bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered Peripheral Blood Gene Expression in Childhood Cancer Survivors With Anthracycline‐Induced Cardiomyopathy – A COG‐ALTE03N1 Report
Authors: Singh Purnima , Shah Disheet A. , Jouni Mariam , Cejas Romina B. , Crossman David K. , Magdy Tarek , Qiu Shaowei , Wang Xuexia , Zhou Liting , Sharafeldin Noha , Hageman Lindsey , McKenna Donald E. , Armenian Saro H. , Balis Frank M. , Hawkins Douglas S. , Keller Frank G. , Hudson Melissa M. , Neglia Joseph P. , Ritchey A Kim , Ginsberg Jill P. , Landier Wendy , Bhatia Ravi , Burridge Paul W. , Bhatia Smita 
Published: September 2023

Background
Anthracycline‐induced cardiomyopathy is a leading cause of premature death in childhood cancer survivors, presenting a need to understand the underlying pathogenesis. We sought to examine differential blood‐based mRNA expression profiles in anthracycline‐exposed childhood cancer survivors with and without cardiomyopathy.

Methods and Results

We designed a matched case‐control study (Children's Oncology Group‐ALTE03N1) with mRNA sequencing on total RNA from peripheral blood in 40 anthracycline‐exposed survivors with cardiomyopathy (cases) and 64 matched survivors without (controls). DESeq2 identified differentially expressed genes. Ingenuity Pathway Analyses (IPA) and Gene Set Enrichment Analyses determined the potential roles of altered genes in biological pathways. Functional validation was performed by gene knockout in human‐induced pluripotent stem cell‐derived cardiomyocytes using CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR‐associated protein 9) technology. Median age at primary cancer diagnosis for cases and controls was 8.2 and 9.7 years, respectively. Thirty‐six differentially expressed genes with fold change ≥±2 were identified; 35 were upregulated. IPA identified “hepatic fibrosis” and “iron homeostasis” pathways to be significantly modulated by differentially expressed genes, including toxicology functions of myocardial infarction, cardiac damage, and cardiac dilation. Leading edge analysis from Gene Set Enrichment Analyses identified lactate dehydrogenase A (
LDHA
) and cluster of differentiation 36 (
CD36
) genes to be significantly upregulated in cases. Interleukin 1 receptor type 1, 2 (
IL1R1
,
IL1R2
), and matrix metalloproteinase 8, 9 (
MMP8, MMP9
) appeared in multiple canonical pathways.
LDHA
‐knockout human‐induced pluripotent stem cell‐derived cardiomyocytes showed increased sensitivity to doxorubicin.

Conclusions

We identified differential mRNA expression profiles in peripheral blood of anthracycline‐exposed childhood cancer survivors with and without cardiomyopathy. Upregulation of
LDHA
and
CD36
genes suggests metabolic perturbations in a failing heart. Dysregulation of proinflammatory cytokine receptors
IL1R1
and
IL1R2
and matrix metalloproteinases,
MMP8
and
MMP9
indicates structural remodeling that accompanies the clinical manifestation of symptomatic cardiotoxicity.
Association of Racial Residential Segregation With Long‐Term Outcomes and Readmissions After Out‐of‐Hospital Cardiac Arrest Among Medicare Beneficiaries
Authors: Abbott Ethan E. , Buckler David G. , Hsu Jesse Y. , Abella Benjamin S. , Richardson Lynne D. , Carr Brendan G. , Zebrowski Alexis M. 
Published: September 2023

Background
The national impact of racial residential segregation on out‐of‐hospital cardiac arrest outcomes after initial resuscitation remains poorly understood. We sought to characterize the association between measures of racial and economic residential segregation at the ZIP code level and long‐term survival and readmissions after out‐of‐hospital cardiac arrest among Medicare beneficiaries.

Methods and Results
In this retrospective cohort study, using Medicare claims data, our primary predictor was the index of concentration at the extremes, a measure of racial and economic segregation. The primary outcomes were death up to 3 years and readmissions. We estimated hazard ratios (HRs) across all 3 types of index of concentration at the extremes measures for each outcome while adjusting for beneficiary demographics, treating hospital characteristics, and index hospital procedures. In fully adjusted models for long‐term survival, we found a decreased hazard of death and risk of readmission for beneficiaries residing in the more segregated White communities and higher‐income ZIP codes compared with the more segregated Black communities and lower‐income ZIP codes across all 3 indices of concentration at the extremes measures (race: HR, 0.87 [95% CI, 0.81–0.93]; income: HR, 0.75 [95% CI, 0.69–0.78]; and race+income: HR, 0.77 [95% CI, 0.72–0.82]).

Conclusions
We found a decreased hazard of death and risk for readmission for those residing in the more segregated White communities and higher‐income ZIP codes compared with the more segregated Black communities and lower‐income ZIP codes when using validated measures of racial and economic segregation. Although causal pathways and mechanisms remain unclear, disparities in outcomes after out‐of‐hospital cardiac arrest are associated with the structural components of race and wealth and persist up to 3 years after discharge.
Immune Markers, Blood Pressure Severity, and Cardiac Remodeling 1 to 2 Years After Hypertensive Disorders of Pregnancy
Authors: Koczo Agnes , Hauspurg Alisse , Countouris Malamo E. , Berlacher Kathryn L. , Özbay Benay , Hanley‐Yanez Karen , Catov Janet 
Published: September 2023

Background
Cardiovascular dysfunction and hypertension can persist postpartum following hypertensive disorders of pregnancy (HDPs). This study hypothesized that activin A, proinflammatory markers and concentric remodeling by echo would be higher 1‐2 years postpartum following HDP with persistent hypertension compared to HDP with normalized blood pressure (BP). We further hypothesized correlations between biomarkers with BP and echocardiographic indices.

Methods and Results

This study enrolled participants with HDPs but no prepregnancy hypertension followed 1 to 2 years after delivery. Activin A and inflammatory cytokines, BP, and echocardiograms were obtained. Biomarker concentrations and echocardiographic parameters were compared between HDP with and without persistent hypertension. Individuals with persistent hypertension at a mean of 1.6 years postpartum had significantly higher activin A concentrations (median[interquartile range 25–75] 230.6 [196.0–260.9] versus 175.3 pg/mL [164.3–188.4];
P
<0.01), more concentric left ventricular concentric remodeling (relative wall thickness >0.42, 48% versus 7%;
P
<0.01), and worse peak left atrial strain (33.4% versus 39.3%;
P
<0.05) as compared with those whose BP normalized. Higher activin A and interleukin‐6 concentrations correlated with higher systolic (activin A:
r
=0.43,
P
=0.01) and diastolic BP (activin A:
r
=0.58,
P
<0.01; interleukin‐6:
r
=0.36;
P
<0.05), as well as greater left ventricular thickness (activin A and interventricular septal thickness:
r
=0.41, interleukin‐6 and interventricular septal thickness:
r
=0.36; both
P
<0.05).

Conclusions
Individuals with HDPs and persistent hypertension had significantly higher activin A and greater concentric remodeling compared with those with HDPs and normalized BP at 1 to 2 years postpartum. Activin A was positively correlated with both BP and echocardiographic indices (left ventricular thickness), suggesting overlapping processes between persistent hypertension and cardiac remodeling.
Rubens’ landscapes and the Dutch Republic
Authors: Büttner Nils 
Published: September 2023

Peter Paul Rubens (1577-1640) is generally regarded as the painter of the Counter-Reformation and the embodiment of Flemish Baroque. Since the founding of the Belgian state in 1830, he and his art have been increasingly appropriated as a point of reference for the cultural identity of Flanders. Art was also appropriated in the formation of the national identity of the Kingdom of the Netherlands – in particular the depiction of nature and landscape that had become a speciality of many painters in the northern provinces.
But Rubens too was admired by his contemporaries for his landscapes, and in the Dutch Republic they were held in high esteem. For his part, Rubens can be shown to have followed closely developments in landscape painting on the Northern side of the border. Despite the difficult political situation, there was also an ongoing exchange between North and South, even during the Eighty Years’ War. Rubens bought and owned Dutch pictures, and added human and animal figures to landscapes of his Dutch colleagues. He took a general interest in such pictures as an incentive to paint landscapes himself, which, reproduced in prints, became well-known in the Dutch Republic.
In terms of landscape art, not only can a lively exchange of images and ideas be demonstrated, but it can also be shown that the existing differences were not understood as an expression of different political or religious contexts. The example of Rubens and his landscapes shows the value of a change of perspective to focus not on the differences between Flemish and Dutch art, but on cultural cross-border connections.
Incidence of herpes simplex virus type 2 positivity among women living with human immunodeficiency virus in South Africa
Authors: Asare Kwabena , Ngcapu Sinaye , Osman Farzana , Mindel Adrian , Naicker Nivashnee , Khanyile Mlungisi , Karim Salim S. Abdool , Tomita Andrew , Garrett Nigel 
Published: September 2023

Background For women living with HIV (WLHIV), co-infection with herpes simplex virus type 2 (HSV-2) causes severe genital ulcers and presents additional challenges for their HIV care. To inform preventive strategies, we aimed to determine the incidence and risk factors of HSV-2 positivity in a prospective cohort of South African women. Methods The CAPRISA 002 study enrolled women at acute HIV infection between 2004 and 2020. HSV-2 testing was conducted by multiplex polymerase chain reaction (PCR) assay on collected vaginal swabs up to twice annually during follow-up. We calculated incidence as the number of new cases per 100 person-years (PYs) and used Cox-proportional-hazard regression to identify factors associated with time-to-HSV-2 PCR positivity. Results At enrolment, the median age of 171 women was 24 years, interquartile range (IQR 21–28), and the estimated median days since HIV infection was 42 (IQR 22–65). Of participants tested at enrolment, HSV-2 antibody prevalence was 81.4% (105/129), and 10.6% (12/113) were positive by PCR. Among 147 women with a prior negative HSV-2 PCR diagnosis, we observed 47 new HSV-2 PCR positive cases over 424.4 PYs of follow-up, yielding an incidence rate of 11.1 cases per-100-PYs. HSV-2 PCR positivity incidence was higher among younger women (<25 years: adjusted Hazard Ratio [aHR] = 5.91, 95%CI 3.02–11.6), those with bacterial vaginosis (BV) (Nugent score 7–10: aHR = 2.17, 95%CI 1.15–4.10) and lower CD4 counts (<500 cells/μl: aHR = 2.04, 95%CI 1.08–3.87). Conclusion After acute HIV infection in women, the incidence of HSV-2 PCR positivity was associated with younger age, BV diagnosis and lower CD4 count.
Assessment of Oral Hygiene Practices Among Antenatal Mothers
Authors: Negi Parul , Kaur Sukhjit , Arora Aashima , Verma Raj Kumar 
Published: September 2023

Introduction: Pregnancy is a natural process. Physiological changes which occur during pregnancy increase the risk of developing oral diseases and potentially result in adverse pregnancy outcomes. So, it is important to maintain oral hygiene, especially during the antenatal period. Objective: To assess the oral hygiene practices among antenatal mothers. Methodology: A descriptive study was carried out in the Obstetrics and Gynecology OPD, PGIMER Chandigarh, where 200 antenatal mothers visiting Obstetrics and Gynecology OPD, PGIMER from October to December 2020 were enrolled using purposive sampling technique. Ethical clearance was obtained from Ethics Committee, PGIMER, Chandigarh, and written consent was taken from participants. Data were collected by interviewing participants as per interview schedule comprising (a) personal profile of antenatal mothers, (b) obstetric profile, and (c) oral hygiene practices and perception. Oral hygiene status was observed by assessment sheet (a) checklist comprising dental markers and (b) plaque index tool for assessing oral hygiene of antenatal mothers. Results: The findings of the study revealed that majority of mothers (86%) had correct perception that poor oral hygiene negatively affects the child and 58% believed that brushing does not cause loosening of teeth. When practices were assessed, it was found that 74.5% mothers brushed once only, 99.5% did not floss and 98.5% did not use mouthwash. Although the perception held by mothers was correct, they did not have good oral hygiene practices. When oral hygiene was assessed, it was found that 84.5% mothers had poor oral hygiene because of various dental problems like gum bleeding, caries, gingivitis, etc., whereas only 3% mothers had good oral hygiene. Conclusion: The study concluded that a majority of antenatal mothers had correct perception about oral hygiene, but they did not put it into practice. Many of them had poor oral hygiene. Hence, there is an urgent need for comprehensive educational program to promote good oral health and impart education about correct oral hygiene practices, as oral hygiene is a neglected aspect in pregnancy.
Activities of Daily Living (ADL) and Fatigue Among Patients Undergoing Hemodialysis
Authors: Rani Deeksha , Kalia Raman 
Published: September 2023

Background: End-stage renal disease is a progressive and permanent deterioration in renal function in which the body’s ability to maintain metabolic and fluid and electrolyte balance is lost, resulting in uremia, increased serum creatinine levels, and elevated levels of blood urea nitrogen (azotemia). It develops over many years or results from repeated attacks of acute kidney disease. Hemodialysis (HD) is used to treat highly complex and permanent kidney failure. In addition to therapeutic effects, repeated HD can cause many complications and health problems. Objectives: To assess the activities of daily living (ADL) and fatigue among patients undergoing HD. Material and Method: A descriptive study was carried out in the month of February 2021. The assessment of daily living activities was done using the Barthel index. Fatigue was assessed by using the Fatigue Assessment Scale. The purposive sampling technique was used ( N = 100). The data were collected by interviewing participants using a semi-structured interview schedule. Result: One-third of patients (35%) were moderately dependent, 31% were independent, 22% were slightly dependent, 8% were severely dependent, and 4% were totally dependent while performing the ADL (mean score, 84.50 ± 21.67). The assessment of fatigue revealed that 37% patients had moderate fatigue, 33% were severely fatigued, and 30% had mild fatigue (mean score, 30.48 ± 10.51). Conclusion: Patients on HD have a dependency of varying levels while performing the ADL. The patients also experience mild to severe fatigue. These problems require care and management by nurses in the hospital or by the caregivers at home.
Prevalence and Risk Factors for High-Risk Human Papillomavirus Infection and Cervical Disorders: Baseline Findings From an Human Papillomavirus Cohort Study
Authors: Saldaña-Rodríguez Paula , Bahena-Román Margarita , Delgado-Romero Karina , Madrid-Marina Vicente , Torres-Poveda Kirvis 
Published: September 2023

Background A persistent infection by high-risk human papillomavirus (HR-HPV) is a prerequisite for the development of cervical neoplasms; however, most studies have focused on risk factors associated with HPV-16 and HPV-18 only. Objectives We assessed the association of risk factors with the prevalence of HPV-16, HPV-18, and non-16/18 HR-HPV infection and with the occurrence of cervical lesions in the baseline of a cohort study of HPV persistence in a Mexican population. Methods Cross-sectional study within the baseline of a 5-year dynamic cohort study of HR-HPV persistence in women with an abnormal cytology study result from 2015 to 2021. HPV DNA was detected using the Anyplex II HPV 28 kit. Data on lifestyle, sociodemographic, and reproductive factors were assessed using bivariate and multivariate analyses to determine the association of risk factors with HR-HPV infection status and histopathologic diagnosis. Results A total of 373 women were included in the study. The overall prevalence of HR-HPV infection was 69.97%. The most prevalent HR-HPV genotypes, including single and multiple infections, were HPV-53 (13.4%), HPV-16 (11.8%), HPV-58 (10.9%), HPV-31 (10.9%), and HPV-66 (10.7%). We found 90 multiple HR-HPV infection patterns, all of them with α-6 and -9 species. Significant associations of multiple HPV-16 and non-16/18 HR-HPV infections were found with marital status, number of lifetime sexual partners, and smoking history. The most prevalent genotype in CIN1 and CIN2 patients was HPV-16. No association was found between biological plausibility risk factors and cervical lesions. Conclusions The risk factors for non-16/18 HR-HPV multiple infections are no different than those linked to HPV-16 multiple infections.
Impact of Initial Body Weight Loss on Prognosis in Advanced Pancreatic Cancer: Insights From a Single-Center Retrospective Study
Authors: Hosokawa Kana , Nishida Tsutomu , Hayashi Daichi , Kitazawa Miharu , Masuda Haruka , Tono Katsuharu , Katanosaka Yuhiko , Sakamoto Naohiro , Fujii Yoshifumi , Sugimoto Aya , Nakamatsu Dai , Matsumoto Kengo , Yamamoto Masashi , Fukui Koji 
Published: September 2023

Background Pancreatic cancer (PC) has a poor prognosis, with body weight loss commonly observed at diagnosis. However, the impact on PC prognosis of weight loss at the time of diagnosis on PC prognosis is unknown. Methods This retrospective, single-center study enrolled consecutively patients diagnosed with metastatic or locally advanced PC or resectable PC who were intolerant of or refused surgery. Patients who had lost more than 5% of their body weight or more than 2% and had a body mass index (BMI) of less than 20 kg/m2 at diagnosis were classified as experiencing body weight loss. Patients were subclassified into 2 groups: patients with and without weight loss. The study evaluated patient-related and PC-related factors affecting prognosis. Cox proportional hazards models were used to assess factors affecting prognosis. The primary endpoint was overall survival. Additionally, 1:1 propensity score matching was performed to reduce bias. Results In total, 220 patients were included in the study. The median age of the patients was 74 years, and 49.1% were male. Weight loss at diagnosis was observed in 43.2% of patients. There were no significant differences in clinical factors, except for anthropometric parameters, between the groups. The median survival time did not differ between the weight loss and no weight loss groups (149 and 173 days, respectively, P = .669). After matching, no significant differences in survival times were observed between the 2 groups. Conclusions This study found no association between weight loss at diagnosis and prognosis in patients with advanced PC treated with best supportive care or chemotherapy.
Re-examining the Nexus Between Maternal Smoking Behavior and Under-Five Children’s ARI in India: A Comprehensive Study
Authors: Rahaman Margubur , Roy Avijit , Latif Md Abdul , Rana Md Juel , Chouhan Pradip , Das Kailash Chandra 
Published: September 2023

Background: The burden of acute respiratory infections (ARIs) among children under-five is a serious concern in lower and middle-income countries (LMICs), including India, where it is positively associated with indoor smoking exposures. This study re-examines the impact of maternal smoking on ARIs among children under 5 in India, considering other indoor air pollutant factors and covariates. The aim is to establish existing findings and capture any differentials in results using comprehensive analytical approaches. Methods: Data from the National Family Health Survey (NFHS-5), 2019 - 21, was used. Descriptive statistics, bivariate analysis, multivariable logistic regression models, and interaction analysis were applied to accomplish the study objective. Results: The adjusted likelihood of ARI was 1.24 (95% CI: 1.04-1.48) times higher in under-five children with smoking mothers than those with non-smoking mothers. The result was also observed to be almost similar across all seasons. Moreover, the combined effect of maternal smoking with other household members smoking and using unclean cooking fuel without a separate ventilated kitchen escalated the risk (AOR: 2.01; 95% CI: 1.98-2.67). Breastfeeding was found to be a preventive measure for reducing the risk of indoor smoking exposure. The children who were never breastfed and were born large or small were more susceptible to maternal smoking. Conclusion: The study highlights the association between maternal smoking and ARIs in Indian under-five children. Interventions include reducing maternal smoking, promoting breastfeeding, and improving respiratory health in fuel-exposed households.
Role of self-efficacy on functional limitations among persons with spinal cord injury
Authors: Bhattarai Muna , Shigemoto Yuki , Smedema Susan Miller 
Published: September 2023

Objectives Spinal cord injury (SCI) results in mild to severe functional limitations, decreasing a person's ability to perform activities of daily living. This study aims to identify the influence of SCI characteristics and self-efficacy on functional limitations, controlling for sociodemographic factors. Methods Participants for this cross-sectional descriptive study included 272 persons with SCI. The participants completed questionnaires on sociodemographic information, secondary physical conditions, self-efficacy, and functional limitations, using an online Qualtrics Survey. Multiple hierarchical regression analysis was performed to test the hypothesis. Results Participants reported higher functional limitations on dressing the lower body and managing their bowels compared to other activities of daily living. The sociodemographics, injury characteristics, and self-efficacy collectively accounted for 66% variance in functional limitations. A higher level of secondary physical conditions and tetraplegia injury contributed to higher functional limitations. As hypothesized, greater self-efficacy significantly contributed to low functional limitations above and beyond sociodemographic and SCI-related variables. Discussion Functional limitations following SCI are a pervasive challange in persons with SCI. Early recognition and management of secondary conditions and implementation of psychological interventions to strengthen self-efficacy in performing activities and managing secondary complications could potentially enhance functional independence and, ultimately, quality of life in this population.