bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Adverse Maternal And Neonatal Outcomes in Adolescent versus Adult Mothers in Sub-Saharan Africa
Authors: Onuzo Chibuikem N. , Sefogah Promise E. , Damale Nelson K. , Boafor Theodore K. , Swarray-Deen Alim , Mumuni Kareem 
Published: January 2024

AbstractObjectiveAdolescent pregnancy is a major social and public health problem that burdens affected families, the communities and societies globally. It has been associated with a higher prevalence of adverse pregnancy outcomes compared to pregnancy in adults. To compare adverse pregnancy outcomes in adolescents (13-19 years) and those in adults (20 to 35 years) at the Korle-Bu Teaching Hospital in Accra, Ghana and investigate the associated factors among adolescents.MethodsThis comparative cross-sectional study involved 110 adolescents (13-19 years) and 220 adults (20 to 35 years) who delivered at the Maternity Unit of the Korle-Bu Teaching Hospital between November 2016 and February 2017. Participants were recruited using the convenience sampling method. After study protocol was explained to the parturient, informed voluntary consent and assent were obtained. Participants who met the inclusion criteria were recruited in the study. Sociodemographic characteristics, antenatal and delivery records; and maternal and perinatal outcomes were collected using an interviewer administered questionnaire and the participants’ records. Data analysis was done using SPSS version 16.0.ResultsThe incidence of adolescent pregnancies during the study period was 5.1%. Compared to adults, adolescents were about 3 times more likely to have eclampsia although preeclampsia occurred more in adults. Adolescents that resided in sub-urban dwellings were more likely to have an adverse perinatal outcome compared to their adult counterparts.ConclusionOur study found that, in addition to their socioeconomic and biophysical disadvantages, adolescents were likely to have exceptionally high risk of eclampsia.
A comparison of self-triage tools to nurse driven triage in the emergency department
Authors: Trivedi Sachin V , Batta Rachit , Henao – Romero Nicolas , Mondal Prosanta , Wilson Tracy , Stempien James 
Published: January 2024

ABSTRACTINTRODUCTIONCanadian patients presenting to the emergency department (ED) typically undergo a triage process where they are assessed by a specially trained nurse and assigned a Canadian Triage and Acuity Scale (CTAS) score, indicating their level of acuity and urgency of assessment. We sought to assess the ability of patients to self-triage themselves through use of one of two of our proprietary self-triage tools, and how this would compare with the standard nurse-driven triage process.METHODSWe enrolled a convenience sample of ambulatory ED patients aged 17 years or older who presented with chief complaints of chest pain, abdominal pain, breathing problems, or musculoskeletal pain. Participants completed one, or both, of an algorithm generated self-triage (AGST) survey, or visual acuity scale (VAS) based self-triage tool which subsequently generated a CTAS score. Our primary outcome was to assess the accuracy of these tools to the CTAS score generated through the nurse-driven triage process.RESULTSA total of 223 patients were included in our analysis. Of these, 32 (14.3%) presented with chest pain, 25 (11.2%) with shortness of breath, 75 (33.6%) with abdominal pain, and 91 (40.8%) with musculoskeletal pain. Of the total number of patients, 142 (47.2%) completed the AGST tool, 159 (52.8%) completed the VAS tool and 78 (25.9%) completed both tools. When compared to the nurse-driven triage standard, both the AGST and VAS tools had poor levels of agreement for each of the four presenting complaints.CONCLUSIONSSelf-triage through use of an AGST or VAS tool is inaccurate and does not appear to be a viable option to enhance the current triage process. Further study is required to show if self-triage can be used in the ED to optimize the triage process.
Vitamin D for glycemic control following an acute pulmonary exacerbation: A secondary analysis of a multicenter, double-blind, randomized, placebo-controlled trial in adults with cystic fibrosis
Authors: Sivapiromrat Alisa K. , Hunt William R. , Alvarez Jessica A. , Ziegler Thomas R. , Tangpricha Vin 
Published: January 2024

AbstractIndividuals with cystic fibrosis (CF) often incur damage to pancreatic tissue due to a dysfunctional cystic fibrosis transmembrane conductance regulator (CFTR) protein, leading to altered chloride transport on epithelial surfaces and subsequent development of cystic fibrosis-related diabetes (CFRD). Vitamin D deficiency has been associated with the development of CFRD. This was a secondary analysis of a multicenter, double-blind, randomized, placebo-controlled study in adults with CF hospitalized for an acute pulmonary exacerbation (APE), known as the Vitamin D for the Immune System in Cystic Fibrosis (DISC) trial (NCT01426256). This was a pre-planned secondary analysis to examine if a high-dose bolus of cholecalciferol (vitamin D3) can mitigate declined glucose tolerance commonly associated with an acute pulmonary exacerbation (APE). Glycemic control was assessed by hemoglobin A1c (HbA1c) and fasting blood glucose levels before and 12 months after the study intervention. Within 72 hours of hospital admission, participants were randomly assigned to a single dose of oral vitamin D3(250,000 IU) or placebo, and subsequently, received 50,000 IU of vitamin D3or placebo every other week, beginning at month 3 and ending on month 12. Forty-nine of the 91 participants in the parent study were eligible for the secondary analysis. There were no differences in 12-month changes in HbA1c or fasting blood glucose in participants randomized to vitamin D or placebo. A high-dose bolus of vitamin D3followed by maintenance vitamin D3supplementation did not improve glycemic control in patients with CF after an APE.
Coronary perforation occurring during percutaneous coronary intervention is associated with persistent high inpatient mortality and complications
Authors: Movahed Mohammad Reza , Satapathy Nishant , Hashemzadeh Mehrtash 
Published: January 2024

AbstractBackgroundCoronary perforation is one of the major complications of percutaneous coronary intervention (PCI). The goal of this study was to evaluate adverse outcomes and mortality in patients suffering from coronary perforation during PCI above the age of 30.MethodsThe National Inpatient Sample (NIS) database, years 2016-2020, was studied using ICD 10 codes. Patients suffering from perforation were compared to patients without perforation during PCI.ResultsPCI was performed in a weighted total of 10,059,269 patients. Coronary perforation occurred in 11,725 (0.12 %) of all PCI performed. The mortality rate of patients with perforations was very high in comparison to patients without perforations. (12.9% vs 2.5%, OR: 5.6, CI:5-6.3 p<0.001). Furthermore, patients with coronary perforations had much higher rates of urgent coronary bypass surgery, tamponade, cardiac arrest, and major cardiovascular outcomes. Mortality remained high and over 10% in the 5-year study period.ConclusionUsing a large national inpatient database, all-cause inpatient mortality in patients with coronary perforation is very high (over 10%) with persistently high mortality rates over the years study suggesting that treatment of perforations needs further improvement.
Rivaroxaban for patients with coronary dissection after drug-coated balloon angioplasty : A Randomized Controlled Trial
Authors: Liu Kaiyuan , Guo Quan , Qingbo Shi , Nie Ming , Yu Haosen , Zhang Zhiwen , Li Muwei 
Published: January 2024

ABSTRACTBackgroundAfter drug-coated balloon (DCB) angioplasty in patients with de novo coronary lesions, coronary dissections can result in the continuous presence of thrombi within the vessel wall, potentially leading to late luminal loss. Rivaroxaban, a novel oral anticoagulant, may mitigate lumen loss attributable to coronary dissection.ObjectivesThis study was conducted to evaluate the effectiveness and safety of low-dose rivaroxaban in improving outcomes for patients with dissections following DCB intervention.MethodsThis trial was a prospective, randomized, controlled study including patients with acute coronary syndrome (ACS) who exhibited non-flow-limiting dissections after DCB angioplasty for de novo coronary lesions. The rivaroxaban group received a standard dual antiplatelet therapy (DAPT) regimen along with 2.5 mg of rivaroxaban twice daily for one month, reverting to DAPT thereafter. The control group was treated with standard DAPT for 6 months. All patients underwent coronary angiography at the 6-month mark. The primary endpoint involved late lumen loss in the target vessel at 6 months, and the primary safety endpoint consisted of bleeding events, as classified according to BARC criteria (types 1-3 or 5). This study has been registered with ClinicalTrials.gov, numberNCT05750758.ResultsOut of 140 randomized patients, 137 (69 in the rivaroxaban group, 68 in the control group) completed the study. Low-dose rivaroxaban was associated with a significant reduction in late lumen loss compared to controls (−0.12 ± 0.56 mm versus 0.14 ± 0.37 mm, P = 0.002). The rivaroxaban group experienced more minor bleeding events (BARC 1-2), though this was not statistically significant (P = 0.059). Clinical outcomes were similar between groups (P = 0.354).ConclusionsThis study demonstrates that the combination of rivaroxaban with dual antiplatelet therapy shows promise in reducing stenosis and enhancing late lumen expansion in lesions with dissections post-DCB intervention.
Post-Market Surveillance of Six COVID-19 Point-of-Care Tests Using Pre-Omicron and Omicron SARS-CoV-2 Variants
Authors: Exner Hannah M. , Gregorchuk Branden S. J. , Castor AC-Green , Crisostomo Leandro , Kolsun Kurt , Giesbrecht Shayna , Dust Kerry , Alexander David , Bolaji Ayooluwa , Quill Zoe , Head Breanne M. , Meyers Adrienne F. A. , Sandstrom Paul , Becker Michael G. 
Published: January 2024

ABSTRACTPost-market surveillance of test performance is a critical function of public health agencies and clinical researchers that ensures diagnostics maintain performance characteristics following their regulatory approval. Changes in product quality, manufacturing processes over time, or the evolution of new variants may impact product quality. During the COVID-19 pandemic, a plethora of point-of-care tests (POCTs) were released onto the Canadian market. This study evaluated the performance characteristics of several of the most widely-distributed POCTs in Canada, including four rapid antigen tests (Abbott Panbio, BTNX Rapid Response, SD Biosensor, Quidel QuickVue) and two molecular tests (Abbott ID NOW, Lucira Check IT). All tests were challenged with 149 SARS-CoV-2 clinical positives, including multiple variants up to and including Omicron XBB.1.5, as well as 29 clinical negatives. Results were stratified based on whether the isolate was Omicron or pre-Omicron as well as by RT-qPCR Ct value. The test performance of each POCT was consistent with the manufacturers’ claims and showed no significant decline in clinical performance against any of the variants tested. These findings provide continued confidence in the results of these POCTs as they continue to be used to support decentralized COVID-19 testing. This work demonstrates the essential role of post-market surveillance in ensuring reliability in diagnostic tools.
Are aortic biomechanical properties early markers of dilatation in patients with Marfan Syndrome? – A Systematic Review and Meta-Analysis
Authors: Rosnel Claire , Sivera Raphael , Cervi Elena , Danton Mark , Schievano Silvia , Capelli Claudio , Aggarwal Ankush 
Published: January 2024

AbstractBackgroundAlthough the stiffness of tissue is known to play an important role in aortic dilatation, the current guidelines for offering a preventative aortic surgery in patients with Marfan syndrome rely solely on the aortic diameter. In this systematic review and meta-analysis, we analyze and compare literature on in-vivo aortic stiffness measurements in Marfan patients. Our aim is to assess the potential of these measurements as early indicators of aortic dilatation.MethodsFollowing the PRISMA guidelines, we collected literature on diameter and three in-vivo stiffness measures: Pulse Wave Velocity (PWV),β-stiffness index and Distensibility, at five different aortic locations in patients with Marfan syndrome. Reported results were reviewed and compared against each other. For meta-analysis, an augmented dataset was created by combining extracted data from the reviewed literature. Regression with respect to age and statistical comparison were performed on the augmented dataset for all three measures at five different locations.Results30 articles reporting data from 1925 patients with Marfan and 836 patients without Marfan were reviewed. PWV was found to be statistically higher in Marfan at most aortic locations, but only when the aorta is already dilated. Distensibility was found to be lower at all aortic locations even in non-dilated aortas, and its decrease has been associated with higher chances of developing aortic dilatation.β-stiffness index was higher in Marfan patients and was positively correlated with the rate of aortic dilatation, emphasizing its role as a valuable indicator. In our meta-analysis based on a total 1197 datapoints, diameter was found to be higher only at the root (p <0.001). All stiffness measures showed a significant variation with age. PWV at the root and carotid-femoral region was not statistically different (p= 0.62 andp= 0.14 respectively), but was positively correlated with age at all locations. Distensibility andβ-stiffness index were different in Marfan patients at all locations, and the difference was more pronounced after accounting for age-related variation.ConclusionBased on the results in the literature,β-stiffness index and distensibility emerge as the best predictors of future aortic dilatation. Our meta-analysis quantifies age-related changes in aortic stiffness and highlights the importance of accounting for age in comparing these measurements. Missing diameter values in the literature limited our analysis. Further analysis based on combined aortic stiffness and diameter criteria is recommended to evaluate aortic disease in a comprehensive way and assist clinical decisions for prophylactic surgery.
Bridging the gap: improving correspondence between low-field and high-field magnetic resonance images in young people
Authors: Cooper Rebecca , Hayes Rebecca , Corcoran Mary , Sheth Kevin N , Arnold Thomas Campbell , Stein Joel , Glahn David C. , Jalbrzikowski Maria 
Published: January 2024

AbstractBackgroundPortable low-field-strength magnetic resonance imaging (MRI) systems represent a promising alternative to traditional high-field-strength systems with the potential to make MR technology available at scale in low-resource settings. However, lower image quality and resolution may limit the research and clinical potential of these devices. We tested two super-resolution methods to enhance image quality in a low-field MR system and compared their correspondence with images acquired from a high-field system in a sample of young people.MethodsT1- and T2-weighted structural MR images were obtained from a low-field (64mT) Hyperfine and high-field (3T) Siemens system in N = 70 individuals (mean age=20.39 years, range 9-26 years). We tested two super-resolution approaches to improve image correspondence between images acquired at high- and low-field: 1) processing via a convolutional neural network (‘SynthSR’), and 2) multi-orientation image averaging. We extracted brain region volumes, cortical thickness, and cortical surface area estimates. We used Pearson correlations to test the correspondence between these measures, and Steiger Z tests to compare the difference in correspondence between standard imaging and super-resolution approaches.ResultsSingle pairs of T1- and T2-weighted images acquired at low field showed high correspondence to high-field-strength images for estimates of total intracranial volume, surface area cortical volume, subcortical volume, and total brain volume (rrange=0.60-0.88). Correspondence was lower for cerebral white matter volume (r=0.32,p=.007,q=.009) and non-significant for mean cortical thickness (r=-0.05,p=.664,q =.664). Processing images with SynthSR yielded significant improvements in correspondence for total brain volume, white matter volume, total surface area, subcortical volume, cortical volume, and total intracranial volume (rrange=0.85-0.97), with the exception of global mean cortical thickness (r=0.14). An alternative multi-orientation image averaging approach improved correspondence for cerebral white matter and total brain volume.Processing with SynthSR also significantly improved correspondence across widespread regions for estimates of cortical volume, surface area and subcortical volume, as well as within isolated prefrontal and temporal regions for estimates of cortical thickness.ConclusionsApplying super-resolution approaches to low-field imaging improves regional brain volume and surface area accuracy in young people. Finer-scale brain measurements, such as cortical thickness, remain challenging with the limited resolution of low-field systems.
The diabetic myocardial transcriptome reveals Erbb3 as a novel biomarker of incident heart failure
Authors: Conning-Rowland Marcella S , Giannoudi Marilena , Drozd Michael , Brown Oliver I , Yuldasheva Nadira Y , Cheng Chew W , Meakin Paul J , Straw Sam , Gierula John , Ajjan Ramzi A , Kearney Mark T , Levelt Eylem , Roberts Lee D , Griffin Kathryn J , Cubbon Richard M 
Published: January 2024

AbstractAimsDiabetes mellitus (DM) increases heart failure incidence and worsens prognosis, but the molecular basis of diabetic heart disease is poorly defined in humans. We aimed to define the diabetic myocardial transcriptome and validate hits in their circulating protein form to define disease mechanisms and biomarkers.Methods and ResultsRNA-sequencing data from the Genotype-Tissue Expression (GTEx) project was used to define differentially expressed genes (DEGs) in right atrial (RA) and left ventricular (LV) myocardium from people with versus without DM (type 1 or 2). DEGs were validated in their circulating protein form in the UK Biobank cohort, searching for directionally concordant differential expression. Validated plasma proteins were characterized in UK Biobank participants, irrespective of diabetes status, using cardiac magnetic resonance imaging, incident heart failure and cardiovascular mortality.We found 32 and 32 DEGs associated with DM in the RA and LV, respectively, with no overlap between these. Plasma proteomic data was available for 6 hits, with only ERBB3 (LV hit) exhibiting directional concordance, being lower in myocardium and blood of people with DM. Irrespective of DM status, lower circulating ERBB3 was associated with impaired left ventricular contractility and higher LV mass. Participants in the lowest quartile of circulating ERBB3 had increased incident heart failure and cardiovascular death vs. participants in all other quartiles. Similar associations were noted for ERBB2 and ERBB4.ConclusionsDM is characterized by lower ERBB3 expression in the myocardium and lower plasma protein concentration. This is associated with left ventricular dysfunction, incident heart failure and cardiovascular mortality.
Availability and prescribing of extended release buprenorphine injection for Medicaid beneficiaries, 2018-2022
Authors: Ross Rachael K. , Rudolph Kara E. , Shover Chelsea 
Published: January 2024

AbstractBackground and aimsExtended release buprenorphine injection (INJ-BUP) has been available in the United States since 2018. INJ-BUP has the potential to positively impact OUD treatment outcomes by providing additional treatment options and patient choice. We aimed to describe the availability and prescribing of INJ-BUP for Medicaid beneficiaries since its availability, nationwide and by state.MethodsTo assess availability, we measured the number of substance use disorder (SUD) facilities that offered INJ-BUP and accepted Medicaid insurance in 2018-2021 and calculated the percentage of all facilities offering medications of OUD. To assess prescribing, we measured the number of prescriptions for INJ-BUP paid by Medicaid 2018-2022 and calculated the percentage of all buprenorphine prescriptions paid by Medicaid. Data sources were publicly available.ResultsThe number of facilities that offered INJ-BUP and accepted Medicaid insurance increased from 360 (2.5% of all SUD facilities offering medication) in 2018 to 2,257 (13.3%) in 2021. The number of prescriptions for INJ-BUP paid by Medicaid increased from 4,322 (0.1% of all buprenorphine prescriptions) in 2018 to 186,861 (2.0%) in 2022. There was notable variability in the number of facilities and prescriptions by state.ConclusionsThere has been exponential increase in the number of INJ-BUP prescriptions but uptake is much less than observed in other countries in shorter time periods. Limited availability at SUD treatment facilities that accept Medicaid may be one barrier to access.
TP53Variant Clusters Stratify the Li-Fraumeni Spectrum and Reveal an Osteosarcoma-Prone Subgroup
Authors: Fischer Nicholas W , Laverty Brianne , Alon Noa , Montellier Emilie , Maxwell Kara N , Kratz Christian P , Hainaut Pierre , Kafri Ran , Malkin David 
Published: January 2024

ABSTRACTLi-Fraumeni syndrome (LFS) has recently been redefined as a ‘spectrum’ cancer predisposition disorder to reflect its broad phenotypic heterogeneity. The wide functional gradient associated with differentTP53variants is thought to contribute to LFS heterogeneity, although it is still poorly understood and there is an unmet clinical need for risk stratification strategies. Leveraging p53 mutagenesis dataset, we performed an unsupervised cluster analysis that revealed fiveTP53variant clusters with unique structural and functional consequences. Classifying variant carriers according to these clusters stratified cancer onset and survival using discovery and validation cohorts, and exposed important clinical characteristics to consider for patient management. In particular, we identified a subgroup of monomericTP53variant carriers prone to osteosarcoma, along with a cluster associated with less “LFS-like” phenotypes enriched in carriers with no history of cancer. Our classification ofTP53variants demonstrates the existence of a wideTP53-heritable cancer susceptibility spectrum and provides a new framework to delineate carriers toward personalized patient care.