bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer odds among Ohio firefighters: data from the Ohio Cancer Incidence Surveillance System (OCISS) 1996–2019
Authors: Olivo-Marston Susan Elizabeth , Singh Shashank , Hood Robert , Adetona Olorunfemi 
Published: May 2024

ObjectivesThe objective of the current case–control study was to examine the odds of cancer among firefighters in the state of Ohio and compare the odds of being a firefighter versus police or the general population across different cancer types.MethodsCancer cases were examined from the Ohio Cancer Incidence Surveillance System (OCISS) between 1996 and 2019. Occupation status was classified as firefighter, police or general population. Logistic regression models were run to calculate ORs to determine the odds of being a firefighter compared with police or the general population across different cancer types. Models were adjusted for gender, race, age at cancer diagnosis and year of cancer diagnosis.ResultsAmong the 906 164 cancer cases, 3397 were firefighters and 3341 were police. Firefighters were more likely to be men, white, non-Hispanic, married and a mean age of 66 at the time of cancer diagnosis. Firefighters had increased odds of cancer of the brain (OR=1.40, 95% CI: 0.99 to 1.99) and thyroid (OR=1.53, 95% CI: 1.05 to 2.23) compared with police and oesophageal (OR=1.83, 95% CI: 1.43 to 2.33), skin (OR=1.23, 95% CI: 1.06 to 1.42), brain (OR=1.37, 95% CI: 1.08 to 1.73) and thyroid (OR=1.52, 95% CI: 1.18 to 1.96) compared with the general population. They had decreased odds of pancreas, lung and bronchus and bladder compared with both police and the general population. Similar patterns were observed among male firefighters.ConclusionsThe current study demonstrated increased odds of several different types of cancer among Ohio firefighters compared with other individuals within the OCISS, which may be associated with differences in risk factors, including occupational exposures. The results align with evidence that firefighting is a cancer risk factor. This study is strengthened by the ability to also compare firefighters to police with regards to the odds of cancer. This supports future hypothesis-driven studies examining how specific occupational exposures are associated with increased cancer risk among Ohio firefighters.
Innovative continuum of care to promote exclusive breast feeding in Pakistan: protocol of a pilot randomised controlled trial
Authors: Chaudry Zahid Azam , Naz Tehmina , Arshad Iqra , Zahoor Aisha , Javaid Mahum , Sikander Siham 
Published: May 2024

BackgroundBreastmilk being the ideal nutrition from birth to 2 years and beyond has many health benefits for both newborn and mothers. This study will assess the feasibility and acceptability of a continuum of care programme, which is a health facility and community based till 6 months post partum to encourage ideal breastfeeding practices.Methods and analysisA pilot randomised control trial having two-parallel arms of intervention and control groups was conducted in gynaecology and obstetrics department of Aziz Bhatti Shaheed Teaching Hospital with a community outreach component of 6 months. 50 women between 28 and 32 weeks of gestation fulfilling inclusion criteria will be allocated in 1:1 randomly into intervention and control groups through computer-generated random number generator software. 25 participants in intervention group will receive counselling and training on breast feeding during antenatal visits along with a family member of support by a trained female doctor within the hospital, at birth by a trained nurse and at home for 6 months by a trained lady health worker. It will be supported by reading materials and videos through a mobile phone WhatsApp application. The 25 participants in control group will receive the support already provided within the hospital and at home. The primary outcomes feasibility and acceptability will be determined at 6 months post partum from participants and providers by a semistructured questionnaire. The secondary outcomes are rates of infant early initiation and exclusive breast feeding at 2 weeks, 1, 3 and 6 months, Infant Feeding Attitude at 1 month and Breastfeeding Self-Efficacy at 3 months. Quantitative and qualitative data will be analysed via SPSS software V.20 and thematic analysis, respectively.ConclusionThis pilot randomised controlled trial (RCT) will guide the interventions for the definite RCT.Ethics and disseminationApproved by institutional ethical committee, informed consent from all participants and results will be disseminated in peer-reviewed journal.Trial registration numberNCT05951868.
Development and validation of a risk scoring system to identify patients with lupus nephritis in electronic health record data
Authors: Izadi Zara , Gianfrancesco Milena , Anastasiou Christine , Schmajuk Gabriela , Yazdany Jinoos 
Published: May 2024

ObjectiveAccurate identification of lupus nephritis (LN) cases is essential for patient management, research and public health initiatives. However, LN diagnosis codes in electronic health records (EHRs) are underused, hindering efficient identification. We investigated the current performance of International Classification of Diseases (ICD) codes, 9th and 10th editions (ICD9/10), for identifying prevalent LN, and developed scoring systems to increase identification of LN that are adaptable to settings with and without LN ICD codes.MethodsTraining and test sets derived from EHR data from a large health system. An external set comprised data from the EHR of a second large health system. Adults with ICD9/10 codes for SLE were included. LN cases were ascertained through manual chart reviews conducted by rheumatologists. Two definitions of LN were used: strict (definite LN) and inclusive (definite, potential or diagnostic uncertainty). Gradient boosting models including structured EHR fields were used for predictor selection. Two logistic regression-based scoring systems were developed (‘LN-Code’ included LN ICD codes and ‘LN-No Code’ did not), calibrated and validated using standard performance metrics.ResultsA total of 4152 patients from University of California San Francisco Medical Center and 370 patients from Zuckerberg San Francisco General Hospital and Trauma Center met the eligibility criteria. Mean age was 50 years, 87% were female. LN diagnosis codes demonstrated low sensitivity (43–73%) but high specificity (92–97%). LN-Code achieved an area under the curve (AUC) of 0.93 and a sensitivity of 0.88 for identifying LN using the inclusive definition. LN-No Code reached an AUC of 0.91 and a sensitivity of 0.95 (0.97 for the strict definition). Both scoring systems had good external validity, calibration and performance across racial and ethnic groups.ConclusionsThis study quantified the underutilisation of LN diagnosis codes in EHRs and introduced two adaptable scoring systems to enhance LN identification. Further validation in diverse healthcare settings is essential to ensure their broader applicability.
Untangling the relationship between smoking and systemic sclerosis: an analysis of the EUSTAR cohort
Authors: Ciaffi Jacopo , Liem Sophie I E , Cannegieter Suzanne , Ahmed Saad , Hoekstra Eva M , Wiland Piotr , Atsumi Tatsuya , Szücs Gabriella , Balbir Gurman Alexandra , Czirják László , Zanatta Elisabetta , Koetter Ina , Henes Joerg C , Matucci-Cerinic Marco , Airò Paolo , Ursini Francesco , Huizinga Tom W J , De Vries-Bouwstra Jeska , Collaborators EUSTAR 
Published: May 2024

ObjectivesTo untangle the association between smoking and systemic sclerosis (SSc).MethodsIn the European Scleroderma Trials and Research cohort, the autoantibody status was compared between ever-smokers and never-smokers. Time until disease progression was assessed using Kaplan-Meier curves. Cox models were built to investigate the influence of smoking over 15 years of follow-up. All analyses were performed for the total cohort and stratified for sex and for positivity of anti-centromere (ACA) and anti-topoisomerase antibodies (ATA).ResultsOverall, 12 314 patients were included in the study. Of these, 10 393 were women (84%), 4637 were ACA-positive (38%), 3919 were ATA-positive (32%) and 4271 (35%) were ever-smokers. In men, but not in women, smoking was associated with mortality (HR 1.63, 95% CI 1.23 to 2.16, p=0.001). Ever-smoking women were at higher risk for skin progression (HR 1.10, 95% CI 1.00 to 1.22, p=0.046) and for ‘any organ progression’ (HR 1.07, 95% CI 1.00 to 1.13, p=0.036). In women, 34% of never-smokers were ATA-positive compared with 21% of ever-smokers (p<0.001). In the group of ever-smokers, higher exposure rates, reflected by the number of pack-years (OR 0.98, 95% CI 0.97 to 0.99, p<0.001) and by smoking duration (OR 0.96, 95% CI 0.95 to 0.97, p<0.001), were associated with lower frequency of ATA. In ACA-positive patients, the risk of mortality (HR 1.29, 95% CI 1.02 to 1.63, p=0.033), cardiac involvement (HR 1.25, 95% CI 1.03 to 1.43, p=0.001), skin progression (HR 1.21, 95% CI 1.03 to 1.42, p=0.018) and ‘any organ progression’ (HR 1.14, 95% CI 1.05 to 1.24, p=0.002) was increased among smokers. In ATA-positive smoking patients, mortality (HR 1.40, 95% CI 1.10 to 1.78, p=0.006), skin progression (HR 1.19, 95% CI 1.03 to 1.37, p=0.020) digital ulcers (HR 1.17, 95% CI 1.02 to 1.34, p=0.029) and ‘any organ progression’ (HR 1.11, 95% CI 1.00 to 1.22, p=0.048) occurred more frequently.ConclusionsOur stratified analysis demonstrates that smoking is associated with an increased risk for mortality in male SSc patients but not in women. Strikingly, smoking is associated with lower prevalence of ATA positivity, in particular in women. In both ATA-positive and ACA-positive patients, smoking is a risk factor for mortality, skin progression and ‘any organ progression’.
Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid
Authors: Ramírez Medina Carlos Raúl , Feng Mengyu , Huang Yun-Ting , Jenkins David A , Jani Meghna 
Published: May 2024

ObjectivesFibromyalgia is frequently treated with opioids due to limited therapeutic options. Long-term opioid use is associated with several adverse outcomes. Identifying factors associated with long-term opioid use is the first step in developing targeted interventions. The aim of this study was to evaluate risk factors in fibromyalgia patients newly initiated on opioids using machine learning.MethodsA retrospective cohort study was conducted using a nationally representative primary care dataset from the UK, from the Clinical Research Practice Datalink. Fibromyalgia patients without prior cancer who were new opioid users were included. Logistic regression, a random forest model and Boruta feature selection were used to identify risk factors related to long-term opioid use. Adjusted ORs (aORs) and feature importance scores were calculated to gauge the strength of these associations.ResultsIn this study, 28 552 fibromyalgia patients initiating opioids were identified of which 7369 patients (26%) had long-term opioid use. High initial opioid dose (aOR: 31.96, mean decrease accuracy (MDA) 135), history of self-harm (aOR: 2.01, MDA 44), obesity (aOR: 2.43, MDA 36), high deprivation (aOR: 2.00, MDA 31) and substance use disorder (aOR: 2.08, MDA 25) were the factors most strongly associated with long-term use.ConclusionsHigh dose of initial opioid prescription, a history of self-harm, obesity, high deprivation, substance use disorder and age were associated with long-term opioid use. This study underscores the importance of recognising these individual risk factors in fibromyalgia patients to better navigate the complexities of opioid use and facilitate patient-centred care.
Delay volterra integrodifferential models of fractional orders and exponential kernels: Well-posedness theoretical results and Legendre–Galerkin shifted approximations
Authors: Sweis Hind , Shawagfeh Nabil , Abu Arqub Omar 
Published: May 2024

The utilized research work studies the well-posedness theoretical results and Galerkin-shifted approximations of delay Volterra integrodifferential models of fractional orders and exponential kernels in linear and nonlinear types in the Caputo–Fabrizio sense. Schauder’s and Arzela–Ascoli’s theorems are employed to prove a local existence theorem. After that, the Laplace continuous transform is employed to establish and confirm the global well-posedness theoretical results for the presented delay model. For numerical solutions, the Legendre–Galerkin shifted approximations’ algorithm has been used by the dependence on the orthogonal Legendre shifted polynomials to find out the required approximations. Utilizing this scheme, the considered delay model is reduced to an algebraic system with initial constraints. The algorithm precision, error behavior, and convergence are studied. Several numerical experiments together with several tables and figures are included to present the performance and validation of the algorithm presented. At last, some consequences and notes according to the given consequences were offered in the final section with several suggestions to guide future action.
Repeatability of Platelet Aggregation Characteristics Using Impedance Aggregometry With and Without Aspirin Intervention
Authors: Williams Auni , Fisher Kat , Kenney W. Larry , Alexander Lacy 
Published: May 2024

Nearly 40% of adults over 50-years-old regularly take aspirin for primary or secondary prevention of cardiovascular disease and/or adverse cardiovascular events. The effcacy of aspirin therapy is commonly assessed with light transmission aggregometry. However, this method requires removal of large platelets as well as the mechanical disturbance of platelets remaining to be tested in the sample. Impedance aggregometry presents a solution to this problem, but the repeatability of impedance aggregometry analysis remains to be tested. We hypothesized repeated impedance aggregometry analysis would show decreased platelet aggregation activity following aspirin intervention compared with control visits. Venous blood samples were obtained from ten participants on three occasions each, separated by at least two weeks. One sample followed seven days of aspirin intervention (81 mg once daily; ASA) and the other two with no intervention (control). Platelet aggregation was induced using 1 μg/ml collagen (Col1), 5 μg/ml collagen (Col5), and 0.5 mM arachidonic acid (AA) via impedance aggregometry to determine area under the aggregation curve (AUC, au), time to aggregation initiation following addition of reagent (Lag, s), the rate of aggregation (Slope), and the maximal aggregation (Amp, Ohms). These characteristics were statistically analyzed for an impact of aggregometer channel (intra-test repeatability), visit (inter-test repeatability), intervention (ASA or control), and incubation (samples were incubated with either saline or Terutroban solution to block thromboxane receptors). Results were analyzed by multiple paired t-tests and represented with lowest relevant p-value if insignificant or highest relevant p-value if significant. Impedance aggregometry revealed no difference in any aggregation characteristics (AUC, Lag, Slope, or Amp) for duplicate samples (all p ≥ 0.10) or visits (all p ≥ 0.06). ASA decreased AUC, Slope, and Amp while increasing or completely inhibiting Lag response to the addition of all reagents (all p ≤ 0.01). Terutroban incubation had no effect on aggregation characteristics following the ASA intervention (all p ≥ 0.09), but attenuated the AUC, Slope, and Amp (all p ≤ 0.01), and entirely prevented or substantially increased the Lag response to AA (p ≤ 0.01) without impacting the responses to Col1 or Col5 (all p ≥ 0.24). These findings suggest the impedance aggregometry approach is a repeatable method for platelet aggregometry analysis for the characteristics of AUC, Lag, Slope, and Amp. NIH R01 Grant 1R01AG067471-01 NIH F31 Grant 1F31HL170616-01. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Sodium Bicarbonate Decreases Alcohol Consumption in Mice
Authors: Lin Jason , Ye Yani , Ryu Clara , Choi Inyeong 
Published: May 2024

pH is an important biological factor in the brain as H+ alters the structure and function of many ion channels, transporters and receptors, thus affecting relevant synaptic activities and complex firing patterns. pH may change activities in the neural circuits responsible for motivation and reward, such that drug reward values or modulatory properties are modified to change drinking frequency and amount. In this study, we tested whether alcohol consumption can be affected by systemic pH in mice. C57BL/6J mice were given free access to 0.2 M NaHCO3 for 6 days, which resulted in a 0.2 pH unit increase compared to water-fed control mice ( p < 0.05; n = 6/group). Mice were then subjected to voluntary alcohol consumption in the two-bottle free choice procedure with one bottle containing water and the other containing 5-20% alcohol (5% increment for 4 days each). NaHCO3-fed mice consumed similar amounts of 5-15% alcohol as pair-fed mice but decreased the consumption of 20% alcohol (p < 0.05). Consistent with this result, NaHCO3-fed mice had decreased alcohol preference (i.e., alcohol intake/total fluid intake) at 20%. These changes were observed in both males and females. In separate experiments, mice were subjected to the two-bottle free choice procedure using water and 20% alcohol, with both bottles containing 0.05-0.4 M NaHCO3. The alcohol consumption was significantly decreased in the presence of 0.1 M or higher NaHCO3. The minimum effective dose of NaHCO3 was 0.08 g/kg body weight, calculated from the amount of alcohol mice consumed. Determined by the diarrhea scoring system, mice produced a normal state of feces after receiving 0.4 M NaHCO3 for 2 days, thus indicating negligible abdominal discomfort at this concentration. In other experiments, mice were given NaHCO3 by oral gavage and 1 hour later subjected to 20% alcohol in the drinking in the dark procedure. The alcohol consumption was significantly decreased in NaHCO3-fed mice, compared to pair-fed mice. In conclusion, our study shows that mildly raising blood pH by NaHCO3 decreases alcohol consumption in mice. Given that pH change has been considered as a consequence of alcohol metabolism, our data provide first evidence on the pH as a factor affecting alcohol consumption. This work was supported by the grant from the National Institute of Alcohol Abuse and Alcoholism (R21AA028606). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Method of storage impacts graft immune cell populations in intestinal transplantation
Authors: McKinney-Aguirre Caroline , Schaaf Cecilia , Ludwig Elsa , Antezana Ariana , Freund John , Gonzalez Liara 
Published: May 2024

Intestinal transplantation (IT) is the only treatment for intestinal failure patients who cannot tolerate parenteral nutrition. Although cold storage (CS) is the gold standard for intestinal allograft preservation, normothermic machine perfusion (NMP) has improved transplantation success in other organs. Allograft immune modulation is thought to contribute to this success. The objective of this study was to assess the impact of NMP on intestinal immune cell populations as it relates to ultimate allograft and recipient health. We hypothesized that NMP would stabilize overall immune cell populations while reducing pro-inflammatory cohorts, thus improving IT success. Porcine intestines were stored for 6H at 4°C (CS-T6, n=6) or perfused at 34°C (NMP-T6, n=8) and transplanted. Samples were collected following intestinal procurement (T0), storage (T6), 1-hour post-transplant (T1PT), and euthanasia (T48). Flow cytometric profiling and quantification of intraepithelial (IEL) and lamina propria (LP) lymphocytes and NK cells were performed at T0, T6, and T48. Immunofluorescence (IF) identified CD3+ T-cells at T1PT. One-way ANOVA analyzed cell counts with significance set at p< 0.05. Flow cytometry revealed that NMP preserved CD3+ IELs in the jejunum at T6 (63.74% vs 32.79%, p< 0.0001), and in the ileum at T6 (51.31% vs 42.77%, p< 0.0001) and at T48 (57.73% vs 34.21%, p<0.0001). Immunofluorescent cell quantification confirmed this preservation of CD3+ IEL at T1PT in the crypts of the jejunum (4.9% vs 2.1 %, p< 0.05) and ileum (6.9% vs 2.8%, p< 0.001) compared to CS. However, upon further subpopulation analyses using flow cytometry, ileal IEL T-cells were reduced throughout NMP compared to CS (T6 28.7% vs 44.0%; T48 16.65% vs 22.37%; p< 0.0001). NK cells were also decreased in ileal and jejunal LP at NMP-T6 compared to T0 (3.6% vs 5.6%, p< 0.01; 2.4% vs 4.3% p< 0.05). NMP reduces NK cells, a cell type known to be associated with rejection. Interestingly, NMP preserved the overall CD3+ T cell populations in the jejunum and ileum at T6, T1PT, and T48. The subpopulation of IELs, however, were reduced in the ileum following NMP. The role of these populations, specifically in IT, has yet to be determined. Further characterization of T-cell subpopulations and dynamics is needed. Complimentary evaluations of the microbiome and proteomic responses to IT NMP are ongoing. Understanding immune cell dynamics will improve IT outcomes for patients requiring this critical, lifesaving surgery. U.S. Department of Defense PR181265; NIH K01OD010199 SERCA, T32OD011130-15. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.