bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Burden of Clostridioides difficile in Ontario, Canada
Authors: Pereira Jennifer A , McGeer Allison , Tomovici Antigona , Selmani Alex , Chit Ayman 
Published: December 2019

Abstract

Background
To understand the clinical burden of Clostridioides difficile infection (CDI), we analyzed health outcome data from Ontario, Canada for CDI associated with and manifested in acute care hospitals (ACH), long-term care facilities (LTCF), the community, or ACH-associated with community-onset.

Methods
We performed a retrospective analysis using individual-level data from Ontario databases (April 1, 2005 to March 31, 2015), identifying CDI cases ≥18 years requiring hospitalization, and stratifying into cohorts based on association and onset location. Cohort members were matched to controls on demographics and medical conditions at onset, for outcomes including 30- and 180-day all-cause mortality and rehospitalization.

Results
We stratified 22 617 individuals hospitalized with CDI during the study period: 13 152 (58.1%) ACH-associated/ACH-onset, 7116 (31.5%) community-associated/community-onset, 1847 (8.2%) ACH-associated/community-onset, and 502 (2.2%) LTCF-associated/LTCF-onset. Compared with controls, unadjusted 30-day rehospitalization rates were significantly higher (P &lt; .0001) for ACH-associated/ACH-onset CDI (9.5% vs 0.4%), LTCF-associated/LTCF-onset (7.2% vs 1.1%), community-associated/community-onset (7.8% vs 0.8%), and ACH-associated/community-onset (10.9% vs 0.7%). One hundred eighty-day mortality rates were higher in the community-associated/community-onset and the LTCF-associated/LTCF-onset cohorts than controls: 66.3% vs 12.3% (P &lt; .0001) and 30.9% vs 3.1% (P &lt; .0001), respectively. All differences remained significant after adjusting for patient factors.

Conclusions
Clostridioides difficile infection is associated with higher rates of 30-day rehospitalization compared with controls. In addition, mortality rates within 180-days of hospital discharge are significantly higher for community-associated/community-onset and LTCF-associated/LTCF-onset CDI cohorts than controls. Clostridioides difficile infection warrants increased prevention and monitoring efforts.
Markers of CNS Injury in Adults Living With HIV With CSF HIV Not Detected vs Detected &lt;20 Copies/mL
Authors: Farhadian Shelli F , Mistry Hetal , Kirchwey Tobias , Chiarella Jennifer , Calvi Rachela , Chintanaphol Michelle , Patel Payal , Landry Marie L , Robertson Kevin , Spudich Serena S 
Published: December 2019

Abstract
The presence of quantifiable HIV RNA in cerebrospinal fluid (CSF) during antiretroviral therapy (ART) can associate with central nervous system (CNS) pathology, but the significance of RNA detected below the limit of quantification (LOQ) on a standard assay during ART remains unknown. We compared CNS parameters between individuals with CSF RNA detected below the LOQ (20 copies/mL) with those with HIV RNA not detected. Detection of CSF HIV RNA associated with decreased blood–brain barrier integrity and with decreased executive function, but not with CNS immune activation or poorer performance in overall neuropsychological testing.
Clinical Outcomes Following the Use of Archived Proviral HIV-1 DNA Genotype to Guide Antiretroviral Therapy Adjustment
Authors: Ellis Kristen E , Nawas George T , Chan Connie , York Lawrence , Fisher Julia , Connick Elizabeth , Zangeneh Tirdad T 
Published: December 2019

AbstractBackgroundEvidence regarding the safety of using proviral HIV-1 DNA genotype (DNA GT) to guide antiretroviral therapy (ART) is limited. We hypothesized that HIV RNA would not increase following ART adjustment guided by DNA GT in a university HIV clinic.MethodsData were obtained from electronic medical records of adult persons living with HIV-1 (PWH) who underwent DNA GT testing and changed ART between October 2014 and November 2017. Logistic regression was used to evaluate the effect of ART switch on HIV RNA over time.ResultsEighty-three PWH had DNA GT performed, 66 (80%) switched ART, and 59 had postswitch follow-up. Data were analyzed pre-/postswitch for these 59 PWH (median age, 54 years; 71% LWH ≥10 years; 46% ≥2 previous regimens; 36% recent low-level viremia; 34% unknown medication history). On DNA GT, 58% had ≥1-class ART resistance, 34% ≥2-class, and 10% 3-class. Median follow-up (range) was 337 (34–647) days. There was no change in probability of HIV RNA ≥50 copies/mL over time (P &gt; .05). At baseline, 76% had HIV RNA &lt;50 vs 88% at last postswitch follow-up (P = .092). Protease inhibitor use decreased from 58% to 24% (P &lt; .001). Average daily pills and dosing frequency decreased from 3.48 to 2.05 (P &lt; .001) and 1.39 to 1.09 (P &lt; .001), respectively; ART cost did not change.ConclusionsDNA GT facilitated changes in ART in a treatment-experienced population without increases in HIV RNA. Decreased pill burden occurred without increased ART cost. Further studies to identify optimal use of DNA GT are needed.
Snoring: a source of noise pollution and sleep apnea predictor
Authors: Sowho Mudiaga , Sgambati Francis , Guzman Michelle , Schneider Hartmut , Schwartz Alan 
Published: December 2019

Abstract
Snoring is a highly prevalent condition associated with obstructive sleep apnea (OSA) and sleep disturbance in bed partners. Objective measurements of snoring in the community, however, are limited. The present study was designed to measure sound levels produced by self-reported habitual snorers in a single night. Snorers were excluded if they reported nocturnal gasping or had severe obesity (BMI &gt; 35 kg/m2). Sound was measured by a monitor mounted 65 cm over the head of the bed on an overnight sleep study. Snoring was defined as sound ≥40 dB(A) during flow limited inspirations. The apnea hypopnea index (AHI) and breath-by-breath peak decibel levels were measured. Snore breaths were tallied to determine the frequency and intensity of snoring. Regression models were used to determine the relationship between objective measures of snoring and OSA (AHI ≥ 5 events/h). The area under the curve (AUC) for the receiver operating characteristic (ROC) was used to predict OSA. Snoring intensity exceeded 45 dB(A) in 66% of the 162 participants studied, with 14% surpassing the 53 dB(A) threshold for noise pollution. Snoring intensity and frequency were independent predictors of OSA. AUCs for snoring intensity and frequency were 77% and 81%, respectively, and increased to 87% and 89%, respectively, with the addition of age and sex as predictors. Snoring represents a source of noise pollution in the bedroom and constitutes an important target for mitigating sound and its adverse effects on bed partners. Precise breath-by-breath identification and quantification of snoring also offers a way to risk stratify otherwise healthy snorers for OSA.
Genetic and Epigenetic Intratumor Heterogeneity Impacts Prognosis of Lung Adenocarcinoma
Authors: Hua Xing , Zhao Wei , Pesatori Angela C. , Consonni Dario , Caporaso Neil E. , Zhang Tongwu , Zhu Bin , Wang Mingyi , Jones Kristine , Hicks Belynda , Song Lei , Sampson Joshua , Wedge David , Shi Jianxin , Landi Maria Teresa 
Published: December 2019

AbstractIntratumor heterogeneity (ITH) of genomic alterations may impact prognosis of lung adenocarcinoma (LUAD). We investigated ITH of somatic copy number alterations (SCNAs), DNA methylation, and point mutations in lung cancer driver genes in 292 tumor samples from 84 LUAD patients. We found substantial SCNA and methylation ITH, and clonal architecture analyses showed congruent evolutionary trajectories for SCNAs and DNA methylation aberrations. Interestingly, methylation ITH mapping to gene promoter areas or tumor suppressor genes was low. Moreover, ITH composed of genetic and epigenetic mechanisms altering the same cancer driver genes was found in several tumors. To quantify ITH for valid statistical association analyses we developed an average pairwise ITH index (APITH), which does not depend on the number of samples per tumor. APITH indexes for SCNAs and methylation aberrations were both significantly associated with poor prognosis. This study further establishes the important clinical implications of genetic and epigenetic ITH in LUAD.
Metabolomics pilot study identifies circadian desynchronization and distinct intra-patient variability patterns in critical illness
Authors: Lusczek Elizabeth R. , Parsons Lee , Elder Jesse , Harvey Stephen B. , Skube Mariya , Muratore Sydne , Beilman Greg , Cornelissen-Guillaume Germaine 
Published: December 2019

AbstractBackgroundSynchronized circadian rhythms play a key role in coordinating physiologic health. Desynchronized circadian rhythms may predispose individuals to disease or be indicative of underlying disease. Intensive care unit (ICU) patients likely experience desynchronized circadian rhythms due to disruptive environmental conditions in the ICU and underlying pathophysiology. This observational pilot study was undertaken to determine if circadian rhythms are altered in ICU patients relative to healthy controls by profiling circadian rhythms in vital signs and plasma metabolites.MethodsWe monitored circadian rhythms in 5 healthy controls and 5 ICU patients for 24 hours. Heart rate and blood pressure were measured every 30 minutes, temperature was measured every hour, and blood was sampled for mass spectrometry-based plasma metabolomics every 4 hours. Bedside sound levels were measured every minute. Circadian rhythms were evaluated in vitals and plasma metabolites individually and in each group using the cosinor method.ResultsICU patient rooms were significantly louder than healthy controls’ rooms and average noise levels were above EPA recommendations. Healthy controls generally had significant circadian rhythms individually and as a group. While a few ICU patients had significant circadian rhythms in isolated variables, no significant rhythms were identified in ICU patients as a group, except in cortisol. This indicates a lack of coherence in circadian phases and amplitudes among ICU patients. Finally, principal component analysis of metabolic profiles showed surprising patterns in plasma sample clustering. Each ICU patient’s samples were clearly discernable in individual clusters, separate from a single cluster of healthy controls.ConclusionsICU patients’ circadian rhythms show significant desynchronization compared to healthy controls. Clustering of plasma metabolic profiles suggests that metabolomics could be used to track individual patients’ clinical courses longitudinally. Our results show global disordering of metabolism and the circadian system in ICU patients which should be characterized further in order to determine implications for patient care.
A novel art of continuous non-invasive blood pressure measurement
Authors: Fortin Jürgen , Rogge Dorothea , Fellner Christian , Flotzinger Doris , Grond Julian , Lerche Katja , Saugel Bernd 
Published: December 2019

AbstractWearable sensors to continuously measure blood pressure (BP) and derived cardiovascular variables have the potential to revolutionize patient monitoring. Current wearable methods analyzing time components (e.g., pulse transit time) still lack clinical accuracy, whereas existing technologies for direct BP measurement are too bulky. Here we present a new art of continuous non-invasive arterial blood pressure monitoring (CNAP2GO). It directly measures BP by using a new “volume control technique” and could be used for small wearable sensors integrated in a finger ring. As a software prototype, CNAP2GO showed excellent BP measurement performance in comparison with invasive BP in 46 patients having surgery. The resulting pulsatile BP signal carries information to derive cardiac output and other hemodynamic variables. We show that CNAP2GO can be miniaturized for wearable approaches. CNAP2GO potentially constitutes the breakthrough for wearable sensors for blood pressure and flow monitoring in both ambulatory and in-hospital clinical settings.
Considering the APOE locus in polygenic scores for Alzheimer’s disease
Authors: Ware Erin B. , Faul Jessica D. , Mitchell Colter M. , Bakulski Kelly M. 
Published: December 2019

AbstractPolygenic scores are a strategy to aggregate the small, additive effects of single nucleotide polymorphisms across the genome. With phenotypes like Alzheimer’s disease, which have a strong and well established genomic locus (APOE), the cumulative effect of genetic variants outside of this area has not been well established in a population-representative sample. Here we examine the association between polygenic scores both with and without the APOE region at different P value thresholds. We also investigate the addition of APOE-ε4 carrier status and its effect on the polygenic score – dementia association. We found that including the APOE region through weighted variants in a polygenic score was insufficient to capture the large amount of risk attributed to this region. We recommend removing this region from polygenic score calculation and treating the APOE locus as an independent covariate.
Using Media to Promote Public Awareness of Early Detection of Kaposi’s Sarcoma in Africa
Authors: Laker-Oketta Miriam , Butler Lisa , Kadama-Makanga Philippa , Inglis Robert , Wenger Megan , Katongole-Mbidde Edward , Maurer Toby , Kambugu Andrew , Martin Jeffrey 
Published: December 2019

AbstractBackgroundDespite its hallmark cutaneous presentation, most Kaposi’s sarcoma (KS) in Africa is diagnosed too late for effective treatment. Early diagnosis will only be achievable if patients with KS present earlier for care. We hypothesized that public awareness about KS can be enhanced through exposure to common media.MethodsWe developed educational messages regarding early detection of KS for the general African public portraying a three-part theme: “Look” (regularly examine one’s skin/mouth); “Show” (bring to the attention of a healthcare provider any skin/mouth changes); and “Test” (ask for a biopsy for definitive diagnosis). We packaged the messages in three common media forms (comic strips, radio, and video) and tested their effect on increasing KS awareness among adults attending markets in Uganda. Participants were randomized to a single exposure to one of the media and evaluated for change in KS-related knowledge and attitudes.ResultsAmong 420 participants, media exposure resulted in increased ability to identify KS (from 0.95% pre-test to 46% post-test); awareness that anyone is at risk for KS (29% to 50%); belief that they may be at risk (63% to 76%); and knowledge that definitive diagnosis requires biopsy (23% to 51%) (all p<0.001). Most participants (96%) found the media culturally appropriate.ConclusionExposure to media featuring a theme of “Look”, “Show”, “Test” resulted in changes in knowledge and attitudes concerning KS among the general public in Uganda. High incidence and poor survival of KS in Africa are an impetus to further evaluate these media, which are freely available online.
Prevalence and associated factors of pterygium among adults living in Kolla diba town, Northwest Ethiopia
Authors: Alemayehu Tibebu Kassie , Addis Yezinash , Bizuneh Zewdu Yenegeta , Tegegne Mebratu Mulusew , Alemayehu Abiy Maru 
Published: December 2019

AbstractIntroductionPterygium is a disfiguring disease that can potentially lead to blindness and has a significant public health problem in rural areas. It is more common in warm, windy and dry climates of tropical and sub-tropical “pterygium belt” regions of Africa, including Ethiopia. Globally, the prevalence ranging from 0.07% to 53%. Studies conducted on the prevalence of pterygium in developing countries like Ethiopia were limited with wider discrepancy between them.ObjectiveThe aim of this study was to assess the prevalence of pterygium and associated factors among adults in Kolla Diba town, Northwest Ethiopia, 2019.MethodA community-based cross-sectional study was done in Kolla Diba town from May 30-June 16, 2019. Systematic random sampling technique was used to select 627 study participants. Data was collected through basic ophthalmic examination with portable slit lamp, 3x magnifying loop and torchlight and a pretested structured questionnaire was administered to collect the data. Then the data entered into EPI INFO version 7 and analyzed using SPSS version 20. Descriptive statistics and binary logistic regression analysis were employed. P-values of <0.05 was considered statistically significant.ResultA total of 605 study participants were involved with a response rate of 96.5%. Among them 317 (52.4%) participants were males. The mean age of the respondents was 38.18 ± 15.56 with a range of (18-95) in years. The overall Prevalence of pterygium among adults living in Kolla Diba town was 112 (18.5% (95% CI (15.6-21.7)). Being widowed (AOR = 7.32 (95%CI: 2.88, 18.57)), outdoor occupation (AOR = 2.50 (95%CI: 1.46, 4.29)), sun exposure (AOR = 2.38 (95%CI: 1.28, 4.43)), wind exposure (AOR = 1.97 (95%CI: 1.04, 3.72)), alcohol drinking (AOR = 2.26 (95%CI: 1.48, 4.63)), and severe blepharitis (AOR = 2.45 (95%CI: 1.48, 4.05)) had statistically significant positive association with pterygium.ConclusionThe prevalence of pterygium was relatively higher. Marital status (being widowed), outdoor occupation, sun exposure, wind exposure, alcohol drinking, and severe blepharitis were significantly associated with the development of pterygium.
Towards early risk biomarkers: serum metabolic signature in childhood predicts cardio-metabolic risk in adulthood
Authors: Ojanen Xiaowei , Cheng Runtan , Törmäkangas Timo , Wu Na , Rappaport Noa , Wilmanski Tomasz , Yan Wei , Price Nathan D. , Cheng Sulin , Wiklund Petri 
Published: December 2019

AbstractCardiovascular diseases have their origin in childhood. Early biomarkers identifying individuals with increased risk for disease are needed to support early detection and to optimize prevention strategies. By applying machine learning approach on high throughput NMR-based metabolomics data, we identified metabolic predictors of cardiovascular risk in circulation in a cohort of 396 females, followed from childhood (mean age 11.2 years) to early adulthood (mean age 18.1 years). The identified childhood metabolic signature included three circulating biomarkers robustly associating with increased cardiovascular risk in early adulthood (AUC = 0.641 to 0.802, all p<0.01). These associations were confirmed in two validation cohorts including middle-aged women, with similar effect estimates. We subsequently applied random intercept cross-lagged panel model analysis, which suggested causal relationship between metabolites and cardio-metabolic risk score from childhood to early adulthood. These results provide evidence for the utility of circulating metabolomics panel to identify children and adolescents at risk for cardiovascular disease, to whom preventive measures and follow-up could be indicated.
Satellite glial cells promote regenerative growth in sensory neurons
Authors: Avraham Oshri , Deng Pan-Yue , Jones Sara , Kuruvilla Rejji , Semenkovich Clay F. , Klyachko Vitaly A. , Cavalli Valeria 
Published: December 2019

SUMMARYPeripheral sensory neurons switch to a regenerative state after nerve injury to enable axon regeneration and functional recovery. Intrinsic mechanisms operating in sensory neurons are known to regulate nerve repair, but whether satellite glial cells (SGC), which completely envelop the neuronal soma, undergo injury-evoked transcriptional changes and contribute to nerve regeneration remains unexplored. This is largely due to the lack of molecular and genetic tools to study SGC. Using a single cell RNAseq approach to define the transcriptional profile of SGC in naïve and injured conditions, we reveal that these cells are distinct from Schwann cells and share similarities with astrocytes. We find that nerve injury elicits gene expression changes in SGC, which are related to fatty acid synthesis and peroxisome proliferator-activated receptor (PPARα) signaling. Conditional deletion of Fatty acid synthase (Fasn), the committed enzyme inde novofatty acid synthesis, in SGC, impairs axon regeneration. The PPARα agonist fenofibrate rescues the impaired axon regeneration in mice lacking Fasn in SGC, indicating that PPARα functions downstream of fatty acid synthesis in SGC to promote axon regeneration. These results identify fatty acid synthesis in SGC as a fundamental novel mechanism mediating axon regeneration in adult peripheral nerves. These results also highlight that the sensory neuron and its surrounding glial coat form a functional unit that orchestrates nerve repair.
Non-ionic CT Contrast Solutions Rapidly Alter Bovine Cartilage and Meniscus Mechanics
Authors: Baylon Eva G. , Crowder Hollis A. , Gold Garry E. , Levenston Marc E. 
Published: December 2019

AbstractObjectiveTo evaluate effects of a common CT contrast agent (iohexol) on the mechanical behaviors of cartilage and meniscus.MethodsIndentation responses of juvenile bovine cartilage and meniscus were monitored following exposure to undiluted contrast agent (100% CA), 50% CA/water, 50% CA/Phosphate Buffered Saline (PBS) or PBS alone, and during re-equilibration in PBS. The normalized peak force, effective osmotic strain (εosm), and normalized effective contact moduluswere calculated for every cycle, with time constants determined for both exposure and recovery via mono- or biexponential fits to.ResultsAll cartilage CA groups exhibited long-term increases infollowing exposure, although the hyperosmolal 100% CA and 50% CA/PBS groups showed an initial transient decrease. Meniscus presented opposing trends, with decreasingfor all CA groups. Re-equilibration in PBS for 1hr after exposure to 100% CA did not produce recovery to baselinein either tissue. The recovery time for meniscus was substantially longer than that of cartilage.increased with CA exposure time for cartilage but decreased for meniscus, suggesting an increased effective stiffness for cartilage and decreased stiffness for meniscus. Long-term changes toεosmin both tissues were consistent with changes in.ConclusionExposure to iohexol solutions affected joint tissues differentially, with increased cartilage stiffness, likely relating to competing hyperosmotic and hypotonic interactions with tissue fixed charges, and decreased meniscus stiffness, likely dominated by hyperosmolarity. These altered tissue mechanics could allow non-physiological deformation during ambulatory weight-bearing, resulting in an increased risk of tissue or cell damage.
Visual impairment, spectacle wear and academic performance among junior high school students in western China
Authors: Nie Jingchun , Nie Wei , Mu Ming , Zhang Lifang , Song Shuyi , Peng Lanxi , Gao Qiufeng , Yang Jie 
Published: December 2019

AbstractIn September 2013, 2248 students from 36 junior high schools in Shaanxi Province underwent assessment of visual acuity (VA), completed a questionnaire about their spectacle use and were administered a standardized mathematics examination. Among 2,248 students (mean age 13.6 years, 52% male), visual impairment was present in 699 (31%, 95% Confidence Interval 29-33%). Spectacle wear was observed in 360 of 966 children needing glasses (37%). Ownership of spectacles among children needing glasses was associated with poorer uncorrected vision in the better-seeing eye (P <0.001) and paternal educational (p=0.001), but not age, sex, boarding at school, both parents having out-migrated for work or maternal education. Spectacle ownership among children with visual impairment was associated with better test performance (P=0.035). Therefore, visual impairment and non-wear of spectacle were common. Wearing spectacles was associated with better academic performance in this cross-sectional analysis, consistent with recent trial results among younger children.