bluuebunny/crossref_metadata_2025_split huggingface dataset:
PersistentIDHmutations are not associated with increased relapse or death in patients withIDH-mutated acute myeloid leukemia undergoing allogeneic hematopoietic cell transplant with post-transplant cyclophosphamide
Authors: Ravindra Niveditha , Dillon Laura W. , Gui Gege , Smith Matthew , Gondek Lukasz P. , Jones Richard J. , Corner Adam , Hourigan Christopher S. , Ambinder Alexander J. 
Published: August 2023

AbstractThe presence of measurable residual disease (MRD) prior to an allogeneic hematopoietic transplant (alloHCT) in Acute Myeloid Leukemia (AML) has been shown to be associated with an increased risk of post-transplant relapse. Since the Isocitrate Dehydrogenase genes (IDH1/2) are mutated in a considerable proportion of patients with AML, we studied if these mutations would serve as useful targets for MRD. Fifty-fiveIDH-mutated AML patients undergoing non-myeloablative alloHCT with post-transplant cyclophosphamide at a single center were sequenced at baseline using a multi-gene panel followed by targeted testing for persistentIDHmutations at the pre- and post-alloHCT timepoints by digital droplet PCR or error-corrected next generation sequencing. The cohort included patients who had been treated withIDHinhibitors pre- and post-transplant (20% and 17% forIDH1and 38% and 28% forIDH2). Overall, 55% of patients analyzed had detectableIDHmutations during complete remission prior to alloHCT. However, there were no statistically significant differences in overall survival (OS), relapse-free survival (RFS), and cumulative incidence of relapse (CIR) at 3 years between patients who tested positive or negative for a persistentIDHmutation during remission (OS:IDH1p=1,IDH2p=0.87; RFS:IDH1p=0.71,IDH2p= 0.78; CIR:IDH1p=0.92,IDH2p=0.97). There was also no difference in the prevalence of persistentIDHmutation between patients who did and did not receive anIDHinhibitor (p=0.59). Mutational profiling of available relapse samples showed that 8 out of 9 patients still exhibited the originalIDHmutation, indicating that theIDHmutations remained stable through the course of the disease. This study demonstrates that persistentIDHmutations during remission is not associated with inferior clinical outcomes after alloHCT in patients with AML.
Clinical outcomes after viraemia among people receiving dolutegravir versus efavirenz-based first-line antiretroviral therapy in South Africa
Authors: Asare Kwabena , Lewis Lara , van der Molen Johan , Sookrajh Yukteshwar , Khubone Thokozani , Moodley Pravikrishnen , Lessells Richard J , Naidoo Kogieleum , Sosibo Phelelani , Garrett Nigel , Dorward Jienchi 
Published: August 2023

AbstractIntroductionWe aimed to compare clinical outcomes after viraemia between dolutegravir versus efavirenz-based first-line antiretroviral therapy (ART) as evidence is lacking outside clinical trials in resource-limited settings.MethodsWe conducted a retrospective cohort analysis with routine data from 59 South African clinics. We included people living with HIV ≥15 years old receiving first-line tenofovir disoproxil fumarate, lamivudine, dolutegravir (TLD) or tenofovir disoproxil fumarate, emtricitabine, efavirenz (TEE), and with first viraemia (≥50 copies/ml) between June to November 2020. We used multivariable modified Poisson regression models to compare retention-in-care and viral suppression (<50 copies/ml) after 12 months between participants on TLD versus TEE.ResultsAt first viraemia, among 9657 participants, 6457 (66.9%) were female, median age was 37 years (interquartile range [IQR] 31-44); 7598 (78.7%) were receiving TEE and 2059 (21.3%) TLD. Retention-in-care was higher in the TLD group (84.9%) than TEE (80.8%), adjusted risk ratio (aRR) 1.03, 95%CI 1.00-1.06. Of 6569 participants retained in care and had a 12-month viral load, viral suppression was similar between TLD (78.9%) and TEE (78.8%) groups, aRR 1.02, 95%CI 0.98-1.05. However, 3368 participants changed ART during follow-up; the majority from TEE to first-line TLD (89.1%) or second-line (TLD 3.4%, zidovudine/emtricitabine/lopinavir-ritonavir 2.1%). In sensitivity analysis among the remaining 3980 participants who did not change ART during follow-up and had a 12-month viral load, viral suppression was higher in the TLD group (78.9%) than TEE (74.9%), aRR 1.07, 95%CI 1.03-1.12.ConclusionsAmong people with viraemia on first-line ART, dolutegravir was associated with better retention-in-care and similar or better viral suppression than efavirenz.
Association of blood pressure with cognitive impairment in elderly hypertensive patients in China: A cross-sectional study
Authors: Jia Yao , Qi Shige , Yin Peng , Zhou Maigeng , Ji Fusui , Wang Zhihui , Yu Xue 
Published: August 2023

AbstractAimsTo investigate the prevalence of cognitive impairment among elderly Chinese patients with hypertension and explore the relationship between blood pressure and cognitive impairment. Additionally, the study examined the characteristics of cognitive impairment in hypertensive patients and its impact on blood pressure control.MethodsA cross-sectional study was conducted involving 23,271 subjects. Data collection involved questionnaires, physical examinations, and blood tests. AD8 questionnaire, MMSE questionnaire, and neurologist interview, was used to screen patients for cognitive disabilities. Risk factors and prevalence of cognitive impairment were compared between hypertensive and non-hypertensive groups. The prevalence of cognitive impairment at different blood pressure levels was analyzed within the hypertension group. Differences in MMSE scores across dimensions were compared between hypertensive and non-hypertensive groups.ResultsThe hypertensive group exhibited additional risk factors for cognitive impairment and a higher prevalence of cognitive impairment. The prevalence of cognitive impairment among hypertensive patients followed a U-shaped curve with increasing blood pressure, with the lowest rate observed among patients with blood pressure in the range of 120-139/80-89 mmHg. Several dimensions of cognitive function were significantly diminished in individuals with hypertension. Patients with cognitive impairment demonstrated lower compliance with hypertension treatment and poorer blood pressure control.ConclusionCognitive decline across multiple dimensions is typical among older Chinese patients with hypertension, and cognitive impairment has detrimental effects on blood pressure management. Maintaining blood pressure in the 120-139/80-89 mmHg range appears to be more favorable for preserving cognitive function in hypertensive patients.
Physical and psychosocial consequences of falls in individuals with cerebral palsy
Authors: Thill Marissa , Krach Linda E. , Pederson Kari , Wandersee Nathan G. , Tierney Sandy Callen , Boyer Elizabeth R. 
Published: August 2023

ABSTRACTAimTo quantify fall frequency, characteristics, injuries, and psychosocial impact across the lifespan and between Gross Motor Classification System (GMFCS) levels in cerebral palsy (CP).MethodAmbulatory individuals with CP (201 adults) or minors’ caregivers (180) completed online surveys on falls and their physical and psychosocial consequences for this cross-sectional study.ResultsAlmost everyone fell in the past year (86%); GMFCS level II fell most often. Having experienced serious fall-related injuries (e.g., head/face stitches, concussion) increased with age, affecting 80% of ≥50-year-olds. Forward falls caused by tripping during shod ambulation were common. Uneven surfaces and fatigue were notable causes. Concern about falling and associated activity avoidance was highest for GMFCS level III. Psychosocial consequences of falls (e.g., embarrassment, lost confidence) were elevated across GMFCS levels. Nearly everyone (88%) wished they fell less.InterpretationFall frequency in ambulatory children and adults with CP is 2-3-fold higher than the general older adult population. Physical and psychosocial consequences of falls were frequent and impacted life choices. Differences observed by GMFCS level and age should be considered in care delivery. Clinically tracking and discussing falls and their repercussions across the lifespan will aid in addressing this under-researched and under-resourced concern of people with CP.WHAT THIS PAPER ADDSAmong 381 individuals with CP, 86% fell in the past year.Falling was most common among 5-12-year-olds and GMFCS level II.Head/face stitches, fractures, sprained knee/ankle, and concussions were common serious injuries.Participants experienced high levels of embarrassment, pain, and loss of confidence.GMFCS level III had the greatest fall concern and avoidance behavior.
Anti-Hepatitis C Antibody Carriage and Risk of Liver Impairment in Rural-Cameroon: Adapting the Control of Hepatocellular Carcinoma for Resource-Limited Settings
Authors: Kamga Wouambo Rodrigue , Panka Tchinda Gaelle , Kagoue Simeni Luc Aime , Djouela Djoulako Paule Dana , Yateu Wouambo Clarisse Irene , Tamko Mella Ghislaine Flore , Tchoumi Leuwat Eric pascal , Bello Djoda , Fokam Joseph 
Published: August 2023

ABSTRACTBackgroundThe global Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS.MethodsA facility-based observational study was conducted from July-August 2021 among individuals attending the “St Monique” Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p<0.05 considered statistically significant.ResultsOut of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35±3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI)=3.69(2.11-9.29),p=0.04]. HCVAb Carriage was greater among participants aged >50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI)=4.43(2.11-9.29), p<0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI)= 2.27(1.07-4.80),p=0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged>50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p<0.000). Interestingly, the burden of liver impairment (abnormal AST+ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p=0.0001.ConclusionsIn this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS.
Offspring cardiometabolic outcomes and postnatal growth trajectories after exposure to maternal SARS-CoV-2 infection
Authors: Shook Lydia L. , Castro Victor M. , Herzberg Emily M. , Fourman Lindsay T. , Kaimal Anjali J. , Perlis Roy H. , Edlow Andrea G. 
Published: August 2023

AbstractContextPrior birth cohorts have suggested an association between maternal infection in pregnancy and offspring risk for childhood obesity. Whether maternal SARS-CoV-2 infection is similarly associated with increased cardiometabolic risk for offspring is not known.ObjectiveTo determine whether in utero exposure to SARS-CoV-2 is associated with increased risk for cardiometabolic diagnoses by 18 months after birth, compared with unexposed offspring born during the COVID-19 pandemic.DesignThis retrospective cohort study included the live offspring of all individuals who delivered during the COVID-19 pandemic (April 1, 2020 - December 31, 2021) at 8 hospitals within 2 health systems in Massachusetts.ExposureSARS-CoV-2 positivity on polymerase chain reaction (PCR) test during pregnancy.Main Outcome MeasuresElectronic health record documentation ofInternational Statistical Classification of Diseases and Related Health Problems, Tenth Revisiondiagnostic codes corresponding to cardiometabolic disorders. Offspring weight-for-age, length-for-age, and body mass index (BMI)-for-age z-scores at birth, 6 months, 12 months, and 18 months of age.ResultsThe full study cohort includes 29,510 live born offspring (1,599 exposed and 27,911 unexposed offspring). 6.7% of exposed and 4.4% of unexposed offspring had received a cardiometabolic diagnosis by 18 months of age (crude OR 1.47 [95% CI: 1.10-1.94], p=0.007; adjusted OR 1.37 [1.01-1.83]; p=0.04). These diagnoses were preceded by significantly greater mean BMI-for-age z-scores in exposed versus unexposed offspring at 6 months (mean z-score difference 0.19, 95% CI: 0.10, 0.29, p<0.001), and a greater proportion of offspring at risk of, or meeting criteria for, overweight/obesity (16.5% vs. 12.2%, p=0.006).ConclusionsExposure to maternal SARS-CoV-2 infection was associated with an increased risk of receiving a cardiometabolic diagnosis by 18 months and greater BMI-for-age at 6 months.
Association Between Diabetes Mellitus and Endodontic Pathosis
Authors: Strother Kortnie K. , Kookal Krishna Kumar , Bueso Vashti , Walji Muhammad F. , Letra Ariadne 
Published: August 2023

ABSTRACTBackgroundStudies have shown that periodontal and periapical diseases are more prevalent among diabetes mellitus (DM) patients. Here, we evaluated the potential relationship between endodontic pathologies and DM through a retrospective analysis of 2,000 electronic health records (EHR) of individuals with/without DM.MethodsRecords of patients treated at UTHealth School of Dentistry presenting with a history of endodontic treatment with and without DM were randomly selected for analysis of 24 treatment- and patient-centric variables to assess for the association between endodontic disease and DM. Data between groups were compared using Chi-square, Fisher Exact tests, and one-way analysis of variance (ANOVA). Significant differences were set at P<0.05.ResultsDiabetic patients had significantly less symptomatic pulpal diagnoses, particularly less symptomatic irreversible pulpitis (P<0.00005); whereas they had significantly more symptomatic apical periodontitis (P=0.01) than non-diabetics. Diabetics had a significantly greater number of endodontically-treated teeth (P=2.2 × 10−16), particularly canines and molars (P<0.002). The frequency of active periapical lesions was higher in non-diabetics, although no differences in lesion size were observed. The frequency of periodontal disease and additional systemic disease(s), and smoking was significantly increased in DM patients with endodontic treatment (P<0.05). No differences were observed between the number of medications taken between groups or upon stratifying analysis by gender (P>0.05).ConclusionsOur results continue to support that DM contributes to increased endodontic disease and highlight the complex relationships between oral and systemic diseases.Practical ImplicationsDental professionals should be cognizant of endodontic pathology as a clinical complication of DM that presents as more chronic in nature, at a greater frequency, and have a tendency toward a nonhealing outcome.
CHANGES IN CORNEAL ABERRATIONS IN PATIENTS WITH CATARACT SURGERY WITH TORIC LENS IMPLANT: AN EXPLORATORY REVIEW
Authors: Assis Jorge Karim , Montaño Luisa Fernanda , Quintero DAniela Tutal , Giraldo Simon 
Published: August 2023

ABSTRACTIntroductionThe cataract is one of the main causes of visual alterations, which is normally treated with surgery since it improves the visual acuity of the patients, the object of the present investigation is to synthesize evidence on how the surgical intervention affects or changes the corneal aberrations.Methodologyconducted an exploratory review of the literature, observational studies on changes in corneal aberrations after cataract surgery with toric lens implant, using Pubmed, Google Scholar, Lilacs, Scopus, and Science Direct, searching and selecting articles from blindly and independently, following the PRISMA methodology.ResultsThe body of evidence selected was 4 articles published in a 6-year window, between 2011 and 2016. The average age of the surgically operated population was 65.3 ± 7.7 years, while the proportion according to sex there was a similar and greater change in corneal aberrations due to coma and trefoil.Conclusionssurgery with an incision equal to or less than 2.2 mm induces slight changes in the aberration of the total cornea, which increase before in eyes with a high pre-existence of corneal astigmatism and it is independent if the lens is toric or not.
Evidence for increased fitness of a plant pathogen conferred by epigenetic variation
Authors: Gopalan-Nair Rekha , Coissac Aurore , Legrand Ludovic , Lopez-Roques Céline , Pécrix Yann , Vandecasteele Céline , Bouchez Olivier , Barlet Xavier , Lanois Anne , Givaudan Alain , Brillard Julien , Genin Stéphane , Guidot Alice 
Published: August 2023

AbstractAdaptation is usually explained by adaptive genetic mutations that are transmitted from parents to offspring and become fixed in the adapted population. However, more and more studies show that genetic mutation analysis alone is not sufficient to fully explain the processes of adaptive evolution and report the existence of non-genetic (or epigenetic) inheritance and its significant role in the generation of adapted phenotypes. In the present work, we tested the hypothesis of the role of DNA methylation, a form of epigenetic modification, in adaptation of the plant pathogenRalstonia solanacearumto the host plant during an experimental evolution. Using SMRT-seq technology, we analyzed the methylomes of 31 experimentally evolved clones that were obtained after serial passages on a given host plant during 300 generations, either on susceptible or tolerant hosts. Comparison with the methylome of the ancestral clone revealed between 12 and 21 differential methylated sites (DMSs) at the GTWWAC motif in the evolved clones. Gene expression analysis of the 39 genes targeted by these DMSs revealed limited correlation between differential methylation and differential gene expression. Only one gene showed a correlation, the RSp0338 gene encoding the EpsR regulator protein. The MSRE-qPCR (Methylation Sensitive Restriction Enzyme - qPCR) technology was used as an alternative approach to assess the methylation state of the DMSs found by SMRT-seq between the ancestral and evolved clones. This approach also found the two DMSs upstream of RSp0338. Using site-directed mutagenesis, we demonstrated the contribution of these two DMSs in host adaptation. As these DMSs appeared very quickly in the experimental evolution, we hypothesize that such fast epigenetic changes can allow rapid adaptation to the plant stem environment. To our knowledge, this is the first study showing a link between epigenetic variation and evolutionary adaptation to new environment.
MDMA Assisted Psychotherapy Decreases PTSD Symptoms, Dissociation, Functional Disability, and Depression: A Systematic Review and Meta-Analysis
Authors: Green W. M. , Raut S.B. , James F.L.J. , Benedek D.M. , Ursano R.J. , Johnson L.R. 
Published: August 2023

AbstractPost-Traumatic Stress Disorder (PTSD) causes broad impairments affecting quality of life. However, despite current treatment many people with PTSD do not fully recover. MDMA assisted psychotherapy has emerged as a new therapy for PTSD and its comorbidities. We aimed to analyse the current evidence for MDMA assisted psychotherapy in PTSD and associated quality of life, and physiological effects, by conducting a systematic review and metanalysis of randomised controlled trials. ClinicalTrials.gov, MEDLINE, PsycINFO, PsycARTICLES, and Cochrane Library database were searched from inception to July 2022. We included both published and unpublished randomized control trials comparing MDMA assisted psychotherapy (MDMA-AP) with control. Meta-analysis of primary and secondary outcome measures was performed using Review-Manager software. Effect sizes were calculated using Standardised Mean Difference for CAPS scores and Mean Difference for secondary measures. MDMA-AP significantly improves dissociation, depression, and functional impairment, compared to controls, but not sleep quality. This data supports the use of MDMA-AP for PTSD with an improvement found in PTSD core symptoms and quality of life measures. While these findings are limited by small samples sizes in currently available clinical trials, this study provides empirical evidence to support development of MDMA-AP in PTSD.
Adjusting for the progressive digitization of health records: working examples on a multi-hospital clinical data warehouse
Authors: Remaki Adam , Playe Benoît , Bernard Paul , Vittoz Simon , Doutreligne Matthieu , Chatelier Gilles , Audureau Etienne , Kempf Emmanuelle , Porcher Raphaël , Bey Romain 
Published: August 2023

AbstractObjectivesTo propose a new method to account for time-dependent data missingness caused by the increasing digitization of health records in the analysis of large-scale clinical data.Materials and MethodsFollowing a data-driven approach we modeled the progressive adoption of a common electronic health record in 38 hospitals. To this end, we analyzed data collected between 2013 and 2022 and made available in the clinical data warehouse of the Greater Paris University Hospitals. Depending on the category of data, we worked either at the hospital, department or unit level. We evaluated the performance of this model with a retrospective cohort study. We measured the temporal variations of some quality and epidemiological indicators by successively applying two methods, either a naive analysis or a novel complete-source-only analysis that accounts for digitization-induced missingness.ResultsUnrealistic temporal variations of quality and epidemiological indicators were observed when a naive analysis was performed, but this effect was either greatly reduced or disappeared when the complete-source-only method was applied.DiscussionWe demonstrated that a data-driven approach can be used to account for missingness induced by the progressive digitization of health records. This work focused on hospitalization, emergency department and intensive care units records, along with diagnostic codes, discharge prescriptions and consultation reports. Other data categories may require specific modeling of their associated data sources.ConclusionsElectronic health records are constantly evolving and new methods should be developed to debias studies that use these unstable data sources.