bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcriptomic Signatures of Antibody-mediated Rejection in Early Biopsies With Negative Histology in HLA-incompatible Kidney Transplantation
Authors: Hruba Petra , Klema Jiri , Mrazova Petra , Girmanova Eva , Jaklova Katerina , Voska Ludek , Kment Martin , Mackova Martina , Osickova Klara , Hanzal Vladimir , Halloran Philip F. , Viklicky Ondrej 
Published: December 2024

Background.
Presensitized patients with circulating donor-specific antibodies (DSAs) before transplantation are at risk for antibody-mediated rejection (AMR). Peritransplant desensitization mitigates but does not eliminate the alloimmune response. We examined the possibility that subthreshold AMR activity undetected by histology could be operating in some early biopsies.

Methods.
Transcriptome of kidney allograft biopsies performed within the first month in presensitized patients (DSA+) who had received desensitization and did not develop active/probable AMR by histology (R–) was compared with biopsies showing active/probable AMR (R+/DSA+). As negative controls, biopsies without rejection by histology in patients without DSA at transplantation were used (R–/DSA–). RNA sequencing from biopsies selected from the biobank was used in cohort 1 (n = 32) and microarray, including the molecular microscope (Molecular Microscope Diagnostic System [MMDx]) algorithm, in recent cohort 2 (n = 30).

Results.
The transcriptome of R–/DSA+ was similar to R+/DSA+ as these groups differed in 14 transcripts only. Contrarily, large differences were found between both DSA+ groups and negative controls. Fast gene set enrichment analyses showed upregulation of the immune system in both DSA+ groups (gene ontology terms: adaptive immune response, humoral immune response, antigen receptor-mediated signaling, and B-cell receptor signaling or complement activation) when compared with negative controls. MMDx assessment in cohort 2 classified 50% of R–/DSA+ samples as AMR and found no differences in AMR molecular scores between R+ and R– DSA+ groups. In imlifidase desensitization, MMDx series showed a gradual increase in AMR scores over time.

Conclusions.
Presensitized kidney transplant recipients exhibited frequent molecular calls of AMR in biopsy-based transcript diagnostics despite desensitization therapy and negative histology.
Care process for breast cancer patients with sleep disturbances: a best practice implementation project
Authors: Chuang Chia-Wen , Li Chuan-Fang , Chiang Ming-Chu , Wu Shih-Chung , Li Yun-Fun , Liu Shu-Chien , Wang Mei-Wen , Liao Wen-Chun 
Published: December 2024

ABSTRACT

Introduction:
Patients with breast cancer are 50% more likely to experience sleep disturbances during treatment. Sleep disturbances may affect physiological and psychological functions and even induce cancer recurrence. Screening, assessment, and management of sleep disturbances improves sleep quality in breast cancer patients.

Objectives:
This project aimed to establish a care process for breast cancer patients with sleep disturbances in a cancer ward.

Methods:
The project was implemented using the JBI Evidence Implementation Framework, which is grounded in audit and feedback. A baseline audit examined the existing care for sleep disturbances in breast cancer patients undergoing chemotherapy. Eight criteria were applied to evaluate compliance with best practice recommendations. A JBI Getting Research into Practice (GRiP) analysis was conducted, and five barriers to recommended practices were identified. Fourteen improvement strategies were then implemented and a follow-up audit was conducted to measure changes in practice.

Results:
The baseline audit showed that the sleep screening rate was 71% (Criterion 1). However, for the remaining criteria (2–8), the compliance rate was 0%. After project implementation, all criteria improved. Thus, 100% of nurses received education on sleep disturbance; the screening rate increased to 90%; 100% of screened patients received comprehensive sleep assessment; and 100% of assessed patients received tailored, multimodal sleep management based on their assessment results.

Conclusions:
This project improved compliance with evidence-based practices in caring for breast cancer patients with sleep disturbances. Process orientation, interdisciplinary collaboration, and leadership contributed to project success. Further studies in digitalized sleep assessment are needed to ensure the efficiency and sustainability of sleep care.

Spanish abstract:

http://links.lww.com/IJEBH/A300
The impact of sub-national heterogeneities in demography and epidemiology on the introduction of rubella vaccination programs in Nigeria
Authors: Nakase Taishi , Brownwright Tenley , Okunromade Oyeladun , Egwuenu Abiodun , Ogunbode Oladipo , Lawal Bola , Akanbi Kayode , Grant Gavin , Bassey Orji O. , Coughlin Melissa M. , Bankamp Bettina , Adetifa Ifedayo , Metcalf Jessica , Ferrari Matthew 
Published: December 2024

ABSTRACTRubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80%. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.
Evaluating Predictive Value ofSchistosoma mansoniPrevalence and Infection Intensity in School-Age Children in Estimating Community-Wide Prevalence in Siaya County, Western Kenya
Authors: Wanja Dollycate , Odiere Maurice R. , Kavere Emmy A. , Muchiri Geoffrey , Awandu Shehu Shagari 
Published: December 2024

AbstractBackgroundVarious milestones have been set targeting the elimination of schistosomiasis with the vision of “a world free of schistosomiasis” including the 2020 and 2025 goals. Despite the increased control and prevention efforts, schistosomiasis still affects many people, partly because treatment doesn’t cover all at-risk populations. Preventive chemotherapy (PC), the cornerstone of control interventions is primarily inclined toward school-age children (SAC), whose prevalence also informs interventions for other age groups in the community. Whereas prevalence in SAC has been shown to be a good indicator of the prevalence in other age groups, it remains to be seen as if this is not true in different epidemiological settings and risk areas.MethodsThis study evaluated the predictive value of schistosomiasis prevalence among SAC in estimating community-wide prevalence in Siaya County, Kenya. A single stool sample was collected from participants aged 2-50 years. Stool samples were collected from preschool-age children (2-6 years), SAC (7-14 years), adolescents (15 to <18 years), and adults (≥18-50 years) in a cross-sectional survey. The prevalence and intensity ofSchistosoma mansoniinfection were determined using the Kato-Katz technique (single stool, 4 slides) and compared across the age groups and risk categories (low >0 to <10%; moderate ≥10% to <50%; and high (≥50%).ResultsOf the 1,814 participants sampled, 25.6% (95% CI: 23.7-27.7) were infected withS. mansoni. There was no significant difference between the mean egg intensity ofS. mansoniin SAC compared to the other age groups. There was a strong positive correlation between SAC prevalence and intensity and community-wide prevalence and intensity; rs=0.8, P<0.001, and rs=0.6, P<0.001 respectively. A positive relationship between the overallS. mansoniprevalence andS. mansoniprevalence in SAC was observed. The regression analysis indicated that SAC prevalence/intensity can be used to predict overallS. mansoniprevalence/intensity. In terms of age groups, it can predict in all age groups but adolescents.ConclusionsIn this setting, generally, the prevalence ofS. mansoniamong SAC was a good predictor of the prevalence in other age groups and the overall (all age groups combined) prevalence. However, in terms of risk strata SAC data was only a good predictor of overall prevalence and intensity only in the moderate risk stratum. These findings suggest thatS. mansoniprevalence and intensity among SAC are valid for community sampling purposes and informing interventions including MDA at the community level.
Adjusting for medication status in genome-wide association studies
Authors: Chong Amanda H.W. , Kintu Christopher , Cho Yoonsu , Fatumo Segun , Torres Jason , Smith George Davey , Gaunt Tom R. , Hemani Gibran 
Published: December 2024

AbstractWhen conducting genome-wide association studies, improper handling of medication status that is relevant to the trait of interest can induce biases by opening up different pathways that distort estimates of the true effect. Here, we propose the genetic empirical medication reduction adjustment (GEMRA) method which uses a heuristic search for an empirical adjustment to be applied to phenotypic values of participants reporting medication use. Through simulations we show that the direct genetic effect estimates in the GEMRA approach exhibited less bias and greater statistical power than either restricting the sample to unmedicated users, or including all samples without adjustment. We then applied the GEMRA approach to estimate statin medication adjustment for analysis of LDL cholesterol levels, using multi ancestry data from UK Biobank and the Uganda Genome Resource. We found that a relative rather than an absolute adjustment better modelled the effect of medication on LDL cholesterol, with an effect of 40% reduction appearing to be consistent across ancestral groups. These findings are consistent with the current clinical guidelines.
SalmonellaSenftenberg isolated from wastewater is linked to a 2022 multistate outbreak
Authors: Goldblum Zoe S. , M’ikanatha Nkuchia M. , Nawrocki Erin M. , Cesari Nicholas , Kovac Jasna , Dudley Edward G 
Published: December 2024

AbstractThe ability of wastewater-based surveillance (WBS) to infer viral loads in communities was showcased during the COVID-19 pandemic. Whether WBS could be used to track other microorganisms is less studies. We tested forSalmonella enterica, a common foodborne pathogen, in community wastewater and investigated whether such isolates could be linked to past or ongoing outbreaks. During June 2022, composite wastewater samples were collected from treatment facilities in two communities in central Pennsylvania. A total of 42 confirmedS. entericaisolates were whole genome sequenced, revealing 7 different serovariants. Four isolates identified asS. entericaser. Senftenberg were in a cluster, separated by 0-4 SNPs from clinical isolates uploaded to the web-based National Centers for Biotechnology Information Pathogen Detection platform. Most isolates in the cluster were previously associated with a 2022 multistate foodborne outbreak that was caused by contaminated peanut butter. Our targeted study suggests that wastewater-based surveillance forSalmonellawould complement public health efforts by providing information about the extent of an outbreak and help focus public health resources and guidance to areas most impacted.
Increase but pronounced regional disparities in gamma-hydroxybutyrate (GHB) prescriptions among Medicaid and Medicare patients
Authors: Barnhart Josephine R. , Vujovich Sondra A. , Piper Brian J. 
Published: December 2024

AbstractBackgroundGamma-hydroxybutyrate (GHB) is a Schedule III drug in the US approved for treatment of cataplexy associated with narcolepsy. Narcolepsy with cateplaxy is a rare disorder with an annual incidence of less than one per one-hundred thousand and GHB is a third-line treatment. The purpose of this study was to describe the temporal pattern of GHB distribution and cost nationally and between states for Medicaid and Medicare patients.MethodsGHB prescriptions were extracted from the State Utilization Data Tool fromMedicaid.govand the Medicare part D Prescribers by Provider and Drug Dataset fromCMS.gov. GHB prescriptions were examined by state when corrected for population. States outside a 95% confidence interval were considered statistically significant. GHB cost analyses were performed between 2017-2021. GHB prescribers were identified for Medicare in 2019.ResultsThere was a steady increase in prescriptions (+88.5%) from 2019 to 2021 and spending (+39.6%) from 2017 to 2020 for Medicaid. Specialists other than somnologists, were found to prescribe the highest number of GHB prescriptions to Medicare Part D enrollees. In 2019, two states (Hawaii and North Dakota) did not prescribe GHB to Medicare patients versus twenty states for Medicaid patients. Maryland’s prescribing to Medicare patients was significantly elevated (269.2/100K).ConclusionGHB prescribing has increased to Medicaid and Medicare patients. Further research is necessary to understand how the COVID-19 pandemic and off-label prescribing (e.g. for excessive daytime sleepiness) may have affected these findings including the origins of the pronounced state level disparities.
Characteristics of children readmitted with severe pneumonia in Kenyan hospitals
Authors: Marangu-Boore Diana , Mwaniki Paul , Isaaka Lynda , Njoroge Teresiah , Mumelo Livingstone , Kimego Dennis , Adem Achieng , Jowi Elizabeth , Ithondeka Angeline , Wanyama Conrad , Agweyu Ambrose 
Published: December 2024

AbstractBackgroundPneumonia is a leading cause of childhood morbidity and mortality. Hospital re-admission may signify missed opportunities for care or undiagnosed comorbidities.MethodsWe conducted a retrospective cohort study including children aged ≥2 months to 14 years hospitalised with severe pneumonia between 2013 and 2021 in a network of 22 primary referral hospitals in Kenya. Severe pneumonia was defined using the World Health Organization criteria, and re-admission was based on clinical documentation from individual patient case notes. We estimated the prevalence of re-admission, described clinical management practices, and modelled risk factors for re-admission and inpatient mortality.ResultsAmong 20,603 children diagnosed with severe pneumonia, 2,274 (11.0%, 95% confidence interval (CI) 10.62 to 11.47) were readmitted. Re-admission was independently associated with age (12-59 months vs 2-11 months: adjusted odds ratio (aOR) 1.70, 95% confidence interval (CI) 1.55 to 1.88; >5 years vs 2-11 months: aOR 1.86, 95% CI 1.55 to 2.23), malnutrition (weight for age z-score (WAZ) < -3SD vs WAZ > -2SD: aOR 2.03, 95%1.83 to 2.28); WAZ -2 to -3 SD vs WAZ> -2SD: aOR 1.37, 95% CI 1.20 to 1.56) and presence of a concurrent neurological disorder (aOR 4.04, 95% CI 1.57 to 10.42) . Chest radiography was ordered more frequently among those readmitted (540/2,274 vs 3,102/18,329, p<0.001). Readmitted patients were more likely to receive second-line antibiotics (808/2,256 vs 5,538/18,173 p<0.001), TB medication (69/2,256 vs 298/18,173 p<0.001), salbutamol (530/2,256 vs 3,707/18,173 p=0.003), and prednisolone (157/2,256 vs 764/18,173 p<0.001). Inpatient mortality was 2,354/18,329 (12.8%) among children admitted with a first episode of severe pneumonia and 269/2,274 (11.8%) among those who were readmitted (adjusted hazard ratio (aHR) 0.94, 95% CI 0.82-1.07). Age (12-59 months vs 2-11 months: aHR 0.62, 95% 0.57 to 0.67), female sex (aHR 1.23, 95% 1.14 to 1.33), malnutrition (WAZ <-3SD vs WAZ> -2SD: aHR 1.90 95% CI 1.74 to 2.08); WAZ -2 to -3 SD vs WAZ> -2SD: aHR 1.48, 95% CI 1.32 to 1.65), incomplete vaccination (aHR 1.43, 95% CI 1.16 to 1.75), and anaemia (aHR 2.16, 95% CI 1.90 to 2.45) were independently associated with mortality.ConclusionsChildren readmitted with severe pneumonia account for a substantial proportion of pneumonia hospitalisations and deaths. Further research is required to develop evidence-based approaches to screening, case management, and follow-up of children with severe pneumonia, prioritising those with underlying risk factors for readmission and mortality.
Prevalence and correlates of Human Papillomavirus infection in females from Southern Province, Zambia: A cross-sectional study
Authors: Muchaili Lweendo , Simushi Precious , Mweene Bislom C. , Mwakyoma Tuku , Masenga Sepiso K. , Hamooya Benson M. 
Published: December 2024

AbstractBackgroundHuman papillomavirus (HPV) infection is strongly associated with cervical cancer with almost all cases being associated with the infection. Cervical cancer is the leading cause of cancer death among women in Zambia and the fourth leading cause of cancer death in women worldwide. However, there is limited data on the burden and associated factors of HPV in sub-Saharan Africa. This study aimed to determine the prevalence and correlates of HPV infection in the Southern province of Zambia.MethodsThis was a cross-sectional study conducted at Livingstone University Teaching Hospital (LUTH) among 4,612 women from different districts of the southern province being screened for HPV infection between September 2021 and August 2022. Demographic and clinical data were collected from an existing laboratory programmatic database. Multivariable logistic regression was used to estimate the factors associated with HPV infection.ResultsThe study participants had a median age of 39 years [interquartile range (IQR) 30, 47]. The prevalence of HPV infection was 35.56% (95%CI). At multivariable analysis, the factors associated with a positive HPV result were younger age (adjusted odds ratio (AOR) 0.98; 95% confidence interval (CI) 0.98-0.99; p. value 0.001), having provider collected sample (AOR 2.15; 95%CI 1.66 -2.79; p. value <0.001) and living with HIV (AOR 1.77; 95%CI 1.22 – 2.55; p. value <0.002).ConclusionThe prevalence of HPV in women in the southern province of Zambia is high, and likely influenced by age and HIV status. Additionally, the outcome of the HPV test is affected by the sample collection method. Therefore, there is a necessity to enhance HPV and cervical cancer screening, especially among people with HIV.
Risk of subsequent primary cancers among adult cancer survivors in Alberta
Authors: Warkentin Matthew T. , Cheung Winson Y. , Brenner Darren R. , O’Sullivan Dylan E. 
Published: December 2024

AbstractBackgroundImprovements in cancer control have led to a drastic increase in cancer survivors who may be at an elevated risk of developing a subsequent primary cancer (SPC). In this study, we assessed the risk and patterns of SPC development among 134,693 adult cancer survivors in Alberta, Canada.MethodsWe used data from the Alberta Cancer Registry to identify all first primary cancers (FPC) occurring between 2004 and 2015. A SPC was considered as the next primary cancer occurring in a different site. We estimated standardized incidence ratios (SIR) for SPC development as the observed number of SPC (O) divided by the expected number of SPC (E), where E is a weighted-sum of the population-based year-age-sex-specific incidence rates and the corresponding person-years of follow-up.ResultsThe risk of developing a SPC up to fifteen years after an initial cancer was 16.1% for males and 12.3% for females, though these estimates vary considerably by cancer site. Survivors of initial head and neck cancers had a 21.3% fifteen-year cumulative incidence and a 2.5-fold relative risk of SPC development. Overall, both males (SIR=1.50) and females (SIR=1.64) had an increased risk of a SPC. There were significant increases in SPC risk for nearly all age groups, with a greater than 5-fold increase for survivors of cancers diagnosed between ages 18-39.ConclusionsCancer survivors of nearly every FPC site had substantially increased risk of a SPC, compared to the cancer risk in the general population. Screen-detectable cancers (breast, cervical, colorectal, lung) were common SPC sites and highlights the need to investigate optimal strategies for screening the growing population of cancer survivors.
Protection of natural infection against reinfection with SARS-CoV-2 JN.1 variant
Authors: Chemaitelly Hiam , Coyle Peter , Kacem Mohamed Ali Ben , Ayoub Houssein H. , Tang Patrick , Hasan Mohammad R. , Yassine Hadi M. , Al Thani Asmaa A. , Al-Kanaani Zaina , Al-Kuwari Einas , Jeremijenko Andrew , Kaleeckal Anvar H. , Latif Ali N. , Shaik Riyazuddin M. , Abdul-Rahim Hanan F. , Nasrallah Gheyath K. , Al-Kuwari Mohamed Ghaith , Butt Adeel A. , Al-Romaihi Hamad E. , Al-Thani Mohamed H. , Al-Khal Abdullatif , Bertollini Roberto , Abu-Raddad Laith J. 
Published: December 2024

AbstractThis study investigated the effectiveness of natural infection in preventing reinfection with the JN.1 variant during a large JN.1 wave in Qatar, using a test-negative case-control study design. The overall effectiveness of previous infection in preventing reinfection with JN.1 was estimated at only 1.8% (95% CI: −9.3-12.6%). This effectiveness demonstrated a rapid decline over time since the previous infection, decreasing from 82.4% (95% CI: 40.9-94.7%) within 3 to less than 6 months after the previous infection to 50.9% (95% CI: −11.8-78.7%) in the subsequent 3 months, and further dropping to 18.3% (95% CI: −34.6-56.3%) in the subsequent 3 months. Ultimately, it reached a negligible level after one year. The findings show that the protection of natural infection against reinfection with JN.1 is strong only among those who were infected within the last 6 months, with variants such as XBB*. However, this protection wanes rapidly and is entirely lost one year after the previous infection. The findings support considerable immune evasion by JN.1.