bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analysis of the Procedure Volume and Geographic Distribution of US Urologists Performing Outpatient-Based Inflatable Penile Prosthesis Implantation
Authors: Du Comb William S. , Durand Kathryn , Rojanasarot Sirikan
Published: August 2024

Introduction:

This study described the procedure volume and geographic distribution of US urologists performing outpatient-based inflatable penile prosthesis (IPP) implantation.

Methods:

This retrospective administrative claims analysis from Definitive Healthcare identified urologists performing outpatient IPP implantation (Current Procedural Terminology 54405) on commercially insured or Medicare patients in 2021 in hospital outpatient settings. Procedural volumes for each implanter were calculated, and geographical analyses used their primary affiliated hospitals to identify the states in which the procedures were performed.

Results:

In 2021, 2049 urologists conducted 21,835 outpatient-based IPP procedures on a representative sample of commercially insured and Medicare patients, averaging 10.7 procedures per implanter annually. Procedural volumes were right-skewed: 8.6% of urologists performed 33.7% of procedures. Most urologists (91.4%) performed <20 cases. The highest volume implanters who performed more than 100 cases accounted for 6.3% of procedure volumes. Geographical analysis showed Florida (11.2%), California (7.8%), Texas (7.5%), New York (5.9%), Michigan (4.2%), Ohio (3.9%), and Georgia (3.9%) had the highest numbers of outpatient implanters, consistent with the top 7 states by IPP implantation volume (Florida [11.4%], Texas [9.4%], New York [6.5%], California [6.3%], Ohio [5.8%], Georgia [4.2%], and Michigan [3.4%]).

Conclusions:

Most urologists performing outpatient IPP (91.4%) performed <20 procedures per year in 2021. Less than 10% performed approximately one-third of the procedures. These findings highlight essential considerations for fostering development in the field of urology, particularly for emerging implanters aiming to expand patient outreach. The implications aim to establish a balanced and accessible landscape, benefiting both practitioners and the patients they serve.
Anatomical Retrofitting: Pi (脾) as Spleen and the Persistence of Ontological Ambivalence
Authors: Li Lan A.
Published: August 2024

Over the past decade, medical researchers in China have debated whether the Pi (脾) corresponds to the biomedical spleen or pancreas. This debate exemplifies a broader phenomenon of “anatomical retrofitting”, or the anachronistic imposition of contemporary categories onto living historical objects. “Anatomical retrofitting” as a means of rectifying cases of mistranslation further positions the biomedical spleen and pancreas as representing ahistorical, universal truths. This framework gives rise to a conceptual binary: while the biomedical spleen is universalized as what philosophers may describe as “logical” ontology, the Pi connects to a different nature of reality, or “metaphysical” ontology. Far from being an object of imprecision, the Pi was a dynamic vessel that also shared characteristics with the humoral spleen. Given that scholars in China have already subjected Pi to historical scrutiny, this paper urges scholars to do the same with biomedical anatomy. For instance, historically situating the humoral spleen demonstrates that it became less known and less articulated as it transformed into the biomedical spleen. Meanwhile, the pancreas remained an unstable epistemic object that took on the dynamic functions of the humoral spleen in nineteenth-century organotherapy. Through primary source analysis and literature review, this paper contends that the apparent ontological incommensurability between Pi and spleen is neither mutually exclusive nor irreconcilable. Instead, the dynamic nature of internal viscera, their many functions, and their participation in epistemic practices contribute to an ongoing ontological ambivalence that persists despite the forced certainty of anatomical retrofitting.
COASTing Through Bedside Report
Authors: Webster Kristi , Hlebichuk Jeanne , Jensen Lillian , Zastrow Rachel
Published: August 2024

Background:

Bedside shift report improves patient satisfaction, peer accountability, communication, and decreases safety events.

Local Problem:

Clinical practice of bedside report varied prior to the pandemic. Due to limited personal protective equipment and exposure risk, bedside report was halted during the pandemic.

Approach:

The Iowa Model of Evidence-Based Practice was used to guide this project. To standardize communication during bedside report, safety data and literature were reviewed and grouped by themes. The acronym COAST was developed, consisting of code status, oxygen, access, safety, and tubes/drains. These elements were to be discussed at the bedside during handoff.

Results:

Compliance with completing elements of COAST increased during the pilot, 9- and 12-month sustainment periods. Additional safety-related outcomes of cardiopulmonary resuscitation wristband application, falls, and good catches improved. Notably, overtime declined.

Conclusions:

A bedside report with standardized communication focusing on safety elements can improve compliance with adoption and patient safety outcomes.
Change in Brow Position After Upper Blepharoplasty With or Without Internal Browpexy
Authors: Menderes Adnan , Çağlı Hasan Basri
Published: August 2024

Background

Only upper blepharoplasty can cause a change in the eyebrow position, so browpexy can be combined with blepharoplasty in selected patients. There are many brow lifting techniques, both surgical and nonsurgical, and internal browpexy is one of the most widely used surgical brow lifting techniques. The purpose of this study was to evaluate the change in brow position after upper blepharoplasty with or without internal browpexy using preoperative and postoperative photographs.

Methods

Patients who underwent upper blepharoplasty by a single surgeon at Dokuz Eylul University Hospital between 2018 and 2022 were retrospectively evaluated. A total of 48 patients, 30 of whom underwent upper blepharoplasty only and 18 of whom underwent upper blepharoplasty combined with internal browpexy, were examined to present the change in brow position postoperatively. Preoperative and postoperative photographs were analyzed using the ImageJ program and the proportional changes in brow height were shown.

Results

The first group, which only underwent upper blepharoplasty only, consisted of 30 patients (62.5%), all female; the second group, which underwent upper blepharoplasty and internal browpexy, consisted of 18 patients (37.5%), all female. The change at the midpupil level was determined as a 6.13% decrease in the first group and a 2.99% increase in the second group; at the brow peak level, this change was a 6.2% decrease in the 1st group and a 4.38% increase in the 2nd group.

Conclusions

In cases of dermatochalasis, blepharoplasty alone can cause a shortening of the distance between the eyebrow and the upper eyelid groove and an unaesthetic appearance. Internal browpexy is an easy-to-apply technique that allows stabilization of the eyebrow after skin excision and a small amount of elevation.
Drug-Induced Intracranial Hypertension: The Adverse Effects of Acne Medications and Topical Retinoids
Authors: Shaia Jacqueline K. , Rock Jenna R. , Singh Rishi P. , Talcott Katherine E. , Cohen Devon A.
Published: August 2024

Background:

Tetracyclines and vitamin A derivatives, major components in acne care and antiaging products, have been associated with the development of drug-induced intracranial hypertension (DIIH). Treatment practices and longitudinal visual outcomes have been highly understudied in DIIH. The purpose of this study was to provide management guidelines for DIIH and report visual outcomes of patients with DIIH.

Methods:

This was a single institute ophthalmology center case–control study where patients were seen between June 1, 2012, and September 1, 2023, in the United States. Patients with an International Classification of Disease (ICD) code for IIH and meeting the IIH diagnostic criteria who were taking a tetracycline or a vitamin A derivative during their diagnosis were included in this study. Patients were stratified into the following 3 categories: tetracyclines only, vitamin A derivatives only, or both, and compared with Kruskal–Wallis rank-sum tests. Poor visual outcomes were evaluated for and defined as a visual field mean deviation (peripheral visual measure) of −7 dB or greater. Individuals were followed for up to 1.5 years after diagnosis.

Results:

Among patients with IIH (n = 839), DIIH occurred in 8.10% of them (n = 68) with 83% taking the medication for acne. 88% of cases were female, and patients had a mean age of 24.96 years. DIIH medications were taken for an average length of 25.79 weeks before diagnosis of IIH. 20.5% of patients with DIIH were not treated with any IIH medication and were discontinued from the inducing drug. 3 patients had a poor visual outcome on follow-up with all of them taking a vitamin A derivative (P < 0.05). Patients identified as having a poor visual outcome did not report discontinuing the DIIH drug (P < 0.05).

Conclusions:

We propose treatment guidelines highlighting that patients taking a DIIH medication who develop headaches or visual changes should be immediately referred to ophthalmology, removal of the offending agent, and close monitoring by ophthalmology for vision loss. Importantly, vitamin A DIIH may have more severe visual outcomes, but further research is needed to corroborate this finding.
Knowledge mapping of barriers and strategies for clinical practice guideline implementation: a bibliometric analysis
Authors: Tian Chen , Liu Yajie , Hou Liangying , Jiang Jingwen , Li Ying , Liu Jianing , Ye Ziying , Cheng Qianji , Ma Yan , Ning Jinling , Huang Jiajie , Wang Yong , Wang Yiyun , Tong Bo , Lu JiaLe , Ge Long
Published: August 2024

Objective:

This study provides a comprehensive overview of the knowledge structure and research hotspots regarding barriers and strategies for the implementation of clinical practice guidelines.

Methods:

Publications on barriers and strategies for guideline implementation were searched for on Web of Science Core Collection from database inception to October 24, 2022. R package bibliometrix, VOSviewer, and CiteSpace were used to conduct the analysis.

Results:

The search yielded 21,768 records from 3,975 journals by 99,998 authors from 3,964 institutions in 186 countries between 1983 and 2022. The number of published papers had a roughly increasing trend annually. The United States, the United Kingdom, and Canada contributed the majority of records. The University of Toronto, the University of Washington, and the University of Sydney were the biggest node in their cluster on the collaboration network map. The three journals that published the greatest number of relevant studies were Implementation Science, BMJ Open, and BMC Health Services Research. Grimshaw JM was the author with the most published articles, and was the second most co-cited author. Research hotspots in this field focused on public health and education, evidence-based medicine and quality promotion, diagnosis and treatment, and knowledge translation and barriers. Challenges and barriers, as well as societal impacts and inequalities, are likely to be key directions for future research.

Conclusions:

This is the first bibliometric study to comprehensively summarize the research trends of research on barriers and strategies for clinical practice guideline implementation. A better understanding of collaboration patterns and research hotspots may be useful for researchers.

Spanish abstract:

http://links.lww.com/IJEBH/A247
Opportunities for Microbiology Citizen Science: Lessons Learnt from Three Pilot Projects
Authors: Pateman Rachel M , Bennett Joyce , Hilton Anthony C , Romeo-Melody Isabella , Rosenfeld Anton , Routledge Sarah J , Rymer Caroline , Swift Benjamin MC , Way Lucy , Whatford Louise , Wilkinson Naomi C , Worthington Tony , Yandle Lewis , Younis Ayesha S , West Sarah E , Goddard Alan D
Published: August 2024

Citizen science is the partnering of professional scientists and members of the public to answer real world scientific questions. There has been huge growth in citizen science over the past two decades but uptake in microbiology research has, thus far, been relatively limited. Here we demonstrate why this is a missed opportunity. Citizen science is well aligned with microbiology research because sample collection methods can be simplified and used in a variety of environments; projects are expected to appeal to participants as topics are likely to be of relevance to people’s lives and interests, including the health of people and the environment; and projects can also lead to real world impact, including the identification of new drugs or biotechnological solutions. In the second part of the paper we present our reflections from three pilot microbiology projects we have recently completed. In order for the field to grow, people need to share both their successes as well as the challenges they have faced, so others wanting to use the method can learn from these experiences. We share simplified sampling methods for yeast strains from home brewing and baking, antimicrobial resistant bacteria on home grown produce and microbes on chopping boards. However, participation in our projects was limited by a range of factors, including time available and resourcing, which impacted on our ability to generate new knowledge and wider impacts. We provide recommendations for others wishing to run microbiology citizen science projects, including ensuring appropriate resourcing and considering ethical implications of projects.
Beyond Lectures: Leveraging Competition, Peer Discussion, and Real-World Scenarios in a Digital Card Game to Enhance Learning of Microbiology and Immunology Concepts
Authors: Dillon Michael James , Edwards James , Hughes Alexandra , Stephenson Holly N
Published: August 2024

Teaching the complex interactions between hosts and pathogens is a fundamental yet educationally challenging aspect of life science and healthcare education. The intricate mechanisms of the immune system can pose significant barriers to students’ understanding of infectious disease diagnosis and treatment. To address this, we used a web-based digital whiteboard platform to design a card-based competitive game called Micro-Immune Battles, aimed at more actively engaging students with microbiology and immunology to better develop their knowledge and underlying concepts.
The game facilitates learning through a series of infectious disease scenarios, providing student teams with "immune system response cards" that represent various immune elements. Working in teams, learners must construct sequential card cascades that correctly correspond to the specified pathogen in the scenario. This reinforces the temporal progression of immune responses, whilst encouraging the application of theoretical knowledge to practical cases. Scoring is determined by the accuracy and speed of card placements, incentivising rapid yet correct synthesis of knowledge. Points are deducted for incorrect placements, introducing an element of calculated risk-taking and critical reasoning. Analysis showed statistically significant improvements in microbiology and immunology knowledge after playing the game.
Identification of gene targets that potentiate the action of rifampicin on Mycobacterium bovis BCG
Authors: Chand Pooja , Mendum Tom A. , Butler Rachel E. , Hingley-Wilson Suzanne M. , Stewart Graham R.
Published: August 2024

Tuberculosis (TB) caused by bacteria of the Mycobacterium tuberculosis complex remains one of the most important infectious diseases of mankind. Rifampicin is a first line drug used in multi-drug treatment of TB, however, the necessary duration of treatment with these drugs is long and development of resistance is an increasing impediment to treatment programmes. As a result, there is a requirement for research and development of new TB drugs, which can form the basis of new drug combinations, either due to their own anti-mycobacterial activity or by augmenting the activity of existing drugs such as rifampicin. This study describes a TnSeq analysis to identify mutants with enhanced sensitivity to sub-minimum inhibitory concentrations (MIC) of rifampicin. The rifampicin-sensitive mutants were disrupted in genes of a variety of functions and the majority fitted into three thematic groups: firstly, genes that were involved in DNA/RNA metabolism, secondly, genes involved in sensing and regulating mycobacterial cellular systems, and thirdly, genes involved in the synthesis and maintenance of the cell wall. Selection at two concentrations of rifampicin (1/250 and 1/62 MIC) demonstrated a dose response for mutants with statistically significant sensitivity to rifampicin. The dataset reveals mechanisms of how mycobacteria are innately tolerant to and initiate an adaptive response to rifampicin; providing putative targets for the development of adjunctive therapies that potentiate the action of rifampicin.
Revealing the Auxetic Behavior of Biomimetic Multi-material and Region-specific Nanofibrous Scaffolds via Synchrotron Multiscale Digital Volume Correlation: Innovative Building Blocks for the Enthesis Regeneration
Authors: Sensini Alberto , Giacomini Francesca , Stamati Olga , Lukic Bratislav , Villanova Julie , Proudhon Henry , Gille Maryse , Birgani Zeinab Tahmasebi , Truckenmüller Roman , Tozzi Gianluca , van Griensven Martijn , Moroni Lorenzo
Published: August 2024

Enthesis lesions are one of the prevalent causes of injuries in the tendon tissue. The gradient of mineralization, extracellular matrix organization and auxetic mechanical properties, make enthesis regeneration challenging. Innovative electrospun fascicle-inspired nanofibrous poly(L-lactic)acid/collagen type I blend scaffolds were developed. Specifically, a mineralized fibrocartilage-inspired region (with/without nano-mineralization with hydroxyapatite), where random and aligned nanofibers coexist, is connected to a tendon-like region made of aligned nanofibers, through a conical non-mineralized fibrocartilage-inspired junction. Scanning electron microscopy and synchrotron nano-tomography show the morphological biomimicry of scaffolds with the natural tendon fascicles. Human mesenchymal stromal cells spheroids cultures confirm a balanced expression of both tendon, cartilage and bone markers on the non-mineralized scaffolds compared with the mineralized ones. Mechanical tests, at different physiological strain-rates, reveal a biomimetic mechanical behavior of scaffolds and the ability of junctions to tune the mechanics of their surrounding sites. Multiscale synchrotronin situtensile tests, coupled with Digital Volume Correlation, elucidate the full-field strain distribution of scaffolds from the structural down to the nanofiber level, highlighting the auxetic mechanical behavior of junctions typical of the natural enthesis. The findings and cutting-edge investigations of our study suggest the suitability of these enthesis-inspired fascicles as innovative scaffolds for enhanced enthesis regeneration.
Applying a Random Forest Approach in Predicting Health Status in Patients with Carotid Artery Stenosis 30 Days Post-Stenting
Authors: Qureshi Omar , Mena-Hurtado Carlos , Romain Gaëlle , Cleman Jacob , Callegari Santiago , Smolderen Kim G.
Published: August 2024

Background

Approximately 20% of ischemic strokes in the U.S. result from carotid artery stenosis. Carotid artery stenting (CAS) can reduce stroke risk, but variability in post-stenting health outcomes and their predictors are poorly understood. We examined 30-day post-CAS health status and derived its most important clinical predictors.

Methods

The SAPPHIRE Worldwide Registry measured pre-procedural and 30-day health status for carotid artery stenosis patients undergoing transfemoral-CAS using the SF-36 or EQ-5D between 2010-2014. Four health status scores were calculated: SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS), EQ-5D Index Value and Visual Analogue Scale (VAS). Random Forest models ranked 66 pre-procedural candidate variables by relative importance in predicting 30-day post-CAS health status, stratified by symptomatic status. Variables with highest importance were used to develop predictive multivariable linear regression models. Model accuracy was assessed via Out of Bag accuracy and R-square, respectively.

Results

Health status was assessed using the SF-36 in 3,017 patients and EQ-5D in 3,390 patients. Random Forest models demonstrated high accuracy (86.7% - 95.2%) and identified nine key predictors of post-stenting health status: pre-procedural health status (RI 100%), Modified Rankin Scale (RI 26.2-76.5%), NIH Stroke Scale (RI 12.1-28.0%), history of stroke (RI 9.2- 19.8%), congestive heart failure (RI 12.3-19.7%), spinal immobility (RI 6.7-31.0%), diabetes mellitus (RI 8.1-32.9%), severe pulmonary disease/COPD (RI 13.8-45.6%), and non-Hispanic/Latino ethnicity (RI 8.4-32.4%). Multivariable linear regression models explained ∼36- 61% of health status variance, with the asymptomatic SF-36 PCS model explaining 61%. SF-36 PCS and MCS models outperformed EQ-5D Index Value and VAS models regarding R-square and visual fit of observed vs. predicted values.

Conclusions

We successfully derived prediction models for patient-centered outcomes following CAS which partially explained 30-day post-CAS health status outcomes. Pre-procedural health status, stroke scale scores, and medical comorbidities should be considered when discussing health status benefits in pre-CAS treatment decision discussions.
scatterbar: an R package for visualizing proportional data across spatially resolved coordinates
Authors: Velazquez Dee , Fan Jean
Published: August 2024

Displaying proportional data across many spatially resolved coordinates is a challenging but important data visualization task, particularly for spatially resolved transcriptomics data. Scatter pie plots are one type of commonly used data visualization for such data but present perceptual challenges that may lead to difficulties in interpretation. Increasing the visual saliency of such data visualizations can help viewers more accurately identify proportional trends and compare proportional differences across spatial locations. We developed scatterbar, an open-source R package that extends ggplot2, to visualize proportional data across many spatially resolved coordinates using scatter stacked bar plots. We apply scatterbar to visualize deconvolved cell-type proportions from a spatial transcriptomics dataset of the adult mouse brain to demonstrate how scatter stacked bar plots can enhance the distinguishability of proportional distributions compared to scatter pie plots.

Availability and implementation

Scatterbar is available athttps://github.com/JEFworks-Lab/scatterbarwith additional documentation and tutorials athttps://jef.works/scatterbar/.
TissuePlot: A Multi-Scale Interactive Visualization Tool for Spatial Data
Authors: Khawatmi Muhammed , Sailem Heba
Published: August 2024

Abstract

Visualization of spatial datasets is essential for understanding biological systems that are composed of several interacting cell types. For example, gene expression data at the molecular level needs to be interpreted based on cell type, spatial context, tissue type, and interactions with the surrounding environment. Recent advances in spatial profiling technologies allow measurements of the level of thousands of proteins or genes at different spatial locations along with corresponding cellular composition. Representing such high dimensional data effectively to facilitate data interpretation is a major challenge. Existing methods such as spatially plotted pie charts obscure underlying tissue regions and necessitate switching between different views for comprehensive interpretations. Here, we present TissuePlot, a novel method for visualizing spatial data. TissuePlot tackles the key challenge of visualizing multi-scale phenotypic data at molecular, cellular and tissue level in the context of their spatial locations. To this end, TissuePlot employs a transparent hexagon tesselation approach that utilizes object borders to represent cell composition or gene-level data without obscuring the underlying cell image. Moreover, we implement a multi-view interactive approach, to allow interrogating spatial tissue data at multiple scales linking molecular information to tissue anatomy and motifs. We demonstrate TissuePlot utility using mouse brain data from the Bio+MedVis Redesign Challenge 2024. Our tool is accessible athttps://sailem-group.github.io/TissuePlot/.
Membrane fusion-based drug delivery liposomes transiently modify the material properties of synthetic and biological membranes
Authors: Hammond Jayna , Richards Ceri J. , Ko YouBeen , Jonker Thijs , Åberg Christoffer , Roos Wouter H. , Lira Rafael B.
Published: August 2024

Many drug targets are located in intracellular compartments of cells but they often remain inaccessible to standard imaging and therapeutic agents. To aid intracellular delivery, drug carrier nanoparticles have been used to overcome the barrier imposed by the plasma membrane. The carrier must entrap large amounts of cargo, efficiently and quickly deliver the cargo in the cytosol or other intracellular compartments, and must be as inert as possible. In other words, they should not induce cellular responses or alter the cell state in the course of delivery. Here, we show that cationic liposomes with high charge density efficiently fuse with synthetic membranes and the plasma membrane of living cells. Direct fusion efficiently delivers large amounts of cargo to cells and cell-like vesicles within seconds, bypassing slow and often inefficient internalization-based pathways. These effects depend on liposome charge density and, to some extent, liposome concentration and the helper lipid. However, fusion-mediated cargo delivery results in the incorporation of large amounts of foreign lipids that leads to changes in the material properties of these membranes, namely modifications in membrane packing and fluidity, induction of membrane curvature, decrease in surface tension and the formation of (short-lived) pores. Importantly, these effects are transient and liposome removal allows cells to recover their state prior to liposome interaction.
A common phthalate replacement disrupts ovarian function in young adult mice
Authors: Potts Courtney , Harbolic Allison , Murphy Maire , Jojy Michelle , Hanna Christine , Nadeem Maira , Alahmadi Hanin , Martinez Stephanie , Warner Genoa R
Published: August 2024

Di-2-ethylhexyl terephthalate (DEHTP) is a replacement for its structural isomer di-2-ethylhexyl phthalate (DEHP), a known endocrine disrupting chemical and ovarian toxicant. DEHTP is used as a plasticizer in polyvinyl chloride products and its metabolites are increasingly found in biomonitoring studies at levels similar to phthalates. However, little is known about the effects of DEHTP on the ovary. In this research, we tested the hypothesis that DEHTP is an ovarian toxicant and likely endocrine disrupting chemical like its isomer DEHP. The impact of environmentally relevant exposure to DEHTP and/or its metabolite mono-2-ethylhexyl terephthalate (MEHTP) on the mouse ovary was investigated in vivo and in vitro. For the in vivo studies, young adult CD-1 mice were orally dosed with vehicle, 10 ug/kg, 100 ug/kg, or 100 mg/kg of DEHTP for 10 days. For the in vitro studies, isolated untreated ovarian follicles were exposed to vehicle, 0.1, 1, 10, or 100 ug/mL of DEHTP or MEHTP. Follicle counts, hormone levels, and gene expression of steroidogenic enzymes, cell cycle regulators, and apoptosis factors were analyzed. In vivo, DEHTP exposure increased primordial follicle counts at 100 ug/kg and 100 mg/kg and decreased primary follicle counts at 100 mg/kg compared to control. DEHTP exposure also decreased expression of cell cycle regulators and apoptotic factors compared to control. In vitro, follicle growth was reduced by 1 ug/mL DEHTP and 1, 10, and 100 ug/mL MEHTP compared to controls, and expression of the cell cycle regulator Cdkn2b was increased. Steroid hormone levels and steroidogenic enzyme gene expression trended toward decreases in vivo, whereas progesterone was significantly increased by exposure to 100 ug/mL MEHTP in vitro. Overall, these results suggest that DEHTP and MEHTP may be ovarian toxicants at low doses and should be subjected to further scrutiny for reproductive toxicity due to their similar structures to phthalates.
Exposures and conditions prior to age 16 are associated with dementia status among adults in the United States Health and Retirement Study
Authors: Cockell Scarlet , Wang Herong , Benke Kelly S. , Ware Erin B. , Bakulski Kelly M.
Published: August 2024

Background

Dementia susceptibility likely begins years before symptoms. Early life has not been comprehensively tested for dementia associations.

Method

In the US Health and Retirement Study (normal baseline cognition; n=16,509; 2008-2018 waves), 31 exposures before age 16 were retrospectively assessed with ten-year incident cognitive status (dementia, impaired, normal). Using parallel logistic models, each exposure was tested with incident cognition, adjusting for sex, baseline age, follow-up, race/ethnicity, personal/parental education.

Result

14.5% had incident impairment and 5.3% had dementia. Depression was associated with 1.71 (95%CI:1.28,2.26) times higher odds of incident impairment, relative to normal cognition. Headaches/migraines were associated with 1.63 (95%CI:1.18,2.22) times higher odds of incident impairment. Learning problems were associated with 1.75 (95%CI:1.05,2.79) times higher odds of incident impairment. Childhood self-rated health of fair (1.86, 95%CI:1.27,2.64) and poor (3.39, 95%CI:1.91,5.82) were associated with higher incident dementia odds, relative to excellent.

Conclusion

Early life factors may be important for impairment or dementia, extending the relevant risk window.
Content quality versus sharing practices on social media: A cross-sectional analysis of nutrition information on Twitter
Authors: Ellis Cassandra H. , Ho Peter , Moore J Bernadette , Evans Charlotte E.L.
Published: August 2024

Objective

To use the validated Online Quality Assessment Tool (OQAT) to assess; the quality of online nutrition information, the difference between re-tweeted articles, and the impact of original information source.

Setting

Twitter (X) as little known about the quality of nutrition information shared on the platform.

Design

Tweet Archiver collected tweets including the word ‘nutrition’ on seven randomly selected days in 2021. Tweets were screened for URL inclusion and grouped based on retweet status. URLs were assessed using the OQAT. Rasch measures defined quality levels (low, satisfactory, and high-quality), while mean differences of retweeted and non-retweeted data were assessed by the Mann-Whitney U test. The Cochran-Mantel-Haenszel test was used to compare information quality by source.

Results

In total, 10,573 URLs were collected from 18,230 tweets. After screening for relevance, 1,005 articles were assessed (9,568 were out of scope) sourced from: professional-blogs (n=354), news-outlets (n=213), companies (n=166), personal-blogs (n=120), NGOs (n=60), magazines (n=55), universities (n=19), government (n=18). Rasch measures indicated the quality levels; 0-3.48, poor, 3.49-6.3, satisfactory and, 6.4-10, high quality. Personal and company-authored blogs were more likely to rank as poor quality. There was a significant difference in quality of retweeted (n=267, sum of rank, 461.6) and non-retweeted articles (n=738, sum of rank, 518.0), U = 87475, p=0.006, but no significant effect of information source on quality.

Conclusions

Lower-quality nutrition articles were more likely to be retweeted. Caution is required when using or sharing articles, particularly from companies and personal blogs, which tended to be lower-quality sources of nutritional information.
A Large Harmonized Upper and Lower Limb Accelerometry Dataset: A Resource for Rehabilitation Scientists
Authors: Miller Allison E. , Lohse Keith R. , Bland Marghuretta D. , Konrad Jeffrey D. , Hoyt Catherine R. , Lenze Eric J. , Lang Catherine E.
Published: August 2024

Wearable sensors can measure movement in daily life, an outcome that is salient to patients, and have been critical to accelerating progress in rehabilitation research and practice. However, collecting and processing sensor data is burdensome, leaving many scientists with limited access to such data. To address these challenges, we present a harmonized, wearable sensor dataset that combines 2,885 recording days of sensor data from the upper and lower limbs from eight studies. The dataset includes 790 individuals ages 0 – 90, nearly equal sex proportions (53% male, 47% female), and representation from a range of demographic backgrounds (69.4% White, 24.9% Black, 1.8% Asian) and clinical conditions (46% neurotypical, 31% stroke, 7% Parkinson’s disease, 6% orthopedic conditions, and others). The dataset is publicly available and accompanied by open source code and an app that allows for interaction with the data. This dataset will facilitate the use of sensor data to advance rehabilitation research and practice, improve the reproducibility and replicability of wearable sensor studies, and minimize costs and duplicated scientific efforts.
Obstructive Sleep Apnea is a Risk Factor for Incident COVID-19 Infection
Authors: Quan Stuart F. , Weaver Matthew D. , Czeisler Mark É. , Barger Laura K. , Booker Lauren A. , Howard Mark E. , Jackson Melinda L. , McDonald Christine F. , Ridgers Anna , Robbins Rebecca , Varma Prerna , Rajaratnam Shantha M.W. , Czeisler Charles A.
Published: August 2024

Cross-sectional studies suggest that obstructive sleep apnea (OSA) is a potential risk factor for incident COVID-19 infection, but longitudinal studies are lacking. In this study, two surveys from a large general population cohort, the COVID-19 Outbreak Public Evaluation (COPE) Initiative, undertaken 147 ± 58 days apart were analyzed to determine whether the pre-existing OSA was a risk factor for the incidence of COVID-19. Of the 24,803 respondents completing the initial survey, 14,950 were negative for COVID-19; data from the follow-up survey were available for 2,325 respondents. Those with incident COVID-19 infection had a slightly higher prevalence of OSA (14.3 vs. 11.5%, p=0.068). Stratification by treatment status revealed that those untreated for their OSA were at greater risk for developing COVID-19 infection (OSA Untreated, 14.2 vs. 7.4%, p≤0.05). In a logistic regression model adjusted for comorbidities, demographic and socioeconomic factors and the interaction between vaccination status and OSA, incident COVID-19 infection was 2.15 times more likely in those with untreated OSA (aOR: 2.15, 95% CI: 1.18-3.92, p≤0.05). Stratification by treatment status revealed only untreated OSA participants were at greater risk for COVID-19 (aOR: 3.21, 95% CI: 1.25-8.23, p≤0.05). The evidence from this study confirms untreated OSA as a risk factor for acquiring COVID-19 infection and highlights the importance of actively treating and managing OSA as a preventative mechanism against COVID-19 disease.
Decomposition of phenotypic heterogeneity in autism reveals distinct and coherent genetic programs
Authors: Litman Aviya , Sauerwald Natalie , Snyder LeeAnne Green , Foss-Feig Jennifer , Park Christopher Y. , Hao Yun , Dinstein Ilan , Theesfeld Chandra L. , Troyanskaya Olga G.
Published: August 2024

Unraveling the phenotypic and genetic complexity of autism is extremely challenging yet critical for understanding the biology, inheritance, trajectory, and clinical manifestations of the many forms of the condition. Here, we leveraged broad phenotypic data from a large cohort with matched genetics to characterize classes of autism and their patterns of core, associated, and co-occurring traits, ultimately demonstrating that phenotypic patterns are associated with distinct genetic and molecular programs. We used a generative mixture modeling approach to identify robust, clinically-relevant classes of autism which we validate and replicate in a large independent cohort. We link the phenotypic findings to distinct patterns ofde novoand inherited variation which emerge from the deconvolution of these genetic signals, and demonstrate that class-specific common variant scores strongly align with clinical outcomes. We further provide insights into the distinct biological pathways and processes disrupted by the sets of mutations in each class. Remarkably, we discover class-specific differences in the developmental timing of genes that are dysregulated, and these temporal patterns correspond to clinical milestone and outcome differences between the classes. These analyses embrace the phenotypic complexity of children with autism, unraveling genetic and molecular programs underlying their heterogeneity and suggesting specific biological dysregulation patterns and mechanistic hypotheses.
A Modeling Analysis on Eliminating Racial/Ethnic Disparities in HIV Incidence in the United States
Authors: Jacobson Evin Uzun , Viguerie Alex , Bates Laurel , Hicks Katherine , Honeycutt Amanda A. , Carrico Justin , Lyles Cynthia , Farnham Paul G.
Published: August 2024

Background

Despite progress in HIV prevention and treatment, resulting in overall incidence reductions in the United States, large racial/ethnic (r/e) disparities in HIV incidence remain due to stigma, discrimination, racism, poverty, and other social and structural factors.

Setting

We used the HIV Optimization and Prevention Economics (HOPE) model to analyze which intervention strategies provide the most effective path towards eliminating r/e disparities in HIV incidence.

Methods

We considered four intervention scenarios for 2023-2035, which focused on eliminating r/e disparities by 2027 in the HIV care continuum only, HIV prevention services only, both continuum and prevention services, and a final scenario where prevention and care levels for Black and Hispanic/Latino were set to maximum feasible levels. The primary outcome is the incidence-rate-ratio (IRR) for Black and Hispanic/Latino populations compared to Other populations (of whom 89% are White) with the goal of IRRs ≤ 1 by 2035.

Results

All scenarios reduced IRRs but onlyMaximum Feasibleeliminated HIV incidence disparities by 2035, with respective IRRs of 0.9 and 1.1 among the Black and Hispanic/Latino populations, compared to 6.5 and 4.1 in the baseline scenario.Continuum-onlywas more effective at reducing disparities (2035 IRRs of 4.7 for Black and 3.1 for Hispanic/Latino populations) thanPrevention-only(6.1 and 3.7 respectively).

Conclusions

With no prioritized changes, our simulation showed that r/e disparities in HIV incidence persist through 2035. Elimination of r/e incidence disparities by 2035 is only possible if maximum HIV prevention and care levels for Black and Hispanic/Latino populations can be realized by 2027.
The diagnostic value of plasma phosphorylated tau 181 in Alzheimer’s disease within the Chinese population: A systematic review and meta-analysis
Authors: Yan Keqiang , He Shuxin , Jia Xiaodong , Li Haiyan , Liu Dequan , Chen Jianchun
Published: August 2024

Among all related biomarkers, plasma phosphorylated tau (p-tau181) has demonstrated strong diagnostic performance in the very early stages of Alzheimer’s disease (AD), showing significant differences between AD patients and healthy controls. The aim of our present systematic review and meta-analysis was to roundly evaluate the clinical diagnostic value of plasma p-tau181 based on the Simoa platform in Chinese populations. We systematically searched five databases (Embase, PubMed, Cochrane Library, MEDLINE, and Web of Science) from inception to May 11th, 2024, as well as the references of retrieved relevant articles. We included prospective cohort studies and retrospective case-control studies in our analysis. Out of 1165 identified articles, 10 met the inclusion criteria for meta-analysis. Our quantitative analysis showed that plasma p-tau181 levels were significantly increased in patients with AD and mild cognitive impairment (MCI) compared to healthy controls (standard mean difference [SMD]: 1.45 [1.25 – 1.65], p<0.00001; SMD: 0.55 [0.31 – 0.78], p<0.00001) and were lower in MCI patients compared to AD patients (SMD: -0.88 [-0.93 – -0.82], p<0.00001). The reference values for plasma p-tau181 were 4.48 [95% confidence interval (CI): 4.01 – 5.00] for AD patients, 2.86 [95% CI: 2.45 – 3.34] for MCI patients, and 2.09 [95% CI: 1.90 – 2.30] for healthy controls. The meta-analysis confirmed that plasma p-tau181 significantly increases from healthy controls to mild cognitive impairment (MCI) and then to AD in the Chinese population. We also provide reliable reference values for plasma p-tau181, which contribute to the early diagnosis of AD in Chinese clinical settings.
Reimagining Cryptogenic Stroke Care: Collaborative Care and Inpatient Insertable Cardiac Monitors for Detection of Atrial Fibrillation
Authors: Herial Nabeel A. , Frisch Daniel R. , Miller Elan , Patel Priyadarshee , Munoz Alfredo , Warren Melissa , Khalife Jane , Majmundar Shyam , Farkas Nathan , Alam Shaista , Dharia Robin , Tzeng Diana , Pavri Behzad B. , Ho Reginald T. , Greenspon Arnold , Bell Rodney , Jabbour Pascal , Rosenwasser Robert
Published: August 2024

Background

Atrial fibrillation (AF) is a known risk factor of ischemic stroke and AF-related stroke is twice more likely to be fatal. Long-term cardiac rhythm monitoring using insertable cardiac monitors (ICMs) has greater diagnostic yield compared to conventional monitoring in detecting AF, and clinical utility of ICMs is established in cryptogenic stroke, strokes due to large artery atherosclerosis and small vessel disease. A registry-based study was conducted to evaluate inpatient implantation of ICMs and feasibility of vascular and interventional neurologists as implanters using novel collaborative clinical care pathway for cryptogenic stroke.

Methods

Multiyear data from a hospital-based registry at a comprehensive stroke center was reviewed to evaluate inpatient ICM implantation and test feasibility of vascular and interventional neurologists/VIN as implanters of ICMs together with cardiology using a novel collaborative care pathway. Reviewed data included number of ICMs, implantation trend, inpatient vs. outpatient setting, time to ICM implantation, inpatient workflow including defined roles of team members, and AF detection rate.

Results

Total of 290 ICMs for cryptogenic stroke were implanted when patients where in the hospital and 78 as outpatient after discharge during the study period of 3 years. The majority of inpatient ICM implants were performed by VIN (n=181) and ICM use for cryptogenic stroke increased by 130%. Average time to inpatient ICM implant was 4.1 days with 77% in 5 and 95.5% within 10 days post-stroke. Average time to out-patient ICM placement was 57 days. AF detection rate of 36.5% was noted at 24 months with a collaborative care pathway.

Discussion

Inpatient implantation of ICMs is feasible and was performed safely and efficiently by VIN together with cardiology using a collaborative care pathway. Increase in utilization of ICMs and higher AF detection rates were noted. Findings support innovative efforts to improve access and close the gaps in delivery of cryptogenic stroke care to ultimately reduce the secondary stroke burden.

Clinical Perspective

Direct inpatient implantation of ICMs in cryptogenic stroke allows increased rates of early long-term cardiac rhythm monitoring and detection of AF.

Collaborative clinical practice with inpatient ICM implantation by vascular and interventional neurologists is feasible and safe. This novel approach could potentially increase access to cardiac rhythm monitoring and exemplify patient-centered care.
Comparison of the results of in-person and mobile phone surveys for a health facility assessment in Tajikistan: a validation study protocol
Authors: Fernandez Pablo Amor , Neill Rachel , Bhatia Ruchika , Sharma Jigyasa , Andrews Kathryn , Neelsen Sven , Pinder Etoile , Abdullaev Marifat , Safarova Firuza , Latypova Mutriba , Sjoblom Mirja Channa , Ahmed Tashrik , Peters Michael A. , Sheffel Ashley , Hashemi Tawab , Hansen Peter Meredith , Muhsinzoda Gafur , Shapira Gil
Published: August 2024

Health facility assessments provide important data to measure the quality of health services delivered to populations. These assessments are comprehensive, resource intensive, and periodic to inform medium-to-longer-term policies. However, in absence of other reliable data sources, country decision makers often rely on outdated data to address service delivery challenges that change more frequently. High-frequency phone surveys are a potential option to improve the efficiency and timeliness of collecting time-sensitive service delivery indicators in-between comprehensive in-person assessments. The objectives of this study are to assess the reliability, concurrent criterion validity, and non-response rates in a rapid phone-based health facility assessment developed by the Global Financing Facility’s FASTR initiative compared to a comprehensive in-person health facility assessment developed by the World Bank’s Service Delivery Indicators Health Program. The in-person survey and corresponding in-person item verification will serve as the gold standard. Both surveys will be administered to an identical sample of 500 health facilities in Tajikistan using the same data collection entity. To assess reliability, percent agreement, Cohens Kappa, and prevalence and bias adjusted Kappa will be calculated. To assess concurrent criterion validity, sensitivity and specificity will be calculated, with a cut-off of .7 used for adequate validity. The study will further compare response rates and dropout rates of both surveys using simple t-tests and balance tests to identify if the characteristics of the phone-based and in-person survey samples are similar after accounting for any differences in survey response rates. The results of this study will provide important insights into the reliability and validity of phone-based data collection approaches for health facility assessments. This is critical as Ministries of Health seek to establish and sustain more continuous data collection, analysis, and use of health facility-level data to complement periodic in-person assessments to improve the quality of services provided to their populations.
Predicting the global economic costs of biological invasions by tetrapods
Authors: Bodey Thomas W , Cuthbert Ross N. , Diagne Christophe , Marino Clara , Turbelin Anna , Angulo Elena , Fantle-Lepczyk Jean , Pincheira-Donoso Daniel , Courchamp Franck , Hudgins Emma J
Published: August 2024

Globalisation has steadily accelerated rates of biological invasions worldwide, leading to widespread environmental perturbations that often translate into rapidly expanding socioeconomic costs. Although such monetary costs can be estimated based on the observed effects of invasions, the pathways that lead invasive species to become economically impactful remain poorly understood. Here, we implement the first global-scale test of the hypothesis that adaptive traits that influence demographic resilience predict economic costs, using invasive terrestrial vertebrates as models given their rising impacts and well-catalogued characteristics. Our results reveal that total global costs of invasive tetrapods are conservatively in the tens of billions of dollars, with the vast majority due to damage costs from invasive mammals. These monetary impacts are predicted by longevity, female maturation age, diet and invasional pathway traits, although the directionality of predicted economic impacts also varied by trait across classes. Alarmingly, costs remain unknown for >90% of recorded established alien tetrapods worldwide, and across the majority of invaded countries. These huge socio-economic costs demonstrate the necessity of mitigating tetrapod invasions and filling knowledge gaps. Effective identification of traits predictive of costs among and within these groups can facilitate the prioritisation of resources to efficiently target the most damaging existing and emerging invasive tetrapod species.