bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the COVID-19 pandemic on primary care for hypertension in the UK: a population-based cohort study
Authors: Johnson Kyle , Beradid Sarah , Brophy James M. , Platt Robert W. , Renoux Christel 
Published: December 2024

ObjectivesTo describe the impact of the COVID-19 pandemic on hypertension diagnosis and management in UK primary care.DesignPopulation-based cohort study.SettingOver 2000 general practices across the UK contributing to the Clinical Practice Research Datalink.ParticipantsA cohort of 23 076 390 patients over 18 years of age and registered with their general practice for at least 1 year between 2011 and 2022, who did not have a previous diagnosis of hypertension. From these patients, a subcohort of 712 461 patients diagnosed with hypertension between 2011 and 2022 was selected.Primary and secondary outcome measuresCoprimary outcomes included rates of hypertension diagnosis and rates of antihypertensive treatment initiation, treatment change and blood pressure measurement in patients newly diagnosed with hypertension.ResultsIn April 2020, the first month of lockdown, incident hypertension diagnosis rates fell by 65% (95% CI 64% to 67%) compared with historical trends and remained depressed until November 2021, leading to 51 000 fewer diagnoses than expected by March 2022. However, by March 2022, there were 2.6% fewer diagnoses than expected in Scotland, compared with 20%–30% fewer in other UK Nations. Rates of treatment initiation and change fell by 47% (95% CI 43% to 51%) and 36% (95% CI 33% to 38%), respectively, in April 2020. However, initiation rates rebounded above expectations and remained elevated until March 2022. Blood pressure measurements fell by 69% (95% CI 65% to 72%) in April 2020, recovering in February 2021.ConclusionsHypertension diagnosis and management in UK primary care were significantly disrupted during the COVID-19 pandemic. Future studies should investigate the potential clinical implications for the cardiovascular health of the UK population.
Feasibility and acceptability of multiple methods of recording injecting drug use episode data among people who inject drugs in Melbourne, Australia: a pilot evaluation study protocol
Authors: Djordjevic Filip , Stewart Ashleigh Cara , Vella-Horne Dylan , Gleeson Zoe , Pavlyshyn Damian , Gill Matthew , Petrovic Rebekka , Scott Nick , Higgs Peter , Roth Alexis , Cocchiaro Ben , Dietze Paul , O’Keefe Daniel 
Published: December 2024

IntroductionOpioid overdose and blood-borne virus transmission are key health risks for people who inject drugs. Existing study methods that record data on injecting drug risks mostly rely on retrospective self-reporting that, while valid, are limited to being broad and subject to recall bias. The In-The-Moment-Expanded (ITM-Ex) study will evaluate the feasibility and acceptability of multiple novel data collection methods to capture in situ drug injecting data.Methods and analysisITM-Ex will purposively recruit 50 participants from an existing longitudinal cohort (SuperMIX study) of people who inject drugs in Melbourne, Australia. Over a 4-week study period, participants will be asked to complete baseline/endline spirometry, continuously wear a heart rate monitoring device, complete short-form ecological momentary assessment (EMA) questionnaires for every injecting episode during the study period and return previously used needles/syringes for drug residue testing. These multiple data sources will be combined to conduct a comprehensive analysis of the physiological and risk characteristics of an estimated 800 individual injecting drug use episodes (if participants inject four times weekly). Finally, post-participation qualitative interviews will explore the acceptability of the data collection methods.Ethics and disseminationEthics approval for ITM-Ex was obtained from Alfred Hospital Ethics Committee (project number 368/22). Results will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications.Results from ITM-Ex may demonstrate vastly more complete and accurate methods of capturing data on injecting drug use risk and support future development and evaluation of devices to monitor and intervene during drug overdose. Further, ITM-Ex may demonstrate innovative methodologies to support myriad future public health research studies.
Descriptive analysis to establish the prevalence of lead-associated chronic conditions among adult public health registry participants in Flint, Michigan: identifying disparities to support focused recovery efforts
Authors: Yousef Mohannad , Haggerty Diana , Jones Nicole , LaChance Jenny , Tayler Brittany , Hanna Mona 
Published: December 2024

BackgroundA population-level trauma, the Flint water crisis (FWC) exposed approximately 140 000 people to lead in water. In response, the Flint Registry (FR) was established by a local university in partnership with the community. Lead exposure has been linked to multiple adult-onset chronic diseases, and addressing the health needs of those exposed requires estimating the prevalence of these conditions. Our objective was to calculate the prevalence of chronic conditions among FR-enrolled adults and compare prevalence to state-wide surveillance estimates.MethodsData collection for the FR started 4.5 years after the onset of the FWC; this cross-sectional study included participants who completed their enrolment survey December 2018–July 2022. Participants reported if they had ever been diagnosed with 11 chronic conditions. We used crude and age-adjusted prevalence of the 11 chronic conditions and compared them to 2019–2021 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) estimates.ResultsWe included 14 274 adult (≥18) participants in this study. Crude and age-adjusted prevalence was higher in FR participants than MiBRFSS estimates for 9 of the 11 chronic conditions, such as kidney disease. Age-adjusted results suggested that 8.1% of participants would have kidney disease if they had the same age distribution as the adult population of Michigan, whereas only 3.4% of the adult population in Michigan has a kidney disease diagnosis. Patterns for males, females, black and white participants were similar to the overall results, though differences between the black FR participants and MiBRFSS estimates were less extreme.ConclusionThe FR is a resource for the Flint community and an example for other communities experiencing mass environmental disruptions. We cannot assert the FWC caused any cases of the health conditions evaluated, however, establishing the prevalence of lead-associated conditions among people exposed to the FWC is needed to prioritise secondary prevention efforts and demonstrate the utility of a university-run registry in response to events like the FWC.
Core components of male-specific person-centred HIV care: a qualitative analysis from client and healthcare worker perspectives in Malawi
Authors: Hubbard Julie , Mphande Misheck , Robson Isabella , Balakasi Kelvin , Phiri Khumbo , Chikuse Elijah , Thorp Marguerite , Phiri Sam , Choko Augustine T , Cornell Morna , Coates Thomas , Dovel Kathryn 
Published: December 2024

IntroductionPerson-centred care (PCC) improves clinical outcomes for people living with HIV. Heterosexual men in sub-Saharan Africa are under-represented in HIV care, yet PCC interventions for men are lacking. We identified core components of a PCC intervention for men living with HIV (MLHIV) in Malawi from both client and healthcare worker (HCW) perspectives, as well as strategies for implementation in routine settings.MethodsMLHIV≥15 years and not in care were enrolled in parent randomised trials to test the impact of male-tailored HIV services on 6-month treatment outcomes (n=1303). Clients received a PCC package including male-specific counselling+facility ART distribution or outside-facility ART distribution. 50 male clients were recruited for qualitative in-depth interviews using stratified random sampling to assess perceptions of the PCC packages. Focus group discussions were conducted with HCWs who delivered the intervention to understand implementation strategies and potential considerations for scale-up in routine settings. Interviews were audio recorded, translated into English, transcribed and coded in Atlas.ti V.9 and analysed using thematic analysis.Results36 MLHIV and 20 HCWs (10 lay cadre and 10 nurses) were interviewed between February and July 2022. Positive interactions with HCWs—characterised by kindness, reciprocity, privacy and focused conversations—and compelling, relevant counselling were considered the most important components of male PCC. While outside-facility ART dispensing was considered helpful, it was not as critical as these other components. HCWs outlined five steps to implementing male PCC: begin with kindness, apologise for past negative interactions, understand men’s holistic story, provide tailored counselling and support development of strategies for adherence. HCWs believed that male PCC enhanced their ability to support male clients but emphasised the need to be integrated into routine services.DiscussionPCC strategies that foster positive HCW relationships and addresses men’s unique experiences are highly valued by MLHIV. HCWs identified several strategies for delivering PCC to MLHIV that may help close gaps in HIV care for men.Trial registration numbersNCT04858243;NCT05137210.
Incident chronic kidney disease among Canadian immigrants: a population-based cohort study
Authors: Olaye Ida-Ehosa , Sood Manish M , Yu Chengchun , Tuna Meltem , Akbari Ayub , Tanuseputro Peter , Mucsi Istvan , Knoll Greg A , Hundemer Gregory L 
Published: December 2024

IntroductionA ‘healthy immigrant effect’ has been demonstrated for a number of chronic health conditions including cardiovascular disease, diabetes mellitus and dementia; however, the link between immigrant status and kidney health remains uncertain. We sought to compare the risk for incident chronic kidney disease (CKD) between Canadian immigrants and non-immigrants.MethodsWe conducted a population-level, observational cohort study of all adult (≥18 years of age) Ontario residents, including foreign-born immigrant Canadian citizens and non-immigrant Canadian citizens by birth, with normal baseline kidney function (outpatient estimated glomerular filtration rate (eGFR) ≥70 mL/min/1.73 m2) between 1 April 2007 and 30 September 2020 using provincial health administrative data. Multivariable Cox proportional hazard regression modelling was used to evaluate the relationship between immigrant status and the development of incident CKD (outpatient eGFR <60 mL/min/1.73m2).ResultsThe study cohort included 10 440 210 Ontario residents, consisting of 22% immigrants (n=2 253 360) and 78% (n=8 186 850) non-immigrants. The mean (SD) age and eGFR were 45 (17) years and 102 (16) mL/min/1.73 m2, respectively, and 54% of individuals were female. A total of 117 028 immigrants (5%, 7 events per 1000 person-years) and 984 277 non-immigrants (12%, 16 events per 1000 person-years) developed incident CKD during follow-up. Immigrants experienced a 20% lower risk for incident CKD compared with non-immigrants (adjusted HR 0.80, 95% CI 0.80 to 0.81). Consistent findings were seen for refugee and non-refugee immigrants, immigrants with remote (1985–2004) and recent (2005–2020) landing dates, and immigrants from different world regions. Results were similar on re-defining incident CKD as two outpatient eGFR measurements <60 mL/min/1.73 m2at least 90 days apart, treating death as a competing risk, and adjusting for baseline albuminuria.ConclusionImmigrants experience a lower risk for incident CKD compared with non-immigrants. These findings provide evidence of a ‘healthy immigrant effect’ in relation to kidney health.
Engineered GM-CSF polarizes protumorigenic tumor-associated macrophages to an antitumorigenic phenotype and potently synergizes with IL-12 immunotherapy
Authors: Kang Seounghun , Mansurov Aslan , Kurtanich Trevin , Chun Hye Rin , Slezak Anna J , Volpatti Lisa R , Chang Kevin , Wang Thomas , Alpar Aaron T , Refvik Kirsten C , Hansen O Isabella , Borjas Gustavo J , Berg Brendan T K , Shim Ha-Na , Hultgren Kevin T , Gomes Suzana , Wang Yue , Solanki Ani , Ishihara Jun , Swartz Melody A , Hubbell Jeffrey A 
Published: December 2024

BackgroundThe use of immune checkpoint inhibitors (CPIs) has become a dominant regimen in modern cancer therapy, however immune resistance induced by tumor-associated macrophages (TAMs) with immune suppressive and evasion properties limits responses. Therefore, the rational design of immune modulators that can control the immune suppressive properties of TAMs and polarize them, as well as dendritic cells (DCs), toward a more proinflammatory phenotype is a principal objective in cancer immunotherapy.MethodsHere, using a protein engineering approach to enhance cytokine residence in the tumor microenvironment, we examined combined stimulation of the myeloid compartment via tumor stroma-binding granulocyte–macrophage colony-stimulating factor (GM-CSF) to enhance responses in both DCs and T cells via stroma-binding interleukin-12 (IL-12). We evaluated tumor responses at the levels of outcome, cellular responses, and cytokine responses in both the tumors and the tumor-draining lymph nodes. We further investigated the potentiation of DC response to IL-12 by GM-CSF stimulation ex vivo.ResultsEngineered GM-CSF restored an antitumorigenic tumor myeloid microenvironment otherwise suppressed by TAMs, while engineered IL-12 provided effector signals to T cells, thereby boosting both tumor-resident antitumor macrophage and CD8+T cell populations. Furthermore, engineered GM-CSF potentiated DC response to IL-12, upregulating DC expression of IL-12 receptor and enhancing their expression of proinflammatory cytokines and chemokines on IL-12 exposure. This resulted in remarkable synergistic efficacy in multiple solid tumor models treated with the dual cytokine combination. The combination therapy also improved the efficacy of CPI in a CPI-resistant genetically-engineered melanoma model and exhibited synergistic antitumor efficacy in a pulmonary metastasis model.ConclusionOur strategy provides a rational design for combination immunotherapy targeting both myeloid and lymphoid compartments through complementary mechanisms.
The NHS England Jewish BRCA Testing Programme: overview after first year of implementation (2023–2024)
Authors: Torr Bethany , Bell Nicola , McCarthy Ruth , Hamill Monica , Nolan Joshua , Muralidharan Sudeekshna , Andrews Charlotte , Valganon-Petrizan Mikel , Clinch Yasmin , MacMahon Suzanne , Morilla Alison , George Angela , Ryves Paul , Dasani Pooja , Adegoroye Moses , Schlecht Helene , Burghel George J , Ornadel Wendy , Gordon Nicole , Steele Lisa , Lukic Susana , Watts Emily , Evans D Gareth , Manchanda Ranjit , Turnbull Clare 
Published: December 2024

BackgroundThe NHS Jewish BRCA Testing Programme is offering germlineBRCA1andBRCA2genetic testing to people with ≥1 Jewish grandparent. Who have an increased likelihood of having an Ashkenazi Jewish (AJ) founder germline pathogenic variant (gPV) compared with the general population.Testing is offered via a self-referral, home-based saliva sampling pathway, supported by a genetic counsellor telephone helpline. A first-of-its-kind in the United Kingdom (UK) for population genetic testing, outside of research.MethodsWe reviewed data from germline testing of 5389 people who registered during the soft-launch phase (January 2023–January 2024) and their families to observe trends in uptake and outcomes of testing.ResultsOf the 5389 self-referrals, 4339 (80.5%) consented to testing. Of those with results returned, 2.3% (98/4,274) had a gPV (89.8% AJ founder and 10.2% non-AJ founder).Notably, the detection rate was higher in men (42/790, 5.3%) compared with women (56/3484, 1.6%), with the proportion reporting known BRCA variants within the family prior to consent also significantly increased (13.1% compared with 9.2%, respectively).ConclusionOverall detection rates of gPVs are similar to those reported elsewhere from Jewish population testing. The pathway, particularly for males, may attract uptake of testing by those previously aware of familial gPVs.
Obesity, laypeople’s beliefs and implications for clinicians and leaders of healthcare organisations
Authors: Karnani Aneel , McFerran Brent , Mukhopadhyay Anirban 
Published: December 2024

Background/AimOverweight and obesity (OAO) is a major and growing public health crisis in the world. There is convincing medical evidence that caloric overconsumption, rather than lack of exercise, is the primary driver of OAO.MethodsIn this translation piece, we summarise our programme of research on laypeople’s beliefs about the primary cause of OAO, the origins of these beliefs and implications for clinicians and leadership in healthcare organisations.ResultsIn contrast to the medical consensus, our research conducted in several countries has found that approximately half of the population mistakenly believes that lack of exercise is the primary cause of obesity. These misbeliefs have consequences: people who mistakenly believe that exercise is the most important factor are more likely to be overweight or obese than people who correctly believe that diet is the primary cause of obesity. We argue that these misbeliefs are caused in part by systematic and multipronged communications efforts by the food and beverage industry—a phenomenon we term ‘leanwashing’.ConclusionsNot only does leanwashing require public policy intervention by the government, healthcare professionals also need to respond appropriately. In this article, we focus on the implications of leanwashing for leaders of public health organisations, health delivery organisations and clinicians.
Detection of cardiac amyloidosis using machine learning on routine echocardiographic measurements
Authors: Chang Rachel Si-Wen , Chiu I-min , Tacon Phillip , Abiragi Michael , Cao Louie , Hong Gloria , Le Jonathan , Zou James , Daluwatte Chathuri , Ricchiuto Piero , Ouyang David 
Published: December 2024

BackgroundCardiac amyloidosis (CA) is an underdiagnosed, progressive and lethal disease. Machine learning applied to common measurements derived from routine echocardiogram studies can inform suspicion of CA.ObjectivesOur objectives were to test a random forest (RF) model in detecting CA.MethodsWe used 3603 echocardiogram studies from 636 patients at Cedars-Sinai Medical Center to train an RF model to predict CA from echocardiographic parameters. 231 patients with CA were compared with 405 control patients with negative pyrophosphate scans or clinical diagnosis of hypertrophic cardiomyopathy. 19 common echocardiographic measurements from echocardiogram reports were used as input into the RF model. Data was split by patient into a training data set of 2882 studies from 486 patients and a test data set of 721 studies from 150 patients. The performance of the model was evaluated by area under the receiver operative curve (AUC), sensitivity, specificity and positive predictive value (PPV) on the test data set.ResultsThe RF model identified CA with an AUC of 0.84, sensitivity of 0.82, specificity of 0.73 and PPV of 0.76. Some echocardiographic measurements had high missingness, suggesting gaps in measurement in routine clinical practice. Features that were large contributors to the model included mitral A-wave velocity, global longitudinal strain (GLS), left ventricle posterior wall diameter end diastolic (LVPWd) and left atrial area.ConclusionMachine learning on echocardiographic parameters can detect patients with CA with accuracy. Our model identified several features that were major contributors towards identifying CA including GLS, mitral A peak velocity and LVPWd. Further study is needed to evaluate its external validity and application in clinical settings.
An inquisitive study on photophysical properties of few modified indole derivatives
Authors: Banana Tejendra , Rajput Swati Singh , Chandravanshi Neelam , Alam Md Mehboob 
Published: December 2024

Indole is an interesting molecule that exists in nature as a part of several important biomolecules including melatonin — a chemical that maintains the circadian rhythm in human body, serotonin — a chemical carrying messages through nerve cells, and tryptophan — an amino acid. It has a benzene ring fused with a pyrrole ring. Similar molecules containing cycloheptene ring fused with pyrrole — called azulene, cyclohepta[b]pyrrole and dihydrocyclohepta[b]pyrrole — also exist. It would be very interesting to see the effect on different properties of the above-mentioned biomolecules, if indole is replaced by azulene or cyclohepta[b]pyrrole or dihydro-cyclohepta[b]pyrrole. This paper precisely investigates such interesting substitutions. We replaced indole in the three biomolecules by azulene, cyclohepta[b]pyrrole, and dihydrocyclohepta[b]pyrrole and studied the corresponding change in acid-dissociation constant, static polarizabilities, first and second hyperpolarizabilities, absorption spectra, fluorescence, charge-transfer, and nature of the first two singlet, and the first two triplet states, using the state-of-the-art (time-dependent) density functional theory. The results are compared with the values obtained for the indole analogues calculated at the same level of theory.
Coccoliths as Recorders of Paleoceanography and Paleoclimate over the Past 66 Million Years
Authors: Bolton Clara T. , Stoll Heather M. 
Published: December 2024

Coccolithophores are a major group of oceanic calcifying phytoplankton, and their calcite skeletal remains, termed calcareous nannofossils, are a major component of deep-sea sediments accumulating since the Jurassic. Coccolithophores play a role in both the biological pump and the carbonate pump, exporting organic and inorganic carbon, respectively, out of the surface ocean. This means that they are key responders to and recorders of ocean carbon cycle and climate changes over geological and shorter timescales, and studying these responses can help elucidate the uncertain fate of calcifying phytoplankton under projected climate change scenarios. Here, we review established and emerging approaches for reconstructing (a) mixed-layer ocean temperature, (b) marine productivity, and (c) aspects of the ocean carbon cycle, using calcareous nannofossils from deep-sea sediments. For each parameter, we discuss the different proxies that have been proposed, based on abundance or species composition, inorganic geochemistry, and/or coccolith morphology, and explore their applications and limitations in Cenozoic paleoceanography.

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Calcareous nannofossils can be used to reconstruct upper ocean conditions and changes over centennial to million-year timescales.

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Key coccolith-based proxies for temperature, productivity, and the carbon cycle are reviewed.

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Approaches based on assemblages, geochemistry, and morphology provide novel insights into the evolution and adaptation of coccolithophores and past climate.