bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Telehealth Use and Downstream 30-Day Medicare Spending
Authors: Ellimoottil Chad , Kulkarni Ashwin J. , Zhu Ziwei , Dunn Rodney L. , Chang Chiang-Hua , Chun Elena , Hou Hechuan , Lee James D. , McCullough Jeffrey S. , Thompson Michael P. 
Published: February 2025

ABSTRACTObjectivesThe objective of this study was to investigate whether healthcare visits initiated by telehealth had higher or lower 30-day spending compared to in-person-initiated visits. The study compared the overall spending, rates of return visits, laboratory tests, and imaging procedures within 30 days for Medicare fee-for-service patients who underwent in-person and telehealth evaluations between July 1, 2020 and December 31, 2022.Study DesignA large-scale retrospective cohort study using propensity score matching.MethodsThis study included 100% of Medicare fee-for-service beneficiaries who are aged >65 years while excluding those with Medicare Advantage coverage and those without continuous Medicare Parts A and B. We identified patients with no prior visits and 30-day episodes of care initiated by outpatient telehealth or in-person visits from July 1, 2020 through December 31, 2022. We then compared adjusted 30-day total Medicare spending, rates of return visits, laboratory tests, and imaging utilization between propensity-matched index visits initiated by telehealth versus in-person.ResultsTelehealth-initiated visits were associated with lower 30-day spending ($260 vs. $342; net: −$82), though return visit rates were higher for telehealth (16.1% vs. 14.1%). Both lab test rates (7.8% vs. 24.2%) and imaging rates (3.5% vs 7.8%) were lower for telehealth-initiated episodes compared to in-person-initiated episodes.ConclusionsTelehealth-initiated episodes of care were associated with lower 30-day Medicare spending and reduced utilization of labs and imaging. These findings suggest that telehealth, when used as a substitute for office visits, may reduce overall Medicare spending.
Factors Influencing Early Childhood Caries in a University-Based Infant Oral Health Clinic
Authors: Ijaz Anum , Mugayar Leda Regina F , Noorullah Khatija , Molena Kelly Fernanda , AlSaleh Majd , Bilal Sobia 
Published: February 2025

AbstractIntroductionEarly Childhood Caries (ECC) is a major public health issue that poses significant challenges in pediatric dentistry, affecting infants and preschool children globally. Socioeconomic factors, dietary habits, and parental health literacy play crucial roles in ECC’s development and progression.ObjectiveThe study aims to identify and evaluate factors contributing to ECC in pediatric patients at a university-based infant oral health clinic, with a secondary objective of assessing the effectiveness of newly developed oral health promotional materials through a pilot study.MethodsA retrospective and cross-sectional design was employed to analyze data from 514 pediatric patients. The study examined demographic information, parental and environmental factors, dietary habits, and feeding practices. Statistical analysis was conducted to identify significant predictors of ECC. The pilot study involved 10 participants who provided feedback on the content and face validity of promotional materials.ResultsKey factors associated with ECC included race, socioeconomic status, parental health literacy, dietary habits, and bottle use at night. Early detection and preventive strategies, such as regular dental checkups, were found to be critical in reducing caries risk. The pilot study showed positive feedback on promotional materials, indicating relevance, clarity, and visual appeal, with ongoing feedback used to refine the materials.ConclusionThe study highlights the importance of comprehensive preventive strategies that encompass both individual and community-level interventions. It underscores the role of early detection, preventive measures, and tailored oral health education in reducing ECC risk. Limitations include the retrospective design and potential generalization issues due to the study’s focus on a single clinic. Future research should aim to address these limitations through longitudinal studies and larger, more diverse samples to validate the findings and enhance the effectiveness of oral health promotional materials.
Pregnancy outcomes and HIV amongst women in Northwest Tanzania, from 2015-2016
Authors: Hariharan Samika , Mosha Neema , Materu Jacqueline , Baker Margaret , Kishawame Coleman , Urassa Mark 
Published: February 2025

AbstractBackgroundAdverse pregnancy outcomes are rampant across Sub Saharan Africa and significantly increase the risk of neonatal deaths. HIV infection is a key contributor to adverse pregnancy outcomes and has a disproportionately high burden amongst women in both Sub Saharan Africa and Tanzania. Socio-demographic factors and care-seeking behaviors can either exacerbate or prevent HIV infection and adverse pregnancy outcomes.ObjectivesThis study aims to determine HIV prevalence by age, residence, marital status, and education and to determine how pregnancy outcomes are impacted by HIV infection, the use of health services, and socio-demographic factors.MethodsThis study utilized secondary data from an epidemiological Sero Survey Round 8 (2015-2016) within the Kisesa HIV cohort in Magu District, Mwanza, Tanzania. All data was analyzed using the statistical software “Stata Version 17.0.” The variables were re-coded for operational use and cross-tabulations with chi-squared tests and logistic regression models were conducted.ResultsData analysis showed an HIV prevalence of 9.5% amongst women who had been pregnant before. HIV positive women were more likely to lose a child (AOR=1.4; 95% CI: 1.1,1.7). Women with higher education had significantly lower odds of adverse pregnancy outcomes as compared to women with no formal education (AOR=0.5; 95% CI: 0.4, 0.7). Women with more children, especially 10+ children, also had higher odds of adverse outcomes as compared to mothers with 1-3 children (AOR=25.1; 95% CI: 17.0, 37.0). Elderly mothers had seven times the odds of losing a child as compared to young mothers (AOR=7.0; 95% CI: 2.5, 19.6).ConclusionsThis study provides needed insight into factors that contribute to HIV infection and adverse pregnancy outcomes. The results support the implementation of new policies that target HIV prevention and treatment amongst women and emphasize maternal education to reduce adverse pregnancy outcomes.
Prevalence, Geographical Distribution and Determinants of Zero Dose Vaccination Status in Uttar Pradesh, India: An Analysis of The National Family Health Survey – 5 Data
Authors: Singh Prem , Sharma Varun , Srivastava Ashish , John Alan Noble , Tripathi Bhupendra , Kumar Somesh 
Published: February 2025

AbstractBackgroundRecent decades have witnessed considerable progress in immunization, leading to significant improvements in vaccination coverage worldwide. Despite these global achievements, regional disparities in vaccine uptake remain a challenge. In Uttar Pradesh (UP), India, there’s been a rise in the number of Zero-dose (ZD) children – those who have not received any routine vaccinations – over the past few years. This study delves into household-level data from the National Family Health Survey (NFHS-5, 2019-2021), aiming to uncover the prevalence and key factors contributing to the ZD status in UP.MethodsUtilizing unit-level data from NFHS-5, we conducted a nested case-control analysis focusing on children aged 12-23 months. The primary outcome variable was ZD children, operationally defined as children who had not received the first dose of the pentavalent vaccine. The study focused on socio-demographic factors, maternal health, post-natal care, and systems’ engagement as potential predictors for ZD prevalence. These variables included type of residence, caste, religion, economic status, maternal education, place of delivery, antenatal care visits, and post-natal check-ups. Interactions with health workers and benefits received from community health programs were also considered.ResultsThe prevalence of ZD children stands at 6.4% in UP. A significant urban-rural divide was observed, with 11.9% of urban children classified as ZD compared to 8.4% in rural areas. Bi-variate analysis revealed a significant association between ZD prevalence and residence type (χ2 =28.6421; p<0.01), with urban children being 37.1% more likely to be ZD than their rural counterparts at 24.5%. Economic status also showed a notable impact, with the poorest wealth quintile having 32.7% ZD children, significantly higher than the richer (23.4%) and richest (27.7%) quintiles. Maternal religion also showed significant association with ZD status, with 34.4% of children from Muslim households being ZD as compared to 24.9% in Hindu households. Maternal health indicators such as children of mothers with no antenatal care visits had 3.7 times higher odds (CI: 2.351 - 5.69; p<0.001) of being ZD compared to those whose mothers had 4+ visits. Engagement with health systems also influenced ZD rates; children from households that had not met community health workers were 1.6 times more likely to be ZD (OR: 1.566; CI: 1.135-2.16; p=0.006).ConclusionsThe higher prevalence of ZD children among specific groups underscores the need for targeted interventions. Strategies to address this issue must encompass an integration of maternal and child health services with existing immunization program.
A secondary data analysis investigating the link between weather elements and incident presentation for mental disorders at a Ugandan tertiary psychiatric hospital
Authors: Mwesiga Emmanuel Kiiza , Munabi Ian , Ssemata Andrew Sentoogo , Kalungi Allan , Balinga Sophia , Aujo Blessed Tabitha , Mutamba Bryan Byamah , Bbosa Martha , Kalyesubula Robert , Babweetera Fred , Kinyanda Eugene , Ssembajjwe Wilber 
Published: February 2025

AbstractThe link between weather elements and mental disorders is often described in high-income countries, with hardly any data from low-and middle-income countries where the resources to cope with the negative mental health impacts of climate change are extremely constrained. In this paper, we examined the association between weather elements and the incident presentation with a mental disorder at Butabika National Referral Mental Hospital. We used secondary data from two datasets: i) a mental health data set collated from all patients presenting at Butabika National Referral Mental Hospital in 2019; and ii) a climatic dataset for the geographic location of Butabika National Referral Mental Hospital for the same year (2019). The mental health data set included socio-demographic variables and mental disorder diagnoses, while the climatic data set included data on, atmospheric pressure (hPa), rainfall (mm), sunshine (hours/month), humidity (%), temperature (°C) and wind speed (m/s). We performed descriptive statistical analyses to summarize the frequency of mental disorder diagnoses and the monthly averages of weather variables. We then undertook correlation and multiple logistic regression analyses to investigate the associations between specific weather elements and the incident presentation of different mental disorders. In the mental health data, we had 2,827 participants, males were 56.1%(n=1,584), and the median age was 29 years (IQR 23-38). Psychotic disorders were the most common diagnosis at 43.8% (n=1,239). Overall, various weather elements correlated at different strengths with incident presentation of various mental disorders, particularly humidity and rainfall. On controlling for age and sex in the multiple regression models, the strongest associations were between heat elements and incident presentation for psychotic disorders [AOR1.12, 95%CI (1.04; 1.27) p<0.001]. No associations were demonstrated between weather elements and incident presentation for neurocognitive and neurodevelopmental disorders. These preliminary findings point to a possible relationship between incident presentation of mental disorders to a tertiary psychiatric hospital in Uganda and various weather elements. There is need for longitudinal studies to confirm these associations and to explore underlying social and biological mechanisms.
Machine learning-based analysis of genomic and transcriptomic data unveils sarcoma clusters with superlative prognostic and predictive value
Authors: Esperança-Martins Miguel , Vasques Hugo , Ravasqueira Manuel Sokolov , Lemos Maria Manuel , Fonseca Filipa , Coutinho Diogo , López Jorge Antonio , Huang Richard S.P. , Dias Sérgio , Gallego-Paez Lina , Costa Luís , Abecasis Nuno , Gonçalves Emanuel , Fernandes Isabel 
Published: February 2025

AbstractSoft tissue sarcomas (STS) histopathological classification system has several conceptual caveats, impacting prognostication and treatment. The clinical and molecular-based tools currently employed to estimate prognosis also have limitations. Clinically driven molecular profiling studies may cover these gaps. We performed DNA sequencing (DNAseq) and RNA sequencing (RNAseq), portraying the molecular profile of 102 samples of 3 of the most common STS subtypes. The RNAseq data was analyzed using unsupervised machine learning models, unravelling previously unknown molecular patterns and identifying 4 well-defined transcriptomic clusters. These transcriptomic clusters have a clear prognostic value, a finding that was externally validated. This transcriptomic cluster-based classification’s prognostic value is superior to the prognostic accuracy of currently used clinical-based (SARCULATOR nomograms) and molecular-based (CINSARC) prognostication tools. The analysis of DNAseq data from the same cohort of samples revealed a plethora of unique and, in some cases, never documented molecular targets for precision treatment across different transcriptomic clusters.
YY1 protein is essential for the promotion of Muller glia reprogramming and retina regeneration
Authors: Chaudhary Mansi , Desai Omkar Mahadeo , Sharma Poonam , Premraj Sharanya , Shukla Pooja , Ramachandran Rajesh 
Published: February 2025

AbstractUnlike mammals, the Muller glia reprogramming in zebrafish retina restores vision after an acute retinal injury. Here, we explored the Ying yang (Yy1) protein and its multi-faceted roles in different phases of retina regeneration. We show that the acetylation and deacetylation status of Yy1 contribute to its transcriptional activation and repression functions on various target genes, including regeneration-associated genes (RAGs). Yy1 is regulated positively by TGF-β and negatively through Delta-Notch signaling in the injured retina. Yy1-knockdown caused reduced retinal progenitor induction and regeneration, while the opposite was seen in its overexpression. Yy1 collaborates with histone deacetylases, BAF complex, and the effector of TGF-β signaling, pSMAD3, to target the genome differentially. Lastly, the whole transcriptome analysis of the Yy1-debilitated retina revealed differential expression of various RAGs and BMP-signaling. Yy1 facilitates the BMP pathways genes through the downregulation ofnoggin3. Our study unravels how a single transcription factor, Yy1, could influence many important regulatory steps of retina regeneration.
Strain-Specific Variation in the Complement Resistome ofPseudomonas aeruginosa
Authors: Janet-Maitre Manon , Robert-Genthon Mylène , Cretin François , Elsen Sylvie , Attrée Ina 
Published: February 2025

AbstractBloodstream infections caused byPseudomonas aeruginosaare associated with the highest mortality rates. The complement system, key component of the innate immune response, is mostly responsible forP. aeruginosaelimination in human blood. Nevertheless, the plasma sensitivity ofP. aeruginosastrains varies, ranging from highly sensitive, persistent to fully resistant. Whereas most studies rely on model strains, given the species’ high genomic and phenotypic diversity, the interaction betweenP. aeruginosaand the complement system may be highly complex. In this work, we characterized the plasma resistome ofP. aeruginosain three strains displaying variable plasma sensitivity using Tn-seq. The gain-of-function screen performed on the sensitive strain PA14 highlighted numerous bacterial factors impacting plasma resistance, including members of the RetS-LadS/Gac/Rsm regulatory system and outer membrane porins. Tn-seq in plasma-resistant strains CHA and YIK, suggested that each strain utilizes a specific and limited set of proteins to evade complement-dependent killing. Despite this strain-specific response, we identified common strategies across all strains, including the production of exopolysaccharides (EPSs), the presence of surface appendages and modification in the O-specific antigen. We evidence Ssg and Crc as common factors contributing to plasma resistance. However, whereas mutants lackingssgand/orcrcin plasma had reduced survival, a subpopulation of these mutants persisted over prolonged exposure to human plasma. Overall, this work provides valuable insights into the complex interplay betweenP. aeruginosaand the complement system in the context of bloodstream infections and raises concerns for the development of therapies targeting individual virulence factors.
Equilibrium properties of a coupled contagion model of mosquito-borne disease and mosquito preventive behaviors
Authors: Poterek Marya L. , Santos-Vega Mauricio , Perkins T. Alex 
Published: February 2025

AbstractAlthough different strategies for mosquito-borne disease prevention can vary significantly in their efficacy and scale of implementation, they all require that individuals comply with their use. Despite this, human behavior is rarely considered in mathematical models of mosquito-borne diseases. Here, we sought to address that gap by establishing general expectations for how different behavioral stimuli and forms of mosquito prevention shape the equilibrium prevalence of disease. To accomplish this, we developed a coupled contagion model tailored to the epidemiology of dengue and preventive behaviors relevant to it. Under our model’s parameterization, we found that mosquito biting was the most important driver of behavior uptake. In contrast, encounters with individuals experiencing disease or engaging in preventive behaviors themselves had a smaller influence on behavior uptake. The relative influence of these three stimuli reflected the relative frequency with which individuals encountered them. We also found that two distinct forms of mosquito prevention—namely, personal protection and mosquito density reduction—mediated different influences of behavior on equilibrium disease prevalence. Our results highlight that unique features of coupled contagion models can arise in disease systems with distinct biological features.
Modeling the Spread of Misfolded Proteins in Alzheimer’s Disease using Higher-Order Simplicial Complex Contagion
Authors: Wardynski Marcin , Iacopini Iacopo , Petri Giovanni , Latora Vito , Crimi Alessandro 
Published: February 2025

AbstractNeurodegenerative diseases are characterized by complex proteins misfolded that propagate within the brain. For instance, current findings highlight the role of 2 specific misfolded proteins in Alzheimer which are believed to spread using brain fibers as highways. Previous studies investigated such spreading by simulation models or machine learning-based predictors which adopt the brain connectome as the underlying spreading network. However, the structural connectome by construction only describes pairwise connections between nodes in a graph. High-order interaction complex networks offer significant advantages over normal graphs because they can capture interactions that go beyond simple pairwise relationships. Protein misfolding and aggregation often involve cooperative behaviors or group dynamics that normal graphs, with their focus on individual edges, cannot adequately represent. The non-linear and multiscale nature of protein misfolding might be better suited to a richer representation of higher-order models. In this study we investigate whether higher-order networks can provide improved fits and explanatory power in this context. More specifically, we employ a simplicial complex contagion model for amyloid beta to predict protein misfolding spread. The simplicial contagion complex produced a mean reconstruction error of 0.030 for Alzheimer’s patients regarding the predicted protein deposition across all brain region in a 2-year horizon and other results, outperforming previous studies, especially for cases in which the misfolded protein were non-increasing steadily. Despite the limited time span, this study highlights the potential of combining advanced network analysis to capture the intricate dynamics of protein aggregation across neural networks.Clinical relevanceThis study highlights the potential of high-order networks to improve predictions of misfolded protein spread in Alzheimer’s, offering better insight into protein aggregation dynamics.
A Robust Fluorogenic Substrate for Chikungunya Virus Protease (nsP2) Activity
Authors: Makhaik Sparsh , Rut Wioletta , Choudhary Shruti , Upadhyay Tulsi , Hao Chenzhou , Westberg Michael , Bobst Cedric , Yoo Euna , Fejzo Jasna , Lin Michael Z , Bogyo Matthew , Thompson Paul , Drag Marcin , Hardy Jeanne A. 
Published: February 2025

ABSTRACTChikungunya virus (CHIKV) is an emerging pathogen with pandemic potential. CHIKV infection in humans is transmitted by mosquitoes and induces common symptoms of high fever, arthralgia and myalgia. Because no specific antiviral drugs for treatment of CHIKV infection are available, drug development remains a central goal. The chikungunya virus protease nsP2 (CHIKVP) has emerged as a key drug target due to its indispensable role in viral replication via cleavage of the viral polyprotein. To date, effective tools for screening for CHIKVP inhibitors that reflect the most critical polyprotein cleavage sites have been lacking, hampering drug-development efforts. We found that the recognition ability of CHIKVP is sensitive to the length of peptide substrates. In this study, we report a robust fluorogenic substrate comprising a 15-mer peptide derived from the nsP3/4 junction from the CHIKV polyprotein. This peptide is flanked by an ACC-Lys(dnp) donor-quencher pair. Our new substrate acc-CHIK15-dnp shows a 20-fold improved signal-to-noise ratio as compared to the previously reported edab8substrate, which is also based on the nsP3/4 junction. We found acc-CHIK15-dnp is recognized only by CHIKVP but not by other alphavirus proteases. This is surprising due to the high level of sequence conservation in the alpha virus polyprotein junctions and indicates that the P-side residues are more important than the P’-side sequence for effective CHIKVP cleavage. The robust signal-to-noise ratio obtained using acc-CHIK15-dnp derived from the nsP3/4 cleavage site enabled much improved small molecule HTS on CHIKV relative to other fluorogenic reporters.