bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenge of missing data in observational studies: investigating cross-sectional imputation methods for assessing disease activity in axial spondyloarthritis
Authors: Georgiadis Stylianos , Pons Marion , Rasmussen Simon , Hetland Merete Lund , Linde Louise , di Giuseppe Daniela , Michelsen Brigitte , Wallman Johan K , Olofsson Tor , Zavada Jakub , Glintborg Bente , Loft Anne G , Codreanu Catalin , Melim Daniel , Almeida Diogo , Provan Sella Aarrestad , Kvien Tore K , Rantalaiho Vappu , Peltomaa Ritva , Gudbjornsson Bjorn , Palsson Olafur , Rotariu Ovidiu , MacDonald Ross , Rotar Ziga , Pirkmajer Katja Perdan , Lass Karin , Iannone Florenzo , Ciurea Adrian , Østergaard Mikkel , Ørnbjerg L M 
Published: February 2025

Objectives
We aimed to compare various methods for imputing disease activity in longitudinally collected observational data of patients with axial spondyloarthritis (axSpA).

Methods
We conducted a simulation study on data from 8583 axSpA patients from ten European registries. Disease activity was assessed by the Axial Spondyloarthritis Disease Activity Score (ASDAS) and the corresponding low disease activity (LDA; ASDAS<2.1) state at baseline, 6 and 12 months. We focused on cross-sectional methods which impute missing values of an individual at a particular time point based on the available information from other individuals at that time point. We applied nine single and five multiple imputation methods, covering mean, regression and hot deck methods. The performance of each imputation method was evaluated via relative bias and coverage of 95% confidence intervals for the mean ASDAS and the derived proportion of patients in LDA.

Results
Hot deck imputation methods outperformed mean and regression methods, particularly when assessing LDA. Multiple imputation procedures provided better coverage than the corresponding single imputation ones. However, none of the evaluated methods produced unbiased estimates with adequate coverage across all time points, with performance for missing baseline data being worse than for missing follow-up data. Predictive mean and weighted predictive mean hot deck imputation procedures consistently provided results with low bias.

Conclusions
This study contributes to the available methods for imputing disease activity in observational research. Hot deck imputation using predictive mean matching exhibited the highest robustness and is thus our suggested approach.
Predicted Risk of Ventricular Arrhythmias in a Genome-First Population With Genetic Risk for Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Carruth Eric D. , Murray Brittney , Tichnell Crystal , Young Katelyn , Calkins Hugh , James Cynthia A. , Haggerty Christopher M. 
Published: February 2025

BACKGROUND:
Population genomic screening for desmosome variants associated with arrhythmogenic right ventricular cardiomyopathy (ARVC) may facilitate early disease detection and protective intervention. The validated ARVC risk calculator offers a novel means to risk stratify individuals with diagnosed ARVC, but predicted risk in the context of genomic screening identification has not been explored.

METHODS:

Individuals harboring a pathogenic/likely pathogenic variant in a desmosome gene (
PKP2
,
DSP
,
DSG2
, or
DSC2
) were identified through the Geisinger MyCode Genomic Screening and Counseling program. The ARVC risk calculator was applied to patients with a subsequent evaluation of right ventricular function. This predicted risk was compared with outcomes in the first 5 years (range, 0.3–5.0 years) after genetic result return.

RESULTS:

Of 254 individuals with a clinically confirmed pathogenic/likely pathogenic desmosome variant, 113 (median age, 56 [interquartile range, 42–66]; 71% female) had cardiac imaging in follow-up and no prior sustained ventricular arrhythmia (VA). Eighty-two (73%) had no ARVC task force criteria (TFC) besides the variant (possible diagnosis), 22 (19%) had a single additional minor criterion (borderline diagnosis), and 9 (8%) met criteria for definite diagnosis. The median 5-year predicted VA risk was 3.9% (2.3%–6.6%), notably lower than that of the calculator derivation cohort (20.6%). The risk of fast VA was 1.6% (1.0%–2.9%). The predicted VA risk was higher in individuals with any nongenetic ARVC task force criteria (6.3% [2.5–13.2%]) versus those without (3.7% [2.2–5.6%];
P
=0.01), and in individuals with
DSP
variants (6.1% [3.9–7.8%] versus
PKP2
3.4% [2.2–5.3%];
P
=0.01). Over a median 3.0 years of follow-up (≤5 years only), no sustained VA events were observed in this cohort.

CONCLUSIONS:
The predicted 5-year risk of VA in individuals ascertained via population genomic screening for desmosome variants is low (3.9%; 1.6% for fast VA) but may vary by affected gene and ARVC task force criteria burden.
Left Ventricular Entry to Reduce Brain Lesions During Catheter Ablation: A Randomized Trial
Authors: Marcus Gregory M. , Tung Roderick , Gerstenfeld Edward P. , Hue Trisha F. , Lin Feng , Cheng Jing , Weiss J. Peter , Tzou Wendy S. , Hsia Henry , Ehdaie Ashkan , Cooper Daniel H. , Bunch T. Jared , Arkles Jeffrey , Nazer Babak , Lee Adam , Hadjis Alexios , Nguyen Duy T. , Chelu Mihail G. , Moss Joshua , Hsu Jonathan C. , Valderrábano Miguel , Bhave Prashant D. , Beaser Andrew D. , Kanagasundram Arvindh , Wazni Oussama , Bradfield Jason , Wall Grace , Chang Kathleen , Yang Michelle , Montenegro Gabrielle , Jarrott Sabrina , Kramer Joel H. , Kim Anthony S. , Morris Yvonne M. , Dillon William P. 
Published: February 2025

BACKGROUND:
Catheter ablation of ventricular arrhythmias, one of the most rapidly growing procedures in cardiac electrophysiology, is associated with magnetic resonance imaging–detected brain lesions in more than half of cases. Although a retrograde aortic approach is conventional, modern tools enable entry through a transseptal approach that may avoid embolization of debris from the arterial system. We sought to test the hypothesis that a transseptal puncture would mitigate brain injury compared with a retrograde aortic approach.

METHODS:
The TRAVERSE trial (Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce Systemic Emboli) was a multicenter randomized controlled comparative effectiveness trial. Patients with left ventricular arrhythmias undergoing catheter ablation procedures were randomly assigned to a transseptal puncture approach compared (1:1) with a retrograde aortic approach. The primary outcome was the presence of an acute brain lesion detected by magnetic resonance imaging. Secondary outcomes included clinically manifest complications, procedural efficacy, and 6-month neurocognitive assessments.

RESULTS:

Among the 62 patients randomly assigned to a retrograde aortic approach with postoperative brain magnetic resonance imaging, 28 (45%) exhibited an acute brain lesion compared with 19 of the 69 (28%) of those randomized to a transseptal puncture (
P
=0.036). No differences in clinically manifest complications or procedural efficacy were observed. More patients in the retrograde aortic arm were categorized as having a high likelihood of cognitive impairment at 6 months (33% compared with 19% of those in the transseptal arm), but substantial loss to follow-up was present.

CONCLUSIONS:
Among patients undergoing left ventricular catheter ablation procedures, a transseptal approach reduced the risk of acute brain lesions by nearly half compared with a retrograde aortic approach without sacrificing safety or efficacy. Given a likely embolic pathogenesis, the brain magnetic resonance imaging findings may reflect a propensity to other organ damage; these findings may extend to other procedures requiring left ventricular entry.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03946072
Big data analysis of influenza vaccination and liver cancer risk in hypertensive patients: insights from a nationwide population-based cohort study
Authors: Chiu Chun-Chih , Hao Wen-Rui , Lin Kuan-Jie , Chen Chun-Chao , Yang Tsung-Yeh , Fang Yu-Ann , Yang Tsung-Lin , Lai Yu-Hsin , Chen Ming-Yao , Hsu Min-Huei , Lin Cheng-Hsin , Hsiu Hsin , Chen Huan-Yuan , Cheng Tzu-Hurng , Chen Nai-Hsuan , Liu Ju-Chi 
Published: February 2025

Abstract

Background
previous studies have indicated that influenza vaccination may be associated with reduced risks of certain types of cancer. However, the protective effect of influenza vaccination against primary liver cancer in individuals with hypertension remains unclear.

Methods
In this cohort study, 37,022 patients over 55 years of age who received a diagnosis of hypertension at any time between January 1, 2001, and December 31, 2012, were enrolled from the National Health Insurance Research Database. The patients were divided into a vaccinated and an unvaccinated group. Categorical and continuous variables were analyzed using the chi-square test and t test, respectively, and the correlation between influenza vaccination and liver cancer in patients with hypertension was analyzed using time-varying COX model. Propensity score method was performed to reduce selection bias.

Results
Compared with the unvaccinated group, the vaccinated group had a significantly lower incidence of liver cancer (hazard ratio = 0.56, 95% confidence interval = 0.46–0.64; p < .001). In addition, a protective effect was observed regardless of sex, age, or comorbidities. Besides, the association was dose-dependent which could be noted when patients were stratified based on the total number of vaccinations. The adjusted HRs for patients receiving 1, 2 to 3, and ≥ 4 vaccinations during the follow-up period were 0.60 (0.51–0.78), 0.48 (0.38–0.65), and 0.39(0.30–0.51), respectively.

Conclusions
In summary, influenza vaccination is linked to a decreased risk of liver cancer in individuals with hypertension. However, unmeasurable confounders may have been present in the analysis.
Evaluating the level of knowledge of HIV prevention methods and associated socio-demographic factors among adolescents before and after participating in health education in Nimule town of South Sudan
Authors: Bojo Samuel , Kokwaro Gilbert , Agweyu Ambrose 
Published: February 2025

Abstract

Introduction
Adolescents in conflict-affected settings often face limited access to health information and other prevention resources, making them more vulnerable to HIV and other sexually transmitted infections. This study assessed adolescents’ level of knowledge of at least three HIV prevention methods and sociodemographic characteristics among adolescents and associated with this knwoledge before and after participating in health education in the town of Nimule, South Sudan.

Materials and methods
We collected and analysed baseline and endline data from 557 adolescents aged 10–17 aged recruited from HIV-affected households in Nimule town. The surveys were conducted between December 2020 and December 2022. Assent to participate for all participants was obtained from their caregivers while additional informed consent was obtained from adolescents aged 15–17 who were considered empowered minors by the South Sudan Ministry of Health. Adolescents were then recruited into 40 peer-led health clubs and completed a three-month comprehensive sexuality education curriculum developed by the South Sudan Ministry of Health. These participants were then followed up for 24 months, and an endline survey was conducted to collect comparabel data. Binay logistic regression analysis was used to assess the level of knowledge of at least three mIV prevention methods in line with UNAIDS conceptualisation of knowledge and associated sociodemographic factors. Associations were reported using adjusted odds ratios.

Results
Of the 768 adolescents enrolled, 557 were surveyed at baseline and endline with 301 (54.0%) being females and 276 (46.0%) males. The median age was 14 years (IQR: 11–16) at baseline and 15 years (IQR: 12–17) at the endline survey. The proportion of adolescents who knew at least three methods of HIV prevention increased from 465 (83.5%) at baseline to 556 (99.8%) at the endline survey. Unemployed adolescents had a 99% reduced chance of knowing at least three HIV prevention methods (aOR 0.01, 95% CI: 0.002–0.025, p < 0.001), whereas adolescents who self-rated their health as excellent had a 46% lower chance (aOR 0.56, 95% CI: 0.27–1.14, p < 0.025).

Conclusions
The increase in knowledge of at least three methods of HIV prevention at the endline survey highlights the important role peer-led health education programs plays in closing gaps in HIV prevention among adolescents in conflict-affected settings like South Sudan.
Serological and molecular analysis of henipavirus infections in synanthropic fruit bat and rodent populations in the Centre and North regions of Cameroon (2018–2020)
Authors: Mbu’u Cyrille Mbanwi , Gontao Pierre , Wade Abel , Penning Maren , Sadeghi Balal , Mbange Aristid Ekollo , LeBreton Matthew , Kamdem Sylvain Leroy Sado , Stoek Franziska , Groschup Martin Hermann , Mbacham Wilfred Fon , Balkema-Buschmann Anne 
Published: February 2025

Abstract

Background
Bats and rodents have been identified as reservoirs for several highly pathogenic and zoonotic viruses including henipaviruses, a genus within the Paramyxoviridae family. A number of studies have revealed the circulation of henipaviruses at the wildlife-human-livestock interface in Cameroon. In this study, we describe the molecular analysis as well as the development and evaluation of a Bead-based Multiplex Binding Assay (BMBA) using an in-house Indirect Enzyme Linked Immunosorbent Assay (ELISA) to confirm the detection of henipavirus infection in wildlife species.

Results
A total of 600 fruit bats and 600 rodents were sampled between March 2018 and June 2020. Samples were analyzed using a semi-nested RT-PCR assay followed by sequencing of the PCR fragments. Transudates (754) were screened for the presence of henipavirus-specific antibodies in a BMBA and confirmed by ELISA using Hendra virus (HeV), Nipah virus (NiV) and Ghana virus (GhV) glycoproteins expressed in Leishmania tarentolae, and commercially available HeV G and NiV G glycoproteins.
Henipavirus-specific antibodies were detected in 19/531 (3.6%) bat transudates screened by BMBA and confirmed by ELISA. Seroprevalence rates in the Centre and North Regions were 12/291 (4.1%) and 7/240 (2.9%) respectively. All rodents and shrews were serologically negative. Henipavirus RNA sequences were not detected in any of the samples screened in this work.

Conclusion
This study provides further data supporting the circulation of Henipaviruses in fruit bats (Eidolon helvum) which are roosting and reproducing in proximity to human and livestock populations in the Centre and North Regions of Cameroon. This also establishes the first detection of Henipavirus specific antibodies in Eidolon helvum populations in the North Region of Cameroon.
Ethical collection of animal cadavers for veterinary education
Authors: Louis-Maerten Edwin , Shaw David M. 
Published: February 2025

Abstract
The use of animal cadavers in initial and continuing veterinary education is widely accepted, but ethical considerations regarding how to obtain and use them are often lacking. It can be argued that the use of animal cadavers should be guided by principles similar to those regulating the collection of human cadavers for scientific purposes. In humans, the use of unclaimed cadavers from unknown provenance, cadavers from criminals or homeless people, or cadavers robbed from their grave no longer happens in most countries. Accordingly, body donation programs have been emphasized to be the sole acceptable source of cadavers for medical education. The purpose of this article is to argue that this should also be the case for domestic animals, contrary to the current practices of using unwanted animals or animals bred for this purpose. But having a body donation program is not enough to make it ethical: care should also be taken in order to include principles such as informed consent from the owners, the absence of commercial uses of the bodily remains and the respect for all parties involved in the process. Overall, the importance of maintaining respect towards the reception and use of a donated cadaver in all circumstances should be the ethical priority for students and practitioners. By applying such principles, we can better ensure that the use of animal cadavers in education and training is transparent, respectful and responsible.
Feasibility and reliability of an online version of the beat alignment test in neurotypical adults and people with stroke
Authors: Gregor Sarah , Mansfield Avril , Mochizuki George , Chen Joyce , Patterson Kara K. 
Published: February 2025

Abstract

Background
Rhythm-based rehabilitation interventions are gaining attention and measuring their effects is critical. With more clinical care and research being conducted online, it is important to determine the feasibility of measuring rhythm abilities online. However, some tools used to measure rhythm abilities, in particular the beat alignment test (BAT), have not been validated for online delivery. This study aims to determine the feasibility, reliability, and learning effects for online delivery of the BAT in adults with and without stroke.

Methods
Neurotypical adults and adults with chronic stroke completed the BAT online three times, with testing sessions separated by 2 to 4 days. The BAT includes a perception task (identifying whether tones overlayed on music matched the beat of the music) and a production task (tapping to the beat of music). Feasibility was evaluated with completion rates, technical challenges and resolutions, participant experience via exit questionnaire, and test duration. Reliability was measured using inter-class correlations and standard error of measurement, and learning effects were determined using a repeated-measures ANOVA.

Results
Thirty-nine neurotypical adults and 23 adults with stroke participated in this study. More a priori feasibility criteria for the online BAT were met with neurotypical adults than people with stroke. Most components of the online BAT were considered reliable based on an ICC = 0.60 cut-off, except for perception in the neurotypical group, and production asynchrony in the stroke group. There was notable variability in performance, but no learning effects in either group.

Conclusions
Online administration of the BAT is more feasible for neurotypical adults than people with stroke. Challenges with online administration for people with stroke may be partly related to the delivery platform. The BAT is a reliable tool with no learning effects and therefore is a promising way to assess for rhythm abilities online with careful consideration of user interface for people with stroke.
Soil drought thresholds of alpine grassland deceased rapidly under the influence of extreme low temperature in northeastern Qinghai-Tibet Plateau
Authors: Wang Yuxin , Du Yu , Zhao Wenzhi , Liu Hu , Jiang Jiachang , He Zhibin 
Published: February 2025

Abstract

Background
Droughts likely lead to the decrease of vegetation coverage and plant productivity. Due to climate change, more extreme climatic events, including soil droughts and extreme temperatures, may occur both independently and simultaneously. Therefore, it is important to understand the thresholds of soil drought in order to avoid various undesired transitions of alpine grassland.

Methods
Soil droughts were identified based on the change of soil moisture, and vegetation coverage decline events were identified by the abnormal decrease of normalized difference vegetation index (NDVI). Three thresholds based on two curves of vegetation responses to soil drought illustrated the tipping points that reflected the rapid loss of ecosystem resistance (Tp1), the complete loss of ecosystem resistance (Tp2) and the amplified magnitude of NDVI decrease (Tm). The influences of legacy effects and extreme temperatures were also considered.

Results
Alpine grasslands in northeastern Qinghai-Tibet Plateau had mean Tp1, Tp2 and Tm of 1.25, 1.98 and 1.93, respectively, indicating low resistance and high vulnerability. Tp1 was low for the most study area, and Tp2 and Tm varied with elevation and vegetation types. Besides the low occurrence of soil droughts coupled with high temperatures, the extremely low temperatures decreased 36% Tp1, nearly all of Tp2 and 30% Tm. Different grassland types showed varying responses to soil droughts, with alpine sparse vegetation having the lowest resistance and alpine wetland having the highest. However, the responses according to soil types did not show obvious differences.

Conclusions
Alpine grasslands in northeastern Qinghai-Tibet Plateau were sensitive to soil droughts, and extremely low temperatures intensified the decrease of ecosystem resistance to soil drought. The identification of soil drought thresholds advances the understanding of how alpine grassland responds to soil droughts, and helps the restoration of alpine grasslands when faced with soil droughts and benefits climate adaptation.
Parameter regionalization of large-scale distributed rainfall–runoff models using a conditional probability method
Authors: Sayama Takahiro , Yamada Masafumi , Yamakita Ayato , Sugawara Yoshito 
Published: February 2025

Abstract
Given the evident impact of climate change, the frequency of severe flood events has increased worldwide. For various risk-reduction measures, covering all rivers in a country or regions including small-to-medium-sized rivers, flood risk assessment and real-time forecasting based on large-domain and high-resolution distributed rainfall–runoff models are fundamental. Due to limited observed records in such small-to-medium-sized rivers, the used distributed model must be robust and physically sound with the regionalized model parameters. Specifically, rather than optimizing parameters in many independent river basins, leading to a patched parameter distribution, regionalization should reflect the spatial distribution of hydrological signatures, such as soil and geology types. However, optimizing the parameters with existing methods incurs computational costs, posing difficulties in the parameter regionalization of large-domain and high-resolution distributed runoff models. To address this challenge, we propose a parameter regionalization method based on conditional probability. The key feature of this method is that the calibration phase calculation assumes spatially uniform parameter sets within the calibrating basins, significantly reducing computational costs. However, the resulting parameter sets are spatially distributed corresponding to the region’s pre-prepared soil or geological maps. It was achieved by introducing the Bayes’ theorem to estimate the conditional probability of the parameter set. The proposed method was applied to the distributed rainfall–runoff–inundation (RRI) model developed for Japan with a resolution of 150 m. The model performance in the validation phase, in which the performance was evaluated with 2723 flood events at 711 gauging stations, the median Nash–Sutcliffe efficiency (NSE) being 0.87, comparable or even improved to the performance in the calibration phase (NSE = 0.83) with 525 flood events at 75 dam reservoirs. Overall, the obtained nationwide high-resolution model is robust with good performance, even in ungauged basins. Furthermore, the proposed regionalization is a simple and useful way reflecting spatially distributed hydrologic signatures in the model parameters, and it can be utilized for any distributed rainfall–runoff model.