bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographical variation in treated psychotic and other mental disorders in Finland by region and urbanicity
Authors: Suokas Kimmo , Kurkela Olli , Nevalainen Jaakko , Suvisaari Jaana , Hakulinen Christian , Kampman Olli , Pirkola Sami 
Published: April 2023

AbstractBackgroundIn Finland, prevalence of schizophrenia is higher in the eastern and northern regions and co-occurs with the distribution of schizophrenia polygenic risk scores. Both genetic and environmental factors have been hypothesized to contribute to this variation, but its reasons are not fully understood. We aimed to examine the prevalence of psychotic and other mental disorders by region and degree of urbanicity, and the impacts of socio-economic adjustments on these associations.MethodsNationwide population registers from 2011 to 2017 and healthcare registers from 1975 to 2017. We used 19 administrative and three aggregate regions, and a seven-level urban-rural classification with 250 × 250 m resolution. Prevalence ratios (PRs) were calculated by Poisson regression models and adjusted for gender, age, and calendar year (basic adjustments), and origin, residential history, urbanicity, household income, economic activity, and physical comorbidity (additional adjustments) on an individual level. Average marginal effects were used to visualize interaction effects between region and urbanicity.ResultsA total of 5 898 180 individuals were observed. All mental disorders were slightly more prevalent (PR 1.03 [95% CI, 1.02-1.03]), and psychotic disorders (1.11 [1.10-1.12]) and schizophrenia (1.19 [1.17-1.21]) considerably more prevalent in eastern and northern than in western coastal regions. After the additional adjustments, however, the PRs were 0.95 (0.95-0.96), 1.00 (0.99-1.01), and 1.03 (1.02-1.04), respectively. Urban residence was associated with increased prevalence of psychotic disorders across all regions (adjusted PR 1.21 [1.20-1.22]).ConclusionsSocioeconomic and sociodemographic factors modulate the within-country geographical distribution of mental disorders highlighting their truly contextual nature.
Non-Metastatic Axillary Lymph Nodes Have Distinct Morphology and Immunophenotype in Obese Breast Cancer patients at Risk for Metastasis
Authors: Song Qingyuan , Muller Kristen E. , Hondelink Liesbeth M. , diFlorio-Alexander Roberta M. , Karagas Margaret , Hassanpour Saeed 
Published: April 2023

AbstractObese patients have worse breast cancer outcomes than normal weight women including a 50% to 80% increased rate of axillary nodal metastasis. Recent studies have shown a potential link between increased lymph node adipose tissue and breast cancer nodal metastasis. Further investigation into potential mechanisms underlying this link may reveal potential prognostic utility of fat-enlarged lymph nodes in breast cancer patients. In this study, a deep learning framework was developed to identify morphological differences of non-metastatic axillary nodes between node-positive and node-negative obese breast cancer patients. Pathology review of the model-selected patches found an increase in the average size of adipocytes (p-value=0.004), an increased amount of white space between lymphocytes (p-value<0.0001), and an increased amount of red blood cells (p-value<0.001) in non-metastatic lymph nodes of node-positive breast cancer patients. Our downstream immunohistology (IHC) analysis showed a decrease of CD3 expression and increase of leptin expression in fat-replaced axillary lymph nodes in obese node-positive patients. In summary, our findings suggest a novel direction to further investigate the crosstalk between lymph node adiposity, lymphatic dysfunction, and breast cancer nodal metastases.
Risk factors for food contamination among children 6-59 months discharged from community management of acute malnutrition (CMAM) programmes for severe acute malnutrition (SAM) in Aweil East, South Sudan
Authors: Wells Joseph , Abugo David Gama , Angong John , Lamwaka Nancy Grace , Gallandat Karin , Hassan Jackson Lwate , Deng Lino , Save Dimple , Braun Laura , Gose Mesfin , Amanya Jacob , Ayoub Khamisa , King Sarah , Stobaugh Heather , Cumming Oliver , D’Mello-Guyett Lauren 
Published: April 2023

AbstractChildren under-five years of age are particularly vulnerable to severe acute malnutrition (SAM), and the risk factors associated with relapse to SAM are poorly understood. Possible causes are asymptomatic or symptomatic infection with enteric pathogens, with contaminated food as a critical transmission route. This cross-sectional study comprised a household survey with samples of child food (n=382) and structured observations of food preparation (n=197) among children aged 6-59 months that were discharged from treatment in community management of acute malnutrition (CMAM) programmes in Aweil East, South Sudan. We quantifiedEscherichia coliand total faecal coliforms (TFCs), measured in colony forming units per g of food (CFU/g), as indicators of microbial contamination of child food. A modified hazard analysis critical control point (HACCP) approach was utilised to determine critical control points (CCPs) followed by multivariate logistic regression analysis to understand the risk factors associated with contamination. Over 40% of samples were contaminated withE. coli(43% >0E. coliCFU/g, 95%CI 38-48%), and 90% had >10 TFCs (CFU/g) (>10TFC CFU/g, 95%CI 87-93%). Risk factors associated (p<0.05) with child food contamination included if the child fed themselves (95% CI 1.16, 3.44, log[odds] = 2.20), exposure to animals (95% CI 0.28, 1.68, log[odds] = 0.97), and protective factors for contamination included feeding with a spoon (95% CI -7.81, -1.54, log[odds] = -4.17). This study highlights strategies that can support interventions that reduce food contamination exposure in young children and help further protect those that are highly vulnerable to recurrent exposure to diarrhoeagenic pathogens.
Factors Associated with Arteriovenous Fistula Maturation Failure among Patients Undergoing Hemodialysis in Hospitals Based in a Low and Middle-Income Country
Authors: Sichona Arlon S , Kyaruzi Victor Meza , Joseph Alex , Mavura Maurice P , Khamis Ramadhani H 
Published: April 2023

ABSTRACTIntroductionThe demand for haemodialysis among patients with end stage renal disease (ESRD) is rising worldwide, arteriovenous fistulas (AVF) are considered the gold standard vascular access modality for hemodialysis (HD) because of its longer patency, enhanced durability, and reduced risk of infection for those that mature compared to grafts and central venous catheters. This study will therefore assess the factors associated with arteriovenous fistula maturation for patients requiring hemodialysis in Dar es Salaam.MethodsA multi-centre based prospective study conducted among patients with ESRD between April 2021 to May 2022 at Muhimbili National Hospital (MNH), Jakaya Kikwete Cardiac Institute (JKCI), Comprehensive Community Based Rehabilitation in Tanzania (CCBRT),Kairuki hospital (KH) in Dar es Salaam. Patients with End stage renal disease eligible for arteriovenous fistula (AVF) creation and Hemodialysis were included. Socio-demographic data were extracted from the patients, intraoperative and postoperative variables were obtained from medical records. Patients were assessed through eight weeks for maturation and complications. Data analyzed accordingly by IBM-SPSS version 27.0, Univariate and multivariate analysis were used to stratify the factors and control the confounders for the effects on outcome, and p-value of <5% was used to state the level of significance at 95% CI.ResultsTotal of 151 fistulas were created, most (80.8%) were created on male, (31.8%) in the age group of less than 50 Years old, 58.9% of the participants had normal Body Mass Index (BMI), with majority (45%) being suffered from Hypertension and 54% of them were using Antihypertensive medication. Brachial cephalic fistulas were the most common type of fistula created 77(51%) and most matured 67(52.7%) among ESRD patients who had AVF creation, while radial cephalic fistulas were the most failed created AVFs 13 (54%). The AVF maturation failure rate was 16%.ConculusionFailure of newly created AVF is a major barrier to the successful establishment of hemodialysis access, in this study the failure rate of AVF maturation was 16 percent. The major factors associated with failure to mature were; extreme age group (50-59), being suffered with both hypertension and diabetes, long period of alcohol taking and distal location of AVF(radiocephalic fistula).Vascular imaging was not regularly done to assess the status of veins and arteries for AVF creation.
Structural complexity of brain regions in mild cognitive impairment and Alzheimer’s disease
Authors: Tibon Roni , Madan Christopher R. , Vaghari Delshad , Reyes-Aldasoro Constantino Carlos 
Published: April 2023

AbstractEarly detection of Alzheimer’s disease (AD) has been a major focus of current research efforts to guide interventions at the earliest stages of the disease. Subtle changes to the brain might be observed with neuroimaging techniques, even before symptoms surface. We interrogated brain images obtained with Magnetic Resonance Imaging (MRI) from two large-scale dementia datasets (namely, ADNI and BioFIND) to establish the utility of fractal dimensionality (FD)—a relatively understudied measure that estimates the complexity of 3D structures (in this case, brain regions)—for the detection of AD. We show that FD can be used to detect group differences between patients and healthy controls, with the former showing significantly reduced complexity across multiple brain regions. Furthermore, these measures were successful when used as features for individual-based classification and were highly consistent across the two datasets. Finally, the contribution of specific brain regions to individual-based classification adhered to previous literature on the properties of the brain’s memory network. Taken together, the study offers novel and interpretable evidence for the utility of FD for the detection of AD.
Longitudinal alterations in brain microstructure surrounding subcortical ischemic stroke lesions detected by free-water imaging
Authors: Nägele Felix L. , Petersen Marvin , Mayer Carola , Bönstrup Marlene , Schulz Robert , Gerloff Christian , Thomalla Götz , Bastian Cheng 
Published: April 2023

AbstractBackgroundFree-water imaging identifies subtle changes in white matter microstructure indicative of cellular and extracellular pathologies not visible on conventional stroke MRI. We explore the spatial extent and temporal trajectory of free-water changes in patients with subcortical stroke and their relationship to symptoms, as well as lesion evolution.MethodsTwenty-seven patients with isolated subcortical infarct with mean age of 66.73 (SD 11.57) and median initial NIHSS score of 4 (IQR 4) received MRI 3-5 days, 1 month, 3 months and 12 months after symptom-onset. After lesion segmentation, 8 unique tissue shells (2 mm distance) surrounding stroke lesions were created. Extracellular freewater and fractional anisotropy of the tissue (FAT), derived from diffusion-weighted MRI, were averaged within tissue shells/stroke lesions, and normalized to corresponding contralateral regions. Linear mixed-effects models and t-tests were used for statistics. Baseline imaging measures were correlated with clinical outcomes 3 months after stroke.ResultsWe found increased free-water and decreased FATin the stroke lesion, as well as the surrounding tissue with a characteristic spatio-temporal distribution. Free-water and FATchanges were most prominent within the lesion and gradually became less with increasing distance from the lesion. Free-water elevations continuously increased over time and peaked after 12 months. In contrast, FATdecreases were most pronounced 1 month after stroke, after which there was a steady increase leading to similarly reduced FATlevels 12 months compared to 3-5 days after stroke. Higher perilesional free-water and higher lesional FATat baseline were correlated with greater reductions in lesion size, while there were no associations with clinical measures.ConclusionsBoth free-water and FATare altered beyond isolated subcortical stroke lesions. The spatial extent of these extracellular and cellular changes varies differentially over time indicating a dynamic parenchymal response to the initial insult characterized by vasogenic edema, cellular damage and white matter atrophy.
IDENTIFYING DIFFERENT PHENOTYPES OF SYMPTOMATIC GASTROESOPHAGEAL REFLUX DISEASE USING ARTIFICIAL INTELLIGENCE
Authors: Gardner Jerry D. , Triadafilopoulos George 
Published: April 2023

ABSTRACTIntroductionThe Lyon Consensus Conference proposed criteria for the clinical diagnosis of three different phenotypes of gastroesophageal reflux disease: nonerosive gastroesophageal reflux disease, Reflux Hypersensitivity, and Functional Heartburn.MethodsIn the present study, we examined the potential of ChatGPT, an artificial intelligence-based conversational large language model to describe how one can identify the different phenotypes as identified by the Lyon Consensus Conference, and to provide a diagnosis when given important clinical findings in a given patient with a particular phenotype.ResultsAlthough in our analyses ChatGPT captured correct information regarding symptoms, upper gastrointestinal endoscopy findings and response to gastric antisecretory agents when asked to describe different phenotypes, it failed, however, to return correct information on esophageal acid exposure time and the association of symptoms with esophageal reflux episodes. ChatGPT was even less effective in returning the correct diagnosis after being given specific clinical features of a particular phenotype.ConclusionsAlthough it seems likely that the ability of ChatGPT to capture information from multiple sources will improve with future use and refinement, presently it is inadequate as a standalone tool for processing information for the description or diagnosis of different clinical disease states. On the other hand, artificial intelligence might prove useful to clinicians in performing tasks that involve obtaining data from a single source such as the electronic medical record and generating a document having a standardized format such as a discharge summary.
Ongoing symptoms and functional impairment 12 weeks after testing positive to SARS-CoV-2 or influenza in Australia: an observational cohort study
Authors: Brown Matthew , Gerrard John , McKinlay Lynne , Marquess John , Sparrow Teneika , Andrews Ross 
Published: April 2023

ABSTRACTObjectiveIn a highly vaccinated Australian population we aimed to compare ongoing symptoms and functional impairment 12 weeks after PCR-confirmed COVID-19 infection with PCR-confirmed influenza infection.Methods and AnalysisThe study commenced upon a positive PCR test for either COVID-19 or influenza in June 2022 during concurrent waves of both viruses. Participants were followed up 12 weeks later in September 2022 and self-reported ongoing symptoms and functional impairment. We conducted a multivariate logistic regression analysis, controlling for age, sex, First Nations status, vaccination status, and socio-economic profile.ResultsThere were 2 195 and 951 participants in the COVID-19 and influenza-positive cohorts respectively. After controlling for potential predictor variables, we found no evidence to suggest adults with COVID-19 were more likely to have ongoing symptoms (21.4% vs 23.0%, aOR 1.18; 95% CI 0.92-1.50) or moderate to severe functional impairment (4.1% vs 4.4%, OR 0.81; 95% CI 0.55-1.20) at 12 weeks after their diagnosis than adults who had influenza.ConclusionsIn a highly vaccinated population exposed to the SARS-CoV-2 omicron variant, long COVID may manifest as a post-viral syndrome of no greater severity than seasonal influenza but differing in terms of the volume of people affected and the potential impact on health systems. This study underscores the importance of long COVID research featuring an appropriate comparator group.What is already known on this subject?Post-acute infection syndromes are associated with a range of illnesses, including COVID-19 and influenza. “Long COVID” may pose a risk to health systems.What are the new findings?In a highly vaccinated population whose primary exposure has been to the Omicron variant, the rates of ongoing symptoms and moderate to severe functional impairment at 12 weeks after COVID-19 are no different to influenza.How might these results change the focus of research or clinical practice?The public health impact arising from long COVID may not stem from severity, but from volume. We do not dismiss the validity of long COVID but recommend an appropriate comparator group when researching this condition.
An unsupervised deep clustering for Bone x-ray classification and anomaly detection
Authors: Zhou Guola , Hu Caiping , Zhang Yulin , Jiang Jieru 
Published: April 2023

AbstractIn the medical field, bone abnormality detection is a very important issue. Bone abnormalities include various diseases such as fractures, osteoporosis, bone tumors, and joint diseases. If these diseases are not diagnosed and treated in a timely manner, they can seriously affect the health and quality of life of patients. Artificial intelligence has made remarkable advances in Cluster analysis of medical big data, effectively mining its hidden associations to provide effective information for clinical diagnosis and medical research. However, the effectiveness of deep learning in domains with limited or no labeled data is often limited. To address this issue, we propose a novel and reliable two-stage unsupervised deep clustering framework for skeletal anomaly detection. This framework combines neural network parameters with feature clustering for collaborative learning to detect anomalies. We trained eight separate models, one for classification and seven for anomaly detection, using the MURA dataset, the largest publicly available skeletal imaging dataset. In the first stage, our approach achieved an average sensitivity and specificity of 99.76% and 99.53%, respectively. The second stage performed optimally with an average sensitivity and specificity of 83.28% and 97.56%, respectively. Our method can be easily implemented as software modules and used as a visualization tool for skeletal physicians, making it a promising approach for future development.
Reproducibility of 3D MRSI for imaging human brain glucose metabolism using direct (2H) and indirect (1H) detection of deuterium labeled compounds at 7T and clinical 3T
Authors: Niess Fabian , Strasser Bernhard , Hingerl Lukas , Niess Eva , Motyka Stanislav , Hangel Gilbert , Krššák Martin , Gruber Stephan , Spurny-Dworak Benjamin , Trattnig Siegfried , Scherer Thomas , Lanzenberger Rupert , Bogner Wolfgang 
Published: April 2023

AbstractIntroductionDeuterium metabolic imaging (DMI) and quantitative exchange label turnover (QELT) are novel MR spectroscopy techniques for non-invasive imaging of human brain glucose and neurotransmitter metabolism with high clinical potential. Following oral or intravenous administration of non-ionizing [6,6’-2H2]-glucose, its uptake and synthesis of downstream metabolites can be mapped via direct or indirect detection of deuterium resonances using2H MRSI (DMI) and1H MRSI (QELT), respectively.The purpose of this study was to compare the dynamics of spatially resolved brain glucose metabolism, i.e., estimated concentration enrichment of deuterium labeled Glx (glutamate+glutamine) and Glc (glucose) acquired repeatedly in the same cohort of subjects using DMI at 7T and QELT at clinical 3T.MethodsFive volunteers (4m/1f) were scanned in repeated sessions for 60 min after overnight fasting and 0.8g/kg oral [6,6’-2H2]-glucose administration using time-resolved 3D2H FID-MRSI with elliptical phase encoding at 7T and 3D1H FID-MRSI with a non-Cartesian concentric ring trajectory readout at clinical 3T.ResultsOne hour after oral tracer administration regionally averaged deuterium labeled Glx4concentrations and the dynamics were not significantly different over all participants between 7T2H DMI and 3T1H QELT data for GM (1.29±0.15 vs. 1.38±0.26 mM, p=0.65 & 21±3 vs. 26±3 µM/min, p=0.22) and WM (1.10±0.13 vs. 0.91±0.24 mM, p=0.34 & 19±2 vs. 17±3 µM/min, p=0.48). Also, the observed time constants of dynamic Glc6data in GM (24±14 vs. 19±7 min, p=0.65) and WM (28±19 vs. 18±9 min, p=0.43) dominated regions showed no significant differences.Between individual2H and1H data points a weak to moderate negative correlation was observed for Glx4concentrations in GM (r=-0.52, p<0.001), and WM (r=-0.3, p<0.001) dominated regions, while a strong negative correlation was observed for Glc6data GM (r=- 0.61, p<0.001) and WM (r=-0.70, p<0.001).ConclusionThis study demonstrates that indirect detection of deuterium labeled compounds using1H QELT MRSI at widely available clinical 3T without additional hardware is able to reproduce absolute concentration estimates of downstream glucose metabolites and the dynamics of glucose uptake compared to2H DMI data acquired at 7T. This suggests significant potential for widespread application in clinical settings especially in environments with limited access to ultra-high field scanners and dedicated RF hardware.
Engineered autocrine signaling eliminates muscle cell FGF2 requirements for cultured meat production
Authors: Stout Andrew J. , Zhang Xiaoli , Letcher Sophia M. , Rittenberg Miriam L. , Shub Michelle , Chai Kristin M. , Kaul Maya , Kaplan David L. 
Published: April 2023

AbstractCultured meat is a promising technology that faces substantial cost barriers which are currently driven largely by the price of media components. Growth factors such as fibroblast growth factor 2 (FGF2) drive the cost of serum-free media for relevant cells including muscle satellite cells. Here, we engineered immortalized bovine satellite cells (iBSCs) for inducible expression of FGF2 and/or mutated RasG12Vin order to overcome media growth factor requirements through autocrine signaling. Engineered cells were able to proliferate over multiple passages in FGF2-free medium, thereby eliminating the need for this costly component. Additionally, cells maintained their myogenicity, albeit with reduced differentiation capacity. Ultimately, this offers a proof-of-principle for lower-cost cultured meat production through cell line engineering.