bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARING EFFICACY AND SAFETY OF LEFT ATRIAL APPENDAGE CLOSURE DEVICES: A NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Davis John W , Mai Steven L , Harmouch Wissam , Reisler Jenna , MacKay Micaela , Davis Elizabeth , Rich Mike 
Published: March 2024

AbstractIntroductionAtrial fibrillation-related stroke is a leading cause of morbidity and mortality. Options for prevention include left atrial appendage closure devices or oral anticoagulation. However, it remains unclear which option may be superior overall.MethodsWe conducted a systematic review and network meta-analysis of all clinical trials comparing the WATCHMAN, Amplatzer Amulet (Amulet), and/or OACs. The primary outcomes of interest were any stroke and all-cause death. Safety outcomes included any thromboembolism, device embolization, and pericardial effusion. We calculated risk ratios and heterogeneity statistics for each comparison, and calculated the probability of intervention superiority where at least one comparison was significant.ResultsThere were 441 articles identified from the search, from which 5 eligible RCTs were identified (n=1,811). Compared to OACs (all warfarin), risk of stroke was non-significantly decreased with WATCHMAN (RR=0.90, 95% CI: 0.48, 1.72, I2=13.4%), but risk with Amulet was non-significantly lower than WATCHMAN (RR=0.95, 95% CI: 0.50, 1.81). However, observed risk of all-cause death was significantly lower with Amulet than OAC (RR=0.53, 95% CI: 0.33, 0.85, I2=0%) and trended towards significance versus WATCHMAN (RR=0.74, 95% CI: 0.55, 1.02, p=0.06). The P-score was 0.982, signifying a >98% probability Amulet was superior to all alternatives. Risk of thromboembolism was non-significantly increased with WATCHMAN (RR=2.04, 95% CI: 0.23, 18.4) and Amulet (RR=1.54, 95% CI: 0.11, 22.1), with head-to-head comparison favoring Amulet (RR=0.76, 95% CI: 0.17, 3.38, I2=0%). Versus WATCHMAN, device embolization risk was non-significantly elevated with Amulet (RR= 2.38, 95% CI: 0.67, 8.43, I2=0%). Finally, risk of pericardial effusion was significantly elevated with Amulet versus OACs (RR=27.0, 95% CI: 3.48, 210) and versus WATCHMAN (RR=2.11, 95% CI: 1.41, 3.17, I2=0%). The inverse P-score for Amulet (0.9995) indicated a very high probability Amulet was inferior to alternatives.ConclusionWhile risk of some adverse events was greater with Amulet, we estimated >98% probability Amulet is superior to alternatives in risk of death. Pooled patient-level analyses are warranted.
A genetic and clinical risk factor algorithm to aid in identifying new cases of chronic kidney disease from the general population
Authors: Rodwell Graham , Ioannidis John P. A. , Kim Stuart K. 
Published: March 2024

AbstractOne of the biggest challenges in treating chronic kidney disease (CKD) is that 80 – 90% of people with this disease are undiagnosed, and thus do not access healthcare promptly. The problem arises because early stage CKD has no overt symptoms and the current policy is to perform diagnostic tests (e.g. glomerular filtration rate and urinary albumin to creatinine ratio) only when accompanied by risk factors such as old age, hypertension and diabetes. Genetic testing may be useful to identify those most likely to have CKD and who therefore may benefit from screening. This work describes the development of an algorithm termed RICK (for RIsk for Chronic Kidney disease) that employs a polygenic risk score for CKD plus clinical risk factors to identify people at risk. In data from the UK biobank, those in the top decile of RICK have a 4.4-fold increased risk of CKD, and about 34% of all those with CKD are included in this decile. Using RICK to selectively test those in the general population with highest risk may help in early identification of CKD and thereby facilitate early access to renal healthcare.Lay SummaryOne of the biggest challenges in renal health is that 80 – 90% of people with Chronic Kidney Disease (CKD) are undiagnosed, and thus do not access healthcare promptly. The problem arises because early stage CKD has no overt symptoms and the current policy is to perform diagnostic tests (e.g. glomerular filtration rate and urinary albumin to creatinine ratio) only when accompanied by risk factors such as old age, hypertension and diabetes.This work describes the development of an algorithm termed RICK (for RIsk for Chronic Kidney disease) that employs a genetic test for CKD plus clinical risk factors to identify people at risk and who therefore may benefit from screening. Those in the top ten percentile of RICK have a 15-fold increased risk of stage 3 CKD. Diagnostic testing of the top decile would capture about 43% of the undiagnosed stage 3 CKD cases. Thus, using RICK to selectively test those with highest risk could have an immense impact on renal health by facilitating early identification of CKD and thereby enabling access to healthcare.
A Novel Coach-Approach to Clinical Faculty Mentoring and the UW Department of Medicine Clinical Faculty Development Program
Authors: Alstott James D , Gent Chariti , Bell Christine Fabian , Marlin Daniel R , Hernandez Anthony , Schulman Esther , Gehl Sharon , Schnapp Lynn M , Stein James H 
Published: March 2024

AbstractBackgroundClinical faculty at academic health centers may benefit from specific mentorship and proficiencies that are distinct from those on research tracks. We describe the creation, activities, and one-year impact of a faculty development program that included novel professional coaching training (the Clinical Faculty Mentoring Program, CFMP) which was supplemented by skills- and knowledge-building activities (the Clinical Faculty Development Series, CFDS).MethodsThe goals and components of the CFMP and CFDS are described in detail. A mixed methods evaluation plan guided collection of confidential survey and interview data before and after the first year of these activities. We used paired t-tests to identify statistically significant changes.ResultsThe 43 clinical mentors reported significant gains in job satisfaction, teaching attitudes, knowledge of mentorship competencies, and confidence with coaching skills for mentorship (all p<0.05). Of mentor respondents, 88% found the coach approach to mentoring program to be “very” or “somewhat” helpful. Coaching behavioral domains with the greatest evidence of improvement were supporting the mentee to integrate new awareness, insight, learning into their worldview and behaviors (p=0.0503) and managing time and focus of mentoring sessions (p=0.022). All 37 mentees had at least one meeting with a mentor (100%). Over 9 months, 39 virtual CFDS sessions had an average participation of 38 participants (range 22-59). A majority of surveyed faculty (>55%) agreed or strongly agreed the CFDS sessions provided valuable opportunities for skills development with teaching, leadership, wellness, diversity, equity, inclusion, and promotion.ConclusionsAmong clinical mentors, our novel coach approach to clinical faculty mentoring and skill-building had favorable effects on job satisfaction, knowledge of mentorship competencies, and confidence in coaching skills. Outcomes from the clinical faculty development series supported the mentoring program outcomes. Longitudinal follow-up is needed to determine how this program will impact mentees.
Cortical Visual Processing Differences in Myopia and Blur
Authors: Steinfeld Katia , Murray Micah M. 
Published: March 2024

AbstractMyopia is projected to impact over 50% of the global population by 2050. Despite links to long-lasting anatomical changes in visual cortices, little is known of potential consequences of myopia on visual brain functions, such as visual completion. We hypothesized that adults suffering from moderate myopia process attentionally demanding visual stimuli under optical blur differently than emmetropic adults. Non myopes (N=12) and low-to-mild myopes(N=13) were tested under −3 diopters of lens-induced blur. Participants performed an illusory contour discrimination task while 128-channel EEG was recorded. Each trial also included an intervening, task-irrelevant dartboard stimulus. Visual evoked potentials (VEPs) to the illusory contour (IC), no contour (NC), and dartboard stimuli were analyzed using an electrical neuroimaging framework. We provide evidence for cortical processing differences between non myopes and mild myopes at 218-2800ms post-stimulus during visual completion, but not during viewing of dartboards. These differences stemmed from topographic modulations, indicative of the engagement of distinct networks of brain regions that were localized to medial portions of the occipital pole. Moreover, the predominant VEP topography during this time period both correlated with extent of refractive error and also was an excellent classifier of myopia vs. emmetropia. By contrast, our analyses provided no evidence for differences in visual completion processes between groups. To our knowledge, this is the first study of myopia pairing high-density EEG and a behavioral task. Collectively, this pattern of findings supports a model of myopia wherein low-level visual cortices are impacted at relatively late post-stimulus processing stages.
Illicit Fentanyl Use Independently Predicts HCV Seroconversion Among a Cohort of People Who Inject Drugs in Tijuana and San Diego
Authors: Friedman Joseph R , Abramovitz Daniela , Skaathun Britt , Rangel Gudelia , Harvey-Vera Alicia , Vera Carlos F , Artamonova Irina , Muñoz Sheryl , Martin Natasha K , Eger William H , Bailey Katie , Go Bo-Shan , Bourgois Philippe , Strathdee Steffanie A 
Published: March 2024

AbstractBackgroundIllicitly manufactured fentanyl (IMF) increases overdose mortality, but its role in infectious disease transmission is unknown. We examined whether IMF use predicts HCV and HIV incidence among a cohort of people who inject drugs (PWID) in San Diego, CA and Tijuana, Mexico.MethodsPWID were recruited into a prospective cohort in two waves during 2020-2022, undergoing semi-annual interviewer-administered surveys, HIV and HCV serology through February 2024. Cox regression was conducted to examine predictors of seroconversion considering self-reported IMF use as a fixed or lagged, time-dependent covariate.ResultsOf 398 PWID at baseline, 67% resided in San Diego, 70% were male, median age was 43, 42% reported receptive needle sharing and 25% reported using IMF. Participants contributed a median of 6 semi-annual study visits (IQR:4-6). HCV incidence was 14.26 per 100 person-years (95% CI: 11.49-17.02), and HIV incidence was 1.29 (1.00-2.28). IMF was associated with HCV seroconversion, with a univariable hazard ratio (HR) of 1.68 (95%CI: 1.12-2.53) which remained significant in multivariable models (adjHR1.54; 95%CI:1.01-2.34). The direction of the relationship with HIV was similar, albeit not significant, with an HR of 2.53 (0.7-9.15).ConclusionWe document a novel association between IMF and HCV seroconversion among PWID in Tijuana-San Diego. There was insufficient power to detect if a similar relationship held for HIV. IMF’s short half-life may destabilize PWID— increasing the need for repeat dosing and sharing smoking materials and syringes. Tailoring medication dosing for opioid use disorder and new preventative care approaches may reduce HCV transmission in the fentanyl era.SummaryIn this cohort study of people who inject drugs in Tijuana, Mexico, and San Diego, California, fentanyl use was independently associated with HCV seroconversion. Tailored treatment and prevention efforts are needed for patients using fentanyl to minimize blood-borne infections.
A Wearable In-pad Diagnostic for the Detection of Disease Biomarkers in Menstruation Blood
Authors: Dosnon Lucas , Rduch Thomas , Meyer Charlotte , Herrmann Inge K. 
Published: March 2024

ABSTRACTThe pain-free regular monitoring of blood-based biomarkers is a highly appealing yet difficult-to-realize approach for the early detection of pathological changes, including cancers, infections, or metabolic diseases, such as diabetes. While a major focus of the research community lies on the investigation of pain-free blood sampling and devices for venous blood analysis, menstruation blood remains a largely ignored sampling source. Growing evidence shows excellent correlation between biomarker levels in menstruation blood and venous blood for an entire clinical panel of analytes. Here, we introduce a wearable, microfluidic diagnostic platform integrated into standard hygiene pads for the electronic-free naked eye-readable direct detection of disease biomarkers in menstruation blood (MenstruAI). We demonstrate semi-quantitative biomarker detection from menstruation using infection and inflammation biomarker C-reactive protein (CRP), gynecological cancer biomarkers (CEA and CA-125), and endometriosis biomarker CA-125 as representative examples of relevant proteinaceous biomarkers. The color-changes induced by the presence of these biomarkers can be read-out by the naked eye as well as by a machine-learning algorithm implemented into a smartphone-app, enabling semi-quantitative analysis. The presented MenstruAI platform has the potential to revolutionize women’s health by providing a non-invasive, affordable, and accessible approach to health monitoring, potentially democratizing healthcare by making health services more available and equitable.
The iCARE feasibility non-experimental design study: An integrated collection of education modules for fall and fracture prevention for healthcare providers in long term care
Authors: Rodrigues Isabel B. , Ioannidis George , Kane Lauren , Hillier Loretta M. , McArthur Caitlin , Adachi Jonathan , Thabane Lehana , Heckman George , Holroyd-Leduc Jayna , Jaglal Susan , Kaasalainen Sharon , Straus Sharon , Abbas Momina , Tarride Jean-Eric , Marr Sharon , Hirdes John , Lau Arthur N. , Costa Andrew , Papaioannou Alexandra 
Published: March 2024

ABSTRACTFalls and hip fractures are a major health concern among older adults in long term care (LTC) with almost 50% of residents experiencing a fall annually. Hip fractures are one of the most important and frequent fall-related injuries in LTC. The purpose of this study was to determine the feasibility (recruitment rate and adaptations) of implementing the PREVENT (Person-centred Routine Fracture PreEVENTion) model in practice, with a subobjective to understand facilitators and barriers. The model includes a multifactorial intervention on diet, exercise, environmental adaptations, hip protectors, medications (including calcium and vitamin D), and medication reviews to treat residents at high risk of fracture. Our secondary outcomes aimed to assess change in knowledge uptake of the guidelines among healthcare providers and in the proportion of fracture prevention prescriptions post-intervention. We conducted a mixed-methods non-experimental design study in three LTC homes across southern Ontario. A local champion was selected to guide the implementation. We reported recruitment rates using descriptive statistics and adaptations using content analysis. We reported changes in knowledge uptake using the paired sample t-test and the percentage of osteoporosis medications prescriptions using absolute change. Within five months, we recruited three LTC homes. We required two months to identify and train the local champion over three 1.5-hour train-the-trainer sessions, and the champion required three months to deliver the intervention to the healthcare team. We identified several facilitators, barriers, and adaptations. Benefits of the model include easy access to the Fracture Risk Scale, clear and succinct educational material catered to each healthcare professional, and an accredited educational module for physicians and nurses. Challenges included misperceptions between the differences in fall and fracture prevention strategies, fear of perceived side effects associated with fracture prevention medications, and time barriers with completing the audit report. Our study did not increase knowledge uptake of the guidelines, but there was an increase in the proportion of osteoporosis medication post-intervention.
Detection of early-onset severe preeclampsia by cell-free DNA fragmentome
Authors: Zhang Haiqiang , Qiao Longwei , Hu Xintao , Zhang Chunhua , Lin Yu , Zhao Jingyu , Wu Xiaojuan , Song Xiaoyan , Tang Hui , Xue Ying , Sun Yang , Ou Rijing , Wang Xinxin , Zhang Yan , Jin Xin , Wang Ting 
Published: March 2024

AbstractEarly-onset severe preeclampsia (EO-PE) is a distinct and highly consequential form of preeclampsia (PE), presenting significant challenges for early detection. Here, we investigated the fragmentation pattern of plasma cell-free DNA (cfDNA) in EO-PE patients. We uncovered that the nucleotide composition at the 5’ end (i.e. ends motif) of plasma cfDNA showed a unique pathological preference in EO-PE pregnancies and gestational-psychology preference in healthy pregnancies. By integrating 91 EO-PE specific motifs into a machine-learning model, we achieved accurate prediction of EO-PE development in early pregnancies. Remarkably, our model demonstrated robust performance in an independent cohort of 74 early pregnancies and 1,241 non-invasive prenatal testing (NIPT) samples with ultra-low sequencing depth. Additionally, we revealed that these PE-specific motif signatures lacked tissue specificity, originating extracellularly, and were associated with the abnormal concentration of DNA fragmentation factor subunit beta (DFFB) in EO-PE patients’ plasma. These findings establish the plasma DNA fragmentome as a non-invasive and cost-effective biomarker that can be simultaneously captured during NIPT for early EO-PE detection and provide valuable insights into cfDNA production mechanisms in preeclampsia patients.
Zero-Shot Prompting is the Most Accurate and Scalable Strategy for Abstracting the Mayo Endoscopic Subscore from Colonoscopy Reports Using GPT-4
Authors: Yim Richard P. , Rudrapatna Vivek A. 
Published: March 2024

Structured AbstractIntroductionLarge-language models can help extract information from clinical notes, making them potentially useful for research in ulcerative colitis. However, it remains unclear if these models will scale well in practice.MethodsWe analyzed the performance and cost of programmatically using GPT-4 to abstract Mayo endoscopic subscores (MES) from 499 colonoscopy reports using different prompting strategies.ResultsZero-shot prompting, where GPT-4 is instructed without examples, was most accurate (83.55%)andcost-effective ($0.097/note).DiscussionUsing GPT-4 to automatically curate the MES and other variables is a practical strategy for quantifying UC activity and measuring improvements to clinical care.
Primary progressive aphasia in Italian and English: a cross-linguistic cohort study
Authors: Mazzeo Salvatore , Hardy Chris JD , Jiang Jessica , Morinelli Carmen , Moschini Valentina , Brooks Ella , Johnson Jeremy CS , Chokesuwattanaskul Anthipa , Volkmer Anna , Rohrer Jonathan D , Ingannato Assunta , Bagnoli Silvia , Padiglioni Sonia , Nacmias Benedetta , Sorbi Sandro , Bessi Valentina , Warren Jason D 
Published: March 2024

ABSTRACTBackground and objectivesPrimary progressive aphasia (PPA) signifies a diverse group of neurodegenerative disorders principally affecting language functions. The major syndromic variants of PPA present with distinct profiles of linguistic deficits. However, current concepts and diagnosis of PPA are largely based on English-speaking patients, while few studies have explored how PPA syndromes might vary between languages. Here we undertook a comprehensive neuropsychological comparison of all major PPA syndromes in two languages with contrasting characteristics: Italian and English.MethodsWe retrospectively compared the PPA cohorts attending our specialist referral centres on neuropsychological tests sampling a range of linguistic and general cognitive domains. The cohorts comprised 106 native Italian-speakers with PPA (14 nonfluent/agrammatic variant [nfvPPA], 20 semantic variant [svPPA], 41 logopenic variant [lvPPA], 31 mixed PPA [mPPA]) and 166 native English-speakers with PPA (70 nfvPPA, 45 svPPA, 42 lvPPA, 9 mPPA). Neuropsychological scores were normalised to healthy older native speakers (adjusted for age and years of education) and dichotomised (impaired/unimpaired) to identify the proportion of each cohort showing impairment on each test. Cohorts were compared in logistic regression models, covarying for symptom duration and overall cognitive severity.ResultsThe English PPA cohort was significantly younger (mean 62.7 years) than the Italian cohort (mean 65.9 years; p=0.003), with longer symptom duration (mean 4.6 vs 3.1 years; p=0.048), a higher proportion of nfvPPA cases (42% vs. 13%, p<0.001) and lower proportions of lvPPA (25% vs. 38%, p=0.019) and mPPA (5% vs. 29%, p<0.001). Compared with Italian-speaking patients, English-speaking nfvPPA patients had less frequent expressive agrammatism (p=0.015) and more frequently impaired single-word comprehension (p=0.013) and nonverbal working memory (p=0.041). English svPPA patients had more frequent surface dyslexia (p=0.046) and dysgraphia (p=0.021), while English lvPPA patients had more frequently impaired single-word comprehension (p<0.001), word repetition (p=0.02), nonverbal working memory (p=0.005) and visuospatial perception (p<0.001).DiscussionLanguage-specific characteristics importantly influence PPA phenotypes: degeneration of language networks may predispose to expressive agrammatism in Italian (reflecting its morphological complexity) and to impaired spoken word processing and regularisation errors in English (reflecting its articulatory, acoustic and orthographic complexity). These findings have implications for diagnosis, management and cross-linguistic collaborative initiatives in PPA.
Circulating Levels of Angiotensinogen, Sex, and Hormone Therapy - The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Lidani Karita C. F. , Trainor Patrick J. , Buscaglia Robert , Foster Kristoff , Jaramillo Sophia , Michael Kirolos , Landry Alexander Pete , Michos Erin D. , Ouyang Pamela , Morgan Erin S. , Tsimikas Sotirios , DeFilippis Andrew P. 
Published: March 2024

ABSTRACTBackgroundAngiotensinogen, the unique precursor of all angiotensin hormones of the Renin-Angiotensin-Aldosterone System (RAAS), is now a potential target in a novel pharmacological approach to hypertension. Investigating the factors that influence angiotensinogen levels, including sex hormones, may have important therapeutic implications.MethodsPlasma angiotensinogen and sex hormones levels were measured in 5,171 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Linear models were employed to determine the associations of angiotensinogen with sex hormones, and mediation analysis was performed to evaluate the effect of HT on blood pressure (BP) and hypertension through angiotensinogen.ResultsAngiotensinogen levels were significantly higher in postmenopausal women receiving HT (n=760) compared to women not receiving HRT (n=1,675) and in men (n=2,736). A positive association was present between angiotensinogen and estrogen levels that differed in magnitude between sexes and by HT status among postmenopausal women (women on HT: r=0.44, p< 0.0001; women not on HT: r=0.09, p=0.0002; and men: r= 0.07, p=0.0003). The type of HT formulation (estrogen or estrogen/progesterone) and its duration of use did not significantly affect angiotensinogen levels. HT indirectly increased systolic BP (β=1.24) and the odds of hypertension (OR=1.065) through its effect of increasing angiotensinogen.ConclusionsA positive association was present between angiotensinogen and estrogen levels that differed by HT status. HT impacts systolic BP and hypertension indirectly by increasing angiotensinogen. This study underscores the role of angiotensinogen in hypertension, and the complex relationship between HT and hypertension.