bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Selah trial: A preference-based partially randomized waitlist control study of three stress management interventions
Authors: Proeschold-Bell Rae Jean , Eagle David E. , Tice Logan C. , Platt Alyssa , Yao Jia , Larkins Jessie S. , Kim Eunsoo Timothy , Rash Joshua A. 
Published: January 2023

ABSTRACTObjectiveChronic stress can undermine psychological and physiological health. We sought to evaluate three stress management interventions among clergy, accounting for intervention preferences.MethodsUnited Methodist clergy in North Carolina enrolled in a partially randomized, preference-based waitlist control trial. The interventions were: mindfulness-based stress reduction (MBSR), Daily Examen prayer practice, and Stress Proofing (stress inoculation plus breathing skills). The intervention period spanned 12 weeks with a 12-week follow-up. Daily text message data were collected to assess practice across the 24 weeks. Co-primary outcomes were symptoms of stress using the Calgary Symptoms of Stress Inventory and 48-hour ambulatory heart rate variability (HRV) at 12-weeks post-intervention compared to waitlist control. Survey data were collected at 0, 12 and 24 weeks, with HRV collected at 0 and 12 weeks.Results255 participants (mean age=54 years old; 91% white; 48% female) were randomized and initiated an intervention (n=184) or waitlist control (n=71). Compared to waitlist control, lower stress symptoms were found for MBSR participants [Mean Difference (MD)=-0.30, 95% CI:-0.41,-0.20;p<.001] and Stress Proofing (MD=-0.27, 95% CI:-0.40,-0.14;p<.001) at 12 weeks, and Daily Examen participants not until 24 weeks (MD=-0.24, 95% CI:-0.41,-0.08). Only MBSR participants demonstrated improvement in HRV at 12 weeks (MD=+3.32 millisecond; 95% CI:0.21,6.44;p=.036).ConclusionsMBSR demonstrated robust improvement in self-reported and objective physical correlates of stress whereas Stress Proofing and Daily Examen resulted in improvements in self-reported correlates of stress only. These brief practices were sustainable and beneficial for an occupational sample during the COVID pandemic.RegistrationClinicalTrials.govidentifier:NCT04625777(https://clinicaltrials.gov/ct2/show/NCT04625777)
A transcriptomic approach to understand patient susceptibility to pneumonia after abdominal surgery
Authors: Torrance Hew D , Zhang Ping , Longbottom E Rebecca , Mi Yuxin , Whalley Justin P , Allcock Alice , Kwok Andrew J , Cano-Gamez Eddie , Geoghegan Cyndi G , Burnham Katie L , Antcliffe David B , Davenport Emma E , Pearse Rupert M , O’Dwyer Michael J , Hinds Charles J , Knight Julian C , Gordon Anthony C 
Published: January 2023

AbstractRationaleNosocomial infections are a major healthcare challenge, developing in over 20% of patients aged 45 or over undergoing major-abdominal surgery, with postoperative pneumonia associated with an almost five-fold increase in 30-day mortality.ObjectivesTo describe immune-pathways and gene-networks altered following major-abdominal surgery and identify transcriptomic patterns associated with postoperative pneumonia.Methods and MeasurementsFrom a prospective consecutive cohort (n=150) undergoing major-abdominal surgery whole-blood RNA was collected preoperatively and at three time-points postoperatively (2-6, 24 and 48hrs). Twelve patients diagnosed with postoperative pneumonia and 27 matched patients remaining infection-free were identified for analysis with RNA-sequencing.Main ResultsCompared to preoperative sampling, 3,639 genes were upregulated and 5,043 downregulated at 2-6hrs. Pathway-analysis demonstrated innate-immune activation with neutrophil-degranulation and Toll-like-receptor signalling upregulation alongside adaptiveimmune suppression. Cell-type deconvolution of preoperative RNA-sequencing revealed elevated S100A8/9-high neutrophils alongside reduced naïve CD4 T-cells in those later developing pneumonia. Preoperatively, a gene-signature characteristic of neutrophil-degranulation was associated with postoperative pneumonia acquisition (P=0.00092). A previously reported Sepsis Response Signature (SRSq) score, reflecting neutrophil-dysfunction and a more dysregulated host response, at 48hrs postoperatively, differed between patients subsequently developing pneumonia and those remaining infection-free (P=0.045). Analysis of the novel neutrophil gene-signature and SRSq scores in independent major-abdominal surgery and polytrauma cohorts indicated good predictive performance in identifying patients suffering later infection.ConclusionsMajor-abdominal surgery acutely upregulates innate-immune pathways while simultaneously suppressing adaptive-immune pathways. This is more prominent in patients developing postoperative pneumonia. Preoperative transcriptomic signatures characteristic of neutrophil-degranulation and postoperative SRSq scores may be useful predictors of subsequent pneumonia risk.
Whole exome sequencing and replication for breast cancer among Hispanic/Latino women identifiesFANCMas a susceptibility gene for estrogen-receptor-negative breast cancer
Authors: Nierenberg Jovia L. , Adamson Aaron W. , Hu Donglei , Huntsman Scott , Patrick Carmina , Li Min , Steele Linda , Tong Barry , Shieh Yiwey , Fejerman Laura , Gruber Stephen B. , Haiman Christopher A. , John Esther M. , Kushi Lawrence H. , Torres-Mejía Gabriela , Ricker Charité , Weitzel Jeffrey N. , Ziv Elad , Neuhausen Susan L. 
Published: January 2023

ABSTRACTIntroductionBreast cancer (BC) is one of the most common cancers globally. Genetic testing can facilitate screening and risk-reducing recommendations, and inform use of targeted treatments. However, genes included in testing panels are from studies of European-ancestry participants. We sequenced Hispanic/Latina (H/L) women to identify BC susceptibility genes.MethodsWe conducted a pooled BC case-control analysis in H/L women from the San Francisco Bay area, Los Angeles County, and Mexico (4,178 cases and 4,344 controls). Whole exome sequencing was conducted on 1,043 cases and 1,188 controls and a targeted 857-gene panel on the remaining samples. Using ancestry-adjusted SKAT-O analyses, we tested the association of loss of function (LoF) variants with overall, estrogen receptor (ER)-positive, and ER-negative BC risk. We calculated odds ratios (OR) for BC using ancestry-adjusted logistic regression models. We also tested the association of single variants with BC risk.ResultsWe saw a strong association of LoF variants inFANCMwith ER-negative BC (p=4.1×10−7, OR [CI]: 6.7 [2.9-15.6]) and a nominal association with overall BC risk. Among known susceptibility genes,BRCA1(p=2.3×10−10, OR [CI]: 24.9 [6.1-102.5]),BRCA2(p=8.4×10−10, OR [CI]: 7.0 [3.5-14.0]), andPALB2(p=1.8×10−8, OR [CI]: 6.5 [3.2-13.1]) were strongly associated with BC. There were nominally significant associations withCHEK2, RAD51D, andTP53.ConclusionIn H/L women, LoF variants inFANCMwere strongly associated with ER-negative breast cancer risk. It previously was proposed as a possible susceptibility gene for ER-negative BC, but is not routinely tested in clinical practice. Our results demonstrate thatFANCMshould be added to BC gene panels.
Determinants of Under-nutrition among Children Aged 6 up to 59 Months in Akaki Kaliti Sub City, Addis Ababa: Unmatched Case-Control Study
Authors: Kebede Abeje , Getaneh Dagmawit , Asfaw Derbachew , Birhanu Addis 
Published: January 2023

AbstractBackgroundMalnutrition remains a major health problem and globally it is responsible for one-third of all infant and child mortality. Despite progress has been made in improving child nutrition in Ethiopia in the last decades, it remains a problem of public health importance. Though, there were numerous studies undertaken previously, no studies were previously tried to verify the determinants of malnutrition among children age 6 to 59 months in the study area. Hence, there is a necessity to carry out a study to come up with the determinant factors of malnutrition in the Akaki Kaliti sub-city, Addis Ababa.Objective of the StudyTo identify determinants of undernutrition among children age 6 to 59 months in Akaki Kaliti Sub-city, Addis Ababa, 2021.Methods and MaterialsFacility-based unmatched case control study was conducted in public health facilities of Akaki Kaliti Sub-city, Addis Ababa from April 26 to May 31, 2021. Consecutive sampling technique was employed. Primary data was collected using interviewer-administered structured questionnaire and analyzed using SPSS for windows version 21. Variables with P-value <0.25 in the bivariate analysis were identified and fitted in multivariable logistic regression model to identify independent predictors of child undernutrition. The magnitude of association was measured by AOR with 95% confidence interval. A P-value less than 0.05 were used to declare the observed association is statistically significant.ResultA total of 83 children (cases) and 159 children (controls) with their mothers/care givers were participated in the study. Having upper respiratory tract infection in the past two weeks [AOR = 1.89; 95%CI (1.2 – 3.57)], lack of water supply to the household [AOR = 2.93; 95%CI (1.3 – 6.57)], and use of public toilet facility [AOR = 2.35; 95%CI (1.21 – 4.57)] were factors statistically significant with the outcome variables.Conclusion and Recommendationhaving upper respiratory tract infection in the past two weeks, not having water supply to the household, and using public toilet facilities had contributed to the risk of undernutrition. Strengthening screening of all children for undernutrition and improving water and sanitation services to the household are recommended.
Using the Index of Concentration at the Extremes to Evaluate Associations of Income and Black-White Racial Segregation with HIV Outcomes Among Adults Aged ≥18 Years — United States and Puerto Rico, 2019
Authors: Gant Zanetta , Dailey André , Hu Xiaohong , Song Wei , Beer Linda , Johnson Lyons Shacara , Denson Damian J. , Satcher Johnson Anna 
Published: January 2023

AbstractObjective(s)To examine associations between Index of Concentration at the Extremes (ICE) measures for economic and racial segregation and HIV outcomes in the United States (U.S.) and Puerto Rico.MethodsCounty-level HIV testing data from CDC’s National HIV Prevention Program Monitoring and Evaluation and census tract-level HIV diagnoses, linkage to HIV medical care, and viral suppression data from the National HIV Surveillance System were used. Three ICE measures of spatial polarization were obtained from the U.S. Census Bureau’s American Community Survey: ICEincome (income segregation), ICErace (Black-White racial segregation), and ICEincome+race (Black-White racialized economic segregation). Rate ratios (RRs) for HIV diagnoses and prevalence ratios (PRs) for HIV testing, linkage to care within 1 month of diagnosis, and viral suppression within 6 months of diagnosis were estimated with 95% confidence intervals (CIs) to examine changes across ICE quintiles using the most privileged communities (Quintile 5, Q5) as the reference group.ResultsPRs and RRs showed a higher likelihood of testing and adverse HIV outcomes among persons residing in Q1 (least privileged) communities compared with Q5 (most privileged) across ICE measures. For HIV testing percentages and diagnosis rates, PRs and RRs were consistently greatest for ICErace. For linkage to care and viral suppression, PRs were consistently lower for ICEincome+race.ConclusionsIncome, racial, and economic segregation—as measured by ICE—might contribute to poor HIV outcomes and disparities by unfairly concentrating certain groups (i.e., Black persons) in highly segregated and deprived communities that experience a lack of access to quality, affordable health care. Expanded efforts are needed to address the social/economic barriers that might impede access to HIV care among Black persons. Increased partnerships between government agencies and the private sector are needed to change policies that promote and sustain racial and income segregation.
Difficulty with Mobility among the Aged in Ghana: Evidence from Wave 2 of the World Health Organization’s study on Global Ageing and Adult Health
Authors: Boakye Kingsley , Aidoo Antoinette Ama , Aliyu Mohammed , Boateng Daniel , Nakua Emmanuel Kweku 
Published: January 2023

ABSTRACTBackgroundThe recent decline in mortality, increase in life expectancy and technological and scientific advancements have led to an increasingly ageing population. About 727 million people globally were aged 65 or more in 2020, and 1 in 6 people will be age 65 years or above by 2050. About 7% of Ghana’s population was over 60 years in 2010, and projected to be 12% by 2050. However, the aged are confronted with degenerative conditions that translate into difficulty with mobility. The study was conducted to investigate the difficulty with mobility among the aged in Ghana.MethodsThe study utilised a cross-sectional dataset of the 2014/2015 (wave 2) Study on Global Ageing and Adult Health and included 1,848 participants aged ≥50 years. The survey command was applied to adjust for sampling biases and the design of the study. At 5% alpha level, a chi-square test of independence was conducted to determine the association between dependent and independent variables. At 95% confidence interval and 5% alpha level, three-level multilevel logistic regression models were performed. The fixed-effects were presented in odds ratio and the random effects were presented using the Intra-Class Correlation. All analysis were performed using STATA statistical software version 16.0.ResultsOut of the 1,848 participants, 62.3% had difficulty with mobility. Additionally, age (80 and above) [AOR=4.70, 95%CI=2.34 – 9.43], difficulty performing household activities [AOR=6.96, 95%CI=5.03 – 9.64], experiencing bodily pains [AOR=3.21, 95%CI=1.81 – 5.60] and bodily discomfort [AOR=3.39, 95%CI=1.91 – 5.99] and difficulty with vision [AOR=1.70, 95%CI=1.18 – 2.43] had higher odds of difficulty with mobility. However, engaging in vigorous activities [AOR=0.44, 95%CI=0.32 – 0.63] and having good health [AOR=0.41, 95%CI=0.19 – 0.88] were protective of difficulty with mobility.ConclusionThe study concludes that the aged in Ghana had higher prevalence (62.3%) of difficulty with mobility which is associated with age (80 and above), difficulty performing household activities, bodily pains and discomfort, and difficulty with vision. This suggests the need to provide support and assistive devices for the aged and provide geriatric care including recreational fields and care homes to address the health and physical needs of the aged in Ghana.
Ultrasound and biochemical predictors of pregnancy outcome at diagnosis of early-onset fetal growth restriction
Authors: Spencer Rebecca , Maksym Kasia , Hecher Kurt , Maršál Karel , Figueras Francesc , Ambler Gareth , Whitwell Harry , Nené Nuno Rocha , Sebire Neil J. , Hansson Stefan R. , Diemert Anke , Brodszki Jana , Gratacós Eduard , Ginsberg Yuval , Weissbach Tal , Peebles Donald M , Zachary Ian , Marlow Neil , Huertas-Ceballos Angela , David Anna L. 
Published: January 2023

AbstractBackgroundSevere early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, preventing accurate patient counselling. We investigated the use of maternal serum protein and ultrasound measures at diagnosis to predict fetal or neonatal death and three secondary outcomes: fetal death or delivery ≤28+0 weeks; development of abnormal umbilical artery Doppler velocimetry; slow fetal growth.MethodsWomen with singleton pregnancies (n=142, estimated fetal weights [EFWs] <3rdcentile, <600g 20+0-26+6 weeks of gestation, no known chromosomal, genetic or major structural abnormalities), were recruited from four European centres. Maternal serum from the discovery set (n=63) was analysed for seven proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease and five proteins identified through pooled liquid chromatography tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n=60), with final models calculated from combined data.ResultsThe most discriminative model for fetal or neonatal death included EFW z-score (Hadlock 3 formula/Marsal chart), gestational age and umbilical artery Doppler category (AUC 0.91, 95%CI 0.86-0.97) but was less well calibrated than the model containing only EFW z-score (Hadlock3/Marsal). The most discriminative model for fetal death or delivery ≤28+0 weeks included maternal serum placental growth factor (PlGF) concentration and umbilical artery Doppler category (AUC 0.89, 95%CI 0.83-0.94).ConclusionUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe early-onset FGR predict pregnancy outcomes of importance to patients and clinicians.Trial registrationClinicalTrials.govNCT02097667FundingEuropean Union, Rosetrees Trust, Mitchell Charitable Trust.
Antidepressant and antipsychotic drug prescribing and complications of diabetes: a systematic review of observational studies
Authors: Greene Charlotte R L , Ward-Penny Hanna , Ioannou Marianna F , Wild Sarah H , Wu Honghan , Smith Daniel J , Jackson Caroline A 
Published: January 2023

AbstractAimsPsychotropic medication may be associated with adverse effects, particularly in people with diabetes. We conducted a systematic review of observational studies investigating the association between antidepressant or antipsychotic drug prescribing and diabetes outcomes.MethodsWe systematically searched PubMed, EMBASE, and PsycINFO to 15thAugust 2022 to identify eligible studies. We used the Newcastle-Ottawa scale to assess study quality and performed a narrative synthesis.ResultsWe included 18 studies, 14 reporting on antidepressants and four on antipsychotics. There were 11 cohort studies, one self-controlled before and after study, two case-control studies, and four cross-sectional studies, of variable quality and highly heterogeneous in terms of study population, exposure definition and outcome analysed. Antidepressant prescribing may be associated with increased risk of macrovascular outcomes, whilst evidence on antidepressant and antipsychotic prescribing and glycaemic control was mixed. Few studies reported on microvascular complications and cardiometabolic factors other than glycaemic control and just one study reported on antipsychotics and diabetes complications.ConclusionsThere has been little study of antidepressant and antipsychotic drug prescribing in relation to diabetes outcomes. Further, more methodologically robust, research is needed to inform and enhance antidepressant and antipsychotic drug prescribing and monitoring practices in people with diabetes.
Can medication mentions in CRIS be used for researching medication use in older people with dementia? Comparing the natural language processing app for medicines to GP prescribing
Authors: Davis Katrina A.S. , Broadbent Matthew , Bishara Delia , Mueller Christoph , Stewart Robert 
Published: January 2023

AbstractBackgroundThe efficacy of long-term preventative medication in people who have dementia and other comorbidities is unknown. Electronic health record-based observational studies may play a role in evaluating medicines, and SLaM-CRIS is one such resource. Medication in SLaM-CRIS is extracted from structured and unstructured fields using a natural language processing app. We aimed to compare the results from the medication app with GP prescribing, using an innovative data link with primary care (Lambeth DataNet, LDN) that covers around one-quarter of the SLaM-CRIS population.MethodsA cohort was created of people with both LDN record and SLaM-CRIS record who had received a diagnosis of dementia in either record, in which ascertainment of medication could be compared. Ten classes of medication commonly taken long-term for preventative purposes were studied (aspirin, statins, ACE inhibitors, anticoagulants, beta-blockers, bisphosphonates, calcium with vitamin D, non-aspirin antiplatelets, proton pump inhibitors and antidepressants), plus medications taken for dementia itself. Mentions of these medication classes in SLaM-CRIS from around the time of dementia diagnosis were extracted using a natural language processing application. Prescription issue for the same medications was extracted from LDN in the year of dementia diagnosis and compared with that from SLaM-CRIS on a cohort and individual level.ResultsOur sample included 4410 with documentation of dementia in either SLaM-CRIS or LDN. Estimation of the prevalence of the use of each medication in CRIS was compared to LDN, and was within +/-3 per 100, except for calcium with vitamin D supplement, where SLaM-CRIS prevalence was 13 people per 100 lower than LDN (8.6% vs 21.2%). Medication ascertainment of all groups except calcium with vitamin D supplement showed good agreement (kappa above 0.7), and very good agreement for antidepressants and dementia drugs (kappa above 0.8). Sensitivity was highest for dementia drugs and antidepressants (above 90%), 85% for statins and 75% for aspirin. Restricting to those with a memory clinic referral did not change the levels of agreement.DiscussionRoutinely collected data cannot provide a gold-standard measure of what medications are truly taken by patients with dementia, but several sources can provide a proxy measure. This analysis supports the use of the natural language processing application for medication in SLaM-CRIS to extract medication mentions of relevance to people with dementia, as compared to prescribing from the GP at around the same time. However, some medications show low sensitivity, possibly due to low recording or inconsistency in the text used to record, and enhancement will be needed before studying these medications.
Examining the impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study
Authors: Fuzzell Lindsay , Lake Paige , Brownstein Naomi C. , Fontenot Holly B. , Whitmer Ashley , Michel Alexandra , McIntyre McKenzie , Rossi Sarah L. , Kajtezovich Sidika , Vadaparampil Susan T. , Perkins Rebecca 
Published: January 2023

AbstractBackgroundThe COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed method study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers.MethodsBetween October 2021 and June 2022, a national sample of 148 clinicians completed surveys; a subset (n=13) clinicians completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021-July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients.ResultsCompared to clinicians in OBGYN/Women’s health, those in family medicine and other specialties were less likely to report maintaining or increasing screening compared to pre-pandemic. Advanced practice providers (compared to MDs/DOs,) and Hispanic/Latinx/other clinicians (compared to white non-Hispanic) were more likely to report maintaining or increasing screening vs. pre-pandemic. Most (91%) felt that screening using HPV self-sampling would be helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement.ConclusionsIdentifying barriers to screening and instituting solutions in federally qualified health centers is critical to preventing cervical cancers among patients at highest risk.FundingThis study was funded by the American Cancer Society, who had no role in the study’s design, conduct, or reporting.