bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testing federated analytics across secure data environments using differing statistical approaches on cross-disciplinary data
Authors: Gallier S. , Topham A. , Hodson J. , McNulty D. , Giles T. , Cox S. , Chaganty J. , Cooper L. , Perks S. , Quinlan P. , Sapey E. 
Published: January 2024

ABSTRACTBACKGROUNDIntroducing data-driven technologies into health systems can enhance population health and streamline care delivery. The use of diverse and geographically varied data is key for tackling health and societal challenges, despite associated technical, ethical, and governance complexities. This study explored the efficacy of federated analytics using general linear models (GLMs) and machine learning (ML) models, comparing outcomes with non-federated data analysis.METHODSA Conditional Transformation Generative Adversarial Network was used to create two synthetic datasets (training set: N=10,000; test set: N=1,000), using real-world data from 381 asthma patients. To simulate a federated environment, the resulting data were distributed across nodes in a Microsoft Azure Trusted Research Environment (TRE). GLMs (one-way ANOVA) and ML models (gradient boosted decision trees) where then produced, using both federated and non-federated approaches. The consistency of predictions produced by the ML models were then compared between approaches, with predictive accuracy of the models quantified by the area under the receiver operating characteristic curve (AUROC).FINDINGSGLMs produced from federated data distributed between two TREs were identical to those produced using a non-federated approach. However, ML models produced by federated and non-federated approaches, and using different data distributions between TREs, were non-identical. Despite this, when applied to the test set, the classifications made by the federated models were consistent with the non-federated model in 84.7-90.4% of cases, which was similar to the consistency of repeated non-federated models (90.9-91.5%). Consequently, overall predictive accuracies for federated and non-federated models were similar (AUROC: 0.663-0.669).INTERPRETATIONThis study confirmed the robustness of GLMs utilising ANOVA within a federated framework, yielding consistent outcomes. Moreover, federated ML models demonstrated a high degree of classification agreement, with comparable accuracy to traditional non-federated models. These results highlight the viability of federated approaches for reliable and accurate data analysis in sensitive domains.
Delayed effects of cigarette graphic warning labels on smoking behavior
Authors: Shi Zhenhao , Wang An-Li , Liu Jiaying , Audrain-McGovern Janet , Lynch Kevin G. , Loughead James , Langleben Daniel D. 
Published: January 2024

ABSTRACTIntroductionGraphic warning labels (GWLs) are widely employed to communicate smoking-related health risks; however, their implementation in the US has been held back by concerns about their efficacy. Most GWLs elicit a high level of emotional reaction (ER). The extent to which ER contributes to GWLs efficacy in improving smoking outcomes is a subject of debate. Our recent study showed poorer efficacy of the high-ER GWLs versus the low-ER ones during a month-long naturalistic exposure. Whether GWL effects persist after discontinuing the exposure remains unclear.MethodsWe conducted a secondary analysis to investigate the delayed effects of GWLs on smoking severity in adult smokers. The number of cigarettes smoked per day (CPD) was measured immediately as well as 4 weeks after the end of a month-long exposure to high-ER versus low-ER GWLs. Participants indicated their subjective feeling of being relieved from having to see the GWLs.ResultsWe found a significant reduction in CPD from the immediate to the 4-week post-exposure timepoint. There was no difference in CPD reduction between the high-ER and low-ER groups.Subjective sense of relief from GWL exposure was associated with greater CPD reduction in the high-ER group, but not the low-ER group.ConclusionsOur study suggests lasting impact of GWLs on smoking behavior. The findings may be particularly important to high-arousal GWLs, which appear less effective in reducing smoking during active exposure.ImplicationsWhether GWLs that evoke higher ER are more effective remains inconclusive. We recently showed that high-ER GWLs are less effective than low-ER ones in reducing smoking during continuous exposure. Here, we found evidence of delayed GWL effects such that smoking decreased from immediately to four weeks after the end of GWL exposure. Feeling of relief from GWL exposure was associated greater smoking reduction in the high-ER group. We suggest that continuously exposing smokers to high-ER GWLs that have been well remembered may be unnecessary and counterproductive.
Symptoms of children and adolescents infected with SARS-CoV-2 variants alpha, delta or omicron
Authors: Schulze Hansjörg , Bayer Wibke 
Published: January 2024

AbstractSymptoms experienced by children and adolescents with SARS-CoV-2 infections in the alpha, delta and omicron variant dominated phases were investigated using an online survey, and the frequencies of reported symptoms and changes over time were analyzed. The most prevalent symptoms were fever above 38 °C, tiredness, headache, runny or blocked nose, sneezing and dry cough. Lethargy and nausea were reported significantly more frequently in the omicron variant dominated phase than in the earlier phases of the pandemic. Compared to symptoms reported by adults, fever and gastrointestinal symptoms were reported more frequently for children, especially in the omicron variant dominated phase, whereas the frequency of loss of smell and loss of taste was significantly lower in children than in adults.
Sex Differences in People with Tourette Syndrome and Persistent Motor or Vocal Tic Disorder in the Tourette Association of America International Consortium for Genetics Database
Authors: Dy-Hollins Marisela E. , Chibnik Lori B. , Tracy Natasha A. , Osiecki Lisa , Budman Cathy L. , Cath Danielle C. , Grados Marco A. , King Robert A. , Gholson Lyon , Rouleau Guy A. , Sandor Paul , Singer Harvey S. , Sharma Nutan , Mathews Carol A. , Scharf Jeremiah 
Published: January 2024

AbstractBackground and ObjectiveTourette Syndrome (TS) and Persistent Motor or Vocal Tic Disorders (PMVT) are more prevalent in males (vs. females). Females with TS may have a delay in diagnosis, and more complex tic features (vs. males). With respect to comorbidities, obsessive-compulsive disorder (OCD) is more prevalent in females; attention-deficit hyperactivity disorder (ADHD) is more prevalent in males. Less is known about sex differences in PMVT. This study analyzes sex differences in outcomes among individuals with TS and PMVT in the Tourette Association of America International Consortium for Genetics dataset (TAAICG).Design/MethodsData from 2403 individuals (N=2109 TS; N=294 PMVT) from the TAAICG were analyzed to explore the relationship between sex and TS or PMVT outcomes: age at tic onset; age at diagnosis; time-to-diagnosis; tic severity; and comorbidity rates. Regression models were adjusted for age and family relationships to examine the impact of sex on outcomes.ResultsFemales with TS (25.5% of the sample) had a later age of symptom onset (6.5±2.8 vs. 6.0±2.7; p=0.001), later age at diagnosis (13.3±11.2 vs. 10.7±8.1; p=0.0001), and a longer time-to-diagnosis [3 (1,7) vs. 2 (1,5), p=0.01] than males. The total Yale-Global Tic Severity Scale (YGTSS) was lower in females with TS (28.4±9.1 vs. 30.7±8.7); p<0.0001); OCD was slightly more prevalent in females (55% vs. 48.7%; p=0.01) although OCD severity did not differ by sex; ADHD was more prevalent in males (55.7% vs 38.9%; p<0.001). Females with TS had 0.46 lower odds of being diagnosed with TS (p<0.00001). Females with PMVT (42.9% of the sample) had an earlier age of symptom onset (7.9±3.3 vs. 8.9±3.7; p=0.05). Motor or vocal tic severity (YGTSS) was not significantly different. OCD, but not ADHD, was more prevalent in females (OCD: 41.9% vs. 22.2%; p<0.001: ADHD:16.5% vs 21.0%; p=0.4).ConclusionFemales with TS are less likely to be formally diagnosed and have a later age of symptom onset, later age at diagnosis, longer time-to-diagnosis, higher prevalence of OCD, and lower prevalence of ADHD (vs. males). Females with PMVT have an earlier age of symptom onset, higher prevalence of OCD, but similar ADHD prevalence rates (vs. males). Females with TS and PMVT may be clinically different than males with TS. Future research is needed to understand differences longitudinally in TS and PMVT.
Predictors of upper respiratoryStreptococcus pneumoniaecolonization among working-age adults with prevalent exposure to overcrowding
Authors: Parker Anna M. , Jackson Nicole , Awasthi Shevya , Kim Hanna , Alwan Tess , Wyllie Anne L. , Kogut Katherine , Holland Nina , Mora Ana M. , Eskenazi Brenda , Riley Lee W. , Lewnard Joseph A. 
Published: January 2024

ABSTRACTBackgroundThe epidemiology of adult pneumococcal carriage remains poorly understood. We assessed risk factors for pneumococcal carriage among adults in socioeconomically-disadvantaged farmworker communities with prevalent overcrowding.MethodsFrom July-November 2020, we administered surveys and collected saliva from working-age adults within clinical and community settings throughout Monterey County, California. We detected pneumococci via qPCR assays targetinglytAandpiaBgenes. We evaluated predictors of pneumococcal carriage detection via conditional logistic regression.ResultsAmong 1,283 participants, 117 (9.1%) had any detectable pneumococcal carriage and 53 (4.1%) carried pneumococci at a higher density threshold (lytAandpiaBcT<35). Pneumococcal carriage was more common among individuals of lower socioeconomic status, as signified by indigenous background (odds ratio [OR]=3.94 [95% confidence interval: 2.36-6.60]), engagement in fieldwork (OR=2.01 [1.12-3.63]), and lacking high school-level education (OR=0.48 [0.26-0.90]). Within the household, carriers were more likely than non-carriers to be exposed to children aged <5 years (OR=1.45 [0.95-2.20]), and to be exposed to crowding (OR=1.48 [0.96-2.30] and 2.84 [1.20-6.73], respectively, for participants living in households with >2-4 and >4 persons per bedroom vs. ≤2 persons per bedroom). Household crowding was independently associated with increased risk of carriage among participants not exposed to children aged <5 years (OR=2.05 [1.18-3.59] for participants living in households with >2 vs. ≤2 persons per bedroom). Exposure to children aged <5 years and exposure to household crowding were each associated with increased pneumococcal density among carriers (piaBcTdifference of 2.04 [0.36-3.73] and 2.44 [0.80-4.11], respectively).ConclusionsWhile exposure to young children was an important risk factor for pneumococcal carriage, the association of crowding with increased risk of carriage in households without young children suggests transmission among adults may also occur in crowded congregate settings.
Customization and acceptability of the WHO Labor care guide to improve labor monitoring among health workers in Uganda. An Iterative Development Study
Authors: Godfrey Mugyenyi R , Josaphat Byamugisha K , Wilson Tumuhimbise , Esther Atukunda C , Fajardo Yarine T 
Published: January 2024

AbstractBackgroundCognisant of the persistent maternal and perinatal mortality rates, the WHO has called for adoption and evaluation of new adaptable and context-specific health solutions to improve labor monitoring and health outcomes. We aimed at customizing and refining the new WHO labour care guide (LCG) to suite health care provider (HCP) needs in monitoring labour in Southwestern Uganda.MethodsWe used an iterative approach to customize and refine the new WHO LCG. Between 1stJuly 2023 and 30thNovember 2023, we conducted; 1)30 stakeholder interviews to identify user needs and challenges, and inform the first LCG modifications; 2)10 HCP exit interviews to obtain feedback and modify LCG prototype one; 3)Two focus group discussions following use of prototype two to identify any further user needs; 4)Exit expert panel interviews involving HCPs to refine LCG components; 5)Pilot testing of final prototype among 40 HCPs; 6)Final panel reviews from two expert conferences, the National Safe Motherhood Conference, and Association of Obstetricians and Gynaecologists of Uganda to refine/consolidate modifications of final prototype for Uganda, ready for evaluation.ResultsA total of 120 HCPs and MOH officials previously exposed to the new WHO LCG, with median age of 36 years (IQR;26-48) were interviewed. Over 53 modifications were made to tailor the WHO LCG into the modified LCG prototype for Uganda including; 1)Adjusting observation ordering to improve flow, clarity, and facilitate an easy user interface; 2)Inclusion of vital socio-demographic data compatible with existing programs in Uganda to prompt risk identification; 3)Modification of medications, baby-mother parameters/observations to suit local context; and 4)Inclusion of key cues to action, clinical notes and labour outcome data to facilitate auditing, accountability, reference, utilization and immediate postpartum care. All HCPs found the modified LCG useful, easy to use, appropriate, comprehensive, inclusive and would recommend it to others for use. Over 80% HCPs reported they took <2 minutes to plot/fill all observations on the LCG after assessment.ConclusionsActive involvement of targeted end-users in customizing the LCG was observed to improve inclusiveness, ownership, comprehensiveness, acceptability, engagement and uptake. The modified LCG prototype was found to be simple, appropriate and easy-to-use. Further research to evaluate this LCG prototype feasibility and effectiveness is needed.
Frequency of ocular manifestations in rheumatic autoimmune diseases (ARDs); a cross-sectional study
Authors: Sohail Usama 
Published: January 2024

ABSTRACTAutoimmune disorders involve diverse symptomatic manifestations constituting an abnormal or exaggerated immune function and serve to attack self-antigens and result in tissue destruction. This study aims to comprehensively analyse the prevalence, type, associative factors, and the resultant impact of ocular symptoms on patients presented to rheumatology departments of multi-center tertiary care hospitals in Lahore. Methods. A total of 300 patients were studied during the time frame of Jan 2021-Dec 2022. Results. Rheumatoid Arthritis comprised 45.7 % (n=137) of patients, Systemic Lupus Erythematosus (SLE) was present in 34.3% (N=103) patients. Spondylarthritis 8.3%, Granulomatous Polyangiitis 3.3%, Juvenile idiopathic arthritis 0.7%, and Bechet Disease 2.3% were present. The total number of patients who developed eye manifestations was 18%. Keratoconjunctivitis Sicca was observed in 4 females and 2 males with overall frequency of 11.1%. Conclusions. Our study showed a surge in the cases of SLE diagnosed and witnessed during the period of 2022, but our study showed an overall decrease in the incidence of eye complications.
Prevalence of diabetes among Indigenous women in Guatemala: A retrospective chart review study of 13 643 patients between 2015-2022
Authors: Alajajian Stephen , Bartolimin Jenny , Martin Yolanda Juarez , Scott Caitlin , Rohloff Peter , Flood David 
Published: January 2024

ABSTRACTThere are limited data on diabetes among Indigenous populations in Guatemala. In a retrospective chart review of a clinical program serving more than 13 000 primarily Indigenous women in Guatemala, age-adjusted diabetes prevalence was 7.9% (95% CI: 7.3 to 8.5), and 37.9% (95% CI: 35.1 to 40.8%) of women were undiagnosed.
Assessing the impact of interventions on the major Omicron BA.2 outbreak in spring 2022 in Shanghai
Authors: Liu Hengcong , Cai Jun , Zhou Jiaxin , Xu Xiangyanyu , Ajelli Marco , Yu Hongjie 
Published: January 2024

AbstractBackgroundShanghai experienced a significant surge in Omicron BA.2 infections from March to June 2022. In addition to the standard interventions in place at that time, additional interventions were implemented in response to the outbreak. However, the impact of these interventions on BA.2 transmission remains unclear.MethodsWe systematically collected data on the daily number of newly reported infections during this wave and utilized a Bayesian approach to estimate the daily effective reproduction number. Data on public health responses were retrieved from the Oxford COVID-19 Government Response Tracker and served as a proxy for the interventions implemented during this outbreak. Using a log-linear regression model, we assessed the impact of these interventions on the reproduction number. Furthermore, we developed a mathematical model of BA.2 transmission. By combining the estimated effect of the interventions from the regression model and the transmission model, we estimated the number of infections and deaths averted by the implemented interventions.ResultsWe found a negative association (-0.0069, 95% CI: -0.0096 to -0.0045) between the level of interventions and the number of infections. If interventions did not ramp up during the outbreak, we estimated that the number of infections and deaths would have increased by 22.6% (95% CI: 22.4-22.8%), leading to a total of 768,576 (95% CI: 768,021-769,107) infections and 722 (95% CI: 722-723) deaths. If no interventions were deployed during the outbreak, we estimated that the number of infections and deaths would have increased by 46.0% (95% CI: 45.8-46.2%), leading to a total of 915,099 (95% CI: 914,639-915,518) infections and 860 (95% CI: 860-861) deaths.ConclusionOur findings suggest that the interventions adopted during the Omicron BA.2 outbreak in spring 2022 in Shanghai were effective in reducing SARS-CoV-2 transmission and disease burden. Our findings emphasize the importance of non-pharmacological interventions in controlling quick surges of cases during epidemic outbreaks.
Priorities and barriers for research related to primary ciliary dyskinesia
Authors: Goutaki Myrofora , Lam Yin Ting , Rubbo Bruna , Chalmers James D , Kouis Panayiotis , Marsh Gemma , Papon Jean-François , Raidt Johanna , Robinson Phil , Behan Laura , Lucas Jane S 
Published: January 2024

ABSTRACTBackgroundDespite advances in primary ciliary dyskinesia (PCD) research, many questions remain; diagnosis is complex and no disease specific therapies exist. Using a mixed-methods approach, we aimed to identify priorities for clinical and epidemiological research and explore barriers to research.MethodsTo obtain rich, relevant, diverse data, we performed in-depth semi-structured interviews with PCD specialists selected using purposive sampling. We transcribed, coded, and analysed interview data using thematic analysis. Based on interview themes we identified, we developed an anonymous survey and circulated it widely through the BEAT-PCD network.ResultsWe interviewed 28 participants from 15 countries across different disciplines and expertise levels. The main themes identified as priorities for PCD research were improving diagnosis, understanding prevalence, and disease course; phenotypic variability; disease monitoring; treatment strategies; clinical trial endpoints; and neglected research areas. In total, 136 participants (49% paediatric pulmonologists) from 36 countries completed the survey. Most commonly reported barriers for research were low awareness about PCD and difficulties securing funding—in more than one-third of cases, participants reported undertaking predominantly unfunded research. Research questions ranked highest included priorities related to further improving diagnosis, treating PCD, managing upper and lower airway problems, and studying clinical variability and disease prognosis.ConclusionWe need to overcome barriers of limited funding and low awareness and promote collaborations between centres, disciplines, experts, and patients to address PCD priorities effectively. Our results contribute to the ongoing efforts of guiding the use of existing limited research resources and setting up a roadmap for future research activities.Take home messageOur study defined PCD research priorities including improving diagnosis, treatments, managing upper and lower airway disease, and understanding prognosis. Key barriers identified include low disease awareness and limited funding opportunities.
Immunotherapy Time of Infusion Impacts Survival in Head and Neck Cancer: A Propensity Score Matched Analysis
Authors: Ruiz-Torres Daniel A. , Naegele Saskia , Podury Archana , Wirth Lori , Shalhout Sophia Z. , Faden Daniel L. 
Published: January 2024

AbstractThe adaptive immune response is physiologically regulated by the circadian rhythm. Data in lung and melanoma malignancies suggests immunotherapy infusions earlier in the day may be associated with improved response; however, the optimal time of administration for patients with HNSCC is not known. We aimed to evaluate the association of immunotherapy infusion time with overall survival (OS) and progression free survival (PFS) in patients with HNSCC in an Institutional Review Board-approved, retrospective cohort study. 113 patients met study inclusion criteria and 98 patients were included in a propensity score-matched cohort. In the full unmatched cohort (N=113), each additional 20% of infusions received after 1500h conferred an OS hazard ratio (HR) of 1.35 (95% C.I.1.2-1.6; p-value=0.0003) and a PFS HR of 1.34 (95% C.I.1.2-1.6; p-value <0.0001). A propensity score-matched analysis of patients who did or did not receive ≥ 20% of infusions after 1500h showed that those who were administered ≥20% of infusions after 1500h trended towards a shorter OS (HR=1.35; p-value=0.26) and a shorter PFS (HR=1.57, 95% C.I. 1.02-2.42, p-value=0.04). Each additional 20% of infusions received after 1500h remained robust in the matched cohort multivariable analysis and was associated with shorter OS (adjusted HR=1.4 (95% C.I.1.2-1.8), p-value<0.001). Patients with advanced HNSCC who received more of their infusions in the afternoon were associated with shorter OS and PFS and scheduling immunotherapy infusions earlier in the day may be warranted.Conflict of Interest StatementDr. Wirth reports receiving advisory board fees from Ayala Pharmaceuticals, Blueprint Medicines, Cue Biopharma, Cullinan Oncology, Genentech USA, Loxo Oncology, Merck, NewLink Genetics, Novartis, and Rakuten Medical, consulting fees and advisory board fees from Bayer HealthCare Pharmaceuticals and Eisai, advisory board fees and fees for serving on a steering committee from Eli Lilly, and fees for serving on a data and safety monitoring board from Iovance Biotherapeutics. Dr. Faden has received research funding from Bristol Myers Squibb and Foundation Medicine, holds equity in Illumina and receives consulting fees from Noetic and Focus on Boston. The remaining authors have no conflicts to report.Research HighlightsImmunotherapy early in the day may result in improved response rates in HNSCC, consistent with data in other solid malignancies.