bluuebunny/crossref_metadata_2025_split huggingface dataset:
EARLY DIFFERENTIATION BETWEEN SEPSIS AND STERILE INFLAMMATION VIA URINARY GENE SIGNATURES OF METABOLIC DYSREGULATION
Authors: Bandyopadhyay Sabyasachi , Loftus Tyler J. , Peng Ying-Chih , Lopez Maria-Cecilia , Baker Henry V. , Segal Mark S. , Graim Kiley , Ozrazgat-Baslanti Tezcan , Rashidi Parisa , Bihorac Azra 
Published: July 2022

ABSTRACT

Objective: The aim of this study was to characterize early urinary gene expression differences between patients with sepsis and patients with sterile inflammation and summarize in terms of a reproducible sepsis probability score. Design: This was a prospective observational cohort study. Setting: The study was conducted in a quaternary care academic hospital. Patients: One hundred eighty-six sepsis patients and 78 systemic inflammatory response syndrome (SIRS) patients enrolled between January 2015 and February 2018. Interventions: Whole-genome transcriptomic analysis of RNA was extracted from urine obtained from sepsis patients within 12 hours of sepsis onset and from patients with surgery-acquired SIRS within 4 hours after major inpatient surgery. Measurements and Main Results: We identified 422 of 23,956 genes (1.7%) that were differentially expressed between sepsis and SIRS patients. Differentially expressed probes were provided to a collection of machine learning feature selection models to identify focused probe sets that differentiate between sepsis and SIRS. These probe sets were combined to find an optimal probe set (UrSepsisModel) and calculate a urinary sepsis score (UrSepsisScore), which is the geometric mean of downregulated genes subtracted from the geometric mean of upregulated genes. This approach summarizes the expression values of all decisive genes as a single sepsis score. The UrSepsisModel and UrSepsisScore achieved area under the receiver operating characteristic curves 0.91 (95% confidence interval, 0.86–0.96) and 0.80 (95% confidence interval, 0.70–0.88) on the validation cohort, respectively. Functional analyses of probes associated with sepsis demonstrated metabolic dysregulation manifest as reduced oxidative phosphorylation, decreased amino acid metabolism, and decreased oxidation of lipids and fatty acids. Conclusions: Whole-genome transcriptomic profiling of urinary cells revealed focused probe panels that can function as an early diagnostic tool for differentiating sepsis from sterile SIRS. Functional analysis of differentially expressed genes demonstrated a distinct metabolic dysregulation signature in sepsis.
LONGITUDINAL ANALYSIS OF TRANSCRIPTOMIC SUBTYPES IN TRAUMA PATIENTS
Authors: Chen Tianmeng , Wei Yue , Vodovotz Yoram , Chen Wei , Billiar Timothy R. 
Published: July 2022

ABSTRACT

Objective: We previously identified two transcriptomic subtypes (Signature Groups: SG1 vs. SG2) in trauma patients at 12 hours postinjury, with SG1 associated with worse outcomes. In this study, we aimed to further characterize the changes in SG subtype categorization of trauma patients over time after injury and define the corresponding association with outcomes based on the timing of the subtype designation. Methods and Results: This study was a secondary analysis of published data of whole-blood leukocyte transcriptomics, a longitudinal data from 167 severe blunt trauma patients. We assigned trauma patients to SG1 or SG2 subtype for time points between 12 hours and 28 days, inclusive, postinjury and characterized their longitudinal outcomes. SG1 assignment, regardless of time point, was associated consistently with slower recovery. Further analysis revealed that additional prognostic information could be obtained by assessing SG subtype at both 12 hours and 1 day. Conclusions: This study provides a proof of concept that immune status can worsen after admission and highlights the benefit of longitudinally monitoring SG subtypes in trauma patients.
Social contact patterns during the COVID-19 pandemic in 21 European countries – evidence from a two-year study
Authors: Wong Kerry LM , Gimma Amy , Coletti Pietro ,   CoMix Europe Working Group, Faes Christel , Beutels Philippe , Hens Niel , Jaeger Veronika K , Karch Andre , Johnson Helen , Edmunds W John , Jarvis Christopher I 
Published: July 2022

AbstractMost countries have enacted some restrictions to reduce social contacts to slow down disease transmission during the COVID-19 pandemic. For nearly two years, individuals likely also adopted new behaviours to avoid pathogen exposure based on personal circumstances. We aimed to understand the way in which different factors affect social contacts – a critical step to improving future pandemic responses. The analysis was based on repeated cross-sectional contact survey data collected in 21 European countries between March 2020 and March 2022. We calculated the mean daily contacts reported using a clustered bootstrap by country and by settings (at home, at work, or in other settings). Where data were available, contact rates during the study period were compared with rates recorded prior to the pandemic. We fitted censored individual-level generalized additive mixed models to examine the effects of various factors on the number of social contacts. The survey recorded 463,336 observations from 96,456 participants. In all countries where comparison data were available, contact rates over the previous two years were substantially lower than those seen prior to the pandemic (approximately from over 10 to <5), predominantly due to fewer contacts outside the home. Government restrictions imposed immediate effect on contacts, and these effects lingered after the restrictions were lifted. Across countries, the relationships between national policy, individual perceptions, or personal circumstances determining contacts varied. Our study, coordinated at the regional level, provides important insights into the understanding of the factors associated with social contacts to support future infectious disease outbreak responses.
IMPACT OF PHYSICAL ACTIVITY ON POSTURAL STABILITY AND COORDINATION IN CHILDREN WITH POSTERIOR FOSSA TUMOR: RANDOMIZED CONTROL PHASE III TRIAL
Authors: Usama Mahmoud , Abdelaziem Faten , Rashed Wafaa M. , Maher Eslam , El Beltagy Mohamed , Zekri Wael 
Published: July 2022

ABSTRACTBackgroundPosterior fossa tumor is a type of brain tumor that is located at the borders of both the brain stem and cerebellum. The cerebellum is the brain region in charge of balance and coordination. Pediatric patients diagnosed with posterior fossa tumor have been reported to fall frequently.ObjectivesThe aim of this study is to investigate the effectiveness of balance and coordination training in these children.MethodsThis randomized control clinical trial (ClinicalTrials.gov Identifier: NCT04528316) was carried out between September 2020 and April 2021 at Children’s Cancer Hospital-57357. The inclusion criteria were - patients with posterior fossa tumor in maintenance phase and, age between 5-12 years. The exclusion criteria were - patients who had a genetic disorder or suffer from mental retardation, a chronic lung disease, sever cardiomyopathy, or a neuromuscular disease that doesn’t not related to tumor. The study participants were randomly assigned into three groups: Group I/Control group: they received Pilates core stability exercises program, Group II/Postural stability group: They received the same program plus HUMAC balance program, and Group III/Coordination group: They received the same program plus coordination exercises of BOT-2. The semi-parametric proportional odds model was used to compare follow up scores of the Postural stability group vs Control, and Coordination group vs Control, while adjusting for baseline values. All tests were two-sided, with alpha set to 0.05.ResultsSixty children including 38 boys and 22 girls were enrolled in this study. In all three groups, postural stability and coordination improved significantly in terms of modified clinical test of sensory integration of balance, center of pressure, limits of stability, bilateral coordination, and upper-limb coordination.ConclusionThe current study supports the value of adding postural stability and coordination training to the physiotherapy plan for children with posterior fossa tumor.
SARS-CoV-2 infection is associated with anti-desmoglein 2 autoantibody detection
Authors: Ward Kerensa E , Steadman Lora , Karim Abid R , Reynolds Gary M , Pugh Matthew , Chua Winnie , Faustini Sian E , Veenith Tonny , Thwaites Ryan S , Openshaw Peter JM , Drayson Mark T , Shields Adrian M , Cunningham Adam F , Wraith David C. , Richter Alex G 
Published: July 2022

AbstractPost-acute cardiac sequelae, following SARS-CoV-2 infection, are well recognised as complications of COVID-19. We have previously shown the persistence of autoantibodies against antigens in skin, muscle, and heart in individuals following severe COVID-19; the most common staining on skin tissue displayed an inter-cellular cement pattern consistent with antibodies against desmosomal proteins. Desmosomes play a critical role in maintaining the structural integrity of tissues. For this reason, we analysed desmosomal protein levels and the presence of anti-desmoglein (DSG) 1, 2 and 3 antibodies in acute and convalescent sera from patients with COVID 19 of differing clinical severity. We find increased levels of DSG2 protein in sera from acute COVID patients. Furthermore, we find that DSG2 autoantibody levels are increased significantly in convalescent sera following severe COVID-19 but not in hospitalised patients recovering from influenza infection or healthy controls. Levels of autoantibody in sera from patients with severe COVID-19 were comparable to levels in patients with non-COVID-19-associated cardiac disease, potentially identifying DSG2 autoantibodies as a novel biomarker for cardiac damage. To determine if there was any association between severe COVID-19 and DSG2, we stained post-mortem cardiac tissue from patients who died from COVID-19 infection. This revealed disruption of the intercalated disc between cardiomyocytes that was consistent with separation of the DSG2 protein homodimer. Our results reveal the potential for DSG2 protein and autoimmunity to DSG2 to contribute to unexpected pathologies associated with COVID-19 infection.
Urinary tract infection in infants with asymptomatic Jaundice: a meta-analysis UTI and Jaundice Review
Authors: Gourishankar Anand , Akkinapally Smita. S. 
Published: July 2022

AbstractINTRODUCTIONInfants, especially neonates, present with jaundice with an unclear association with urinary tract infection. Evidence for such association is unclear, especially in a specific group of otherwise well-appearing infants born > 35 weeks.EVIDENCE ACQUISITIONData sourcesWe used the following databases: Medline, Embase, CINAHL Plus, Scopus, and Cochrane library.Study selectionWe included observational studies that included infants born > 35 weeks gestation, younger than 12 months, asymptomatic other than jaundice, and urinary tract infection. Data extraction: After reviewing the eligibility, two reviewers extracted data and assessed the quality of each study using the Newcastle-Ottawa scale.EVIDENCE SYNTHESISWe analyzed sixteen studies for a total of 2933 infants. The pooled incidence of UTI was 9.6% (95% confidence interval of 6% to 15%). The subgroup analysis failed to show any difference in incidence within the publication year, sample size, study design, study region, urine collection method, and age group. There was no explanation of heterogeneity noted by the meta-regression for UTI incidence with publication year, total bilirubin, sample size, and study quality. The funnel plot and Egger’s test revealed publication bias.CONCLUSIONSNearly 1 in 10 otherwise asymptomatic infants with jaundice have a UTI. We recommend a rigorous large prospective study to confirm this finding.
Assessment of the Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative at Healthcare Facilities in East Java, Indonesia
Authors: Januraga Pande Putu , Anom Harjana Ngakan Putu , Kowara Mellysa , Indrayathi Putu Ayu , Lubis Dinar SM , Putra I Gusti Ngurah Edi , Izwardi Doddy 
Published: July 2022

AbstractBackgroundThe implementation of the Ten Steps to Successful Breastfeeding (TSSB) of the Baby-Friendly Hospital Initiative (BFHI) has been shown to be associated with improved breastfeeding outcomes. Indonesia still lags other countries in promoting breastfeeding in the first hour and 6 months of exclusive breastfeeding. This study aimed to assess health facilities’ compliance with the TSSB in Indonesia.MethodsA cross-sectional survey of 242 health facility managers and 130 postpartum mothers across hospitals, community health centers (puskesmas), and private clinics at 5 sites in the East Java province was conducted between January and June, 2019. The health facility managers and mothers were interviewed using questionnaires consisting of questions adopted from the TSSB. The data were analyzed using the descriptive method to present the level of compliance with each step, the overall steps, comparing self-appraisal and validating methods, and comparing results by study site and type of health facility.ResultsThe assessment data showed various levels of compliance with the TSSB, with scores ranging from 65.47 to 98.09 (mean score 77.5 on a scale from 0 to 100). The highest compliance was found in step 8 (breastfeeding on demand) and the lowest in step 7 (rooming-in). The validation results showed a significantly lower compliance with steps 3, 4, 8, and 9 compared with the self-appraisal. The assessment of compliance with the TSSB also showed certain variations between the site and the type of health facility.ConclusionWe recommend that policy makers and managers of health facilities formulate effective and appropriate policies to increase institutional compliance with the TSSB. Greater efforts are needed to facilitate puskesmas and private clinics in implementing the TSSB for better breastfeeding outcomes.
A multi-state transition model for child stunting in two urban slum settlements of Nairobi: a longitudinal analysis, 2011-2014
Authors: Oduro Michael S. , Iddi Samuel , Asiedu Louis , Asiki Gershim , Kadengye Damazo T. ,   the Nairobi Urban Health and Demographic Surveillance System
Published: July 2022

AbstractIntroductionStunting is common among children in many low and middle income countries, particularly in rural and urban slum settings. Few studies have described child stunting transitions and the associated factors in urban slum settlements. We describe transitions between stunting states and associated factors among children living in Nairobi slum settlements.MethodsData are from the Nairobi Urban and Demographic Surveillance System and a Vaccination Project nested within this surveillance system collected between 2010 and 2014. A subset of 692 children aged 0 to 3 years, with complete anthro-pometric data, and household socio-demographic data was used for the analysis. Height-for-age Z-scores (HAZ) was used to define stunting: normal (HAZ ≥ 1), marginally stunted (−2 ≤ HAZ < -1), moderately stunted (−3 ≤ HAZ < -2), and severely stunted (HAZ < -3). Transitions from one stunting level to another and in the reverse direction were computed. The associations between explanatory factors and the transitions between four child stunting states were modeled using a continuous-time multi-state modelResultsWe observed that 48%, 39%, 41%, and 52% of children remained in the normal, marginally stunted, moderately stunted, and severely stunted states, respectively. About 29% transitioned from normal to marginally stunted state, 15% to the moderately stunted state, and 8% to the severely stunted state. Also, 8%, 12%, and 29% back transitioned from severely stunted, moderately stunted, and marginally stunted states, to the normal state, respectively. The shared common factors associated with all transitions to a more severe state include: male gender, ethnicity (only for mild and severe transition states), child’s age, and household food insecurity. In Korogocho, children whose parents were married and those whose mothers had attained primary or post-primary education were associated with a transition from a mild state into a moderately stunted state. Children who were breastfed exclusively were less likely to transition from moderate to severe stunting state.ConclusionThese findings reveal a high burden of stunting and transitions in urban slums. Context-specific interventions targeting the groups of children identified by the socio-demographic factors are needed. Improving food security and exclusive breastfeeding could potentially reduce stunting in the slums.
Characterizing Patient Representations for Computational Phenotyping
Authors: Callahan Tiffany J. , Stefanksi Adrianne L. , Ostendorf Danielle M. , Wyrwa Jordan M. , Davies Sara J. Deakyne , Hripcsak George , Hunter Lawrence E. , Kahn Michael G. 
Published: July 2022

AbstractPatient representation learning methods create rich representations of complex data and have potential to further advance the development of computational phenotypes (CP). Currently, these methods are either applied to small predefined concept sets or all available patient data, limiting the potential for novel discovery and reducing the explainability of the resulting representations. We report on an extensive, data-driven characterization of the utility of patient representation learning methods for the purpose of CP development or automatization. We conducted ablation studies to examine the impact of patient representations, built using data from different combinations of data types and sampling windows on rare disease classification. We demonstrated that the data type and sampling window directly impact classification and clustering performance, and these results differ by rare disease group. Our results, although preliminary, exemplify the importance of and need for data-driven characterization in patient representation-based CP development pipelines.
Abortion Attitudes and Behavioral Intentions of Obstetrics and Gynecology Residents at Four Midwestern Residency Programs
Authors: Cutler Abigail S. , Cowley Elise S. , Ralph Jessika A. , Chen Jessie , Godecker Amy , Ward Jordan , Hutto Sarah , Jacques Laura 
Published: July 2022

AbstractIn June 2022, the U.S. Supreme Court overturned Roe v Wade. Half of states now face proposed or in-effect abortion bans, which affect the ability of obstetrics and gynecology (ObGyn) residency programs to provide abortion training. Prior to the Supreme Court decision, we surveyed ObGyn residents at all four programs in Wisconsin and Minnesota to assess residents’ attitudes toward abortion, desire to learn about abortion, and intentions about providing abortion care in their future practice. We found that participants overwhelmingly support abortion, find the issue to be important, and plan to incorporate abortion into future practice. The reversal of Roe v Wade and its impact on access to abortion training may have implications for ObGyn residency recruitment and training, related career decision-making, and future workforce.
Incidence of pancreatic cancer in angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs): a population-based cohort study
Authors: Tse Gary , Zhou Jiandong , Lee Sharen , Hung Joshua Kai Fung , Leung Keith Sai Kit , Liu Ying , Zhang Yuhui , Liu Tong , Wong Wing Tak , Wong Ian Chi Kei , Zhang Qingpeng , Cheung Bernard Man Yung 
Published: July 2022

AbstractBackgroundAngiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been associated with lower rates of pancreatic cancer. However, some studies did not similarly reveal significant associations. The objective of this study was to examine the associations between use of ACEIs or ARBs and incident pancreatic cancer.MethodsPatients who were prescribed ACEI or ARB between 1 January 2000 and 31 August 2020 at Hong Kong public hospitals, or their associated clinics and ambulatory care facilities were included. The primary outcome was incident pancreatic cancer.ResultsA total of 411,883 patients (ACEI users: n=355771, 86.38%; ARB users: 56112, 13.62%) were included. Over a median follow up of 2875 days (SD: 1901), 1194 incident cases of pancreatic cancer (0.28%) were identified. After 1:1 propensity score matching, univariable Cox regression found that ARB use was associated with lower risks of new onset new onset pancreatic cancer (hazard ratio [HR]: 0.69, 95% CI: [0.53, 0.90], P=0.0065). This association remained significant after multivariable adjustment (HR: 0.67, 95% CI: [0.52, 0.88], P=0.0036). Similar conclusions were reached on competing risk analyses using cause-specific and subdistribution hazard models before and after matching, and after inverse probability of treatment weighting. Subgroud analyses identified higher protective effects of ARB exposures in females than in males, while more severe adverse risks of ACEI exposure effects for males than for females (log-rank test, P<0.05).ConclusionsARB use was associated with lower risks of new onset pancreatic cancer both before and after propensity score matching compared to ACEI use.
Angiotensin converting enzyme (ACE) 1 expression in leukocytes of adults from 64 to 67 years old
Authors: Bueno Valquiria , Destro Pedro Henrique , Teixeira Daniela , Frasca Daniela 
Published: July 2022

AbstractThe renin angiotensin system (RAS) is composed of several enzymes and substrates on which angiotensin converting enzyme (ACE) 1 and renin act to produce angiotensin II. ACE1 and its substrates control blood pressure, affect cardiovascular and renal function, hematopoiesis, reproduction, and immunity. The increased expression of ACE1 has been observed in human monocytes during congestive heart failure and abdominal aortic aneurysm. Moreover, T lymphocytes from hypertensive patients presented increased expression of ACE1 gene after in vitro stimulation with Angiotensin-II (AngII) with the highest ACE1 expression observed in hypertensive patients with low-grade inflammation. Our group and others have shown that aging is associated with comorbidities, chronic inflammation and immunosenescence, but there is a lack of data about ACE1 expression on immune cells during the aging process. Therefore, our aim was to evaluate the levels of ACE1 expression in non-lymphoid as compared to lymphoid cells in association with the immunosenescence profile in adults older than 60 years. Cryopreserved peripheral blood mononuclear cells obtained from blood samples were used. Cells were stained with monoclonal antibodies and evaluated by flow cytometry. We found that ACE1 was expressed in 56.9% of non-lymphocytes and in more than 90% of lymphocytes (all phenotypes). All donors exhibited characteristics of immunosenescence, as evaluated by low frequencies of Naive CD4+and CD8+T cells, high frequencies of EMRA CD8+T cells, and double-negative memory B cells. These findings in addition to the increased C-reactive protein levels are intriguing questions for the study of ACE1, inflammaging, immunosenescence and perspectives for drug development or repurposing.