bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective associations of health literacy with clinical outcomes in adults with CKD: findings from the CRIC study
Authors: Estrella Mayra L , Allen-Meares Paula , Ricardo Ana C , Fischer Michael J , Gordon Elisa J , Carmona-Powell Eunice , Sondheimer James , Chen Jing , Horwitz Edward , Wang Xue , Hsu Jesse Y , Lash James P , Lora Claudia ,   the CRIC Study Investigators, Appel Lawrence J , Chen Jing , Feldman Harold I , Go Alan S , Nelson Robert G , Rahman Mahboob , Rao Panduranga S , Shah Vallabh O , Townsend Raymond R , Unruh Mark L 
Published: June 2022

ABSTRACTBackgroundLimited health literacy is associated with significant morbidity and mortality in the general population but the relation of health literacy with long-term clinical outcomes among adults with chronic kidney disease (CKD) is less clear.MethodsProspective data from the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3715) were used. Health literacy was assessed with the Short Test of Functional Health Literacy in Adults (dichotomized as limited/adequate). Cox proportional hazards models were used to separately examine the relations of health literacy with CKD progression, cardiovascular event (any of the following: myocardial infarction, congestive heart failure, stroke or peripheral artery disease), and all-cause, cardiovascular and non-cardiovascular mortality. Poisson regression was used to assess the health literacy–hospitalization association. Models were sequentially adjusted: Model 1 adjusted for potential confounders (sociodemographic factors), while Model 2 additionally adjusted for potential mediators (clinical and lifestyle factors) of the associations of interest.ResultsIn confounder-adjusted models, participants with limited (vs adequate) health literacy [555 (15%)] had an increased risk of CKD progression [hazard ratio (HR) 1.34; 95% confidence interval (CI) 1.06–1.71], cardiovascular event (HR 1.67; 95% CI 1.39–2.00), hospitalization (rate ratio 1.33; 95% CI 1.26–1.40), and all-cause (HR 1.54; 95% CI 1.27–1.86), cardiovascular (HR 2.39; 95% CI 1.69–3.38) and non-cardiovascular (HR 1.27; 95% CI 1.01–1.60) mortality. Additional adjustments for potential mediators (Model 2) showed similar results except that the relations of health literacy with CKD progression and non-cardiovascular mortality were no longer statistically significant.ConclusionsIn the CRIC Study, adults with limited (vs adequate) health literacy had a higher risk for CKD progression, cardiovascular event, hospitalization and mortality—regardless of adjustment for potential confounders.
Glomerular deposition of galactose-deficient IgA1-containing immune complexes via glomerular endothelial cell injuries
Authors: Makita Yuko , Suzuki Hitoshi , Nakano Daisuke , Yanagawa Hiroyuki , Kano Toshiki , Novak Jan , Nishiyama Akira , Suzuki Yusuke 
Published: June 2022

ABSTRACT

Background
Galactose-deficient immunoglobulin A1 (Gd-IgA1) plays a crucial role in the development of IgA nephropathy (IgAN). However, the pathological role of Gd-IgA1-containing immune complexes (ICs) and the mechanism of deposition in the mesangial region remain unclear.

Methods
To examine the deposition of Gd-IgA1-containing ICs in the mesangial region through glomerular endothelial cell injury, we evaluated the alteration of renal microvascular endothelial glycocalyx in nude mice injected with Gd-IgA1-IgG ICs. Human renal glomerular endothelial cells (HRGECs) were used to assess the potential capacity of Gd-IgA1-IgG ICs to activate endothelial cells.

Results
Nude mice injected with Gd-IgA1-containing ICs showed podocyte and endothelial cell injuries, with IgA, IgG and C3 depositions in glomerular capillaries and the mesangium. Moreover, albuminuria and hematuria were induced. Real-time glycocalyx imaging showed that renal microvascular glycocalyx was decreased immediately after injection of Gd-IgA1-containing ICs and then mesangial IgA deposition was increased. After coculture of Gd-IgA1-containing ICs with HRGECs, messenger RNA expression levels of endothelial adhesion molecules and proinflammatory mediators were upregulated significantly.

Conclusion
Gd-IgA1-IgG ICs had a high affinity for glomerular endothelial cells, which resulted in glomerular filtration barrier dysfunction mediated by glycocalyx loss. Furthermore, Gd-IgA1-IgG ICs accelerated the production of adhesion factors and proinflammatory cytokines in glomerular endothelial cells. The glomerular endothelial cell injury induced by Gd-IgA1-containing ICs may enhance the permeability of Igs in the mesangial region and subsequent inflammatory responses in the pathogenesis of IgAN.
Epidemiology of Complicated Urinary Tract Infections due to Enterobacterales Among Adult Patients Presenting in Emergency Departments Across the United States
Authors: Lodise Thomas P , Chopra Teena , Nathanson Brian H , Sulham Katherine , Rodriguez Mauricio 
Published: June 2022

Abstract
In this multicenter study of adult patients who presented to the emergency department with an Enterobacterales complicated urinary tract infection (cUTI), high rates of resistance and co-resistance to commonly used oral antibiotics (fluoroquinolones, trimethoprim-sulfamethoxazole, nitrofurantoin, and third-generation cephalosporins) were observed.
High Yield of Blood Cultures in the Etiologic Diagnosis of Cellulitis, Erysipelas, and Cutaneous Abscess in Elderly Patients
Authors: Taniguchi Tomohiro , Tsuha Sanefumi , Shiiki Soichi , Narita Masashi , Teruya Mariko , Hachiman Teruyuki , Kogachi Noriyasu 
Published: June 2022

Abstract

Background
Cellulitis is a common disease in the elderly, and detecting etiologic organisms with blood cultures is difficult because of the low positive rate and occasional skin contamination. Therefore, routine blood cultures are not recommended for uncomplicated cellulitis. However, it is unclear whether blood culture collection for the diagnosis of cellulitis in elderly patients is useful.

Methods
This single hospital–based observational study was performed between April 2012 and March 2015 in Okinawa, Japan. All enrolled patients were aged 15 years or older and admitted to the Division of Infectious Diseases with suspected cellulitis, erysipelas, and cutaneous abscess. Two routine sets of blood cultures were obtained.

Results
Two hundred and twenty-one patients were enrolled. The median age was 77 years. The proportion of bacteremia was 21.7% for all patients (48/221), 8.5% (4/47) for those &lt;65 years, and 25.3% (44/174) for those ≥65 years old (P = .013). The skin contamination rate was 0.9% (2/221). The most common pathogen was Streptococcus dysgalactiae (62.5%). Gram-negative bacteremia not susceptible to cefazolin was detected in 8.3%. Cefazolin and ampicillin were the first- and second-most commonly used therapies. Anti–methicillin-resistant Staphylococcus aureus therapy was required in 3.6% of patients. In addition to age and severe infection, shaking chills and white blood count ≥13 000 cells/µL were independent risk factors of bacteremia.

Conclusions
Two routine sets of blood cultures are recommended for the precise diagnosis and appropriate treatment of cellulitis in elderly patients, especially in patients with shaking chills or leukocytosis.
Effects of depolarizing intervening galaxies on background radio emission. I. Global disk magnetic field
Authors: Omae Rikuto , Akahori Takuya , Machida Mami 
Published: June 2022

AbstractExternal galaxies often intervene in front of background radio sources such as quasars and radio galaxies. Linear polarization of the background emission is depolarized by Faraday rotation of inhomogeneous magnetized plasma of the intervening galaxies. Exploring the depolarizing intervening galaxies (DINGs) can be a powerful tool to investigate the cosmological evolution of the galactic magnetic field. In this paper, we investigate the effects of DINGs on background radio emission using theoretical DING models. We find that complex structures of galaxy result in complicated depolarization features and Faraday dispersion functions (FDFs), but, for the features of depolarizations and FDFs, the global component of magnetic fields is important. We show the simplest results with ring magnetic field in the galactic disk. We find that the degree of depolarization significantly depends on the inclination angle and the impact parameter of the DING. We found that the larger the standard deviation, the more likely it is that depolarization will occur. The FDF represents the rotation measure (RM) structure within the beam. The FDF exhibits multi-components due mainly to the RM structure within the beam and the fraction of the DING that covers the background emission (the filling factor). The peak Faraday depth of the FDF is different from the beam-averaged RM of the DING. The Monte Carlo simulations indicate that a DING’s contribution to the standard deviation of observed RMs follows σRM ∝ 1/(1 + z)k with k ∼ 2.7 and exhibits a steeper redshift dependence than the wavelength squared. DINGs will have a significant impact on RM catalogs created by future survey projects such as the Square Kilometer Array (SKA) and SKA Precursor/Pathfinder.
Evaluation of Anterior Coverage in Children With Developmental Dysplasia of the Hip Using Transverse Magnetic Resonance Imaging at 2 Years Is Predictive of Future Radiographic Coverage
Authors: Tsukagoshi Yuta , Kamada Hiroshi , Takeuchi Ryoko , Tomaru Yohei , Nakagawa Shogo , Kimura Mio , Aiba Shutaro , Shimada Hayato , Ikezawa Yoshiyasu , Yamazaki Masashi 
Published: June 2022

Background:
Although normal anterior acetabular coverage provides stability to the hip, acetabular retroversion leads to femoroacetabular impingement related to hip osteoarthritis. Previous studies have focused on acetabular version and anteroposterior coverage in children with developmental dysplasia of the hip (DDH); however, the correlation between anteroposterior coverage and acetabular development is unclear. We measured anteroposterior acetabular coverage in DDH patients using transverse magnetic resonance imaging (MRI) and subsequent bony acetabular growth, and evaluated the correlation of those findings.

Methods:
We evaluated 37 DDH (dislocations) in 36 patients who underwent MRI at 2 years of age. The mean age was 2.2±0.3 years at the time of MRI (1.6±0.4 y after reduction) and 6.0±0.1 years at the time of plain radiography for the Severin classification. On MRI scans, we measured the cartilaginous center-edge angle (CCEA) and cartilaginous acetabular-head index (CAHI) in the coronal plane and the anterior and posterior cartilaginous center-edge angles (AC-CEA and PC-CEA, respectively) in the transverse plane. Severin I or II was defined as a good outcome and III or IV as a poor outcome.

Results:
In the evaluations conducted at 2 years of age, the mean CCEA, CAHI, AC-CEA, and PC-CEA were 14±9 degrees, 66%±10%, 39±8 degrees, and 77±7 degrees, respectively; the CEA at 6 years of age was 13±7 degrees. Twelve and 25 hips were classified in the good and poor outcome groups, respectively. Although CCEA, CAHI, and AC-CEA were significantly associated with the outcome in a single regression analysis (P<0.05), only AC-CEA was significant in the multiple regression analysis with a stepwise selection method (P=0.018). The cutoff AC-CEA value for a good outcome was 38 degrees (sensitivity, 67%; specificity, 68%) using a receiver operating characteristic curve.

Conclusions:
Among MRI findings for acetabular cartilaginous morphology, AC-CEA was strongly associated with the outcome. Anteroposterior coverage was correlated with bony acetabular growth in childhood, and anterior coverage was particularly important for subsequent acetabular growth.

Level of Evidence:
Level IV—case series.
Rationale, Criteria, and Impact of Identifying Extreme Risk in Patients with Atherosclerotic Cardiovascular Disease
Authors: Zeng Yuhong , Zhao Dong 
Published: June 2022

Abstract
Assessment of the overall risk of atherosclerotic cardiovascular disease (ASCVD) is the first step in managing dyslipidemia and is an important reference for the target and intensity of treatment. Recently, different guidelines and consensuses on the management of this condition have successively recommended further risk stratification among patients with ASCVD, and a new “extreme risk” category has been proposed to identify patients who may obtain greater benefit from more intensive lipid-lowering therapy. The definition and terminology of extreme risk varies among different guidelines and consensuses; however, they all recommended an aggressive lipid-lowering therapeutic approach and/or a more stringent low-density lipoprotein cholesterol target for patients at extreme risk. Regardless of the definitions, this general approach may have a remarkable effect on the treatment of this condition in clinical practice. To help clinicians and patients to better understand the new strategy for the secondary prevention of ASCVD, this review provides a summary highlighting the necessity of further risk stratification among ASCVD patients, how patients at extreme risk can be identified, and the potential impact of applying the new “extreme risk” category in clinical practice.
COMBINATION OF VITRECTOMY AND INTENTIONAL MACULAR DETACHMENT IS ASSOCIATED WITH A FASTER EDEMATOUS REGRESSION THAN VITRECTOMY ALONE IN THE TREATMENT OF REFRACTORY DIABETIC MACULAR EDEMA
Authors: Yan Ying , Zhu Li , Zeng Miao , Huang Zhijian , Ding Qin , Liu Yang , Gao Chengyuan , Yu Doudou , Chen Xiao 
Published: June 2022

Purpose:
To compare clinical outcomes in eyes with refractory diabetic macular edema managed by vitrectomy combined with and without intentional macular detachment (IMD).

Methods:
This is a retrospective cohort study. Forty-one eyes with diabetic macular edema that were previously poorly responsive to at least 5 monthly anti–vascular endothelial growth factor and at least twice switch therapy previously were included in this study. All eyes underwent pars plana vitrectomy with internal limiting membrane peeling, 21 of which were combined with an IMD procedure (assigned to an IMD group) and 20 of which did not have IMD performed (nMD group). Macular morphologic and visual acuity changes were analyzed from baseline through the endpoint (24 weeks) postprocedure, and were compared between groups.

Results:
All patients completed at least six months of follow-up, with a mean of 29.7 weeks (24–56 weeks). The mean central retinal thickness reduction was greater in the IMD group than that in the nMD group at 1 week (P = 0.001), 2 weeks (P = 0.008), and 4 weeks (P = 0.004), but there was no statistically significant difference at 12 weeks (P = 0.051) or 24 weeks (P = 0.056). There were no significant differences in the mean changes of best-corrected visual acuity from baseline to the 24 weeks endpoint in either group (P = 0.83).

Conclusion:
Vitrectomy can release macular edema in the eyes with refractory diabetic macular edema. Combined with IMD technical, patients seemed to achieve a faster central retinal thickness decrease but neither the final morphologic outcome nor the visual acuity was affected.
Peripapillary and Macular Vascular Density in Patients With Preperimetric and Early Primary Open Angle Glaucoma
Authors: Oba Turker , Solmaz Nilgun , Onder Feyza 
Published: June 2022

Précis:
Decreased circumpapillary vascular density (cpVD) and average retinal nerve fiber layer (RNFL) thickness were detected at different locations in eyes with preperimetric glaucoma (PPG). Although RNFL loss was more prominent in preperimetric eyes, in early glaucoma, both cpVD and RNFL thickness showed comparable diagnostic ability.

Purpose:
To evaluate changes in circumpapillary and macular vascular density and investigate correlations between vascular and structural parameters in PPG and early glaucoma.

Method:
This cross-sectional study included a total of 27 patients with PPG in 1 eye and early primary open angle glaucoma in the fellow eye, as well as a control group consisting of 27 eyes of 27 healthy volunteers. All subjects underwent optical coherence tomography angiography (OCTA) imaging. RNFL and macular ganglion cell complex measurements were obtained simultaneously with vascular parameters by AngioVue OCTA using the single-scan protocol. cpVD was examined in 8 sectors. Diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve.

Results:
In preperimetric eyes, average RNFL thickness and whole-image vessel density had comparable diagnostic performance (area under the receiver operating characteristic curve =0.853 and 0.753, respectively). Compared with the control group, PPG eyes had significantly lower RNFL thickness in all quadrants (P<0.001–0.003) except for the temporal quadrant, whereas cpVD differed only in the nasal inferior and nasal superior sectors (P=0.001 and 0.041, respectively). In early glaucoma eyes, cpVD differed significantly from controls in all sectors except for the inferotemporal, temporal inferior, and temporal superior sectors, whereas perifoveal macular vascular parameters differed in all quadrants (all P<0.05). cpVD was strongly correlated with RNFL thickness in the superior, nasal, and temporal quadrants (r=0.664, 0.698, and 0.649, respectively, P<0.001) and moderately correlated in the inferior quadrant (r=0.450, P<0.001).

Conclusion:
Although RNFL involvement is valuable in the diagnosis and follow-up of PPG, the change in nasal cpVD has an important place in these patients. The role of macular vascular parameters and macular ganglion cell complex in glaucoma follow-up becomes important in early glaucoma. Longitudinal studies are needed to determine the place of OCTA in the diagnosis and follow-up of glaucoma.
Acute Cognitive Effects of the Dual Orexin Receptor Antagonist Lemborexant Compared With Suvorexant and Zolpidem in Recreational Sedative Users
Authors: Landry Ishani , Hall Nancy , Alur Jagadeesh , Filippov Gleb , Reyderman Larisa , Setnik Beatrice , Henningfield Jack , Moline Margaret 
Published: June 2022

Abstract

Purpose/Background
As part of a human abuse potential (HAP) study of lemborexant (LEM), the effects of therapeutic (LEM 10 mg), and supratherapeutic doses of LEM 20 mg and LEM 30 mg on cognition and psychomotor performance were compared with placebo (PBO) and supratherapeutic doses of zolpidem (ZOL) 30 mg and suvorexant (SUV) 40 mg. Subjects (n = 32) were healthy, nondependent, recreational sedative users able to discriminate the effects of both SUV and ZOL from PBO on subjective drug measures.

Methods/Procedures
The human abuse potential study was a single-dose, randomized, double-blind, PBO-controlled, 6-way crossover study. Eligible subjects admitted to the treatment phase completed the choice reaction test (CRT) and divided attention test. The CRT included measurements of recognition reaction time (RRT) and motor reaction time.

Findings/Results
Recognition reaction time and mean maximum change from baseline (CFBmax) scores were significantly increased (slower performance) versus PBO for all LEM doses (all P < 0.001), ZOL (P < 0.001), and SUV (P = 0.004), and LEM (all doses) was not statistically different from ZOL or SUV. Motor reaction time and mean CFBmax versus PBO were significantly increased for all LEM doses (all P < 0.001), and ZOL (P < 0.001) and SUV (P < 0.001). All LEM doses showed significantly decreased (better performance) mean CFBmax versus ZOL (all P < 0.001), but not SUV. Notably, all cognitive effects in the CRT and divided attention test were limited to the main treatment phase (up to 8 hours postdose).

Implications/Conclusions
All active doses of LEM, ZOL, and SUV generally increased reaction time and reduced divided attention capabilities versus PBO. However, at therapeutic/supratherapeutic doses, LEM led to significantly less cognitive impairment than supratherapeutic doses of ZOL in some measures.
Internal Operational Metrics and Center for Medicare and Medicaid Services Hospital Compare Quality Ratings
Authors: Thornton Michele , Bonzo Sarah , Khan Raihan , Souza Leah 
Published: June 2022

ABSTRACT
The Center for Medicare and Medicaid Services (CMS) has made several refinements to their model for calculating hospital quality star ratings (Hospital Compare) amidst criticism and evidence of bias against some institutions. We argue that the CMS model does align with important internal quality metrics and encourage a measured approach to redesign, potentially using categorizations or tiers, rather than a complete abandonment of the ratings system. We find that institutional characteristics (available resources, average severity of illness, and academic affiliation) are associated with internal quality metrics related to patient flow. Furthermore, regression results from the original and revised CMS star rating methodologies suggest that patient flow metrics (discharges before noon [p < .01] and weekend discharges [p < .001]) have a positive relationship with the Hospital Compare rating. Hospitals with better patient flow, as measured by higher levels of discharges before noon and weekend discharges, are associated with higher CMS quality ratings. These findings suggest that CMS star ratings do reflect key aspects of operational performance, specifically efforts to improve patient flow, but the ranking system should consider hospital characteristics that influence internal operations as we move toward a system capable of quality and price transparency for consumers.
The influence of age and sex in sarcoidosis
Authors: Singha Arindam , Kirkland Marina , Drake Wonder , Crouser Elliott D 
Published: June 2022

Purpose of review
This review aims to describe how the clinical manifestations of sarcoidosis may be shaped by the effects of sex hormones and by age dependent changes in immune functions and physiology This review is intended to highlight the need to consider the effects of sex and sex in future studies of sarcoidosis

Recent findings
The clinical manifestations of sarcoidosis differ based on sex and gender There is emerging evidence that female and male hormones and X-linked genes are important determinants of immune responses to environmental antigens, which has important implications for granuloma formation in the context of sarcoidosis Furthermore, sex hormone levels predictably change throughout adolescence and adulthood, and this occurs in parallel with the onset immune senescence and changes in physiology with advanced age

Summary
Recent studies indicate that sex and age are important variables shaping the immune response of humans to environmental antigens We posit herein that sex and age are important determinants of sarcoidosis clinical phenotypes Many gaps in our understanding of the roles played by sex and gender in sarcoidosis, and these need to be considered in future studies