bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of opioid overdoses on US life expectancy and years of life lost, by demographic group and stimulant co-involvement: a mortality data analysis from 2019-2022
Authors: Hébert Anne H. , Hill Alison L. 
Published: July 2023

AbstractBackgroundThe United States’ opioid crisis is worsening, and the number of deaths reached 81,806 in 2022 after more than tripling over the past decade. This study aimed to comprehensively characterize changes in burden of opioid overdose mortality in terms of life expectancy reduction and years of life lost between 2019-2022, including differential burden across demographic groups and the contribution of polysubstance use.MethodsUsing life tables and counts for all-cause and opioid overdose deaths from the National Center for Health Statistics, we constructed cause-eliminated life tables to estimate mortality by age in the absence of opioid-related deaths. We calculated the loss in life expectancy at birth (LLE) and total years of life lost (YLL) due to opioid overdose deaths by state of residency, sex, racial/ethnic group, and co-involvement of cocaine and psychostimulants.FindingsOpioid-related deaths in the US led to an estimated 3·1 million years of life lost in 2022 (38 years per death), compared to 2·0 million years lost in 2019. Relative to a scenario with no opioid mortality, we estimate that opioid-related deaths reduced life expectancy nationally by 0·67 years in 2022 vs 0·52 years in 2019. This LLE worsened in all racial/ethnic groups during the study period: 0·76y to 0·96y for white men, 0·36y to 0·55y for white women, 0·59y to 1·1y for Black men, 0·27y to 0·53y for Black women, 0·31y to 0·82y for Hispanic men, 0·19y to 0·31y for Hispanic women, 0·62y to 1·5y for American Indian/Alaska Native (AI/AN) men, 0·43y to 1y for AI/AN women, 0·09y to 0·2y for Asian men, and 0.08y to 0.13y for Asian women. Nearly all states experienced an increase in years of life lost (YLL) per capita from 2019-2022, with YLL more than doubling in 16 states. Cocaine or psychostimulants with abuse potential (incl. methamphetamines) were involved in half of all deaths and years of life lost in 2022, with substantial variation in the predominant drug class by state and racial/ethnic group.InterpretationThe burden of opioid-related mortality increased dramatically in the US between 2019-2022, coinciding with the period of the COVID-19 pandemic and the associated disruptions to social, economic, and health systems. Opioid overdose deaths are an important contributor to decreasing US life expectancy, and Black, Hispanic, and Native Americans now experience mortality burdens approaching or exceeding white Americans.FundingNone
Low-cost, local production of a safe and effective disinfectant for resource-constrained communities
Authors: Naranjo-Soledad Andrea , Smesrud Logan , Bandaru Siva RS , Hernandez Dana , Mehare Meire , Mahmoud Sara , Matange Vijay , Rao Bakul , Chandana N , Balcom Paige , Omole David Olugbenga , Alvarez-Mejia Cesar , Lopez-Ramirez Varinia , Gadgil Ashok 
Published: July 2023

AbstractImproved sanitation and hygiene depend on the accessibility and availability of effective disinfectant solutions. These disinfectant solutions are unavailable to many communities worldwide due to resource limitations, among other constraints. Safe and effective chlorine- based disinfectants can be produced via simple electrolysis of salt water, providing a low-cost and reliable option for on-site, local production of disinfectant solutions to improve sanitation and hygiene. We report on a system (herein called “Electro-Clean”) that can produce concentrated solutions of hypochlorous acid (HOCl) using only low-cost and now widely accessible materials. Using only table salt, water, graphite welding rods, and a DC power supply, HOCl solutions (∼1.5 liters) of 0.1% free chlorine (i.e. 1000 ppm) can be safely produced in less than two hours at low potential (5 V DC) and modest current (∼5 A). Rigorous testing of free chlorine production and durability of the Electro-Clean system components, described here, have been verified to work in multiple locations around the world by our project team, including microbiological tests conducted in two different countries to confirm the biocidal efficacy of the Electro-Clean solution as a surface disinfectant. We provide cost estimates for making HOCl locally with this method in the USA, India, and Mexico. Our findings show that Electro-Clean is an affordable alternative to off-the-shelf commercial chlorinator systems in terms of first costs (or capital costs), and cost-competitive relative to the unit cost of the disinfectant produced. By minimizing dependence on supply chains and allowing for local production, the Electro-Clean production process has the potential for improving public health by addressing the need for high- strength disinfectant solutions in resource-constrained communities.
Clinical outcomes after the introduction of dolutegravir for second-line antiretroviral therapy in South Africa: a retrospective cohort study
Authors: Asare Kwabena , Sookrajh Yukteshwar , van der Molen Johan , Khubone Thokozani , Lewis Lara , Lessells Richard J , Naidoo Kogieleum , Sosibo Phelelani , van Heerden Rosemary , Garrett Nigel , Dorward Jienchi 
Published: July 2023

ABSTRACTBackgroundDolutegravir is now recommended for second-line anti-retroviral therapy (ART) in low- and middle-income countries. We compared outcomes with dolutegravir (DTG) versus the previous lopinavir/ritonavir (LPV/r) regimen in South Africa.MethodsWe used routinely collected, de-identified data from 59 South African clinics. We included people living with HIV aged ≥ 15 years with virologic failure (two consecutive viral loads ≥1000 copies/mL) on first-line tenofovir disoproxil fumarate (TDF)-based ART and switched to second-line ART. We used modified Poisson regression models to compare outcomes of 12-month retention-in-care and viral suppression (<50 copies/ml) after switching to second-line regimens of zidovudine (AZT), emtricitabine/lamivudine (XTC), DTG and TDF/XTC/DTG and AZT/XTC/LPV/r.FindingsOf 1214 participants, 729 (60.0%) were female, median age was 36 years (interquartile range 30 to 42), 689 (56.8%) were switched to AZT/XTC/LPV/r, 217 (17.9%) to AZT/XTC/DTG and 308 (25.4%) to TDF/XTC/DTG. Retention-in-care was higher with AZT/XTC/DTG (85.7%, adjusted risk ratio (aRR) 1.14, 95% confidence interval (CI) 1.03 to 1.27; adjusted risk difference (aRD) 10.89%, 95%CI 2.01 to 19.78) but not different with TDF/XTC/DTG (76.9%, aRR 1.01, 95%CI 0.94 to 1.10; aRD 1.04%, 95%CI -5.03 to 7.12) compared to AZT/XTC/LPV/r (75.2%). Retention-in-care with TDF/XTC/DTG was not statistically significantly different from AZT/XTC/DTG (aRR 0.89, 95%CI 0.78 to 1.01; aRD - 9.85%, 95%CI -20.33 to 0.63). Of 799 participants who were retained-in-care with a 12-month viral load, viral suppression was higher with AZT/XTC/DTG (59.3%, aRR 1.25, 95%CI 1.06 to 1.47; aRD 11.57%, 95%CI 2.37 to 20.76) and TDF/XTC/DTG (60.7%, aRR 1.30, 95%CI 1.14 to 1.48; aRD 14.16%, 95%CI 7.14 to 21.18) than with the AZT/XTC/LPV/r regimen (46.7%).InterpretationDTG-based second-line regimens were associated with similar or better retention-in-care and better viral suppression than the LPV/r-based regimen. TDF/XTC/DTG had similar viral suppression compared to AZT/XTC/DTG.FundingBill & Melinda Gates Foundation, Africa Oxford Initiative.
Effects of time management interventions on mental health and wellbeing factors: A protocol for a systematic review
Authors: Young Anna Navin , Burke Aoife , Foley Sarah , Di Blasi Zelda 
Published: July 2023

AbstractBackgroundPoor employee mental health and wellbeing are highly prevalent and costly. Time-related factors such as work intensification and perceptions of time poverty or pressure pose risks to employee health and wellbeing. While reviews suggest that there are positive associations between time management behavior and wellbeing, there is limited rigorous and systematic research examining the effectiveness of time management interventions on wellbeing in the workplace. A thorough review is needed to synthesize time management interventions and their effectiveness to promote employee mental health and wellbeing.MethodA systematic search will be conducted using the following databases: PsychINFO via OVID (1806-Present), Web of Science, Scopus via Elsevier (1976-Present), Academic Search Complete (EBSCO), Cochrane Library via Wiley (1992-Present), and MEDLINE via OVID (1946-Present). The review will include experimental and quasi-experimental studies that evaluate the effects of time management interventions on wellbeing outcomes on healthy adults in a workplace context. Only studies in English will be included. Two authors will independently perform the literature search, record screening, data extraction, and quality assessment of each study included in the systematic review and meta-analysis. Data will be critically appraised using the Cochrane risk-of-bias tools. Depending on the data, a meta-analysis or a narrative synthesis will be conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in the development of this protocol. The protocol has been registered in PROSPERO (CRD4202125715).DiscussionThis review will provide systematic evidence on the effects of time management interventions on wellbeing outcomes in the workplace. It will contribute to our understanding of how time management approaches may help to address growing concerns for employee mental health and wellbeing.
A novel approach to classification and segmentation of colon cancer imaging towards personalized medicine
Authors: Harikrishnan Keerthi , Botelho Neil , Rebelo Penjo , Kenkre Amit , Tarcar Amogh 
Published: July 2023

AbstractRecent advances in the field of pathology coupled with the rapid evolution of machine learning based techniques have revolutionized healthcare practices. Colorectal cancer accounts for one of the top 5 cancers with high incidence (126,240 in 2020) with a high mortality worldwide [1] [2]. Tissue biopsy remains to be the gold standard procedure for accurate diagnosis, treatment planning and prognosis prediction [3]. As an image based modality, pathology has attracted a lot of attention for development of AI algorithms and there has been a steady increase in the number of filings for FDA authorized use of AI algorithms in clinical practice [4]. The SemiCOL Challenge aims to develop computational pathology methods for automatic segmentation and classification of tumor and other tissue classes using H&E stained images. In this paper, we present a novel machine learning framework addressing the SemiCOL Challenge, focusing on semantic segmentation, segmentation-based whole-slide image classification, and effective use of limited annotated data. Our approach leverages deep learning techniques and incorporates data augmentation to improve the accuracy and efficiency of tumor tissue detection and classification in CRC. The proposed method achieves an average Dice score of 0.2785 for segmentation and an AUC score of 0.71 for classification across 20 whole-slide images. This framework has the potential to revolutionize the field of computational pathology, contributing to more efficient and accurate diagnostic tools for colorectal cancer.
Growth patterns and ratios of posterior cranial fossa structures in the Japanese pediatric population: A study utilizing CT scans
Authors: Hashimoto Hiroaki , Takemoto Osamu , Chiba Yasuyoshi 
Published: July 2023

AbstractPurposeThe changes in the proportion of posterior cranial fossa structures during pediatric development remain unclear. This retrospective study aimed to investigate the growth patterns and ratios of these structures using computed tomography (CT) scans.MethodsHead CT scans of pediatric patients with minor head trauma from our institute between March 2006 and May 2023 were analyzed. The study segmented the intracranial volume (ICV), posterior cranial fossa volume (PCFV), cerebellum volume (CBMV), and brainstem volume (BSV). Correlation coefficients were calculated among the parameters. Patients aged 0 to 10 years were divided into 15 age-related clusters, and mean and standard deviation values were measured. Growth curves were created by plotting mean values sequentially. Ratios such as PCFV/ICV and (CBMV + BSV)/PCFV were examined. Statistical analyses, including unpaired T-tests and logarithmic curve fitting, were performed.ResultsA total of 234 CT scans (97 from females, 115 from infants under one year of age) were analyzed. Positive correlations were observed among the parameters, with the strongest between PCFV and CBMV. The growth curves for ICV, PCFV, CBMV, and BSV exhibited a two-phase process, with rapid growth until approximately 4 years of age, followed by stabilization. The ratios PCFV/ICV and (CBMV + BSV)/PCFV showed increasing trends from birth onwards, stabilizing by 4 and one years of age, respectively.ConclusionThis study provides insights into the growth patterns and ratios of posterior cranial fossa structures in the pediatric population. The findings demonstrate a two-phase growth process and increasing trends in the examined ratios.
Phenotypic and Genetic Characteristics of Retinal Vascular Parameters and their Association with Diseases
Authors: Vela Sofía Ortín , Beyeler Michael J. , Trofimova Olga , Iuliani Ilaria , Quiros Jose D. Vargas , de Vries Victor A. , Meloni Ilenia , Elwakil Adham , Hoogewoud Florence , Liefers Bart , Presby David , Ramdas Wishal D. , Tomasoni Mattia , Schlingemann Reinier , Klaver Caroline C.W. , Bergmann Sven 
Published: July 2023

AbstractFundus images allow for non-invasive assessment of the retinal vasculature whose features provide important information on health. Using a fully automated image processing pipeline, we extracted 17 different morphological vascular phenotypes, including median vessels diameter, diameter variability, main temporal angles, vascular density, central retinal equivalents, the number of bifurcations, and tortuosity, from over 130k fundus images of close to 72k UK Biobank subjects. We performed Genome-Wide Association Studies of these phenotypes. From this, we estimated their heritabilities, ranging between 5 and 25%, and genetic cross-phenotype correlations, which mostly mirrored the corresponding phenotypic correlations, but tended to be slightly larger. Projecting our genetic association signals onto genes and pathways revealed remarkably low overlap suggesting largely decoupled mechanisms modulating the different phenotypes. Our disease phenotype associations confirmed some previously known findings and revealed many novel connections. Notably, diameter variability, especially for the veins, seems to have new and interesting associations with diseases, including heart attack, pulmonary embolism, and age of death. Mendelian Randomization analysis suggests a causal influence of blood pressure and body mass index on retinal vessel morphology, among other results. We validated key findings in two independent smaller cohorts. Our analyses provide evidence that large-scale analysis of image-derived vascular phenotypes has sufficient power for obtaining functional, as well as some initial causal insights into the processes modulating the retinal vasculature.
Immune-Neuroendocrine Patterning and Response to Stress. A latent profile analysis in the English Longitudinal Study of Ageing
Authors: Hamilton Odessa S. , Iob Eleonora , Ajnakina Olesya , Kirkbride James B. , Steptoe Andrew 
Published: July 2023

AbstractPsychosocial stress exposure can disturb communication signals between the immune, nervous, and endocrine systems that are intended to maintain homeostasis. This dysregulation can provoke a negative feedback loop between each system that has high pathological risk. Here, we explore patterns of immune-neuroendocrine activity and the role of stress. Using data from the English Longitudinal Study of Ageing (ELSA), we first identified the latent structure of immune-neuroendocrine activity (indexed by high sensitivity C-reactive protein [CRP], fibrinogen [Fb], hair cortisol [cortisol], and insulin growth-factor-1 [IGF-1]), within a population-based cohort using latent profile analysis (LPA). Then, we determined whether life stress was associated with membership of different immune-neuroendocrine profiles. We followed 4,934 male and female participants with a median age of 65 years over a four-year period (2008-2012). A three-class LPA solution offered the most parsimonious fit to the underlying immune-neuroendocrine structure in the data, with 36%, 40%, and 24% of the population belonging to profiles 1 (low-risk), 2 (moderate-risk), and 3 (high-risk), respectively. After adjustment for genetic predisposition, sociodemographics, lifestyle, and health, higher exposure to stress was associated with a 61% greater risk of belonging to thehigh-riskprofile (RRR: 1.61; 95%CI=1.23-2.12,p=0.001), but not themoderate-riskprofile (RRR=1.10, 95%CI=0.89-1.35,p=0.401), as compared with thelow-riskprofile four years later. Our findings extend existing knowledge on psychoneuroimmunological processes, by revealing how inflammation and neuroendocrine activity cluster in a representative sample of older adults, and how stress exposure was associated with immune-neuroendocrine responses over time.
Variational autoencoders to predict DNA-methylation age and provide biological insights in age-related health and disease
Authors: Steyaert Sandra , Verhelle Adriaan , Criekinge Wim Van 
Published: July 2023

AbstractMotivationEpigenetic ageing clocks based on age-associated changes in DNA-methylation (DNAm) profiles have shown great potential as predictors to quantify age-related health and disease. Most of these clocks are built using penalized linear regression models with the aim to predict chronological and/or biological age. However, the precise underlying biological mechanisms influencing these clocks remain unclear. In this work, we explored if a Variational Autoencoder (VAE) can be trained to model DNAm age, and whether this VAE captures biologically relevant features of ageing in the latent space.ResultsOur results indicate that VAEs present a promising framework to construct embeddings that capture complex interactions and that can be used to extract biological meaningful features upon predicting DNAm age. By using deep learning interpretation methods, we show it is possible to determine which genomic loci and pathways are important in making the predictions, both on a population and individual level, paving the way to unravel what makes the DNAm clock tick.
Appropriateness of ChatGPT in answering heart failure related questions
Authors: King Ryan C. , Samaan Jamil S. , Yeo Yee Hui , Mody Behram , Lombardo Dawn M. , Ghashghaei Roxana 
Published: July 2023

AbstractIntroductionHeart failure requires complex management with increased patient knowledge shown to improve outcomes. This study assessed the knowledge of Chat Generative Pre-Trained Transformer (ChatGPT) and its appropriateness as a supplemental resource of information for patients with heart failure.Materials and MethodsA total of 107 frequently asked heart failure-related questions were included. Responses were generated using GPT-3.5 and GPT-4. The accuracy and reproducibility of responses were graded by two reviewers board-certified in cardiology, with differences resolved by a third reviewer board-certified in cardiology and advanced heart failure. Accuracy was graded using a four-point scale: 1) Comprehensive 2) Correct but inadequate 3) Some correct and some incorrect 4) Completely incorrect.ResultsGPT-4 displayed a greater proportion of comprehensive knowledge for the categories of “basic knowledge” and “management” (89.8%, 82.9%). GPT-3.5 performed best in the “management” and “other” category (prognosis, procedures, and support) (78.1%, 94.1%). There were two total responses (1.9%) graded as “some correct and incorrect” for GPT-3.5, while no “completely incorrect” responses were produced. The models also provided highly reproducible responses, with GPT-3.5 scoring above 94% in every category and GPT-4 with 100% for all answers.ConclusionsGPT-3.5 and GPT-4 answered the majority of heart failure-related questions accurately and reliably. ChatGPT may lead to better outcomes in patients with heart failure by providing accessible and easy to understand health education. However, in its current state the model necessitates further rigorous testing and validation to ensure patient safety and equity across all patient demographics.
Causal associations between type 1 diabetes mellitus and cardiovascular diseases: A Mendelian randomization study
Authors: Liu Zirui , Wang Haocheng , Yang Zhengkai , Lu Yu , Zou Cao 
Published: July 2023

AbstractBackgroundThe presence of type 1 diabetes mellitus (T1DM) has been demonstrated to pose an increased risk for developing cardiovascular diseases (CVDs). However, the causal relationships between T1DM and CVDs remain unclear due to the uncontrolled confounding factors and reverse causation bias of the observational studies.AimTo investigate the causal relationships between T1DM and seven major CVDs, including myocardial infarction (MI), heart failure (HF), coronary artery disease (CAD), atrial fibrillation (AF), coronary atherosclerosis, peripheral atherosclerosis, and stroke, using a two-sample bidirectional Mendelian randomization (MR) method.MethodWe selected genetic instruments for T1DM and the seven CVDs from the largest available genome-wide association studies (GWAS) of European ancestry for the MR analysis. Three complementary methods: inverse variance weighted (IVW), weighted median, and MR-Egger were used for the MR estimates. The potential pleiotropic effects were assessed by MR-Egger intercept and MR-PRESSO global test. Additionally, multivariable MR (MVMR) analysis was performed to examine whether T1DM has independent effects on CVDs with adjustment of potential confounding factors. Moreover, a two-step MR approach was used to assess the potential mediating effects of these factors on the causal effects between T1DM and CVDs.ResultsCausal effects of T1DM on peripheral atherosclerosis (odds ratio [OR]=1.06, 95% confidence interval [CI]: 1.02–1.10;p= 0.002)] and coronary atherosclerosis (OR=1.03, 95% CI: 1.01–1.05;p= 0.001) were found. The results were less likely to be biased by the horizontal pleiotropic effects (both p values of MR-Egger intercept and MR-PRESSO Global test > 0.05). In the following MVMR analysis, we found the causal effects of T1DM on peripheral atherosclerosis and coronary atherosclerosis remain significant after adjusting for a series of potential confounding factors. Moreover, we found that hypertension partly mediated the causal effects of T1DM on peripheral atherosclerosis (proportion of mediation effect in total effect: 11.47%, 95% CI: 3.23%–19.71%) and coronary atherosclerosis (16.84%, 95% CI: 5.35%–28.33%). We didn’t find significant causal relationships between T1DM and other CVDs, including MI, CAD, HF, AF, or stroke. For the reverse MR from CVD to T1DM, no significant causal relationships were identified.ConclusionThis MR study provided evidence supporting the causal effect of T1DM on peripheral atherosclerosis and coronary atherosclerosis, with hypertension partly mediating this effect.