bluuebunny/crossref_metadata_2025_split huggingface dataset:
Within-city spatial variations in long-term average outdoor oxidant gas concentrations and cardiovascular mortality: Effect modification by oxidative potential in the Canadian Census Health and Environment Cohort
Authors: Ripley Susannah , Gao Dong , Pollitt Krystal J. Godri , Lakey Pascale S. J. , Shiraiwa Manabu , Hatzopoulou Marianne , Weichenthal Scott 
Published: June 2023

Background:
Health effects of oxidant gases may be enhanced by components of particulate air pollution that contribute to oxidative stress. Our aim was to examine if within-city spatial variations in the oxidative potential of outdoor fine particulate air pollution (PM2.5) modify relationships between oxidant gases and cardiovascular mortality.

Methods:
We conducted a retrospective cohort study of participants in the Canadian Census Health and Environment Cohort who lived in Toronto or Montreal, Canada, from 2002 to 2015. Cox proportional hazards models were used to estimate associations between outdoor concentrations of oxidant gases (O
x
, a redox-weighted average of nitrogen dioxide and ozone) and cardiovascular deaths. Analyses were performed across strata of two measures of PM2.5 oxidative potential and reactive oxygen species concentrations (ROS) adjusting for relevant confounding factors.

Results:
PM2.5 mass concentration showed little within-city variability, but PM2.5 oxidative potential and ROS were more variable. Spatial variations in outdoor O
x
were associated with an increased risk of cardiovascular mortality [HR per 5 ppb = 1.028, 95% confidence interval (CI): 1.001, 1.055]. The effect of O
x
on cardiovascular mortality was stronger above the median of each measure of PM2.5 oxidative potential and ROS (e.g., above the median of glutathione-based oxidative potential: HR = 1.045, 95% CI: 1.009, 1.081; below median: HR = 1.000, 95% CI: 0.960, 1.043).

Conclusion:
Within-city spatial variations in PM2.5 oxidative potential may modify long-term cardiovascular health impacts of O
x
. Regions with elevated O
x
and PM2.5 oxidative potential may be priority areas for interventions to decrease the population health impacts of outdoor air pollution.
Global blood pressure screening during the COVID-19 pandemic: results from the May Measurement Month 2021 campaign
Authors: Beaney Thomas , Wang Wei , Schlaich Markus P. , Schutte Aletta E. , Stergiou George S. , Alcocer Luis , Alsaid Jafar , Diaz Alejandro Bimbo , Hernandez-Hernandez Rafael , Ishaq Mohammad , Jozwiak Jacek , Khan Nadia , Kiru Gaia , McCardle Harsha , Odili Augustine Nonso , Pyun Wook Bum , Romero Cesar A. , Wang Jiguang , Poulter Neil R. 
Published: June 2023

Background:
Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

Methods:
Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and clinical data. Hypertension was defined as a systolic BP at least 140 mmHg and/or a diastolic BP at least 90 mmHg (using the mean of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to impute the average BP when readings were missing.

Results:
Of the 642 057 screenees, 225 882 (35.2%) were classified as hypertensive, of whom 56.8% were aware, and 50.3% were on antihypertensive medication. Of those on treatment, 53.9% had controlled BP (<140/90 mmHg). Awareness, treatment and control rates were lower than those reported in MMM campaigns before the COVID-19 pandemic. Minimal changes were apparent among those testing positive for, or being vaccinated against COVID-19. Of those on antihypertensive medication, 94.7% reported no change in their treatment because of the COVID-19 pandemic.

Conclusion:
The high yield of untreated or inadequately treated hypertension in MMM 2021 confirms the need for systematic BP screening where it does not currently exist.
Association of oral montelukast with reduced odds of developing exudative age-related macular degeneration
Authors: Matsumiya Wataru , Karaca Irmak , Pham Brandon Huy , Akhavanrezayat Amir , Uludag Gunay , Yasar Cigdem , Ghoraba Hashem , Mobasserian Azadeh , Regenold Jonathan , Halim Muhammad Sohail , Sepah Yasir J. , Do Diana V. , Chong Victor , Nguyen Quan Dong 
Published: June 2023

Abstract

Purpose:
This study was conducted to evaluate the association of oral montelukast, selective antagonism for cysteinyl leukotriene receptor 1, with reduced odds of exudative age-related macular degeneration (exAMD) development.

Methods:
This case-control study was conducted using Institutional Cohort Finder tool, and included 1913 patients with exAMD (ICD: H35.32 and 362.52) and 1913 age- and gender-matched control subjects without exAMD. Sub-analysis among 1913 exAMD and 324 non-exudative AMD was also conducted.

Results:
A total of 47 (2.5%) exAMD cases were identified to have a history of oral montelukast use prior to exAMD diagnosis, compared to 84 (4.4%) controls. Montelukast usage was significantly associated with reduced odds of exAMD in the multivariable analysis (adjusted OR: 0.50, 95% CI: 0.31 – 0.80) as well as NSAID usage (adjusted OR: 0.69). Caucasian race, history of smoking, non-exudative macular degeneration in either eye were also found to have significant relationship with increased odds of exAMD. In the sub-analysis, montelukast usage showed significant association with reduced odds of developing exAMD from non-exudative AMD (adjusted OR: 0.53 95% CI: 0.29 – 0.97) as well as the presence of atopic disease (adjusted OR: 0.60).

Conclusion:
The study results suggested that oral montelukast is linked to reduced odds of exAMD development.
Cadaveric Evaluation of the Canalicular-Lacrimal Sac-Mucosal Folds and Clinical Implications
Authors: Lim Blanche Xiao Hong , Gungab Alexander Gerard Nino L. , Boniao Emmanuel Lee Ong , Sundar Gangadhara , Ali Mohammad Javed 
Published: June 2023

Purpose:
The purpose is to study the anatomical variations of the characteristic mucosal folds at the canalicular-lacrimal sac junction and their potential clinical implications.

Methods:
Twelve lacrimal drainage systems of six fresh frozen Caucasian cadavers were studied to assess the openings of the common canaliculus into the lacrimal sac. A standard endoscopic dacryocystorhinostomy was performed until complete lacrimal sac marsupialization and reflection of the flaps. All specimens were subjected to clinical assessment of lacrimal patency via irrigation. A high-definition nasal endoscopy assessed the internal common opening and the mucosal folds in its close vicinity. Probing at the internal common opening was performed to aid in the assessment of the folds. Videography and photo documentation was performed.

Results:
All 12 specimens had a single common canalicular opening. Ten of the 12 specimens (83.3%) were noted to have canalicular/lacrimal sac-mucosal folds (CLS-MF). Anatomical variations were noted across these 10 specimens and included inferior 180° (n = 6), anterior 270° (n = 2), posterior 180° (n = 1), and 360° CLS-MF (n = 1). Cases were randomly chosen to demonstrate the clinical implications of misinterpreting them as canalicular obstructions or the potential to cause an inadvertent false passage.

Conclusion:
The inferior 180° was the most common CLS-MF noted in the cadaveric study. It is helpful for clinicians to recognize the prominent CLS-MF and their clinical implications intraoperatively. Further fundamental work is needed to characterize the anatomy and the possible physiological role of CLS-MFs.
Characteristics of Retrobulbar Hemorrhage Presentation in the Emergency Department
Authors: Tram Justin K. , Pauze Denis R. , Wladis Edward J. 
Published: June 2023

Purpose:
To describe demographic and clinical features of emergency department patients presenting with fracture-associated (FA) or fracture-independent retrobulbar hemorrhage (RBH).

Methods:
The Nationwide Emergency Department Sample database 2018 and 2019 was used to compare demographic and clinical features of patients with fracture-independent RBH and FA RBH.

Results:
A total of 444 fracture-independent and 359 FA RBH patients were identified. Demographics such as age distribution, gender, and payer type differed significantly, with young (21–44 years), privately insured males more likely to develop FA RBH and the elderly (65+ years) more likely to develop fracture-independent RBH. Prevalence of hypertension and anticoagulation did not differ, but substance use and ocular-related injuries were more prevalent in the FA RBH.

Conclusion:
Presentations of RBH differ in demographic and clinical features. Further research is needed to explore trends and guide decision-making in the emergency department.
Optimizing liver transplant prioritization for hepatocellular carcinoma through risk stratification
Authors: Norman Joshua , Mehta Neil , Kwong Allison 
Published: June 2023

Purpose of review
In the United States, candidates with hepatocellular carcinoma (HCC) meeting standardized qualifying criteria receive similar priority on the liver transplant waiting list through Model for End-Stage Liver Disease exception points, without consideration of the dropout risk or relative expected benefit from liver transplantation. A more nuanced allocation scheme for HCC is needed to better represent the individual urgency for liver transplant and optimize organ utility. In this review, we discuss the development of HCC risk prediction models for practical use in liver allocation.

Recent findings
HCC is a heterogenous disease that requires improved risk stratification for patients who fall within current transplant eligibility criteria. Several models have been proposed, though none have been adopted in clinical practice or liver allocation to date, due to various limitations.

Summary
Improved HCC risk stratification for liver transplant candidates is needed to more accurately represent their urgency for transplant, with continued attention to the potential impact on post-liver transplant outcomes. Plans to implement a continuous distribution model for liver allocation in the United States may provide an opportunity to re-consider a more equitable allocation scheme for patients with HCC.
Inpatient rehabilitation for acute presentations of motor functional neurological disorder (FND): A retrospective cohort study
Authors: Polich Ginger , Zalanowski Stacey , Lewis Julie Maney , Sugarman Sarah , Christopulos Kanella , Hebb Caitlin , Perez David L. , Baslet Gaston , Shah Priyanca , Herman Seth 
Published: June 2023

ABSTRACT

Objective
Patients with Functional Neurological Disorder (FND) involving the motor system (e.g., functional weakness, functional gait) may acutely present to the hospital for new-onset symptoms. For some, symptoms may remain severe enough at the time of hospital discharge to qualify for an inpatient rehabilitation facility (IRF) stay.

Design
Data were extracted via retrospective chart review on FND patients (n = 22) admitted to an IRF between September 2019 and May 2022. Demographic and clinical data, including admission and discharge physical and occupational therapy measurements on the IRF-Patient Assessment Instrument (IRF-PAI), were recorded and analyzed.

Results
Symptom duration was less than one week for nearly two-thirds of the cohort. Following an approximately two-week length of stay, patients showed statistically significant changes in admission to discharge measures of self-care, transfers, ambulation, and balance. More than 95% of patients were able to be discharged home. The presence or absence of comorbid depression, anxiety, or PTSD did not impact outcomes.

Conclusions
For a subset of patients with persistent motor symptoms following an acute hospital admission for a new diagnosis of FND, a relatively short IRF stay was associated with significant clinical gains.
DETERMINANTS OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) TRANSMISSION AMONG CHILDREN BORN TO HIV-INFECTED MOTHERS ON PMTCT PROGRAM IN KILIFI COUNTY: A CASE CONTROL STUDY
Authors: Koriow Rukiya Mohammed , Oyugi Julius Otieno , Muasya Christine , Moindi Rodgers Onsomu 
Published: June 2023

AbstractBackgroundElimination and prevention of mother to child human immunodeficiency virus (HIV) transmission remains a global public health concern. Identification of significant risk factors of mother to child transmission is essential in reducing the burden of pediatric HIV in terms of cost of treatment, morbidity and mortality. Only a few studies have been done to demonstrate the importance of Prevention of Mother to Child Transmission (PMTCT) cascade, including the indicators and how missing one of the crucial steps of the cascade could increase the risk of infant HIV transmission. This study seeks to determine maternal risk factors related to HIV transmission among children born to HIV-infected mothers enrolled in PMTCT program in Kilifi County between July 2018 and June 2019.MethodsThis was a retrospective unmatched case control study. Systematic random sampling was used to select medical records of 183 exposed infants (61 cases and 122 controls). A structured tool was used to collect data. Proportions and frequency distribution was done in univariate analysis and in bivariate analysis, chi-square and logistic regression (odds ratio) was used to determine any association and strength of association between categorical variables.ResultsReceiving maternal HAART in ANC was established as the major determinant of a favorable HEI outcome in this study. Infants whose mothers had received maternal HAART in ANC were 52.55 (14.89 - 185.48) times more likely to be HIV negative compared to those whose mothers did not receive maternal HAART in ANC. Disclosure of HIV status by the mother at ANC was 3.18 (1.28 - 7.90) times more likely to determine a favorable outcome of the HEI compared to non-disclosure. When adjusted for other factors, it was 6.27 (1.20 - 20.05) times more likely to determine a favorable outcome.ConclusionThe study established the importance of PMTCT service delivery in reduction of vertical transmission of HIV. Women who defaulted on the PMTCT cascade services had higher odds of having a HIV positive infant compared to women who accessed all the PMTCT services at the recommended time.
Clinical trial and real-world data: A comparative study in patients with diabetic kidney disease
Authors: Kurki Samu , Halla-aho Viivi , Haussmann Manuel , Lähdesmäki Harri , Leinonen Jussi , Koskinen Miika 
Published: June 2023

ABSTRACTObjectiveA growing body of research is focusing on clinical real-world data (RWD) to supplement or replace randomized controlled trials (RCTs). However, due to the disparities in data generation mechanisms between RCTs and RWDs, differences are likely and necessitate scrutiny to validate the merging of these datasets.Materials and MethodsWe compared the temporal and completeness characteristics of pharmaceutical RCT data from 5,734 diabetic kidney disease patients with corresponding RWD from electronic health records (EHRs) of 23,523 patients. Demographics, diagnoses, medications, laboratory measurements, and vital signs were analyzed using visualization, descriptive statistics, statistical testing, and cluster analysis.ResultsRCT and RWD sets exhibited significant differences in prevalence, longitudinality, completeness, and sampling density. The cluster analysis revealed distinct patient subgroups within both RCT and RWD sets, as well as clusters containing patients from both sets.Discussion and ConclusionsThe results highlight the differences between RCT and RWD datasets, and their respective data generation mechanisms. Nonetheless, in certain instances, RWD has the potential to enrich RCT data. These discrepancies should be taken into account during the planning stages of an RCT-RWD study, and we stress the importance of validation to verify the feasibility of combining RCT and RWD. Moreover, advanced methods are needed to mitigate these differences, for instance, when building an external control arm.
Tracking national opinion about wastewater monitoring as a standard complement of public health tools in the United States
Authors: LaJoie A. Scott , Holm Rochelle H. , Anderson Lauren B. , Ness Heather D. , Smith Ted 
Published: June 2023

AbstractNational opinion on a wide variety of public health topics can change over time or have highly contextual nuisances. As the COVID-19 pandemic has progressed, we aimed to see how public perceptions have changed regarding the acceptance of using wastewater for community health monitoring in the metropolitan United States. This study is an annual update of prior inquiry into knowledge of wastewater-based epidemiology, privacy concerns surrounding the collection of wastewater samples and the use of data acquired along with privacy awareness from an online survey administered in the winter of 2023. We found public support for monitoring of toxins (90.8%), disease (90.6%), terror (86.8%), illicit drugs (70.5%), prescription medications (68.6%), and gun residue (59.8%) remained high. Most respondents supported monitoring of the entire city (77.6%). This longitudinal research has shown year-upon-year only slight increases in public support of wastewater monitoring for public health protection and continues to show an absence of significant nationwide privacy concerns as long as catchment population sizes ensure fully anonymous households. This support is conditional and is probably best understood through the lens of the COVID-19 pandemic where the value proposition of public protection was popularized. The survey also consistently showed the public would support expansion of wastewater monitoring as a standard complement of public health tools into other areas of public health protection.
Infrastructure tools to support an effective Radiation Oncology Learning Health System
Authors: Kapoor Rishabh , Sleeman William , Ghosh Preetam , Palta Jatinder 
Published: June 2023

AbstractPurposeRadiation Oncology Learning Health System (RO-LHS) is a promising approach to improve the quality of care by integrating clinical, dosimetry, treatment delivery, research data in real-time. This paper describes a novel set of tools to support the development of a RO-LHS and the current challenges they can address.MethodsWe present a knowledge graph-based approach to map radiotherapy data from clinical databases to an ontology-based data repository using FAIR concepts. This strategy ensures that the data is easily discoverable, accessible, and can be used by other clinical decision support systems. It allows for visualization, presentation, and data analyses of valuable information to identify trends and patterns in patient outcomes. We designed a search engine that utilizes ontology-based keyword searching, synonym-based term matching that leverages the hierarchical nature of ontologies to retrieve patient records based on parent and children classes, connects to the Bioportal database for relevant clinical attributes retrieval. To identify similar patients, a method involving text corpus creation and vector embedding models (Word2Vec, Doc2Vec, GloVe, and FastText) are employed, using cosine similarity and distance metrics.ResultsThe data pipeline and tool were tested with 1660 patient clinical and dosimetry records resulting in 504,180 RDF tuples and visualized data relationships using graph-based representations. Patient similarity analysis using embedding models showed that the Word2Vec model had the highest mean cosine similarity, while the GloVe model exhibited more compact embeddings with lower Euclidean and Manhattan distances.ConclusionsThe framework and tools described support the development of a RO-LHS. By integrating diverse data sources and facilitating data discovery and analysis, they contribute to continuous learning and improvement in patient care. The tools enhance the quality of care by enabling the identification of cohorts, clinical decision support, and the development of clinical studies and machine learning programs in radiation oncology.
Phenome-wide association of acne susceptibility loci highlights shared and unique biology
Authors: Kim Minsoo , Cheng Carol 
Published: June 2023

ABSTRACTThe latest genome-wide association studies (GWAS) comprising 20,165 acne cases and 595,231 controls have successfully identified 42 genomic regions associated with increased risk of acne. Yet, it remains unclear the extent to which these individual acne susceptibility loci contribute to other disorders. To begin to identify shared and unique biology underlying acne pathogenesis, we conducted phenome-wide association (PheWAS) of the 42 acne loci across 110 phenotypes with large-scale, well-powered GWAS results that broadly span autoimmune, endocrine, psychiatric, cardiovascular, dermatologic conditions, and cancer, as well as serum and urine biomarkers. Much of the acne loci did not share GWAS signals with any of 110 phenotypes, suggesting that there may be acne-specific biology in these genomic regions. Conversely, we also identified shared genetic effects at several loci with testosterone, sex hormone binding globulin (SHBG), non-albumin protein levels, liver enzymes (AST, AST/ALT ratio), and blood cell phenotypes (MCV, MCH, eosinophil count), some of which recapitulate known acne pathophysiology. Overall, this work highlights shared and unique genetic effects of individual acne GWAS loci via phenome-wide investigation. All GWAS summary statistics used herein and code to reproduce bioinformatic data analyses are publicly available.