bluuebunny/crossref_metadata_2025_split huggingface dataset:
Divergent Findings in the Diagnosis of ATTR-CM Using Common Cardiac Diagnostics and 99mTc-DPD Scintigraphy
Authors: Kunte Sophie C. , Schwarting Stéphanie K. , Holzgreve Adrien , Wöhrle Caroline , Unterrainer Marcus , Bartenstein Peter , Unterrainer Lena M. 
Published: August 2023

Abstract
A 77-year-old man presented with progressive deterioration of physical capacity after successful percutaneous coronary intervention of known chronic coronary syndrome. Transthoracic echocardiography revealed hypertrophy of the left ventricle, and electrocardiogram showed low QRS voltage in all leads. 99mTc-DPD scintigraphy was conducted to differentiate etiology such as amyloidosis and revealed increased cardiac tracer uptake in the left (grade 3) and right ventricle. Immunofixation showed no signs of paraproteinemia or Bence-Jones proteinuria. Thus, biventricular involvement of ATTR-cardiomyopathy was identified by 99mTc-DPD scintigraphy. This approach should be considered if hypertrophic phenotype is present in patients with persistent deterioration of physical capacity not attributable to coronary artery disease.
Decreased Utilization Rate of Grafts for Liver Transplantation After Implementation of Acuity Circle–based Allocation
Authors: Bekki Yuki , Myers Bryan , Tomiyama Koji , Imaoka Yuki , Akabane Miho , Kwong Allison J. , Melcher Marc L. , Sasaki Kazunari 
Published: August 2023

Background.
The allocation system for livers began using acuity circles (AC) in 2020. In this study, we sought to evaluate the impact of AC policy on the utilization rate for liver transplantation (LT).

Methods.
Using the US national registry data between 2018 and 2022, LTs were equally divided into 2 eras: pre-AC (before February 4, 2020) and post-AC (February 4, 2020, and after). Deceased potential liver donors were defined as deceased donors from whom at least 1 organ was procured.

Results.
The annual number of deceased potential liver donors increased post-AC (from 10 423 to 12 259), approaching equal to that of new waitlist registrations for LT (n = 12 801). Although the discard risk index of liver grafts was comparable between the pre- and post-AC eras, liver utilization rates in donation after brain death (DBD) and donation after circulatory death (DCD) donors were lower post-AC (P < 0.01; 79.8% versus 83.4% and 23.7% versus 26.0%, respectively). Recipient factors, ie, no recipient located, recipient determined unsuitable, or time constraints, were more likely to be reasons for nonutilization after implementation of the AC allocation system compared to the pre-AC era (20.0% versus 12.3% for DBD donors and 50.1% versus 40.8% for DCD donors). Among non–high-volume centers, centers with lower utilization of marginal DBD donors or DCD donors were more likely to decrease LT volume post-AC.

Conclusions.
Although the number of deceased potential liver donors has increased, overall liver utilization among deceased donors has decreased in the post-AC era. To maximize the donor pool for LT, future efforts should target specific reasons for liver nonutilization.
Pulmonary Artery Pressures and Mortality during VA ECMO: An ELSO Registry Analysis
Authors: Owyang Clark G. , Rippon Brady , Teran Felipe , Brodie Daniel , Araos Joaquin , Burkhoff Daniel , Kim Jiwon , Tonna Joseph E. 
Published: August 2023

AbstractBackgroundSystemic hemodynamics and specific ventilator settings have been shown to predict survival during venoarterial extracorporeal membrane oxygenation (VA ECMO). While these factors are intertwined with right ventricular (RV) function, the independent relationship between RV function and survival during VA ECMO is unknown.ObjectivesTo identify the relationship between RV function with mortality and duration of ECMO support.MethodsCardiac ECMO runs in adults from the Extracorporeal Life Support Organization (ELSO) Registry between 2010 and 2022 were queried. RV function was quantified via pulmonary artery pulse pressure (PAPP) for pre-ECMO and on-ECMO periods. A multivariable model was adjusted for Society for Cardiovascular Angiography and Interventions (SCAI) stage, age, gender, and concurrent clinical data (i.e., pulmonary vasodilators and systemic pulse pressure). The primary outcome was in-hospital mortality.ResultsA total of 4,442 ECMO runs met inclusion criteria and had documentation of hemodynamic and illness severity variables. The mortality rate was 55%; non-survivors were more likely to be older, have a worse SCAI stage, and have longer pre-ECMO endotracheal intubation times (P < 0.05 for all) than survivors. Improving PAPP from pre-ECMO to on-ECMO time (Δ PAPP) was associated with reduced mortality per 10 mm Hg increase (OR: 0.91 [95% CI: 0.86-0.96]; P=0.002). Increasing on-ECMO PAPP was associated with longer time on ECMO per 10 mm Hg (Beta: 15 [95% CI: 7.7-21]; P<0.001).ConclusionsEarly improvements in RV function from pre-ECMO values were associated with mortality reduction during cardiac ECMO. Incorporation of Δ PAPP into risk prediction models should be considered.
Comprehensive identification of potentially functional genes for transposon mobility in theC. elegansgenome
Authors: Arata Yukinobu , Jurica Peter , Parrish Nicholas , Sako Yasushi 
Published: August 2023

AbstractTransposons are mobile DNA elements that encode genes for their own mobility. Whereas transposon copies accumulate on the genome during evolution, many lose their mobile activity due to mutations. Here, we focus on transposon-encoded genes that are directly involved in the replication, excision, and integration of transposon DNA, which we refer to as “transposon-mobility genes”, in theCaenorhabditis elegansgenome. Among the 62,773 copies of retro- and DNA transposons in the latest assembly of theC. elegansgenome (VC2010), we found that the complete open reading frame structure was conserved in 290 transposon-mobility genes. Critical amino acids at the catalytic core were conserved in only 145 of these 290 genes. Thus, in contrast to the huge number of transposon copies in the genome, only a limited number of transposons are autonomously mobile. We conclude that the comprehensive identification of potentially functional transposon-mobility genes in all transposon orders of a single species can provide a basis of molecular analysis for revealing the developmental, aging, and evolutionary roles of transposons.
Pregnancy-Associated Bleeding and Genetics: Five Sequence Variants in the Myometrium and Progesterone Signaling Pathway are associated with postpartum hemorrhage
Authors: Westergaard David , Steinthorsdottir Valgerdur , Stefansdottir Lilja , Rohde Palle Duun , Wu Xiaoping , Geller Frank , Tyrmi Jaakko , Havulinna Aki S. , Navais Pol Sole , Flatley Christopher , Ostrowski Sisse Rye , Pedersen Ole Birger , Erikstrup Christian , Sørensen Erik , Mikkelsen Christina , Brun Mie Topholm , Jensen Bitten Aagaard , Brodersen Thorsten , Ullum Henrik ,   FinnGen,   Danish Blood Donor Study Genomic Consortium,   Estonian Biobank Research Team,   Nordic Collaboration for Womens and Reproductive Health, Magnus Per , Andreassen Ole A. , Njolstad Pål R. , Kolte Astrid Marie , Krebs Lone , Nyegaard Mette , Hansen Thomas Folkmann , Fenstra Bjarke , Daly Mark , Lindgren Cecilia M. , Thorleifsson Gudmar , Stefansson Olafur A. , Sveinbjornsson Gardar , Gudbjartsson Daniel F. , Thorsteinsdottir Unnur , Banasik Karina , Jacobsson Bo , Laisk Triin , Laivuori Hannele , Stefansson Kari , Brunak Søren , Nielsen Henriette Svarre 
Published: August 2023

AbstractBleeding in early pregnancy and postpartum hemorrhage (PPH) bear substantial risks, with the former closely associated with pregnancy loss and the latter being the foremost cause of maternal death, underscoring the severity of these complications in maternal-fetal health. Here, we investigated the genetic variation underlying aspects of pregnancy-associated bleeding and identified five loci associated with PPH through a meta-analysis of 21,512 cases and 259,500 controls. Functional annotation analysis indicated candidate genes,HAND2,TBX3, andRAP2C/FRMD7,at three loci and showed that at each locus, associated variants were located within binding sites for progesterone receptors (PGR). Furthermore, there were strong genetic correlations with birth weight, gestational duration, and uterine fibroids. Early bleeding during pregnancy (28,898 cases and 302,894 controls) yielded no genome-wide association signals, but showed strong genetic correlation with a variety of human traits, indicative of polygenic and pleiotropic effects. Our results suggest that postpartum bleeding is related to myometrium dysregulation, whereas early bleeding is a complex trait related to underlying health and possibly socioeconomic status.
Lessons learned from operationalizing the integration of nutrition-specific and nutrition-sensitive interventions in rural Ethiopia
Authors: Mersha Girmay Ayana , Tariku Eshetu Zerihun , Boynito Wanzahun Godana , Woldeyohaness Meseret , Wodajo Birhanu , Kebebe Tadese , Henauw Stefaan De , Abbeddou Souheila 
Published: August 2023

AbstractBackgroundUndernutrition reduction requires coordinated efforts across sectors to address its causes. A multisectoral approach is important in diagnosing the problem and identifying solutions that would be implemented across different sectors.The study aims to explore the experience of health and agriculture extension workers in integrating nutrition services provided to households with children under two years of age at community level.MethodsA qualitative study has been conducted in agrarian areas of Ethiopia in 2021 at the end of a large intervention program to reduce stunting. In total, 28 key informant interviews were conducted with health- and agriculture-extension workers and mothers. A framework analysis approach was applied to manage and analyze data using NVivo version 12 software.ResultsCommunity-level joint intervention is a feasible approach to integrating nutrition services. Farm gardening and cooking demonstrations were practiced jointly with extension workers and households. Because of service integration, extension workers perceived an improved father’s role in supporting mothers in childcaring and feeding nutritious diets to children, and decreased severe cases of undernutrition. Integration of health and agriculture sectors for nutrition intervention was challenged by the high workload on extension workers, poor supervision and leadership commitment, lack of appropriate agricultural inputs, and absence of clarity on sector-specific roles. In some areas nutrition services are not owned by the health and agriculture sectors, and it was overlooked.ConclusionIntegrating existing community-level platforms are key entry points to address undernutrition and promote key agriculture and health interventions in Ethiopia. Empowering extension workers through training, monitoring, and supervision is part of ensuring the sustainability of integration between sectors.
Evolution of Myocarditis Incidence at a Large Healthcare System Before and During COVID-19 Pandemic
Authors: Case Brian C. , Waksman Ori , Rappaport Hank , Zhang Cheng , Waksman Ron 
Published: August 2023

AbstractBackgroundMyocarditis is a recognized complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Emerging studies further suggest an associated risk of myocarditis following administration of messenger RNA (mRNA) COVID-19 vaccinations. coronavirus disease 2019 (COVID-19) vaccinations. We investigated the incidence of myocarditis throughout the COVID-19 pandemic across a large healthcare system in the Washington, DC, metropolitan area.MethodsThis retrospective analysis of patients admitted from 2017-2022. Myocarditis cases were temporally divided into two cohorts based on year of admission (pre-pandemic 2017-2019; pandemic 2020-2022), which were compared for overall myocarditis incidence. The primary endpoint was in-hospital mortality.ResultsThe cohort included 573 myocarditis patients (pre-pandemic=208, pandemic=365). From 2017-2019, the total number and rate of myocarditis cases was consistent. Overall cases of myocarditis increased during the pandemic (97, 126, 142 patients in 2020, 2021, 2022, respectively). Interestingly, the rate of myocarditis cases not related to COVID-19 or the vaccines stayed consistent (0.0674%, 0.0676%, 0.0807%), but the rate of myocarditis related to COVID-19 or the vaccines myocarditis increased each year (0.0210%, 0.0416%, 0.0480%). In-hospital mortality was similar between the two pre-pandemic and pandemic cohorts (5.35% versus 7.7%, 0.276).ConclusionAmong hospitalized patients, during the COVID-19 pandemic, the incidence of myocarditis increased as compared to the pre-pandemic era. It appears this increase is associated with either the SARS-CoV-2 infection or COVID-19 vaccination. In-hospital outcomes did not differ during the pandemic, but ongoing research is needed to evaluate the long-term impact of myocarditis during the pandemic.
Cardiovascular risk in treated hypertensive patients with isolated diastolic hypertension and isolated low diastolic blood pressure
Authors: Chang Wei-Lun , Chen Ying-Fan , Lee Yu-Hsuan , Shiu Ming-Neng , Chang Po-Yin , Guo Chao-Yu , Huang Chi-Jung , Chiang Chern-En , Chen Chen-Huan , Chuang Shao-Yuan , Cheng Hao-Min 
Published: August 2023

AbstractBackgroundThe prognosis of high or markedly low diastolic blood pressure (DBP) with normalized on-treatment systolic blood pressure (SBP) on major adverse cardiovascular events (MACE) is uncertain. This study examined whether isolated diastolic hypertension (IDH) and isolated low DBP (ILDBP) were associated with MACE in treated patients.Methods7582 hypertensive patients with on-treatment SBP <130 mmHg from the Systolic Blood Pressure Intervention Trial (SPRINT) were categorized based on average DBP: <60 mmHg (n=1031; ILDBP), 60–79 mmHg (n=5432), ≥80 mmHg (n=1119; IDH). MACE risk was estimated using Cox proportional hazards models. The analysis was supplemented by a meta-analysis involving 10106 SPRINT and four cohort participants.ResultsMedian age of the SPRINT participants was 67.0 years, and 64.9% were men. Over a median follow-up of 3.4 years, 512 patients developed MACE. The incidence of MACE was 3.9 cases per 100 person-years for ILDBP, 1.9 cases for DBP 60–79 mmHg, and 1.8 cases for IDH. ILDBP was associated with 1.32-fold increased MACE risk (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.05–1.66), whereas IDH was not (HR: 1.18, 95% CI: 0.87–1.59). There was no effect modification by age, sex, atherosclerotic cardiovascular disease risk, or cardiovascular disease history (all p-values for interaction >0.05). The meta-analysis indicated increased MACE risk in ILDBP (HR: 1.26, 95% CI: 1.05–1.52) compared with DBP 60–79 mmHg.ConclusionsIn treated patients with normalized SBP, excessively low DBP was associated with increased MACE risk, while IDH was not. Further research is required for ILDBP management.
Effectiveness and cost-effectiveness of a culturally tailored Behavioural Activation intervention (DiaDeM) for treating Depression in Type 2 Diabetes: Protocol for a parallel arm, multi-country, randomised controlled trial in South Asia
Authors: Siddiqui Faraz , Aslam Faiza , Ahmed Naveed , Afaq Saima , Khan Asima , Keding Ada , Walker Simon , Jennings Hannah Maria , Zavala Gerardo A , Ekers David , Fottrell Edward , Hewitt Catherine , Haq Zia Ul , Siddiqi Najma ,   DiaDeM Global Health Research Group
Published: August 2023

AbstractBackgroundThe co-occurrence of depression among individuals with type 2 diabetes is a recognised global health problem and can lead to poorer health outcomes for both conditions. Behavioural activation is an evidence-based brief, low-cost psychological therapy which can be delivered by trained non-specialists, and is useful in treating depression, particularly in low-resource settings. The aim of this study is to test the effectiveness and cost-effectiveness of culturally adapted behavioural activation for depression in people with both depression and type 2 diabetes in two South Asian countries - Bangladesh and Pakistan.MethodsA parallel arm, multi-country randomised controlled trial will be conducted in urban health care facilities providing diabetes services. We will recruit 604 adults in total, and randomise them using a 1:1 allocation ratio to receive culturally adapted behavioural activation (DiaDeM), or optimised usual care. DiaDeM comprises six sessions of behavioural activation with a trained non-mental health facilitator, conducted face-to-face and/or remotely. Optimised usual care includes information on depression, pharmacological and non-pharmacological treatment options for depression and details for accessing help locally. Participants in both arms will be followed up at 6- and 12-months post-randomisation. The primary outcome is the severity of depressive symptoms at 6 months, measured using the 9-item Patient Health Questionnaire (PHQ-9). Secondary outcomes include diabetes control, measured using glycosylated haemoglobin. An embedded process evaluation will evaluate the quality of intervention delivery and explore mechanisms of change and the contextual factors associated with the implementation and observed outcomes of DiaDeM. An economic evaluation will gauge DiaDeM’s cost-effectiveness and estimate the impact of diabetes and depression on economic outcomes.ConclusionThere is an urgent need to address the rising burden of depression and chronic physical illnesses, such as type 2 diabetes. Interventions such as DiaDeM, which are culturally relevant and rely on a task-sharing approach, offer a potentially low-cost treatment within existing health services. If found to be effective and cost-effective, DiaDeM may be scaled up to address the mental health ‘treatment gap’ and improve mental and physical health outcomes for people with diabetes in South Asia.Trial registrationISRCTN40885204. Trial registered on 11th April 2023
Mitigating Pathogenesis for Target Discovery and Disease Subtyping
Authors: Strobl Eric V. , Lasko Thomas A. , Gamazon Eric R. 
Published: August 2023

AbstractTreatments ideally mitigate pathogenesis, or the detrimental effects of the root causes of disease. However, existing definitions of treatment effect fail to account for pathogenic mechanism. We therefore introduce theTreated Root causal Effects(TRE) metric which measures the ability of a treatment to modify root causal effects. We leverage TREs to automatically identify treatment targets and cluster patients who respond similarly to treatment. The proposed algorithm learns a partially linear causal model to extract the root causal effects of each variable and then estimates TREs for target discovery and down-stream subtyping. We maintain interpretability even without assuming an invertible structural equation model. Experiments across a range of datasets corroborate the generality of the proposed approach.
Comprehensive Analysis of Lung Cancer Classification Using Gaussian Process Classifier: Unveiling Exceptional Performance and Clinical Implications
Authors: Santos Dheiver Francisco 
Published: August 2023

AbstractIn this analysis, the performance of the Gaussian Process Classifier (GPC) was evaluated for classifying instances of lung cancer using various metrics. The GPC model achieved impressive results, with accuracy ranging from approximately 83.87% to 96.67%. Precision values ranged from 75.86% to 96.79%, recall values ranged from 83.87% to 96.67%, and F1-score values ranged from 81.09% to 96.36%. These metrics highlight the GPC model’s exceptional performance in accurately classifying lung cancer cases. The findings from this analysis have significant implications for improving lung cancer diagnosis, treatment planning, and ultimately enhancing patient outcomes.
Sexually dimorphic leading-edge serrations evolved in silent swallows
Authors: Hasegawa Masaru 
Published: August 2023

AbstractLeading-edge serrations are specialized feather structures, mitigating acoustic noise during foraging flight in owls, and have been extensively studied and applied to man-made noise-reducing structures. Similar structures occur in other avian species, such as swallows, although the ecological functions of the serrations in these species remain unclear. I conducted macroevolutionary analyses of hirundines (subfamily: Hirundininae), in which leading-edge serrations evolved multiple times, to examine their evolution in relation to vocal activity. I found that silent hirundines showed a higher probability of possessing leading-edge serrations, indicating that leading-edge serrations of swallows serve some functions associated with acoustics as in owls. I also found that silent vocal activity accompanied loss of song, a well-known acoustic sexual signal, but not with sexual plumage dimorphism, indicating that not sexual selection in general but sexual selection on acoustic traits matters. These findings explain sexually dimorphic leading-edge serrations, a unique characteristic in these diurnal visually-foraging birds: stealth males rather than noisy males would be favored. Although leading-edge serrations in hirundines would serve acoustic functions like nocturnal birds such as owls, they might serve a unique sexual function.
Risk of opioid-related mortality associated with buprenorphine versus methadone: A systematic review of observational studies
Authors: Lim Jihoon , Farhat Imen , Douros Antonios , Ouizzane Soukaina , Panagiotoglou Dimitra 
Published: August 2023

ABSTRACTIntroductionBuprenorphine and methadone are effective treatments of opioid use disorder (OUD) and can reduce drug-related mortality. While observational studies have compared head-to-head buprenorphine and methadone, this evidence has not been previously synthesized. Our study aims to systematically review the available evidence on the comparative effectiveness of buprenorphine and methadone in people with OUD, thereby rigorously assessing the methodological quality of individual studies.MethodsWe searched Medline, Embase, PsycINFO, and Web of Science for all relevant articles published between 1978 and April 8, 2023. Observational studies directly comparing the risk of drug-related mortality between buprenorphine and methadone among people with OUD were eligible. We assessed the overall risk of bias using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.ResultsOur systematic review included seven studies. There was mixed evidence of comparative mortality risk, with heterogeneity across study region, time, and treatment status (on treatment vs. discontinued). Three studies reported no difference, and four reported findings in favour of buprenorphine. Based on ROBINS-I, three studies had a moderate risk of bias, two had a severe risk, and two had a critical risk. Major sources of biases were residual confounding and selection bias along with presence of prevalent user bias, informative censoring, and left truncation.ConclusionsDue to methodological limitations of the observational studies, generalizability of their findings remains unknown. Therefore, to provide a more accurate comparative safety profile for these two medications, further observational studies with methodological rigour are warranted.