bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timeliness of reperfusion in ST-segment elevation myocardial infarction and outcomes in Kerala, India: results of the TRUST outcomes registry
Authors: Mathew Anoop , Moolla Muhammad , Jeemon Panniyammakal , Punnoose Eapen , Ashraf S M , Pisharody Sunil , Viswanathan Sunitha , Jayakumar T G , Jabir Abdullakutty , Mathew Jubil P , John Thomas , Thomas Vinod , Bainey Kevin 
Published: October 2024

Abstract

Purpose
Transatlantic guidelines endorse quality metrics for timely reperfusion in patients with ST-elevation myocardial infarction (STEMI). Compliance in low- and middle-income countries (LMICs) is largely unknown.

Study Design
We prospectively evaluated 2928 STEMI patients in Kerala, India, across 16 PCI-capable hospitals who received reperfusion with either primary percutaneous coronary intervention (PPCI) or fibrinolysis. Primary endpoint was a major adverse cardiovascular event (MACE) composite of death, non-fatal myocardial infarction, stroke or readmission for heart failure at 1-year.

Results
Among reperfused STEMI patients, 320 (10.9%) received timely reperfusion with either PPCI or fibrinolysis, 1985 (67.8%) received delayed PPCI, and 623 (21.3%) received delayed fibrinolysis. Timely reperfusion had lower unadjusted MACE rates than delayed PCI or fibrinolysis (timely reperfusion: 11.9%, delayed PPCI: 13.6%, delayed fibrinolysis: 23.9%, P &lt; 0.001). Mortality was lowest in the timely reperfusion group (timely reperfusion: 6.3%, delayed PPCI: 7.8%, delayed fibrinolysis 18.8%, P &lt; 0.001). After multivariate analysis, delayed fibrinolysis had a higher MACE rate (HR 1.52 95% CI 1.04–2.21) and mortality (HR 1.97, 95% CI 1.18–3.25) compared to timely reperfusion. Total ischemic time &gt; 3 h and delayed first medical contact-to-needle time predicted MACE at 1 year.

Conclusions
Among STEMI patients in Kerala, India, only one in 10 eligible patients received timely reperfusion. Longer total ischemic times and delayed fibrinolysis were associated with 1-year MACE. Improving timely reperfusion is critical to enhancing STEMI outcomes in LMICs.
What is already known on this topic Given the established link between delay to reperfusion and worse major adverse cardiac events (MACE), global efforts have concentrated on minimizing different components of the total ischemic time to improve ST-elevation myocardial infarction (STEMI) outcomes. Compliance in low- and middle-income countries (LMICs) is largely unknown. What this study adds In this cohort of STEMI patients in Kerala, India, total ischemic time and first medical contact-to-needle time correlated with long-term MACE rates, whereas other timeliness indicators did not. How this study might affect research, practice or policy Our study highlights the significant barriers to accessing STEMI care that are prevalent in LMICs despite incremental growth in the number of PCI-capable hospitals. The pre-hospital phase within total ischemic time is the most important quality improvement metric of STEMI care in LMICs, especially for patients chosen for fibrinolysis.
A Mendelian analysis of the causality between inflammatory cytokines and digestive tract cancers
Authors: Ren Xing , Hu Rong , Zhang Hui 
Published: October 2024

Abstract

Purpose
In this study, we performed a two-sample Mendelian randomization (MR) analysis to assess the causality between inflammatory cytokines and the risk of digestive tract cancers (DTCs). Furthermore, we conducted a molecular docking study to predict the therapeutic mechanisms of traditional Chinese medicine (TCM) compounds in the treatment of DTCs.

Methods
In our MR analysis, genetic variations associated with eight types of DTCs were utilized, which were sourced from a large publicly available genome-wide association study dataset (7929 cases and 1 742 407 controls of European ancestry) and inflammatory cytokines data from a genome-wide association study summary of 8293 European participants. Inverse-variance weighted method, MR-Egger, and weighted median were performed to analyze and strengthen the final results. We investigated the effects of 41 inflammatory molecules on 8 types of DTCs. Subsequently, the effect of DTCs on positive inflammatory factors was analyzed by means of inverse MR. Molecular docking was exploited to predict therapeutic targets with TCM compounds.

Results
Interleukin-7, interleukin-16, macrophage colony-stimulating factor, monokine induced by interferon-gamma, and vascular endothelial growth factor may be significantly associated with various types of DTCs. Five TCM compounds (baicalin, berberine, curcumin, emodin, and salidroside) demonstrated better binding energies to both interleukin-7 and vascular endothelial growth factor than carboplatin.

Conclusion
This study provides strong evidence to support the potential causality of some inflammatory cytokines on DTCs and indicates the potential molecular mechanism of TCM compounds in the treatment of DTCs.
Key message What is already known on this topic The increasing evidence indicates that inflammatory cytokines are implicated in the pathogenesis of digestive tract cancers (DTCs). Nevertheless, the causal relationship between inflammatory cytokines and DTCs remains indistinct. Additionally, certain traditional Chinese medicine compounds have been demonstrated to treat DTCs by influencing inflammatory factors, yet their underlying potential mechanisms remain ambiguous. What this study adds In this study, Mendelian randomization analysis was performed for the first time regarding the causality between human inflammatory cytokines and eight types of DTCs, which revealed that inflammatory factors may play different roles in different types of DTCs. Moreover, molecular docking of key inflammatory factors was implemented, indicating the targets for drug actions. How this study might affect research, practice, or policy This research has the potential to reveal the causality between 41 inflammatory factors and 8 DTCs, offering novel perspectives for the prevention and management strategies of DTCs. Additionally, it indicates the targets for the actions of traditional Chinese medicine on the key inflammatory factors of these cancers.
Emotional Support and Financial Distress
Authors: Ke Da 
Published: October 2024

Abstract
This paper is the first to explore emotional support as an important determinant of household financial outcomes. Using microdata from the United States and Australia, I document that individuals who feel emotionally supported are less likely to experience financial distress. This relationship is not confounded by nonemotional aspects of social support and is confirmed by between-siblings and within-individual analyses. Further investigation suggests emotional support helps to overcome psychological barriers that impede individuals from taking precautions against adverse shocks. Moreover, when such shocks occur, those with strong emotional support can better cope with the adversity as emotional support boosts their confidence. (JEL D14, D91, G41, G51, Z13)
Cost-effectiveness of allergen immunotherapy
Authors: Rodríguez-Otero Natalia , Ramírez-Mateo Elena , Plana Maria Nieves , Heffler Enrico , Antolín-Amérigo Darío 
Published: October 2024

Purpose of review
Allergic rhinitis is a relevant and global health problem affecting up to 5–50% of the general population and its prevalence is increasing due to climate change and pollution among other factors and counts among the 10 most frequent reasons for medical consultation, generating an important economic impact. Allergen immunotherapy (AIT) is the only allergy-disease-modifying treatment and there is plenty of evidence of its effectiveness with regards subcutaneous and oral routes of AIT.
This narrative review article examines published literature in the last 24 months regarding the pharmacoeconomics of AIT versus standard of care treatment (SOC) for the treatment of allergic rhinitis and asthma.

Recent findings
Farraia et al. assessed in 2022 subcutaneous immunotherapy (SCIT, _438/$500.28) and sublingual immunotherapy (SLIT) (_1021/$1116.19) plus symptomatic treatment versus SOC treatment in children with HDM-driven allergic asthma, measuring QALYs, decrease of medication, decrease of exacerbations and symptoms. They used the cost-effective threshold: _18 482.80 ($21 110.14), finding that AIT is cost-effective.
Also, SCIT and SLIT plus symptomatic treatment was assessed versus SOC treatment in children with grass pollen allergic rhinitis. The authors concluded that SCIT (_933/$1065.67) and SLIT (_1408/ $1608.22) seem cost-effective, particularly SCIT.

Summary
Allergen immunotherapy is cost-effective in the management of allergic rhinitis and asthma as compared with SOC alone. As most studies consider only during-treatment costs and no long-term benefits or preventive effects are being assessed, the real cost-effectiveness of allergen immunotherapy could be even higher.
Dual-Plane Treatment With Highly Concentrated Hybrid Cooperative Complexes of Hyaluronans for Facial Atrophic Acne Scars
Authors: Sparavigna Adele , Grimolizzi Franco , Cigni Clara , Lualdi Roberto , Bellia Gilberto 
Published: October 2024

BACKGROUND
Managing patients with acne scars remains an important challenge, as scarring negatively affects psychosocial wellbeing. Hyaluronic acid (HA) cross-linked fillers have demonstrated good efficacy and tolerability for the correction of acne scars but are limited by their reduced biological activity and low concentrations.

OBJECTIVE
This study investigated the efficacy and safety on scars of a high-concentration (4.5%) HA-based filler with hybrid cooperative complexes (HCC) of high-molecular-weight and low-molecular-weight HA.

METHODS
Participants received treatment twice; the first was provided at baseline (T0) and the second after 4 weeks (T1). Data were collected at T1 and after 4 months (T2) by photographs and instrumental evaluation of the skin.

RESULTS
The study population included 28 patients. Improvements in the mean Goodman and Baron grade were significant across time points T0 and T1 (12% improvement; p = .0002) and T0 and T2 (31% improvement; p < .0001). Instrumental evaluation of the skin surface demonstrated a 20% reduction in the average deepness of acne scars after 4 months (p < .0001). No serious adverse events were reported during the study procedure.

CONCLUSION
Highly concentrated (4.5%) HCC appears to be an effective option for the correction of facial acne scars.
Evaluation of the Danish Colorectal Cancer Screening Program Among People With Cystic Fibrosis
Authors: Exsteen Banoo B. , Katzenstein Terese L. , Faurholt-Jepsen Daniel , Bjerregaard Niels C. , Bader-Larsen Karlen , Jensen-Fangel Soeren , Mynster Tommie 
Published: October 2024

Goals:
We aimed to evaluate the Danish CRC screening program, estimate colonic neoplasia's prevalence, and assess the utilized BP regimens.

Background:
People with cystic fibrosis (pwCF) have an increased risk of precancerous polyps and colorectal cancer (CRC), with occurrence at an earlier age compared with the general population. Consequently, colonoscopy screening is recommended. PwCF requires specific bowel preparation (BP) regimens to ensure an adequate colonoscopy.

Study:
We conducted a national retrospective cohort study, which included all pwCF eligible for colonoscopy according to international recommendations in 26 months.

Results:
Among 119 eligible pwCF, 58 completed colonoscopies during the screening period. The screening was omitted in 25% of pwCF. Among the pwCF undergoing colonoscopy screening, precancerous polyps were found in 24% and none with CRC. One patient developed CRC before being offered screening. Risk factors for neoplasia were old age and male sex. The quality of BP was high, even though most pwCF received standard BP. The best quality was found in nonorgan transplanted, pwCF who received modulator treatment and those with no laxatives use.

Conclusions:
We detected a high adherence to CRC screening, but also a substantial proportion of pwCF who were not informed about screening recommendations, calling for greater awareness among clinicians. Although lower than previously described, our study revealed high numbers of precancerous polyps and CRC compared with the general population, underlining the need for screening. BP quality remained high, despite frequent use of standard regimens, implicating the need for more individualized regimens before undergoing colonoscopy.
Postoperative management following endoscopic skull base surgery
Authors: Vozel Domen , Urbančič Jure 
Published: October 2024

Purpose of review
The purpose of this opinion is to review current evidence regarding postoperative management following endoscopic skull base surgery.

Recent findings
Postoperative management encompasses consideration of level of care, laboratory tests, analgetic and antiemetic therapy, antibiotic, antithrombotic and antiepileptic prophylaxis, pharmacological and nonpharmacological cerebrospinal fluid (CSF) pressure reduction measures, including CSF diversion, activity restrictions, nasal packing removal, nasal debridement and toilet, nasal glucocorticoid administration, positive pressure ventilation, imaging, CSF leak diagnosis, and future perspectives.

Summary
Although significant effort has been put into research of postoperative measures after endoscopic skull-base surgery, there is a heterogeneity of practices and deficit of high-level studies, which would enable highly powered systematic reviews and meta-analyses.
Multimorbidity representation via graph learning: A population-based study on hepatosplenic conditions in schistosomiasis-endemic areas of rural Uganda
Authors: Zhi Yin-Cong , Mpooya Simon , Kabatereine Narcis B. , Nabatte Betty , Opio Christopher K. , Chami Goylette F. 
Published: October 2024

AbstractBackgroundThe global burden of multimorbidity is increasing yet poorly understood, owing to insufficient methods available for modelling complex systems of conditions. In particular, hepatosplenic multimorbidity has been inadequately investigated.MethodsFrom 17 January to 16 February 2023, we examined 3186 individuals aged 5-92 years from 52 villages across Uganda within the SchistoTrack Cohort. Point-of-care B-mode ultrasound was used to assess 45 hepatosplenic conditions. Three graph learning methods for representing hepatosplenic multimorbidity were compared including graphical lasso (GL), signed distance correlations (SDC), and co-occurrence. Graph kernels were used to identify thresholds of relevant condition inter-dependencies (edges). Graph neural networks were applied to validate the quality of the graphs by assessing their predictive performance. Clinical utility was assessed through medical expert review.FindingsMultimorbidity was observed in 54·65% (1741/3186) of study participants, who exhibited two or more hepatosplenic conditions. Conditions of mildly fibrosed vessels were most frequently observed (>14% of individuals). Percentage thresholds were found to be 50·16% and 64·46% for GL and SDC, respectively, but could not be inferred for co-occurrence. Thresholded GL and SDC graphs had densities of 0·11 and 0·17, respectively. Both thresholded graphs were similar in predictive utility, although GL produced marginally higher AUCs under certain experiments. Both GL and SDC had significantly higher AUCs than co-occurrence. Numerous conditions were predicted with perfect sensitivity using both GL and SDC with graph convolutional network with five input conditions.InterpretationThe most common method for multimorbidity (co-occurrence) provided an uninformative representation of hepatosplenic conditions with respect to sparsity and predictive performance. More clinically useful graphs were computed when algorithms consisted of statistical assumptions, such as graphical lasso. Future work could apply the pipeline developed here for clinically relevant multimorbidity representations.FundingNDPH Pump Priming Fund, John Fell Fund, Robertson Foundation, UKRI EPSRC (EP/X021793/1).
Real-Time Spatiotemporal Tracking of Infectious Outbreaks in Confined Environments with a Host-Pathogen Agent-Based System
Authors: Srinivasan Suhas , King Jeffrey , Colubri Andres , Korkin Dmitry 
Published: October 2024

AbstractDeadly infection outbreaks in confined spaces, whether it is a COVID-19 outbreak on a cruise ship or at a veteran home, or measles and stomach flu outbreaks in schools, can be characterized by their rapid spread due to the abundance of common spaces, shared airways, and high population density. Preventing future infectious outbreaks and developing efficient mitigation protocols can benefit from advanced computational modeling approaches. Here, we developed an agent-based modeling approach to study the spatiotemporal dynamics of an infection outbreak in a confined environment caused by a specific pathogen and to determine effective infection containment protocols. The approach integrates the 3D geographic information system of a confined environment, the behavior of the hosts, key biological parameters about the pathogen obtained from the experimental data, and the general mechanics of host-pathogen and pathogen-fomite interactions. To assess our approach, we applied it to the historical data of infectious outbreak caused by norovirus, H1N1 influenza A, and SARS-CoV-2 viruses. As a result our model was able to accurately predict the number of infections per day, correctly identify the day when the CDC vessel sanitation protocol would be triggered, single out key biological parameters affecting the infection spread, and propose important changes to existing containment protocols, specific for different pathogens. This research not only contributes to our understanding of infection spread and containment in cruise ships but also offers insights applicable to other similar confined settings, such as nursing homes, schools, and hospitals. By providing a robust framework for real-time outbreak modeling, this study proposes new, more effective containment protocols and enhances our preparedness for managing infectious diseases and emerging pathogens in confined environments.
Neighbourhood topology unveils pathological hubs in the brain networks of epilepsy-surgery patients
Authors: Di Gaetano Leonardo , Santos Fernando A.N. , Battiston Federico , Bianconi Ginestra , Defenu Nicolò , Nissen Ida , van Straaten Elisabeth C. W. , Hillebrand Arjan , Millán Ana P. 
Published: October 2024

AbstractPathological hubs in the brain networks of epilepsy patients are hypothesized to drive seizure generation and propagation. In epilepsy-surgery patients, these hubs have traditionally been associated with the resection area: the region removed during the surgery with the goal of stopping the seizures, and which is typically used as a proxy for the epileptogenic zone. However, recent studies hypothesize that pathological hubs may extend to the vicinity of the resection area, potentially complicating post-surgical seizure control. Here we propose a neighbourhood-based analysis of brain organization to investigate this hypothesis. We exploit a large dataset of presurgical MEG (magnetoencephalography)-derived whole-brain networks from 91 epilepsy-surgery patients. Our neighbourhood-focus is two-fold. Firstly, we propose a partition of the brain regions into three sets, namely resected nodes, their neighbours, and the remaining network nodes. Secondly, we introduce generalized centrality metrics that describe the neighrbourhood of each node, providing a regional measure of hubness. Our analyses reveal that both the resection area and its neighborhood present large hub-status, but with significant variability across patients. For some, hubs appear in the resection area; for others, in its neighborhood. Moreover, this variability does not correlate with surgical outcome. These results highlight the potential of neighborhood-based analyses to uncover novel insights into brain connectivity in brain pathologies, and the need for individualized studies, with large-enough cohorts, that account for patient-specific variability.
Comparison of Cerebral ECD Perfusion in Patients with Dementia with Lewy Bodies and Parkinson’s Disease Dementia
Authors: Toyli Aili , Hung Guang-Uei , Zhao Chen , Sha Qiuying , Chiu Pai-Yi , Zhou Weihua 
Published: October 2024

AbstractDementia with Lewy bodies (DLB) and Parkinson’s Disease Dementia (PDD) are closely related neurodegenerative conditions within the Lewy body spectrum. The relationship between DLB and PDD remains debated, with ongoing discussion about whether they are distinct diseases or different manifestations of the same disorder. This study aimed to identify differences in cerebral perfusion patterns between DLB and PDD patients. Single-photon emission computed tomography (SPECT) Ethyl Cysteinate Dimer (ECD) imaging was performed on each patient, and relative tracer uptake levels across 47 regions of interest (ROIs) and 240 subregions were analyzed. A two-sided Welch’s t-test was employed to evaluate mean perfusion differences, with results further confirmed through a voxel-wise t-test mapping. After adjusting for multiple comparisons using the Benjamini-Hochberg procedure, no regions showed statistically significant differences at the 0.05 level. However, a few subregions in the visual cortices exhibited p-values just above the significance threshold, with lower mean perfusion observed in PDD patients than those with DLB. Validating these findings in larger samples could enhance scientific understanding of the differences in the pathology and progression of DLB and PDD.
Genome-wide Association Studies of Missing Metabolite Measures: Results From Two Population-based Studies
Authors: Faquih Tariq O. , Imtiaz Mohammed Aslam , Talevi Valentina , Landstra Elvire N. , van Hylckama Vlieg Astrid , Li-Gao Ruifang , Rosendaal Frits R. , Noordam Raymond , van Heemst Diana , Mook-Kanamori Dennis O. , Breteler Monique M. B. , Aziz N. Ahmad , van Dijk Ko Willems 
Published: October 2024

AbstractMetabolomic studies are increasingly used for both etiological and predictive research, but frequently report missing values. We hypothesized that interindividual genetic variation may account for part of this missingness. Therefore, we performed a GWAS of missingness in measured metabolite levels using an untargeted mass spectrometry-based platform in the Netherlands Epidemiology of Obesity Study (N=594) and the Rhineland Study (N=4,165). We considered metabolites missing in 10%-90% of individuals in both cohorts (N=224). GWAS meta-analyses of these metabolites’ probability of missingness revealed 55 metabolome-wide significant associations, including 42 novel ones (p<1.58×10-10), involving 28 metabolites and 41 lead SNPs. Despite considerable pleiotropy, the majority of identified SNP-‘missing metabolite’ associations were biologically plausible, relating to beta-oxidation, bile acids, steroids, and xenobiotics metabolism. These findings suggest that missing values in metabolomics are nonrandom and partly reflect genetic variation, accounting for which is important for both clinical and epidemiological studies, especially nutritional and pharmacogenetics studies.