bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pediatric Case of Treatment-related Myelodysplastic Syndrome While on Therapy for Pre-B Acute Lymphoblastic Leukemia
Authors: McElroy Sara , Myers G. Doug , Flatt Terrie 
Published: January 2023

Background:
Treatment-related myelodysplastic syndrome (t-MDS) is a rare late effect of cancer therapy. After alkylating agents, this typically occurs years after completion of therapy. Treatment of t-MDS in pediatrics is an allogeneic stem cell transplant, however, the prognosis remains poor.

Observations:
This case demonstrates t-MDS developing in a patient receiving treatment for pre-B acute lymphoblastic leukemia. This patient was treated with a combination of hematopoietic stem cell transplant and hypomethylating agents.

Conclusions:
These agents should be considered for use in patients with t-MDS, before transplant to limit additional chemotherapy and as maintenance therapy post-transplant to reduce the risk of relapse.
Investigating the Expression Pattern of the SETMAR Gene Transcript Variants in Childhood Acute Leukemia: Revisiting an Old Gene
Authors: Boroumand-Noughabi Samaneh , Pashaee Ali , Montazer Mehdi , Rahmati Atefe , Ayatollahi Hossein , Sadeghian Mohammad Hadi , Keramati Mohammad Reza 
Published: January 2023

Background:
The chimeric enzyme SETMAR (or Metnase) has been associated with several DNA processes, including DNA damage repair through the non-homologous joining pathway and suppression of chromosomal translocation in mouse fibroblasts. SETMAR overexpression has been reported in certain cancers suggesting that it might contribute to the establishment or progression of these cancers. In leukemia, the SETMAR gene transcript variants have not been widely studied. Therefore, this study aimed to quantify 3 predominant SETMAR variants in 2 types of childhood acute leukemia, acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL).

Methods:
In this study, using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), the relative expression of 3 SETMAR transcript variants (Var 1, Var 2, and Var A) were evaluated in the bone marrow samples collected from 30 newly diagnosed patients with AML, 65 newly diagnosed patients with ALL, and 15 healthy individuals.

Results:
The expression of SETMAR variants 1 and A were significantly higher in AML patients compared with controls (P=0.02, and P=0.009, respectively). Variant A expression was significantly higher in ALL compared with controls (P=0.003). When comparing the expression in translocation-positive and negative subgroups, the expression of variant 1 was significantly higher in translocation-positive ALL patients (P=0.03). The variants’ distribution patterns differed concerning translocation status (P=0.041), as variants 1 and A were dominant in the translocation-positive ALL group, and variant 2 was more prevalent in translocation-negative ones.

Conclusions:
According to the results, SETMAR showed increased expression in pediatric acute leukemia’s bone marrow samples, indicating a role for this molecule in leukemia pathogenesis. As this is the first report of SETMAR expression in pediatric leukemias, further studies are needed to investigate the causality of this association.
Preparing for the Next Pandemic: An After-Action Review of Infection Prevention and Control Audit Strategies Within Airport and Hotel Quarantine Program
Authors: Jain Susan , Dempsey Kathy , Clezy Kate , Bradd Patricia 
Published: January 2023

Background:
Effective infection prevention and control (IPAC) practices within the New South Wales (NSW) Airport Operations and Hotel Quarantine Program (Quarantine Program) were required to mitigate the risk of COVID-19 being transmitted to staff, other guests, contractors, and the community.

Method:
The Quarantine Program relied on complex logistical arrangements and an end-to-end process that included all steps from the time travelers boarded the returning flight until completion of the quarantine period. This required compliance with relevant IPAC standards historically reserved for health care and the implementation of a quality assurance audit framework.

Results:
The Clinical Excellence Commission (CEC) as the NSW Health Pillar for quality and safety and the lead in IPAC provided training and resources coupled with an IPAC quality audit framework after program commencement.

Conclusion:
This approach ensured a clear governance structure and a regular review process to minimize risk and support continuous improvement within the program.
Development and Validation of a Multidimensional Short Version Zarit Burden Interview (ZBI-9) for Caregivers of Persons With Cognitive Impairment
Authors: Zhi-Xiang Lim , Lim Wee Shiong , Chan Ee-Yuee 
Published: January 2023

Background:
There is a lack of appreciation of the full dimensionality of the original 22-item Zarit Burden Interview (ZBI) in the development of short versions. Existing short versions are premised upon a 1-factor or 2-factor structure or statistical techniques for item selection. Thus, there is a need for ZBI short versions that considers the multidimensional constructs of role strain, personal strain, and worry about performance (WaP) during item selection to provide a more holistic and comprehensive evaluation.

Purpose:
To develop and validate a short version of ZBI through a combined quantitative and qualitative approach that incorporates the validated 4-factor structure of role strain demands; role strain-control; personal strain, and WaP.

Patients:
We studied 202 caregivers of patients with dementia (84.2%) or mild cognitive impairment (15.8%) attending a memory clinic in Singapore.

Methods:
Confirmatory factor analysis and qualitative considerations from expert consensus were used for item selection. Confirmatory factor analysis fit statistics support the 4-factor structure. The 9-item ZBI-9 showed good internal consistency (Cronbach’s α=0.87) and convergent validity with anxiety and depression (Pearson correlation: Hospital Anxiety and Depression sub-scales, r≥0.56, P<0.001; ZBI- 22, r=0.95, P<0.001). Using a cut-off score of ≥13, ZBI-9 displayed good discriminatory ability for depressive symptoms (area under curve=0.79, P<0.001; sensitivity=70%, specificity=75%). The ZBI-9 also displayed comparable performance to the 22-item full version and three 12-item short versions.

Conclusion:
The ZBI-9 is a multidimensional short-version assessment tool for caregivers of persons with dementia and mild cognitive impairment that is reliable, valid, and discriminates depressive symptoms.
Sodium chloride inhibits effective bubbly drag reduction in turbulent bubbly Taylor–Couette flows
Authors: Blaauw Luuk J. , Lohse Detlef , Huisman Sander G. 
Published: January 2023

Using the Taylor–Couette geometry we experimentally investigate the effect of salt on drag reduction caused by bubbles present in the flow. We combine torque measurements with optical high-speed imaging to relate the bubble size to the drag experienced by the flow. Previous studies have shown that a small percentage of air (4%) can lead to dramatic drag reduction (40%). In contrast to previous laboratory experiments, which mainly used fresh water, we will vary the salinity from that of fresh water to the average salinity of ocean water. We find that the drag reduction is increasingly more inhibited for increasing salt concentrations, going from 40% for fresh water to just 15% for sea water. Salts present in the working fluid inhibit coalescence events, resulting in smaller bubbles in the flow and, with that, a decrease in the drag reduction. Above a critical salinity, increasing the salinity has no further effect on the size of bubbles in the flow and thus the drag experienced by the flow. Our new findings demonstrate the importance of sodium chloride on the bubbly drag reduction mechanism, and will further challenge naval architects to implement promising air lubrication systems on marine vessels.

This article is part of the theme issue ‘Taylor–Couette and related flows on the centennial of Taylor’s seminal
Philosophical Transactions
paper (part 1)’.
Impact of vaccination and risk factors on COVID-19 mortality amid delta wave in Libya: a single centre cohort study
Authors: Alhudiri Inas , Abusrewil Zakarya , Dakhil Omran , Zwaik Mosab Ali , Awn Mohammed Ammar , Jallul Mwada , Ahmed Aimen Ibrahim , Abughrara Rasha , Elzaghied Adam 
Published: January 2023

AbstractBackgroundThe Delta variant has led to a surge in COVID-19 cases in Libya, making it crucial to investigate the impact of vaccination on mortality rates among hospitalized patients and critically ill.AimsTo study risk factors and COVID-19 mortality rates among unvaccinated and vaccinated adults during delta wave at a single COVID-19 care centre in Tripoli, Libya.MethodsThe study involved two independent cohorts (n=341). One cohort was collected retrospectively from May 2021-August 2021 and the second cohort was prospectively collected from August 2021-October 2021 and most of them were during the Delta wave. The two cohorts were merged and analysed as one group.ResultsMost patients were male (60.5%) and 53.3% were >60 years. The vast majority of admitted patients did not have previous COVID-19 infection (98.9%) and were unvaccinated (90.3%). Among vaccinated, 30 patients had one dose and only 3 had two doses. Among patients who received one dose, 58.1% (18/31) died and 41.9% (13/31) survived. Most patients (72.2%) had a pre-existing medical condition. Multivariable prediction model showed that age >60 years was significantly associated with death (odds ratio=2.328, CI 1.456-3.724, p-value=<0.0001).ConclusionPrevious infection or full vaccination against COVID-19 significantly reduces hospitalization and death, as most admitted patients were unvaccinated and not previously infected. However, a single vaccine dose may not be adequate, especially for older individuals and those with underlying medical conditions. High-risk older patients with comorbidities should be fully vaccinated and offered up to date bivalent COVID-19 booster doses.
Limited evidence for validity and reliability of non-navigated low and high frequency rTMS over the motor cortex
Authors: Prei Kilian , Kanig Carolina , Osnabrügge Mirja , Langguth Berthold , Mack Wolfgang , Abdelnaim Mohamed , Schecklmann Martin , Schoisswohl Stefan 
Published: January 2023

AbstractThe neuromodulatory effects of repetitive transcranial magnetic stimulation (rTMS) are often described as inhibiting for low frequency and facilitating for high frequency protocols, leading to the lofi-hife heuristic. However, the data basis for this is inconsistent and reliability of rTMS is barely evaluated. The present study examines the validity of this lofi-hife heuristic at group and single subject level and the reliability of rTMS in a non-navigated setting close to clinical application. In 30 healthy participants, 1 Hz and 20 Hz rTMS were each administered twice over the left motor cortex resulting in four sessions/participant. Motor evoked potentials (MEPs) were measured before and after each session. Reliability measures were intraclass and Pearson’s correlation coefficient (ICC andr). The heuristic was not evident at group level. At single-subject level four participants responded with heuristic-conform changes, i.e., concomitant decreases for 1 Hz and increases for 20 Hz sessions. ICCs andrwere low to moderate. Within subgroups of less confounded measures, we found goodrvalues for 20 Hz rTMS. Results demonstrate high inter- and intraindividual variability of rTMS questioning the lofi-hife heuristic. Methodological improvements for the usage of rTMS might help to increase validity and reliability of non-invasive brain stimulation.
serosim: an R package for simulating serological survey data arising from vaccination, epidemiological and antibody kinetics processes
Authors: Menezes Arthur , Takahashi Saki , Routledge Isobel , Metcalf C. Jessica E. , Graham Andrea L. , Hay James A. 
Published: January 2023

Abstractserosimis an open source R package designed to aid inference of serological surveys, by simulating data arising from user-specified vaccine and infection-generated antibody kinetics processes using a random effects model. Serological surveys are used to assess population immunity by directly measuring individuals’ antibody titers. They uncover locations and/or populations which are susceptible and provide evidence of past infection or vaccination to help inform public health measures and surveillance. Both serological surveys and new analytical techniques used to interpret them are increasingly widespread. This expansion creates a need for tools to simulate serological surveys and the processes underlying the observed titer values, as this will enable researchers to identify best practices for serological survey design, and provide a standardized framework to evaluate the performance of different inference methods.serosimallows users to specify and adjust model inputs representing underlying processes responsible for generating the observed titer values like time-varying patterns of infection and vaccination, population demography, immunity and antibody kinetics, and serological survey sampling design in order to best represent the population and disease system(s) of interest. This package will be useful for planning sampling design of future serological surveys, understanding determinants of observed serological data, and validating the accuracy and power of new statistical methods.Author SummaryPublic health researchers use serological surveys to obtain serum samples from individuals and measure antibody levels against one or more pathogens. When paired with appropriate analytical methods, these surveys can be used to determine whether individuals have been previously infected with or vaccinated against those pathogens. However, there is currently a lack of tools to simulate realistic serological survey data from the processes determining these observed antibody levels. We developedserosim, an open source R package which enables users to simulate serological survey data matching their disease system(s) of interest. This package allows users to specify and modify model inputs responsible for generating an individual’s antibody level at various levels, from the within-host processes to the observation process.serosimwill be useful for designing more informative serological surveys, better understanding the processes behind observed serological data, and assessing new serological survey analytical methods.
Effectiveness of a chatbot in improving the mental wellbeing of health workers in Malawi during the COVID-19 pandemic: A randomized, controlled trial
Authors: Kleinau Eckhard F. , Lamba Tilinao , Jaskiewicz Wanda , Gorentz Katy , Hungerbuehler Ines , Rahimi Donya , Kokota Demoubly , Maliwichi Limbika , Jamu Edister S. , Zumazuma Alex , Negrão Mariana , Mota Raphael , Khouri Yasmine , Kapps Michael 
Published: January 2023

AbstractWe conducted a randomized, controlled trial (RCT) to investigate our hypothesis that the interactive chatbot, Vitalk, is more effective in improving mental wellbeing and resilience outcomes of health workers in Malawi than the passive use of Internet resources.For our 2-arm, 8-week, parallel RCT (ISRCTN Registry: trial IDISRCTN16378480), we recruited participants from 8 professional cadres from public and private healthcare facilities. The treatment arm used Vitalk; the control arm received links to Internet resources. The research team was blinded to the assignment. Of 1,584 participants randomly assigned to the treatment and control arms, 215 participants in the treatment and 296 in the control group completed baseline and endline anxiety assessments. Six assessments provided outcome measures for: anxiety (GAD-7); depression (PHQ-9); burnout (OLBI); loneliness (ULCA); resilience (RS-14); and resilience-building activities. We analyzed effectiveness using mixed-effects linear models, effect size estimates, and reliable change in risk levels.Results support our hypothesis. Difference-in-differences estimators showed that Vitalk reduced: depression (−0.68 [95% CI −1.15 to −0.21]); anxiety (−0.44 [95% CI −0.88 to 0.01]); and burnout (−0.58 [95% CI −1.32 to 0.15]). Changes in resilience (1.47 [95% CI 0.05 to 2.88]) and resilience-building activities (1.22 [95% CI 0.56 to 1.87]) were significantly greater in the treatment group. Our RCT produced a medium effect size for the treatment and a small effect size for the control group.This is the first RCT of a mental health app for healthcare workers during the COVID-19 pandemic in Southern Africa combining multiple mental wellbeing outcomes and measuring resilience and resilience-building activities. A substantial number of participants could have benefited from mental health support (1 in 8 reported anxiety and depression; 3 in 4 suffered burnout; and 1 in 4 had low resilience). Such help is not readily available in Malawi. Vitalk has the potential to fill this gap.
Relationship of mild to moderate impairment of left ventricular ejection fraction with fatal ventricular arrhythmic events in cardiac sarcoidosis
Authors: Akama Yuka , Fujimoto Yudai , Matsue Yuya , Maeda Daichi , Yoshioka Kenji , Dotare Taishi , Sunayama Tsutomu , Nabeta Takeru , Naruse Yoshihisa , Kitai Takeshi , Taniguchi Tatsunori , Tanaka Hidekazu , Okumura Takahiro , Baba Yuichi , Minamino Tohru 
Published: January 2023

AbstractBackgroundCurrent guidelines recommend placing an implantable cardiac defibrillator for patients with cardiac sarcoidosis (CS) and severely impaired left ventricular ejection fraction (LVEF) of ≤35%. In this study, we aimed to explore the association between mild or moderate LVEF impairment and fatal ventricular arrhythmic event (FVAE).MethodsHere, 401 patients with CS without sustained ventricular arrhythmia at diagnosis were retrospectively analyzed. The primary endpoint was an FVAE, which was defined as the combined endpoint of documented ventricular tachycardia or ventricular fibrillation and sudden cardiac death. Two cut-off points for LVEF were used; sex-specific lower threshold of normal range of LVEF, 52% for men and 54% for women, and LVEF of 35% which is used in the current guidelines.ResultsDuring a median follow-up of 3.2 years, 58 FVAEs were observed, and the 5- and 10-year estimated incidences of FVAE were 16.8% and 23.0%, respectively. All patients were classified into three groups according to LVEF: impaired LVEF group, mild to moderate impairment of LVEF group, and maintained LVEF group. Multivariable competing risk analysis showed that both the impaired LVEF group (HR: 3.02, 95% CI: 1.25–7.32) and the mild to moderate impairment of LVEF group (HR: 2.12, 95% CI: 1.02–4.40) were associated with a higher incidence of FVAE than the maintained LVEF group after adjustment for covariates.ConclusionsPatients with CS are at a high risk of FVAEs, regardless of documented ventricular arrhythmia at the time of diagnosis. In patients with CS, even mild to moderate impairment of LVEF is associated with FVAEs.Clinical PerspectiveWhat is KnownPatients with cardiac sarcoidosis (CS) are at a higher risk of fatal ventricular arrhythmic event (FVAE).Current guidelines adopt left ventricular ejection fraction (LVEF) ≤35% as a cut-off value for Class I indication for implantable cardioverter defibrillators (ICD) implantation.What the Study AddsCumulative incidence curves showed that the 5-year FVAE risk in patients with CS with preserved LVEF was 7%, which was as high as that of non-ischemic cardiomyopathy with reduced LVEF.For risk stratification of future fatal ventricular arrhythmic events, even milder left ventricular ejection fraction impairment, compared to that currently suggested by guidelines, needs to be considered as a risk factor in patients with cardiac sarcoidosis.Preventive strategies for fatal ventricular arrhythmic events and sudden cardiac death using an implantable cardiac defibrillator according to individualized risk stratification need to be developed and evaluated in clinical studies of patients with cardiac sarcoidosis.
Combination of Antidepressants and Antipsychotics as A Novel Treatment Option for Psychosis in Alzheimer’s Disease
Authors: Fan Peihao , Zeng Lang , Ding Ying , Kofler Julia , Silverstein Jonathan , Krivinko Joshua , Sweet Robert A , Wang Lirong 
Published: January 2023

BackgroundPsychotic symptoms are reported as one of the most common complications of Alzheimer’s disease (AD), affecting approximately half of AD patients, in whom they are associated with more rapid deterioration and increased mortality. Empiric treatments, namely first and second-generation antipsychotics, confer modest efficacy in AD patients with psychosis (AD+P) and themselves increase mortality. A recent genome-wide meta-analysis and early clinical trials suggest the use and beneficial effects of antidepressants among AD+P patients. This motivates our rationale for exploring their potential as a novel combination therapy option amongst these patients.MethodsWe included University of Pittsburgh Medical Center (UPMC) electronic medical records (EMRs) of 10,260 AD patients from January 2004 and October 2019 in our study. Survival analysis was performed to assess the effects of the combination of antipsychotics and antidepressants on the mortality of these patients. To provide more valuable insights on the hidden mechanisms of the combinatorial therapy, a protein-protein interaction (PPI) network representing AD+P was built, and network analysis methods were used to quantify the efficacy of these drugs on AD+P. An indicator score combining the measurements on the separation between drugs and the proximity between the drugs and AD+P was used to measure the effect of an antipsychotic-antidepressant drug pair against AD+P.ResultsOur survival analyses replicated that antipsychotic usage is strongly associated with increased mortality in AD patients while the co-administration of antidepressants with antipsychotics showed a significant beneficial effect in reducing mortality. Our network analysis showed that the targets of antipsychotics and antidepressants are well-separated, and antipsychotics and antidepressants have similar proximity scores to AD+P. Eight drug pairs, including some popular recommendations like Aripiprazole/Sertraline and other pairs not reported previously like Iloperidone/Maprotiline showed higher than average indicator scores which suggest their potential in treating AD+P via strong synergetic effects as seen in our study.ConclusionOur proposed combinations of antipsychotics and antidepressants therapy showed a strong superiority over current antipsychotics treatment for AD+P. The observed beneficial effects can be further strengthened by optimizing drug-pair selection based on our systems pharmacology analysis.
Differential patterns of automatic segmentation of 3T and 7T MRI: Implications in neuropsychiatric disease
Authors: Verma Gaurav , Choi Ki Sueng , Mayberg Helen , Balchandani Priti 
Published: January 2023

SummaryAutomatic segmentation was performed on T1-MPRAGE structural MRI data acquired at 3T and 7T from 37 and 69 distinct healthy controls, respectively. Additionally, segmentation was performed on imaging acquired from 215 major depressive disorder (MDD) patients at 3T and 40 MDD patients at 7T. Of 259 segmentation-derived imaging features evaluated, 120 showed significant 3T vs. 7T differences among controls, and 153 among patients. 7T imaging metrics showed consistently lower cortical thickness and cortical gray/white matter ratios. Subcortical and cortical volumes measured at 7T were more mixed, with 7T images showing greater frontal lobe volume, but lower cortical volumes elsewhere.