bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surveys on androgen abuse: a review of recent research
Authors: Ganson Kyle T. , Nagata Jason M. 
Published: August 2023

Purpose of review
To summarize recent survey research on androgen abuse [i.e., anabolic-androgenic steroids (AAS)], including prevalence among international samples, risk factors for use, associated impairments of use, and treatment and interventions for abusers.

Recent findings
Recent research has documented the prevalence of androgens abuse remains most common among boys and men compared to girls and women, which was stable across nations. However, fewer studies have focused on population-based samples and instead focused on convenience or high-risk samples (i.e., gym goers). Androgen abusers commonly report a history of violent victimization, including adverse childhood experiences. Research continues to document many adverse biological, psychological, and social effects related to androgen abuse, including more than 50% of abusers reporting at least one side effect. Mental health problems and polysubstance use continues to be highly prevalent among androgen abusers. Despite these adverse effects from use, there remains little survey research on treatment and interventions for androgen abusers, representing an important area of future investigation.

Summary
Androgen abuse remains relatively common, particularly among boys and men, with adverse health effects regularly occurring. Healthcare professionals and systems can adapt their treatment approaches to focus on reducing harms associated with androgen abuse.
Mental health and health behaviors of parents of survivors of childhood cancer in the early COVID-19 pandemic: Exploring the role of intolerance of uncertainty
Authors: Hou Sharon H. J. , Forbes Caitlin , Cho Sara , Tran Andrew , Forster Victoria J. , Wakefield Claire E. , Heathcote Lauren C. , Wiener Lori , Michel Gisela , Patterson Pandora , Stokoe Mehak , Reynolds Kathleen , Schulte Fiona M. S. 
Published: August 2023

Abstract

Introduction:
Parents of survivors of childhood cancer may be particularly vulnerable to the experience of poor mental health amid the COVID-19 pandemic. This study aimed to (1) describe the mental health of parents of childhood cancer survivors; (2) explore the role of intolerance of uncertainty (IU) in mental health; and (3) explore the associations of parent mental health and health behaviors with IU.

Methods:
A cross-sectional, quantitative assessment of parents of survivors of childhood cancer (younger than 18 years) was conducted between May and June 2020. Participants completed an online questionnaire regarding their mental health (PROMIS anxiety, depression), IU (Intolerance of Uncertainty Scale), and health behaviors. Recruitment was conducted through social media and community organizations using convenience and snowball sampling.

Results:
Seventy-two participants from 6 countries completed the study (99% mothers, mean age of survivors = 11.4 years). Fifty percent of participants reported that their mental health had declined since the start of the COVID-19 pandemic, whereas 46% reported their mental health did not change. More than half of the participants (56%) reported decreased physical activity and 38% reported increased alcohol use. Exploring associations of parent mental health and health behaviors with IU, parent depression, and hours of exercise emerged as significant predictors (B = 3.62, P < .01; B = –1.58, P < .01, respectively), whereby higher depression and less exercise was associated with higher IU.

Conclusions:
At the height of the COVID-19 global pandemic, some parents of survivors of childhood cancer experienced poor mental health. IU plays a significant role in mental health outcomes, but this does not translate to health behaviors.
Principal component analysis of a swine injury model identifies multiple phenotypes in trauma
Authors: Buzzard Lydia , Smith Sawyer , Dixon Alexandra , Kenny James , Appleman Ma , Subramanian Sarayu , Behrens Brandon , Rick Elizabeth , Madtson Brianne , Goodman Andrew , Murphy James , McCully Belinda , Kanlerd Amonpon , Trivedi Alpa , Pati Shibani , Schreiber Martin 
Published: August 2023

BACKGROUND
Trauma is the third leading cause of death in the United States and the primary cause of death for people between the ages of 1 year and 44 years. In addition to tissue damage, trauma may also activate an inflammatory state known as trauma-induced coagulopathy (TIC) that is associated with clotting malfunctions, acidemia, and end-organ dysfunction. Prior work has also demonstrated benefit to acknowledging the type and severity of endothelial injury, coagulation derangements, and systemic inflammation in the management of trauma patients. This study builds upon prior work by combining laboratory, metabolic, and clinical metrics into an analysis of trauma phenotypes, evolution of phenotypes over time after trauma, and significance of trauma phenotype on mortality.

METHODS
Seventy 3-month-old female Yorkshire crossbred swine were randomized to injury and resuscitation groups. Principal component analysis (PCA) of longitudinal swine TEG data (Reaction time, Alpha-Angle, Maximum Amplitude, and Clot Lysis at 30 minutes), pH, lactate, and MAP was completed in R at baseline, 1 hour postinjury, 3 hours postinjury, 6 hours postinjury, and 12 hours postinjury. Subjects were compared by principal component factor scores to assess differences in survival, injury severity, and treatment group.

RESULTS
Among injured animals, three phenotypes were observed at each time point. Five phenotypes were associated with differences in survival, and of these, four were associated with differences in injury severity. Phenotype alignment was not significantly different by treatment group.

CONCLUSION
This application of PCA to a set of coagulation, hemodynamic, and organ perfusion variables has identified multiple evolving phenotypes after trauma. Some of these phenotypes may correlate with injury severity and may have implications for survival. Next steps include validating these findings over greater numbers of subjects and exploring other machine-learning techniques for phenotype identification.

LEVEL OF EVIDENCE
Level IV, Therapeutic/Care Management
A PSEUDO-DILEMMA: ARE WE OVER-DIAGNOSING AND OVER-TREATING TRAUMATIC SPLENIC INTRAPARENCHYMAL PSEUDOANEURYSMS?
Authors: Radding Sydney , Harfouche Melike N. , Dhillon Navpreet K. , Ko Ara , Hawley Kristy L. , Kundi Rishi , Maddox John S. , Radowsky Jason S. , DuBose Joseph J. , Feliciano David V. , Kozar Rosemary A. , Scalea Thomas M. 
Published: August 2023

Abstract

Introduction
Splenic embolization for traumatic vascular abnormalities in stable patients is a common practice. We hypothesize that modern contrast-enhanced CT over diagnoses post-traumatic splenic vascular lesions such as intraparenchymal pseudoaneurysms (PSA) that may not require embolization.

Methods
We reviewed the experience at our high-volume center with endovascular management of blunt splenic injuries from Jan 2016-Dec 2021. Multidisciplinary review was used to compared initial CT findings to subsequent angiography, analyzing management and outcomes of identified vascular lesions.

Results
Of 853 splenic injuries managed overall during the study period, 255 (29.9%) underwent angiography of the spleen at any point during hospitalization. Vascular lesions were identified on 58% of initial CTs; extravasation (12.2%) and PSA (51.0%). Angiography was performed a mean of 22 hours after admission, with 38% done within 6 hours. Embolization was performed for 90.5% (231) of patients. Among the 130 patients with PSA on initial CT, 36 (27.7%) had no visible lesion on subsequent angiogram. From the 125 individuals who did not have a PSA identified on their initial CT, 67 (54%) had a PSA seen on subsequent angiography. On post-embolization CT at 48-72 hours, persistently perfused splenic PSAs were seen in 41.0% (48/117) of those with and 22.2% (2/9) without embolization. Only one of 24 (4.1%) patients with PSA on angiography observed without embolization required delayed splenectomy, whereas 6.9% (16/231) in the embolized group had splenectomy at a mean of 5.5 + 4 days after admission.

Conclusion
There is a high rate of discordance between CT and angiographic identification of splenic PSAs. Even when identified at angiogram and embolized, close to half will remain perfused on follow-up imaging. These findings question the use of routine angioembolization for all splenic PSAs.

Level of Evidence
IV

Study Type
Therapeutic/care management
SARS-CoV-2 variants Omicron BA.4/5 and XBB.1.5 significantly escape T cell recognition in solid organ transplant recipients vaccinated against the ancestral strain
Authors: Halvorson Torin , Ivison Sabine , Huang Qing , Ladua Gale , Yotis Demitra M. , Mannar Dhiraj , Subramaniam Sriram , Ferreira Victor H. , Kumar Deepali , Belga Sara , Levings Megan K. 
Published: August 2023

AbstractBackgroundImmune-suppressed solid organ transplant recipients (SOTRs) display impaired humoral responses to COVID-19 vaccination, but T cell responses are incompletely understood. The highly infectious SARS-CoV-2 variants Omicron BA.4/5 and XBB.1.5 escape neutralization by antibodies induced by vaccination or infection with earlier strains, but T cell recognition of these lineages in SOTRs is unclear.MethodsWe characterized Spike-specific T cell responses to ancestral SARS-CoV-2, Omicron BA.4/5 and XBB.1.5 peptides in a prospective study of kidney, lung and liver transplant recipients (n = 42) throughout a three- or four-dose ancestral Spike mRNA vaccination schedule. Using an optimized activation-induced marker assay, we quantified circulating Spike-specific CD4+ and CD8+ T cells based on antigen-stimulated expression of CD134, CD69, CD25, CD137 and/or CD107a.ResultsVaccination strongly induced SARS-CoV-2-specific T cells, including BA.4/5- and XBB.1.5-reactive T cells, which remained detectable over time and further increased following a fourth dose. However, responses to Omicron BA.4/5 and XBB.1.5 were significantly lower in magnitude compared to ancestral strain responses. Antigen-specific CD4+ T cell frequencies correlated with anti-receptor-binding domain (RBD) antibody titres, with post-second dose T cell responses predicting subsequent antibody responses. Patients receiving prednisone, lung transplant recipients and older adults displayed weaker responses.ConclusionsAncestral strain vaccination stimulates BA.4/5 and XBB.1.5-cross-reactive T cells in SOTRs, but responses to these variants are diminished. Antigen-specific T cells can predict future antibody responses and identify vaccine responses in seronegative individuals. Our data support monitoring both humoral and cellular immunity in SOTRs to track effectiveness of COVID-19 vaccines against emerging variants.
Coronary Artery anomalies in PatienTs Undergoing transcatheter aortic valve REplacement. The CAPTURE registry
Authors: Oliva Omar A. , Scalia Lorenzo , Sisinni Antonio , Poletti Enrico , Zannoni Jessica , Mazzucca Mattia , Criscione Enrico , Popolo Rubbio Antonio , Gorla Riccardo , Agnifili Mauro , Bedogni Francesco , Testa Luca 
Published: August 2023

AbstractBackgroundThe incidence and possible implications of coronary artery anomalies (CAA) in patients undergoing transcatheter aortic valve replacement (TAVR) are uncertain.AimsTo evaluate the impact of CAA on TAVR outcomes, and to suggest possible strategies to prevent CAA related complications.MethodsAmong 2,164 consecutive patients who underwent TAVR in our center, 15 (0.69%) were identified to have a CAA, based on pre-operative Computed Tomography (CT) scans.ResultsCT-angiography revealed the following features of CAA: the majority of anomalous CAA concerned the right coronary artery (80%), followed by the left main (13.3%) and the left circumflex (6.7%). An intramural course was observed only in 26.7% patients, whereas an acute take-off was detected in more than half of the study cohort (53.3%). High-risk sudden cardiac death features were observed in 6 (40%) patients.Technical success was 86.7%, device success was 80%. One patient experienced a cardiac arrest 15 minutes after procedure, resulting from occlusion of the anomalous right coronary artery with the ostium located at the right-to-non coronary commissure. There were no cases of ≥ moderate paravalvular leak or stroke. One non-cardiac related death was recorded 4 months after the procedure.ConclusionsThe interaction between transcatheter bioprosthesis and different CAA types could lead to ominous sequelae, if not promptly recognized and treated accordingly.
Achatina fulicaHaemocyanin-Derived Peptides as Novel Antimicrobial Agents
Authors: Pereira Andrés , Suarez Libardo , Roman Tanya , Guzmán Fanny , Rincón-Orozco Bladimiro , Sierra Leidy , Hidalgo William 
Published: August 2023

AbstractAnteriorly we found Haemocyanin-derived peptides in semi-purified fractions of mucus secretion ofAchatina fulicathat showed an inhibitory effect onS. aureusstrains. Here, we appliedin silicorational design strategy to obtain new potential Antimicrobial Peptides (AMPs) fromA. fulicahaemocyanin-derived peptides (AfH). Designed peptides were chemically synthetized using the Fmoc strategy and antimicrobial activity againstE. coliandS. aureusstrains was investigated using the broth microdilution method. Cytotoxic activity on Vero, HaCat, and human erythrocytes cells was also evaluated. The results showed that 15-residue synthetic peptides, alpha-helical and cationic, were those with the highest biological activity against Gram positive strains, with Minimum Inhibitory Concentrations (MIC) in the range of 20 to 30 µM. The positive selectivity index suggests a higher selectivity mainly on the microorganisms evaluated and not on eukaryotic cells. In this study,A. fulicahemocyanin turned out to be an appropriate protein model for the rational design of AMPs against bacteria of public health importance. Additional studies are required to evaluate the activity of the peptides on Gram negative bacteria.
ReMiND: Recovery of Missing Neuroimaging using Diffusion Models with Application to Alzheimer’s Disease
Authors: Yuan Chenxi , Duan Jinhao , Tustison Nicholas J. , Xu Kaidi , Hubbard Rebecca A. , Linn Kristin A. 
Published: August 2023

AbstractObjectiveMissing data is a significant challenge in medical research. In longitudinal studies of Alzheimer’s disease (AD) where structural magnetic resonance imaging (MRI) is collected from individuals at multiple time points, participants may miss a study visit or drop out. Additionally, technical issues such as participant motion in the scanner may result in unusable imaging data at designated visits. Such missing data may hinder the development of high-quality imaging-based biomarkers. Furthermore, when imaging data are unavailable in clinical practice, patients may not benefit from effective application of biomarkers for disease diagnosis and monitoring.MethodsTo address the problem of missing MRI data in studies of AD, we introduced a novel 3D diffusion model specifically designed for imputing missing structural MRI (Recovery ofMissingNeuroimaging usingDiffusion models (ReMiND)). The model generates a whole-brain image conditional on a single structural MRI observed at a past visit or conditional on one past and one future observed structural MRI relative to the missing observation.ResultsExperimental results show that our method can generate highquality individual 3D structural MRI with high similarity to ground truth, observed images. Additionally, images generated using ReMiND exhibit relatively lower error rates and more accurately estimated rates of atrophy over time in important anatomical brain regions compared with two alternative imputation approaches: forward filling and image generation using variational autoencoders.ConclusionOur 3D diffusion model can impute missing structural MRI data at a single designated visit and outperforms alternative methods for imputing whole-brain images that are missing from longitudinal trajectories.
A school-based randomized clinical trial of silver diamine fluoride for dental caries incidence
Authors: Ruff Ryan Richard , Godín Tamarinda Barry , Niederman Richard 
Published: August 2023

AbstractImportanceDental caries is the world’s most prevalent noncommunicable disease and a source of severe health inequity. To prevent and reduce this burden, the Centers for Disease Control and Prevention recommends school dental sealant programs.ObjectiveTo determine whether silver diamine fluoride (SDF) is non-inferior to dental sealants and atraumatic restorative treatment (ART) for dental caries when used in a school-based program.DesignThe CariedAway study was a cluster-randomized, single-blind, pragmatic non-inferiority trial conducted from 2018-2023. Four years of follow-up were included.SettingPrimary schools in New York City with at least 55% of the student population reporting as Black or Hispanic/Latino and at least 80% receiving free or reduced lunch.ParticipantsAny child between the ages of 5 and 13 was eligible. There were 17741 eligible children across 48 schools.InterventionsParticipants were cluster-randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish.Main OutcomesPrimary study outcomes were the prevalence and incidence of dental caries. Our a priori hypothesis was that SDF was non-inferior to sealants and ART in reducing caries prevalence.ResultsA total of 7418 children were enrolled and treated, of which 4100 completed at least one follow-up observation (55%). The overall baseline prevalence of dental caries was approximately 27% (95% CI = 25.7, 28.6). Following treatment, the odds of decay prevalence decreased longitudinally (OR = 0.79, 95% CI = 0.75, 0.83) and SDF was non-inferior compared to sealants and ART (OR = 0.94, 95% CI = 0.80, 1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1,000 tooth-years, versus 9.8 per 1,000 tooth-years in children treated with sealants and ART, for a rate ratio of 1.046 (95% CI = 0.97, 1.12).Conclusions and RelevanceIn a pragmatic trial, application of silver diamine fluoride resulted in nearly identical caries incidence compared to dental sealants and ART and was non-inferior in the longitudinal prevalence of caries. SDF is an effective alternative for use in school caries prevention, increasing access and reducing costs for oral healthcare.Trial RegistrationClinicalTrials.gov, #NCT03442309
Hemodynamics with Mechanical Circulatory Support Devices Using a Cardiogenic Shock Model
Authors: Yahagi Kazuyuki , Nishimura Gohki , Kuramoto Kei , Tsuboko Yusuke , Iwasaki Kiyotaka 
Published: August 2023

AbstractBackgroundMechanical circulatory support (MCS) devices, including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella, have been widely used for patients with cardiogenic shock (CS). However, hemodynamics with each device and combination therapy is not thoroughly understood. We aimed to elucidate the hemodynamics with MCS using a CS pulsatile flow model.Methods and ResultsA pulsatile flow circulation system comprising a ventricle, aortic valve, mitral valve, elastic artery, and venous reservoir was developed. Hemodynamics with Impella CP, VA-ECMO, and a combination of Impella CP and VA-ECMO were assessed based on the pressure and flow under support with each device and the pressure-volume loop of the ventricle model. The self-recirculation with Impella was assessed using particle image velocimetry. The Impella CP device with CS status resulted in increased afterload, leading to an increase in aortic pressure and a decrease in end-diastolic volume and end-diastolic pressure (EDP). VA-ECMO support resulted in increased afterload, leading to a significant increase in aortic pressure with an increase in end-systolic volume and EDP and decreasing venous reservoir pressure. The combination of Impella CP and VA-ECMO led to left ventricular unloading, regardless of increase in afterload. Self-recirculation with Impella CP was observed in a patient with significant aortic insufficiency, leading to reduced hemodynamic support.ConclusionsThe Impella system improved hemodynamics with ventricular unloading. Hemodynamic support with Impella and VA-ECMO should be a promising combination for patients with severe CS. Physicians should be alert to the presence of significant aortic insufficiency, leading to self-recirculation with Impella.Clinical PerspectiveWhat is new?This is a non-clinical study using a novel experimental pulsatile flow system with venous function that can be used to assess MCS, including Impella and VA-ECMO.The self-recirculation phenomenon of the Impella device was assessed by a flow visualization method using particle imaging velocimetry.What are the clinical implications?The combination of Impella and VA-ECMO led to left ventricular unloading, regardless of the increase in afterload.VA-ECMO could increase arterial pressure owing to increased LV afterload and alter the direction of the aortic flow (antegrade or retrograde) depending on the flow level with VA-ECMO.Effective Impella flow was reduced during ventricular diastole when aortic insufficiency was present owing to self-recirculation with the Impella device.
Clinical and laboratory features of COVID-19 illness and outcomes in immunocompromised individuals during the first pandemic wave in Sydney, Australia
Authors: Dharan Nila J. , Sasson Sarah C. , Ahlenstiel Golo , Andersen Christopher R. , Bloch Mark , Buckland Griselda , Hamad Nada , Han Win Min , Kelleher Anthony D. , Long Georgina V. , Matthews Gail V. , Mina Michael M. , Papot Emmanuelle , Petoumenos Kathy , Swaminathan Sanjay , Withers Barbara , Yun James , Polizzotto Mark N. 
Published: August 2023

AbstractPeople with immunocompromising conditions are at increased risk of SARS-CoV-2 infection and mortality, however early in the pandemic it was challenging to collate data on this heterogenous population. We conducted a registry study of immunocompromised individuals with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection from March – October 2020 in Sydney, Australia to understand clinical and laboratory outcomes in this population prior to the emergence of the Delta variant. 27 participants were enrolled into the study including people with a haematologic oncologic conditions (n=12), secondary immunosuppression (N=8) and those with primary or acquired immunodeficiency (i.e. HIV; N=7). All participants had symptomatic COVID-19 with the most common features being cough (64%), fever (52%) and headache (40%). Five patients demonstrated delayed SARS-CoV-2 clearance lasting three weeks to three months. The mortality rate in this study was 7% compared to 1.3% in the state of New South Wales Australia during the same period. This study provides data from the first eight months of the pandemic on COVID-19 outcomes in at-risk patient groups.