Time-Dependent Association Between Cardiotocographic Features and Hypoxic-Ischemic Encephalopathy.

Neonatal hypoxic-ischemic encephalopathy (HIE) is caused by sustained hypoxemia near birth. Clinical assessment using cardiotocography (CTG), which measures the fetal heart rate (FHR) and maternal uterine pressure (UP), aims to identify infants at increased risk of HIE. Although CTG is nonstationary, current automated methods for its analysis use time invariant discrimination rules.

Maternal fever during labor and the risk of neonatal encephalopathy: duration and magnitude of hyperthermia.

Background: Maternal fever occurs in up to 10% of laboring individuals. It is associated with adverse maternal and neonatal outcomes such as low Apgar scores, respiratory distress, sepsis, meconium aspiration syndrome, and death. Few studies have investigated the dose-response relationship between the duration and magnitude of maternal hyperthermia and hypoxic-ischemic encephalopathy.

Network changes associated with right anterior temporal lobe atrophy: insight into unique symptoms.

Semantic behavioural variant (also referred to as right temporal) frontotemporal dementia is a newly described syndrome associated with predominant right anterior temporal lobe atrophy and a distinctive combination of behavioural and semantic changes. It is considered the right-sided counterpart of semantic variant primary progressive aphasia, with which it has overlapping neuropathological and cognitive mechanisms. Although more is known about how brain network alterations relate to both losses (e.

Spatial patterns of fat within the deep multifidus as a biomarker for chronic low back pain.

Background Context: Chronic low back pain (cLBP) patients often have elevated fat infiltration (FI) in the multifidus (MF), but it is unclear how this relates to pain and degenerative spine features. Most prior work assess MF degeneration as the average whole-muscle fat content even though deep and superficial fascicles of the MF have different structural and functional characteristics. Assessing the spatial distribution of MF FI may provide regional context for causal mechanisms which may have distinct regional presentations within the muscle.

Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA.

Introduction: As dementia cases increase and new therapies become available, timely diagnosis is critical yet challenging in primary care. We evaluated the TabCAT-Brain Health Assessment (TabCAT-BHA) digital paradigm to assist with early detection and diagnosis.

Methods: This implementation study involved 21 primary care providers (PCPs) serving 2733 eligible patients in a family medicine clinic.

Maternal Social Determinants of Health and Risk of Perinatal Hypoxic-Ischemic Encephalopathy.

Importance: Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of mortality and long-term morbidity. The association between maternal social determinants of health (SDOH) and perinatal HIE has not been established.

Objective: To examine the association of maternal race, ethnicity, and other SDOH with perinatal HIE.

Awareness and utilization of genetic testing for hereditary cancers in cancer survivors: a cross-sectional 2021 HINTS-SEER study.

Purpose: We aimed to identify factors associated with genetic testing awareness and use among a large sample of US cancer survivors participating in NCI's Health Information National Trends Survey of cancer survivors identified through the Surveillance, Epidemiology, and End Results program, a unique pilot study expanding the number of cancer survivors typically captured by HINTS.

Methods: We analyzed 2021 HINTS-SEER data to determine sociodemographic factors associated with awareness and utilization of germline genetic testing using survey-weight-adjusted multivariable logistic regression.

Results: Of 1232 survivors (any site), the majority had breast (23%) or prostate (23%) cancer.

Sex-based differences in biomechanical function for chronic low back pain and how it relates to pain experience.

Purpose: The relationship between pain experience and biomechanical impairment in chronic low back pain (LBP) is unclear. Among the broader pain literature, sex-based differences in pain experience have been established. However, it is unknown if sex-based differences in pain experience relates to compromised movement patterns for patients with chronic LBP.

Neurological Injury in Comatose Patients Following Substance-Use-Related Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study in a Safety Net Hospital.

Background: Substance-use-related cardiac arrest (SURCA) is a public health crisis, contributing to high mortality and severe neurological disability, particularly affecting young adults. This study aims to characterize the demographic and multimodal neurological prognostication features of patients with SURCA.

Methods: This retrospective study included patients with out-of-hospital cardiac arrest who presented to an urban academic safety net hospital between July 2016 and April 2022 and were comatose on admission.

Longitudinal profiling of IDH-mutant astrocytomas reveals acquired RAS-MAPK pathway mutations associated with inferior survival.

Background: Isocitrate dehydrogenase (IDH)-mutant astrocytomas represent the most frequent primary intraparenchymal brain tumor in young adults, which typically arise as low-grade neoplasms that often progress and transform to higher grade despite current therapeutic approaches. However, the genetic alterations underlying high-grade transformation and disease progression of IDH-mutant astrocytomas remain inadequately defined.

Methods: Genomic profiling was performed on 205 IDH-mutant astrocytomas from 172 patients from both initial treatment-naive and recurrent post-treatment tumor specimens.

Network changes associated with right anterior temporal lobe atrophy: insight into unique symptoms.

Semantic behavioral variant (also referred to as right temporal) frontotemporal dementia is a newly described syndrome associated with focal right anterior temporal lobe atrophy and a distinctive combination of behavioral and semantic changes. It is considered the right-sided counterpart of semantic variant primary progressive aphasia, with which it has overlapping neuropathological and cognitive mechanisms. Although more is known about how brain network alterations relate to both losses (e.

Chronic low back pain causal risk factors identified by Mendelian randomization: a cross-sectional cohort analysis.

Background Context: There are a number of risk factors- from biological, psychological, and social domains- for nonspecific chronic low back pain (cLBP). Many cLBP treatments target risk factors on the assumption that the targeted factor is not just associated with cLBP but is also a cause (ie, a causal risk factor). In most cases this is a strong assumption, primarily due to the possibility of confounding variables.

Machine learning for forecasting initial seizure onset in neonatal hypoxic-ischemic encephalopathy.

Objective: This study was undertaken to develop a machine learning (ML) model to forecast initial seizure onset in neonatal hypoxic-ischemic encephalopathy (HIE) utilizing clinical and quantitative electroencephalogram (QEEG) features.

Methods: We developed a gradient boosting ML model (Neo-GB) that utilizes clinical features and QEEG to forecast time-dependent seizure risk. Clinical variables included cord blood gas values, Apgar scores, gestational age at birth, postmenstrual age (PMA), postnatal age, and birth weight.

Chronic Low Back Pain Causal Risk Factors Identified by Mendelian Randomization: a Cross-Sectional Cohort Analysis.

Background Context: There are a number of risk factors- from biological, psychological, and social domains- for non-specific chronic low back pain (cLBP). Many cLBP treatments target risk factors on the assumption that the targeted factor is not just associated with cLBP but is also a cause (i.e, a causal risk factor).

Epidural Analgesia During Labor and Neonatal Hypoxic-Ischemic Encephalopathy.

Importance: Epidural analgesia is used by approximately 70% of birthing persons in the US to alleviate labor pain and is a common cause of elevated temperature in the birthing parent during labor, which, in turn, is associated with adverse neonatal outcomes such as hypoxic-ischemic encephalopathy (HIE).

Objective: To determine whether epidural analgesia is associated with increased risk of HIE after adjusting for the birthing person's maximal temperature before epidural placement and for the propensity to get an epidural.

Design, Setting, And Participants: This retrospective, population-based cohort study was conducted at 15 Kaiser Permanente Northern California hospitals.

Design of the COMEBACK and BACKHOME Studies, Longitudinal Cohorts for Comprehensive Deep Phenotyping of Adults with Chronic Low-Back Pain (cLBP): a part of the BACPAC Research Program.

Objective: The University of California, San Francisco (UCSF) Core Center for Patient-centric, Mechanistic Phenotyping in Chronic Low Back Pain (REACH) is one of the three NIH Back Pain Consortium (BACPAC) Research Programs Mechanistic Research Centers (MRCs). The goal of UCSF REACH is to define cLBP phenotypes and pain mechanisms that can lead to effective, personalized treatments for patients across the population. The primary objective of this research project is to address the critical need for new diagnostic and prognostic markers, and associated patient classification protocols for chronic low back pain (cLBP) treatment.

Quantitative analysis of promoter methylation in glioblastoma suggests nonlinear prognostic effect.

Background: Epigenetic inhibition of the () gene has emerged as a clinically relevant prognostic marker in glioblastoma (GBM). Methylation of the promoter has been shown to increase chemotherapy efficacy. While traditionally reported as a binary marker, recent methodological advancements have led to quantitative methods of measuring promoter methylation, providing clearer insight into its functional relationship with survival.

Perinatal Hypoxic-Ischemic Encephalopathy: Incidence Over Time Within a Modern US Birth Cohort.

Background: Recent studies suggest that the incidence of perinatal hypoxic-ischemic encephalopathy (HIE) may be increasing in developed countries. However, this observed increase may be due to increased ascertainment and increased treatment with therapeutic hypothermia rather than an increase in disease burden. In a US population-based cross-sectional study, we determined the incidence of perinatal HIE over time.

Bayesian adaptive design for covariate-adaptive historical control information borrowing.

Interest in incorporating historical data in the clinical trial has increased with the rising cost of conducting clinical trials. The intervention arm for the current trial often requires prospective data to assess a novel treatment, and thus borrowing historical control data commensurate in distribution to current control data is motivated in order to increase the allocation ratio to the current intervention arm. Existing historical control borrowing adaptive designs adjust allocation ratios based on the commensurability assessed through study-level summary statistics of the response agnostic of the distributions of the trial subject characteristics in the current and historical trials.

Correlating Quantitative MRI-based Apparent Diffusion Coefficient Metrics with 24-month Neurodevelopmental Outcomes in Neonates from the HEAL Trial.

Background Multiple qualitative scoring systems have been created to capture the imaging severity of hypoxic ischemic brain injury. Purpose To evaluate quantitative volumes of acute brain injury at MRI in neonates with hypoxic ischemic brain injury and correlate these findings with 24-month neurodevelopmental outcomes and qualitative brain injury scoring by radiologists. Materials and Methods In this secondary analysis, brain diffusion-weighted MRI data from neonates in the High-dose Erythropoietin for Asphyxia and Encephalopathy trial, which recruited participants between January 2017 and October 2019, were analyzed.

Neonatal brain MRI and short-term outcomes after acute provoked seizures.

Objective: We investigated how diagnosis and injury location on neonatal brain MRI following onset of acute provoked seizures was associated with short term outcome.

Study Design: A multicenter cohort of neonates with acute provoked seizures enrolled in the Neonatal Seizure Registry. MRIs were centrally evaluated by a neuroradiologist for location of injury and radiologic diagnosis.

Network anatomy in logopenic variant of primary progressive aphasia.

The logopenic variant of primary progressive aphasia (lvPPA) is a neurodegenerative syndrome characterized linguistically by gradual loss of repetition and naming skills, resulting from left posterior temporal and inferior parietal atrophy. Here, we sought to identify which specific cortical loci are initially targeted by the disease (epicenters) and investigate whether atrophy spreads through pre-determined networks. First, we used cross-sectional structural MRI data from individuals with lvPPA to define putative disease epicenters using a surface-based approach paired with an anatomically-fine-grained parcellation of the cortical surface (i.