bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colposcopy Referral and CIN3+ Risk of Human Papillomavirus Genotyping Strategies in Cervical Cancer Screening
Authors: Kroon Kelsi R. , Bogaards Johannes A. , Heideman Daniëlle A.M. , Meijer Chris J.L.M. , Berkhof Johannes 
Published: March 2024

Abstract

Background:
High-risk human papillomavirus (hrHPV)-based cervical cancer screening in the Netherlands led to a substantial increase in number of colposcopy referrals and low-grade lesions detected. Genotyping strategies may be employed to lower the screening-related burden.

Methods:
We evaluated 14 triage strategies with genotyping (HPV16/18 or HPV16/18/31/33/45/52/58) for hrHPV-positive borderlineormilddyskaryosis (BMD)ornormal cytology,usingdata from a population-based hrHPV-based screening trial with 5-year interval (POBASCAM). We considered colposcopy referral at baseline, after 6-month repeat cytology and after 5-year hrHPV testing. Performance was evaluated by one-round positive and negative predictive value (PPVandNPV) for CIN3+ and by two-roundcolposcopy referral rate. To identify efficient strategies, they were ordered by the one-round colposcopy referral rate. Adjacent strategies were compared by the marginal PPV for detecting one additional CIN3+ (mPPV).

Results:
The most conservative strategy (repeat cytology after BMD and HPV16/18/31/33/45/52/58-positive normal cytology, next round otherwise) yielded an mPPV of 28%, NPV of 98.2%, and two-round colposcopy referral rate of 47.2%. Adding direct referral after BMD or genotype-positive BMD yielded an mPPV ≤ 8.2%, NPV ≥ 98.5% and an increase in colposcopy referral rate of 1.9% to 6.5%. Adding direct referral after HPV16/18-positive normal cytology yielded an mPPV ≤ 3.5%, NPV ≥ 99.5% and an increase in colposcopy referral rate of 13.9%.

Conclusions:
Direct colposcopy referral of women with BMD or normal cytology is unlikely to be efficient, but genotype-guided direct referral after BMD may be considered because the increase in colposcopies is limited.

Impact:
hrHPV screening programs can become very efficient when immediate colposcopy referral is limited to women at highest CIN3+ risk.
See related In the Spotlight, p. 979
PIGA Mutations and Glycosylphosphatidylinositol Anchor Dysregulation in Polyposis-Associated Duodenal Tumorigenesis
Authors: Meuser Elena , Chang Kyle , Walters Angharad , Hurley Joanna J. , West Hannah D. , Perry Iain , Mort Matthew , Reyes-Uribe Laura , Truscott Rebekah , Jones Nicholas , Lawrence Rachel , Jenkins Gareth , Giles Peter , Dolwani Sunil , Al-Sarireh Bilal , Hawkes Neil , Short Emma , Williams Geraint T. , Taggart Melissa W. , Luetchford Kim , Lynch Patrick M. , Terlouw Diantha , Nielsen Maartje , Walton Sarah-Jane , Latchford Andrew , Clark Susan K. , Sampson Julian R. , Vilar Eduardo , Thomas Laura E. 
Published: March 2024

Abstract

The pathogenesis of duodenal tumors in the inherited tumor syndromes familial adenomatous polyposis (FAP) and MUTYH-associated polyposis (MAP) is poorly understood. This study aimed to identify genes that are significantly mutated in these tumors and to explore the effects of these mutations. Whole exome and whole transcriptome sequencing identified recurrent somatic coding variants of phosphatidylinositol N-acetylglucosaminyltransferase subunit A (PIGA) in 19/70 (27%) FAP and MAP duodenal adenomas, and further confirmed the established driver roles for APC and KRAS. PIGA catalyzes the first step in glycosylphosphatidylinositol (GPI) anchor biosynthesis. Flow cytometry of PIGA-mutant adenoma-derived and CRISPR-edited duodenal organoids confirmed loss of GPI anchors in duodenal epithelial cells and transcriptional profiling of duodenal adenomas revealed transcriptional signatures associated with loss of PIGA.

Implications:
PIGA somatic mutation in duodenal tumors from patients with FAP and MAP and loss of membrane GPI-anchors may present new opportunities for understanding and intervention in duodenal tumorigenesis.
Evaluation of Plasma Biomarkers for Causal Association With Peripheral Artery Disease
Authors: Sharma Pranav , Klarin Derek , Voight Benjamin F. , Tsao Philip S. , Levin Michael G. , Damrauer Scott M. 
Published: March 2024

BACKGROUND:
Hundreds of biomarkers for peripheral artery disease (PAD) have been reported in the literature; however, the observational nature of these studies limits causal inference due to the potential of reverse causality and residual confounding. We sought to evaluate the potential causal impact of putative PAD biomarkers identified in human observational studies through genetic causal inference methods.

METHODS:
Putative circulating PAD biomarkers were identified from human observational studies through a comprehensive literature search based on terms related to PAD using PubMed, Cochrane, and Embase. Genetic instruments were generated from publicly available genome-wide association studies of circulating biomarkers. Two-sample Mendelian randomization was used to test the association of genetically determined biomarker levels with PAD using summary statistics from a genome-wide association study of 31 307 individuals with and 211 753 individuals without PAD in the Veterans Affairs Million Veteran Program and replicated in data from FinnGen comprised of 11 924 individuals with and 288 638 individuals without PAD.

RESULTS:
We identified 204 unique circulating biomarkers for PAD from the observational literature, of which 173 were genetically instrumented using genome-wide association study results. After accounting for multiple testing (false discovery rate, <0.05), 10 of 173 (5.8%) biomarkers had significant associations with PAD. These 10 biomarkers represented categories including plasma lipoprotein regulation, lipid homeostasis, and protein-lipid complex remodeling. Observational literature highlighted different pathways including inflammatory response, negative regulation of multicellular organismal processes, and regulation of response to external stimuli.

CONCLUSIONS:
Integrating human observational studies and genetic causal inference highlights several key pathways in PAD pathophysiology. This work demonstrates that a substantial portion of biomarkers identified in observational studies are not well supported by human genetic evidence and emphasizes the importance of triangulating evidence to understand PAD pathophysiology. Although the identified biomarkers offer insights into atherosclerotic development in the lower limb, their specificity to PAD compared with more widespread atherosclerosis requires further study.
A Radar-Based 10-Year Climatology of Convective Snow Events in Central Pennsylvania
Authors: Schneider Karl , Lombardo Kelly , Kumjian Matthew R. , Bowley Kevin 
Published: March 2024

Abstract
Convective snow (CS) presents a significant hazard to motorists and is one of the leading causes of weather-related fatalities on Pennsylvania roadways. Thus, understanding environmental factors promoting CS formation and organization is critical for providing relevant and accurate information to those impacted. Prior research has been limited, mainly focusing on frontal CS bands often called “snow squalls”; thus, these studies do not account for the diversity of CS organizational modes that is frequently observed, highlighting a need for a robust climatology of broader CS events. To identify such events, a novel, radar-based CS detection algorithm was developed and applied to WSR-88D radar data from 10 cold seasons in central Pennsylvania, during which 159 cases were identified. Distinct convective organization modes were identified: linear (frontal) snow squalls, single cells, multicells, and streamer bands. Each algorithm-flagged radar scan containing CS was manually classified as one of these modes. Interestingly, the most-studied frontal mode only occurred <5% of the time, whereas multicellular modes dominated CS occurrence. Using the times associated with each CS mode, synoptic and local environmental information from model analyses was investigated. Key characteristics of CS environments compared to null cases include a 500-hPa trough in the vicinity, lower-tropospheric conditional instability, and sufficient moisture. Environments favorable for the different CS modes featured statistically significant differences in the 500-hPa trough axis position, surface-based CAPE, and the unstable layer depth, among others. These results provide insights into forecasting CS mode, explicitly presented in a forecasting decision tree.

Significance Statement
Convective snow events such as snow squalls are a leading cause of weather-related deaths on Pennsylvania roads. Research into these events is limited, thus negatively impacting forecast skill. To better understand convective snow event frequency of occurrence, inter- and intra-annual variability, and their supporting environments, we performed a 10-yr radar-based climatology of these events. We report the results of this climatology and on the statistically significant differences in their supporting environments. The latter are used to propose a forecasting framework for convective snow, which may improve the predictability of convective snow in an operational setting.
Spelling Bees
Authors: Boudreau James W. , Kettering Jeremy , Sanders Shane D. 
Published: March 2024

In this note, we consider a form of competition in which two contestants face separate sequences of independent trials. The contestant with the longer sequence of successful trials wins. However, since the trials are independent, there may be a form of paradox whereby the loser is able to pass all of the trials in the winner’s sequence, whereas the winner could not have overcome two or more trials in the loser’s sequence. We refer to this as the spelling bee paradox and explore its likelihood in simple settings. JEL Classification Codes: C46, D74, Z29.
Changes in Otitis Media During COVID-19
Authors: Cho Yongmin , Lee Jong-Geun , Ryu Gi Hwan , Song Jae-Jun , Im Gi Jung , Chae Sung-Won 
Published: March 2024

Objectives: During the COVID-19 pandemic, various non-pharmaceutical interventions such as individual hygiene practices like hand washing, social distancing, and mandates for the use of masks in public spaces were implemented to reduce the spread of the disease. Otitis media (OM) is a common infectious disease. How the changed environment due to the COVID-19 pandemic has influenced the prevalence of infectious diseases like OM is not known. This study aimed to investigate how OM prevalence and trends changed during COVID-19 in Korea. Methods: OM patient data from 2017 to 2021 were extracted from the Health Insurance Review and Assessment Service database. Patients diagnosed with disease code H66 (suppurative and unspecified otitis media) were selected for analysis. Data on OM prevalence, gender, region, medical institution, and number of ventilating-tube prescriptions were analyzed. All age groups were included, and ages were categorized into 5-year ranges Results: The number of patients diagnosed with the OM disease code decreased continuously from 2017 to 2021 (1 598 205, 1 560 178, 1 520 948, 983 701, and 734 901). The average OM prevalence per 1000 persons decreased by 45.0% from 30.2 in 2017 to 2019 to 16.6 in 2020 to 2021. The change of OM prevalence was greater for the 0 to 5 age group than other age groups. The decrease in average prevalence per 1000 persons was greatest in the 0 to 5 age group (48.6% decrease from 358.2 in 2017-2019 to 184.1 in 2020-2021). The impact of environmental changes on ventilation-tube insertion was smaller than on OM prevalence. The average number of ventilating-tube insertions decreased by 28.1% from 27 311 in 2017 to 2019 to 19 650 in 2020 to 2021. Conclusions: OM prevalence decreased by 45.0%, and the number of ventilating-tube insertions decreased by 28.1% in Korea during COVID-19.
A revisionist model for treatment-resistant and difficult-to-treat depression
Authors: Parker Gordon 
Published: March 2024

Objective: The aim of this study is to consider limitations to the heuristics ‘treatment-resistant depression’ (TRD) and ‘difficult-to-treat’ depression (DTD) and to offer a revisionist model. Methods: A number of limitations to the two constructs are noted, particularly the risk of each positioning clinical depression as an entity and then applying a linear sequencing management model. Results: Arguing that clinical depression is heterogenous in nature (with categorical and ‘fuzzy set conditions), in cause and in response to treatment, allows an alternate model for addressing depressive conditions that are not readily responsive to treatment. A skeletal model for proceeding is offered for consideration and development. Conclusion: If such a model is accepted, then differing criteria for defining treatment resistance and treatment failure might be generated for differing depressive conditions, and condition-specific sequencing algorithms (embracing drug and non-drug strategies) developed for their management.
Performance analysis of fiber-reinforced polypropylene composite laminates under quasi-static and super-sonic shock loading conditions for impact application
Authors: Ram Khushi , Gupta Mohit , Kartikeya Kartikeya , Khatkar Vikas , Mahajan Puneet , Bhatnagar Naresh 
Published: March 2024

In the present research, glass and basalt fiber-reinforced polypropylene composites’ behaviour in quasi-static and dynamic conditions is studied. Composites were fabricated by vacuum assisted Compression molding method. Composites failure under quasi-static tension and compressive conditions was studied along with its failure behaviour under low-velocity impact and super-sonic shock loading under dynamic conditions. The study results showed that basalt fiber-reinforced polypropylene (Basalt/PP) composite’s tensile and compressive strength is higher than glass fiber-reinforced polypropylene (Glass/PP). The Basalt/PP showed no penetration against low velocity impact (LVI) with negligible deformations till 50 J. However, the Glass/PP perforated at 50 J with various failure patterns occurring at back side. The fiber-matrix interface adhesion plays an important role in super-sonic shock loading by absorbing shock wave energy due to ductile nature of polypropylene and the two composites absorbed energy via matrix and fibers failure, no brittle failure of laminates occurred under shock loading.
The legal and medical consequences of child marriage
Authors: Farrukh Affifa , Buttar Hamza , Mayberry John F 
Published: March 2024

The Marriage and Civil Partnership (Minimum Age) Act 2022 came into force in England on 27 February 2023 and made both registered and unregistered marriages involving people under 18 illegal in England and Wales. This means that such marriages which take place outside England and Wales will not be recognised and those who organised them, including parents, will have committed a criminal offence. This review considers issues related to families where such marriages have happened, including their impact on the health of the victim and any resulting children. It touches on religious and societal issues and the need for targeted and appropriate education.
Butylphthalide combined with donepezil for the treatment of vascular dementia: a meta-analysis
Authors: Liu Puqing , Liu Xiangjuan , Chen Jingwen , Zhang Yi , Chen Jun , Yu Lei , Shou Zhangxuan 
Published: March 2024

Objective To systematically evaluate the efficacy and safety of butylphthalide combined with donepezil versus butylphthalide monotherapy for the treatment of vascular dementia. Methods Randomized controlled trials were searched in electronic databases, including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database (VIP), Wan Fang, and China Biology Medicine from inception to 29 November 2022. Two reviewers independently screened the papers and extracted data from the included studies. The data were processed using RevMan5.4 statistical software. Results Nine randomized controlled trials (n = 1024) were included in this meta-analysis. Regarding the primary outcomes, compared with butylphthalide monotherapy, combined butylphthalide and donepezil treatment exhibited significantly greater total clinical efficacy (relative risk = 1.24, 95% confidence interval [1.17, 1.31]) and did not increase the adverse event rate (relative risk = 1.39, 95% confidence interval [0.91, 2.14]). Regarding the secondary outcomes, the meta-analysis results for the Mini-Mental State Examination, abilities of daily living, and Montreal Cognitive Assessment scores and the interleukin-6, tumor necrosis factor-α, and superoxide dismutase blood levels all supported combined butylphthalide and donepezil treatment. Conclusion Butylphthalide combined with donepezil may be a better treatment strategy than donepezil alone for the treatment of vascular dementia in clinical practice.
Should atelectasis be considered a pulmonary complication and indicator of poor prognosis in cystic fibrosis?
Authors: Martínez Redondo María , Carpio Segura Carlos , Zamarrón De Lucas Ester , Álvarez-Sala Walther Rodolfo , Prados Sánchez Concepción 
Published: March 2024

Objective This study examined whether bronchoscopy leads to clinicoradiological improvement in cystic fibrosis (CF) and the predictive factors. The study also investigated whether pulmonary atelectasis is a poor prognostic factor in CF. Methods This multicenter, case–control, observational, retrospective study included two groups of patients with CF: a case group (patients with persistent atelectasis who were followed-up at least for 2 years) and a control group (patients without atelectasis matched 1:1 by sex and age [±3 years]). We recorded demographic data, lung function test results, pulmonary complications, comorbidities, treatments (including bronchoscopies, surgery and transplantation), and deaths. Results Each group included 55 patients (case group: 20 men, mean age 25.4 ± 10.4 years; control group: 20 men, mean age 26.1 ± 11.4 years). Bronchoscopy did not lead to clinicoradiological improvement. Allergic bronchopulmonary aspergillosis (ABPA) was more frequent in the case group. Patients in the case group more frequently used inhaled steroids, their pre-atelectasis lung function was statistically worse, and they had more exacerbations during follow-up. Conclusion Moderate-to-severe pulmonary disease and ABPA can favor atelectasis. Pulmonary atelectasis can be a poor prognostic factor in CF because it increases exacerbations. Despite our results, we recommend enhancing treatment, including bronchoscopy, to prevent persistent atelectasis.
Biomechanical Comparison Between Superior Capsular Reconstruction and Lower Trapezius Tendon Transfer in Irreparable Posterosuperior Rotator Cuff Tears
Authors: Baek Gyuna , Kim Jung Gon , Baek Gyu Rim , Hui Aaron T. , McGarry Michelle H. , Baek Chang Hee , Lee Thay Q. 
Published: March 2024

Background: Superior capsular reconstruction (SCR) and lower trapezius tendon transfer (LTT) have recently been used to manage irreparable posterosuperior rotator cuff tears (PSRCTs). There has been a paucity of comparative biomechanical considerations between the 2 procedures. Purpose: To compare the glenohumeral stability and biomechanical properties between SCR and LTT in PSRCTs involving the entire infraspinatus tendon region. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric shoulders were tested at 0°, 20°, and 40° of shoulder abduction. Maximum internal, external, and total humeral range of motion (ROM), superior translation of the humeral head, and subacromial contact characteristics were compared among 4 conditions: (1) intact rotator cuff, (2) PSRCTs involving the entire infraspinatus tendon region, (3) LTT using Achilles allograft (12 N and 24 N of loading), and (4) SCR using fascia lata allograft. Results: Although a decrease in total ROM was noted in LTT with 12 N compared with the tear condition, LTT with both 12 N and 24 N as well as SCR did not restrict total rotational ROM compared with the intact condition. LTT had decreased total ROM compared with tear condition at 20° of abduction ( P = .042), while no significant decrease was confirmed at all abduction angles after SCR. SCR and LTT with 24 N decreased superior translation compared with the PSRCT condition at 0° and 20° of abduction ( P < .037) but not significantly at 40° of abduction, whereas LTT with a 24-N load decreased glenohumeral superior translation at all abduction angles ( P < .039). Both SCR and LTT decreased subacromial contact pressure compared with the tear condition ( P < .014) at all abduction angles. SCR decreased subacromial contact pressure at 0° and 40° of abduction ( P = .019 and P = .048, respectively) compared with LTT with 12 N of loading, while there was no difference between SCR and LTT with 24 N of loading in all abduction angles. SCR increased the contact area compared with the PSRCT condition at all abduction angles ( P < .023), whereas LTT did not increase the contact area. Conclusion: SCR and LTT decreased glenohumeral superior translation and contact pressure compared with PSRCT conditions. The LTT was superior to SCR in terms of superior translation of the humeral head at a higher shoulder abduction angle, whereas the SCR showed more advantageous subacromial contact characteristics compared with LTT. Clinical Relevance: These biomechanical findings provide insights into these 2 fundamentally different procedures for the treatment of young and active patients with PSRCTs involving the entire infraspinatus tendon region.
Brain Volumes in Opsoclonus-Myoclonus Ataxia Syndrome: A Longitudinal Study
Authors: Almudhry Montaha , Wagner Matthias W. , Longoni Giulia , Yea Carmen , Vidarsson Logi , Ertl-Wagner Birgit , Yeh E. Ann 
Published: March 2024

Introduction Little is known about the longitudinal trajectory of brain growth in children with opsoclonus-myoclonus ataxia syndrome. We performed a longitudinal evaluation of brain volumes in pediatric opsoclonus-myoclonus ataxia syndrome patients compared with age- and sex-matched healthy children. Patients and Methods This longitudinal case-control study included brain magnetic resonance imaging (MRI) scans from consecutive pediatric opsoclonus-myoclonus ataxia syndrome patients (2009-2020) and age- and sex-matched healthy control children. FreeSurfer analysis provided automatic volumetry of the brain. Paired t tests were performed on the curvature of growth trajectories, with Bonferroni correction. Results A total of 14 opsoclonus-myoclonus ataxia syndrome patients (12 female) and 474 healthy control children (406 female) were included. Curvature of the growth trajectories of the cerebral white and gray matter, cerebellar white and gray matter, and brainstem differed significantly between opsoclonus-myoclonus ataxia syndrome patients and healthy control children (cerebral white matter, P = .01; cerebral gray matter, P = .01; cerebellar white matter, P < .001; cerebellar gray matter, P = .049; brainstem, P < .01). Discussion/Conclusion We found abnormal brain maturation in the supratentorial brain, brainstem, and cerebellum in children with opsoclonus-myoclonus ataxia syndrome.