bluuebunny/crossref_metadata_2025_split huggingface dataset:
Imperfect high‐resolution manometry studies: Prevalence and predictive factors
Authors: Hengehold Tricia , Rogers Benjamin , Gyawali C. Prakash 
Published: October 2021

AbstractBackgroundImperfect high‐resolution manometry (HRM) studies can impact clinical management of patients with esophageal symptoms.MethodsEsophageal high‐resolution manometry (HRM) studies attempted and/or performed by trained motility operators at a tertiary care center over a 2‐year period were identified. When studies were attempted but not completed, reasons for an imperfect study (critically imperfect = LES not adequately traversed; non‐critically imperfect = diaphragm not traversed), and point of identification (identified by motility nurse vs. identified on physician review) were recorded. Prevalence and clinical predictors of critically and non‐critically imperfect studies were determined.Key ResultsOf 962 HRM studies attempted in 951 patients, 33 (3.4%) were critically imperfect (17 curled catheters), and 125 (13.0%) were non‐critically imperfect. A third of critically imperfect studies, and 64.7% of curled catheters had achalasia, while 99.2% of non‐critically imperfect studies had large hiatus hernias. Motility nurses detected 90.9% of critically imperfect and 55.8% of non‐critically imperfect studies in real‐time (p < 0.001). Achalasia independently predicted curled catheters; large hiatus hernias predicted non‐critically imperfect studies (p < 0.001 for each). Compared to technically perfect studies, catheter curling was encountered more often in older patients, catheter intolerance in younger patients, and non‐critically imperfect studies in females (p < 0.001 for each). No critical motor disorder was identified in intolerant patients.Conclusions and InferencesAchalasia should be suspected when a curled catheter is encountered especially in older patients, while intolerant patients do not have critical motor disorders. Critically imperfect HRM studies are rare when performed by trained motility operators, which are identified in real time and aborted.
Ownership and use of insecticide‐treated nets under Ghana’s National Malaria Control Program: What are the correlates?
Authors: Bawuah Alex , Ampaw Samuel 
Published: October 2021

AbstractObjectivesGhana's National Malaria Control Program distributes free insecticide‐treated nets (ITNs) as a malaria control measure. Some households with the ITN do not use it, however. This paper explores the socioeconomic and demographic determinants of ITN ownership and use among Ghanaian families.MethodsData on 5741 households were obtained from the 2019 Ghana Malaria Indicator Survey. The survey is a nationally representative survey that obtains data on malaria‐related issues. Negative binomial and Tobit regressions were applied to achieve the study’s objectives.ResultsResidence (rural‐urban), wealth, and administrative region emerged as the most important predictors of ITN ownership and usage in Ghana. The results favoured rural and non‐Greater Accra residents. However, wealth had a contrasting association with ITN ownership and use. Whereas affluent households owned more ITNs than the extremely poor, the latter used them more. Also, age and household size were significant for ITN ownership. Both variables had a nonlinear (inverted U‐shaped) relationship with ITN ownership. In contrast, the proportion of household members under 5 and the bed net‐to‐household size ratio were positive and statistically significant determinants of ITN use.ConclusionThe study highlights the need to effectively target the poor, especially in rural areas, for ITNs under the NMCP instead of universal distribution.
Fracture outcome definitions in observational osteoporosis drug effects studies: a scoping review protocol
Authors: Konstantelos Natalia , Rzepka Anna M. , Cadarette Suzanne M. 
Published: October 2021

ABSTRACT

Objective:
The objective of this review is to describe fracture outcome definitions in observational osteoporosis drug effects studies from Canada and the United States.

Introduction:
Health care administrative data are commonly utilized in pharmacoepidemiologic studies. These data are used to define outcomes, such as fractures, and are critical to determining real-world safety and effectiveness of medications. However, there is no current standard for fracture outcome definitions in observational studies. As a result, fractures are inconsistently defined. To inform future research, a synthesis of how fractures are defined in observational studies using health care administrative claims data is needed. Providing clarity on how fractures are defined will provide guidance for future research.

Inclusion criteria:
We will include observational studies from the United States and Canada that consider the impact of osteoporosis pharmacotherapies on fracture risk and leverage health care administrative data.

Methods:
This review will follow the three-step JBI methodology for scoping reviews. We will search MEDLINE, Embase, and CINAHL for studies published in English from 2000 to the present. Following de-duplication, titles and abstracts will be screened independently by two reviewers. We will then conduct full-text screening for eligible studies. In addition, Canadian and US government pharmacovigilance websites will be searched to identify gray literature. Data extraction will be completed by two reviewers. Results will be presented in figures and in tabular format.
Barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal: a mixed methods systematic review protocol
Authors: Hermes Isabelle , Cibich Mikaela , Woodyatt Lydia , Finan Samantha , Hines Sonia 
Published: October 2021

ABSTRACT

Objective:
The objective of this review is to synthesize existing qualitative, quantitative, and mixed methods evidence in order to identify and examine the barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal.

Introduction:
Early intervention and prevention is key to reducing the risk of child abuse, neglect, and removal. Prenatal screening and referral to appropriate treatment and supports underpins best practice early-intervention responses. However, research suggests that pregnant people most in need of support services are often those least likely to engage with them. For early intervention to work, the barriers and facilitators of prenatal engagement must be identified and addressed within service and practice approaches with this group.

Inclusion criteria:
This mixed methods systematic review will consider qualitative, quantitative, and mixed methods studies of pregnant people at risk of child removal. Studies will be considered if they report on barriers to or facilitators of engagement in early-intervention services that address risk factors for child removal.

Methods:
The systematic review will be conducted in accordance with JBI methodology for mixed methods systematic reviews. A range of databases will be searched, including Informit online, MEDLINE (Ovid), ProQuest Central and Social Sciences Premium, PsycINFO (Ovid), and Scopus (Elsevier). Critical appraisal and data extraction for studies meeting the inclusion criteria will be performed by two reviewers using standardized JBI tools. Data synthesis will follow the convergent integrated approach to mixed methods systematic reviews.

Systematic review registration number:
PROSPERO CRD42021254794
Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review
Authors: McKay Fiona H. , Godrich Stephanie L. 
Published: October 2021

Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
Inclusion of sprints during moderate-intensity continuous exercise enhances post-exercise fat oxidation in young males
Authors: Mello-Silva Bruno Nicanor , Protzen Gabriel Völz , Del Vecchio Fabrício Boscolo 
Published: October 2021

To assess the physiological demands of including high-intensity efforts during continuous exercise, we designed a randomized crossover study, in which 12 physically active young males executed 3 different exercises in random order: FATmax – continuous exercise at the highest fat oxidation zone; 2min-130% – FATmax interspersed by a 2-minute bout at 130% of the maximal oxygen uptake associated intensity (iV̇O2max); and 20s:10s-170% – FATmax interspersed by four 20-s bouts at 170%iV̇O2max interpolated by 10s of passive recovery. We measured oxygen uptake (V̇O2), blood lactate concentration ([LAC]), respiratory exchange rate (RER), and fat and carbohydrate (CHO) oxidation. For statistical analyses, repeated-measures ANOVA was applied. Although no differences were found for average V̇O2 or carbohydrate oxidation rate, the post-exercise fat oxidation rate was 37.5% and 50% higher during the 2min-130% and 20s:10s-170% protocols, respectively, compared with the FATmax protocol, which also presented lower values of RER during exercise compared with 2min-130% and 20s:10s-170% (p < 0.001 in both), and higher values post-exercise (p = 0.04 and p = 0.002, respectively). [LAC] was higher during exercise when high-intensity bouts were applied (p < 0.001 for both) and was higher at post-exercise during the intermittent bouts compared with FATmax (p = 0.016). The inclusion of high-intensity efforts during moderate-intensity continuous exercise promoted higher physiological demands and post-exercise fat oxidation. Novelty: The inclusion of 2-minute efforts modifies continuous exercise demands. Maximal efforts can increase post-exercise fat oxidation. 2-minute maximal efforts, continuous or intermittent, presents similar demands.
Cosmological constant, axial anomalies and photon mass dynamos from chiral fermionic torsion
Authors: Garcia de Andrade L. C. 
Published: October 2021

Motivated by Palle’s investigation on the handness of chirality of vorticity in Einstein–Cartan cosmology [Entropy 5 (2014)], several aspects of chiral torsional handness in magnetogenesis and cosmology are presented. In the first one, we obtain torsion bounds from massive photons and axial anomalies. In the second, we deal with magnetogenesis from photon mass and in the third, we discuss chiral torsion degrees of freedom to obtain a torsion cosmological constant dependent solution. The torsion solution decays fast and implies a strong suppression of torsion at present universe. Our result contains the Poplawski [Phys. Lett. B (2010)] results in the case axial torsion vector associated to Einstein–Cartan fermionic sector matter and conformal anomalies of quarks. In the third example, a magnetic field bound from chiral torsionic dynamos is obtained as [Formula: see text]. In the non-minimal cosmological models, chiral dynamos are sourced by massive photons, London currents and chiral magnetic effect (CME). Chiral chemical potential is found to be mimic by torsion. Cosmological constant bound [Formula: see text] is found. At the early universe, the cosmological constant [Formula: see text] is obtained. Torsion used in the present universe is [Formula: see text]. In the last and fourth example, chiral anisotropic currents are obtained and magnetic helicity is shown to depend upon torsion when the chiral chemical potential is non-constant.
Reorganization of the 3D Genome Pinpoints Noncoding Drivers of Primary Prostate Tumors
Authors: Hawley James R. , Zhou Stanley , Arlidge Christopher , Grillo Giacomo , Kron Ken J. , Hugh-White Rupert , van der Kwast Theodorus H. , Fraser Michael , Boutros Paul C. , Bristow Robert G. , Lupien Mathieu 
Published: October 2021

AbstractProstate cancer is a heterogeneous disease whose progression is linked to genome instability. However, the impact of this instability on the noncoding genome and its three-dimensional organization to aid progression is unclear. Using primary benign and tumor tissue, we find a high concordance in higher-order three-dimensional genome organization. This concordance argues for constraints to the topology of prostate tumor genomes. Nonetheless, we identified changes in focal chromatin interactions, typical of loops bridging noncoding cis-regulatory elements, and showed how structural variants can induce these changes to guide cis-regulatory element hijacking. Such events resulted in opposing differential expression of genes found at antipodes of rearrangements. Collectively, these results argue that changes to focal chromatin interactions, as opposed to higher-order genome organization, allow for aberrant gene regulation and are repeatedly mediated by structural variants in primary prostate cancer.Significance:This work showcases how the noncoding genome can be hijacked by focal insults to its three-dimensional organization that contribute to prostate cancer oncogenesis.
SMARCA4: Implications of an Altered Chromatin-Remodeling Gene for Cancer Development and Therapy
Authors: Mardinian Kristina , Adashek Jacob J. , Botta Gregory P. , Kato Shumei , Kurzrock Razelle 
Published: October 2021

AbstractThe SWI/SNF chromatin remodeling complex, via nucleosome topology modulation, regulates transcription. The SMARCA4 (BRG1) subunit codes for the ATPase energy engine of the SWI/SNF complex. SMARCA4 is a tumor suppressor that is aberrant in ∼5% to 7% of human malignancies. Class I SMARCA4 alterations (truncating mutations, fusions, and homozygous deletion) lead to loss of function whereas class II alterations (missense mutations) have a dominant negative/gain-of-function effect and/or loss-of function. SMARCA4 alterations typify the ultra-rare small cell carcinomas of the ovary hypercalcemic type (SCCOHT) and SMARCA4-deficient thoracic and uterine sarcomas; they are also found in a subset of more common tumors, for example, lung, colon, bladder, and breast carcinomas. Germline variants in the SMARCA4 gene lead to various hereditary conditions: rhabdoid tumor predisposition syndrome-2 (RTPS2), characterized by loss-of-function alterations and aggressive rhabdoid tumors presenting in infants and young children; and Coffin-Siris syndrome, characterized by dominant negative/gain-of function alterations and developmental delays, microcephaly, unique facies, and hypoplastic nails of the fifth fingers or toes. A minority of rhabdoid tumors have a germline SMARCA4 variant as do &gt;40% of women with SCCOHT. Importantly, immune checkpoint blockade has shown remarkable, albeit anecdotal, responses in SCCOHT. In addition, there is ongoing research into BET, EZH2, HDAC, CDK4/6, and FGFR inhibitors, as well as agents that might induce synthetic lethality via DNA damage repair impairment (ATR inhibitors and platinum chemotherapy), or via the exploitation of mitochondrial oxidative phosphorylation inhibitors or AURKA inhibitors, in SMARCA4-aberrant cancers.
Single-Cell Atlas of Lineage States, Tumor Microenvironment, and Subtype-Specific Expression Programs in Gastric Cancer
Authors: Kumar Vikrant , Ramnarayanan Kalpana , Sundar Raghav , Padmanabhan Nisha , Srivastava Supriya , Koiwa Mayu , Yasuda Tadahito , Koh Vivien , Huang Kie Kyon , Tay Su Ting , Ho Shamaine Wei Ting , Tan Angie Lay Keng , Ishimoto Takatsugu , Kim Guowei , Shabbir Asim , Chen Qingfeng , Zhang Biyan , Xu Shengli , Lam Kong-Peng , Lum Huey Yew Jeffrey , Teh Ming , Yong Wei Peng , So Jimmy Bok Yan , Tan Patrick 
Published: October 2021

Abstract

Gastric cancer heterogeneity represents a barrier to disease management. We generated a comprehensive single-cell atlas of gastric cancer (&gt;200,000 cells) comprising 48 samples from 31 patients across clinical stages and histologic subtypes. We identified 34 distinct cell-lineage states including novel rare cell populations. Many lineage states exhibited distinct cancer-associated expression profiles, individually contributing to a combined tumor-wide molecular collage. We observed increased plasma cell proportions in diffuse-type tumors associated with epithelial-resident KLF2 and stage-wise accrual of cancer-associated fibroblast subpopulations marked by high INHBA and FAP coexpression. Single-cell comparisons between patient-derived organoids (PDO) and primary tumors highlighted inter- and intralineage similarities and differences, demarcating molecular boundaries of PDOs as experimental models. We complemented these findings by spatial transcriptomics, orthogonal validation in independent bulk RNA-sequencing cohorts, and functional demonstration using in vitro and in vivo models. Our results provide a high-resolution molecular resource of intra- and interpatient lineage states across distinct gastric cancer subtypes.

Significance:
We profiled gastric malignancies at single-cell resolution and identified increased plasma cell proportions as a novel feature of diffuse-type tumors. We also uncovered distinct cancer-associated fibroblast subtypes with INHBA–FAP-high cell populations as predictors of poor clinical prognosis. Our findings highlight potential origins of deregulated cell states in the gastric tumor ecosystem.
This article is highlighted in the In This Issue feature, p. 587
Syndrome of Reversible Cardiogenic Shock and Left Ventricular Ballooning in Obstructive Hypertrophic Cardiomyopathy
Authors: Sherrid Mark V. , Swistel Daniel G. , Olivotto Iacopo , Pieroni Maurizio , Wever‐Pinzon Omar , Riedy Katherine , Bach Richard G. , Husaini Mustafa , Cresci Sharon , Reyentovich Alex , Massera Daniele , Maron Martin S. , Maron Barry J. , Kim Bette 
Published: October 2021

Background
Cardiogenic shock from most causes has unfavorable prognosis. Hypertrophic cardiomyopathy (HCM) can uncommonly present with apical ballooning and shock in association with sudden development of severe and unrelenting left ventricular (LV) outflow obstruction. Typical HCM phenotypic features of mild septal thickening, outflow gradients, and distinctive mitral abnormalities differentiate these patients from others with Takotsubo syndrome, who have normal mitral valves and no outflow obstruction.

Methods and Results
We analyzed 8 patients from our 4 HCM centers with obstructive HCM and abrupt presentation of cardiogenic shock with LV ballooning, and 6 cases reported in literature. Of 14 patients, 10 (71%) were women, aged 66±9 years, presenting with acute symptoms: LV ballooning; depressed ejection fraction (25±5%); refractory systemic hypotension; marked LV outflow tract obstruction (peak gradient, 94±28 mm Hg); and elevated troponin, but absence of atherosclerotic coronary disease. Shock was managed with intravenous administration of phenylephrine (n=6), norepinephrine (n=6), β‐blocker (n=7), and vasopressin (n=1). Mechanical circulatory support was required in 8, including intra‐aortic balloon pump (n=4), venoarterial extracorporeal membrane oxygenation (n=3), and Impella and Tandem Heart in 1 each. In refractory shock, urgent relief of obstruction by myectomy was performed in 5, and alcohol ablation in 1. All patients survived their critical illness, with full recovery of systolic function.

Conclusions
When cardiogenic shock and LV ballooning occur in obstructive HCM, they are marked by distinctive anatomic and physiologic features. Relief of obstruction with targeted pharmacotherapy, mechanical circulatory support, and myectomy, when necessary for refractory shock, may lead to survival and normalization of systolic function.
Repeat Flow Diversion for Cerebral Aneurysms Failing Prior Flow Diversion: Safety and Feasibility From Multicenter Experience
Authors: Salem Mohamed M. , Sweid Ahmad , Kuhn Anna L. , Dmytriw Adam A. , Gomez-Paz Santiago , Maragkos Georgios A. , Waqas Muhammad , Parra-Farinas Carmen , Salehani Arsalaan , Adeeb Nimer , Brouwer Patrick , Pickett Gwynedd , Ku Jerry , X.D. Yang Victor , Weill Alain , Radovanovic Ivan , Cognard Christophe , Spears Julian , Cuellar-Saenz Hugo H. , Renieri Leonardo , Kan Peter , Limbucci Nicola , Mendes Pereira Vitor , Harrigan Mark R. , Puri Ajit S. , Levy Elad I. , Moore Justin M. , Ogilvy Christopher S. , Marotta Thomas R. , Jabbour Pascal , Thomas Ajith J. 
Published: October 2021

Background:
Aneurysmal persistence after flow diversion (FD) occurs in 5% to 25% of aneurysms, which may necessitate retreatment. There are limited data on safety/efficacy of repeat FD—a frequently utilized strategy in such cases.

Methods:
A series of consecutive patients undergoing FD retreatment from 15 centers were reviewed (2011–2019), with inclusion criteria of repeat FD for the same aneurysm at least 6 months after initial treatment, with minimum of 6 months post-retreatment imaging. The primary outcome was aneurysmal occlusion, and secondary outcome was safety. A multivariable logistic regression model was constructed to identify predictors of incomplete occlusion (90%–99% and <90% occlusion) versus complete occlusion (100%) after retreatment.

Results:

Ninety-five patients (median age, 57 years; 81% women) harboring 95 aneurysms underwent 198 treatment procedures. Majority of aneurysms were unruptured (87.4%), saccular (74.7%), and located in the internal carotid artery (79%; median size, 9 mm). Median elapsed time between the first and second treatment was 12.2 months. Last available follow-up was at median 12.8 months after retreatment, and median 30.6 months after the initial treatment, showing complete occlusion in 46.2% and near-complete occlusion (90%–99%) in 20.4% of aneurysms. There was no difference in ischemic complications following initial treatment and retreatment (4.2% versus 4.2%;
P
>0.99). On multivariable regression, fusiform morphology had higher nonocclusion odds after retreatment (odds ratio [OR], 7.2 [95% CI, 1.97–20.8]). Family history of aneurysms was associated with lower odds of nonocclusion (OR, 0.18 [95% CI, 0.04–0.78]). Likewise, positive smoking history was associated with lower odds of nonocclusion (OR, 0.29 [95% CI, 0.1–0.86]). History of hypertension trended toward incomplete occlusion (OR, 3.10 [95% CI, 0.98–6.3]), similar to incorporated branch into aneurysms (OR, 2.78 [95% CI, 0.98–6.8]).

Conclusions:
Repeat FD for persistent aneurysms carries a reasonable success/safety profile. Satisfactory occlusion (100% and 90%–99% occlusion) was encountered in two-thirds of patients, with similar complications between the initial and subsequent retreatments. Fusiform morphology was the strongest predictor of retreatment failure.