bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-exposure Prophylaxis Discontinuation During the COVID-19 Pandemic Among Men Who Have Sex With Men in a Multisite Clinical Cohort in the United States
Authors: Goedel William C. , Rogers Brooke G. , Li Yu , Nunn Amy S. , Patel Rupa R. , Marshall Brandon D. L. , Mena Leandro A. , Ward Lori M. , Brock J. Benjamin , Napoleon Siena , Zanowick-Marr Alexandra , Curoe Kate , Underwood Ashley , Johnson Catrell J. , Lockwood Khadijra R. , Chan Philip A. 
Published: June 2022

Background:
The coronavirus disease 2019 (COVID-19) pandemic continues to put strain on health systems in the United States, leading to significant shifts in the delivery of routine clinical services, including those offering HIV pre-exposure prophylaxis (PrEP). We aimed to assess whether individuals discontinued PrEP use at higher rates during the COVID-19 pandemic and the extent to which disruptions to usual clinical care were mitigated through telehealth.

Methods:
Using data from an ongoing prospective cohort of men who have sex with men (MSM) newly initiating PrEP in 3 mid-sized cities (n = 195), we calculated the rate of first-time discontinuation of PrEP use in the period before the COVID-19 pandemic and during the COVID-19 pandemic and compared these rates using incidence rate ratios (IRRs). Furthermore, we compared the characteristics of patients who discontinued PrEP use during these periods with those who continued to use PrEP during both periods.

Results:
Rates of PrEP discontinuation before the COVID pandemic and during the COVID-19 pandemic were comparable [4.29 vs. 5.20 discontinuations per 100 person-months; IRR: 1.95; 95% confidence interval (CI): 0.83 to 1.77]. Although no significant differences in the PrEP discontinuation rate were observed in the overall population, the rate of PrEP discontinuation increased by almost 3-fold among participants aged 18–24 year old (IRR: 2.78; 95% CI: 1.48 to 5.23) and by 29% among participants covered by public insurance plans at enrollment (IRR: 1.29; 95% CI: 1.03 to 5.09). Those who continued to use PrEP were more likely to have had a follow-up clinical visit by telehealth in the early months of the pandemic (45% vs. 17%).

Conclusions:
In this study, rates of PrEP discontinuation were largely unchanged with the onset of the COVID-19 pandemic. The use of telehealth likely helped retain patients in PrEP care and should continue to be offered in the future.
Implementation of a digital early warning score (NEWS2) in a cardiac specialist and general hospital settings in the COVID-19 pandemic: A qualitative study
Authors: Alhmoud Baneen , Bonnici Timothy , Patel Riyaz , Melley Daniel , Hicks Louise , Banerjee Amitava 
Published: June 2022

AbstractObjectivesTo evaluate implementation of EHR-integrated NEWS2 in a cardiac care setting and a general hospital setting in the COVID-19 pandemic.DesignThematic analysis of qualitative semi-structured interviews with purposefully sampled nurses and managers, as well as online surveys.SettingsSpecialist cardiac hospital (St Bartholomew’s Hospital) and General teaching hospital (University College London Hospital).ParticipantsEleven nurses and managers from cardiology, cardiac surgery, oncology, and intensive care wards (St Bartholomew’s) and medical, haematology and intensive care wards (UCLH) were interviewed and sixty-seven were surveyed online.ResultsThree main themes emerged: (i) Implementing NEWS2 challenges and supports; (ii) Value of NEWS2 to alarm, escalate, particularly during the pandemic; and (iii) Digitalisation: EHR integration and automation. The value of NEWS2 was partly positive in escalation, yet there were concerns by nurses who undervalued NEWS2 particularly in cardiac care. Challenges, like clinicians’ behaviours, lack of resources and training and the perception of NEWS2 value, limit the success of this implementation. Changes in guidelines in the pandemic have led to overlooking NEWS2. EHR integration and automated monitoring are improvement solutions that are not fully employed yet.ConclusionWhether in specialist or general medical settings, the health professionals implementing EWS in healthcare face cultural and systems related challenges to adopting NEWS2 and digital solutions. The validity of NEWS2 in specialised settings and complex conditions is not yet apparent and requires comprehensive validation. EHRs integration and automation are powerful tools to facilitate NEWS2 if its principles are reviewed and rectified, and resources and training are accessible. Further examination of implementation from the cultural and automation domains are needed.
Impact of clonal hematopoiesis on atherosclerotic cardiovascular disease according to low-density lipoprotein cholesterol levels
Authors: Lee Heesun , Song Han , Koh Youngil , Park Hyo Eun , Yoon Ji Won , Kim Min Joo , Chung Soie , Bae Jung Ho , Choi Seung Ho , Choi Su-Yeon , Koo Bon-Kwon 
Published: June 2022

ABSTRACTBackgroundClonal hematopoiesis of indeterminate potential (CHIP), defined as a clonal expansion of hematopoietic stem cells with age-related recurrent somatic mutations, has recently emerged as a novel cardiovascular risk factor. However, the pathogenic mechanism of CHIP in atherosclerotic cardiovascular disease (ASCVD) development is not yet fully understood.MethodsIn a cohort comprising 4,300 asymptomatic Korean participants aged 40–79 years, we investigated the risks associated with ASCVD by CHIP and the interplay of CHIP with other traditional risk factors for developing ASCVD. Using coronary computed tomography angiography (CCTA), we noninvasively assessed the changes in coronary arteries to evaluate CHIP-associated atherosclerosis.ResultsCHIP was present in 368 participants (8.6%). The most commonly mutated genes in CHIP included DNMT3A, TET2, and ASXL1. During follow-up (median, 4.7 years), 18 ASCVD cases (4.9%) were observed in CHIP carriers vs. 62 (1.6%) in non-carriers (p<0.001). The presence of CHIP was associated with an increased risk of ASCVD (adjusted hazard ratio [HR] 2.54, 95% confidence interval [CI] 1.48–4.37, p<0.001) after adjusting for other conventional cardiovascular risk factors. Particularly, in participants with high levels of low-density lipoprotein (LDL) cholesterol, CHIP enhanced the risk of ASCVD development (adjusted HR 4.18, 95% CI 1.99–8.77, p<0.001), demonstrating a significant synergism between CHIP and LDL cholesterol (S-index, 4.61; 95% CI 1.04–20.57, p=0.045). Serial CCTAs supported our findings by displaying de novo measurable coronary atherosclerosis with unstable plaque and in proximal lesions only in CHIP carriers with high LDL cholesterol.ConclusionThe presence of CHIP was significantly associated with the risk of ASCVD through synergy with LDL cholesterol in the general population, which might promote the early stage of coronary atherosclerosis.
Anti-vascular endothelial growth factor for diabetic macular edema: a Bayesian network analysis
Authors: Wang Xianhuai , Guo Xinyu , Li Tianhui , Sun Xincheng 
Published: June 2022

AbstractAimsComparison of the efficacy of six Anti- vascular endothelial growth drugs in the treatment of diabetic macular edemaMethodsThis network meta-analysis has been registered on the PROSPERO platform (CRD42022295684).A comprehensive search of eight databases without language restrictions.PubMed, EMBASE, Web of Science, Cochrane Library, CBM, CNKI, VIP, and Wanfang were used to search for randomized controlled trials on anti- vascular endothelial growth factor of diabetic macular edema, no language restrictions and publication time restrictions. According to the inclusion and exclusion criteria, literatures were screened, data were extracted and literature quality was evaluated, and the mean changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were obtained. Using the Gemtc 1.0-1 package in R 4.1.2 to call the JAGS and the Markov Chain-Monte Card (MC-MC) method for Bayesian network meta-analysis. Risk of bias was assessed using RevMan 5.3. Stata 14.0 draws funnel plots to assess publication bias.RESULTSSixteen studies including 3651 eyes were included, all with treatment follow-up over 6 months. The overall heterogeneity in the network analysis was low(I²=0), and there was no inconsistency. For the efficacy of reducing CMT, ranking according to the cumulative probability: Faricimab (0.9) > Brolucizumab (0.87) > Aflibercept (0.58) > Conbercept (0.37) > Ranibizumab (0.29)>Bevacizumab (0), but there was no statistically significant difference between Conbercept and Faclibercept, Aflibercept, and Buloxizumab. For the efficacy of improving BCVA, ranking according to the cumulative probability: Conbercept (0.87) > Faricimab (0.79) > Aflibercept (0.61) > Brolucizumab (0.51) > Ranibizumab (0.2)>Bevacizumab (0.02), but there was no statistically significant difference between Conbercept and Faclibercept, Aflibercept, and Brolucizumab.
The evolving scenario of COVID-19 in hemodialysis patients
Authors: Esposito Pasquale , Picciotto Daniela , Cappadona Francesca , Russo Elisa , Falqui Valeria , Conti Novella Evelina , Parodi Angelica , Mallia Laura , Cavagnaro Sara , Battaglia Yuri , Viazzi Francesca 
Published: June 2022

ABSTRACTBackground‘Coronavirus disease 2019 (COVID-19) is a rapidly changing disease. So, in this study, we evaluated the evolution of COVID-19 presentation and course in hemodialysis patients (HD).MethodsWe retrospectively compared clinical data and outcomes of HD patients affected by COVID-19 during the first pandemic waves of 2020 (from March to December 2020-Group 1) with patients diagnosed with COVID-19 from September 2021 to February 2022 (Group 2), after the full completion of vaccination. Then, we distinguished among them patients responsive (antibody levels > 13 binding antibody units/ml) and unresponsive to the vaccine. We collected data on COVID-19 clinical presentation, laboratory examinations, and outcomes.ResultsGroup 1 was constituted of 44 patients (69.3±14.6 years) and Group 2 of 55 patients (67.4±15.3 years). Among Group 2, fifty-two patients (95%) were vaccinated, 43 of them (83%) with three doses. Patients of Group 2, compared with Group 1, were more often asymptomatic (38 vs 10%, p=0.002), and reported less frequent fever and pulmonary involvement. At diagnosis, the Group 2 showed a significantly higher number of lymphocytes (0.97±0.45 vs 0.69±0.35 cells x109/L, p=0.008) and lower levels of circulating IL-6 (16±13.3 vs 41±39.4 pg/ml, p=0.002). Moreover, in Group 2, inflammatory parameters significantly improved after a few days from diagnosis. Patients of Group 2 presented a lower hospitalization rate (12.7 vs 38%, p=0.004), illness duration (18.8±7.7 vs 29.2±19.5 days, p=0.005), and mortality rate (5.4 vs 25%, p= 0.008). Finally, responders to the vaccination (80% of the vaccinated patients) compared with non-responders showed a reduction in infection duration and hospitalization (5 vs 40%, p=0.018).ConclusionsCOVID-19 presentation and course in HD patients have improved over time after the implementation of vaccine campaigns. However, due to the evolving nature of the disease, active surveillance is necessary.
Estimating the contribution of subclinical tuberculosis disease to transmission – an individual patient data analysis from prevalence surveys
Authors: Emery Jon C. , Dodd Peter J. , Banu Sayera , Frascella Beatrice , Garden Frances L. , Horton Katherine C. , Hossain Shahed , Law Irwin , van Leth Frank , Marks Guy B. , Nguyen Hoa Binh , Nguyen Hai Viet , Onozaki Ikushi , Quelapio Maria Imelda D. , Richards Alexandra S , Shaikh Nabila , Tiemersma Edine W. , White Richard G , Zaman Khalequ , Cobelens Frank , Houben Rein MGJ 
Published: June 2022

AbstractBackgroundIndividuals with bacteriologically confirmed pulmonary tuberculosis disease (TB) that do not report symptoms (subclinical TB) represent around half of all prevalent cases of TB, yet their contribution to Mycobacterium tuberculosis (Mtb) transmission is unknown, especially compared to individuals who report symptoms at time of diagnosis (clinical TB). Relative infectiousness can be approximated by cumulative infections in household contacts, but such data are rare.Methods and FindingsWe reviewed the literature to identify studies where surveys of Mtb infection were linked to population surveys of TB disease. We collated individual population data for analysis and used literature on the relative durations of subclinical and clinical TB to estimate relative infectiousness through a cumulative hazard model, accounting for sputum-smear status. Relative prevalence of subclinical and clinical disease in high burden settings was used to estimate the contribution of subclinical TB to global Mtb transmission.We collated data on 414 index cases and 789 household contacts from three prevalence surveys (Bangladesh, Philippines, Viet Nam) and one case-finding trial in Viet Nam. The odds ratio of household infection prevalence was 1.2 (0.6-2.3, 95% Confidence Interval). Adjusting for duration of disease, we found a per-unit-time infectiousness of subclinical TB relative to clinical TB of 1.93 (0.62-6.18, 95% Prediction Interval (PrI)). 14 countries across Asia and Africa provided data on relative prevalence of subclinical and clinical TB, suggesting an estimated 68% (27-92%, 95% PrI) of global transmission is from subclinical TB.ConclusionsOur results suggest that subclinical TB contributes substantially to transmission and needs to be diagnosed and treated for effective progress towards TB elimination.
Right Or Left: Laterality Incidence Of Billed Plantar Fasciitis Plus Foot Pain
Authors: Kezelian Harry A. , Qadri Ali A. , Chakrabortty Shushovan , Gupta Deepak 
Published: June 2022

AbstractBackgroundFootedness and its potential role still remains largely underexplored in terms of laterality of lower extremity diseases.Materials and MethodsPodiatric medicine patients’ electronic health/medical records were explored based on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes billed from October 1, 2015-September 30, 2021 for pain in right foot (ICD-10-CM Diagnosis Code M79.671) as well as for plantar fasciitis (ICD-10-CM Diagnosis Code M72.2) vs. for pain in left foot (ICD-10-CM Diagnosis Code M79.672) as well as for plantar fasciitis (ICD-10-CM Diagnosis Code M72.2).ResultsDuring the six-year period, 1077 patients were only billed for pain in right foot vs. 921 patients were only billed for pain in left foot (p=0.0005) but only 362 patients with pain in right foot were concurrently billed for plantar fasciitis while only 372 patients with pain in left foot were concurrently billed for plantar fasciitis (p=0.71).ConclusionAlthough there was no significance difference between right vs. left plantar fasciitis incidence, the incidental finding of significant difference between right vs. left foot pain incidence warrants future investigations.
Plasma pTau-217 in preclinical Alzheimer’s disease
Authors: Jonaitis Erin M. , Janelidze Shorena , Cody Karly A. , Koscik Rebecca Langhough , Du Lianlian , Chin Nathaniel A. , Mattsson-Carlgren Niklas , Hogan Kirk J. , Christian Bradley T. , Betthauser Tobey J. , Hansson Oskar , Johnson Sterling C. 
Published: June 2022

AbstractBackground and ObjectivesAn accurate blood test for Alzheimer’s disease (AD) that is sensitive to preclinical proteinopathy and cognitive decline has clear implications for early detection and secondary prevention of AD. We assessed the performance of plasma pTau against brain PET markers of amyloid ([11C]-PiB) and tau ([18F]MK-6240), and its utility for predicting longitudinal cognition.MethodsSamples were analyzed from a subset of participants with up to 8 years follow-up in the Wisconsin Registry for Alzheimer’s Prevention (WRAP; 2001-present; plasma 2011-present), a longitudinal cohort study of adults from midlife, enriched for parental history of AD. Participants were a convenience sample who volunteered for at least one PiB scan, had usable banked plasma, and were cognitively unimpaired at first plasma collection. Study personnel who interacted with participants or samples were blind to amyloid status. We used mixed effects models and receiver-operator characteristic curves to assess concordance between plasma pTau217 and PET biomarkers of AD, and mixed effects models to understand the ability of plasma pTau217 to predict longitudinal performance on WRAP’s preclinical Alzheimer’s cognitive composite (PACC-3).ResultsThe primary analysis included 165 people (108 women; mean age=62.9 ± 6.06; 160 still enrolled; 2 deceased; 3 discontinued). Plasma pTau217 was strongly related to PET-based estimates of concurrent brain amyloid (β̂DVR = 0.83 (0.75, 0.90), p<.001). Concordance was high between plasma pTau217 and both amyloid PET (AUC=0.91, specificity=0.80, sensitivity=0.85, PPV=0.58, NPV=0.94, LR−=5.48) and tau PET (AUC=0.95, specificity=1, sensitivity=0.85, PPV=1, NPV=0.98, LR−=6.47). Higher baseline pTau217 levels were associated with worse cognitive trajectories (β̂pTau=age = -0.07 (-0.09, -0.06), p<.001).Conclusions and RelevanceIn a convenience sample of unimpaired adults, plasma pTau217 levels correlate well with concurrent brain AD pathophysiology and with prospective cognitive performance. These data indicate that this marker can detect AD before clinical signs and thus may disambiguate presymptomatic AD from normal cognitive aging.Classification of EvidenceThis study meets Class III evidential criteria for diagnostic accuracy of plasma pTau217.
Building a Vertically-Integrated Genomic Learning Health System: The Colorado Center for Personalized Medicine Biobank
Authors: Wiley Laura K , Shortt Jonathan A , Roberts Emily R , Lowery Jan , Kudron Elizabeth , Lin Meng , Mayer David A , Wilson Melissa P , Brunetti Tonya M , Chavan Sameer , Phang Tzu L , Pozdeyev Nikita , Lesny Joseph , Wicks Stephen J , Moore Ethan , Morgenstern Joshua L , Roff Alanna N , Shalowitz Elise L , Stewart Adrian , Williams Cole , Edelmann Michelle N , Hull Madelyne , Patton J. Tacker , Axell Lisen , Ku Lisa , Lee Yee Ming , Jirikowic Jean , Tanaka Anna , Todd Emily , White Sarah , Peterson Brett , Hearst Emily , Zane Richard , Greene Casey S , Mathias Rasika , Coors Marilyn , Taylor Matthew RG , Ghosh Debashis , Kahn Michael G , Brooks Ian M , Aquilante Christina L , Kao David , Rafaels Nicholas , Crooks Kristy , Hess Steve , Barnes Kathleen C , Gignoux Christopher R 
Published: June 2022

ABSTRACTPrecision medicine initiatives across the globe have led to a revolution of repositories linking large-scale genomic data with electronic health records, enabling genomic analyses across the entire phenome. Many of these initiatives focus solely on research insights, leading to limited direct benefit to patients. We describe the Biobank at the Colorado Center for Personalized Medicine (CCPM Biobank) that was jointly developed by the University of Colorado Anschutz Medical Campus and UCHealth to serve as a unique, dual-purpose research and clinical resource accelerating personalized medicine. This living resource currently has over 200,000 patients with ongoing recruitment. We highlight the clinical, laboratory, regulatory, and HIPAA-compliant informatics infrastructure along with our stakeholder engagement, consent, recontact, and participant engagement strategies. We characterize aspects of genetic and geographic diversity unique to the Rocky Mountain Region, the primary catchment area for CCPM Biobank participants. We leverage linked health and demographic information of the CCPM Biobank participant population to demonstrate the utility of the CCPM Biobank to replicate complex trait associations in the first 33,674 genotyped patients across multiple disease domains. Finally, we describe our current efforts towards return of clinical genetic test results including high-impact pathogenic variants and pharmacogenetic information, and our broader goals as the CCPM Biobank continues to grow. Bringing clinical and research interests together fosters unique clinical and translational questions that can be addressed from the large EHR-linked CCPM Biobank resource within a HIPAA and CLIA-certified environment.
Estimation of offspring genetic risk scores using parental genotypes
Authors: Adesomo Adebayo , Workalemahu Tsegaselassie , Givens Matthew , Yandell Mark , Quinlan Aaron , Tristani-Firouzi Martin , Heerboth Sarah , Silver Robert , Blue Nathan 
Published: June 2022

AbstractObjectiveOur objective was to determine whether genetic risk scores (GRSs) of offspring can be accurately estimated from parental DNA.MethodsWhole genome sequencing data from a cohort of forty-seven multi-generation Utah families were used to extract single nucleotide polymorphism (SNP) data at genetic loci associated with the following traits: birth weight (BW), fasting plasma glucose (FPG), blood pressure (BP), body mass index (BMI), height, and type 2 diabetes (T2D). Offspring GRSs for each trait were estimated from parental single nucleotide polymorphism (SNP) data and compared to actual offspring GRSs. We also assessed offspring GRS estimation using only one parent’s DNA to simulate scenarios when only one genetic parent is available. The primary outcome was the percent error of parental-derived estimated GRS for each trait. An a priori threshold of 10% error was chosen for estimated GRSs to be considered accurate.ResultsForty-three families with an average of 8.9 ± 1.8 offspring (N = 454 offspring) had parental and offspring SNP data available for GRS calculations. Mean percent errors for estimated offspring GRSs were less than 10% for all traits except for FPG (10.5% ± 8.1%). Percent errors were not significantly different when offspring GRSs were estimated using only one parent’s DNA whether the missing parent was a father or mother. Mean percent error of GRSs decreased exponentially with increasing SNPs per trait, with diminishing improvement in percent error above 500 SNPs.ConclusionParental genetic risk scores can be used to accurately estimate genetic risk scores of offspring. This proof of concept supports further exploration of parental genetic risk scores as a tool for prenatal fetal genetic risk stratification.StatementsWhat’s already known about this topic?Genetic risk scoring is a tool to estimate the probability of development traits or conditions with complex, multifactorial inheritance.What does this study add?Offspring genetic risk scores can be accurately estimated using parental DNA. This proof of concept supports further exploration of parental genetic risk scores as a tool for prenatal fetal genetic risk stratification.