bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosticators of Optic Nerve Imaging in Malignant Pseudotumor Cerebri Syndrome
Authors: Chaulk Alexandria L. , McCarty Jennifer L. , Patel Rajan P. , Chuang Alice Z. , Adesina Ore-ofe O. 
Published: November 2024

Background:
Pseudotumor cerebri (PTC) syndrome is a disorder of increased intracranial pressure, most commonly affecting overweight women of childbearing age. Malignant PTC (MPTC) is a rare presentation that involves rapidly worsening vision, often necessitating surgical intervention to prevent permanent vision loss. The goal of this study was to determine whether radiographic findings of PTC are predictive of MPTC and the final visual outcome.

Methods:
Charts of patients diagnosed with PTC based on the modified Dandy criteria were reviewed. Snellen best-corrected visual acuity (BCVA), automated perimetry mean deviation (APMD), and papilledema grade were documented from the initial and final follow-up examinations. The MRI images were read by 2 neuroradiologists blinded to the clinical diagnosis, and consensus findings were obtained. The patients were classified into malignant and nonmalignant PTC groups. Malignant was defined as BCVA ≤ 20/200 or APMD ≤ −7 dB, and acute onset of symptoms. The sensitivity and specificity of each MRI finding for detecting MPTC was determined. Generalized linear model with random effect and backward model selection was performed to identify which radiographic findings were predictive of final BCVA, APMD, and papilledema grade.

Results:
Overall, 114 eyes (57 malignant/57 nonmalignant) were included. No MRI finding has both sensitivity and specificity for MPTC reaching 60%. The highest sensitivity (86%) was flattening of the posterior globes and unilateral or bilateral transverse sinus stenosis. The highest specificities were completely empty sella (86%), enhancement (84%), and diffusion restriction (81%) of the prelaminar optic nerves. The presence of vertical tortuosity of the optic nerves was predictive of better final BCVA (P = 0.003) and better final APMD (P = 0.011). While papilledema grade was higher in MPTC, no MRI finding was predictive of papilledema grade.

Conclusions:
No single MRI finding has both high sensitivity and specificity for diagnosing MPTC. Vertical tortuosity of the optic nerves may be predictive of better final BCVA and APMD.
Implementing Precision Medicine for Dilated Cardiomyopathy: Insights from The DCM Consortium
Authors: Jordan Elizabeth , Ni Hanyu , Parker Patricia , Kinnamon Daniel D. , Owens Anjali , Lowes Brian , Shenoy Chetan , Martin Cindy M. , Judge Daniel P. , Fishbein Daniel P. , Stoller Douglas , Minami Elina , Kransdorf Evan , Smart Frank , Haas Garrie J. , Huggins Gordon S. , Ewald Gregory A. , Diamond Jamie , Wilcox Jane E. , Jimenez Javier , Wang Jessica , Tallaj Jose , Drazner Mark H. , Hofmeyer Mark , Wheeler Matthew T. , Wever Pinzon Omar , Shah Palak , Gottlieb Stephen S. , Katz Stuart , Shore Supriya , Tang W. H. Wilson , Hershberger Ray E. ,   DCM Precision Medicine study of the DCM Consortium
Published: November 2024

ABSTRACTBackgroundClinical genetic evaluation of dilated cardiomyopathy (DCM) is implemented variably or not at all. Identifying needs and barriers to genetic evaluations will enable strategies to enhance precision medicine care.MethodsAn online survey was conducted in June 2024 among cardiologist investigators of the DCM Consortium from US advanced heart failure/transplant (HF/TX) programs to collect demographics, training, program characteristics, genetic evaluation practices for DCM, and implementation needs. An in-person discussion followed.ResultsTwenty-five cardiologists (28% female, 12% Hispanic, 68% White) participated in the survey and 15 in the discussion; genetics training backgrounds varied greatly. Clinical genetic testing for DCM was conducted by all programs with annual uptake ranging from 5%-70% (median 25%). Thirteen respondents (52%) did not use selection criteria for testing whereas others selected patients based on specific clinical and family history data. Eight (32%) ordered testing by themselves, and the remainder had testing managed mostly by a genetic counselor or others with genetic expertise (16/17; 94%). Six themes were distilled from open-ended responses regarding thoughts for the future and included access to genetics services, navigating uncertainty, knowledge needs, cost concerns, family-based care barriers, and institutional infrastructure limitations. Following an in-person discussion, four areas were identified for focused effort: improved reimbursement for genetic services, genetic counselor integration with HF/TX teams, improved provider education resources, and more research to find missing heritability and to resolve uncertain results.ConclusionsHF/TX programs have implementation challenges in the provision of DCM genetic evaluations; targeted plans to facilitate precision medicine for DCM are needed.
Pupil Abnormality Frequency in the First 72 Hours Improves IMPACT score in Traumatic Brain Injury
Authors: Veerapaneni Divya , Sakthiyendran Naveen Arunachalam , Kim So Yeon , Nguyen Chuong , Daneshmand Ali , Abdalkader Mohamad , Mohammed Shariq , Dupuis Josée , Sheth Kevin N. , Gilmore Emily J. , Greer David , Ong Charlene J. 
Published: November 2024

AbstractImportanceIn patients with traumatic brain injury (TBI), baseline pupillary assessment is common. However, the incidence and frequency of pupil abnormalities within the first several days remain poorly characterized.ObjectivesOur aim was to test the association between pupil abnormality frequency over the first 72 hours of admission and clinical outcomes.DesignWe conducted a retrospective observational study of patients with a primary diagnosis of TBI with at least three quantitative pupillometry measurements within 72 hours at a single-center ICU from 2018 to 2022.Outcomes and MeasuresNeurological Pupil index (NPi), a quantitative composite metric for pupil reactivity, was obtained at each clinical neurologic assessment over 72 hours. Pupil measurements were defined as abnormal if they had a NPi of <3 in either eye, NPi asymmetry ≥0.7, or pupil size asymmetry ≥1mm. We tested the association of increased frequency of pupil abnormalities over 72 hours and unfavorable discharge disposition (death, hospice, or long-term care) using multivariable logistic regression, adjusting for confounders. We then compared whether the IMPACT model was improved by the frequency of pupil abnormalities using goodness-of-fit.ResultsOf 131 patients, median age was 59 years, and 30% were women. Thirty-five percent had unfavorable discharge disposition. Pupil abnormalities occurred in 62%, 61%, and 88% of mild, moderate, and severe TBI patients, respectively. Odds ratio of unfavorable discharge for every 1% increase in pupil abnormality frequency was 1.03 (95% Cl, 1.01-1.05), equivalent to one additional abnormal pupil measurement within a 72-hour period. The adjusted IMPACT TBI model’s goodness-of-fit improved with pupil abnormality frequency (X2=5.67,p=0.02).Conclusions and RelevancePupil abnormalities occur commonly in TBI and have the highest frequency in severe TBI. Increased pupil abnormality frequency is associated with unfavorable discharge disposition and improves performance of prognostic TBI models.Key PointsThe goal of this study was to test the association between pupil abnormality frequency over the first 72 hours of admission and unfavorable discharge disposition and whether it improved the IMPACT model. In this retrospective observational study of 131 TBI patients at a single-center, we found that an increased frequency of pupil abnormalities across 72-hours significantly correlated with unfavorable discharge in patients and improved the IMPACT model’s goodness-of-fit. These findings highlight the potential of long-term pupillary metrics and their role as not only a prognostic indicator in patients but also a tool that improves the performance of prognostic TBI models.
Windows of Susceptibility to Air Pollution During and Surrounding Pregnancy in Relation to Longitudinal Maternal Measures of Adiposity and Lipid Profiles
Authors: India Aldana Sandra , Demateis Danielle , Valvi Damaskini , Just Allan C. , Gutiérrez-Avila Iván , Estrada-Gutierrez Guadalupe , Téllez Rojo Martha María , Wright Robert O. , Baccarelli Andrea A. , Wu Haotian , Keller Kayleigh P. , Wilson Ander , Colicino Elena 
Published: November 2024

AbstractPregnancy is a critical window for long-term metabolic programming of fetal effects stemming from airborne particulate matter ≤2.5μm (PM2.5) exposure. Yet, little is known about long-term metabolic effects of PM2.5exposure during and surrounding pregnancy in mothers. We assessed potential critical windows of PM2.5exposure during and surrounding pregnancy with maternal adiposity and lipid measures later in life. We included 517 pregnant women from the PROGRESS cohort with adiposity [body mass index (BMI), waist circumference (WC), % body fat] and lipids [total cholesterol, high-density-lipoprotein (HDL), low-density-lipoprotein (LDL)] measured repeatedly at 4, 6 and 8 years post-delivery. Monthly average PM2.5exposure was estimated at each participant’s address using a validated spatiotemporal model. We employed distributed lag interaction models (DLIMs) adjusting for socio-demographics and clinical covariates. We found that a 1 μg/m3increase in PM2.5exposure throughout mid-/late-pregnancy was associated with higher WC at 6-years post-delivery, peaking at 6 months of gestation: 0.04 cm (95%CI: 0.01, 0.06). We also identified critical windows of PM2.5exposure during and surrounding pregnancy associated with higher LDL and lower HDL both measured at 4 years post-delivery with peaks at pre-conception for LDL [0.17 mg/dL (95%CI: 0.00, 0.34)] and at the 11thmonth after conception for HDL [-0.07 mg/dL (95%CI: -0.11, -0.02)]. Stratified analyses by fetal sex indicated stronger associations with adiposity measures in mothers carrying a male, whereas stronger associations were observed with lipids in mothers carrying a female fetus. Stratified analyses also indicated potential stronger deleterious lagged effects in women with folic acid intake lower than 600mcg/day during pregnancy.
Effects of Prenatal Substance Exposure on Longitudinal Tri-Ponderal Mass Index Trajectories from Pre- to Early Adolescence in the ABCD study
Authors: Li Ru , Wigley Isabella Mariani , Suuronen Ilkka , Jolly Ashmeet , Tuulari Jetro J. 
Published: November 2024

AbstractObjectivesThe long-term relationship between prenatal substance exposure (PSE) and obesity development remains inconclusive and poorly understood. This study aimed to explore the heterogeneity in adiposity developmental trajectories from pre- to early adolescence and investigate the influence of PSE on these patterns.MethodsFive waves of data from 7 881 children enrolled in the Adolescent Brain Cognitive Development (ABCD) Study (Release 5.1) were analyzed. Tri-Ponderal Mass Index (TMI) was used to assess adiposity levels. PSE (e.g., tobacco, alcohol, caffeine, and marijuana) was collected via maternal self-report. Latent growth mixture modeling was conducted to identify TMI trajectories, followed by multinomial logistic regression to examine the role of PSE in TMI profiles, controlling for various factors.ResultsThree trajectories were identified:Stable TMI(86.6%),Increasing TMI(12.5%), andDecreasing TMI(0.9%). The risk of exhibiting anIncreasing TMIwas associated with prenatal exposure to tobacco (β = 1.53, 95% CI = 1.26–1.86, p < .001) and caffeine (daily use: β = 1.39, 95% CI = 1.16–1.68, p < .001; weekly use: β = 1.38, 95% CI = 1.13–1.69, p < .05), with dose-dependent effects. Notably, tobacco exposure both before (β = 1.55, 95% CI = 1.27–1.89, p < .001) and after awareness of pregnancy (β = 1.51, 95% CI = 1.10–2.08, p < .05) contributed to this risk, with no significant benefit from maternal cessation after pregnancy awareness. Multiple PSE substantially elevated the risk of increasing adiposity (β = 1.70, 95% CI = 1.27–2.27, p < .001).ConclusionsObesity risk can emerge long before adolescence, even during prenatal development. The findings regarding the long-term influence of prenatal substance exposure on adiposity development during adolescence highlight the importance of preconception and prenatal health interventions to mitigate the risk of obesity in offspring.
Prediction of Pediatric No-Show Rates Before and During the COVID-19 Pandemic Utilizing Machine Learning
Authors: Hathaway Quincy A. , Yanamala Naveena , Narumanchi TaraChandra , Narumanchi Janani 
Published: November 2024

AbstractBackgroundPatient no-shows significantly disrupt pediatric healthcare delivery, highlighting the necessity for precise predictive models, especially during the dynamic shifts caused by the SARS-CoV-2 pandemic. In outpatient settings, these no-shows result in medical resource underutilization, increased healthcare costs, reduced access to care, and lower clinic efficiency and productivity.MethodsThe objective is to develop a predictive model for patient no-shows using data-driven techniques. We analyzed five years of historical data retrieved from both a scheduling system and electronic health records from a general pediatrics clinic within the WVU Health systems. This dataset comprises a total of 209,408 visits from 2015 to 2018, 82,925 visits in 2019, and 58,820 visits in 2020, spanning both pre-pandemic and pandemic periods. The data includes variables such as patient demographics, appointment details, timing, hospital characteristics, appointment types, and environmental factors.ResultsOur XGBoost model demonstrated robust predictive capabilities, notably outperforming traditional "no-show rate" metrics. Precision and recall metrics for all features were 0.82 and 0.88, respectively. Receiver Operator Characteristic (ROC) analysis yielded AUCs of 0.90 for all features and 0.88 for the top 5 predictors when evaluated on the 2019 cohort. Furthermore, model generalization across racial/ethnic groups was also observed. Evaluation on 2020 telehealth data reaffirmed model efficacy (AUC: 0.90), with consistent top predictive features.ConclusionsOur study presents a sophisticated predictive model for pediatric no-show rates, offering insights into nuanced factors influencing attendance behavior. The model’s adaptability to evolving healthcare landscapes, including telehealth, underscores its potential for enhancing clinical practice and resource allocation.
Caregiver Mind-Mindedness Training as an Early Intervention for Social Anxiety in Children: A protocol for an RCT intervention
Authors: Javadian Hiva , Stewart Mary E. , Mathews Minu , Williams Andrew James , Hale Daniel 
Published: November 2024

AbstractBackgroundThis paper describes a randomised controlled trial (RCT) protocol aimed at investigating the efficacy of caregivers’ Mind-Mindedness training as an early intervention for preschoolers with social anxiety. Mind-mindedness, a caregiver’s ability to recognise and respond to a child as an individual with their own thoughts, feelings, and intentions, is associated with secure attachment and socioemotional skills. While previous studies indicate brief Mind-Mindedness training may increase caregiver mentalisation in high-risk groups, rigorous research on the impacts of social anxiety in children is limited. Building on the well-established link between caregiver’s Mind-Mindedness and positive socioemotional outcomes in children, this study aims to bridge the existing research gap by directly testing the impact of Mind-Mindedness training on social anxiety.MethodsThis randomized controlled trial aims to recruit 100 caregivers of preschool-aged 4 to 7-year-old children with social anxiety from the UK and Iran. The caregivers will be randomly assigned to either a mind-mindedness training group (n=50) or a peer support (control) group(n=50). The mind-mindedness training will involve three online sessions focused on teaching strategies for using mind-minded comments, the program will consist of three online sessions, each lasting one hour and conducted over three consecutive weeks. The peer support (control) group will have access to a private online peer-support platform for sharing experiences. Measures of mind-mindedness, child social anxiety, attachment, and theory of mind will be assessed at baseline, post-intervention, and 3-month follow-up using established assessment tools.DiscussionThe study aims to evaluate the effectiveness of a mind-mindedness parental intervention for social anxiety in children and to uncover the potential mediating roles of attachment and theory of mind in the relationship between mind-mindedness and child anxiety. The cross-cultural design, involving participants from the UK and Iran, will offer valuable information on the cultural aspect of the intervention. The training group is hypothesized to lead to increased mind-mindedness and reduced child social anxiety versus a peer support (control) group. This research can establish evidence for mind-mindedness training as an early intervention approach for childhood social anxiety.Trial registrationProspectively registered onClinicalTrials.gov(ID:NCT06657014; registered on 23rd October 2024) and on the Iranian Registry of Clinical Trials (IRCT) Version1(ID: 80088; approved on 2nd November 2024). These registrations promote transparency and ensure compliance with international standards for reporting clinical trials.
The East London Parkinson’s Disease Project – A case-control study in a diverse population
Authors: Zirra Alexandra , Dey Kamalesh C. , Camboe Ellen , Waters Sheena , Haque Tahrina , Huxford Brook , Chohan Harneek , Donkor Natalie , Kahan Joshua , Ben-Joseph Aaron , Gallagher David A. , Budu Caroline , Boyle Thomas , Simonet Cristina , Lees Andrew J , Marshall Charles R. , Noyce Alastair J. 
Published: November 2024

AbstractBackgroundThere is a relative dearth of research on patients with Parkinson’s disease (PD) from under-represented ethnic groups in the United Kingdom.ObjectivesThe East London Parkinson Disease project seeks to understand the clinical manifestations and determinants of PD in a diverse population.MethodsPatients with PD were recruited from the Royal London Hospital. Healthy controls came from community engagement events and partners of patients. Data on clinical features assessed by motor and non-motor scales were collected between January 2019 and February 2024, and compared between groups. Parametric, non-parametric tests, and unmatched logistic models, adjusted for age, gender and duration of disease were used.ResultsWe assessed 218 patients with PD and 90 controls. Among them, 50% of patients and 64% controls identified as South Asian or Black. Males comprised 63% of patients and 70% of controls. After adjusting for age, gender, disease duration and treatment burden, South Asian and Black patients had significantly worse motor scores compared to White patients (mean [SD], 42.2 [18.8], and 47 [16.6] vs 35.2 [16.4], p<0.001 and p<0.001). Cognitive impairment was more prevalent in South Asian (73%) and Black patients (75%) than in White patients (45%, p=0.002).ConclusionsOur results suggest that patients with PD from South Asian and Black ethnic groups may have more severe motor and certain non-motor features, including cognitive impairment, compared to White patients.
Cohort Profile Update: Expanding the Cardiovascular Risk in Young Finns Study into a multigenerational cohort
Authors: Pahkala Katja , Rovio Suvi , Auranen Kari , Bourgery Matthieu , Elovainio Marko , Fogelholm Mikael , Haapala Johanna , Hirvensalo Mirja , Hutri Nina , Jokinen Eero , Jula Antti , Juonala Markus , Kaikkonen Jari , Kartiosuo Noora , Kiviranta Hannu , Koskinen Juhani S. , Kotaja Noora , Kähönen Mika , Laitinen Tomi P. , Lehtimäki Terho , Lisinen Irina , Loo Britt-Marie , Lyytikäinen Leo-Pekka , Magnussen Costan G. , Mishra Pashupati P. , Mykkänen Juha , Mäkelä Juho-Antti , Männistö Satu , Nevalainen Jaakko , Pulkki-Råback Laura , Raitoharju Emma , Rantakokko Panu , Rönnemaa Tapani , Stenbacka Sini , Taittonen Leena , Tammelin Tuija H. , Toppari Jorma , Tossavainen Päivi , Viikari Jorma , Raitakari Olli 
Published: November 2024

AbstractCardiovascular Risk in Young Finns Study (YFS) is a prospective cohort of 3596 males and females (baseline age 3-18 years) that was established in 1980 to study cardiovascular risk factors in children and adolescents. The YFS has been instrumental in demonstrating the links between childhood risk factors and adult cardiovascular outcomes with implications on paediatric cardiovascular preventive practise.In the latest follow-up in 2018-2020, the study was expanded into a three-generation cohort, including the original cohort members, as well as their parents and offspring. Altogether 7341 individuals aged 3-92 years participated; 2127 original cohort members (now aged 40-58 years), 2452 parents (aged 58-92 years) and 2762 offspring (aged 3-37 years) of the original cohort members.The main aim was to establish a multigenerational population data base, sample biobank and links to national health registries that would offer a unique platform to study familial transmission of health-related traits. The field studies and data collections were conducted as part of the ERC funded MULTIEPIGEN project designed testing a specific hypothesis that epigenetic markers in the semen play a role in the transmission of intergenerational information in the paternal lineage. It is a firsta prioridesigned epidemiologic study assessing the role of paternal life exposures, including chemical and psychosocial stress, in the development of cardio-metabolic, cognitive and psychosocial outcomes in their offspring.
The 14-Day Incidence and Risk Factors of Gastrointestinal Anastomotic Leak Among Adult Patients in Mulago Hospital
Authors:   A PROSPECTIVE COHORT STUDY, Omare Isaac , Mbiine Ronald , Kasagga Brian , Kabweru Wilberforce Musoga , Okeny Paul 
Published: November 2024

AbstractIntroductionAnastomotic leak is a dreaded complication following gastrointestinal (GI) anastomotic surgery. It increases morbidity and mortality of patients undergoing GI surgery. However, there is paucity of data on the incidence and risk factors of anastomotic leak following gastrointestinal surgery in Uganda. The main objective of this study was to determine the incidence and risk factors of anastomotic leak following gastrointestinal surgery in Mulago Hospital.MethodsWe consecutively recruited adult patients admitted to the general surgery wards in Mulago Hospital, 24 hours following gastrointestinal surgery. The recruitment process started on 22ndApril 2024 and ended on 11thJuly 2024. The participants provided informed written consent prior to enrolment into the study. Patient related factors including preoperative anemia, preoperative albumin level, and ASA status were recorded on entry, while the outcome (anastomotic leak) was obtained upon 14 day’s follow-up. Data were analysed using SPSS version 26. Multivariate logistic regression was used to determine the independent risk factors for anastomotic leak, p< 0.05 was considered statistically significant.ResultsEighty-five participants were studied. The incidence of anastomotic leak was 8.2% (n=7). Hemoglobin level less than 10 g/dl was the only independent predictor for anastomotic leak in this study. (RR, 8.15; 95% C.I, 1.16 - 57.48; p=0.035).ConclusionThe incidence of anastomotic leak in Mulago National Referral Hospital was low. Low Hemoglobin (Hb<10g/dl) was associated with increased rates of anastomotic leak.