bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Adjustment for Differential Testing by Age and Sex on Apparent Epidemiology of SARS-CoV-2 Infection in Ontario, Canada
Authors: Bosco Savana , Peng Amy , Tuite Ashleigh R. , Simmons Alison , Fisman David N. 
Published: August 2023

AbstractBackgroundSurveillance of communicable diseases typically relies on case counts for estimates of risk, and counts can be strongly influenced by testing rates. In the Canadian province of Ontario, testing rates varied markedly by age, sex, geography and time over the course of the SARS-CoV-2 pandemic. We applied a standardization-based approach to test-adjustment to better understand pandemic dynamics from 2020 to 2022, and to better understand when test-adjustment is necessary for accurate estimation of risk.MethodsSARS-CoV-2 case counts by age, sex, public health unit and week were obtained from Ontario’s Case and Contact Management system (CCM), which includes all SARS-CoV-2 cases from March 2020 to August 2022. Complete data on testing volumes was obtained from the Ontario Laboratory Information System (OLIS). Case counts were adjusted for under-testing using a previously published standardization-based approach that estimates case numbers that would have been expected if the entire population was tested at the same rate as most-tested age and sex groups. Logistic regression was used to identify threshold testing rates beyond which test-adjustment was unnecessary.ResultsTesting rates varied markedly by age, sex, public health unit and pandemic wave. After adjustment for under-testing, overall case counts increased threefold. Adjusted epidemic curves suggested, in contrast to reported case counts, that the first two pandemic waves were equivalent in size, and that there were three distinct pandemic waves in 2022, due to the emergence of Omicron variants. Under-reporting was greatest in children and young males, and varied significantly across public health units, with variation explained partly by testing rates and prevalence of multigenerational households. Test adjustment resulted in little change in the epidemic curve during pandemic waves when testing rates were highest; we found that test-adjustment did not increase case counts once weekly per capita testing rates exceeded 6.3%.ConclusionsStandardization-based adjustment for differential testing by age and sex, and for dynamic changes in testing over time, results in a different picture of infection risk during the SARS-CoV-2 pandemic in Ontario; test-adjusted epidemic curves are concordant with observed patterns of mortality during the pandemic and have face validity. This methodology offers an alternative to sero-epidemiology for identification of true burden of infection when reinfection, sero-reversion, and non-specificity of serological assays make sero-epidemiology challenging.
The effect of High Definition Transcranial Direct Current Stimulation (HD-tDCS) on pain in Somatic Symptom Disorder with predominant pain (SSD-P): a randomized single-blind sham controlled cross-over study
Authors: Kathiravan Sanjana , Ghosh Abhishek , Singh Shubh Mohan 
Published: August 2023

AbstractBackgroundSomatic Symptom Disorder with predominant pain (SSD-P) is a common disorder with unsatisfactory treatment options. Transcranial Direct Current Stimulation(tDCS) is useful in chronic pain conditions.ObjectiveTo assess the effect of two within session repeated High Definition tDCS (HD-tDCS) over left motor cortex on pain and other associated variables in SSD-P.MethodsInstitute Ethics Committee approval was sought and the study was registered in the Clinical Trials Registry of India. Single-blind, sham controlled, cross-over study design was employed. Thirty right handed patients with DSM-5 diagnosis of SSD-P, aged 18-60 years, receiving stable treatment were enrolled by consecutive sampling. After simple randomization, two short interval repeated sessions (2mA, 20 minutes each) of either active or sham HD-tDCS was administered followed by a wash out period of seven days and cross over. Assessments were done at baseline, week one and two. Analysis was done using SPSS 21.ResultsParticipants were comparable on all baseline parameters. ANCOVA showed no order×group interaction. On RM-ANOVA all participants irrespective of entering active or sham arm showed statistically significant difference (Cohen’s d >0.8) in pain and associated parameters like depression, anxiety, pain related interference, burden and disability at week two (p< 0.01). But at week one, this was observed only in active arm. Transient mild local side effects like burning, pain and itching were noted, with no cognitive side effects.ConclusionThis was the first study of HD-tDCS on SSD-P. Single session repeated protocol can be effective in pain reduction with sustained effects up to one week.
A Metabolic Biomarker Panel for Congenital Heart Disease Assessment with Newborn Dried Blood Spots
Authors: Ceresnac Scott R. , Zhang Yaqi , Su Kuo Jung , Tang Qiming , Jin Bo , Schilling James , James Chou C. , Han Zhi , Floyd Brendan J. , Whitin John C. , Sylvester Karl G , Chubb Henry , Luo Ruben Y. , Tian Lu , Cohen Harvey J. , McElhinney Doff B. , Ling Xuefeng B. 
Published: August 2023

AbstractBackgroundCongenital heart disease (CHD) represents a significant contributor to both morbidity and mortality in neonates and children. The prompt recognition of CHD can facilitate timely and appropriate intervention, reducing the probability of complications and enhancing the prognosis for impacted newborns. However, unlike other rare conditions routinely identified through federal and state newborn screening (NBS) programs, there’s currently no analogous dried blood spot (DBS) screening for CHD immediately after birth.ObjectiveThis study was set to identify reliable metabolite biomarkers with clinical relevance, with the aim to assess feasibility of screening and subtype classification of CHD utilizing the DBS newborn screening method.MethodsWe assembled a cohort of DBS datasets from the California Department of Public Health (CDPH) Biobank, encompassing both normal controls and three pre-defined CHD categories (tetralogy of Fallot, inherited arrhythmia syndrome, neonatal cardiomyopathy). A robust, DBS-oriented metabolomic method, employing both global and targeted strategies based on liquid chromatography with tandem mass spectrometry (LC-MS/MS), was developed. To verify the reliability of this metabolic profiling, we conducted a correlation analysis comparing the absolute quantitated metabolite concentration in DBS against the CDPH NBS records. Additionally, for hydrophilic and hydrophobic metabolites, we executed significant pathway and metabolite analyses respectively. Finally, logistic and LightGBM models were established to aid in CHD discrimination and classification.ResultsOur metabolomic workflow demonstrated consistent and reliable quantification of metabolites in DBS samples stored at the California Department of Public Health (CDPH) for up to 15 years. Through this process, we discerned dysregulated metabolic pathways in CHD patients, including deviations in lipid and energy metabolism, as well as oxidative stress pathways. Furthermore, we identified three metabolites as potential biomarkers for CHD assessment, and an additional twelve metabolites as potential markers for classifying different CHD subtypes within DBS samples.ConclusionsThis study represents the first attempt to validate metabolite profiling results using long-term storage DBS samples procured from the high-quality conditions of the CDPH biobank. The results unveil distinct metabolic discrepancies between various CHD subtypes and healthy controls. Furthermore, our findings highlight the potential clinical applications of our DBS-based methods for CHD screening and subtype classification.
Predictors of Population Estimates in a Critically Endangered Species of Black-and-White Colobus Monkeys
Authors: Wikberg Eva C. , Glotfelty Emily , Yeboah Bright Adu , Koranteng Robert , Kodom Charles , Anfwi Bismark Owusu , Boahen Afia 
Published: August 2023

AbstractPopulation monitoring can help us determine population status and trajectory, but it is important to assess what factors may influence the number of individuals counted. In this study we conducted a complete count of the Critically EndangeredColobus vellerosusin the forests attached to the Boabeng and Fiema communities in central Ghana. We used 157 repeated counts of the same groups, including both good and unreliable counts to assess what factors predict the number of counted individuals in each group. The number of counted individuals increased with proxies for observation condition, observer experience, and habituation. We therefore recommend observer training and careful planning to increase the chances of having good observation. Then, we used the good counts to calculate the population size and group compositions. The obtained maximum number was 393 individuals in 25 groups. There were no significant differences in group sizes or immature to adult female ratios between groups occupying the older growth forest and groups in other forest types. Although there was still a relatively high immature to adult female ratio indicating that the population size may still increase, it does not appear to grow as rapidly as it used to, based on comparisons with previous population counts. Based on these findings, we recommend priority areas to promote conservation success.
Examining Differences in the Genetic and Functional Architecture of ADHD Diagnosed in Childhood and Adulthood
Authors: Breunig Sophie , Lawrence Jeremy M. , Foote Isabelle F. , Gebhardt Hannah J. , Willcutt Erik G. , Grotzinger Andrew D. 
Published: August 2023

ABSTRACTBackgroundAttention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is diagnosed when symptoms onset in childhood. Here we investigate whether individuals who are diagnosed as children differ from those who are diagnosed in adulthood with respect to shared and unique architecture at the genome-wide, functional, and gene expression level of analysis.MethodsWe utilize Genomic SEM to investigate the differences in genetic correlations of childhood and adulthood diagnosed ADHD with 98 behavioral, psychiatric, cognitive, and health outcomes. We go on to apply Stratified Genomic SEM and transcriptome-wide SEM (T-SEM) to identify functional annotations and patterns of gene expression associated with genetic risk sharing or divergence across the ADHD subgroups.ResultsRelative to the childhood subgroup, adulthood diagnosed ADHD exhibited a significantly larger negativergwith educational attainment, the noncognitive skills of educational attainment, and age at first sexual intercourse. We also observe a larger positivergfor adulthood diagnosed ADHD with major depression, suicidal ideation, loneliness, and a latent internalizing factor. At the functional and gene expression levels, Stratified Genomic SEM and T-SEM analyses revealed three annotations and 22 genes, respectively, that were significantly associated with genetic risk sharing across the subtypes.ConclusionThis project demonstrates that ADHD diagnosed later in life shows much stronger genetic overlap with internalizing disorders and related traits, indicating the potential clinical relevance of distinguishing these subgroups. Given shared clinical features across internalizing disorders and ADHD (e.g., difficulty concentrating) one interpretation is that the internalizing spectrum is often misdiagnosed as ADHD in adulthood.
Ground level utility of AWaRe Classification: Insights from a Tertiary Care Center In North India
Authors: Negi Gunjita , KB Arjun , Panda Prasan Kumar 
Published: August 2023

AbstractBackgroundThe overuse and misuse of antimicrobials contribute significantly to antimicrobial resistance (AMR), which is a global public health concern. India has particularly high rates of antimicrobial resistance, posing a threat to effective treatment. The WHO AWaRe classification system was introduced to address this issue and guide appropriate antibiotic prescribing. However, there is a lack of studies examining the prescribing patterns of antimicrobials using the AWaRe classification, especially in North India. Therefore, this study aimed to assess the prescribing patterns of antimicrobials using the WHO AWaRe classification in a tertiary care centre in North India.AimTo study the prescribing patterns of antimicrobials using WHO AWaRe classification through a cross-sectional study in AIIMS Rishikesh.MethodsA descriptive, cross-sectional study was conducted from July 2022 to August 2022 at a tertiary care hospital. Prescriptions containing at least one antimicrobial were included in the study. Data on prescriptions, including patient demographics, departments, types of antimicrobials prescribed, and duration of treatment, were collected. A questionnaire-based survey was also conducted to assess the knowledge and practices of prescribing doctors regarding the utility of AWaRe classification.ResultsA total of 123 patients were included in the study, with antibiotic prescriptions being written for all of them. Most prescriptions were for inpatients, evenly distributed between Medicine and Surgical departments. Metronidazole and Ceftriaxone were the most prescribed antibiotics. According to the AWaRe classification, 57.61% of antibiotics fell under the Access category, 38.27% in Watch, and 4.11% in Reserve. The majority of Access antibiotics were prescribed in the Medicine department, while Watch antibiotics were more common in the Medicine department as well. The questionnaire survey showed that only a third of participants were aware of the AWaRe classification, and there was a lack of knowledge regarding antimicrobial resistance and the potential impact of AWaRe usage.ConclusionThis study highlights the need for better antimicrobial prescribing practices and increased awareness of the WHO AWaRe classification and antimicrobial resistance (AMR) among healthcare professionals. The findings indicate a high proportion of prescriptions falling under the Access category, suggesting appropriate antibiotic selection. However, there is a significant difference between the WHO DDD and the prescribed daily dose in the analysed prescriptions suggesting overuse and underuse of antibiotics. There is room for improvement and educational interventions and antimicrobial stewardship programs should be implemented to enhance knowledge and adherence to guidelines, ultimately contributing to the containment of antimicrobial resistance.
TikTok is an effective platform for bicycle safety injury prevention education
Authors: Witte Michelina M. , McEvoy Joey M. , Hotz Gillian A. 
Published: August 2023

AbstractSocial media is an efficient way to spread information, given its widespread daily use by the general population. While it has been shown that public health information can be rapidly disseminated, whether the newer social media platform, TikTok, is effective for this purpose has yet to be explored. The goal of this study is to determine the effectiveness of TikTok to educate about bicycle safety. The TikTok account “iBikeSafe” was created to disseminate injury prevention information related to bicycle safety. Data collected was both qualitative (video classification, comment categorization) and quantitative (likes, views, comments). Performance data was compared between TikTok and another video-sharing social media platform (YouTube). Posts that were didactic (or educational) in nature yielded more views, likes, and comments than posts that were fun or casual in nature. Almost half (46%) of comments made by users on iBikeSafe’s TikTok videos were made to constructively further the discussion and to educate others with accurate injury prevention information. Five of the six videos that were adapted from the iBikeSafe YouTube channel for use on TikTok garnered exponentially more views on TikTok (from 118% to 2057%) than on YouTube, despite having less followers/subscribers (759 TikTok vs. 977 YouTube) and being in existence for less time (11 months vs. 8 years). TikTok is an effective platform for injury prevention education. Didactic posts best provide users with the ability to engage with content and to discuss takeaways, while fun posts keep users active within the platform. Both educational and fun types of videos play an integral role in the effective use of this platform for bicycle safety education. Consideration should be taken into account for the appropriate ratio of didactic vs. fun posts for information dissemination in any public health educational campaign making use of this platform.
Trans-ancestry polygenic models for the prediction of LDL blood levels: An analysis of the UK Biobank and Taiwan Biobank
Authors: Hassanin Emadeldin , Lee Ko-Han , Hsieh Tzung-Chien , Aldisi Rana , Lee Yi-Lun , Bobbili Dheeraj , Krawitz Peter , May Patrick , Chen Chien-Yu , Maj Carlo 
Published: August 2023

AbstractBackgroundPolygenic risk scores (PRSs) are proposed for use in clinical and research settings for risk stratification. PRS predictions often show bias toward the population of available genome-wide association studies, which is typically of European ancestry. This study aims to assess the performance differences of ancestry-specific PRS and test the implementation of multi-ancestry PRS to enhance the generalizability of low-density lipoprotein (LDL) cholesterol predictions in the East Asian populationMethodsWe computed ancestry-specific and multi-ancestry PRS for LDL using data from the global lipid consortium while accounting for population-specific linkage disequilibrium patterns using PRS-CSx method. We first conducted an ancestry-wide analysis using the UK Biobank dataset (n=423,596) and then applied the same models to the Taiwan Biobank dataset (TWB, n=68,978). PRS performances were based on linear regression with adjustment for age, sex, and principal components. PRS strata were considered to assess the extent to which a PRS categorization can stratify individuals for LDL cholesterol levels in East Asian samples.ResultsPopulation-specific PRS better predicted LDL levels within the target population but multi-ancestry PRS were more generalizable. In the TWB dataset, covariate-adjusted R2values were 9.3% for ancestry-specific PRS, 6.7% for multi-ancestry PRS, and 4.5% for European-specific PRS. Similar trends (8.6%, 7.8%, 6.2%) were observed in the smaller East Asian population of the UK Biobank (n=1,480). Consistent with the R2values, PRS stratification in East Asians (TWB) effectively captured a heterogenous variability in LDL blood cholesterol levels across PRS strata. The mean difference in LDL levels between the lowest and highest East Asian-specific PRS (EAS_PRS) deciles was 0.82, compared to 0.59 for European-specific PRS (EUR_PRS) and 0.76 for multi-ancestry PRS. Notably, the mean LDL values in the top decile of multi-ancestry PRS were comparable to those of EAS_PRS (3.543 vs. 3.541,P=0.86).ConclusionsOur analysis of the PRS prediction model for LDL cholesterol further supports the issue of PRS generalizability across populations. Our targeted analysis of the East Asian (EAS) population revealed that integrating non-European genotyping data, accounting for population-specific linkage disequilibrium, and considering meta-analyses of non-European-based GWAS alongside powerful European-based GWAS can enhance the generalizability of LDL PRS.
Health Economics Assessment of Statin Therapy Initiation Thresholds for Atherosclerosis Prevention in China: a Cost-Effectiveness Analysis
Authors: Feng Tianyu , Zhang Xiaolin , Xu Jiaying , Gao Shang , Yu Xihe 
Published: August 2023

AbstractBackgroundThe latest revised Chinese guidelines for the management of dyslipidemia have lowered the 10-year risk threshold for initiating statins for primary prevention of atherosclerotic heart disease. The aim of this study was to examine the negative impact of different statin treatment initiation thresholds on diabetes in a Chinese population and to assess their health economics value.MethodsIn this study, we constructed an event probability-based Microsimulation model to assess the health economics value of statin therapy. The model was based on the Prediction for atherosclerotic cardio-vascular disease (ASCVD) risk in China (China-PAR) and used data from a nationally representative survey and published meta-analysis of the Chinese middle-aged and elderly population as input. We evaluated four different strategies: a 7.5% 10-year risk threshold strategy, a guideline strategy, a 15% 10-year risk threshold strategy, and a 20% 10-year risk threshold strategy. Additionally, we calculated the incremental cost per quality-adjusted life year (QALY) obtained for each strategy to better understand the economics of the various strategies.ResultThe incremental cost per QALY for the 10% 10-year risk threshold strategy, compared to the untreated, was $52,218.75. The incremental cost per QALY for the guideline strategy, compared to the 7.5% 10-year risk threshold strategy, was $464,614.36. These results were robust in most sensitivity analyses.ConclusionThe current 10-year ASCVD risk thresholds used in China’s dyslipidemia management guidelines are cost-effective in preventing ASCVD events and should be maintained with the current statin initiation thresholds. Relaxing the initiation threshold as willingness to pay increases would be more cost-effective.
COVID-19 among migrants, refugees, and internally displaced persons: systematic review, meta-analysis and qualitative synthesis of the global empirical literature
Authors: Hintermeier Maren , Gottlieb Nora , Rohleder Sven , Oppenberg Jan , Baroudi Mazen , Pernitez-Agan Sweetmavourneen , Lopez Janice , Flores Sergio , Mohsenpour Amir , Wickramage Kolitha , Bozorgmehr Kayvan 
Published: August 2023

SUMMARYBackgroundPandemic response and preparedness plans aim at mitigating the spread of infectious diseases and protecting public health, but migrants are often side-lined. Evidence amounted early that migrants are disproportionately affected by the COVID-19 pandemic and its consequences. However, synthesised evidence is lacking that quantifies the inequalities in infection risk and disease outcomes, or contextualises the consequences of pandemic measures and their underlying mechanisms.MethodsSystematic review searching 25 databases and grey literature (12/2019 to 11/2021). We considered empirical articles covering migrants, refugees, asylum-seekers, and internally displaced persons reporting SARS-CoV-2 cases, hospitalisation, ICU admission, mortality, COVID-19 vaccination rates or health consequences of pandemic measures. Random-effects meta-analysis of observational studies and qualitative analysis were performed for evidence synthesis. A Protocol was registered with PROSPERO (CRD42021296952).FindingsOut of 6956 studies, we included 241 in the review. For the quantitative studies (n=46), meta-analysis with over 40 million study participants showed that compared to non-migrants, migrants have an elevated risk of infection (RR = 2·33; 95%-CI: 1·88-2·89) but similar risk for hospitalisation (RR = 1·05; 0·80-1·37), while the likelihood of ICU admission was higher (RR = 1·36; 1·04-1·78). Among those hospitalised, migrants had a lower risk of mortality (RR = 0·47; 0·30-0·73), while their population-based excess mortality tended to be higher (RR = 1·31; 0·95-1·80). The qualitative synthesis (n=44) highlighted the complex interplay of social and COVID-19-related factors at different levels. This involved increased exposure, risk, and impact of pandemic measures that compromised the health of migrants.InterpretationEven in the advanced stages of the pandemic, migrants faced higher infection risks and disproportionately suffered from the consequences of COVID-19 disease, including deaths. Population-level interventions in future health emergencies must better consider socio-economic, structural and community-level exposures to mitigate risks among migrants and enhance health information systems, to close coverage gaps in migrant groups.FundingNone.