bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overweight followed by obesity have the lowest mortality among patients with systolic or diastolic heart failure independent of comorbidities whereas cachexia has the highest mortality
Authors: Movahed Mohammad Reza , Mineer Austin , Hashemzadeh Mehrtash 
Published: January 2024

AbstractIntroductionA phenomenon known as the obesity paradox has been reported in patients with heart failure (HF) suggesting lower mortality with increasing weight. The goal of this study is to characterize this observation in HF using the largest available inpatient database of adult patients.MethodWe searched the National Inpatient Sample (NIS) database for patients for the years 2016-2020 with a diagnosis of systolic (SHF) or diastolic heart failure (DHF) using International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes. We evaluated mortality association based on body weight. Multivariate statistical analysis was performed to adjust all-cause inpatient mortality for comorbidities.ResultsThere was a total of 7,364,023 patients with a diagnosis of SHF and 10,064,223 patients with a diagnosis of DHF. All-cause inpatient mortality was lowest in overweight patients followed by those with obesity and morbid obesity, whereas mortality was highest in cachexia compared to normal weight for SHF and DHF patients (mortality: overweight 2.56%, obese 3.12%, morbidly obese 3.70%, normal weight 5.60%, and cachexia 15.22%; p<0.001) and DHF patients (mortality: overweight 2.08%, obese 2.43%, morbidly obese 2.93%, normal weight 4.58%, and cachexia 14.25%; p<0.001). This relationship remains similar after multivariate analysis. (SHF patients: overweight OR: 0.49 (0.41-0.58), obesity OR: 0.64 (0.62-0.66), morbid obesity OR: 0.85 (0.83-0.88), and cachexia OR: 2.78 (2.67-2.90); p<0.001; DHF patients: overweight OR: 0.47 (0.40-0.56), obesity OR: 0.61 (0.59-0.63), morbid obesity OR: 0.83 (0.81-0.85), and cachexia OR: 3.09 (2.96-3.23); p<0.001).ConclusionOur data observed that all-cause inpatient mortality in SHF and DHF is lowest in overweight populations followed by obese and morbidly obese populations whereas cachexia has the highest mortality. However, increasing weight above the overweight reduces the obesity paradox benefit.
Cross-Center Validation of Deep Learning Model for Musculoskeletal Fracture Detection in Radiographic Imaging: A Feasibility Study
Authors: Hrubý Robert , Kvak Daniel , Dandár Jakub , Atakhanova Anora , Misař Matěj , Dufek Daniel 
Published: January 2024

AbstractFractures, often resulting from trauma, overuse, or osteoporosis, pose diagnostic challenges due to their variable clinical manifestations. To address this, we propose a deep learning-based decision support system to enhance the efficacy of fracture detection in radiographic imaging. For the purpose of our study, we utilized 720 annotated musculoskeletal (MSK) X-rays from the MURA dataset, augmented by bounding box-level annotation, for training the YOLO (You Only Look Once) model. The model’s performance was subsequently tested on two datasets, sampled FracAtlas dataset (Dataset 1, 840 images,nNORMAL= 696,nFRACTURE= 144) and own internal dataset (Dataset 2, 124 images,nNORMAL= 50,nFRACTURE= 74), encompassing a diverse range of MSK radiographs. The results showed a Sensitivity (Se) of 0.910 (95% CI: 0.852–0.946) and Specificity (Sp) of 0.557 (95% CI: 0.520–0.594) on the Dataset 1, and aSeof 0.622 (95% CI: 0.508–0.724) andSpof 0.740 (95% CI: 0.604–0.841) on the Dataset 2. This study underscores the promising role of AI in medical imaging, providing a solid foundation for future research and advancements in the field of radiographic diagnostics.
Unifying human infectious disease models and real-time awareness of population- and subpopulation-level intervention effectiveness
Authors: Seibel Rachel L. , Tildesley Michael J. , Hill Edward M. 
Published: January 2024

ABSTRACTDuring infectious disease outbreaks, humans often base their decision to adhere to an intervention strategy on individual choices and opinions. However, due to data limitations and inference challenges, infectious disease models usually omit these variables. We constructed a compartmental, deterministic Susceptible-Exposed-Infectious-Recovered (SEIR) disease model that includes a behavioural function with parameters influencing intervention uptake. The behavioural function accounted for an initial subpopulation opinion towards an intervention, their outbreak information awareness sensitivity and the extent they are swayed by the real-time intervention effectiveness information. Applying the model to vaccination uptake and three human pathogens - pandemic influenza, SARS-CoV-2 and Ebola virus - we explored through model simulation how these intervention adherence decision parameters and behavioural heterogeneity impacted epidemiological outcomes. From our model simulations we found that in some pathogen systems, different types of outbreak information awareness at different outbreak stages may be more informative to an information-sensitive population and lead to less severe epidemic outcomes. Incorporating behavioural functions that modify infection control intervention adherence into epidemiological models can aid our understanding of adherence dynamics during outbreaks. Ultimately, by parameterising models with what we know about human behaviour towards vaccination adherence, such models can help assist decision makers during outbreaks.
Contingency-based flexibility mechanisms through a reinforcement learning model in adults with Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder
Authors: Rodríguez-Herrera R. , León J.J. , Fernández-Martína P. , Sánchez Kuhn A. , Soto-Ontoso M. , Amaya-Pascasio L. , Martínez-Sánchez P. , Flores P. 
Published: January 2024

AbtractThe probabilistic reversal learning paradigm is one of the most used to assess cognitive flexibility during a contingency-based learning process. Lack of cognitive flexibility is related to the symptomatology that characterizes disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Disorder (OCD). Resting-state functional connectivity (rsFC) could be a specific predictor of performance in contingency-based cognitive flexibility. However, the mechanisms underlying learning and flexibility in an environment of uncertainty with OCD or ADHD adults have not been widely explored. Computational modelling may be helpful to separate components of the behavioural processes and identify the source of the disorders. In the present study, we aimed to identify the mechanisms underlying contingency-based cognitive flexibility in a sample of the impulsive-compulsive spectrum and healthy controls, and explore the rsFC between the frontoparietal networks (FPN) regions as a possible neuromarker. 148 Spanish-speaking participants (43 patients with OCD, 53 with ADHD, and 52 healthy controls) completed a probabilistic reversal learning task (PRLT). Previously, we obtained a record of FNP rsFC using functional near-infrared spectroscopy (fNIRS). For this purpose, we applied the reinforcement learning model in combination with Bayesian GLM. We found that groups showed an optimal performance in the acquisition phase of the PRLT and higher performance of HC compared to the diagnostic groups in the reversal block, although performance is still optimal in all groups. Likewise, we found that the parameters studied (reinforcement learning rate, punishment learning rate and inverse temperature) predict task performance differently by phase and group. Regarding FNP rsFC, we found that rsFC between left posterior parietal cortex (lpPC) and right posterior parietal cortex (rpPC) seems to credibly predict performance in the acquisition block in the healthy controls. These findings suggest that reducing the uncertainty between action-outcome may help to improve the adaptation of ADHD and OCD patients to changing environments. Thus, understanding sensitivity to punishment or reinforcement and its influence on the decision-making may be important for designing case-specific interventions. According to our data, rsFC between lpPC and rpPC could be important for optimal learning of our task.
Altered IgG4 Antibody Response to Repeated mRNA versus Protein COVID Vaccines
Authors: Kalkeri Raj , Zhu Mingzhu , Cloney-Clark Shane , Plested Joyce S. , Parekh Anand , Gorinson Drew , Cai Rongman , Mahato Soham , Ramanathan Pradhipa , Aurelia L. Carissa , Selva Kevin John , Marchese Anthony M. , Fries Louis , Chung Amy W. , Dunkle Lisa M. 
Published: January 2024

AbstractRepeated mRNA SARS-CoV-2 vaccination has been associated with increases in the proportion of IgG4 in spike-specific antibody responses and concurrent reductions in Fcγ-mediated effector functions that may limit control of viral infection. Here, we assessed anti-Spike total IgG, IgG1, IgG2, IgG3 and IgG4, and surrogate markers for antibody-dependent cellular phagocytosis (ADCP, FcγRIIa binding), antibody-dependent cellular cytotoxicity (ADCC, FcγRIIIa binding), and antibody-dependent complement deposition (ADCD, C1q binding) associated with repeated SARS-CoV-2 vaccination with NVX-CoV2373 (Novavax Inc., Gaithersburg, MD). The NVX-CoV2373 protein vaccine did not induce notable increases in spike-specific IgG4 or negatively impact surrogates for Fcγ effector responses. Conversely, repeated NVX-CoV2373 vaccination uniquely enhanced IgG3 responses which are known to exhibit strong affinity for FcγRIIIa and have previously been linked to potent neutralization of SARS-CoV-2. Subsequent investigations will help to understand the immunological diversity generated by different SARS-CoV-2 vaccine types and have the potential to reshape public health strategies.
Genome-wide association studies reveal differences in genetic susceptibility between single events versus recurrent events of atrial fibrillation and myocardial infarction: the HUNT study
Authors: Hall Martina , Skogholt Anne Heidi , Surakka Ida , Dalen Haavard , Almaas Eivind 
Published: January 2024

ABSTRACTGenetic research into Atrial Fibrillation (AF) and Myocardial Infarction (MI) has predominantly concentrated on contrasting afflicted individuals with their healthy counterparts. However, this approach lacks granularity, overlooking the subtleties within patient populations. In this study, we explore the distinction between AF and MI patients experiencing only single events to those experiencing recurrent events. Integrating hospital records, questionnaire data, clinical measurements, and genetic data from more than 500, 000 HUNT and UKBB participants in our analysis, we compare the two groups for both clinical and genetic characteristics with GWAS meta-analyses, PheWAS-analyses, and gene co-expression networks. We find that the two groups of patients differs in both clinical characteristics and genetic risk. More specifically, recurrent AF patients are significantly younger with a better baseline health, in terms of lower cholesterol and blood pressure, than the single AF patients. The GWAS meta-analysis results indicate that recurrent AF patients seem to have a greater genetic risk of recurrent events and the PheWAS-analysis and gene co-expression network analyses highlight differences in the diseases and genetic functions associated to the set of SNPs and genes for to each group. In contrast, we find that for MI patients experiencing single events are significantly younger and have a better baseline health, yet they exhibit higher genetic risk. The GWAS meta-analysis identifies mostly genetic regions uniquely associated with single MI, and the PheWAS-analysis and gene co-expression networks support the genetic differences between these two groups.
Ratios Of Submitted Charge Amounts To Medicare Allowed Amounts Have Variably Worsened For Anesthesiologists And Certified Registered Nurse Anesthetists Serving Medicare Beneficiaries Across The United States During 2013-2021 Period
Authors: Gupta Deepak , Ismaeil Yara 
Published: January 2024

AbstractBackgroundInterstate variations among anesthesia providers in terms of their submitted charge amounts with corresponding Medicare allowed amounts have not been recently explored.ObjectiveTo quantify interstate variations in submitted charge amounts in relation to corresponding Medicare allowed amounts for the services provided by anesthesia providers during 2013-2021 for Medicare beneficiaries in the United States (U.S.).Materials and MethodsPublic Use Files for 2013-2021 period from Centers for Medicare & Medicaid Services were accessed to generate cumulative excel sheets of de-identified anesthesia providers data according to anesthesia providers stated location in fifty U.S. states and the District of Columbia. Thereafter, total number of providers, total number of services, total submitted charge amounts and total Medicare allowed amounts were finally tabulated according to the year of billed anesthesia service as well as according to anesthesia providers state.ResultsThe submitted charge amount to Medicare allowed amount ratios varied from 4-9 across the states in 2013 for anesthesiologists as well as certified registered nurse anesthetists (CRNAs). These ratios worsened to 5-13 across the states for anesthesiologists in 2021 while these ratios worsened to 5-12 across the states for CRNAs in 2021. The greatest number of anesthesiologists serving Medicare beneficiaries have been located in California across the years while the greatest number of CRNAs serving Medicare beneficiaries have been located in Florida across the years. Overall, some states have more anesthesiologists per 100,000 population serving Medicare beneficiaries with District of Columbia having the maximum (28 anesthesiologists per 100,000 population) while some states have more CRNAs per 100,000 population serving Medicare beneficiaries with North Dakota having the maximum (38 CRNAs per 100,000 population).ConclusionOver the years (2013-2021), ratios of submitted charge amounts to Medicare allowed amounts have variably worsened for anesthesiologists and CRNAs serving Medicare beneficiaries across U.S. irrespective of the state stated by anesthesiologists and CRNAs as their primary location per National Plan and Provider Enumeration System.
Pathways of Exposure toVibrio Choleraein an Urban Informal Settlement in Nairobi, Kenya
Authors: Kering Kelvin , Wang Yuke , Mbae Cecilia , Mugo Michael , Ongadi Beatrice , Odityo Georgina , Muturi Peter , Yakubu Habib , Liu Pengbo , Durry Sarah , Deshpande Aniruddha , Gebreyes Wondwossen , Moe Christine , Kariuki Samuel 
Published: January 2024

AbstractCholera is a diarrhoeal disease caused by the toxigenicVibrio cholerae(V. cholerae) bacterium.V. choleraecan contaminate drinking water sources and food through poor sanitation and hygiene, especially in informal settlements and refugee camps where cholera outbreaks have been reported in Kenya.This study aimed to identify environmental transmission routes ofV. choleraewithin Mukuru informal settlement in Nairobi. We collected nine types of environmental samples (drinking water, flood water, open drains, surface water, shaved ice, raw produce, street food, soil, and public latrine swabs) over 12 months. All samples were analysed forV. choleraeby culture and qPCR, then qPCR-positive samples were quantified using aV. choleraeDNA standard. Behavioural data was collected to determine the frequency of contact with the environment among adults and children.Of the 803 samples collected, 20.4% were positive forV. choleraeby qPCR. However, none were positive forV. choleraeby culture.V. choleraegenes were detected in the majority of the environmental water samples (79.3%), including open drains, flood water, and surface water, but were only detected in small proportions of other sample types. Vibrio-positive environmental water samples had higher meanV. choleraeconcentrations [2490–3469 genome copies (gc) per millilitre (mL)] compared to drinking water samples (25.6 gc/mL). Combined with the behavioural data, exposure assessment showed that contact with surface water had the highest contribution to the totalV. choleraeexposure among children while ingestion of municipal drinking water and street food and contact with surface water made substantial contributions to the totalV. choleraeexposure for adults.Detection ofV. choleraein street food and drinking water indicates risk of both endemic and epidemic cholera. Exposure toV. choleraethrough multiple pathways highlights the need to improve water and sanitation infrastructure, strengthen food hygiene practices, and roll out cholera vaccination.
Impact of emerging SARS-CoV-2 on total and cause-specific maternal mortality: A natural experiment in Chile during the peak of the outbreak
Authors: Enriquez Yordanis , Critto María Elena , Weinberg Ruth , de Janon Quevedo Lenin , Galleguillos Aliro , Koch Elard 
Published: January 2024

AbstractBackgroundThis study estimated the effects of the SARS-CoV-2 pandemic on maternal death causes in Chile during the outbreak peak between 2020 and 2021.Materials and MethodsA natural experiment was conducted using official data on maternal deaths and live births (LBs) between 1997 and 2021. Trend changes in the maternal mortality ratio (MMR) were assessed using segmented regression. The effects of the SARS-CoV-2 outbreak were evaluated using interrupted time series (ITS) and an autoregressive integrated moving average (ARIMA) model to forecast the expected rates on MMR and 95% confidence intervals (95% CI).FindingsITS analysis revealed that the SARS-CoV-2 outbreak impacted the MMR due to indirect causes, with a greater increase in indirect nonrespiratory causes than respiratory causes. The ARIMA forecast was consistent with ITS, showing that the expected MMR for indirect causes was substantially lower than the observed rates (9.65 in 2020 and 7.46/100,000 LBs in 2021). The expected MMR was 3.44 in 2020 and 1.55 in 2021. For nonrespiratory causes, the observed values of the MMR for 2020 (8.77/100.000 LBs) and 2021 (7.46/100.000 LBs) doubled the prediction 4.02 (95% CI: 0.44-7.61) and 3.83 (95% CI: -0.12-7.79). No significant effect was found on direct obstetrical deaths.InterpretationDuring 2020-2021, there was a rise in the MMR in Chile attributable to SARS-CoV-2. The pandemic contributed to an escalation in the MMR due to indirect causes, particularly nonrespiratory and infectious causes, suggesting that the risk of pregnant women to SARS-CoV-2 was increased from previous comorbidities.
A genome-wide investigation into the underlying genetic architecture of personality traits and overlap with psychopathology
Authors: Gupta Priya , Galimberti Marco , Liu Yue , Beck Sarah , Wingo Aliza , Wingo Thomas , Adhikari Keyrun ,   VA Million Veteran Program, Stein Murray B. , Gelernter Joel , Levey Daniel F. 
Published: January 2024

AbstractPersonality is influenced by both genetic and environmental factors and is associated with other psychiatric traits such as anxiety and depression. The “Big Five” personality traits, which include neuroticism, extraversion, agreeableness, conscientiousness, and openness, are a widely accepted and influential framework for understanding and describing human personality. Of the big five personality traits, neuroticism has most often been the focus of genetic studies and is linked to various mental illnesses including depression, anxiety, and schizophrenia. Our knowledge of the genetic architecture of the other four personality traits is more limited. Utilizing the Million Veteran Program (MVP) cohort we conducted a genome-wide association study (GWAS) in individuals of European and African ancestry. Adding other published data, we performed GWAS meta-analysis for each of the five personality traits with sample sizes ranging from 237,390 to 682,688. We identified 158, 14, 3, 2, and 7 independent genome-wide significant (GWS) loci associated with neuroticism, extraversion, agreeableness, conscientiousness, and openness, respectively. These findings represent 55 novel loci for neuroticism, as well as the first GWS loci discovered for extraversion and agreeableness. Gene-based association testing revealed 254 genes showing significant association with at least one of the five personality traits. Transcriptome-wide and proteome-wide analysis identified altered expression of genes and proteins such asCRHR1, SLC12A5, MAPT, andSTX4. Pathway enrichment and drug perturbation analyses identified complex biology underlying human personality traits. We also studied the inter-relationship of personality traits with 1,437 other traits in a phenome-wide genetic correlation analysis, identifying new associations. Mendelian randomization showed positive bidirectional effects between neuroticism and depression and anxiety while a negative bidirectional effect was observed for agreeableness and these psychiatric traits. This study improves our comprehensive understanding of the genetic architecture underlying personality traits and their relationship to other complex human traits.
Cross-ancestry genetic investigation of schizophrenia, cannabis use disorder, and tobacco smoking
Authors: Johnson Emma C , Austin-Zimmerman Isabelle , Thorpe Hayley HA , Levey Daniel F , Baranger David AA , Colbert Sarah MC , Demontis Ditte , Khokhar Jibran Y , Davis Lea K , Edenberg Howard J , Di Forti Marta , Sanchez-Roige Sandra , Gelernter Joel , Agrawal Arpana 
Published: January 2024

AbstractIndividuals with schizophrenia frequently experience co-occurring substance use, including tobacco smoking and heavy cannabis use, and substance use disorders. There is interest in understanding the extent to which these relationships are causal, and to what extent shared genetic factors play a role. We explored the relationships between schizophrenia (Scz), cannabis use disorder (CanUD), and ever-regular tobacco smoking (Smk) using the largest available genome-wide studies of these phenotypes in individuals of African and European ancestries. All three phenotypes were positively genetically correlated (rgs = 0.17 – 0.62).Causal inference analyses suggested the presence of horizontal pleiotropy, but evidence for bidirectional causal relationships was also found between all three phenotypes even after correcting for horizontal pleiotropy. We identified 439 pleiotropic loci in the European ancestry data, 150 of which were novel (i.e., not genome-wide significant in the original studies). Of these pleiotropic loci, 202 had lead variants which showed convergent effects (i.e., same direction of effect) on Scz, CanUD, and Smk. Genetic variants convergent across all three phenotypes showed strong genetic correlations with risk-taking, executive function, and several mental health conditions. Our results suggest that both horizontal pleiotropy and causal mechanisms may play a role in the relationship between CanUD, Smk, and Scz, but longitudinal, prospective studies are needed to confirm a causal relationship.