bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and key disparities of obesity among US adolescents: the NHANES from 2007 to 2020
Authors: Deng Yangyang , Yli-Piipari Sami , El-Shahawy Omar , Tamura Kosuke 
Published: August 2023

AbstractThis study aimed to estimate the trends in the body mass index (BMI) and prevalence of obesity among United States (U.S.) adolescents (10-19 years), and to examine the associations between sociodemographic factors and both BMI and obesity prevalence. The 2007-2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative repeated cross- sectional survey data (n = 9,826) were used. Outcomes included: 1) Mean BMI and 2) obesity (yes/no; defined as BMI ≥ 95% percentile). Sociodemographic variables included age, sex, race/ethnicity, and poverty income ratio (PIR; low-income <1.3, Middle-income ≥1.3 and <3.5, high-income ≥3.5). By accounting for the complex survey design, weighted generalized linear/Poisson models were used to conduct the analyses. Girls constituted 49 % of the sample. From 2007-2008 to 2017-2020, BMI and obesity prevalence increased across various subgroups, including Black and Hispanic adolescents, boys, and those from low- and middle-income families. Girls are a 12% lower likelihood of being obese than boys. Compared to White adolescents, Black and Hispanic adolescents had 22% and 19% greater risk of being obese. Compared to those from high-income families, adolescents from low- and middle-income families had 62% and 47% greater risk of being obese, respectively. The results indicated persistent disparities in obesity prevalence among different race/ethnic and sociodemographic groups. Future obesity intervention should address key disparities by targeting specific race/ethnic adolescents from low-income families and promoting health equality.
Risk Score Models for Unplanned Urinary Tract Infection Hospitalization
Authors: Alizadeh Nasrin , Vahdat Kimia , Shashaani Sara , Swann Julie L. , Ozaltin Osman 
Published: August 2023

AbstractAnnually, urinary tract infections (UTIs) affect over a hundred million people worldwide. Early detection of high-risk individuals can help prevent hospitalization for UTIs, which imposes significant economic and social burden on patients and caregivers. We present two methods to generate risk score models for unplanned UTI hospitalization. We utilize a sample of patients from the insurance claims data provided by the Centers for Medicare and Medicaid Services to develop and validate the proposed methods. Our dataset encompasses a wide range of features, such as demographics, medical history, and healthcare utilization of the patients along with provider quality metrics and community-based metrics. The proposed methods scale and round the coefficients of an underlying logistic regression model to create scoring tables. We present computational experiments to evaluate the prediction performance of both models. We also discuss different features of these models with respect to their impact on interpretability. Our findings emphasize the effectiveness of risk score models as practical tools for identifying high-risk patients and provide a quantitative assessment of the significance of various risk factors in unplanned UTI hospitalizations such as admission to ICU in the last 3 months, cognitive disorders and low inpatient, outpatient and carrier costs in the last 6 months.
Why some countries but not others? Urbanisation, GDP and endemic disease predict global SARS-CoV-2 excess mortality patterns
Authors: Fountain-Jones Nicholas M. , Charleston Michael , Flies Emily , Carver Scott , Yates Luke 
Published: August 2023

AbstractThe global impact of the SARS-CoV-2 pandemic has been uneven, with some regions experiencing significant excess mortality while others have been relatively unaffected. Yet factors which predict this variation remain enigmatic, particularly at large spatial scales. We used spatially explicit Bayesian models that integrate socio-demographic and endemic disease data at the country level to provide robust global estimates of excess SARS-CoV-2 mortality (P scores) for the years 2020 and 2021. We find that gross domestic product (GDP), spatial patterns and urbanization are strong predictors of excess mortality, with countries characterized by low GDP but high urbanization experiencing the highest levels of excess mortality. Intriguingly, we also observed that the prevalence of malaria and human immunodeficiency virus (HIV) are associated with country-level SARS-CoV-2 excess mortality in Africa and the Western Pacific, whereby countries with low HIV prevalence but high malaria prevalence tend to have lower levels of excess mortality. While these associations are correlative in nature at the macro-scale, they emphasize that patterns of endemic disease and socio-demographic factors are needed to understand the global dynamics of SARS-CoV-2.
The ABCD-GENE score influences vascular event rates in both users of clopidogrel and aspirin, as well as non-users of either drug in a population-based cohort study
Authors: Narasimhalu Kaavya , Mayerhofer Ernst , Parodi Livia , Georgakis Marios K , De Silva Deidre Anne , Rosand Jonathan , Anderson Christopher D 
Published: August 2023

AbstractBackground and ObjectivesClopidogrel is an antiplatelet used in both primary and secondary prevention of cardiovascular diseases. It is a prodrug, requiringCYP2C19for its metabolism to the active metabolite. The ABCD-GENE score, combining clinical attributes (age, body mass index, chronic kidney disease, diabetes mellitus), with genetic information (presence of 1 or 2 loss of function (LOF) alleles in theCYP2C19gene) has been shown to identify patients with higher risk of recurrent cardiovascular events in high-risk populations undergoing percutaneous coronary intervention. We aimed to determine if the ABCD-GENE score or LOF alleles were associated with an increased risk of vascular events among clopidogrel users in a general population.MethodsWe conducted a population based cohort study with UK Biobank’s primary care prescription records to identify clopidogrel users. ABCD-GENE scores were calculated with closest available data from the first date of clopidogrel prescription. The number of LOF alleles present, and the clinical component ABCD, were separate exposures. The outcome of interest was a composite endpoint of vascular events comprised of myocardial infarction, ischemic stroke, and death due to either of these. We performed Cox proportional hazards models with clopidogrel as a time varying exposure to predict hazards of these outcomes. In order to determine the drug specificity of these exposures, the analyses were repeated in aspirin users, and in non-users of either aspirin or clopidogrel.ResultsAmong 11,248 clopidogrel users, 3,365 (30%) developed a vascular event over a mean follow-up of 5.95±3.94 years. ABCD-GENE score ≥10 was associated with an increased risk of vascular events (HR 1.13, 95% CI 1.03-1.23). In aspirin users, and in non-users of either aspirin or clopidogrel, the ABCD-GENE score was also associated with increased risk of vascular events. In clopidogrel users, aspirin users, and non-users of either drug, the ABCD score was associated with increased risk of vascular events. The presence of twoCYP2C19LOF alleles was associated with an increased risk of vascular events in aspirin and non-users but not in clopidogrel users.DiscussionIn this population-based cohort study, the ABCD-GENE score was associated with an increased risk of vascular events in clopidogrel users, aspirin users, and in non-users of either drug. The clinical component, ABCD was also associated with an increased risk of vascular events in all three groups. This suggests that the ABCD-GENE score is not specific to clopidogrel users in identifying persons at high risk of vascular events in a general sample with low baselineCYP2C19LOF allele frequency.
Impact of ventriculo-cisternal irrigation in preventing delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage
Authors: Umekawa Motoyuki , Yoshikawa Gakushi 
Published: August 2023

AbstractBackgroundDelayed cerebral ischemia (DCI) due to vasospasm following subarachnoid hemorrhage (SAH) is considered a significant determinant of morbidity and mortality; however, no established method exists to prevent and treat vasospasm or DCI. This study aimed to evaluate the effectiveness of ventriculo-cisternal irrigation (VCI) in preventing vasospasms and DCI.MethodsWe retrospectively identified 340 SAH patients with ruptured intracranial aneurysms treated with postoperative VCI at our institution between December 2010 and January 2020. Ventricular/cisternal drainage (VD/CD) was inducted during aneurysm surgery, and lactated Ringer’s solution was used for irrigation until day 4 of SAH, followed by ICP control at 5–10 cmH2O until day 14. We collected data on total vasospasm, DCI, and modified Rankin Scale scores at discharge and analyzed the risk factors using logistic regression models.ResultsThe median age was 65 years (interquartile range: 52–75), with 236 female patients (69%). The World Federation of Neurosurgical Societies grade distribution was as follows: Grade I or II, 175 cases (51%); Grade III or IV, 84 (25%); Grade V, 81 (24%). With VCI management in all cases, total vasospasm occurred in 162 patients (48%), but DCI incidence was low (23 patients [6.8%]). Major drainage-related complications were observed in five patients (1.5%). Early surgery, performed on SAH day 0 or 1, was identified as a preventivefactor against DCI occurrence (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.07–0.67;p= 0.008), while additional surgery (OR 4.76, 95% CI 1.62–13.98;p= 0.005) and dyslipidemia (OR 3.27, 95% CI 1.24–8.63;p= 0.017) were associated with DCI occurrence.ConclusionsManaging vasospasms with VCI after SAH achieved a low incidence of 6.8% for DCI and is considered a safe and effective method. Early surgery after SAH occurrence was associated with a decreased risk of DCI with VCI therapy.
High-throughput detection of neutralizing antibodies to SARS-CoV-2 variants using flow cytometry
Authors: Zhang Xiaohan , Wang Yajie , Li Mansheng , Li Haolong , Zhang Xiaomei , Xu Xingming , Hu Di , Liang Te , Zhu Yunping , Li Yongzhe , Wang Bingwei , Yu Xiaobo 
Published: August 2023

AbstractDetecting neutralizing antibodies (NAbs) to SARS-CoV-2 variants is crucial for controlling COVID-19 spread. We developed a high-throughput assay for the broad systematic examination of NAbs to eleven SARS-CoV-2 variants, which include D614G, Alpha, Beta, Gamma, Delta, Kappa, and Omicron sub-lineages BA.1-BA.5. The assay is cost-effective, reliable, 35-fold more sensitive than Luminex technology, and can include new variants during SARS-CoV-2 evolution. Importantly, our results highly correlated with a commercial IgG serological assay (R = 0.89), the FDA-approved cPass sVNT assay (R = 0.93), pseudivirus-based neutralizing assay (R = 0.96, R = 0.66, R = 0.65) and live virus based neutralization assay (R = 0.79, R = 0.64) . Using this platform, we constructed a comprehensive overview of the interactions between SARS-CoV-2 variants’ Spike trimer proteins and ACE2 receptors, and identified a polyclonal Ab with broad neutralizing activity. Furthermore, when compared to the D614G variant, we found that the serum NAbs elicited by the third dose vaccine demonstrated decreased inhibition to multiple SARS-CoV-2 variants, including Gamma (0.94×), Alpha (0.91×), Delta (0.91×), Beta (0.81×), Kappa (0.81×), BA.2 (0.44×), BA.1 (0.43×), BA.3 (0.41×), BA.5 (0.35×) and BA.4 (0.33×), in cohort of 56 vaccinated individuals. Altogether, our proteomics platform proves to be an effective tool to detect broad NAbs in the population and aid in the development of future COVID-19 vaccines and vaccination strategies.
Caffeinated or decaffeinated coffee consumption and risk of cancer incidence: meta-analyses of prospective cohort studies
Authors: Nguyen Thanh N. , Cherepakhin Olga S. , Eng Devin K. , Kawasumi Masaoki 
Published: August 2023

AbstractMany epidemiological studies have investigated the association between coffee consumption and risks for various types of cancer, yet results are conflicting. To determine the impact of coffee consumption on cancer incidence, we systematically reviewed high-quality prospective cohort studies for 10 major cancer types and performed meta-analyses of 63 studies from different countries. For each cancer type, we calculated summary relative risks using the DerSimonian–Laird random-effects model and assessed dose-response relationships. Our meta-analyses found that caffeinated coffee consumption, but not decaffeinated coffee, prevented liver and skin cancers, highlighting the significant role of caffeine in cancer prevention. Furthermore, both caffeinated and decaffeinated coffee prevented endometrial cancer, indicating the role of other active compounds in coffee. Collectively, our meta-analyses revealed that coffee consumption, particularly caffeinated coffee, prevents the incidence of liver, endometrial, and skin cancers in a dose-dependent manner, suggesting that coffee consumption has a large impact on public health.
Maternal-fetal outcomes in patients with immune mediated inflammatory diseases, with consideration of comorbidities: a retrospective cohort study in a large U.S. healthcare system
Authors: Hwang Yeon Mi , Wei Qi , Piekos Samantha N. , Vemuri Bhargav , Molani Sevda , Mease Philip , Hood Leroy , Hadlock Jennifer J. 
Published: August 2023

AbstractBackgroundImmune-mediated inflammatory diseases (IMIDs) are likely to complicate maternal health. However, literature data on patients with IMIDs undergoing pregnancy is scarce and often overlooks the impact of comorbidities.MethodsWe investigated 12 selected IMIDs: psoriasis, inflammatory bowel disease, rheumatoid arthritis, spondyloarthritis, multiple sclerosis, systemic lupus erythematosus, psoriatic arthritis, antiphospholipid syndrome, Sjögren’s syndrome, vasculitis, sarcoidosis, systemic sclerosis. We characterized patients with IMIDs prior to pregnancy (IMIDs group) based on pregnancy/maternal characteristics, comorbidities, and pre-pregnancy/prenatal immunomodulatory medications (IMMs) prescription patterns. We 1:1 propensity score matched the IMIDs cohort with people who had no IMID diagnoses prior to pregnancy (non-IMIDs cohort). Outcome measures were preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), and cesarean section.FindingsThe prevalence rate of pregnancy occurring with people with a previous IMID diagnosis has doubled in the past ten years. We identified 5,784 patients with IMIDs. 17% of the IMIDs group had at least one prenatal IMM prescription. Depending on the type of IMM, from 48% to 70% of the patients taking IMMs before pregnancy continued them throughout pregnancy. Patients with IMIDs had similar but slightly increased risks of PTB (Relative risk (RR)=1·1[1·0, 1·3]), LBW (RR=1·2 [1·0,1·4]), SGA (RR=1·1 [1·0,1·2]), and cesarean section (RR=1·1 [1·1,1·2]) compared to a matched cohort of people without IMIDs. Out of the 12 selected IMIDs, three for PTB, one for LBW, two for SGA, and six for cesarean section had results supporting increased risk.InterpretationThe association between IMIDs and the increased risk of adverse pregnancy outcomes depend on both the nature of the IMID and the presence of comorbidities.FundingNIH
EEG to fMRI Synthesis for Medical Decision Support: A Case Study on Schizophrenia Diagnosis
Authors: Calhas David , Henriques Rui 
Published: August 2023

AbstractElectroencephalography (EEG) measures the neuronal activity at the scalp, while functional magnetic resonance imaging (fMRI) provides a sub-cortical view of blood supply in the human brain. Although fMRI is known for providing rich spatial information, it is expensive and of restricted use. EEG to fMRI synthesis is a cross modal research area that bridges the gap between the two and has recently received attention. Although these studies promise lower healthcare costs and ambulatory assessments, their utility in diagnostic settings is still largely untapped. Using simultaneous EEG and fMRI recordings, this study combines a state-of-the-art synthesis model with a modified contrastive loss, and subsequent prediction layering, to unprecedentedly assess its predictive power in schizophrenia diagnosis. In addition, we perform an exhaustive search for the (synthesized) hemodynamic brain patterns able to discriminate schizophrenia. Schizophrenia diagnosis using synthesized hemodynamics yield an area under the ROC curve of 0.77, confirming the validity of the undertaken neuroimaging synthesis. Experiments further revealed schizophrenia-related patterns in frontal, left temporal and cerebellum regions of the brain. Altogether, our results suggest that a synthesized fMRI view is able to discriminate this pathology, and it contains discriminative patterns of brain activity in accordance with related work on schizophrenia.
Plasma CXCL8 and MCP-1 as biomarkers of latent tuberculosis infection
Authors: Selvavinayagam Sivaprakasam T , Aswathy Bijulal , Yong Yean K , Frederick Asha , Murali Lakshmi , Kalaivani Vasudevan , Jith Karishma S , Rajeshkumar Manivannan , Anusree Adukkadukkam , Kannan Meganathan , Gopalan Natarajan , Vignesh Ramachandran , Murugesan Amudhan , Tan Hong Yien , Zhang Ying , Chandramathi Samudi , Sivasankaran Munusamy Ponnan , Govindaraj Sakthivel , Byrareddy Siddappa N , Velu Vijayakumar , Larsson Marie , Shankar Esaki M , Raju Sivadoss 
Published: August 2023

ABSTRACTBackgroundEarly detection of latent tuberculosis infection (LTBI) is critical to TB elimination in the current WHO vision ofEnd Tuberculosis Strategy.MethodsWe investigated whether detecting plasma cytokines could aid in diagnosing LTBI across household contacts (HHCs) positive for IGRA, HHCs negative for IGRA, and healthy controls. We also measured the plasma cytokines using a commercialBio-Plex Pro Human Cytokine 17-plexassay.ResultsIncreased plasma CXCL8 and decreased MCP-1, TNF-α, and IFN-γ were associated with LTBI. Regression analysis showed that a combination of CXCL8 and MCP-1 increased the risk of LTBI among HHCs to 14-fold.ConclusionsWe postulated that CXCL8 and MCP-1 could be the surrogate biomarkers of LTBI, especially in resource-limited settings.
Effect of sensor number and location on accelerometry-based vertical ground reaction force estimation during walking
Authors: Pimentel Ricky , Armitano-Lago Cortney , MacPherson Ryan , Sathyan Anoop , Twiddy Jack , Peterson Kaila , Daniele Michael , Kiefer Adam W. , Lobaton Edgar , Pietrosimone Brian , Franz Jason 
Published: August 2023

AbstractKnee osteoarthritis is a major cause of global disability and is a major cost for the healthcare system. Lower extremity loading is a determinant of knee osteoarthritis onset and progression; however, technology that assists rehabilitative clinicians in optimizing key metrics of lower extremity loading is significantly limited. The peak vertical component of the ground reaction force (vGRF) in the first 50% of stance is highly associated with biological and patient-reported outcomes linked to knee osteoarthritis symptoms. Monitoring and maintaining typical vGRF profiles may support healthy gait biomechanics and joint tissue loading to prevent the onset and progression of knee osteoarthritis. Yet, the optimal number of sensors and sensor placements for predicting accurate vGRF from accelerometry remains unknown. Our goals were to: 1) determine how many sensors and what sensor locations yielded the most accurate vGRF loading peak estimates during walking; and 2) characterize how prescribing different loading conditions affected vGRF loading peak estimates.We asked 20 young adult participants to wear 5 accelerometers on their waist, shanks, and feet and walk on a force-instrumented treadmill during control and targeted biofeedback conditions prompting 5% underloading and overloading vGRFs. We trained and tested machine learning models to estimate vGRF from the various sensor accelerometer inputs and identified which combinations were most accurate.We found that a neural network using one accelerometer at the waist yielded the most accurate loading peak vGRF estimates during walking, with errors around 4.3% body weight. The waist-only configuration was able to distinguish between control and overloading conditions prescribed using biofeedback, matching measured vGRF outcomes. Including foot or shank acceleration signals in the model reduced accuracy, particularly for the overloading condition. Our results suggest that a system designed to monitor changes in walking vGRF or to deploy targeted biofeedback may only need a single accelerometer located at the waist.
Pediatric Device Clinical Trials Activity Compared to Drugs and Biologics Trials 1999-2022
Authors: Dienstman Joshua , Stachelek Stanley J. , Krieger Abba M. , Eskandanian Kolaleh , Espinoza Juan C. , Harrison Michael R. , Koh Chester J. , Peiris Vasum , Torjusen Erika , Levy Robert J. 
Published: August 2023

AbstractObjectiveThis study assessed the state of PMD development by comparing PMD clinical trials to pediatric trials evaluating drugs and biologics, from 1999-2022. We hypothesized changes in numbers and types of PMD trials compared to drugs and biologics represent an indicator of PMD growth.Study Designwww.clinicaltrials.govwas used to identify and quantify both PMD clinical trials and pediatric trials for drugs and biologics. Clinical specialty was also assessed. The institutions included were the seven children’s hospitals primarily affiliated with the FDA PDC grants program between 2018-2023.Results243 PMD clinical trials were identified based on the year of initiation. The average number of PMD trials initiated per year per institution was 1.5. PMD trials significantly increased (p=0.0083) from 2014 onward compared to pediatric clinical trials for drugs and biologics, which demonstrated no significant change in trial initiation activity. A more than five-fold increase in PMD trials was observed from 2014-2018 compared to previous time periods, and there were 48% more PMD trials from 2019-2022 compared to 2014-2018. PMD trials represented 5% of clinical trials at the institutions studied.ConclusionsWhile clinical trial activity for drug and biologic development remained stable from 1999-2022, initiation of PMD trials significantly increased. The present results suggest that clinical trials growth reflects increased PMD development. Accommodation and promotion of PMD clinical trial activity, which is still relatively small, by relevant programs and policies at the institutional and government levels may foster the advancement of PMD to further address unmet needs.Article SummaryThis article is an analysis of device trials performed at seven children’s hospitals affiliated with the FDA Consortia grants program between 1999 and 2022.What’s Known on This SubjectThere have been no prior studies of device trial activity at a cohort of children’s hospitals at academic medical centers. Over the past decade, FDA programs have been initiated to assist stakeholders in advancing the development of pediatric medical devices.What This Study AddsPediatric device trials account for only 5% of total trials at the institutions studied. Of note, only half of these PMD trials (2.4% of total clinical trials) were sponsored by industry and likely seeking pediatric labeling.