bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacteriological Analysis of Iyiukwu Stream Water in Uhuagu Awgu L.G.A Enugu State, Nigeria
Authors: Ngozi Ewoh Anthonia , Aneke Chinwe Jacinta , Ezea Ifeanyi Boniface 
Published: September 2023

The majority of the population of the Iyiukwu community in the Awgu Municipal Area of ​​Enugu State in Nigeria depends on the Iyiukwu stream for its water supply. Due to the recent dcrease in cases of waterborne diseases, a study was conducted to examine the bacteriological characteristics of the Iyiukwu stream in order to protect public health from waterborne diseases. Five of this water samples taken from both the longitudinal profile and bottom level of the creek were tested for bacteriological properties using standard methods. Total bacterial counts were determined using the cast plate technique and total bacterial counts. From water samples three genera of bacteria genus Klebsiella Alcaligenes and Salmonella were isolated. Total bacterial counts in water samples ranged from 0 to 32 ×102 CFU/ml. Total bacterial counts in the water samples analyzed ranged from MPN index 0 to 39 for coliforms per 50 ml. It was concluded that not all stream water is suitable for consumption and appropriate measures should be taken to clean and treat stream water on a regular basis before drinking.
Laboratory Studies on Chromatographic Profile, Toxicity and Repellent Activity of Custard Apple (Annona squamosa L.) Seed Extract
Authors: M. Ilakkia , Premalatha K.  , Vellaikumar S.  , Shanmugam P. S.  , Harish S.  , Jayarajan Nelson S.  
Published: September 2023

Plant extracts have toxic substances that can kill termites and other insect pests. Many plant extracts including Annona squamosa have been identified for their anti-termiticidal activity. This study aims to determine the chemical profile, toxicity, and repellent activities of petroleum ether extract against Odontotermes anamallensis and Microcerotermes fletcheri. The GC-MS/MS findings of petroleum ether extract of Annona showed the presence of 9-octadecenoic acid (Z)- as the predominant compound followed by Octadecanoic acid, n-Hexadecanoic acid, 9-Octadecenoic acid (Z)-, 2,3-dihydroxypropyl ester. The probit analysis revealed LC50 values of 2.38 per cent and 3.06 per cent for O. anamallensis and M. fletcheri, respectively. Petroleum ether extract showed repellency with the repellency percent of 48.33 and 31.67 by O. anamalensis and M. fletcheri respectively. These findings suggest that Annona seed extract is a viable source of natural insecticides against termites.
Relationship between Attention Deficit Hyperactivity Disorder and Severe Substance use Disorder in Adult Inpatients: A Cross-sectional Study
Authors: Calazans Sigrid Terezinha Campomizzi , Moura Isabel Cristina Gomes , Soares Aleida Nazareth , Pires Nathalia Lima , Costa Glacira , Almeida Aline , Duarte Raíssa , Guimarães Nathalia Sernizon , Souza Alessandra Hubner de 
Published: September 2023

Objectives: To evaluate the frequency of Attention Deficit Hyperactivity Disorder (ADHD) in adults admitted for treatment of severe chemical dependence in the Therapeutic Community Rios de Água Viva in Coronel Fabriciano, Minas Gerais, Brazil.
Method: A cross-sectional study with male subjects aged 18 years or older, compared to age-matched men without chemical dependence on a 1:1 ratio. Data collection was performed by applying a questionnaire with the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of American Psychiatric Association criteria for diagnosis of ADHD, also information on demographic profile, smoking and age of onset of psychoactive chemical substance use.
Results: Most patients have high school education (72.7%), are not married (93.2%) and are smokers (86.4%). From 44 patients with Substance Use Disorder who were screened for ADHD symptoms, 22.7% screened positive for the disorder, while only 2.3% of the control group received this diagnosis (p<0.001). The most used drug was alcohol (100%), followed by cocaine-crack (47%) and in third place cannabis (4.5%).
Conclusion: Higher frequencies of ADHD symptoms were found among severe chemical dependents interned in Therapeutic Community.
Efficacy and Tolerability of Gefapixant for Treatment of Refractory or Unexplained Chronic Cough
Authors: Kum Elena , Patel Matthew , Diab Nermin , Wahab Mustafaa , Zeraatkar Dena , Chu Derek K. , O’Byrne Paul M. , Guyatt Gordon H. , Satia Imran 
Published: September 2023

ImportanceGefapixant represents an emerging therapy for patients with refractory or unexplained chronic cough.ObjectiveTo evaluate the efficacy and tolerability of gefapixant for the treatment of adults with refractory or unexplained chronic cough.Data SourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from November 2014 to July 2023.Study SelectionTwo reviewers independently screened for parallel and crossover randomized clinical trials (RCTs) that compared, in patients with refractory or unexplained chronic cough, either gefapixant with placebo, or 2 or more doses of gefapixant with or without placebo.Data Extraction and SynthesisTwo reviewers independently extracted data. A frequentist random-effects dose-response meta-analysis or pairwise meta-analysis was used for each outcome. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in whether patients would perceive the effects as important (greater than the minimal important difference [MID]) or small (less than the MID).Main Outcomes and MeasuresCough frequency (measured using the VitaloJAK cough monitor; MID, 20%), cough severity (measured using the 100-mm visual analog scale [VAS]; higher score is worse; MID, 30 mm), cough-specific quality of life (measured using the Leicester Cough Questionnaire [LCQ]; score range, 3 [maximal impairment] to 21 [no impairment]; MID, 1.3 points), treatment-related adverse events, adverse events leading to discontinuation, and taste-related adverse events.ResultsNine RCTs including 2980 patients were included in the primary analysis. Compared with placebo, gefapixant (45 mg twice daily) had small effects on awake cough frequency (17.6% reduction [95% CI, 10.6%-24.0%], moderate certainty), cough severity on the 100-mm VAS (mean difference, −6.2 mm [95% CI, −4.1 to −8.4]; high certainty), and cough-specific quality of life on the LCQ (mean difference, 1.0 points [95% CI, 0.7-1.4]; moderate certainty). Compared with placebo, gefapixant (45 mg twice daily) probably caused an important increase in treatment-related adverse events (32 more per 100 patients [95% CI, 13-64 more], moderate certainty) and taste-related adverse events (32 more per 100 patients [95% CI, 22-46 more], high certainty). High-certainty evidence suggests that gefapixant (15 mg twice daily) had small effects on taste-related adverse events (6 more per 100 patients [95% CI, 5-8 more]).Conclusions and RelevanceCompared with placebo, gefapixant (45 mg orally twice daily) led to modest improvements in cough frequency, cough severity, and cough-specific quality of life but increased taste-related adverse events.
Automated Opt-Out vs Opt-In Patient Outreach Strategies for Breast Cancer Screening
Authors: Marcotte Leah M. , Deeds Stefanie , Wheat Chelle , Gunnink Eric , Gray Kristen , Rojas Jorge , Finch Carolyn , Nelson Karin , Reddy Ashok 
Published: September 2023

ImportanceOptimal strategies for population-based outreach for breast cancer screening remain unknown.ObjectiveTo evaluate the effect on breast cancer screening of an opt-out automatic mammography referral strategy compared with an opt-in automated telephone message strategy.Design, Setting, and ParticipantsThis pragmatic randomized clinical trial was conducted from April 2022 to January 2023 at a single Veterans Affairs (VA) medical center. Participants were female veterans aged 45 to 75 years who were eligible for breast cancer screening and enrolled in VA primary care.InterventionVeterans were randomized 1:1 to receive either an automatic mammography referral (opt-out arm) or an automated telephone call with an option for mammography referral (opt-in arm).Main Outcomes and MeasuresThe primary outcome was completed mammography 100 days after outreach. Secondary outcomes were scheduled or completed mammography by 100 days after outreach and referrals canceled if mammography was not scheduled within 90 days. Both intention-to-treat analyses and a restricted analysis were conducted. The restricted analysis excluded veterans who were unable to be reached by telephone (eg, a nonworking number) or who were found to be ineligible after randomization (eg, medical record documentation of recent mammography).ResultsOf 883 veterans due for mammography (mean [SD] age, 59.13 [8.24] years; 656 [74.3%] had received prior mammography), 442 were randomized to the opt-in group and 441 to the opt-out group. In the intention-to-treat analysis, there was no significant difference in the primary outcome of completed mammography at 100 days between the opt-out and opt-in groups (67 [15.2%] vs 66 [14.9%]; P = .90) or the secondary outcome of completed or scheduled mammography (106 [24.0%] vs 84 [19.0%]; P = .07). A higher number of referrals were canceled in the opt-out group compared with the opt-in group (104 [23.6%] vs 24 [5.4%]; P &amp;lt; .001). The restricted analysis demonstrated similar results except more veterans completed or scheduled mammography within 100 days in the opt-out group compared with the opt-in group (102 of 388 [26.3%] vs 80 of 415 [19.3%]; P = .02).Conclusions and RelevanceIn this randomized clinical trial, an opt-out population-based breast cancer screening outreach approach compared with an opt-in approach did not result in a significant difference in mammography completion but did lead to substantially more canceled mammography referrals, increasing staff burden.Trial RegistrationClinicalTrials.gov Identifier: NCT05313737
Association of Gestational Diabetes With Subsequent Long-Term Risk of Mortality
Authors: Wang Yi-Xin , Mitsunami Makiko , Manson JoAnn E. , Gaskins Audrey J. , Rich-Edwards Janet W. , Wang Liang , Zhang Cuilin , Chavarro Jorge E. 
Published: September 2023

ImportanceGestational diabetes has been associated with numerous chronic diseases. However, few studies have examined the association of gestational diabetes with long-term mortality risk.ObjectiveTo investigate the associations between gestational diabetes and long-term risks of total and cause-specific mortality.Design, Setting, and ParticipantsThis cohort study analyzed participants of the Nurses’ Health Study II who were followed for 30 years (1989-2019). Participants included US female nurses aged 25 to 42 years who reported at least 1 pregnancy (≥6 months) at 18 years or older across their reproductive life span. Data were analyzed from May 1, 2022, to May 25, 2023.ExposureGestational diabetes across the reproductive life span.Main Outcomes and MeasuresHazard ratios (HRs with 95% CIs) for total and cause-specific mortality were estimated by Cox proportional hazards regression models.ResultsA total of 91 426 parous participants were included, with a mean (SD) age of 34.9 (4.7) years and a body mass index of 24.1 (4.7) at baseline. During a follow-up period of 2 609 753 person-years, 3937 deaths were documented, including 255 deaths from cardiovascular disease and 1397 from cancer. Participants with a history of gestational diabetes had a higher crude mortality rate than those without a history of gestational diabetes (1.74 vs 1.49 per 1000 person-years; absolute difference = 0.25 per 1000 person-years). The corresponding HR for total mortality was 1.28 (95% CI, 1.13-1.44), which did not materially change after additional adjustment for potential confounders and lifestyle factors during the reproductive life span (HR, 1.25; 95% CI, 1.11-1.41). The association persisted regardless of the subsequent development of type 2 diabetes and was more robust among participants who adopted less healthy lifestyles; experienced gestational diabetes in 2 or more pregnancies (HR, 1.48; 95% CI, 0.99-2.19); had gestational diabetes both in the initial and subsequent pregnancies (HR, 1.71; 95% CI, 1.11-2.63); and concurrently reported hypertensive disorders in pregnancy (HR, 1.80; 95% CI, 1.21-2.67), preterm birth (HR, 2.46; 95% CI, 1.66-3.64), or low birth weight (HR, 2.11; 95% CI, 1.21-3.68). Cause-specific mortality analyses revealed that gestational diabetes was directly associated with the risk of mortality due to cardiovascular disease (HR, 1.59; 95% CI, 1.03-2.47). Additionally, gestational diabetes was inversely associated with cancer mortality (HR, 0.76; 95% CI, 0.59-0.98); however, it was only evident among participants who later developed type 2 diabetes.Conclusions and RelevanceResults of this cohort study suggest that participants who reported a history of gestational diabetes exhibited a small but elevated risk of subsequent mortality over 30 years. The findings emphasize the importance of considering gestational diabetes as a critical factor in later-life mortality risk.
Inpatient EHR User Experience and Hospital EHR Safety Performance
Authors: Classen David C. , Longhurst Christopher A. , Davis Taylor , Milstein Julia Adler , Bates David W. 
Published: September 2023

IMPORTANCEDespite the broad adoption and optimization of electronic health record (EHR) systems across the continuum of care, serious usability and safety problems persist.OBJECTIVETo assess whether EHR safety performance is associated with EHR frontline user experience in a national sample of hospitals.DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included all US adult hospitals that used the National Quality Forum Leapfrog Health IT Safety Measure and also used the ARCH Collaborative EHR User experience survey from January 1, 2017, to January 1, 2019. Data analysis was performed from September 2020 to November 2022.MAIN OUTCOMES AND MEASURESThe primary outcomes were hospital performance on the Leapfrog Health IT Safety measure (overall and 10 subcomponents) and the ARCH collaborative frontline user experience scores (overall and 8 subcomponents). Ordinary least squares models with survey responses clustered by hospital were used to assess associations between the overall measures and their subcomponents.RESULTSThere were 112 hospitals and 5689 frontline user surveys included in the study. Hospitals scored a mean of 0.673 (range, 0.297-0.973) on the Leapfrog Health IT safety measure; the mean ARCH EHR user experience score was 3.377 (range, 1 [best] to 5 [worst]). The adjusted β coefficient between the overall safety score and overall user experience score was 0.011 (95% CI, 0.006-0.016). The ARCH overall score was also significantly associated with 10 subcategory scores of the Leapfrog Health IT safety score, and the overall Leapfrog score was associated with the 8 subcategory scores of the ARCH user experience score.CONCLUSIONS AND RELEVANCEThis cross-sectional study found a positive association between frontline user–rated EHR usability and EHR safety performance. This finding suggests that improving EHR usability, which is a current well-known pain point for EHR users, could have direct benefits in terms of improved EHR safety.
Predicting successful clinical candidates for fiducial‐free lung tumor tracking with a deep learning binary classification model
Authors: Lafrenière Matthieu , Valdes Gilmer , Descovich Martina 
Published: September 2023

AbstractObjectivesThe CyberKnife system is a robotic radiosurgery platform that allows the delivery of lung SBRT treatments using fiducial‐free soft‐tissue tracking. However, not all lung cancer patients are eligible for lung tumor tracking. Tumor size, density, and location impact the ability to successfully detect and track a lung lesion in 2D orthogonal X‐ray images. The standard workflow to identify successful candidates for lung tumor tracking is called Lung Optimized Treatment (LOT) simulation, and involves multiple steps from CT acquisition to the execution of the simulation plan on CyberKnife. The aim of the study is to develop a deep learning classification model to predict which patients can be successfully treated with lung tumor tracking, thus circumventing the LOT simulation process.MethodsTarget tracking is achieved by matching orthogonal X‐ray images with a library of digital radiographs reconstructed from the simulation CT scan (DRRs). We developed a deep learning model to create a binary classification of lung lesions as being trackable or untrackable based on tumor template DRR extracted from the CyberKnife system, and tested five different network architectures. The study included a total of 271 images (230 trackable, 41 untrackable) from 129 patients with one or multiple lung lesions. Eighty percent of the images were used for training, 10% for validation, and the remaining 10% for testing.ResultsFor all five convolutional neural networks, the binary classification accuracy reached 100% after training, both in the validation and the test set, without any false classifications.ConclusionsA deep learning model can distinguish features of trackable and untrackable lesions in DRR images, and can predict successful candidates for fiducial‐free lung tumor tracking.
Evidence‐based consensus guidelines for ALS genetic testing and counseling
Authors: Roggenbuck Jennifer , Eubank Breda H. F. , Wright Joshua , Harms Matthew B. , Kolb Stephen J. ,   the ALS Genetic Testing and Counseling Guidelines Expert Panel
Published: September 2023

AbstractObjectiveAdvances in amyotrophic lateral sclerosis (ALS) gene discovery, ongoing gene therapy trials, and patient demand have driven increased use of ALS genetic testing. Despite this progress, the offer of genetic testing to persons with ALS is not yet “standard of care.” Our primary goal is to develop clinical ALS genetic counseling and testing guidelines to improve and standardize genetic counseling and testing practice among neurologists, genetic counselors or any provider caring for persons with ALS.MethodsCore clinical questions were identified and a rapid review performed according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA‐P) 2015 method. Guideline recommendations were drafted and the strength of evidence for each recommendation was assessed by combining two systems: the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) System and the Evaluation of Genomic Applications in Practice and Prevention (EGAPP). A modified Delphi approach was used to reach consensus among a group of content experts for each guideline statement.ResultsA total of 35 guideline statements were developed. In summary, all persons with ALS should be offered single‐step genetic testing, consisting of a C9orf72 assay, along with sequencing of SOD1, FUS, and TARDBP, at a minimum. The key education and genetic risk assessments that should be provided before and after testing are delineated. Specific guidance regarding testing methods and reporting for C9orf72 and other genes is provided for commercial laboratories.InterpretationThese evidence‐based, consensus guidelines will support all stakeholders in the ALS community in navigating benefits and challenges of genetic testing.
Decline in Incidence of Extra‐Articular Manifestations of Rheumatoid Arthritis: A Population‐Based Cohort Study
Authors: Kimbrough Bradly A. , Crowson Cynthia S. , Davis John M. , Matteson Eric L. , Myasoedova Elena 
Published: September 2023

ObjectiveThe focus of this study was to assess changes in the cumulative incidence of extra‐articular manifestations of rheumatoid arthritis (ExRAs) and associated mortality risk.MethodsThis study evaluated trends in occurrence of ExRAs using a population‐based inception cohort that included all adult patients with incident rheumatoid arthritis (RA) from 1985 through 2014 meeting the 1987 American College of Rheumatology criteria. Patients were divided into two cohorts based on the incidence date of RA, 1985 to 1999 and 2000 to 2014. The occurrence of ExRAs was determined by manual chart review, and the 10‐year cumulative incidence was estimated for each ExRA in both cohorts. Cox proportional hazard models were used to determine associations between specific demographic and RA disease characteristics and ExRAs and between ExRAs and mortality.ResultsThere were 907 patients included, 296 in the 1985 to 1999 cohort and 611 in the 2000 to 2014 cohort. The 10‐year cumulative incidence of any ExRA decreased significantly between the earlier and later cohorts (45.1% vs 31.6%, P < 0.001). This was largely driven by significant declines in subcutaneous rheumatoid nodules (30.9% vs 15.8%, P < 0.001) and nonsevere ExRAs (41.4% vs 28.8%, P = 0.001). Identified risk factors for the development of any ExRAs include rheumatoid factor positivity (hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.43–2.86) and current smoking (HR 1.61, 95% CI 1.10–2.34). Mortality was increased in patients with either nonsevere (HR 1.83, 95% CI 1.18–2.85) or severe ExRAs (HR 3.05, 95% CI 1.44–6.49).ConclusionsThe incidence of ExRAs has decreased over time. Mortality remains increased in patients with ExRAs.
Disease Course, Treatments, and Outcomes of Children With Systemic Juvenile Idiopathic Arthritis–Associated Lung Disease
Authors: Huang Yannan , Sompii‐Montgomery Laura , Patti Jessica , Pickering Alex , Yasin Shima , Do Thuy , Baker Elizabeth , Gao Denny , Abdul‐Aziz Rabheh , Behrens Edward M. , Canna Scott , Clark Matthew , Co Dominic O. , Collins Kathleen P. , Eberhard Barbara , Friedman Monica , Graham Thomas B. , Hahn Timothy , Hersh Aimee O. , Hobday Patricia , Holland Michael J. , Huggins Jennifer , Lu Pai‐Yue , Mannion Melissa L. , Manos Cynthia K. , Neely Jessica , Onel Karen , Orandi Amir B. , Ramirez Andrea , Reinhardt Adam , Riskalla Mona , Santiago Laisa , Stoll Matthew L. , Ting Tracy , Grom Alexei A. , Towe Christopher , Schulert Grant S. 
Published: September 2023

ObjectiveSystemic juvenile idiopathic arthritis–associated lung disease (SJIA‐LD) is a life‐threatening disease complication. Key questions remain regarding clinical course and optimal treatment approaches. The objectives of the study were to detail management strategies after SJIA‐LD detection, characterize overall disease courses, and measure long‐term outcomes.MethodsThis was a prospective cohort study. Clinical data were abstracted from the electronic medical record, including current clinical status and changes since diagnosis. Serum biomarkers were determined and correlated with presence of LD.ResultsWe enrolled 41 patients with SJIA‐LD, 85% with at least one episode of macrophage activation syndrome and 41% with adverse reactions to a biologic. Although 93% of patients were alive at last follow‐up (median 2.9 years), 37% progressed to requiring chronic oxygen or other ventilator support, and 65% of patients had abnormal overnight oximetry studies, which changed over time. Eighty‐four percent of patients carried the HLA‐DRB1*15 haplotype, significantly more than patients without LD. Patients with SJIA‐LD also showed markedly elevated serum interleukin‐18 (IL‐18), variable C‐X‐C motif chemokine ligand 9 (CXCL9), and significantly elevated matrix metalloproteinase 7. Treatment strategies showed variable use of anti–IL‐1/6 biologics and addition of other immunomodulatory treatments and lung‐directed therapies. We found a broad range of current clinical status independent of time from diagnosis or continued biologic treatment. Multidomain measures of change showed imaging features were the least likely to improve with time.ConclusionPatients with SJIA‐LD had highly varied courses, with lower mortality than previously reported but frequent hypoxia and requirement for respiratory support. Treatment strategies were highly varied, highlighting an urgent need for focused clinical trials.