bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysbiosis of Gut microbiota in patients with Large-Artery Atherosclerotic Stroke: a pilot study
Authors: Samuthpongtorn Chatpol , Saraya Abhinbhen W. , Joyjinda Yutthana , Rodpan Apaporn , Suwanwela Nijasri C. 
Published: March 2023

AbstractIntroductionIncreasing data demonstrate an association between gut microbiome in brain diseases via the gut-brain axis. However, few studies have evaluated the association between gut microbiome and large-artery atherosclerotic ischemic stroke patients.MethodA cross-sectional pilot study was conducted among 15 patients with large-artery atherosclerotic ischemic stroke and 15 asymptomatic persons. Large-artery atherosclerotic stroke were diagnosed using TOAST classification. The control group was selected based on age- and sex-match with the patient group. Participants provided a stool sample profiled by 16S-ribosomal gene-specific methods Next-generation sequencing. The Mann-Whitney U test was used to compare the differences in gut microbiota profile between stroke and control groups. Alpha (Shannon diversity index) and beta diversity (Bray-Curtis dissimilarity) were used to evaluate gut microbial diversity. Generalized linear mixed effects models were used to relate gut microbial genus and stroke which were adjusted for age, BMI, underlying disease (diabetes, hypertension and dyslipidemia), and alcohol use.ResultThe average age of stroke patients was 61.1±7.1 and 59.2±8.2 in the control group. Beta-diversity (Bray-Curtis dissimilarity) of the gut microbiome was statistically significant in order, family and genus level (P-value=0.017, 0.011 and 0.003, respectively) between stroke and control groups; however, there was no statistically significant difference in alpha-diversity (Shannon diversity index; P-value=0.852). The relative abundance ofClass Bacteriodiaincreased in stroke group. Using generalized linear mix effect model, we found 6 genera was significantly associated with stroke after multivariate adjustment.Ruminococcus spp.(P-value=0.017),Streptococcus spp.(P-value=0.019),Actinomyces spp.(P-value=0.02) andDorea spp.(P-value=0.021) showed positive association whileBifidobacterium spp.(P-value=0.04) andFaecalibacterium spp.(P-value=0.041) showed negatively association with stroke.ConclusionPatients with large-artery atherosclerotic stroke had a decreased microbiome beta-diversity and certain gut microbiota genera may be related to large-artery atherosclerotic stroke. Future implications of this study could include the development of targeted interventions to modulate gut microbiota in order to improve outcomes for patients with large-artery atherosclerotic stroke.
CESCProg: A COMPACT PROGNOSTIC MODEL AND NOMOGRAM FOR CERVICAL CANCER BASED ON miRNA BIOMARKERS
Authors: Muthamilselvan Sangeetha , Palaniappan Ashok 
Published: March 2023

ABSTRACTCervical squamous cell carcinoma, more commonly cervical cancer, is the fourth common cancer among women worldwide with substantial burden of disease, and less-invasive, reliable and effective methods for its prognosis are necessary today. Micro-RNAs are increasingly recognized as viable alternative biomarkers for direct diagnosis and prognosis of disease conditions, including various cancers. In this work, we addressed the problem of systematically developing an miRNA-based nomogram for the reliable prognosis of cervical cancer. Towards this, we preprocessed public-domain miRNA -omics data from cervical cancer patients, and applied a cascade of filters in the following sequence: (i) differential expression criteria with respect to controls; (ii) significance with univariate survival analysis; (iii) passage through dimensionality reduction algorithms; and (iv) stepwise backward selection with multivariate Cox modeling. This workflow yielded a compact prognostic DEmiR signature of three miRNAs, namely hsa-miR-625-5p, hs-miR-95-3p, and hsa-miR-330-3p, which were used to construct a risk-score model for the classification of cervical cancer patients into high-risk and low-risk groups. The risk-score model was subjected to blind validation on an unseen test dataset, yielding a one-year AUROC of 0.84 and five-year AUROC of 0.71. The model was validated with an out-of-domain, external dataset yielding significantly worse prognosis for high-risk patients. The risk-score was combined with significant features of the clinical profile to establish a validated predictive prognostic nomogram. Both the miRNA-based risk score model and the integrated nomogram are freely available for academic and not-for-profit use at CESCProg, a web-app (https://apalania.shinyapps.io/cescprog).
CD4+T cell mitochondrial genotype in Multiple Sclerosis: a cross-sectional and longitudinal analysis
Authors: Cortes-Figueiredo Filipe , Asseyer Susanna , Chien Claudia , Zimmermann Hanna G. , Ruprecht Klemens , Schmitz-Hübsch Tanja , Bellmann-Strobl Judith , Paul Friedemann , Morais Vanessa A. 
Published: March 2023

2.AbstractMultiple Sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS), with a largely unknown etiology, where mitochondrial dysfunction significantly contributes to neuroaxonal loss and brain atrophy. Mirroring the CNS, peripheral immune cells from patients with MS, particularly CD4+T cells, show inappropriate mitochondrial phenotypes and/or oxidative phosphorylation (OxPhos) insufficiency, with a still unknown contribution of mitochondrial DNA (mtDNA). We hypothesized that mitochondrial genotype in CD4+T cells might influence MS disease activity and progression.Thus, we performed a retrospective cross-sectional and longitudinal study on patients with a recent diagnosis of either Clinically Isolated Syndrome (CIS) or Relapsing-Remitting MS (RRMS) at two timepoints: six months (VIS1) and 36 months (VIS2) after disease onset. Our primary outcomes were the differences in mtDNA extracted from CD4+T cells between: (I) patients with CIS/RRMS (PwMS) at VIS1 and age- and sex-matched healthy controls (HC), in the cross-sectional analysis, and (II) different diagnostic evolutions in PwMS from VIS1 to VIS2, in the longitudinal analysis.We successfully performed mtDNA whole genome sequencing (WGS) (mean coverage: 2055.77 reads/base pair) in 183 samples (61 triplets). Nonetheless, mitochondrial genotype was not associated with a diagnostic of CIS/RRMS, nor with longitudinal diagnostic evolution.
What are the priority needs for those caring for children and young people with complex neurodisability within an ethnically diverse UK context? - The feasibility phase of the ENCOMPASS study
Authors: Prest Kirsten , Wilson Emma , Vassiliadou Io , Ali Sayeeda , Lakhanpaul Monica , Morris Christopher , Tann Cally , Harniess Phillip , Lewis-Jackson Sasha , Kuper Hannah , Heys Michelle 
Published: March 2023

AbstractBackgroundChildren and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges which require complex packages of multidisciplinary care. Cerebral palsy, an exemplar complex neurodisability condition, is the most common cause of serious physical disabilities among children globally. It is unclear the best way to meet the emotional, social, practical, and empowerment needs of CYP with complex neurodisability and their caregivers. The aim of this study was to determine the needs and priorities of those caring for CYP with complex neurodisability. This forms part of the feasibility phase of a wider study (ENCOMPASS) which aims to adapt the ‘Baby Ubuntu’ intervention, a participatory caregiver programme for families of CYP with complex neurodisability, to an ethnically diverse urban UK context.MethodsTwo rounds of semi-structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six healthcare professionals from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open-ended questions to explore caregiving trajectories, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data-driven inductive thematic analysis.ResultsThree themes were identified that related to the aim of understanding caregivers’ experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) A Thirst for Knowledge and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate.ConclusionsThe delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP.
Sleep features and long-term incident neurodegeneration: a polysomnographic study
Authors: Ibrahim Abubaker , Cesari Matteo , Heidbreder Anna , Defrancesco Michaela , Brandauer Elisabeth , Seppi Klaus , Kiechl Stefan , Högl Birgit , Stefani Ambra 
Published: March 2023

AbstractWhile a growing body of studies suggests a link between sleep disturbances and neurodegenerative diseases’ (NDDs) development, prior studies have been hindered by small sample sizes, short follow-up times and a lack of objective sleep measures.In this cohort study, patients who underwent polysomnography (PSG) at the Innsbruck Sleep Disorders Unit from January 2004 to December 2007, aged ≥18 years, without NDDs at baseline or within five years post PSG, and with at least five years clinical follow-up were included. The main outcome measure was NDDs diagnosis at least five years after polysomnography, assessed until December 2021.Of 1454 patients assessed for eligibility, 999 (68.7%) met inclusion criteria (683 (68.3%) men; median age 54.9 (interquartile range, IQR 33.9-62.7) years. Seventy-five patients (7.5%) developed NDDs, 924 (92.5%) remained disease-free after 12.8 (IQR 9.9-14.6) years median follow-up. After adjusting for demographic, sleep, and clinical covariates, each percent decrease in sleep efficiency, N3 sleep, or REM sleep was associated with 1.9%, 6.5%, and 5.2% increased risk of incident NDDs (hazard ratio, HR, 1.019, CI:1.002-1.035; HR 1.065, CI:1.007-1.118; HR 1.052, CI:1.012-1.085,), respectively whereas one percent decrease in night-time wakefulness represented a 2.2% reduced risk (HR 0.978, CI:0.958-0.997). Random forest analysis identified wake, followed by N3 and REM sleep percentages, as the most important feature associated with NDDs development. Additionally, multiple sleep features combination offered more robust discrimination of incident NDDs compared to single sleep stages.These findings support contribution of sleep architecture changes to NDDs pathogenesis and provide insights into the temporal window during which these changes are detectable, pointing to sleep as early NDDs marker and potential target of neuroprotective strategies.
Association between maternal high-risk fertility behaviour and perinatal mortality in Bangladesh: evidence from the Demographic and Health Survey
Authors: Khan Md Nuruzzaman , Harris Melissa L. 
Published: March 2023

AbstractBackgroundHigh risk fertility behaviours including pregnancy early or late in the reproductive life course, higher parity and short birth intervals are ongoing concerns in Low- and Middle-Income Countries (LMICs) such as Bangladesh. Although such factors have been identified as major risk factors for perinatal mortality, there has been a lack of progress in the area despite the implementation of the Millennium and Sustatinable Development Goals. We therefore explored the effects of high risk maternal fertility behaviour on the occurrence of perinatal mortality in Bangladesh.MethodsA total of 8,930 singleton pregnancies of seven or more months gestation were extracted from 2017/18 Bangladesh Demographic and Health Survey for analysis. Perinatal mortality was the outcome variable (yes, no) and the primary exposure variable was high-risk fertility behaviour in the previous five years (yes, no). The association between the exposure and outcome variable was determined using a mixed-effect multilevel logistic regression model, adjusted for covariates.ResultsForty-six percent of the total births that occurred in the five years preceding the survey were high-risk. After adjusting for potential confounders, a 1.87 times (aOR, 1.87, 95% CI, 1.61-2.14) higher odds of perinatal mortality was found among women with any high-risk fertility behaviour as compared to women having no high-risk fertility behaviours. The odds of perinatal mortality were also found to increase in line with an increasing number of high-risk behaviour. A 1.77 times (95% CI, 1.50-2.05) increase in odds of perinatal mortality was found among women with single high-risk fertility behaviour and a 2.30 times (95% CI, 1.96-2.64) increase in odds was found among women with multiple high-risk fertility behaviours compared to women with no high-risk fertility behaviour.ConclusionWomen’s high-risk fertility behaviour is an important predictor of perinatal mortality in Bangladesh. Increased contraceptive use to allow appropriate birth spacing, educational interventions around the potential risks associated with high risk fertility behaviour (including short birth interval) in future pregnacies, and improved continuity of maternal healthcare service use among this population are required to improve birth outcomes in Bangladesh.
Epigenetic clock acceleration is linked to earlier onset and phenoconversion age in REM sleep behavior disorder
Authors: Senkevich Konstantin , Pelletier Amélie , Sato Christine , Keil Allison , Gan-Or Ziv , Lang Anthony E. , Postuma Ronald , Rogaeva Ekaterina 
Published: March 2023

AbstractRapid-eye movement sleep behavior disorder (RBD) is the strongest prodromal marker for α-synucleinopathies. The Horvath DNA-methylation-age (DNAm-age) is an epigenetic clock that could reflect biological aging. We evaluated whether RBD age-at-onset/phenoconversion are associated with DNAm-age-acceleration in 162 RBD patients. We found an association of DNAm-age-acceleration with RBD age-at-onset at baseline (P=2.59e-08) and at follow-up (N=45; P=9.73e-06). RBD patients with faster aging had 4.6 years earlier onset than patients with slow/normal aging. Similarly, earlier age-at-phenoconversion was associated with DNAm-age-acceleration (N=53; P=1.26e-04). We demonstrated that epigenetic clock acceleration is linked with an earlier RBD age-at-onset and, hence with earlier phenoconversion.
Role of non-classical monocytes in HIV-associated vascular cognitive impairment
Authors: Singh Meera V , Uddin Md Nasir , Vidalle Mae Covacevich , Sutton Karli R. , Boodoo Zachary D. , Peterson Angelique N. , Tyrell Alicia , Brenner Raeann , Tivarus Madalina E , Wang Henry Z. , Sahin Bogachan , Zhong Jianhui , Weber Miriam , Wang Lu , Qiu Xing , Maggiwar Sanjay B. , Schifitto Giovanni 
Published: March 2023

ABSTRACTDespite antiretroviral treatment (cART), people living with HIV (PLWH) are more susceptible to neurocognitive impairment (NCI), probably due to synergistic/additive contribution of traditional cerebrovascular risk factors. Specifically, altered blood brain barrier (BBB) and transmigration of inflammatory monocytes are risk factors for developing cerebral small vessel disease (CSVD). In order to investigate if inflammatory monocytes exacerbate CSVD and cognitive impairment, 110 PLWH on cART and 110 age-, sex- and Reynold’s cardiovascular risk score-matched uninfected individuals were enrolled. Neuropsychological testing, brain magnetic resonance imaging and whole blood analyses to measure platelet-monocyte interaction and monocyte, endothelial activation were performed. Results demonstrated that PLWH exhibited increased levels of platelet-monocyte complexes (PMCs) and higher expression of activation molecules on PMCs. PLWH with CSVD had the poorest cognitive performance and the highest circulating levels of non-classical monocytes which exhibited significant inverse correlation with each other. Furthermore, markers of monocyte and endothelium activation were significantly positively correlated indicating BBB impairment. Our results confirm that interaction with platelets activates and drives monocytes towards an inflammatory phenotype in PLWH. In particular, elevated levels of non-classical monocytes may represent a common pathway to neuroinflammation, CSVD and subsequent cognitive impairment, warranting further longitudinal studies to evaluate responsiveness of this potential biomarker.
Bacterial Isolates and their Sensitivity Profile from CSF Samples – A 5 Year Study at a Tertiary Care Hospital
Authors: Ali Muhammad Moaaz , Kaleem Fatima , Farwa Umme , Ali Haider , Ishtiaq Saima , Javed Samina , Syed Saima , Abbasi Shahid Ahmad 
Published: March 2023

AbstractThe death rates of medical situations like bacterial meningitis are always quite high. Cerebrospinal fluid (CSF) culture is the most common and reliable test to confirm the diagnosis of bacterial meningitis. All CSF samples that were received in the microbiology lab between January 2017 and December 2021 were included in the study. The study removed all duplicate samples and samples from patients who had recently started taking antibiotics. During the course of the trial, 2000 CSF samples were received. Just 157 of these samples successfully tested positive for the presence of infections. The results of the current investigation showed that the typical pathogens associated with meningitis were not isolated from CSF samples in our method. In contrast, in our setups, highly resistant microorganisms were isolated from CSF. primarily from patients with ventriculoperitoneal shunts.
PRERISK: A Personalized, daily and AI-based stroke recurrence predictor for patient awareness and treatment compliance
Authors: Colangelo Giorgio , Ribo Marc , Montiel Estefania , Dominguez Didier , Olive Marta , Muchada Marian , Garcia-Tornel Alvaro , Requena Manuel , Pagola Jorge , Juega Jesus , Rodriguez-Luna David , Rodriguez-Villatoro Noelia , Rizzo Federica , Taborda Belen , Molina Carlos A. , Rubiera Marta 
Published: March 2023

ABSTRACTBACKGROUNDThe risk prediction of stroke recurrence for individual patients is a difficult task. Individualised prediction may enhance stroke survivors selfcare engagement. We have developed PRERISK: a statistical and Machine Learning (ML) classifier to predict individual stroke recurrence risk.METHODSWe analysed clinical and socioeconomic data from a prospectively collected public healthcare-based dataset of 44623 patients admitted with stroke diagnosis in 88 public hospitals over 6 years in Catalonia-Spain. We trained several supervised-ML models to provide individualised risk along time and compared them with a Cox regression model.RESULTSOverall, 16% of patients presented a stroke recurrence along a median follow-up of 2.65 years. Models were trained for predicting early, late and long-term recurrence risk, within 90, 91-365 and >365 days, respectively. Most powerful predictors of stroke recurrence were time since index stroke, Barthel index, atrial fibrillation, dyslipidemia, haemoglobin and body mass index, which were used to create a simplified model with similar performance. The balanced AUROC were 0.77 (±0.01), 0.61 (±0.01) and 0.71 (±0.01) for early, late and long-term recurrence risk respectively (Cox risk class probability: 0.74(±0.01), 0.59(±0.01) and 0.68(±0.01), c-index 0.88). Overall, the ML approach showed statistically significant improvement over the Cox model. Stroke recurrence curves can be simulated for each patient under different degrees of control of modifiable factors.CONCLUSIONPRERISK represents a novel approach that provides continuous, personalised and fairly accurate risk prediction of stroke recurrence along time according to the degree of modifiable risk factors control.CLINICAL PERSPECTIVEWhat is new?Stroke recurrence is frequent after stroke despite advances in stroke treatments, and it is difficult to predict the individual risk of one patient.We have created PRERISK, a predictive model based on machine learning (ML) which provides individualised information of the probability of stroke recurrence and can be re-calculated according to risk factors control.What are the clinical implications?PRERISK information can be used as feedback for secondary prevention strategies and enhance patient engagement and treatment compliance.It could be scalable to optimise ML-based prevention strategies in other chronic conditions.
Facility-based and virtual cardiac rehabilitation in young patients with heart disease during the COVID-19 era
Authors: Aronoff Elizabeth B. , Chin Clifford , Opotowsky Alexander R. , Mays Wayne A. , Knecht Sandra K. , Goessling Jennah E. , Rice Malloree C. , Shertzer Justine , Wittekind Samuel G. , Powell Adam W. 
Published: March 2023

AbstractBackgroundCardiac rehabilitation (CR) is an important tool for improving fitness and quality of life in those with heart disease (HD). Few pediatric centers use CR to care for these patients, and virtual CR is rarely used. Additionally, it is unclear how the COVID-19 era has changed CR outcomes.ObjectivesThis study assessed fitness improvements in young HD patients participating in both facility-based and virtual CR during the COVID-19 pandemic.MethodsThis retrospective single-center cohort study included new patients who completed CR from March 2020 through July 2022. CR outcomes included physical, performance, and psychosocial measures. Comparison between serial testing was performed with a paired t-test with P<0.05 was considered significant. Data are reported as mean±standard deviation.ResultsThere were 47 patients (19±7.3 years-old; 49% male) who completed CR. Improvements were seen in peak oxygen consumption (VO2, 62.3±16.1 v 71±18.2% of predicted, p=0.0007), 6-minute walk (6MW) distance (401±163.8 v 480.7±119.2 meters, p=<0.0001), sit to stand (16.2±4.9 v 22.1±6.6 repetitions; p=<0.0001), Patient Health Questionnaire-9 (PHQ-9) (5.9±4.3 v 4.4±4.2; p=0.002), and Physical Component Score (39.9±10.1 v 44.9±8.8; p=0.002). Facility-based CR enrollees were less likely to complete CR than virtual patients (60%, 33/55 v 80%, 12/15; p=0.005). Increases in peak VO2(60±15.3 v 70.2±17.8 % of predicted; p=0.002) were seen among those that completed facility-based CR; this was not observed in the virtual group. Both groups demonstrated improvement in 6MW distance, sit-to-stand repetitions, and sit-and-reach distance.ConclusionsCompletion of a CR program resulted in fitness improvements during the COVID-19 era regardless of location.