variation in tree growth and climate, larger range sizes for individual species, and lower species' diversity for communities at high latitudes. We predict future increases in growth and reductions in tree lifespan in response to climate change for the 2050s. Taking growth lifespan trade‐offs into account resulted in even larger predictions of decreases in tree lifespan of up to 8%. In conclusion, growth‐lifespan trade‐offs are universal, but the strengths may vary by environment and between different forests. Its effects are important to include in predictions of forest responses to global change and need to be considered more widely.
Amitriptyline for the treatment of vulvodynia in patients with vulvar lichen sclerosus: a case series of 20 patients
Authors: Licata Gaetano , Di Brizzi Eugenia Veronica , Tancredi Vittorio , Arisi Mariachiara , Ariasi Cesare , Giorgio Caterina Mariarosaria 
Published: January 2025

AbstractVulvar Lichen Sclerosus (VLS) is a chronic autoimmune disease that often leads to vulvodynia, a debilitating chronic pain condition in the vulvar region. Treating vulvodynia in the context of VLS presents a significant therapeutic challenge due to the lack of standardized protocols. This article presents a case series of 20 women treated with amitriptyline for vulvodynia secondary to VLS, accompanied by an extended review of the literature. The results suggest that amitriptyline may offer significant pain relief and improvements in the patients’ quality of life, although adverse effects need to be carefully managed. Further studies are needed to validate these findings in larger controlled trials.
The use of submaximal parameters in the assessment of exercise capacity in children with obesity
Authors: Peled K. , Kodesh Einat , Zucker‐Toledano Merav , Bar‐Yoseph R. , Borik‐Chiger S. , Mainzer Gur 
Published: January 2025

SummaryBackgroundPeak oxygen uptake (VO2) is considered the most important indicator of aerobic exercise capacity during cardiopulmonary exercise testing (CPET). However, its accuracy is compromised when maximal effort is not achieved. In such cases, submaximal parameters can serve as surrogates for assessing exercise performance.ObjectivesTo compare the differences in maximal and submaximal exercise parameters between children with obesity and normal weight.MethodsA prospective study evaluating CPET using a treadmill completed by children with and without obesity.ResultsA total of 153 children (50.9% females) were divided into two groups: obese (n = 87) and non‐obese (n = 66). Children with obesity achieved lower exercise capacity (peakVO2 of 68% ± 16% vs. 89% ± 15%; p < 0.0001) with fewer achieving maximal effort (26.4% vs. 78.7%, respectively). VO2‐derived submaximal parameters showed a significantly lower oxygen uptake efficiency slope per body weight (OUES/kg) (30.5 ± 6.1 vs. 39.0 ± 9.5; p < 0.0001) and lower VO2 at ventilatory threshold (VO2@AT) (21.2 ± 4.6 vs. 26.4 ± 5.3, p = 0.0001) in the obese group, with no significant differences in the CO2‐derived parameters.ConclusionsMaximal exercise data in children with obesity is frequently unavailable due to failure to achieve maximal effort. Submaximal parameters, such as OUES and VO2@AT, may be useful substitute options for assessing the health and functional level of this population.
High‐temperature subcritical crack growth in a 3D woven SiC‐based composite
Authors: Kanazawa Shingo , Ikarashi Yoshito , Ogasawara Toshio , Fukuhara Satoru , Kubushiro Keiji , Aoki Takuya , Zok Frank W. 
Published: January 2025

AbstractThis study investigates the subcritical crack growth behavior of a 3D woven SiC‐based composite under cyclic loading at 1100°C in air. The composite was subjected to monotonic tension and tension–tension fatigue tests using both unnotched dumbbell‐shaped and edge‐notched specimens. Detailed examinations of crack growth were conducted through optical microscopy and X‐ray computed tomography (XCT). While the monotonic tensile strength was found to be insensitive to millimeter‐sized notches, the fatigue strength was reduced by 20%–30% in the presence of such notches. Crack growth was found to be irregular and chaotic at the mesoscale, influenced by the complex interplay of chemical and mechanical processes and spatial variability in the composite microstructure. The study emphasizes the importance of XCT imaging for accurate internal crack tracking. It also proposes a phenomenological fracture mechanics model to describe crack growth and lifetime prediction, highlighting the nonmonotonic nature of crack growth rates.
Association of Cardiac CT‐Derived Epicardial Adipose Tissue With Atrial Fibrillation in Patients Without Left Atrial Fibrosis as Defined by Endocardial Voltage Mapping
Authors: Umar Aqeel , Hocking Jeffrey , Massin Sophia Z. , Suszko Adrian , Wintersperger Bernd J. , Chauhan Vijay S. 
Published: January 2025

ABSTRACTIntroductionEpicardial adipose tissue (EAT) is often associated with atrial fibrosis, and both can provide the substrate for atrial fibrillation (AF). However, most AF patients have no evidence of left atrial (LA) fibrosis based on bipolar voltage mapping. We determined whether EAT differs in AF patients without LA fibrosis compared to matched controls without AF.MethodsPatients undergoing cardiac CT before first‐time AF catheter ablation were prospectively enrolled. LA bipolar voltage mapping was performed, and patients were divided into ‐LVZ (LA low voltage zones < 5% of LA surface area; no fibrosis) and +LVZ (LA low voltage zones ≥ 5%; fibrosis). A control group without AF was matched to −LVZ patients. EAT was quantified on CT using standard signal thresholding to quantify total and regional volumes. AF patients were followed for 1‐year postablation to assess atrial arrhythmia (AA) recurrence.Results−LVZ (n = 50) had higher total EAT volumes than matched controls (n = 48) (79 [58–109] vs. 51 [37–73] cm³, p < 0.001), higher LA EAT (9 [6.3–12] vs. 4.2 [2.9–5.8] cm³, p < 0.001), higher posterior LA EAT (9.7 [6.4–12] vs. 5.9 [2.8–7.2] cm³, p < 0.001) and higher right atrial EAT (7.3 [5.1–9.9] vs. 4.8 [3.2–6.5] cm³, p < 0.001). These differences remained even after correcting EAT for BMI and LA volumes. There were no significant differences in EAT volumes between −LVZ and +LVZ (n = 25). There was no significant association between EAT and AF recurrence postablation.ConclusionEAT volume is greater in AF patients without evidence of LA fibrosis compared to matched controls without AF. These findings support an association of EAT with AF pathogenesis even in the absence of LA fibrosis.
Periodontal Care Is Associated With a Lower Risk of Dialysis Initiation in Middle‐Aged Patients With Type 2 Diabetes Mellitus: A 6‐Year Follow‐Up Cohort Study Based on a Nationwide Healthcare Database
Authors: Kusama Taro , Tamada Yudai , Osaka Ken , Takeuch Kenji 
Published: January 2025

ABSTRACTObjectiveTo investigate the association between dental attendance with periodontal care and the risk of dialysis initiation in patients with type 2 diabetes mellitus (T2D).MethodsThis retrospective cohort study used data from the Japan Medical Data Center (JMDC) claims database (January 2015 to August 2022). Patients with T2D, aged 40–74, were included. Dental attendance with periodontal care and initiation of dialysis were used as the exposure and outcome variables, respectively. We fitted the Cox proportional hazards model, including potential confounders, to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs).ResultsAmong 99,273 participants (mean age = 54.4 years [SD = 7.8], male = 71.9%), the incidence rate of dialysis initiation was 0.92 per 1000 person‐years. After adjusting for all covariates, those with periodontal care (HR = 0.68 [95%CI = 0.51–0.91] for ≥ 1 time/year and HR = 0.56 [95%CI = 0.41–0.77] for ≥ 1 time/6 months) had a significantly lower risk of dialysis initiation compared to those without dental attendance.ConclusionPeriodontal disease care in patients with T2D is associated with a reduced risk of dialysis initiation by 32%–44%. This suggests that integrating periodontal care into diabetes management may help prevent the progression of diabetic nephropathy and improve patient outcomes.