bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multidisciplinary assessment of ChatGPT’s knowledge of amyloidosis
Authors: King Ryan C. , Samaan Jamil S. , Yeo Yee Hui , Kunkel David C. , Habib Ali A. , Ghashghaei Roxana 
Published: July 2023

AbstractAmyloidosis is a rare, multisystem disease with several subtypes including AA (secondary), AL (amyloid light chain), and ATTR (transthyretin amyloidosis). In addition to variable symptoms and multidisciplinary management, amyloidosis being a rare disease further contributes to patients being at risk for decreased health literacy regarding their condition. Increased access to education materials containing simple, plain language may bridge literacy gaps and improve outcomes for patients with rare diseases such as amyloidosis. The large language model (LLM), Chat Generative Pre-Trained Transformer (ChatGPT), may be a powerful tool for improving the availability of accurate and easy to understand education materials. Amyloidosis-related questions from cardiology, gastroenterology, and neurology were sourced from esteemed medical societies and institutions along with amyloidosis Facebook support groups and inputted into ChatGPT-3.5 and GPT-4. Answers were graded on 4-point scale with both models responding to the majority of questions with either “comprehensive” or “correct but inadequate” answers with only 1 (1.2%) answer by GPT-3.5 graded as “completely inaccurate”. When assessing reproducibility, GPT-3.5 scored reliably on more than 83.3% of responses, while GPT-4 produced above 98.2% consistent answers. Our findings show that ChatGPT can potentially serve as a supplemental tool in disseminating vital health education to patients living with amyloidosis.
Allelic strengths of encephalopathy-associatedUBA5variants correlate betweenin vivoandin vitroassays
Authors: Pan Xueyang , Alvarez Albert N. , Ma Mengqi , Lu Shenzhao , Crawford Michael W. , Briere Lauren C. , Kanca Oguz , Yamamoto Shinya , Sweetser David A. , Wilson Jenny L. , Napier Ruth J. , Pruneda Jonathan N. , Bellen Hugo J. 
Published: July 2023

AbstractProtein UFMylation downstream of the E1 enzyme UBA5 plays essential roles in development and ER stress. Variants in theUBA5gene are associated with developmental and epileptic encephalopathy 44 (DEE44), an autosomal recessive disorder characterized by early-onset encephalopathy, movement abnormalities, global developmental delay, intellectual disability, and seizures. DEE44 is caused by at least twelve different missense variants described as loss of function (LoF), but the relationships between genotypes and molecular or clinical phenotypes remains to be established. We developed a humanizedUBA5fly model and biochemical activity assays in order to describein vivoandin vitrogenotype-phenotype relationships across theUBA5allelic series.In vivo, we observed a broad spectrum of phenotypes in viability, developmental timing, lifespan, locomotor activity, and bang sensitivity. A range of functional effects was also observedin vitroacross comprehensive biochemical assays for protein stability, ATP binding, UFM1 activation, and UFM1 transthiolation. Importantly, there is a strong correlation betweenin vivoandin vitrophenotypes, establishing a classification of LoF variants into mild, intermediate, and severe allelic strengths. By systemically evaluatingUBA5variants acrossin vivoandin vitroplatforms, this study provides a foundation for more basic and translational UBA5 research, as well as a basis for evaluating current and future individuals afflicted with this rare disease.
Exploring COVID-19 vaccine uptake among healthcare workers in Zimbabwe: A mixed methods study
Authors: Taruvinga Tinotenda , Chingono Rudo S. , Marambire Edson , Larsson Leyla , Olaru Ioana D. , Sibanda Sibusisiwe , Nzvere Farirayi , Redzo Nicole , Ndhlovu Chiratidzo E. , Rusakaniko Simbarashe , Mujuru Hilda , Sibanda Edwin , Chonzi Prosper , Siamuchembu Maphios , Chikodzore Rudo , Mahomva Agnes , Ferrand Rashida A. , Dixon Justin , Kranzer Katharina 
Published: July 2023

ABSTRACTWith COVID-19 no longer categorized as a public health emergency of international concern, vaccination strategies and priority groups for vaccination have evolved. Africa Centers for Diseases Prevention and Control proposed the ‘100-100-70%’ strategy which aims to vaccinate all healthcare workers, all vulnerable groups, and 70% of the general population. Understanding whether healthcare workers were reached during previous vaccination campaigns and what can be done to address concerns, anxieties, and other influences on vaccine uptake, will be important to optimally plan how to achieve these ambitious targets. In this mixed-methods study, between June 2021 and July 2022 a quantitative survey was conducted with healthcare workers accessing a comprehensive health check in Zimbabwe to determine whether and, if so, when they had received a COVID-19 vaccine. Healthcare workers were categorized as those who had received the vaccine ‘early’ (before 30.06.2021) and those who had received it ‘late’ (after 30.06.2021). In addition, 17 in-depth interviews were conducted to understand perceptions and beliefs about COVID-19 vaccines. Of the 2905 healthcare workers employed at 37 facilities who participated in the study, 2818 (97%, 95% CI [92%-102%]) reported that they had received at least one vaccine dose. Geographical location, older age, higher educational attainment and having a chronic condition was associated with receiving the vaccine early. Qualitatively, (mis)information, infection risk perception, quasi-mandatory vaccination requirements, and legitimate concerns such as safety and efficacy influenced vaccine uptake. Meeting the proposed 100-100-70 target entails continued emphasis on strong communication while engaging meaningfully with healthcare workers’ concerns. Mandatory vaccination may undermine trust and should not be a substitute for sustained engagement.
Health-seeking behaviour and beliefs around sore throat in The Gambia: a qualitative study
Authors: Sans Maria Suau , Manneh Muhammed , Ceesay Isatou , Bittaye Amat , de Crombrugghe Gabrielle , Keeley Alexander J , de Silva Thushan I. , Palmer Jennifer , Armitage Edwin P. , Marks Michael 
Published: July 2023

AbstractGroup AStreptococcus(StrepA) bacteria causes a broad spectrum of diseases. The most common manifestations of StrepA infection are sore throat and pus-producing skin infections such as impetigo. Complications of StrepA infection lead to inflammation in the bones, muscles, joints, and internal organs causing acute rheumatic fever and rheumatic heart disease (RHD). In The Gambia, the RHD burden is thought to be very high. However, epidemiological data is minimal, and StrepA control programmes do not exist. This study aims to explore common beliefs and practices related to sore throats among primary caregivers of children, and healthcare providers in a community with a high StrepA disease burden. This will inform the design of preventative strategies for StrepA-related sequelae.Four informal conversations with providers and fifteen semi-structured interviews with caregivers were conducted in the peri-urban area of Sukuta, The Gambia. Sampling was purposive and gradual, beginning from households identified to have recently experienced sore throat through a parallel cohort study. Themes explored in qualitative analysis included: sore throat causal attributions and diagnoses, care practises, health-seeking behaviour, and perceived barriers to using the biomedical sector.Sore throats were typically perceived to affect one child in a family, disproportionately or exclusively. Sore throats are rarely perceived as life-threatening, and awareness of links between sore throat and ARF or RHD was not reported among caregivers or providers in this study population. Most cases of sore throat are initially managed at home using traditional medicine which delays resort to antibiotics, though in two instances of severe pain with the presence of exudate, fear that the child’s life was at risk prompted care-seeking through the formal health system.Our findings can inform the development of tailored strategies to increase community knowledge of the potential long-term consequences of sore throats and appropriate care-seeking, alongside improvements in the health system, to prevent StrepA sequelae effectively.
Application of 4D flow MRI for exploring the anatomical and haemodynamic characteristics of pelvic veins and their correlations
Authors: Nie Chengli , Tao Li , Chen Jiangwei , Yang Jianghu , Huang Wen 
Published: July 2023

AbstractObjectiveThere is currently a lack of studies evaluating the anatomy and haemodynamics of the pelvic veins in clinical practice. Four-dimensional flow magnetic resonance imaging (4D flow MRI) can simultaneously obtain information on vascular anatomy and haemodynamics. The goal of this study was to use 4D flow MRI to explore the anatomical and haemodynamic characteristics of pelvic veins and their correlations in an asymptomatic population.MethodsFour-dimensional flow MRI was used to measure anatomical parameters, including the pelvic vein area, common iliac vein-inferior vena cava angle, iliac vein tortuosity, and common iliac vein stenosis rate, and haemodynamic parameters, including the pelvic venous blood flow, average blood flow velocity, and external iliac vein-inferior vena cava pressure difference, in 30 asymptomatic volunteers. The correlation between iliac vein anatomy and haemodynamics was analysed.ResultsThere were correlations between the anatomical parameters of the iliac vein and the haemodynamic parameters. A larger iliac vein area was correlated with a higher blood flow. A greater iliac vein stenosis rate was correlated with a lower blood flow, lower mean velocity of the external iliac vein, and higher external iliac vein-inferior vena cava pressure difference. A greater common iliac vein-inferior vena cava angle was associated with a lower iliac vein flow velocity and a higher external iliac vein-inferior vena cava pressure difference. Finally, a greater the iliac vein tortuosity was correlated with a lower iliac vein velocity and higher external iliac vein-inferior vena cava pressure difference. There were differences in the anatomical and haemodynamic parameters of the bilateral common iliac vein and external iliac vein. The left pelvic vein common iliac-inferior vena cava angle, iliac vein tortuosity and iliac vein stenosis rate were higher than those of the right side. The flow and average velocity of the left common iliac vein and the left external iliac vein were lower than those of the right, and the pressure of the left external iliac vein was higher than that of the right.ConclusionThe anatomical structure of the pelvic vein, including the iliac vein area, common iliac vein-inferior vena cava angle, iliac vein tortuosity, and iliac vein stenosis rate, are important factors that affect haemodynamic changes in the pelvic vein. There are correlations between parameters related to the anatomical structures and haemodynamic changes of the pelvic veins. Differences in the anatomy and haemodynamics of the bilateral pelvic veins may be one reason why the left extremity is more prone to chronic venous disease (CVD)-related symptoms.
Aneurysmal versus “Benign” Perimesencephalic Subarachnoid Hemorrhage
Authors: Alrohimi Anas , Davison Mark A , Pandhi Abhi , Abdulrazzak Mohammad A , Wadden Daniel , Bain Mark , Moore Nina , Hussain M. Shazam , Toth Gabor 
Published: July 2023

ABSTRACTIntroductionThe rate of underlying ruptured aneurysm, complications, and outcomes in “benign” perimesencephalic subarachnoid hemorrhage (PMSAH) are not well known and underreported.MethodsRetrospective analysis of patients with PMSAH from a large tertiary care center (2007-2023). Clinical and imaging data were studied.ResultsEighty-one patients were included with mean age of 55.5 ± 10.3 years. Median (IQR) Hunt and Hess grade was 2 (1-2), and modified Fisher grade was 3 (1-3). An underlying ruptured aneurysm was diagnosed in 5 patients (6.2%). The most common complication was vasospasm in 25 patients (31%) with a significantly higher rate of symptomatic vasospasm among patients with underlying aneurysm (40% vs 2.6%; P=0.01). The median (IQR) time of vasospasm detection was 7 (8-9) days. The majority of vasospasm cases (84%) were asymptomatic, which was not associated with poor outcomes (OR= 0.95, [0.22–4.1],P=0.9) compared to the asymptomatic vasospasm (OR= 8.6, [1.06-69.88],P= 0.04). Hydrocephalus occurred in 10% of patients within one day, at higher rate in the aneurysmal group (40% vs 8%; P=0.07). A total of 88% of patients had a favorable functional outcome (mRS 0-2) at discharge, but at a significantly higher rate in non-aneurysmal patients (91% vs 40%; P=0.01). An underlying aneurysm and hydrocephalus were associated with poor functional status (OR= 14.7, [2.1–104],P=0.007, and OR= 22.6, [4.2–123.5],P<0.001), respectively.Conclusion“Benign” PMSAH pattern was associated with a ruptured aneurysm in 6.2% of patients, which highlights the critical value of conventional cerebral angiogram in the workup. Expectedly, an underlying aneurysm was associated with higher rates of symptomatic vasospasm, hydrocephalus, and lower rates of good clinical outcome. Aneurysm and hydrocephalus were independently associated with poorer outcomes, however, these were detected very early during hospitalization. Vasospasm alone was not associated with poor outcomes. Our findings suggest that non-aneurysmal PMSAH patients can safely be managed with less strict monitoring and a shorter hospital stay.
Screening Implications for Distribution of Colorectal Cancer Subsite by Age
Authors: Lin Gloria , Hein David M. , Liu Po-Hong , Singal Amit G. , Sanford Nina N. 
Published: July 2023

ObjectivesThe effectiveness of colonoscopy to reduce colorectal cancer (CRC) mortality is extrapolated from cohort studies in the absence of randomized controlled trial (RCT) data, whereas flexible sigmoidoscopy is supported by RCT data and may be easier to implement in practice. We characterized the anatomic distribution of CRC to determine the proportion that is visible with sigmoidoscopy.MethodsPatients with a primary diagnosis of colorectal adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results program (2000-2020). Tumors from the rectum to descending colon were categorized as visible by sigmoidoscopy, whereas more proximal tumors as requiring colonoscopy. Differential prognosis between tumor locations, stratified by age groups and stage, were assessed using overall restricted mean survival time (RMST) at 2, 5, and 10 years.ResultsAmong 309,466 patients, 58% had tumors visible by sigmoidoscopy, including 73% of those under age 50 (OR 2.10, 95%CI 2.03-2.16 age <45, OR 2.20, 95%CI 2.13-2.27 age 45-49 versus age>50). Male sex (OR 1.54, 95%CI 1.51-1.56) and Asian or Pacific Islander race (OR 1.60, 95%CI 1.56-1.64) were also positively associated with tumors visualizable by sigmoidoscopy. Across age groups, for local disease, RMST was comparable for tumors visible versus not visible on sigmoidoscopy. For regional and metastatic cancer, patients with tumors visible by sigmoidoscopy had improved RMST versus those with more proximal tumors.ConclusionsMost CRC arise in locations visible by flexible sigmoidoscopy. Flexible sigmoidoscopy should be considered as a viable option for CRC screening, particularly in younger patients unwilling or unable to undergo colonoscopy.
A randomised controlled trial of preconception lifestyle intervention on maternal and offspring health in people with increased risk of gestational diabetes: study protocol for the BEFORE THE BEGINNING trial
Authors: Sujan MAJ , Skarstad HS , Rosvold G , Fougner SL , Nyrnes SA , Iversen AC , Follestad T , Salvesen KÅ , Moholdt T 
Published: July 2023

AbstractIntroductionGestational diabetes mellitus (GDM) is associated with increased risk for type 2 diabetes in the mother and cardiometabolic diseases in the child. The preconception period is an optimal window to adapt the lifestyle for improved outcomes for both mother and child. Our aim is to determine the effect of a lifestyle intervention, initiated before and continued throughout pregnancy, on maternal glucose tolerance and other maternal and infant cardiometabolic outcomes.Methods and analysisThis ongoing randomised controlled trial has included 167 females aged 18-39 years old at increased risk for GDM who are contemplating pregnancy. The participants were randomly allocated 1:1 to an intervention or control group. The intervention consists of exercise (volume is set by a heart rate-based app and corresponds to ≥ 1 hour of weekly exercise at ≥ 80% of individual heart rate maximum), and time-restricted eating (≤ 10 hours/day window of energy intake). The primary outcome measure is glucose tolerance in gestational week 28. Maternal and offspring outcomes are measured before and during pregnancy, at delivery, and at 6-8 weeks postpartum. Primary and secondary continuous outcome measures will be compared between groups based on the “intention to treat” principle using linear mixed models.Ethics and disseminationThe Regional Committees for Medical and Health Research Ethics in Norway has approved the study (REK 143756). The anonymised results will be submitted for publication and posted in a publicly accessible database of clinical study results.Strengths and limitations of this studyThe intervention starts before and continues throughout pregnancy to make it easier for the participants to adopt an active lifestyle before pregnancy.This study includes individuals at high risk of GDM from multiple ethnic backgrounds, which improves the generalisability of the findings.The effects of the intervention on the cardiac function and body composition of the offspring will be comprehensively evaluated.Due to the difficulty of blinding investigators and participants to behavioural interventions, investigators will not be blinded for outcome assessments.Due to the long duration of the intervention, adherence to lifestyle modifications may be difficult for some participants despite regular monitoring and motivational support.
An updated PREDICT breast cancer prognostic model including the benefits and harms of radiotherapy
Authors: Grootes Isabelle , Wishart Gordon C. , Pharoah Paul David Peter 
Published: July 2023

ABSTRACTBackgroundPredict Breast (www.breast.predict.nhs.uk) is an online prognostication and treatment benefit tool for early invasive breast cancer. However, the most recent version of PREDICT Breast (v2.2) was based on data for breast cancer cases diagnosed from 1999 to 2003 and did not incorporate the benefits of radiotherapy or the harms associated with theray. Since then, there has been a substantial improvement in the outcomes for breast cancer cases. The aim of this study was to update PREDICT Breast to ensure that the underlying model is appropriate for contemporary patients.MethodsData from 4,644 ER-negative and 30,830 ER-positive breast cancer cases diagnosed from 2000 to 2017 in the region served by the Eastern Cancer Registry were used for model development. Multivariable fractional polynomials in a Cox proportional hazards framework were used to estimate the prognostic effects of year of diagnosis, age at diagnosis, tumour size, tumour grade and number of positive nodes and to compute the baseline hazard functions. Separate models were developed for ER-positive and ER-negative disease. Data on 32,408 breast cancer patients from the West Midlands Cancer Registry and from 100,551 breast cancer cases from the other English Cancer Registries combined were used to determine the discriminative power, calibration, and reclassification of the new version of PREDICT Breast (v3.0).ResultsThe new model (v3.0) was well-calibrated; predicted numbers of 5-, 10- and 15-year breast cancer deaths were within 10 per cent of the observed number in both model development and model validation data sets. In contrast, PREDICT Breast v2.2 was found to substantially over-predict the number of deaths. Discrimination was also good: The AUC for 15-year breast cancer survival was 0. 824 in the model development data, 0.809 in the West Midlands data set and 0.846 in the data set for the other registries. There figures were slightly better than those for PREDICT Breast v2.2ConclusionIncorporating the prognostic effect of year of diagnosis, updating the prognostic effects of all risk factors and amending the baseline hazard functions have led to an improvement of model performance of PREDICT Breast. The new model will be implemented in the online tool which should lead to more accurate absolute treatment benefit predictions for individual patients.
Serum Autotaxin is a Prognostic Indicator of Liver-related Events in Patients with Non-alcoholic Fatty Liver Disease
Authors: Iwadare Takanobu , Kimura Takefumi , Okumura Taiki , Wakabayashi Shun-ichi , Nakajima Taro , Kondo Shohei , Kobayashi Hiroyuki , Yamashita Yuki , Sugiura Ayumi , Fujimori Naoyuki , Yamazaki Tomoo , Kunimoto Hideo , Shimamoto Satoshi , Igarashi Koji , Joshita Satoru , Tanaka Naoki , Umemura Takeji 
Published: July 2023

AbstractBackgroundCirculating autotaxin (ATX) levels have been reported to correlate with liver inflammation activity and liver fibrosis severity in patients with non-alcoholic fatty liver disease (NAFLD). The objective of this study was to investigate whether serum ATX could predict liver-related events (LRE) in NAFLD patients.MethodsThis retrospective investigation included 309 biopsy-proven NAFLD patients registered at Shinshu University Hospital between 1998 and 2021. All patients were followed for at least 1 year, during which time the prevalence of LRE, including newly developing hepatocellular carcinoma, hepatic encephalopathy, ascites, and esophagogastric varices, was investigated in relation to ATX levels at the time of liver biopsy.ResultsDuring the median follow-up period of 7.0 years, LRE were observed in 20 patients (6.5%). The area under the receiver operating characteristic curve and cut-off value of serum ATX for predicting LRE were 0.81 and 1.227 mg/L, respectively. Patients with serum ATX greater than the cut-off at the time of liver biopsy had a significantly higher cumulative incidence of LRE than those without (18.4% vs. 2.7%, p < 0.00001). Multivariate Cox proportional hazards models for LRE determined fibrosis stage and ATX divided by the upper limit of normal as independently associated factors.ConclusionSerum ATX may serve as a predictive marker for LRE in patients with NAFLD.