bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systolic Blood Pressure and Survival to Very Old Age. Results from the Women’s Health Initiative
Authors: Haring Bernhard , Andrews Chris A. , Hovey Kathleen , Shadyab Aladdin H. , LaCroix Andrea , Martin Lisa Warsinger , Rosal Milagros C. , Kuller Lewis H. , Salmoirago-Blotcher Elena , Saquib Nazmus , Koo Patrick , Laddu Deepika , Stefanick Marcia L. , Manson JoAnn E. , Wassertheil-Smoller Sylvia , LaMonte Michael J. 
Published: June 2023

AbstractBackgroundThe association between systolic blood pressure (SBP) and longevity is not fully understood. We aimed to determine survival probabilities to age 90 for various SBP levels among women aged ≥ 65 years with or without BP medication.MethodsWe analyzed blood pressure data from participants in the Women’s Health Initiative (n=16,570) who were aged 65 or older and without history of cardiovascular disease, diabetes or cancer. Blood pressure was measured at baseline (1993-1998) and then annually through 2005. The outcome was defined as survival to age 90 with follow-up until February 28, 2020.ResultsDuring a follow-up of 18 years, 9,723 (59%) of 16,570 women survived to age 90. The SBP associated with the highest probability of survival was about 120mmHg regardless of age. Compared to an SBP between 110 and 130 mmHg, women with uncontrolled SBP had a lower survival probability across all age groups and with or without BP medication. A 65-year-old women on BP medication with an interpolated SBP between 110 and 130 mmHg in 80% of the first 5 years of follow-up had a 31% (95% confidence interval, 24%, 38%) absolute survival probability. For those with 20% time in range, the probability was 21% (95% confidence interval, 16%, 26%).ConclusionsAn SBP level below 130 mmHg was found to be associated with longevity among older women. The longer SBP was controlled at a level between 110 and 130 mmHg, the higher the survival probability to age 90. Preventing age-related rises in SBP and increasing the time with controlled BP levels constitute important measures for achieving longevity.Clinical PerspectiveWhat is new ?The age-related rise in SBP is commonly regarded as inevitable and intensified SBP treatment in older adults is still controversial, as strict BP control in older adults has been related to a higher risk of mortality.Based on a real-world national cohort, an SBP level below 130 mmHg was associated with the highest survival probability to age 90 years in women with or without BP medication.The longer the time women had their SBP controlled at ≥ 110 and <130mmHg, the higher the probability of survival to age 90.What are the clinical implications ?The age-related BP estimates in conjunction with survival probabilities to age 90 presented clearly emphasize the importance of maintaining well-controlled BP levels even at older age.Preventive measures and risk factor control to ensure a constant relatively low SBP pattern during ageing are warranted.
Multi-nutrients as Adjunctive Treatment for Bipolar Disorder: A randomized-controlled trial
Authors: Mehl-Madrona Lewis , McFarlane Patrick 
Published: June 2023

AbstractIntroductionAn open-label trial suggested that a comprehensive micronutrient supplement, Empower Plus Advanced, in combination with Fish Oil, could reduce symptoms in adults with bipolar disorder. A double-blind, randomized, controlled feasibility trial explored the parameters necessary for a large-scale trial.MethodsParticipants (N=69) from a family medicine training clinic with diagnoses of bipolar disorder in the electronic health record were randomized in a 3:2 ratio to Multi-nutrients or Placebo. Diagnoses were confirmed via psychiatric interview or chart review (for obvious cases). The primary outcome measure was change on a composite z-score combining changes on the clinical global impressions scale (CGI), changes on the UKU Side Effects Scale, and changes in medication doses. The GLM repeated measures procedure of SPSS compared continuous outcome measures. Chi-square testing compared responders to non-responders.ResultsData were analyzed for 50 participants. The mean difference of the composite z-score for the primary outcome variables was statistically significant (p = 0.019) and for the composite z-score of all variables (primary and secondary) combined (p = 0.047). In non-parametric chisquare analysis, significantly more in the Nutrient group improved on the CGI (rated 1 or 2) (p = 0.04; OR = 4.0; 52% responders vs. 22% in the Placebo Group). All secondary outcome measures showed nonsignificant trends in the expected direction. Patients in both groups made significant improvement in all measures. The only adverse events occurring more among the Multi-nutrient group were nausea and loose stools, not statistically significant.ConclusionsMulti-nutrients show promise for adjunctive treatment of bipolar disorder. We observed substantial benefits for all patients of closer surveillance, medication adjustment (mostly reduction), and increased human contact. Future studies would benefit from use of a longer lead-in period during which medications can be adjusted and participants can decide if they are willing to take Multi-nutrients for an extended time. Our data suggest that primary care patients with bipolar disorder would fare better on lower medications doses and more frequent visits. Further clinical trials are warranted.
Interim Safety and Immunogenicity of COVID-19 Omicron-BA.1 Variant-Containing Vaccine in Children
Authors: Dixit Avika , Bennett Richard , Ali Kashif , Griffin Carl , Clifford Robert A. , Turner Mark , Poston Rosanne , Hautzinger Kelly , Yeakey Anne , Girard Bethany , Zhou Wen , Deng Weiping , Zhou Honghong , Ghamloush Sabine Schnyder , Kuter Barbara J. , Slobod Karen , Miller Jacqueline M. , Priddy Frances , Das Rituparna ,   the ROVER Study Investigators
Published: June 2023

AbstractObjectivesWe report interim safety and immunogenicity results from a phase 3 study of omicron-BA.1 variant-containing (mRNA-1273.214) primary vaccination series (Part 1) and booster dose (Part 2) in children aged 6 months to 5 years (NCT05436834).MethodsIn Part 1, SARS-CoV-2 unvaccinated participants, including participants who received placebo in the KidCOVE study (NCT04796896), received 2 doses of mRNA-1273.214 (25-μg omicron-BA.1 and ancestral Wuhan-Hu-1 mRNA 1:1 co-formulation) primary series. In Part 2, participants who previously completed the mRNA-1273 (25-µg) primary series in KidCOVE received a mRNA-1273.214 (10-μg) booster dose. Primary objectives were safety, reactogenicity, and immunogenicity, including prespecified immune response success criteria.ResultsAt the data cutoff (December 5, 2022), 179 participants had received ≥1 dose of mRNA-1273.214 primary series (Part 1) and 539 participants had received a mRNA-1273.214 booster dose (Part 2). The safety profile of mRNA-1273.214 primary series and booster dose was consistent with that of the mRNA-1273 primary series in this same age group, with no new safety concerns identified and no vaccine-related serious adverse events observed. Compared with neutralizing antibody responses induced by the mRNA-1273 primary series, both the mRNA-1273.214 primary series and booster elicited responses that were superior against omicron-BA.1 and non-inferior against ancestral Wuhan-Hu-1(D614G).ConclusionsmRNA-1273.214 was immunogenic against BA.1 and D614G in children aged 6 months to 5 years, with a comparable safety profile to mRNA-1273, when given as a 2-dose primary series or as a booster dose after the mRNA-1273 primary series.Clinical Trial RegistryNCT05436834
Path to Medical AGI: Unify Domain-specific Medical LLMs with the Lowest Cost
Authors: Zhou Juexiao , Chen Xiuying , Gao Xin 
Published: June 2023

AbstractMedical artificial general intelligence (AGI) is an emerging field that aims to develop systems specifically designed for medical applications that possess the ability to understand, learn, and apply knowledge across a wide range of tasks and domains. Large language models (LLMs) represent a significant step towards AGI. However, training cross-domain LLMs in the medical field poses significant challenges primarily attributed to the requirement of collecting data from diverse domains. This task becomes particularly difficult due to privacy restrictions and the scarcity of publicly available medical datasets. Here, we propose Medical AGI (MedAGI), a paradigm to unify domain-specific medical LLMs with the lowest cost, and suggest a possible path to achieve medical AGI. With an increasing number of domain-specific professional multimodal LLMs in the medical field being developed, MedAGI is designed to automatically select appropriate medical models by analyzing users’ questions with our novel adaptive expert selection algorithm. It offers a unified approach to existing LLMs in the medical field, eliminating the need for retraining regardless of the introduction of new models. This characteristic renders it a future-proof solution in the dynamically advancing medical domain. To showcase the resilience of MedAGI, we conducted an evaluation across three distinct medical domains: dermatology diagnosis, X-ray diagnosis, and analysis of pathology pictures. The results demonstrated that MedAGI exhibited remarkable versatility and scalability, delivering exceptional performance across diverse domains. Our code is publicly available to facilitate further research athttps://github.com/JoshuaChou2018/MedAGI.
HOW HEALTHCARE EXPENDITURES AFFECT COVID-19 FATALITY RATE ACROSS EUROPEAN COUNTRIES?
Authors: Coccia Mario , Benati Igor 
Published: June 2023

AbstractThe goal of this study is to examine the relationship between healthcare expenditures and health capacity, and variability in COVID-19 case fatality rate between European countries. In particular, the purpose of the present study is to see whether statistical evidence supports the hypothesis that the reduction of COVID-19 fatality, between European countries, can be explained by leveraging health expenditures and if so to form some quantitative analyses and estimates of the relation between health expenditures and COVID-19 fatality rate between countries. The research is based on a sample of European countries and data from various sources, including Eurostat, World Bank, and OECD databases. Results suggest that countries with higher COVID-19 fatality rate in 2020 (when pandemic starts) in comparison to countries with lower COVID-19 fatality had (higher) +50.5% of fatality in 2020, +52.9% in 2022, lower health expenditure as % of GDP −5.5%, health expenditure per capita −34.5%, R&D expenditures in health −30.3%, lower reduction of COVID-19 fatality from 2022-2022 by −57.2 % vs 59.3% of the other group. Results also show a negative association between COVID-19 Fatality in 2022 and Health expenditure as a share of GDP 2020 (r=−0.42,p-value 0.05); COVID-19 Fatality in 2022 and Vaccinations in December 2021 (r=−0.75,p-value 0.01). Difference of COVID-19 Fatality 22-20 has also negative correlation coefficients given byr=−0.48 (p-value 0.05) with Health expenditure as a share of GDP of 2020 and byr=−0.52 (p-value 0.01) with vaccinations in December 2021. Partial correlation, controlling population over 65yo in 2020, confirms previous results. The contribution here expands the knowledge in these research topics by endeavoring to clarifyhowhigher health expenditures improve the preparedness and resilience in crisis management of countries to face unforeseen epidemic or pandemic similar to COVID-19 in society.
Creation of a Shortened Version of the of the Sleep Disorders Questionnaire (SDQ)
Authors: Biard Kathleen , Koninck Joseph De , Douglass Alan B. 
Published: June 2023

AbstractThe 176-item Sleep Disorders Questionnaire (SDQ) was initially developed using canonical discriminant function analysis on 4 groups of sleep disorder patients, but it was never studied by factor analysis in its entirety. Several authors have criticized 2 of its subscales as being confounded with each other, and its narcolepsy scale as substantially over-diagnosing narcolepsy. This study describes its first exploratory factor analysis (EFA), the intent of which was to reassess item membership on the 4 existing subscales and to derive new scales to improve differential diagnosis between patient groups. It was also hoped that EFA could reduce the total number of questions, to increase speed of completion. The EFA was performed on the anonymized SDQ results from a retrospective review of the charts of 2131 persons from 7 sleep disorders clinics and research centers. Factors were assessed via scree plots and eigenvalues. The EFA identified four main factors: insomnia, daytime sleepiness, substance use, and sleep-disordered breathing. The insomnia factor had 3 subfactors: psychological symptoms of insomnia, subjective description of insomnia, and insomnia due to periodic limb movements. The sleepiness factor had two subfactors: daytime sleepiness and neurological symptoms of narcolepsy. The novel substance use factor was homogeneous, as was the sleep-disordered breathing factor. Importantly, the EFA reassigned items from the original SDQ’s NAR, PSY, and PLM subscales to five of the new subscales. The Sleep Apnea (SA) subscale emerged mostly unchanged. The 7 resulting factors comprised only 66 items of the original 176-item SDQ. These results have allowed the creation of a new shorter questionnaire, to be called the SDQ-2. External validation of the SDQ-2 is currently underway. It will likely prove to be a superior differential diagnostic instrument for sleep disorders clinics, compared to the original SDQ.
The Greek version of the Richards-Campbell Sleep Questionnaire: Reliability and validity assessment
Authors: Sampani Christina-Athanasia , Charalampopoulos Marios , Triantafyllaki Panagiota , Triantafyllou Christos , Papageorgiou Dimitrios 
Published: June 2023

AbstractAimTo translate the RCSQ into Greek and to determine the reliability and validity of the Greek version of the RCSQ as a measure of sleep among ICU patients in a Greek hospital.MethodsThis study investigated the night-time sleep of 50 patients admitted to the general ICU of General Hospital of Athens “G. Gennimatas” between January 2022– March 2023.The RCSQ questionnaire was used for the present study with the written permission of its author. All guidelines for translating and adapting psychometric scales were followed for translating the RCSQ into Greek. Demographic-clinical characteristics (sex, age, days in hospital, days on mechanical ventilation, days on spontaneous breathing, whether they underwent tracheotomy and the type of tracheotomy, and whether they received a mild sedation formulation to promote sleep) were collected from the participants. Reliability was tested using Cronbach’s alpha coefficient.ResultsThe Cronbach’s correlation coefficientαwas calculated 0.906 revealing excellent reliability of the RCSQ. No question removal significantly increased the coefficient value.ConclusionThe Greek version of the Richards-Campbell Sleep Questionnaire could be used as an alternative to polysomnography when assessing sleep quality in intensive care unit patients.
Mapping out the higher education curricula to locate pre-service teachers training in health education: the case for critical pedagogy
Authors: Soultatou Pelagia , Athanasiou Kyriacos , Bagos Pantelis G 
Published: June 2023

WITHDRAWAL STATEMENTThe authors have withdrawn their manuscript owing to several errors discovered in the manuscript regarding analyses and also language use. Also the Tables have been missing from the manuscript. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
‘Giving birth is like going to war’:Obstetric violence in public maternity centers in Niger
Authors: Alio Amina P. , Garba Rahmatou M. , Mittal Mona , McCormick Anna P. , Mahamane Moha 
Published: June 2023

AbstractObstetric violence has been recognized as a significant risk factor for maternal morbidity and mortality globally. However, there is lack of literature on the abuse of birthing women and their maternal rights in formal healthcare settings in Niger. This paper explores women’s experiences of violence in public maternity care in Niger to identify drivers, facilitators, manifestations, and consequences of the maltreatment of women during labor and delivery. We qualitatively explored the experiences of women who gave birth in a public maternity hospital or clinic within the 5 years preceding the study. We conducted five key informant interviews to help inform recruitment and interview protocols, a listening session with eight mothers, and individual interviews with 50 women from four areas of the urban region of Niamey. The 58 participating mothers shared experiences that included physical abuse (slapping), verbal abuse (insults), psychological abuse (mockery), discrimination (social status/ economic status), financial coercion (demanding money prior to care), and harmful birthing practices (forcing the baby out with elbows). Socio-cultural aspects driving maltreatment of women included beliefs about expression of pain during labor and delivery, while social connection and the presence of the physician during delivery were protective factors. Our study findings reflect global concerns about obstetric violence and its consequences. Given the high burden of maternal and infant morbidity and mortality in Niger, it is critical to train clinical staff in safe and respectful maternity care, to improve supervision of care, to institute legal recourse for women, and to consider the integration of traditional birth attendants in clinical settings.
Assessment of Ultra Processed Foods consumption in Senegal: Validation of the Nova-UPF screener
Authors: Kébé Saliou Diombo , Diouf Adama , Sylla Papa Mamadou Dit Doudou , Kane Kalidou , Costa Caroline dos Santos , Leite Fernanda Helena Marrocos , Andrade Giovanna Calixto , Badiane Abdou , Moubarac Jean-Claude , Idohou-Dossou Nicole , Monteiro Carlos Augusto 
Published: June 2023

AbstractBackgroundUltra-processed foods (UPF), as proposed by the Nova food classification system, are linked to the development of obesity and several non-communicable chronic diseases and deaths from all causes. The Nova-UPF screener developed in Brazil is a simple and quick tool to assess and monitor the consumption of these food products. The aim of this study was to adapt and validate, against the 24-hour dietary recall, this short food-based screener to assess UPF consumption in the Senegalese context.MethodsThe tool adaptation was undertaken using DELPHI methodology with national experts and data from a food market survey. The validation study was conducted in the urban area of Dakar in a sample of 301 adults, using as a reference the dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake obtained via 24-hour recall. Association between the Nova-UPF score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants’ classification according to quintiles of Nova-UPF score and quintiles of the dietary share of UPF.ResultsThe results show a direct association (p-value<0.001) between intervals of the Nova- UPF score and the average dietary share of UPF. There was a near perfect agreement in the distribution of individuals according to score’s quintiles and UPF dietary share quintiles (Pabak index = 0.84).ConclusionThe study concluded that the score provided by the Nova-UPF screener adapted to the Senegalese context is a valid estimate of UPF consumption.
Distinct Neurodevelopmental Patterns and Intermediate Integration-Based Predictive Modeling in Autism Spectral Disorder
Authors: Wang Yanlin , Ma Shiqiang , Ma Ruimin , Xiao Linxia , Tang Shi , Wei Yanjie , Pan Yi 
Published: June 2023

ABSTRACTAutism Spectrum Disorder (ASD) is known to exhibit a more rapid expansion in brain structure during the early years of life compared to typically developing children (TD). This is of utmost importance in understanding atypical brain development and forecasting the onset of ASD. However, the precise age-related cortical changes (trajectories) that could pinpoint atypical brain development in ASD remain largely unknown. In this study, we characterize the distinct developmental patterns of cortical morphology in individuals with ASD, investigate the important neural biomarkers for ASD diagnostics, and propose a deep-learning workflow that combined graph convolutional networks with low-rank multi-model tensor fusion (LMFGCN) for ASD prediction. Our findings reveal that the constituents of gray matter volume (GV), cortical thickness (CT), and surface area (SA) exhibit separable developmental trajectories in ASD. Furthermore, we identify regional differences in CT and SA that underscore the separable brain developmental trajectories, both of which contribute to changes in GV. Our study also demonstrates that LMFGCN, an end-to-end deep-learning model with intermediate integrative approach, outperforms early and late integration methods and other state-of-the-art models in ASD classification. Overall, our results highlight the importance of distinguishing between cortical SA and CT for understanding ASD pathobiology, particularly during the early brain overgrowth period, and demonstrate the potential utility of LMFGCN in ASD classification.
Elevated concentrations of polymyxin B elicit a biofilm-specific resistance mechanism inVibrio cholerae
Authors: Pauzé-Foixet Julien , Duperthuy Marylise 
Published: June 2023

AbstractVibrio choleraecan form biofilms both in the aquatic environment and in the human intestine, facilitating the release of hyper-infectious aggregates. Due to the increasing antibiotic resistance that impedes treatment of infections, alternatives need to be found. One of these alternatives is antimicrobial peptides, including polymyxin B (PmB), which is already used to treat infections caused by antibiotic-resistant bacteria. In this study, we first investigated the resistance ofV. choleraeO1 El Tor strain A1552 to various antimicrobials under aerobic and anaerobic conditions. An increased resistance to PmB is observed in anaerobiosis, with a 3-fold increase in the dose required for 50% growth inhibition. We then studied the impact of the PmB on the formation and the degradation ofV. choleraebiofilms to PmB. Our results show that PmB affects more efficiently biofilm formation under anaerobic conditions. On the other hand, preformed biofilms are susceptible to degradation by PmB at concentrations close to the minimum inhibitory concentration (MIC), resulting in approximately 50% reduction of the biomass. At higher concentrations, we observed less degradation and an opacification of the biofilm structures within 20 minutes post-treatment, suggesting a densification of the structure. This densification does not seem to result from the overexpression of matrix genes but rather from the release of DNA through cellular lysis, forming a protective shield that limits the penetration of the PmB into the biofilm.ImportanceVibrio choleraeis an intestinal pathogen capable of forming biofilms and resisting antimicrobials both in the aquatic environment and during infection. Understanding and determining the resistance ofV. choleraeto antimicrobials during the infection is crucial to improve patient care. During the infection and in the aquatic environment,V. choleraeform biofilms, structures that are known for their significance in antimicrobial resistance. In this study, we investigated the antimicrobial resistance ofV. choleraein both aerobic and anaerobic conditions, in their planktonic and biofilm forms. The major finding of this study is the identification of a resistance mechanism specific to elevated concentrations of polymyxin B, a last-resort antimicrobial used in the treatment of infections caused by multidrug-resistant Gram-negative bacteria. This resistance mechanism likely involves the lysis of bacterial cells on the surface of the biofilm, resulting in the release of DNA that provides a protective shield against PmB for bacteria within the biofilm matrix.