bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prediction of cardiovascular events by phenotype of central and peripheral blood pressure in subjects without hypertension
Authors: Kim Min-Sik , Kim Gee-Hee 
Published: February 2023

AbstractBackgroundHypertension (HBP) is a common disease associated with aging, but the rate of recognition and control of the condition remains low. Most guidelines related to HBP have consisted of only peripheral blood pressure (BP) measurement. However, according to many studies, central BP (CBP) has a clearer relationship with the prediction of cardiovascular (CV) events than does peripheral BP and can more clearly express an individual’s BP status. Therefore, we aimed to evaluate the effect of CBP on the prediction of CV events and to investigate the prediction of CV events by phenotype of central and peripheral BP in subjects without hypertension.MethodA total of 2,910 patients were enrolled from June 2011 to December 2016 and were followed up through October 2022. CBP was measured using radial tonometry. The primary endpoint was a composite outcome.ResultThe median follow-up period for enrolled patients was 7.5 years. Out of a total of 722 patients (mean age of 52.5 ± 13.7 years) without HBP, 21 patients (2.9%) had events of the primary endpoint during the follow-up period. Systolic BP averaged 126 mmHg (±15 mmHg) in the event-free group and 136 mmHg (±15 mmHg) in the CV event group, while CBP measured 115 mmHg (±16 mmHg) in the event-free group and 126 mmHg (±16 mmHg) in the CV event group. In a Cox proportional hazards model, every 10 mmHg increase in CBP and systolic BP showed an increase in risk of 30% and 40%, respectively. Isolated central systolic hypertension and dual central and peripheral systolic hypertension showed 4.9% and 6% of the CV event rate, respectively (p=0.897).ConclusionIrrespective of the brachial BP status, isolated central hypertension increased CV events. Therefore, to prevent CV events, it is essential to control not only peripheral BP but also CBP.
Development and Validation of an MGBP Nomogram for 3-month Unfavorable Functional Prognosis Prediction of Nontraumatic Pediatric Intracerebral Hemorrhage in Chinese Patients: 10-year Experience from a National Children’s Medical Center
Authors: Zhou Ji-Hua , Zhang Zhen-Yu , Chen Yang , Ming Mei-Xiu , Shen Quan-Li , Zheng Ji-Cui , Pan Gang , Zhang Yi , Chen Wei-Ming , Lu Guo-Ping 
Published: February 2023

ABSTRACTBackgroundPediatric intracerebral hemorrhage (pICH) remains a considerable cause of mortality. This study aimed to explore functional prognosis predictors in Chinese patients with pICH and attempted to develop and validate a nomogram for estimating individual risk probability of short-term unfavorable functional prognosis.MethodsA retrospective case-control study through records reviewing was conducted, non-neonate patients with nontraumatic pICH discharged from the Children’s Hospital of Fudan University between January 2012 and December 2021 were all originally included. The primary outcome was unfavorable functional prognosis at 3 months post pICH defined as a score of 3–6 as measured using the modified Rankin Scale (ranging from 0 [asymptomatic] to 6 [death]). Multivariate logistic regression analysis was performed to screen prognosis predictors, a prediction model-based nomogram was developed. Internal validation was assessed and quantified as receiver operating characteristic (ROC) curve and bootstrapped calibration curve.ResultsA total of 269 pICH patients were enrolled, the median age was 57.2 months (interquartile range, 5.4–115.1), and 157 (58.4%) patients were male. The median follow-up time was 3.2 months (interquartile range, 2.8–3.6), 112 (41.6%) patients had unfavorable functional outcome. Cerebral vascularmalformation as etiology, modifiedGlasgow Coma Score on admission,brainstem location, and intracerebral hemorrhage volume aspercentage of total brain volume were identified as functional prognosis predictors. A nomogram was established comprising these four predictors, abbreviated to MGBP, the area under the ROC curve of the nomogram was 0.827 (95% Confidence Interval, 0.778–0.877) with good calibration (P=0.803 for the Spiegelhalter’s Z-test).ConclusionsThe MGBP nomogram is the first model developed and validated in a consecutive cohort to predict 3-month unfavorable functional prognosis post nontraumatic pICH in Chinese children, which may provide clinicians with a potentially effective approach for early prediction and timely management of pICH.
Application and validation of an algorithmic classification of early impairment in cognitive performance
Authors: Cai Yurun , Schrack Jennifer A. , Agrawal Yuri , Armstrong Nicole M. , Wanigatunga Amal , Kitner-Triolo Melissa , Moghekar Abhay , Ferrucci Luigi , Simonsick Eleanor M. , Resnick Susan M. , Gross Alden L. 
Published: February 2023

AbstractObjectiveDue to the long prodromal period for dementia pathology, approaches are needed to detect cases before clinically recognizable symptoms are apparent, by which time it is likely too late to intervene. This study contrasted two theoretically-based algorithms for classifying early cognitive impairment (ECI) in adults aged ≥50 enrolled in the Baltimore Longitudinal Study of Aging.MethodTwo ECI algorithms were defined as poor performance (1 standard deviation [SD] below age-, sex-, race-, and education-specific means) in: (1) Card Rotations or California Verbal Learning Test (CVLT) immediate recall and (2) ≥1 (out of 2) memory or ≥3 (out of 6) non- memory tests. We evaluated concurrent criterion validity against consensus diagnoses of mild cognitive impairment (MCI) or dementia and global cognitive scores using receiver operating characteristic (ROC) curve analysis. Predictive criterion validity was evaluated using Cox proportional hazards models to examine the associations between algorithmic status and future adjudicated MCI/dementia.ResultsAmong 1,851 participants (mean age=65.2±11.8 years, 50% women, 74% white), the two ECI algorithms yielded comparably moderate concurrent criterion validity with adjudicated MCI/dementia. For predictive criterion validity, the algorithm based on impairment in Card Rotations or CVLT immediate recall was the better predictor of MCI/dementia (HR=3.53, 95%CI: 1.59-7.84) over 12.3 follow-up years.ConclusionsImpairment in visuospatial ability or memory may be capable of detecting early cognitive changes in the preclinical phase among cognitively normal individuals.
Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid
Authors: Aguilar Alexia G. , Canals Priscilla C. , Miller Kimberly A. , Piper Brian J. 
Published: February 2023

AbstractBackgroundAntibiotic resistance is a persistent and growing concern. Our objective was to analyze antibiotic prescribing data in the United States (US) to identify trends in the Medical Expenditure Panel System (MEPS) and any state-level disparities to Medicaid patients.MethodsWe obtained total MEPS prescriptions for eight antibiotics from 2013 to 2020. We extracted prescribing rates per 1,000 Medicaid enrollees for two years, 2018 and 2019, for four broad spectrum (azithromycin, ciprofloxacin, levofloxacin, and moxifloxacin) and four narrow spectrum (amoxicillin, cephalexin, doxycycline, and trimethoprim/sulfamethoxazole) antibiotics.ResultsAntibiotics in MEPS decreased from 2013 to 2020 by −38.7% with a larger decline for broad (−53.7%) than narrow spectrum (−23.5%). Antibiotic prescriptions decreased from 2018 to 2019 and by −6.7% when correcting for the number of Medicaid enrollees. Amoxicillin was the predominant antibiotic followed by azithromycin, cephalexin, trimethoprim/sulfamethoxazole, doxycycline, ciprofloxacin, levofloxacin, and moxifloxacin. Substantial geographic variation in antibiotic prescribing existed with 2.8-fold between the highest (Kentucky = 855/1,000) and lowest (Oregon = 299) states. The South prescribed 52.2% more antibiotics (580/1,000) than the West (381/1,000). There were significant correlations across states in antibiotic prescribing.Conclusions & RelevanceThis study identified sizable disparities by geography in prescribing rates of eight antibiotics with over three-fold state level differences. The South had the highest prescribing rates among all the regions. Areas with high antibiotic prescribing rates, particularly for outpatients, may benefit from programs to reduce potentially unnecessary prescribing. Further analysis of state level Medicaid or prescribing policies is needed to identify reasons for the variation in prescribing rates.
Significance of headache in inflammatory bowel diseases
Authors: Khalid Baqir Ali , Ali Bilal , Shah Muhammad Nauman , Saleem Muhammad Asjad , Mohib Khadija , Alam Ehtisham , Wazir Sangeen Khan 
Published: February 2023

AbstractIntroductionResearch has shown clear correlation between inflammatory conditions and a prothrombotic state. Cerebral vein thrombosis can be fatal and diagnosis is challenging as symptoms are unspecific.ObjectivesThe main objective of the study is to find the association between headache and inflammatory bowel diseases.Material and methodsThis cross-sectional study was conducted in Foundation University Islamabad and Dow Medical College Karachi during 2021 to 2022. Data was collected from 20 patients presenting in OPD of the hospital. Patients with inflammatory bowel disease unclassified presented to emergency department with a 3-day history of nausea, vomiting, headache and sporadic abdominal pain along with intermittent bloody stools in recent weeks.ResultsData was collected from 20 patients. There were 8 males and 12 females with mean age of 45.67 ± 2.34 years. No differences were found when comparing the distribution of data including IBD and migraine or severe headache. The prevalence of migraine or severe headache and 95% confidence intervals (CIs) and by selected characteristics were calculated.ConclusionIt is concluded that headache is frequent and disabling in IBD patients, highlighting the probable role of the brain–gut axis in this co-occurrence of pathologies.
Using Mendelian Randomization to model the causal effect of cancer on health economic outcomes and to simulate the cost-effectiveness of anti-cancer interventions
Authors: Dixon Padraig , Martin Richard M , Harrison Sean 
Published: February 2023

ABSTRACTBACKGROUNDCancer is associated with significant economic impacts. Quantifying the scale of these impacts is challenged by confounding variables that jointly influence both cancer status and economic outcomes such as healthcare costs and quality of life. Moreover, the increasing costs attributed to cancer drug development complicate the cost-effective provision of cancer care.METHODSWe address both challenges in this paper by using germline genetic variation in the risk of incident cancer as instrumental variables in Mendelian Randomization analyses of eight cancers. We developed causal estimates of the genetically predicted effect of bladder, breast, colorectal, lung, multiple myeloma, ovarian, prostate and thyroid cancers on healthcare costs and quality adjusted life years (QALYs) using outcome data drawn from the UK Biobank cohort. We then used Mendelian Randomization to model a hypothetical population-wide preventative intervention based on a repurposed class of anti-diabetic drugs known as sodium-glucose co-transporter-2 (SGLT2) inhibitors very recently shown to reduce the odds of incident prostate cancer.RESULTSGenetic liability to prostate cancer and to breast cancer had material causal impacts on healthcare costs and QALYs. Mendelian Randomization results for the less common cancers were associated with considerable uncertainty. SGLT2 inhibition was unlikely to be a cost-effective preventative intervention for prostate cancer, although this conclusion depended on the price at which these drugs would be offered for a novel anti-cancer indication.IMPLICATIONSOur new causal estimates of cancer exposures on health economic outcomes may be used as inputs into decision analytic models of cancer interventions such as screening programmes or simulations of longer-term outcomes associated with therapies investigated in RCTs with short follow-ups. Our new method allows us to rapidly and efficiently estimate the cost-effectiveness of a hypothetical population-scale anti-cancer intervention to inform and complement other means of assessing long-term intervention cost-effectiveness.
Cross-continental environmental and genome-wide association study on children and adolescent anxiety and depression
Authors: Thapaliya Bishal , Ray Bhaskar , Farahdel Britny , Suresh Pranav , Sapkota Ram ,   IMAGEN consortium,   cVEDA consortium, Holla Bharath , Mahadevan Jayant , Chen Jiayu , Vaidya Nilakshi , Perrone-Bizzozero Nora , Benegal Vivek , Schumann Gunter , Calhoun Vince D. , Liu Jingyu 
Published: February 2023

ABSTRACTAnxiety and depression in children and adolescents warrant special attention as a public health issue given their devastating and long-term effects on development and mental health. Multiple factors, ranging from genetic vulnerabilities to environmental stressors, influence the risk for the disorders. This study aimed to understand how environmental factors and genomics affect children and adolescents anxiety and depression across three cohorts: Adolescent Brain and Cognitive Development Study (US, age of 9-10), Consortium on Vulnerability to Externalizing Disorders and Addictions (INDIA, age of 6-17) and IMAGEN (EUROPE, age of 14). We performed data harmonization and identified the environmental impact on anxiety/depression using a linear mixed-effect model, recursive feature elimination regression, and the LASSO regression model. Subsequently, genome-wide association analyses with consideration of significant environmental factors were performed for all three cohorts by mega-analysis and meta-analysis, followed by functional annotations. The results showed that multiple environmental factors contributed to the risk of anxiety and depression during development, where early life stress and school risk had the most significant and consistent impact across all three cohorts. Both meta and mega-analysis identified a novel SNP rs79878474 in chr11p15 to be the most promising SNP associated with anxiety and depression. Gene set analysis on the common genes mapped from top promising SNPs of both meta and mega analyses found significant enrichment in regions of chr11p15 and chr3q26, in the function of potassium channels and insulin secretion, in particular Kv3, Kir-6.2, SUR potassium channels encoded by the KCNC1, KCNJ11, and ABCCC8 genes respectively, in chr11p15. Tissue enrichment analysis showed significant enrichment in the small intestine and a trend of enrichment in the cerebellum. Our findings provide evidence of consistent environmental impact from early life stress and school risks on anxiety and depression during development and also highlight the genetic association between mutations in potassium channels along with the potential role of the cerebellum region, which are worthy of further investigation.
Use of wastewater metrics to track COVID-19 in the U.S.: a national time-series analysis over the first three quarters of 2022
Authors: Varkila Meri , Montez-Rath Maria , Salomon Joshua , Yu Xue , Block Geoffrey , Owens Douglas K. , Chertow Glenn M , Parsonnet Julie , Anand Shuchi 
Published: February 2023

AbstractBackgroundWidespread use of at-home COVID-19 tests hampers determination of community COVID-19 incidence. Using nationwide data available through the US National Wastewater Surveillance System, we examined the performance of two wastewater metrics in predicting high case and hospitalizations rates both before and after widespread use of at-home tests.MethodsWe performed area under the receiver operating characteristic (ROC) curve analysis (AUC) for two wastewater metrics—viral concentration relative to the peak of January 2022 (“wastewater percentile”) and 15-day percent change in SARS-CoV-2 (“percent change”). Dichotomized reported cases (≥ 200 or <200 cases per 100,000) and new hospitalizations (≥ 10 or <10 per 100,000) were our dependent variables, stratified by calendar quarter. Using logistic regression, we assessed the performance of combining wastewater metrics.ResultsAmong 268 counties across 22 states, wastewater percentile detected high reported case and hospitalizations rates in the first quarter of 2022 (AUC 0.95 and 0.86 respectively) whereas the percent change did not (AUC 0.54 and 0.49 respectively). A wastewater percentile of 51% maximized sensitivity (0.93) and specificity (0.82) for detecting high case rates. A model inclusive of both metrics performed no better than using wastewater percentile alone. The predictive capability of wastewater percentile declined over time (AUC 0.84 and 0.72 for cases for second and third quarters of 2022).ConclusionNationwide, county wastewater levels above 51% relative to the historic peak predicted high COVID rates and hospitalization in the first quarter of 2022, but performed less well in subsequent quarters. Decline over time in predictive performance of this metric likely reflects underreporting of cases, reduced testing, and possibly lower virulence of infection due to vaccines and treatments.
Characteristics of COVID-19 in children and potential risk factors for requiring mechanical ventilation; an analysis of 22,490 cases from the United States
Authors: Verma Renuka , Ramphul Kamleshun , Lohana Petras , Sombans Shaheen , Ramphul Yogeshwaree , Pekyi-Boateng Prince Kwabla 
Published: February 2023

AbstractThe pandemic of Coronavirus disease 2019 (COVID-19) has lasted more than two years and caused millions of deaths. While the characteristics and outcomes have been more widely studied in the adult population, we conducted an in-depth analysis via the 2020 National Inpatient Sample to understand the characteristics and predictors for the use of mechanical ventilation in patients of ages 18 and less in the United States. Twenty-two thousand four hundred ninety hospitalizations involving COVID-19-positive children were found. 52.7% (11850 cases) were females, 37.0% were Hispanics, 38.0% (8555 cases) were in the first percentile 0-25th of Median household income, and 66.9% used Medicaid. In total, 1140 cases (5.1%) needed mechanical ventilation. Among factors such as obesity (aOR 1.662, 95%CI 1.368-2.019, p<0.001), Blacks (vs. White) (aOR 1.472, 95%CI 1.23-1.761, p<0.001), private insurances (aOR 1.241, 95%CI 1.06-1.453, p=0.007) or remaining forms of payment other than Medicaid or private insurances (aOR 1.763, 95%CI 1.428-2.177, p<0.001, vs. Medicaid), ages 6 to 10 years (aOR 1.531, 95%CI 1.259-1.862, p<0.001, vs. ages 0-5) showed higher odds of needing mechanical ventilation. On the contrary, Females (aOR 0.54, 95%CI 0.472-0.617, p<0.001, vs. Males), hospitalized patients in November (aOR 0.542, 95%CI 0.399-0.736, p<0.001) and December (aOR 0.446, 95%CI 0.329-0.606, p<0.001) (vs. April), Hispanics (aOR 0.832, 95%CI 0.699-0.99, p=0.038, vs. White), ages 16-18 years (aOR 0.804, 95%CI 0.673-0.96, p=0.016, vs. 0-5years), and in the 76th-100thmedian household income percentile (aOR 0.783, 95%CI 0.628-0.976, p=0.03, vs. 0-25th percentile) showed reduced odds. 9.6% of patients on mechanical ventilation died.
Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients
Authors: Piasecki Rebecca J. , Hunt Elizabeth A. , Perrin Nancy , Spaulding Erin M. , Winters Bradford , Samuel Laura , Davidson Patricia M. , Strobos Nisha Chandra , Churpek Matthew , Himmelfarb Cheryl R. ,   the American Heart Association’s Get With The Guidelines®-Resuscitation Investigators
Published: February 2023

AbstractBackgroundMany rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which RRS triggers co-occur to activate the medical emergency team (MET) to respond to RRS events is unknown. The purpose of this study was to identify and describe the patterns (RRS trigger clusters) in which RRS triggers co-occur when used to activate the MET and determine the association of these clusters with outcomes using a sample of hospitalized adult patients.MethodsRRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines-Resuscitation registry’s MET module were examined (n=134,406). A combination of cluster analyses methods was performed to group patients into RRS trigger clusters based on the triggers used to activate their RRS events. Pearson’s chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regression was used to examine the associations between RRS trigger clusters and outcomes following RRS events.ResultsSix RRS trigger clusters were identified in the study sample. The RRS triggers that predominantly identified each cluster were as follows: tachypnea, new onset difficulty in breathing, and decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, and staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, and mental status changes (Cluster 3); tachycardia and staff concern (Cluster 4); mental status changes (Cluster 5); hypotension and staff concern (Cluster 6). Significant differences in patient characteristics were observed across RRS trigger clusters. Patients in Clusters 3 and 6 were associated with an increased likelihood of in-hospital cardiac arrest (IHCA [p<0.01]), while Cluster 4 was associated with a decreased likelihood of IHCA (p<0.01). All clusters were associated with an increased risk of mortality (p<0.01).ConclusionsWe discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes following RRS events. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and may aid in clinician decision-making during RRS events.
Mitochondrial metabolism in primary and metastatic human kidney cancers
Authors: Bezwada Divya , Lesner Nicholas P. , Brooks Bailey , Vu Hieu S. , Wu Zheng , Cai Ling , Kasitinon Stacy , Kelekar Sherwin , Cai Feng , Aurora Arin B. , Patrick McKenzie , Leach Ashley , Ghandour Rashed , Zhang Yuanyuan , Do Duyen , Sudderth Jessica , Dumesnil Dennis , House Sara , Rosales Tracy , Poole Alan M. , Lotan Yair , Woldu Solomon , Bagrodia Aditya , Meng Xiaosong , Cadeddu Jeffrey A. , Mishra Prashant , Pedrosa Ivan , Kapur Payal , Courtney Kevin D. , Malloy Craig R. , Margulis Vitaly , DeBerardinis Ralph J. 
Published: February 2023

SummaryMost kidney cancers display evidence of metabolic dysfunction1–4but how this relates to cancer progression in humans is unknown. We used a multidisciplinary approach to infuse13C-labeled nutrients during surgical tumour resection in over 70 patients with kidney cancer. Labeling from [U-13C]glucose varies across cancer subtypes, indicating that the kidney environment alone cannot account for all metabolic reprogramming in these tumours. Compared to the adjacent kidney, clear cell renal cell carcinomas (ccRCC) display suppressed labelling of tricarboxylic acid (TCA) cycle intermediates in vivo and in organotypic slices cultured ex vivo, indicating that suppressed labeling is tissue intrinsic. Infusions of [1,2-13C]acetate and [U-13C]glutamine in patients, coupled with respiratory flux of mitochondria isolated from kidney and tumour tissue, reveal primary defects in mitochondrial function in human ccRCC. However, ccRCC metastases unexpectedly have enhanced labeling of TCA cycle intermediates compared to primary ccRCCs, indicating a divergent metabolic program during ccRCC metastasis in patients. In mice, stimulating respiration in ccRCC cells is sufficient to promote metastatic colonization. Altogether, these findings indicate that metabolic properties evolve during human kidney cancer progression, and suggest that mitochondrial respiration may be limiting for ccRCC metastasis but not for ccRCC growth at the site of origin.