bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Care Use Among Patients with Multiple Chronic Conditions Receiving Care from Nurse Practitioner Practices in Health Professional Shortage Areas
Authors: McMenamin Amy , Turi Eleanor , Dixon Justinna , Liu Jianfang , Martsolf Grant , Poghosyan Lusine 
Published: July 2024

Abstract

Background
Patients with multiple chronic conditions often have many care plans, polypharmacy, and unrelieved symptoms that contribute to high emergency department and hospital use. High-quality primary care delivered in practices that employ nurse practitioners can help prevent the need for such acute care services. However, such practices located in primary care health professional shortage areas face challenges caring for these patients due to higher workloads and fewer resources.

Objective
We examined differences in hospitalization and emergency department use among patients with multiple chronic conditions who receive care from practices that employ nurse practitioners in health professional shortage areas compared to practices that employ nurse practitioners in non-health professional shortage areas.

Methods
We performed an analysis of Medicare claims, merged with Health Resources and Services Administration data on health professional shortage area status in five states. Our sample included 394,424 community-dwelling Medicare beneficiaries aged ≥65 with at least two of 15 common chronic conditions who received care in 779 practices that employ nurse practitioners. We used logistic regression to assess the relationship between health professional shortage area status and emergency department visits or hospitalizations.

Results
We found a higher likelihood of emergency department visits among patients in health professional shortage areas compared to those in non-health professional shortage areas, and no difference in the likelihood of hospitalization.

Discussion
Emergency department use differences exist among older adults with multiple chronic conditions receiving care in practices that employ nurse practitioners in health professional shortage areas, compared to those in non-health professional shortage areas. To address this disparity, the health professional shortage area program should invest in recruiting and retaining nurse practitioners to health professional shortage areas to ease workforce shortages.
Using Civic Service Design Methods to Redevelop a Data Communication Website With a Health Literacy Lens
Authors: Montesano Matthew , Porter Michael , Olson Carolyn , Gettings Chris , Torem Emily , Pezeshki Grant 
Published: July 2024

Context:
Public health agencies routinely publish data in hopes that data influence public health policy and practice. However, data websites can often be difficult to use, posing barriers to people trying to access, understand, and use data. Working to make data websites easier to use can add value to public health data communication work.

Program:
The New York City Department of Health and Mental Hygiene (DOHMH) redesigned its Environment and Health Data Portal, a website used to communicate environmental health data, with the goal of making data more accessible and understandable to a broader audience. The DOHMH used Civic Service Design methods to establish priorities and strategies for the redesign work, to build a data communication website that emphasizes a high level of usability, and content that explains data.

Implementation:
By following a Civic Service Design process, the DOHMH synthesized findings from health communications, data visualization and communication, and web usability to create an easy-to-use website with explanations of data and findings alongside datasets. On the new site, automated dataset visualizations are supplemented with narrative content, explanatory content, and custom interactive applications designed to explain data and findings.

Evaluation:
Web analytics showed that, in its first year of operation, the site’s web traffic grew substantially, with the last 12 weeks recording weekly page views 150% higher than the first 12 weeks of operation (7185 average weekly page views compared with 2866 average weekly page views). Two-thirds (66.3%) of page views include recorded user engagement. Additional evaluations to measure specific aspects of usability compared with the previous version of the site are planned.

Discussion:
By following a Civic Service Design process, the DOHMH redesigned a vital data communication platform to increase its usability and saw significant increase in engagement in its first year of operations. By designing data material with usability in mind, public health departments have the potential to improve public health data communication work.
Ventricular lymphatic vessel density correlates with mild cardiac remodelling and preserved heart function in moderate murine aortic valve stenosis
Authors: Becker Katrin 
Published: July 2024

AbstractAortic valve stenosis (AS) is one of the most frequent heart valve diseases in the western world, but aortic valve replacement (AVR) remains the only therapeutic option. While one of the most common complications of AS is heart failure, the early disease phase is asymptomatic with preserved cardiac function. Increased ventricular lymphatic vessel density is part of myocardial remodelling upon cardiac pressure overload and an important adaptation mechanism to maintain heart function after myocardial infarction, while in heart failure patients, circulating lymphatic growth factor levels and ventricular lymphatic vessel numbers are altered. Lymphangiogenesis is enhanced in endocardium of human stenotic aortic valves, however, ventricular lymphatic vessels have not been investigated in AS, yet.Therefore, aim of this study was to in a well-characterized mouse model of moderate AS analyse the link between density of ventricular lymphatic vessels, cardiac remodelling and function.
Objective Markers of Sustained Attention Fluctuate Independently of Mind-Wandering Reports
Authors: Chidharom Matthieu , Bonnefond Anne , Vogel Edward K. , Rosenberg Monica D. 
Published: July 2024

ABSTRACTSustained attention fluctuates between periods of good and poor attentional performance. Two major methodologies exist to study these fluctuations: an objective approach that identifies "in-the-zone" states of consistent response times (RTs) and "out-of-the-zone" states of erratic RTs and a subjective approach that asks participants whether they are on-task or mind wandering. Although both approaches effectively predict attentional lapses, it remains unclear whether they capture the same or distinct attentional fluctuations. We combined both approaches within a single sustained attention task requiring frequent responses and response inhibition to rare targets to explore their consistency (N=40). Behaviorally, both objective out-of-the-zone and subjective mind-wandering states were associated with more attentional lapses. However, the percentage of time spent out-of-the-zone did not differ between on-task and mind-wandering periods and both objective and subjective states independently predicted error-proneness, suggesting that the two methods do not capture the same type of attention fluctuations. Whereas attentional preparation before correct inhibitions was greater during out-of-the-zone compared to in-the-zone periods, preparation did not differ by subjective state. In contrast, post-error slowing differed by both objective and subjective states, but in opposite directions: slowing was observed when participants were objectively out-of-the-zone or subjectively on-task. Overall, our results provide evidence that objective and subjective approaches capture distinct attention fluctuations during sustained attention tasks. Integrating both objective and subjective measures is crucial for fully understanding the mechanisms underlying our ability to remain focused.
GATA6 regulates WNT and BMP programs to pattern precardiac mesoderm during the earliest stages of human cardiogenesis
Authors: Bisson Joseph A. , Gordillo Miriam , Kumar Ritu , de Silva Neranjan , Yang Ellen , Banks Kelly M. , Shi Zhong-Dong , Lee Kihyun , Yang Dapeng , Chung Wendy K. , Huangfu Danwei , Evans Todd 
Published: July 2024

AbstractHaploinsufficiency forGATA6is associated with congenital heart disease (CHD) with variable comorbidity of pancreatic or diaphragm defects, although the etiology of disease is not well understood. Here, we used cardiac directed differentiation from human embryonic stem cells (hESCs) as a platform to study GATA6 function during early cardiogenesis. GATA6 loss-of-function hESCs had a profound impairment in cardiac progenitor cell (CPC) specification and cardiomyocyte (CM) generation due to early defects during the mesendoderm and lateral mesoderm patterning stages. Profiling by RNA-seq and CUT&RUN identified genes of the WNT and BMP programs regulated by GATA6 during early mesoderm patterning. Furthermore, interactome analysis detected GATA6 binding with developmental transcription factors and chromatin remodelers suggesting cooperative regulation of cardiac lineage gene accessibility. We show that modulating WNT and BMP inputs during the first 48 hours of cardiac differentiation is sufficient to partially rescue CPC and CM defects inGATA6heterozygous and homozygous mutant hESCs. This study provides evidence of the regulatory functions for GATA6 directing human precardiac mesoderm patterning during the earliest stages of cardiogenesis to further our understanding of haploinsufficiency causing CHD and the co-occurrence of cardiac and other organ defects caused by humanGATA6mutations.
Genetics identifies obesity as a shared risk factor for co-occurring multiple long-term conditions
Authors: Mounier Ninon , Voller Bethany , Masoli Jane AH , Delgado João , Dudbridge Frank , Pilling Luke C , Frayling Timothy M , Bowden Jack 
Published: July 2024

AbstractBackgroundMultimorbidity, the co-occurrence of multiple long-term conditions (LTCs), is an increasingly important clinical problem, but often little is known about the underlying causes. Observational studies are highly susceptible to confounding and bias, and patients with multiple LTCs are usually excluded from randomised controlled trials. We investigate the role of a potentially critical multimorbidity risk factor, obesity, as measured by body mass index (BMI), in explaining shared genetics amongst 71 common LTCs.Methods and FindingsIn a population of northern Europeans, we estimated unadjusted pairwisegenetic correlation,, between LTCs and partial genetic correlations after adjustment for the genetics of BMI,. We compared these correlations using a bespoke block-jackknife approach to assess whether differences between the estimates were statistically meaningful. We then used multiple causal inference methods to confirm that BMI causally affects not only individual LTCs, but also their co-occurrence. Finally, we attempted to quantify the population-level impact of intervening and lowering BMI on the prevalence of 15 key common multimorbid LTC pairs. Our results showed evidence that BMI partially explains some of the shared genetics for 740 LTC-pairs (30% of all pairs considered). For a further 161 LTC-pairs, the genetic similarity between the LTCs was entirely accounted for by BMI genetics. This list included diabetes and osteoarthritis:, as well as those involving LTCs from the same broad family, or ‘domain’, such as gout and osteoarthritis:. Causal inference methods confirmed that higher BMI acts as a common risk factor for a subset of these pairs, and therefore BMI-lowering interventions would reduce the prevalence of these pairs of LTCs. For example, we estimated that a 1 standard deviation or 4.5 unit decrease in BMI would result in 17 fewer people with both chronic kidney disease and osteoarthritis per 1000 who currently have both LTCs.ConclusionsOur genetics-centred approach shows that obesity is an important mechanistic cause of many shared long-term conditions. We identify LTC pairs for which obesity is the predominating shared risk factor, and cases where it is one of the several shared risk factors involved. Our method for calculating full and partial genetic correlations is published as an R package{partialLDSC}for use by the research community.
Mapping brain lesions to conduction delays: the next step for personalized brain models in Multiple Sclerosis
Authors: Mazzara C. , Ziaeemehr A. , Troisi E. Lopez , Cipriano L. , Angiolelli M. , Sparaco M. , Quarantelli M. , Granata C. , Sorrentino G. , Hashemi M. , Jirsa V. , Sorrentino P. 
Published: July 2024

AbstractMultiple sclerosis (MS) is a clinically heterogeneous, multifactorial autoimmune disorder affecting the central nervous system. Structural damage to the myelin sheath, resulting in the consequent slowing of the conduction velocities, is a key pathophysiological mechanism. In fact, the conduction velocities are closely related to the degree of myelination, with thicker myelin sheaths associated to higher conduction velocities. However, how the intensity of the structural lesions of the myelin translates to slowing of nerve conduction delays is not known. In this work, we use large-scale brain models and Bayesian model inversion to estimate how myelin lesions translate to longer conduction delays across the damaged tracts. A cohort of 38 subjects (20 healthy and 18 with MS) underwent MEG and MRI acquisitions, with detailed white matter tractography analysis. We observed that MS patients consistently showed decreased power within the alpha frequency band (8-13Hz) as compared to the healthy group. We also derived a lesion matrix indicating the percentage of lesions for each tract in every patient. Using large-scale brain modeling, the neural activity of each region was represented as a Stuart-Landau oscillator operating in a regime showing damped oscillations, and the regions were coupled according to subject-specific connectomes. We propose a linear formulation to the relationship between the conduction delays and the amount of structural damage in each white matter tract. Dependent upon the parameterγ, this function translates lesions into edge-specific conduction delays (leading to shifts in the power spectra). Using deep neural density estimators, we found that the estimation ofγshowed a strong correlation with the alpha peak in MEG recordings. The most probable inferredγfor each subject is inversely proportional to the observed peaks, while power peaks themselves do not correlate with total lesion volume. Furthermore, the estimated parameters were predictive (cross-sectionally) of individual clinical disability. This study represents the initial exploration showcasing the location-specific impact of myelin lesions on conduction delays, thereby enhancing the customization of models for individuals with multiple sclerosis.
Acceptability of a community health worker- led health literacy intervention on lifestyle modification among hypertensive and diabetes patients in the City of Harare, Zimbabwe
Authors: Katena Nyaradzai Arster , Shamu Shepherd , Fana Golden Tafadzwa , Dewa Evans , Dombojena Admire , Rusakaniko Simbarashe 
Published: July 2024

AbstractDeploying community health workers (CHWs) is a vital strategy to improve health at a community level in low- and middle-income countries. Whilst there is substantial evidence on the effectiveness of CHWs interventions, there is a need for more research on the mechanisms through which these interventions work. Understanding the acceptability of these interventions is one way of assessing the mechanisms through which they work. This article examines the acceptability of a community health worker-led health literacy intervention on lifestyle modification among hypertensive and diabetes patients based on the perspectives of the CHWs, community nurses and diabetes and hypertensive patients. A qualitative study was imbedded within a cluster randomized trial to assess the effectiveness community health worker-led health literacy intervention on lifestyle modification among hypertensive and diabetes patients in the City of Harare, Zimbabwe. Data were gathered through semi-structured interviews with 3 community health nurses and 15 diabetes and hypertension patients as well as 2 focus group discussions with CHWs. Data were analyzed manually using the thematic analysis method. There was consensus that the intervention had many benefits amongst CHWs and community nurses. However, among patients, there were mixed perceptions regarding the benefits of the intervention. The main challenges that were mentioned by CHWs include resistance to advice by patients, insufficient resources, and lack of acceptance at some of the patient’s homes. All participants believed the intervention was acceptable. Our study provides vital information that should be considered in upscaling CHW led interventions.
New-onset chronic musculoskeletal pain following COVID-19 infection fulfil the Fibromyalgia clinical syndrome criteria
Authors: Khoja Omar , Mulvey Matthew , Astill Sarah , Tan Ai Lyn , Sivan Manoj 
Published: July 2024

ABSTRACTBackgroundNew-onset chronic musculoskeletal (MSK) pain (> 3 months duration) is one of the commonest persistent symptoms of Post-COVID syndrome (PCS). There is emerging evidence that the chronic MSK pain and associated symptoms in PCS have similarities to Fibromyalgia Syndrome (FMS). This study aimed to characterise PCS related new-onset chronic MSK pain and its overlap with Fibromyalgia Syndrome (FMS).MethodsPatients with new-onset chronic MSK pain following COVID-19 infection were enrolled and the nature of pain and associated symptoms captured using the C19-YRS (Yorkshire Rehabilitation Scale). FMS assessment was conducted as part of standard clinical examination using the American College of Rheumatology (ACR) 2010 criteria. Diagnosis of FMS was made when they meet the standard criteria of (1) Widespread Pain Index (WPI) ≥ 7 and Symptoms Severity (SS) score ≥ 5, or WPI is 3-6 and SS score ≥ 9, (2) symptoms have been present at a similar level for at least 3 months, and (3) the patient does not have a disorder that would otherwise explain the symptoms.ResultsEighteen patients, twelve of whom were female, with an average age of 49.6 (SD 11.8) years and a Body Mass Index of 31.7 (SD 8.6) were enrolled. The average duration of symptoms from COVID-19 infection to assessment was 27.9 (SD 6.97) months. The new-onset chronic pain was widespread, primarily manifesting as muscle pain. Thirteen (72.2%) patients met the diagnostic criteria for FMS, with an average WPI score of 8.8 and an average SS score of 8.2, indicating a high level of pain and significant adverse impact on their quality of life.ConclusionThe study found that 72.2% of the patients with new-onset chronic MSK pain following COVID-19 infection met the criteria for FMS. These findings support the hypothesis that FMS may develop as a long-term sequela of a viral infection, underscoring the need for further research into post-viral long-term conditions.
Infectious Complications Following CD30 Chimeric Antigen Receptor T-Cell Therapy in Adults
Authors: Cao Felicia , Xiu Yueling , Mohnasky Michael , Serody Jonathan S. , Armistead Paul , Dotti Gianpietro , Smith Melody , Huggins Jonathan , Messina Julia , Ramachandran Bhanu , Saullo Jennifer , Stromberg Joseph , Saha Manish K. , Walsh Megan , Savoldo Barbara , Grover Natalie , Henderson Heather I. , Andermann Tessa M. 
Published: July 2024

ABSTRACTInfections are increasingly recognized as a common complication of chimeric antigen receptor (CAR) T-cell therapy. The incidence of clinically-defined infection after CD19.CAR T-cell therapy for relapsed/refractory lymphoma ranges from 60-90% in the first year after CAR T-cell therapy and is the most common cause for non-relapse mortality. However, infectious risk after CAR T-cell therapy targeting other malignancies is not well understood. Herein, we report for the first time, infectious complications after CD30.CAR T-cell treatment for patients with Hodgkin’s lymphoma and peripheral T-cell lymphoma. Since CD30 is only expressed on a subset of activated T and B-cells, we hypothesized that CD30.CAR T-cell patients would have reduced incidence and severity of infections after infusion compared to CD19.CAR T-cell patients. We retrospectively evaluated all 64 patients who received CD30.CAR T-cells at a single institution between 2016-2021, and assessed infections within one year after cell infusion, comparing these data to a contemporary cohort of 50 patients who received CD19.CAR T-cells at the same institution between 2018-2021. 23 CD30.CAR T-cell patients (36%) and 18 CD19.CAR T-cell patients (36%) developed a microbiologically confirmed infection. Infection severity and bacterial infections were higher in the CD19.CAR T-cell group compared to CD30.CAR T-cell recipients who more commonly had grade 1 respiratory viral infections. Our data reflect expected outcomes for severity and infection type in CD19.CAR T-cell patients and provide a benchmark for comparison with the novel CD30.CAR T-cell product. Although our findings require replication in a larger cohort, they have implications for antimicrobial prophylaxis guidelines after CD30.CAR T-cell therapy.KEY POINTS1) The incidence of infections within the first year after CD30.CAR T-cell therapy was equivalent to that following CD19.CAR T-cell therapy2) Viral infections were more common after CD30.CAR T-cell therapy but bacterial infections predominated after CD19.CAR T-cell therapy.
Dynamics of bacterial biofilm development imaged using light sheet fluorescence microscopy
Authors: Šmerdová Lenka , Füzik Tibor , Valentová Lucie , Bárdy Pavol , Procházková Michaela , Pařenicová Martina , Plevka Pavel 
Published: July 2024

AbstractBiofilm formation exacerbates bacterial infections and interferes with industrial processes. However, the dynamics of biofilm development is not entirely understood. Here, we present a microfluidic cultivation system that enables continuous imaging of biofilm growth using light sheet fluorescence microscopy (LSFM). We studied the development of biofilms of the human pathogensStaphylococcus aureusandPseudomonas aeruginosa. Due to the low phototoxicity of LSFM, biofilms can be continuously imaged without adverse effects on their development. WhereasS. aureusforms 50-70-μm-thick mushroom-like structures, aP. aeruginosabiofilm is 10-15 μm thick with cell clusters 25 μm in diameter. A combined biofilm, inoculated with an equal OD600ratio ofS. aureusandP. aeruginosa, resulted in the formation of large mushroom-like clusters ofS. aureuscells that were subsequently dispersed by invadingP. aeruginosa.A higher inoculation ratio favoringP. aeruginosaresulted in the formation of small and stableS. aureusclusters overgrown withP. aeruginosacells. Applying conditioned media fromS. aureusandP. aeruginosacoculture to a single-speciesS. aureusbiofilm induced its dispersion. Integrating a microfluidic system into LSFM enables the visualization of biofilm formation dynamics and the effects of compounds on biofilm development.