bluuebunny/crossref_metadata_2025_split huggingface dataset:
The temporal relationship between preeclampsia and heart failure
Authors: Baker Charlotte , Smits Peter D , Rodriguez Patricia , Cartwright Brianna M Goodwin , Gratzl Samuel , Brar Rajdeep , Garrett Emily , Stucky Nicholas L 
Published: August 2023

AbstractImportanceHypertensive disorders of pregnancy (e.g., preeclampsia) occur in approximately 8 to 10% of pregnancies in the US. Preeclampsia is a significant risk factor for future cardiovascular disease but in the US there is no universal long-term clinical follow up or screening for these conditions.ObjectiveTo determine whether having preeclampsia increases the rate of heart failure at or after delivery across demographics and obstetrics related comorbidities.DesignRetrospective cohort study. We examined deliveries between January 1, 2018 and March 31, 2023 and assessed the time to heart failure stratified by preeclampsia status. Index event (T0) was first recorded delivery in time frame.SettingPopulation based using nationally representative data from electronic health records by TruvetaParticipantsFemale. 16 to 50 years of age. First recorded delivery in time frame identified using ICD-9-CM, ICD-10-CM, and SNOMED CT codes for delivery. Exclusion criteria: missing information on sex, race, ethnicity, age; if last contact with the health care system was T0; recent history of related cardiovascular conditions; or congenital heart disease.ExposurePreeclampsia on or before delivery.Main Outcomes and MeasuresDiagnosis of heart failure (HF) at or after T0. Other measures included were Leonard’s obstetric comorbidity score, age, race, ethnicity, and disability. We used Cox proportional hazards models to assess time till HF.Results718,166 individuals were included and 14,204 had preeclampsia. After adjusting for obstetric comorbidities, race, ethnicity, age and disability, Black patients had a higher hazard of HF compared to white women (HR 3.48; CI 2.97, 4.06). Black patients with preeclampsia had a higher hazard of HF than white patients without preeclampsia (HR 4.63; CI 1.65, 12.99). Black patients without preeclampsia had a risk of HF similar to other racial groups with preeclampsia.Conclusions and RelevanceThe risk for HF after preeclampsia was significant and should continue to be explored. Modifiable factors for both preeclampsia and HF which should be a focus include substance use disorder and pregestational diabetes. Regular long term clinical follow up or screening of women with preeclampsia for HF may be warranted.Key PointsQuestionDoes having preeclampsia increase the rate of heart failure at or after delivery across demographics and obstetrics related comorbidities?FindingsIn this retrospective cohort study that included 718,166 deliveries, the risk of heart failure at any point after delivery was 2.82 times greater in women that had preeclampsia than those that did not, after controlling for obstetric comorbidities, race, ethnicity, and age.MeaningRegular long term clinical follow up or screening of women with preeclampsia for heart failure may be warranted.
Mobile instrumental assessment of swallowing in residential aged care homes
Authors: Birchall Olga , Bennett Michelle , Lawson Nadine , Richards Amanda , Cotton Susan M. , Vogel Adam P. 
Published: August 2023

AbstractPurposeAdults living in residential-aged-care-homes (RACHs) with oropharyngeal dysphagia may not have timely access to instrumental swallowing assessment due to barriers, including the need to travel off-site for assessment. This study describes the feasibility, utility, and acceptability of mobile Flexible-Endoscopic-Swallowing-Assessment (mFEES) in Australian residential-aged-care-homes (RACHs).MethodResidents with dysphagia living in RACHs were assessed using onsite mFEES. Feasibility, utility, and acceptability were measured at institutional, resident, and implementation levels.ResultHealthcare professionals and medical decision makers reported that mFEES facilitated a better understanding of residents’ swallowing function/dysphagia management and was beneficial over off-site services. Self-rated discomfort during mFEES was low and most residents presented with no or minimal anxiety about the procedure. Costs of mobile assessments are documented.ConclusionmFEES was a safe, well tolerated, and practical service that offered opportunity to enhance person-centered clinical care in older adults living with dysphagia in RACHs.
Bi-directional associations between mask usage and the associated reasons before and after the downgrading of the legal status of COVID-19 in Japan: A longitudinal study
Authors: Murakami Michio 
Published: August 2023

ABSTRACTObjectivesFrom a public health perspective, it is important to clarify the associations between mask usage and the associated reasons in situations when mask usage is promoted or mitigated. Therefore, I clarified the changes in mask usage and the associated reasons before and after the downgrading of the legal status of COVID-19 in Japan, and analyzed the bi-directional associations between the two.DesignLongitudinal study.MethodsOnline surveys were conducted in two waves, between April 18–19, 2023 and June 6–15, 2023, among people aged 20–69 years living in Japan. A total of 291 participants completed both the surveys. The associations between mask usage and beliefs about the reasons for mask usage were analyzed using a cross-lagged panel model.ResultsMask usage decreased slightly, but significantly, from the first to the second wave (P< 0.001, Cohen’s d = −0.23). Of the eight beliefs regarding mask usage, slight but significant decreases were observed in terms of relief and information effects (P= 0.046, Cohen’s d = −0.12;P= 0.018, Cohen’s d = −0.14). There was a significant association between socio-psychological reasons other than infection risk avoidance (such as norm and relief) during the first wave and mask usage during the second wave [standard estimates:0.25 (95% confidence interval (CI):0.06–0.44)]. Contrarily, mask usage during the first wave was significantly associated with the reasons for infection risk avoidance during the second wave [standard estimates:0.13 (0.03–0.24)].ConclusionsThe impact of downgrading the legal status of COVID-19 in Japan on mask usage and the associated reasons were found to be limited. In terms of promoting or mitigating mask usage, the significance of risk communication based on socio-psychological reasons other than infection risk avoidance, such as norms and relief, was highlighted.
Prevalence of depression and associated factors among cervical cancer patients attending tertiary center in Bhaktapur, Nepal
Authors: Dhakal Mamta , Basel Prem 
Published: August 2023

AbstractBackground/ ObjectivesThis study aimed to estimate the prevalence of depression and associated factors among cervical cancer patients attending tertiary center in Bhaktapur, Nepal.MethodsA cross-sectional study was conducted among 140 women aged 35 years and above with cervical cancer who came for follow-up at Bhaktapur Cancer Hospital using Beck Depression Inventory (BDI). Chi-square test and multivariate logistic regression were performed to determine the association between depression and related variables at 95% confidence level.ResultsThe prevalence of depression was found to be 67.9% (95% CI: 57.5%-76.4%). Age (AOR: 1.3, 95% CI: 0.2-5.1), education of participants (AOR: 1.9, 95% CI: 0.5-7.8), education of husband (AOR: 2, 95% CI: 0.6-7.1) and alcohol consumption status of husband (AOR: 3.5, 95% CI: 1.1-11.8) were found to be the associated factors of depression in women with cervical cancer.ConclusionNearly seven in ten women with cervical cancer are found to be depressed.
“The Running Injury Continuum: A qualitative examination of recreational runners’ description and management of injury”
Authors: Lacey Aisling , Whyte Enda , O’Keeffe Sinéad , O’Connor Siobhán , Burke Aoife , Moran Kieran 
Published: August 2023

AbstractIntroductionA critical step in understanding and preventing running-related injuries (RRIs) is appropriately defining RRIs. Current definitions of RRIs may not represent the full process of injury development, failing to capture lower levels of injury that many athletes continue to train through. Understanding runners’ description and management of the injury development process may allow for a more appropriate examination of all levels of injury. This study aimed to examine recreational runners’ description and management of the injury development process.MethodsA qualitative focus group study was undertaken. Seven semi-structured focus groups with male (n=13) and female (n=18) recreational runners took place. Focus groups were audio and video recorded, and transcribed verbatim. Transcripts were reflexively thematically analysed. A critical friend approach was taken to data coding. Multiple methods of trustworthiness were executed.ResultsRunners describe injury on a nine-level continuum, ranging from injury-free to career-ending injury. There are lower and higher levels of injury. Each level of injury is described across four categories of descriptors; physical description, outcome (effect on running and daily life), psychological description, and management.ConclusionThe Running Injury Continuum is a tool that can be used for injury surveillance (for healthcare professionals and researchers) and for research investigating RRI risk factors. Healthcare professionals, researchers and coaches must ensure they monitor the development of all levels of RRIs, across all categories of descriptors. Runners need to be educated regarding appropriate self-management strategies for lower level injuries, with access to evidence-based information being a critical management tool.
Predicting Wilson’s Disease Progression using Machine Learning with Real-World Electronic Health Records
Authors: Liang Caihua , Kelly Scott P. , Shen Rongjun , Li Ling , Lobello Kasia , Arkin Steven , Huang Kui , Zhou Xiaofeng 
Published: August 2023

AbstractBACKGROUND & AIMSWilson’s disease (WD) is a rare genetic disorder causing excessive copper accumulation. Research on the natural history of WD is limited. Our objective was to identify predictors for WD progression to cirrhosis, liver failure, and death and to predict individual risk of progression to these endpoints at 1, 2, 3, and 5 years after WD diagnosis.METHODSA retrospective natural history cohort study of adult patients with first-recorded WD diagnosis was conducted using the US Optum EHR data between 1/1/2007 and 6/30/2020. LASSO Cox regression, Random Survival Forest (RSF), and XGBoost (XGB) models were used to identify important predictors for progression to cirrhosis, liver failure, and death. The strong predictors for each outcome identified through weighted average rankings across models and reviewed by clinical experts were used for patient-level prediction using RSF and XGB models. The resulting models were validated with an independent sample cohort. C-index and dynamic AUCs were used to evaluate model performance.RESULTSOver the study period, 310 out of 2,901 WD patients developed cirrhosis, 255 out of 3,251 developed liver failure, and 604 out of 3,559 died. Age at WD diagnosis, alcoholism, AST and bilirubin levels within 3 months of WD diagnosis, and neurologic and hepatic conditions were the most common predictors for progression to the study endpoints. XGB had a slight superior predictive performance compared with RSF and was then used to predict individual risks for progression to the study endpoints with the top ensemble predictors. The dynamic AUC was 0.78 at Year 1, 0.74 at Year 2, 0.72 at Year 3 and 0.72 at Year 5 for cirrhosis; 0.82 at Year 1, 0.78 at Year 2, and 0.77 at both Year 3 and Year 5 for liver failure; 0.81 at Year 1, 0.83 at Year 2, and 0.82 at both Year 3 and Year 5 for death.CONCLUSIONSThis study identified the most influential clinical predictors and assessed patient-level risk of WD progression using machine learning. Results from machine learning prognostic models will increase understanding of disease natural history and may help improve clinical trial design and guide individualized clinical care.
Barriers influencing implementation of patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study
Authors: Gqaleni T.M.H , Mkhize Sipho. W. 
Published: August 2023

AbstractBackgroundGlobally, increased occurrences of Patient Safety Incidents have become a public concern. The implementation of Patient Safety Incidents incident reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu- Natal, the views of healthcare professionals were unearthed.AimThis study explores the healthcare professional views toward the implementation of Patient Safety Incidents reporting and learning Guidelines in specialised care units.MethodsA descriptive, explorative qualitative approach, was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in SCUs of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from March to May 2021. Content data analysis was performed using Tesch’s method of analysis process.ResultsThe main themes that emerged during data analysis were: Ineffective reporting system affecting the communication of PSI guidelines, Inadequate Institutional and management for the healthcare professionals, Insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of PSI guidelines. The findings highlighted that there were more major barriers to the implementation of PSI reporting and learning guidelines.ConclusionThis study confirmed that PSI reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised PSI reporting and learning guidelines, designed in consultation with the frontline healthcare professionals, consisting of standardised, simple -user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.
Plasmodium falciparum pfhrp2andpfhrp3gene deletions among patients enrolled at 100 health facilities throughout Tanzania: February to July 2021
Authors: Rogier Eric , Battle Nastassia , Bakari Catherine , Seth Misago D. , Nace Douglas , Herman Camelia , Madebe Rashid A. , Mandara Celine I. , Lyimo Beatus M. , Giesbrecht David J. , Popkin-Hall Zachary R. , Francis Filbert , Mbwambo Daniel , Garimo Issa , Aaron Sijenunu , Lusasi Abdallah , Molteni Fabrizio , Njau Ritha , Cunningham Jane A. , Lazaro Samwel , Mohamed Ally , Juliano Jonathan J. , Bailey Jeffrey A. , Udhayakumar Venkatachalam , Ishengoma Deus S. 
Published: August 2023

AbstractPlasmodium falciparumwith the histidine rich protein 2 gene (pfhrp2) deleted from its genome can escape diagnosis by HRP2-based rapid diagnostic tests (HRP2-RDTs). The World Health Organization (WHO) recommends switching to a non-HRP2 RDT forP. falciparumclinical case diagnosis whenpfhrp2deletion prevalence causes ≥ 5% of RDTs to return false negative results. Tanzania is a country of heterogenousP. falciparumtransmission, with some regions approaching elimination and others at varying levels of control. In concordance with the current recommended WHOpfhrp2deletion surveillance strategy, 100 health facilities encompassing 10 regions of Tanzania enrolled malaria-suspected patients between February and July 2021. Of 7,863 persons of all ages enrolled and providing RDT result and blood sample, 3,777 (48.0%) were positive by the national RDT testing forPlasmodiumlactate dehydrogenase (pLDH) and/or HRP2. A second RDT testing specifically for theP. falciparumLDH (Pf-pLDH) antigen found 95 persons (2.5% of all RDT positives) were positive, though negative by the national RDT for HRP2, and were selected forpfhrp2andpfhrp3(pfhrp2/3) genotyping. Multiplex antigen detection by laboratory bead assay found 135/7,847 (1.7%) of all blood samples positive for Plasmodium antigens but very low or no HRP2, and these were selected for genotyping as well. Of the samples selected for genotyping based on RDT or laboratory multiplex result, 158 were P. falciparum DNA positive, and 140 had sufficient DNA to be genotyped for pfhrp2/3. Most of these (125/140) were found to be pfhrp2+/pfhrp3+, with smaller numbers deleted for only pfhrp2 (n=9) or only pfhrp3 (n=6). No dual pfhrp2/3 deleted parasites were observed. This survey estimated that 0.24% (95% confidence interval: 0.08% to 0.39%) of false-negative HRP2-RDTs for symptomatic persons were due to pfhrp2 deletions in this 2021 Tanzania survey. These data provide evidence for HRP2-based diagnostics as currently accurate for P. falciparum diagnosis in Tanzania.
More youthful brain activations observed in older adults with better cognition
Authors: Gazes Yunglin , Argiris Georgette , Haynes Caleb R. , Stern Yaakov , Habeck Christian G. 
Published: August 2023

AbstractWe investigated factors that influence the maintenance of youthful functional activation for a working memory task in healthy older adults. While task-related functional activation has been found to increase in extent and intensity in aging, there have been few investigations into the factors that enable more youthful-appearing activation patterns. Similarity to young-like templates underlying more successful cognitive aging is an attractive idea and has been operationalized in a variety of different data domains in neuroscience. We applied an operationalization of such template similarity in a well-understood verbal working-memory task examined in 135 older adults (age=64.9 ± 3.17 years) using 44 younger adults (age=26.0 ± 2.9 years) as the reference group. Topographic similarity to the young-reference pattern was computed as spatial correlation across voxels between a young- and an older-group pattern. Similarity to the young-reference pattern was evaluated via two approaches: group-wise and at the individual level. In group-wise similarity, moderating factors were dichotomized, splitting older adults into two group. Examining the similarity between these group patterns and the young-reference pattern, we observed more youthful-appearing activation patterns for females than males, participants with thicker than thinner cortex, less white matter hyperintensity than more, and better performance in vocabulary, processing speed, memory, and reasoning. No difference in similarity was observed for high vs. low education groups. Individual-level similarity was quantified between the young-reference pattern template and each older adult’s pattern, for which linear regression showed that the degree of similarity to the young pattern was associated with more accurate performance on the working-memory task, even after covarying out age, sex, education, and three brain structural measures. Overall, using a novel approach to quantify topographic similarity between younger and older adults, we provided evidence that older adults with better overall cognition recruit more youthful-appearing activation patterns during working-memory rehearsal, and we discussed its relevance to resilience mechanisms in aging.
Analysis of Economic and Educational Spillover Effects in PEPFAR Countries
Authors: Crown William , Hariharan Dhwani , Kates Jennifer , Gaumer Gary , Jordan Monica , Hurley Clare L. , Luan Yiqun , Nandakumar A.K. 
Published: August 2023

AbstractThe United States President’s Emergency Plan for AIDS Relief (PEPFAR) has been credited with saving millions lives and helping to change the trajectory of the global human immunodeficiency virus (HIV) epidemic. This study assesses whether PEPFAR has had impacts beyond health by examining changes in five economic and educational outcomes in PEPFAR countries: the gross domestic product (GDP) per capita growth rate; the share of girls and share of boys, respectively, who are out of school; and female and male employment rates. We constructed a panel data set for 157 low- and middle-income countries between 1990 and 2018 to estimate the macroeconomic impacts of PEPFAR. Our PEPFAR group included 90 countries that had received PEPFAR support over the period. Our comparison group included 67 low- and middle-income countries that had not received any PEPFAR support or had received minimal PEPFAR support (<$1M or <$.05 per capita) between 2004 and 2018. We used differences in differences (DID) methods to estimate the program impacts on the five economic and educational outcome measures. This study finds that PEPFAR is associated with increases in the GDP per capita growth rate and educational outcomes. In some models, we find that PEPFAR is associated with reductions in male and female employment. However, these effects appear to be due to trends in the comparison group countries rather than programmatic impacts of PEPFAR. We show that these impacts are most pronounced in COP countries receiving the highest levels of PEPFAR investment.
IntronicFGF14GAA repeat expansions are a common cause of downbeat nystagmus syndromes: frequency, phenotypic profile, and 4-aminopyridine treatment response
Authors: Pellerin David , Heindl Felix , Wilke Carlo , Danzi Matt C. , Traschütz Andreas , Ashton Catherine , Dicaire Marie-Josée , Cuillerier Alexanne , Del Gobbo Giulia , Boycott Kym M. , Claassen Jens , Rujescu Dan , Hartmann Annette M. , Zuchner Stephan , Brais Bernard , Strupp Michael , Synofzik Matthis 
Published: August 2023

AbstractThe cause of downbeat nystagmus (DBN) remains unknown in approximately 30% of patients (idiopathic DBN). Here, we hypothesized that: (i)FGF14(GAA)≥250repeat expansions represent a frequent genetic cause of idiopathic DBN syndromes, (ii) are treatable with 4-aminopyridine (4-AP), and (iii)FGF14(GAA)200-249alleles are potentially pathogenic.We conducted a multi-modal cohort study of 170 patients with idiopathic DBN that comprised: in-depth ocular motor, neurological, and disease evolution phenotyping; assessment of 4-AP treatment response, including re-analysis of placebo-controlled video-oculography treatment response data from a previous randomized double-blind 4-AP trial; and genotyping of theFGF14repeat.Frequency ofFGF14(GAA)≥250expansions was 48% (82/170) in the entire idiopathic DBN cohort. Additional cerebellar ocular motor signs were observed in 100% (82/82), cerebellar ataxia in 43% (35/82), and extracerebellar features in 21% (17/82) of (GAA)≥250-FGF14patients. Alleles of 200 to 249 GAA repeats were enriched in patients with DBN (12%; 20/170) compared to controls (0.87%; 19/2,191; OR, 15.20; 95% CI, 7.52-30.80;p=9.876e-14). The phenotype of (GAA)200-249-FGF14patients closely mirrored that of (GAA)≥250-FGF14patients. (GAA)≥250-FGF14and (GAA)200-249-FGF14patients had a significantly greater clinician-reported (80% vs 31%;p=0.0011) and self-reported (59% vs 11%;p=0.0003) response rate to 4-AP treatment compared to (GAA)<200-FGF14patients. This included a treatment response with high relevance to everyday living, as exemplified by an improvement of 2 FARS stages in some cases. Placebo-controlled video-oculography data of four (GAA)≥250-FGF14patients previously enrolled in a 4-AP randomized double-blind trial showed a significant decrease in slow phase velocity of DBN with 4-AP, but not placebo.This study shows thatFGF14GAA repeat expansions are a highly frequent genetic cause of DBN syndromes, especially when associated with additional cerebellar features. Moreover, they genetically stratify a subgroup of patients with DBN that appear to be highly responsive to 4-AP, thus paving the way for a “theranostics” approach in DBN syndromes.