bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Inflammatory Bowel Disease in Patients With Atopic Dermatitis
Authors: Chiesa Fuxench Zelma C. , Wan Joy , Wang Sonia , Syed Maha N. , Shin Daniel B. , Abuabara Katrina , Gelfand Joel M. 
Published: August 2023

ImportanceData on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) separately.ObjectivesTo examine the risk of new-onset IBD, UC, and CD in children and adults with AD.Design, Setting, and ParticipantsThis population-based cohort study assessed patients with AD matched with up to 5 controls on age, practice, and index date. Treatment exposure was used as a proxy for AD severity. Data were retrieved from The Health Improvement Network, a UK electronic medical record database, for January 1, 1994, to February 28, 2015. Data analysis was performed from January 8, 2020, to June 30, 2023.Main Outcomes and MeasuresOutcomes of interest were incident IBD, UC, and CD. Logistic regression was used to examine the risk for each outcome in children and adults with AD compared with controls.ResultsA total of 1 809 029 pediatric controls were matched to 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe). The pediatric cohort ranged in median age from 4 to 5 years (overall range, 1-10 years), was predominantly male (936 750 [51.8%] controls, 196 996 [51.6%] with mild AD, 11 379 [50.7%] with moderate AD, and 2985 [56.1%] with severe AD), and with similar socioeconomic status. A total of 2 678 888 adult controls were matched to 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe). The adult cohort ranged in median age from 45 to 50 years (overall range, 30-68 years) and was predominantly female (1 445 589 [54.0%] controls, 256 071 [62.3%] with mild AD, 109 404 [55.8%] with moderate AD, and 10 736 [59.3%] with severe AD). In fully adjusted models, children with AD had a 44% increased risk of IBD (hazard ratio [HR], 1.44; 95% CI, 1.31-1.58) and a 74% increased risk of CD (HR, 1.74; 95% CI, 1.54-1.97), which increased with worsening AD; however, they did not have increased risk of UC (HR, 1.09; 95% CI, 0.94-1.27) except for those with severe AD (HR, 1.65; 95% CI, 1.02-2.67). Adults with AD had a 34% (HR, 1.34; 95% CI, 1.27-1.40) increased risk of IBD, a 36% (HR, 1.36; 95% CI, 1.26-1.47) increased risk of CB, and a 32% (HR, 1.32; 95% CI, 1.24-1.41) increased risk of UC, with risk increasing with worsening AD.Conclusion and RelevanceIn this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD. Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.
Stage-Specific Risk of Recurrence and Death From Melanoma in Denmark, 2008-2021
Authors: Helvind Neel M. , Brinch-Møller Weitemeyer Marie , Chakera Annette H. , Hendel Helle W. , Ellebæk Eva , Svane Inge Marie , Kjærskov Mette W. , Bojesen Sophie , Skyum Helle , Petersen Søren K. , Bastholt Lars , Johansen Christoffer , Bidstrup Pernille E. , Hölmich Lisbet R. 
Published: August 2023

ImportanceTo ensure optimal treatment and surveillance of patients with melanoma, knowledge of the clinical stage-specific risk of recurrence, mortality, and recurrence patterns across the American Joint Committee on Cancer Eighth Edition (AJCC8) substages is needed.ObjectiveTo estimate stage-specific recurrence and melanoma-specific mortality rates, assess absolute stage-specific risks of recurrence and mortality, and describe stage-specific recurrence patterns, including conditional rates.DesignRetrospective cohort study of prospectively collected nationwide population-based registry data.SettingNationwide, population-based cohort study.ParticipantsThe 25 720 Danish patients, 18 years or older, diagnosed with first-time stage IA to IV cutaneous melanoma between January 1, 2008, and December 31, 2019, were included and followed up from time of primary treatment until December 31, 2021.ExposuresFirst diagnosis of stage IA to IV cutaneous melanoma.Main OutcomesStage-specific cumulative incidence of recurrence and melanoma-specific mortality, melanoma-specific recurrence-free survival, and assessed absolute stage-specific risks of recurrence and melanoma-specific mortality. Secondary outcomes were stage-specific recurrence patterns, including conditional rates, and melanoma-specific survival.ResultsWe followed up 25 720 patients for a median of 5.9 years (95% CI, 58.9-59.3 years). Mean age was 59.1 years (95% CI, 58.9-59.3 years). Patients with stage IIB to IIC melanoma were older, had more comorbidities at diagnosis, and had the lowest rate of pathologic staging by sentinel node biopsy (81.6%-87.4%). A total of 10.6% of patients developed recurrence; first recurrence included distant recurrence, alone or with synchronous locoregional recurrence, in 56.6% of patients. We found a comparable risk of recurrence in stages IIIA and IIB (29.7% vs 33.2%) and in stages IIIB and IIC (35.9% vs 36.8%), respectively. Melanoma-specific mortality was comparable between stages IIIA and IIA (13.0% vs 13.6%) and between stages IIIB and IIB (18.4% vs 22.0%), respectively. These risk patterns persisted in cause-specific hazards models.Conclusions and RelevanceThis nationwide, population-based cohort study found that the increasing stages of the current AJCC8 staging system do not accurately reflect an increasing risk of recurrence and mortality in melanoma. The high proportion of distant recurrences suggests that hematogenous spread is a more common metastatic pathway than previously assumed, and surveillance with routine functional/cross-sectional imaging should be considered for stages IIB to IV. Future efforts should be put toward developing new tools for risk stratification and determining the survival effect of routine imaging in surveillance.
Cost-Effectiveness of Pharmacotherapy for the Treatment of Obesity in Adolescents
Authors: Lim Francesca , Bellows Brandon K. , Tan Sarah Xinhui , Aziz Zainab , Woo Baidal Jennifer A. , Kelly Aaron S. , Hur Chin 
Published: August 2023

ImportanceAntiobesity pharmacotherapy is recommended for adolescents ages 12 years and older with obesity. Several medications have been approved by the US Food and Drug Administration for adolescent use, but the most cost-effective medication remains unclear.ObjectiveTo estimate the cost-effectiveness of lifestyle counseling alone and as adjunct to liraglutide, mid-dose phentermine and topiramate (7.5 mg phentermine and 46 mg topiramate), top-dose phentermine and topiramate (15 mg phentermine and 92 mg topiramate), or semaglutide among adolescent patients with obesity.Design, Setting, and ParticipantsThis economic evaluation used a microsimulation model to project health and cost outcomes of lifestyle counseling alone and adjunct to liraglutide, mid-dose phentermine and topiramate, top-dose phentermine and topiramate, or semaglutide over 13 months, 2 years, and 5 years among a hypothetical cohort of 100 000 adolescents with obesity, defined as an initial body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 37. Model inputs were derived from clinical trials, published literature, and national sources. Data were analyzed from April 2022 to July 2023.ExposuresLifestyle counseling alone and as adjunct to liraglutide, mid-dose phentermine and topiramate, top-dose phentermine and topiramate, or semaglutide.Main Outcomes and MeasuresThe main outcome was quality-adjusted life years (QALYs), costs (2022 US dollars), and incremental cost-effectiveness ratios (ICERs), with future costs and QALYs discounted 3.0% annually. A strategy was considered cost-effective if the ICER was less than $100 000 per QALY gained. The preferred strategy was determined as the strategy with the greatest increase in QALYs while being cost-effective. One-way and probabilistic sensitivity analyses were used to assess parameter uncertainty.ResultsThe model simulated 100 000 adolescents at age 15 with an initial BMI of 37, of whom 58 000 (58%) were female. At 13 months and 2 years, lifestyle counseling was estimated to be the preferred strategy. At 5 years, top-dose phentermine and topiramate was projected to be the preferred strategy with an ICER of $56 876 per QALY gained vs lifestyle counseling. Semaglutide was projected to yield the most QALYs, but with an unfavorable ICER of $1.1 million per QALY gained compared with top-dose phentermine and topiramate. Model results were most sensitive to utility of weight reduction and weight loss of lifestyle counseling and top-dose phentermine and topiramate.Conclusions and RelevanceIn this economic evaluation of pharmacotherapy for adolescents with obesity, top-dose phentermine and topiramate as adjunct to lifestyle counseling was estimated to be cost-effective after 5 years. Long-term clinical trials in adolescents are needed to fully evaluate the outcomes of pharmacotherapy, especially into adulthood.
Neighborhood Disadvantage, African Genetic Ancestry, Cancer Subtype, and Mortality Among Breast Cancer Survivors
Authors: Iyer Hari S. , Zeinomar Nur , Omilian Angela R. , Perlstein Marley , Davis Melissa B. , Omene Coral O. , Pawlish Karen , Demissie Kitaw , Hong Chi-Chen , Yao Song , Ambrosone Christine B. , Bandera Elisa V. , Qin Bo 
Published: August 2023

ImportanceRacial disparities in breast cancer (BC) survival arise from multilevel causes, which may exert influence at different stages of BC progression. Clarifying the importance of genetic and social factors could help prioritize interventions.ObjectiveTo jointly examine associations between African genetic ancestry, social environment, and mortality from any cause and BC in Black BC survivors.Design, Setting, and ParticipantsThis population-based cohort study enrolled self-identified Black women aged 20 to 75 years with histologically confirmed BC from June 2005 to May 2019 and followed them up until death or censoring in September 2021. Participants lived in 10 New Jersey counties. Data were analyzed between December 2022 and April 2023.ExposuresA neighborhood socioeconomic status (nSES) index composed of census tract measures (education, income, wealth, employment status, and occupation) was linked to residential addresses at diagnosis. Percentage African ancestry was estimated using the ADMIXTURE program.Main Outcomes and MeasuresSequentially adjusted (age adjusted: age and interview year; fully adjusted: age adjusted with individual SES, lifestyle factors, and comorbidities) logistic regression models were fit to estimate associations with tumor subtypes (estrogen receptor–negative [ER−] vs estrogen receptor–positive [ER+]; triple-negative breast cancer [TNBC] vs luminal A), and Cox models were fit for associations with all-cause mortality (ACM) and breast cancer–specific mortality (BCSM). Models for BCSM were fit using Fine-Gray competing risks models, and robust standard errors were used to account for census tract–level clustering.ResultsAmong 1575 participants, median (IQR) African ancestry was 85% (76%-90%), and median (IQR) age was 55 (46-63) years. A 10–percentage point increase in African ancestry was associated with higher odds of ER− vs ER+ (adjusted odds ratio [aOR], 1.08; 95% CI, 0.98-1.18) and TNBC vs luminal (aOR, 1.15; 95% CI, 1.02-1.31) tumors, but not with ACM or BCSM. A 1-IQR increase in nSES was associated with lower ACM (adjusted hazard ratio [aHR], 0.76; 95% CI, 0.63-0.93), and the HR for BCSM was less than 1 but not statistically significant (aHR, 0.81; 95% CI, 0.62-1.04) in age-adjusted models, but associations attenuated following further adjustment for potential mediators (individual SES, lifestyles, comorbidities).Conclusions and RelevanceIn this cohort study of Black female BC survivors, higher African ancestry was associated with aggressive tumor subtypes. Compared with genetic ancestry, mediating pathways related to social environments may be more important for survival in these patients.
War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia
Authors: Gebrehiwet Tesfay Gebregzabher , Abebe Haftom Temesgen , Woldemichael Abraha , Gebresilassie Kibrom , Tsadik Mache , Asgedom Akeza Awealom , Fisseha Girmatsion , Berhane Kiros , Gebreyesus Aregawi , Alemayoh Yibrah , Gebresilassie Measho , Godefay Hagos , Gesesew Hailay Abrha , Tesfaye Solomon , Siraj Elias S. , Aregawi Maru W. , Mulugeta Afework 
Published: August 2023

ImportanceThe war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented.ObjectiveTo assess the association of the war with the utilization of health care services for patients with chronic diseases.Design, Setting, and ParticipantsOf 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021).Main Outcomes and MeasuresRecords on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods.ResultsOf 4645 records of patients with chronic diseases undergoing treatment during the prewar period, 998 records (21%) indicated having treatment during the war period. Compared with the prewar period, 59 of 180 individuals (33%; 95% CI, 26%-40%) had tuberculosis, 522 of 2211 (24%; 95% CI, 22%-26%) had HIV, 228 of 1195 (19%; 95% CI, 17%-21%) had hypertension, 123 of 632 (20%; 95% CI, 16%-22%) had psychiatric disorders, and 66 of 427 (15%; 95% CI, 12%-18%) had type 2 diabetes records, which revealed continued treatment during the war period. Of 174 records of patients with type 1 diabetes in the prewar period, at 2 to 3 months into the war, the numbers dropped to 10 with 94% decline compared with prewar observations.Conclusions and RelevanceThis study found that the war in Tigray has resulted in critical health care service disruption and high loss to follow-up for patients with chronic disease, likely leading to increased morbidity and mortality. Local, national, and global policymakers must understand the extent and impact of the service disruption and urge their efforts toward restoration of those services.
Association of Birth Weight Centiles and Gestational Age With Cognitive Performance at Age 5 Years
Authors: Eves Robert , Wolke Dieter , Spiegler Juliane , Lemola Sakari 
Published: August 2023

ImportanceBirth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce.ObjectiveTo investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance.Design, Setting, and ParticipantsIn this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023.ExposureThe parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart.Main Outcome and MeasureScores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort.ResultsOf 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups.Conclusions and RelevanceIn this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.
Porosity and fluid budget of a water‐rich megathrust revealed with electromagnetic data at the Middle America Trench
Authors: Naif Samer , Key Kerry , Constable Steven , Evans Rob L. 
Published: August 2023

AbstractAt convergent margins, the distribution of fluids released from the downgoing slab modulates the state of stress and seismic coupling at the megathrust plate interface. However, existing geophysical data are unable to quantify the porosity along this interface. Here we use controlled‐source electromagnetic data collected across the Middle America Trench offshore Nicaragua to image the electrical conductivity structure of the outer fore arc. Our results detect a highly conductive channel, inferred to be the region around the décollement, showing the entire section of water‐rich seafloor sediments underthrust with the subducting lithosphere. We use an empirical model of the electrical conductivity of porous media to quantify the channel porosity. Our estimates are consistent with sediment compaction studies, showing a rapid decay of 65%–10% porosity from the trench to 25 km landward. We constrain the channel thickness and use the porosity estimates to determine the water budget, which represents the fraction taken up by fluid. The porosity and water budget estimates show significant lateral variations that we attribute to changes in subducted sediment thickness caused by outer rise bending faults. Between 18 and 23 km from the trench, the conductive channel broadens greatly to 1.5–2 km thick, possibly due to concentrated blind faults or sediment underplating, which suggests a sudden change in hydrogeologic structure at the plate interface. The impact of the anomalous conductor on the seismic coupling and mechanical properties of the megathrust is potentially related to the discrepancy in estimated fault slip between seismic and tsunami source inversions for the 1992 Nicaragua tsunami earthquake.
Proteomics and mathematical modeling of longitudinal CSF differentiates fast versus slow ALS progression
Authors: Vu Lucas , Garcia‐Mansfield Krystine , Pompeiano Antonio , An Jiyan , David‐Dirgo Victoria , Sharma Ritin , Venugopal Vinisha , Halait Harkeerat , Marcucci Guido , Kuo Ya‐Huei , Uechi Lisa , Rockne Russell C. , Pirrotte Patrick , Bowser Robert 
Published: August 2023

AbstractObjectiveAmyotrophic lateral sclerosis (ALS) is a heterogeneous disease with a complex etiology that lacks biomarkers predicting disease progression. The objective of this study was to use longitudinal cerebrospinal fluid (CSF) samples to identify biomarkers that distinguish fast progression (FP) from slow progression (SP) and assess their temporal response.MethodsWe utilized mass spectrometry (MS)‐based proteomics to identify candidate biomarkers using longitudinal CSF from a discovery cohort of SP and FP ALS patients. Immunoassays were used to quantify and validate levels of the top biomarkers. A state‐transition mathematical model was created using the longitudinal MS data that also predicted FP versus SP.ResultsWe identified a total of 1148 proteins in the CSF of all ALS patients. Pathway analysis determined enrichment of pathways related to complement and coagulation cascades in FPs and synaptogenesis and glucose metabolism in SPs. Longitudinal analysis revealed a panel of 59 candidate markers that could segregate FP and SP ALS. Based on multivariate analysis, we identified three biomarkers (F12, RBP4, and SERPINA4) as top candidates that segregate ALS based on rate of disease progression. These proteins were validated in the discovery and a separate validation cohort. Our state‐transition model determined that the overall variance of the proteome over time was predictive of the disease progression rate.InterpretationWe identified pathways and protein biomarkers that distinguish rate of ALS disease progression. A mathematical model of the CSF proteome determined that the change in entropy of the proteome over time was predictive of FP versus SP.
Developing Single‐Ion Conductive Polymer Electrolytes for High‐Energy‐Density Solid State Batteries
Authors: Meng Nan , Ye Yuning , Yang Zhaoxia , Li Hao , Lian Fang 
Published: August 2023

AbstractSingle‐ion conductive polymer electrolytes (SICPEs) with a cationic transference number (tLi+) close to unity exhibit specific advantages in solid‐state batteries (SSBs), including mitigating the ion concentration gradient and derived problems, suppressing the growth of lithium dendrites, and improving the utilization of cathode materials and the rate performance of SSBs. However, the application of SICPEs remains major challenges, i.e., the ionic conductivity is inferior at room temperature. Therefore, the recent accomplishments in improving the ambient ionic conductivity to be compatible SICPEs with a high transference number are discussed in this review. In particular, some strategies of delocalizing charges in polyanions, designing a highly conductive polymer matrix, and utilizing synergistic effects in SICPEs are focused to shed light on the further development of solid polymer electrolytes for SSBs. Finally, multifunctional species of SICPEs are discussed in view of the mechanical contact and/or charge transfer problems at the solid–solid interface in SSBs.