bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perpendicular drill bit alignment provides a practical guidance to determine the appropriate suture anchor insertion angle during acetabular labral repair
Authors: Ismailoglu Abdul Veli , Ozdogmus Omer , Karaman Muhammed Ilkay , Kayaalp Asim , Kocaoglu Baris 
Published: August 2021

ABSTRACT
The safe acetabular rim angle is an anatomical measurement used to determine the safety margin when inserting suture anchors. The purpose of the present study was to find out whether aligning the drill bit perpendicularly during arthroscopic surgery can provide a reference point for determining an appropriate angle to facilitate the suture anchor insertion and to prevent extra- and intra-articular perforations. One hundred computed tomographic hips were used to reconstruct three-dimensional acetabular hip models. Each model was radially sectioned at the 4 o’clock, 3 o’clock and anterior inferior iliac spine (AIIS) positions (that corresponded mainly to the 2:20 clock position). A perpendicular reference line, representing a perpendicular drill bit alignment, was drawn for each position within the acetabular model, and its relation to the safe acetabular rim angle was measured. The length of the perpendicular reference line and the effect of gender on measurements were also evaluated. The mean safe acetabular rim angle at the 3 o’clock position was significantly smaller compared to other clock positions (P &lt; 0.001). The perpendicular reference line was located out of the safe acetabular rim angle in 28 cases (%28), mostly in female acetabula at the 3 o’clock position, and relative to the perpendicular reference line the required minimal angle was 4° ± 2.3° to place the anchor in the safe acetabular rim angle to avoid extra-articular perforation. The perpendicular reference line was shortest at the 3 o’clock position, and its mean length was shorter in female acetabula at all clock positions (P &lt; 0.001). Aligning the drill bit perpendicular to the acetabular opening plane during an arthroscopic anchor placement is a practical way to estimate and target the position of the safe acetabular rim angle to avoid anchor perforations. Based on measurements from a perpendicularly aligned drill bit, the drill bit should be directed towards the joint minimally by 4° to avoid extra-articular perforations and maximally by 30° to avoid intra-articular perforations.
Anxiety disorders and age-related changes in physiology
Authors: Mutz Julian , Hoppen Thole H. , Fabbri Chiara , Lewis Cathryn M. 
Published: August 2021

AbstractBackgroundAnxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan, and associated with substantially increased morbidity and early mortality.AimsThe aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared to healthy controls.MethodThe UK Biobank study recruited >500,000 adults, aged 37–73, between 2006–2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in cases and in controls.ResultsThe main dataset included 332,078 adults (mean age = 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had a lower hand-grip strength and blood pressure, while their pulse rate and body composition measures were higher than in healthy controls. Case-control differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between female anxiety disorder cases and healthy controls were most evident for blood pressure, pulse rate and body composition, while in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between cases and controls decreased with increasing age.ConclusionsIndividuals with a lifetime history of anxiety disorders differed from healthy controls across multiple physiological measures, with some evidence of case-control differences by age. The differences observed varied by chronicity/severity and depression comorbidity.
External validation of 4C ISARIC mortality score in the setting of a Saudi Arabian ICU. Retrospective study
Authors: Mumtaz Shahzad A. , Shahzad Saima A. , Ahmed Intekhab , Alodat Mohammed A. , Gharba Mohamed , Saif Zohdy A. , Mady Ahmed F. , Mahmood Waqas , Mhawish Huda , Abdulmowla Majd M. , Aletreby Waleed 
Published: August 2021

AbstractCOVID-19 pandemic has burdened healthcare systems, necessitating the development of mortality prediction scores to guide clinical decisions and resource allocation. 4C ISARIC mortality score was developed and validated on a British cohort.ObjectivesExternal validation of the score in the setting of a large Saudi Arabian ICU.MethodRetrospective chart review of COVID-19 patients admitted to ICU of King Saud Medical City, Riyadh, Saudi Arabia. Collecting data to calculate the score, then fitting a ROC curve against known patients’ outcome.ResultsCohort included 1493 patients with 38% mortality, AUC of the score was 0.81 (95% CI: 0.79 – 0.83, p < 0.001), correctly classifying 72.67% of the cohort. Cut-off value of > 9 had sensitivity of 70.5% (95% CI: 66.6 – 74.3), specificity 73.97% (95% CI: 71 – 76.8), positive predictive value 62.4% (95% CI: 59.5 – 65.2), and negative predictive value 80.2% (95% CI: 78.2 – 82.4).Conclusion4C ISARIC mortality risk score performed well with a good discriminatory ability for critically ill patients admitted to ICU in our setting. Cut-off > 9 was the optimal criterion.
Genetic Risk for Hemochromatosis is Associated with Movement Disorders
Authors: Loughnan Robert , Ahern Jonathan , Thompkins Cherisse , Palmer Clare E. , Sugrue Leo , Iversen John , Thompson Wesley , Andreassen Ole , Jernigan Terry , Dale Anders , Boyle Mary ET , Fan Chun Chieh 
Published: August 2021

AbstractHereditary hemochromatosis (HH) is an autosomal recessive genetic disorder that can lead to iron overload, causing oxidative damage to affected organs. HH type 1 is predominantly associated with homozygosity for the mutation p.C282Y. Previous case studies have reported tentative links between HH and movement disorders, e.g., Parkinson’s disease, and basal ganglia abnormalities on magnetic resonance imaging. We investigated the impact of p.C282Y homozygosity: on whole brain T2 intensity differences, a measure of iron deposition, and; on measures of movement abnormalities and disorders within UK Biobank. The neuroimaging analysis (154 p.C282Y homozygotes, 595 matched controls) showed that p.C282Y homozygosity was associated with decreased T2 signal intensity in motor circuits (basal ganglia, thalamus, red nucleus, and cerebellum; Cohen’s d > 1) consistent with substantial iron deposition. Across the whole UK Biobank (2,889 p.C282Y homozygotes, 496,968 controls), we found a significant enrichment for movement abnormalities in male homozygotes (OR (95% CI) = 1.82 (1.27-2.61), p=0.001), but not females (OR (95% CI) = 1.10 (0.69-1.78), p=0.71). Among the 31 p.C282Y homozygote males with a movement disorder only 7 had a concurrent HH diagnosis. These findings indicate susceptibility to iron overload in subcortical structures in p.C282Y homozygotes, and confirmed an increased risk of movement abnormalities and disorders in males. Given the effectiveness of early treatment in HH, screening for p.C282Y homozygosity in high risk individuals may offer a potential avenue to reduce iron accumulation in the brain and limit additional risk for the development of movement disorders among males.
Point-of-care semiquantitative test for adherence to tenofovir alafenamide or tenofovir disoproxil fumarate
Authors: Sevenler Derin , Niu Xin , Dossantos Sandy , Toner Mehmet , Cressey Tim R. , Sandlin Rebecca , Drain Paul 
Published: August 2021

SynopsisObjectiveObjective measurement of antiretrovirals may aid clinical interventions for improving adherence to HIV prevention or treatment regimens. A point-of-care urine test could provide real-time information about recent adherence to regimens containing tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF). We developed a lateral flow immunoassay (LFA) and enzyme-linked immunoassay (ELISA) for urinary tenofovir.MethodsIntensity of the LFA test line was quantified using an optical reader and visually scored 0 – 5 by two independent people, using a reference card. The sensitivity and specificity of both the ELISA and LFA were determined for two different tenofovir concentration cutoffs for TDF and TAF adherence—1,500 ng/mL and 150 ng/mL, respectively. To validate the assays, we measured 586 urine samples from 28 individuals collected as part of a study of tenofovir pharmacokinetics in adults, which were also measured by mass spectrometry as ground truth.ResultsBoth the LFA signal and ELISA signal were each strongly correlated to drug concentrations (0.91 and 0.92 respectively). The LFA signal and ELISA were highly sensitive and specific at both thresholds (LFA se/sp TDF 89%/96%, TAF 90%/96%; ELISA se/sp TDF 94%/94%, TAF 92%/84%). Visual scoring of the LFA was also highly sensitive and specific at both the TDF and TAF thresholds (se/sp TDF 91%/94%, TAF 87%/90%).ConclusionsOur rapid semi-quantitative test can measure TFV concentrations relevant to both TAF or TDF adherence, which may support adherence-promoting interventions across a range of HIV care settings.
Anti-PF4 levels of patients with VITT do not reduce 4 months following AZD1222 vaccination
Authors: Nicolson Phillip L.R. , Montague Samantha J. , Smith Christopher W. , Lodwick Clare S. , Stoneley Charlotte , Roberts Matthew , Watson Steve P. , Lowe Gillian C. , Lester William A. 
Published: August 2021

AbstractBackgroundAnti-Platelet Factor 4 (PF4) IgG antibodies that activate platelets via FcγRIIa have been shown to be an important part of the pathophysiology of vaccine-induced immune thrombocytopenia and thrombosis (VITT). There is now extensive literature on its presentation and initial management. There is no literature however on what happens to these patients following discharge.MethodsWe collected clinical data and samples from seven patients presenting with VITT and followed them up for 82-145 days. We also collected clinical samples from them at last follow-up. Testing for anti-PF4/heparin antibodies was done using an anti-PF4/heparin enzymatic immunoassay. Flow Cytometry was used to look at FcγRIIa levels on patient platelets. Light Transmission Aggregometry with patient serum and healthy donor / patient platelets was used to analyse platelet responsiveness, in the presence and absence of PF4.FindingsAll patients were discharged on direct oral anticoagulants. Two patients remain completely symptom free, three have ongoing headaches, two have residual neurological deficits. Two patients developed mild thrombocytopenia and worsening headache (but without cerebral venous sinus thrombosis) and were retreated, one of these with rituximab. All patients, except the one treated with rituximab, had similar anti-PF4 antibody titres at 80-120 days to their levels at diagnosis. Platelets from patients at follow-up had normal levels of FcγRIIa and had normal responses to thrombin and collagen-related-peptide. Patient serum from diagnosis strongly activated healthy donor platelets in the presence of PF4. Serum from follow-up was much weaker at stimulating platelets, even in the presence of PF4.InterpretationThis study shows that despite similar PF4 antibody titres at diagnosis and during follow-up, there are further differences in patient serum, that are not apparent from currently used testing, that result in lower levels of platelet activation during the follow-up period. Further understanding of these factors are important in order to assess duration of anticoagulation for these patients.FundingThis work was supported by an Accelerator Grant (AA/18/2/34218) from the British Heart Foundation (BHF) and by a National Institute for Health Research (NIHR) grant.Key pointsPF4 antibody titres do not reduce up to 4-months post ChAdOx1 nCoV-19 in patients with VITTDespite similar PF4 antibody titres, diagnostic serum is more potent at activating platelets in the presence of PF4 than follow-up serum.
Fall 2021 Resurgence and COVID-19 Seroprevalence in Canada Modelling waning and boosting COVID-19 immunity in Canada A Canadian Immunization Research Network Study
Authors: Dick David W. , Childs Lauren , Feng Zhilan , Li Jing , Röst Gergely , Buckeridge David L , Ogden Nick H , Heffernan Jane M 
Published: August 2021

AbstractThere is a threat of COVID-19 resurgence in Fall 2021 in Canada. To understand the probability and severity of this threat, quantification of the level of immunity/protection of the population is required. We use an age-structured model including infection, vaccination and waning immunity to estimate the distribution of immunity to COVID-19 in the Canadian population. By late Summer 2021, coinciding with the end of the vaccination program, we estimate that 60 − 80% of the Canadian population will have some immunity to COVID-19. Model results show that this level of immunity is not sufficient to stave off a Fall 2021 resurgence. The timing and severity of a resurgence, however, varies in magnitude given multiple factors: relaxation of non-pharmaceutical interventions such as social distancing, the rate of waning immunity, the transmissibility of variants of concern, and the protective characteristics of the vaccines against infection and severe disease. To prevent large-scale resurgence, booster vaccination and/or re-introduction of public health mitigation may be needed.
Detecting orientation of Brain MR scans using deep learning
Authors: Singhal Chinmay , Gupta Nihit , Stein Anouk , Zhou Quan , Chen Leon , Shih George 
Published: August 2021

AbstractThere has been a steady escalation in the impact of Artificial Intelligence (AI) on Healthcare along with an increasing amount of progress being made in this field. While many entities are working on the development of significant deep learning models for the diagnosis of brain-related diseases, identifying precise images needed for model training and inference tasks is limited due to variation in DICOM fields which use free text to define things like series description, sequence and orientation [1]. Detecting the orientation of brain MR scans (Axial/Sagittal/Coronal) remains a challenge due to these variations caused by linguistic barriers, human errors and de-identification - essentially rendering the tags unreliable [2, 3, 4]. In this work, we propose a deep learning model that identifies the orientation of brain MR scans with near perfect accuracy.
Premature infants display discriminable behavioural, physiological and brain responses to noxious and non-noxious stimuli
Authors: van der Vaart Marianne , Hartley Caroline , Baxter Luke , Mellado Gabriela Schmidt , Andritsou Foteini , Cobo Maria M. , Fry Ria Evans , Adams Eleri , Fitzgibbon Sean , Slater Rebeccah 
Published: August 2021

AbstractPain assessment in preterm infants is challenging, as behavioural, autonomic and neurophysiological measures of pain are reported to be less sensitive and specific than in term infants. Understanding the pattern of preterm infants’ noxious-evoked responses is vital to improve pain assessment in this group. This study investigated the discriminability and development of multi-modal noxious-evoked responses in infants aged 28-40 weeks postmenstrual age. A classifier was trained to discriminate responses to a noxious heel lance from a non-noxious control in 47 infants, using measures of facial expression, brain activity, heart rate and limb withdrawal, and tested in two independent cohorts with a total of 98 infants. The model discriminates responses to the noxious from the non-noxious procedure from 28 weeks onwards with an overall accuracy of 0.77-0.83 and an accuracy of 0.78-0.79 in the 28-31 week group. Noxious-evoked responses have distinct developmental patterns. Heart rate responses increase in magnitude with age, while noxious-evoked brain activity undergoes three distinct developmental stages, including a previously unreported transitory stage consisting of a negative event-related potential between 30-33 weeks postmenstrual age. These findings demonstrate that while noxious-evoked responses change across early development, infant responses to noxious and non-noxious stimuli are discriminable from 28 weeks onwards.
Lifelong association of disorders related to military trauma with subsequent Parkinson’s disease
Authors: Scott Gregory D. , Neilson Lee E. , Woltjer Randy , Quinn Joseph F. , Lim Miranda M. 
Published: August 2021

ABSTRACTBackgroundTrauma-related disorders such as traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are emerging as risk factors for Parkinson’s Disease (PD), but their association with development of PD and independence from comorbid disorders remains unknown. This case-control study examines TBI and PTSD related to early trauma in military veterans.MethodsPD was identified by ICD code, recurrent PD-specific prescriptions, and availability of 5+ years of earlier records. Validation was performed by chart review by a movement disorder-trained neurologist. Controls were matched 4:1 by age, duration of preceding health care, race, ethnicity, birth year, and sex. TBI and PTSD were identified by ICD code and onset based on active duty. Association and interaction were measured for TBI and PTSD with PD going back sixty years. Interaction was measured for comorbid disorders.Results71,933 cases and 287,732 controls were identified. TBI and PTSD increased odds of subsequent PD at all preceding five-year intervals back to year -60 (OR range: 1.5 [1.4,1.7] to 2.1 [2.0,2.1]). TBI and PTSD showed synergism (synergy index range: 1.14 [1.09,1.29] to 1.28 [1.09,1.51]) and additive association (OR range: 2.2 [1.6,2.8] to 2.7 [2.5,2.8]). Chronic pain and migraine showed greatest synergy with PTSD and TBI. Effect sizes for trauma-related disorders were comparable to established prodromal disorders.DiscussionTBI and PTSD are associated with later PD and are synergistic with chronic pain and migraine. These findings provide evidence for TBI and PTSD as risk factors preceding PD by decades and could aid in prognostic calculation and earlier intervention.
Using historical museum samples to examine divergent and parallel evolution in the invasive starling
Authors: Stuart Katarina C. , Sherwin William B. , Austin Jeremy J. , Bateson Melissa , Eens Marcel , Brandley Matthew C. , Rollins Lee A. 
Published: August 2021

1.AbstractDuring the Anthropocene, Earth has experienced unprecedented habitat loss, native species decline, and global climate change. Concurrently, greater globalisation is facilitating species movement, increasing the likelihood of alien species establishment and propagation. There is a great need to understand what influences a species’ ability to persist or perish within a new or changing environment. Examining genes that may be associated with a species’ invasion success or persistence informs invasive species management, assists with native species preservation, and sheds light on important evolutionary mechanisms that occur in novel environments. This approach can be aided by coupling spatial and temporal investigations of evolutionary processes. Here we use the common starling,Sturnus vulgaris,to identify parallel and divergent evolutionary change between contemporary native and invasive range samples and their common ancestral population. To do this, we use reduced-representation sequencing of native samples collected recently in north-western Europe and invasive samples from Australia, together with museum specimens sampled in the UK during the mid-19thCentury. We found evidence of parallel selection on both continents, possibly resulting from common global selective forces such as exposure to pollutants (e.g. TCDD) and food carbohydrate content. We also identified divergent selection in these populations, which might be related to adaptive changes in response to the novel environment encountered in the introduced Australian range. Interestingly, signatures of selection are equally as common within both invasive and native range contemporary samples. Our results demonstrate the value of including historical samples in genetic studies of invasion and highlight the ongoing and occasionally parallel role of adaptation in both native and invasive ranges.
Child Mortality in England During the First Year of the COVID-19 Pandemic
Authors: Odd David , Stoianova Sylvia , Williams Tom , Fleming Peter , Luyt Karen 
Published: August 2021

ABSTRACTOBJECTIVESThe aim of this analysis was to quantify the relative risk of childhood deaths across the whole of England during the first year of the COVID pandemic, compared to a similar period of 2019.DESIGNThis work is based on data collected by the National Child Mortality Database (NCMD) which collates data on all children who die in England. The number of deaths, and their characteristics, from 1st April 2020 until 31st of March 2021 (2020-21), were compared to those from the same period of 2019-20. Relative risk and excess mortality were derived for deaths in 2020-21 vs 2019-20.SETTINGAll deaths reported to NCMD in England of children under 18 years of age, between April 2019 and March 2021.PARTICIPANTS6490 deaths of children, under the age of 18 years, reported to the NCMD over the study period.RESULTSChildren who died between April 2020 and March 2021 had similar demographics to those who died in 2019-20. Overall, there were 356 (198 to 514) fewer deaths in 2020-21 than in 2019-20 (RR 0.90 (0.85-0.94), p<0.001). Repeating the analysis by category of death, suggested that deaths from infection (RR 0.49 (0.38-0.64)) and from other underlying medical conditions (RR 0.75 (0.68-0.82)) were lower in 2020-21 than 2019-20, and weak evidence (p=0.074) that this was also true of deaths from substance abuse.CONCLUSIONSChildhood mortality in England during the first year of the SARS-CoV-2 pandemic was the lowest on record, with over 300 fewer deaths than the preceding 12 months. The greatest reduction was seen in children less than 10 years old. It is important that we learn from this effect, that potentially offers alternative ways to improve the outcome for the most vulnerable children in our society.
A compilation of fecal microbiome shotgun metagenomics from hospitalized patients undergoing hematopoietic cell transplantation
Authors: Yan Jinyuan , Liao Chen , Taylor Bradford P. , Fontana Emily , Amoretti Luigi A. , Wright Roberta J. , Dai Anqi , Waters Nicholas , Peled Jonathan U. , Taur Ying , Perales Miguel-Angel , Siranosian Benjamin A. , Bhatt Ami S. , van den Brink Marcel R.M. , Pamer Eric G. , Schluter Jonas , Xavier Joao B. 
Published: August 2021

AbstractHospitalized patients receiving hematopoietic cell transplants provide a unique opportunity to study how the human gut microbiome changes in response to perturbations, and how the resulting changes in the microbiome feedback on its living host. We previously compiled a large-scale longitudinal dataset of stool microbiome compositions from these patients and associated metadata1. In that dataset the microbiome analysis was limited to the taxonomic composition of the bacterial population obtained from 16S rRNA gene sequencing. Here, we augment those data with shotgun metagenomic sequences from a nested subset of 395 stool samples. We provide accession numbers that link each sample to the paired-end sequencing files deposited in a public repository, which can be directly accessed by the online services of PATRIC2 to be analyzed without the users having to download or transfer the files. We provide examples that show how shotgun sequencing enriches microbiome analyses beyond the taxonomic composition such as the analysis of gene functions including virulence factors and antibiotic resistances, and the assembly of genomes from metagenomic data.