bluuebunny/crossref_metadata_2025_split huggingface dataset:
Who is most at risk of dying if infected with SARS-CoV-2? A mortality risk factor analysis using machine learning of patients with COVID-19 over time: a large population-based cohort study in Mexico
Authors: Liao Lauren D , Hubbard Alan E , Gutierrez Juan Pablo , Juárez-Flores Arturo , Kikkawa Kendall , Gupta Ronit , Yarmolich Yana , de Jesús Ascencio-Montiel Iván , Bertozzi Stefano M 
Published: September 2023

ObjectiveCOVID-19 would kill fewer people if health programmes can predict who is at higher risk of mortality because resources can be targeted to protect those people from infection. We predict mortality in a very large population in Mexico with machine learning using demographic variables and pre-existing conditions.DesignCohort study.SettingMarch 2020 to November 2021 in Mexico, nationally represented.Participants1.4 million laboratory-confirmed patients with COVID-19 in Mexico at or over 20 years of age.Primary and secondary outcome measuresAnalysis is performed on data from March 2020 to November 2021 and over three phases: (1) from March to October in 2020, (2) from November 2020 to March 2021 and (3) from April to November 2021. We predict mortality using an ensemble machine learning method, super learner, and independently estimate the adjusted mortality relative risk of each pre-existing condition using targeted maximum likelihood estimation.ResultsSuper learner fit has a high predictive performance (C-statistic: 0.907), where age is the most predictive factor for mortality. After adjusting for demographic factors, renal disease, hypertension, diabetes and obesity are the most impactful pre-existing conditions. Phase analysis shows that the adjusted mortality risk decreased over time while relative risk increased for each pre-existing condition.ConclusionsWhile age is the most important predictor of mortality, younger individuals with hypertension, diabetes and obesity are at comparable mortality risk as individuals who are 20 years older without any of the three conditions. Our model can be continuously updated to identify individuals who should most be protected against infection as the pandemic evolves.
Opportunities to enhance consumer and community engagement training for researchers and healthcare providers: a qualitative study
Authors: Reeder Sandra , Ayton Darshini , Teede Helena J , Skouteris Helen , Simmons Melissa , Jones Angela 
Published: September 2023

ObjectiveTo identify key training content for the education of researchers and healthcare providers in consumer and community engagement.DesignA qualitative descriptive design, underpinned by pragmatism, involved semi-structured interviews and a focus group. We conducted a thematic analysis using a framework approach.SettingCommunity, hospital and university settings in AustraliaParticipantsThis study involved 28 individual interviews with researchers, ethics officers, leaders from consumer organisations and a focus group with six people working in health service settings.ResultsKey findings from our study reveal a wide scope of consumer and community involvement (CCI) training content recommended for researchers and healthcare providers. Four main themes for training content were identified: (1) Embedding consumer and community involvement in research and health improvement projects; (2) Connecting with consumers and the community; (3) Considerations for consumer and community involvement; and (4) Progressing CCI in research and healthcare. Participants emphasised the importance of building foundational relationships with consumers and community, as well as connecting with experts. While how to partner authentically with consumers and the community was another important training topic raised, so too were the administrative considerations involved in CCI partnerships. Furthermore, the identification of training content including reducing duplication of effort, embedding CCI training into the education of healthcare providers and researchers and building an evidence base for CCI, shows the importance participants placed on investing in and advancing the field.ConclusionsA wide scope of training content is required to support CCI capacity building in researchers and healthcare providers. Key training content is recommended to cover practical, relational, administrative, ethical and logistical aspects of CCI as well as guidance about how to advance CCI practice and its evidence base. Future work needs to focus on how the training content can be successfully implemented, evaluated and updated.
Dietary supplements to reduce symptom severity and duration in people with SARS-CoV-2: a double-blind randomised controlled trial
Authors: Seely Dugald , Legacy Mark , Conte Ellen , Keates Caitlyn , Psihogios Athanasios , Ramsay Tim , Fergusson Dean A , Kanji Salmaan , Simmons John-Graydon , Wilson Kumanan 
Published: September 2023

BackgroundCOVID-19 has caused morbidity, hospitalisation and mortality worldwide. Despite effective vaccines, there is still a need for effective treatments, especially for people in the community. Dietary supplements have long been used to treat respiratory infections, and preliminary evidence indicates some may be effective in people with COVID-19. We sought to evaluate whether a combination of vitamin C, vitamin D3, vitamin K2and zinc could improve overall health and decrease symptom burden in outpatients diagnosed with COVID-19.MethodsParticipants were randomised to receive either vitamin C (6 g), vitamin D3(1000 units), vitamin K2(240 μg) and zinc acetate (75 mg) or placebo daily for 21 days and were followed for 12 weeks. An additional loading dose of 50 000 units vitamin D3(or placebo) was given on day one. The primary outcome was participant-reported overall health using the EuroQol Visual Assessment Scale summed over 21 days. Secondary outcomes included health status, symptom severity, symptom duration, delayed return to usual health, frequency of hospitalisation and mortality.Results90 patients (46 control, 44 treatment) were randomised. The study was stopped prematurely due to insufficient capacity for recruitment. The mean difference (control–treatment) in cumulative overall health was −37.4 (95% CI −157.2 to 82.3), p=0.53 on a scale of 0–2100. No clinically or statistically significant differences were seen in any secondary outcomes.InterpretationIn this double-blind, placebo-controlled, randomised trial of outpatients diagnosed with COVID-19, the dietary supplements vitamin C, vitamin D3, vitamin K2and zinc acetate showed no clinically or statistically significant effects on the documented measures of health compared with a placebo when given for 21 days. Termination due to feasibility limited our ability to demonstrate the efficacy of these supplements for COVID-19. Further research is needed to determine clinical utility.Trial registration numberNCT04780061.
Trends and determinants of tobacco use initiation in India: analysis of two rounds of the Global Adult Tobacco Survey
Authors: Verma Madhur , Rana Kirtan , Bhatt Garima , Sharma Nikita , Lal Pranay 
Published: September 2023

ObjectivesEarly initiation of tobacco use can lead to lifelong addiction and increases tobacco-attributable morbidity and mortality. This study assesses trends in tobacco use initiation and factors associated with tobacco use initiation using disaggregated data from two rounds of the Global Adult Tobacco Survey India (GATS; 2009–2010 (GATS 1) and 2016–2017 (GATS 2)).DesignSecondary analysis of repeated cross-sectional studies.Settings and participantsThe study involved data from 69 296 individuals and 76 069 households in GATS 1 and 74 037 individuals and 77 170 households in GATS 2, two rounds of a nationally representative survey in India.Outcome measuresMean age of initiation (as recalled by the participants) of smoked and smokeless tobacco (SLT) use (dependent variable) was compared and analysed across different sociodemographic variables (independent factors). We assessed change in mean age of initiation of tobacco usage on a daily basis between GATS 1 and GATS 2, and investigated the factors associated with early tobacco use initiation in the GATS 2 dataset (reported using adjusted ORs (aORs) with 95% CIs).ResultsThe mean age of initiation of smoked tobacco and SLT in GATS 2 was 20.9±8.5 and 22.3±10.6 years, compared with 18.5±9.7 and 19.7±12.0 years in GATS 1. The mean age of initiation increased with age and among those who were better aware of the adverse effects of tobacco. As per GATS 2, males initiated smoked tobacco and SLT use earlier (20.6±7.4 and 21.7±9.1) than females (23.3±14.2 and 23.2±12.6 years). Younger participants (15–24 years) reported earlier initiation of SLT (15.5±4.2 years) compared with others. Binary logistic regression depicted variables associated with early initiation of tobacco. Awareness about the harms caused by tobacco affected the odds of SLT (aOR 1.4, 95% CI 1.3 to 1.7) and dual usage initiation (1.8, 1.6 to 2.0), but not of initiation of smoked tobacco products (1.1, 0.9 to 1.2).ConclusionsMore robust health advocacy campaigns that communicate the harmful effects of tobacco on health could be useful to delay tobacco initiation, along with reducing the ease of access and affordability of tobacco products among vulnerable groups.
Predictors of compliance with higher dose omega-3 fatty acid supplementation during pregnancy and implications for the risk of prematurity: exploratory analysis of the ORIP randomised trial
Authors: Sullivan Thomas R , Yelland Lisa N , Gibson Robert A , Thakkar Sagar K , Huang Fang , Best Karen P , Devaraj Surabhi , Zolezzi Irma Silva , Makrides Maria 
Published: September 2023

BackgroundIntention-to-treat analyses of the Omega‐3 to Reduce the Incidence of Prematurity (ORIP) trial found that omega-3 (n-3) fatty acid supplementation reduces the risk of prematurity in the subgroup of women with a singleton pregnancy and low n-3 status early in pregnancy, but not overall. However, results may have been influenced by less-than-optimal compliance.ObjectivesTo identify predictors of compliance with n-3 supplementation and determine treatment effects among compliers.DesignExploratory analyses of a multicentre-blinded randomised trial.Setting6 tertiary care centres in Australia.Participants5328 singleton pregnancies.InterventionsDaily capsules containing 900 mg n-3 long-chain polyunsaturated fatty acids or vegetable oil, consumed from before 20 weeks gestation until 34 weeks gestation.Outcome measuresEarly preterm (<34 weeks gestation) and preterm birth (<37 weeks gestation). Women were considered compliant if they reported missing less than a third of their allocated capsules in the previous week during a mid-pregnancy appointment.ResultsAmong 2654 singleton pregnancies in the n-3 intervention group, 1727 (65%) were deemed compliant with supplementation. Maternal characteristics associated with compliance included age, years of full-time education, consuming alcohol but not smoking in the 3 months leading up to pregnancy, fewer previous births and taking dietary supplements at enrolment. Based on complier average causal effects, n-3 supplementation reduced the risk of preterm birth in compliers (relative risk=0.76; 95% CI 0.60 to 0.97), but not early preterm birth (relative risk=0.80; 95% CI 0.44 to 1.46). Consistent with intention-to-treat analyses, the lack of an overall effect on early preterm birth in compliers appeared to be due to beneficial effects in women with low n-3 status at enrolment but not women with replete status.ConclusionsResults in compliers were similar to those from intention-to-treat analyses, suggesting that non-compliance was not a major factor in explaining outcomes from the ORIP trial.Trial registration numberACTRN12613001142729.
Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk
Authors: Kootar Scherazad , Huque Md Hamidul , Kiely Kim M , Anderson Craig S , Jorm Louisa , Kivipelto Miia , Lautenschlager Nicola T , Matthews Fiona , Shaw Jonathan E , Whitmer Rachel A , Peters Ruth , Anstey Kaarin J 
Published: September 2023

IntroductionCurrent efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual’s risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners.Methods and analysisTen high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors’ contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression.Ethics and disseminationEthics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice.
Early findings in a prospective randomised study on three cross-linking treatment protocols: interruption of the iontophoresis treatment protocol
Authors: Gustafsson Ingemar , Ivarsen Anders , Hjortdal Jesper 
Published: September 2023

PurposeTo present the outcome of the interrupted iontophoresis-assisted treatment arm in an ongoing randomised clinical trial (NCT04427956).MethodsA randomised clinical study of corneal cross-linking (CXL) using continuous UV-A irradiation at a rate of 9 mW/cm2and three different types of riboflavin and riboflavin delivery mode: (1) iso-osmolar dextran-based riboflavin (epithelium-off), (2) hypo-osmolar dextran-free riboflavin (epithelium-off) and (3) iontophoresis-assisted delivery of riboflavin (epithelium-on) for the treatment of progressive keratoconus. Inclusion criteria were an increase in the maximum keratometry value (Kmax) of 1.0 dioptre over 12 months or 0.5 dioptre over 6 months. The primary outcome in evaluating treatment efficacy was Kmax. Recently presented stratified detection limits were used post hoc to confirm the enrolment of patients with truly progressive keratoconus and in the assessment of the need for re-CXL.ResultsThirteen patients had been randomised to iontophoresis-assisted CXL when the treatment arm was interrupted; two patients dropped out. Of the remaining 11 patients, 7 were deemed as having truly progressive disease according to the more recent stratified detection limits. The disease continued to progress in three patients according to the original definition (increase in Kmax≥1 D), necessitating re-CXL with epithelium-off CXL. This progression was confirmed by post hoc analysis using the stratified detection limits for progression.ConclusionsThe iontophoresis-assisted CXL protocol failed to halt further disease progression in 27% of the patients. The failure rate increased to 38% when considering only the patients deemed to have truly progressive disease using the stratified detection limits.
Shorter-acting glucagon-like peptide-1 receptor agonists are associated with increased development of gastro-oesophageal reflux disease and its complications in patients with type 2 diabetes mellitus: a population-level retrospective matched cohort study
Authors: Liu Benjamin Douglas , Udemba Sharon C , Liang Katherine , Tarabichi Yasir , Hill Hannah , Fass Ronnie , Song Gengqing 
Published: September 2023

BackgroundShorter half-life glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying (DGE) more than GLP-1 RAs with longer half-lives. DGE is a known risk factor for gastro-oesophageal reflux disease (GERD) and its complications.AimTo determine whether short-acting or long-acting GLP-1 RAs are associated with an increased risk of new GERD or GERD-related complicationsDesignWe used the TriNetX global database to identify adult patients with type 2 diabetes mellitus and generated two cohorts totalling 1 543 351 patients on (1) GLP-1 RA or (2) other second-line diabetes medication. Using propensity-score matching, Kaplan-Meier Analysis and Cox-proportional hazards ratio (HR), we analysed outcomes and separately examined outcomes in patients starting short-acting (≤1 day) and long-acting (≥5 days) GLP-1 RAs.Results177 666 patients were in each propensity-matched cohort. GLP-1 RA exposure was associated with an increased risk (HR 1.15; 95% CI 1.09 to 1.22) of erosive reflux disease (ERD). However, this was solely due to short-acting (HR 1.215; 95% CI 1.111 to 1.328), but not long-acting (HR 0.994; 95% CI 0.924 to 1.069) GLP-1 RA exposure. Short-acting GLP-1 RAs were also associated with increased risk of oesophageal stricture (HR 1.284; 95% CI 1.135 to 1.453), Barrett’s without dysplasia (HR 1.372; 95% CI 1.217 to 1.546) and Barrett’s with dysplasia (HR 1.505; 95% CI 1.164 to 1.946) whereas long-acting GLP-1 RAs were not. This association persisted in sensitivity analyses, and when individually examining the short-acting GLP-1 RAs liraglutide, lixisenatide and exenatide.ConclusionStarting shorter-acting GLP-1 RAs is associated with increased risks of GERD and its complications.
Impact of a newly parametrized deceleration parameter on the accelerating universe and the reconstruction of f(Q) non-metric gravity models
Authors: Naik Devaraja Mallesha , Kavya N. S. , Sudharani L. , Venkatesha V. 
Published: September 2023

AbstractThis article presents a novel parametrization of the deceleration parameter (DP) to investigate the cosmological scenario. The newly proposed parametric form of the DP is both physically plausible and model-independent. Constrained by a combined dataset of 31 cosmic chronometers (CC) data points, 26 non-correlated baryonic acoustic oscillations (BAO) points, and 1701 Pantheon$$+$$
+
data points from supernovae type Ia (SNeIa), we determine the model parameters using a Markov Chain Monte Carlo (MCMC) method. The analysis explores the kinematic behavior of the model, including the transition from deceleration to acceleration. The results indicate that the Universe is currently in an accelerated phase. Furthermore, we apply the obtained parameter values to constrain f(Q) gravity models and compare them with observations. This study provides valuable insights into the accelerating Universe and underscores the importance of employing a model-independent approach in cosmological investigations.
Impact of the returning radiation in current tests of the Kerr black hole hypothesis using X-ray reflection spectroscopy
Authors: Riaz Shafqat , Mirzaev Temurbek , Abdikamalov Askar B. , Bambi Cosimo 
Published: September 2023

AbstractThe past 10 years have seen remarkable progress in our capability of analyzing reflection features in the X-ray spectra of accreting black holes. Today X-ray reflection spectroscopy is a mature technique and a powerful tool for studying the accretion process around black holes, measuring black hole spins, and testing Einstein’s theory of General Relativity in the strong field regime. However, current reflection models still rely on a number of simplifications and caution is necessary when we derive very precise measurements. In this paper, we study the impact of the returning radiation on our capability of measuring the properties of black holes using X-ray reflection spectroscopy, and in particular on our capability of testing the Kerr black hole hypothesis. While the returning radiation alters the reflection spectrum of the disk, from the analysis of our simulations we find that models without returning radiation can normally recover well the correct black hole spin parameters and can test the Kerr metric.
Emergent local structures in an ecosystem of social bots and humans on Twitter
Authors: Alrhmoun Abdullah , Kertész János 
Published: September 2023

AbstractBots in online social networks can be used for good or bad but their presence is unavoidable and will increase in the future. To investigate how the interaction networks of bots and humans evolve, we created six social bots on Twitter with AI language models and let them carry out standard user operations. Three different strategies were implemented for the bots: a trend-targeting strategy (TTS), a keywords-targeting strategy (KTS) and a user-targeting strategy (UTS). We examined the interaction patterns such as targeting users, spreading messages, propagating relationships, and engagement. We focused on the emergent local structures or motifs and found that the strategies of the social bots had a significant impact on them. Motifs resulting from interactions with bots following TTS or KTS are simple and show significant overlap, while those resulting from interactions with UTS-governed bots lead to more complex motifs. These findings provide insights into human-bot interaction patterns in online social networks, and can be used to develop more effective bots for beneficial tasks and to combat malicious actors.
Harnessing Dendritic Cells: Next Frontier for Durable Immune Control in Myeloma
Authors: Dhodapkar Madhav V. 
Published: September 2023

SummaryImmune-based approaches including T-cell redirection have transformed the therapeutic landscape in myeloma. Injection of dendritic cells (DC) led to the induction of immune responses in vaccinated patients with myeloma. These studies pave the way for future combination strategies harnessing DCs to enhance tumor immunity and improve outcomes in myeloma.See related article by Freeman et al., p. 4575
Endothelial Progenitor Cells and Macrophage Subsets Recruitment in Postischemic Mouse Hind Limbs
Authors: Lamin Victor , Mani Arul M , Singh Madhu V , Dokun Ayotunde O. 
Published: September 2023

Introduction: Peripheral arterial disease (PAD) occurs from atherosclerotic obstruction of arteries in the lower extremities. Restoration of perfusion requires angiogenesis and arteriogenesis through migration and differentiation of endothelial progenitor cells (EPCs) and macrophages at the site of injury. The time of recruitment has not been fully investigated. In this study, we investigated the infiltration of these cells in murine hind limb ischemia (HLI) model of PAD. Methods: EPCs and M1-like and M2-like macrophages from ischemic skeletal muscles were quantified by flow cytometry at day-0, 1, 3, 7, and 14 post-HLI. Results: The abundance of EPCs increased from day 1 and was highest on day 7 until day 14. M1-like population similarly increased and was highest on day 14 during the experiment. M2-like population was significantly greater than M1-like at baseline but surpassed the highest value of M1-like by day 7 during the experiment. Muscle regeneration and capillary density also increased and were highest at days 3 and 7, respectively, during the experiment. All mice achieved near full perfusion recovery by day 14. Conclusion: Thus, we observed a gradual increase in the percentage of EPC’s and this was temporally paralleled with initial increase in M1-like followed by sustained increased in M2-like macrophages and perfusion recovered post-HLI.