bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between Paternal Co-residence and Child Health among African American Children
Authors: Barcelona Veronica , Flowers Ambre , Caceres Billy A. , Crusto Cindy A. , Taylor Jacquelyn Y.
Published: July 2022

We investigated the associations between paternal co-residence and asthma, obesity, and blood pressure among children aged 3–5 years. Mother/child dyads ( N = 250) self-identified as African American or Black. Mothers reported on father’s co-residence and child’s asthma diagnosis. Height, weight, and blood pressure were measured. Regression models were used to examine paternal co-residence with child health outcomes (i.e., asthma, obesity, and blood pressure). Confounders included maternal and child age, child sex, maternal smoking, and insurance status. Children who lived with their fathers were less likely to have asthma ( OR = 0.39, 95% CI 0.18–0.79), though this association was not significant after adjustment for confounders ( aOR = 0.47, 95% CI 0.22–1.01). Paternal co-residence was not significantly associated with child obesity ( aOR = 0.78, 95% CI 0.35–1.73), systolic (β = 0.57, SE = 1.2, p = .64), or diastolic (β = 1.91, SE = 1.0, p = .07) blood pressure. More research is necessary to understand the diversity of family living situations and how they affect child health.
Association between ANXA5 haplotypes and the risk of recurrent pregnancy loss
Authors: Zheng Meiyun , Yan Jinyu , Jiang Lingling , Dai Zhenzhen , Liu Xiang
Published: July 2022

Background

Annexin A5 (ANXA5) haplotypes can increase the risk of recurrent pregnancy loss (RPL). This study aimed to investigate the effect of ANXA5 haplotypes on ANXA5 expression in patients with RPL.

Methods

Female subjects with RPL, parous controls (those who intentionally aborted without medical conditions or complications), and population controls (normal delivery) were studied. Real-time polymerase chain reaction was carried out to evaluate ANXA5 expression in the placenta and peripheral blood. Western blotting and immunohistochemistry were used to assess ANXA5 protein expression. The luciferase assay was performed to detect the effect of M1 and M2 haplotypes on transcription efficiency of the ANXA5 promoter.

Results

We found that the percentage of the M2 carrier was highest in the RPL group. ANXA5 expression in the placenta and peripheral blood in subjects with RPL was significantly inhibited. Furthermore, ANXA5 expression in subjects carrying the M2 haplotype was remarkably suppressed compared with that in carriers of other haplotypes. Finally, the M2 haplotype decreased the transcription efficiency of the ANXA5 promoter.

Conclusion

Our findings show that ANXA5 expression is decreased in carriers of the M2 haplotype and that M1/M2 haplotypes in the ANXA5 gene are associated with an increased risk of RPL.
Temperament and Offending Behaviors in Male Adolescents
Authors: Manetsch Madleina , Aebi Marcel , Barra Steffen , Goth Kirstin , Boonmann Cyril , Schmeck Klaus , Bessler Cornelia , Plattner Belinda
Published: July 2022

The aim of the current paper was to examine temperament profiles and temperament dimensions as risk factors for persistent criminal behavior in juveniles who offended (JOs). A sample of 137 male adolescents from a Swiss detention center and 137 age and sex matched community controls were included in the present study. Temperament was measured with the Junior Temperament and Character Inventory (JTCI). Using Latent Profile Analysis (LPA), three temperament profiles were found, a “moderate,” an “adventurous-disinhibited” (higher levels of novelty seeking, lower levels of harm avoidance, reward dependence, and persistence), and a “worried-passive” profile (higher levels of harm avoidance, low persistence). None of the profiles and dimensions were associated with detention sample (i.e., JO) status. In JOs, the “novelty seeking” scale predicted recidivism after release from detention even when controlling for other covariates. Further research should address temperament profiles and temperament dimensions in larger samples of JOs to elaborate their relation to previous and future offending behavior.
Enhancing Enterprise Family Social Capital Through Family Governance: An Identity Perspective
Authors: de Groot Maarten , Mihalache Oli , Elfring Tom
Published: July 2022

Despite significant discussion surrounding the benefits of family social capital in family business research, precisely how it is built and maintained by enterprise families remains unclear. To explore how and when family governance practices can avoid the decay of enterprise family social capital, we examine the mediating role of family identity and the significance of both generational and business ownership. Testing of our moderated mediation framework using data from 175 enterprise families globally suggests that family governance can stimulate family social capital by strengthening family identity. We also find a negative moderating role for business ownership in this indirect relationship.
Nonsteroidal Anti-inflammatory and Corticosteroid Injections for Shoulder Impingement Syndrome: A Systematic Review and Meta-analysis
Authors: Ziradkar Rhushi , Best Thomas M. , Quintero Daniel , Paultre Kristopher
Published: July 2022

Context:

To determine optimal treatment strategies for shoulder impingement syndrome (SIS).

Objective:

To compare subacromial nonsteroidal anti-inflammatory injections (SNIs) and subacromial corticosteroid injections (SCIs) on pain relief and functional improvement in individuals with SIS. Second, to perform a cost analysis of the 2 injections.

Data Sources:

MEDLINE, SPORTDiscus, CINAHL, Embase, Web of Science, and SCOPUS databases were searched for randomized controlled trials using several keywords.

Study Selection:

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized, and 10 studies comparing changes in pain or function in humans with SIS receiving SNIs or SCIs were included. Quality and risk of bias were assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 scale and the Cochrane Collaboration tool.

Study Design:

Systematic review and meta-analysis.

Level of Evidence:

Level 1.

Data Extraction:

Baseline and follow-up scores of the visual analog, Constant-Murley, and University of California Los Angeles shoulder scales were extracted to calculate effect sizes (ESs), represented as Cohen d. Metaregression and publication bias analyses were performed. Procedural and medication costs were extracted from Medicare guidelines.

Results:

A total of 7 high and 3 good quality studies were included, with a mean score of 21.1. Only 1 study had a high risk of bias. The meta-analyses produced pooled ESs of 0.05 ( P = 0.83), 0.12 ( P = 0.71), and 0.07 ( P = 0.79) for each scale, respectively, with CIs crossing 0. Procedural costs were equal between groups, whereas ketorolac was the least costly medication ($0.47). There was no significant difference in side effects between the 2 injections.

Conclusion:

SNIs are as effective as SCIs for short-term pain relief and improving function in patients with subacromial impingement syndrome. In addition, they are less expensive and cause no major difference in complications, providing a viable, cost-effective alternative for injection therapy in patients with SIS.
Poster 114: Lower Extremity Injury Following Return to Sport from Concussion: A Systematic Review
Authors: Jildeh Toufic , Buckley Patrick , Abbas Muhammad , Hedge Yash , Okoroha Kelechi , Castle Joshua
Published: July 2022

Objectives:

To examine the current body of research and determine whether there is an increased risk for LE musculoskeletal injury following a concussion and identify populations at an increased risk.

Methods:

A systematic review of the literature from January 1, 2000 to September 30, 2020 was performed using MEDLINE and PubMed databases. Key words included concussion, athlete, lower extremity injury, and return to sport. Inclusion criteria required original research articles written in English language examining the rate of LE injuries following a diagnosed concussion. Data extracted from each study included number of subjects, age, sex, sport played, level of play, odds ratio (OR) of injury, and number of concussions per athlete.

Results:

A total of 13 studies involving 4,349 athletes (88.1% male; mean age 19.8 years) met inclusion criteria. Athletes were classified as either high school (46.1%), collegiate (17.0%), or professional (36.9%). Four studies demonstrated an increased risk of LE injury within 90 days of a diagnosed concussion (OR 3.44, 95% CI 2.99-4.42) and 7 studies revealed an elevated risk of injury within one year of concussion (OR 1.85, 95% CI 1.73-2.84). Professional and college athletes demonstrated an increased risk (OR 2.49, 95% CI 2.40-2.72; OR 2.00, 95% CI 1.96-2.16, respectively) compared to high school athletes (OR 0.97, 95% CI 0.89-1.05). A stepwise increase in risk of sustaining a LE injury was observed with multiple concussions, with increasing risk observed from 2+ (OR 2.29, 95% CI 1.85-2.83) to 3+ career concussions (OR 2.86, 95% CI 2.36-3.48).

Conclusions:

An increased incidence of LE injuries was observed at 90-days and one year following the diagnosis of a concussion. Higher levels of competition, such as at the collegiate and professional level, resulted in an increased risk of sustaining a subsequent LE injury following a diagnosed concussion. These results suggest an at-risk population which may benefit from injury prevention methods following a concussion. [Table: see text][Table: see text][Table: see text][Table: see text]
Poster 139: Outcomes After Arthroscopic Assisted Lower Trapezius Transfer: A Retrospective Study
Authors: Wright Melissa , Murthi Anand , Chopra Aman
Published: July 2022

Objectives:

Massive irreparable rotator cuff tears lead to significant pain and disability. Tendon transfers have been described as one option to improve pain and function for patients, but clinical data are limited. The purpose of this study was to evaluate outcomes in patients after arthroscopically assisted lower trapezius tendon transfer (AALTT) for massive irreparable rotator cuff tears.

Methods:

Twenty-one patients with massive irreparable rotator cuff tears who underwent AALTT with a single surgeon from January 2017 to July 2021 were analyzed. Patient demographics such as age, sex, followup, worker’s compensation claims, and prior surgical history were recorded. Preoperative and one-year postoperative range of motion, external rotation strength, and pain visual analogue scale (VAS) were extracted from medical records. Patient reported outcomes measurements used for comparison included American Shoulder and Elbow Score (ASES), as well as Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function and Mental Function. Six-month postoperative MRIs were reviewed when available. Descriptive and univariate statistical analyses were performed.

Results:

The average patient age was 56.1 (range, 29-72) years and 19 patients (90.5%) were male. The average follow up was 13.2 (range, 4-45) months. Seven patients (33.3%) were involved in worker’s compensation claims and 17 patients (81%) had undergone prior rotator cuff repair. Out of 21 patients who were working at the time of surgery, eleven patients (52.4%) were able to return to their same occupation and 19 patients (86.4%) demonstrated complete tendon healing on postoperative MRI scans (Table 1). There was significant improvement in postoperative pain VAS (5.8±2 vs. 1.7±2) and ASES scores (44.3±18 vs. 71.6±23). No significant changes in PROMIS Physical (47.1±7 vs. 51.4±11) and PROMIS Mental (53.1±8 vs. 53.8±10) were observed. There were significant improvements in external rotation motion (11.0±17 degrees vs. 42.1±13 degrees) and strength (2.9/5 ±1 vs. 4.6/5 ±1) at final followup (Table 2).

Conclusions:

AALTT is a successful treatment option for the massive irreparable rotator cuff tear. Patients demonstrated significant improvements in pain, range of motion, and strength at one year, with complete tendon healing visualized on postoperative MRI scans. [Table: see text][Table: see text]
Poster 168: Is Workload Associated with Internal Impingement in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced
Authors: Chalmers Peter , Mcelheny Kathryn , Dangelo John , Ma Kevin , Rowe Dana , Erickson Brandon
Published: July 2022

Objectives:

The purpose of this study was to determine if number of days of rest between outings, number of innings pitched in each outing, number of batters faced in each outing, and being a starting pitcher are risk factors for internal impingement in professional baseball pitchers.

Methods:

All professional baseball pitchers who were diagnosed with internal impingement between 2011-2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared workload variables between pitcher-games 2, 6, 12, and >12 weeks prior to documented internal impingement to pitcher-games from a control group who were never diagnosed with internal impingement. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury to the injured pitcher’s workload >12 weeks prior to injury.

Results:

There were 624 professional baseball pitchers who were documented in the MLB HITS database as having had internal impingement between 2011-2017. Across all time points, players with more innings pitched per game and more batters faced per game were associated with a higher incidence of subsequent internal impingement compared to controls. However, there were not significantly more innings pitched, more batters faced, or fewer days rest in the acute period (12 weeks) prior to injury when compared to baseline workload. Being a starting pitcher was associated with a higher incidence of internal impingement.

Conclusions:

Greater pitcher workload and being a starting pitcher were associated with increased risk for internal impingement in professional baseball players. However, this injury was not associated with an acute increase in workload, suggesting that internal impingement may be due to the cumulative effects of workload over a career. [Table: see text]
Poster 175: Beach Chair Versus Lateral Decubitus Positioning for Primary Arthroscopic Posterior Shoulder Stabilization
Authors: Anderson Ashley , Mescher Patrick , Tennent David , LeClere Lance , Rue John Paul , Owens Brett , Cameron Kenneth , Posner Matthew , Dickens Jonathan , Donohue Michael , Yow Bobby
Published: July 2022

Objectives:

There are no studies that directly compare beach chair (BC) versus lateral decubitus (LD) position for arthroscopic treatment of posterior instability. In the few systematic reviews evaluating BC vs. LD, no difference had been demonstrated in regard to recurrence and revision rates. Additionally, bone loss was not accounted for in the recurrence rate. The purpose of this study is to identify predictors of shoulder instability recurrence and revision after posterior shoulder stabilization surgery in a young, high demand population and evaluate surgical position and glenoid bone loss as independent predictors of the outcomes of interest, recurrence and revision at short- and mid- term follow-up.

Methods:

A consecutive series of 147 arthroscopic posterior stabilization procedures were performed by sports medicine certified and fellowship trained orthopaedic surgeons from 2005-2019 in either the BC or LD position. Patients were included if they underwent an isolated primary arthroscopic posterior capsulolabral repair. Patients were excluded if concomitant anterior labral repair was performed at the time of surgery. Shoulders were additionally excluded if magnetic resonance imaging (MRI) was not available at the time of preoperative evaluation, or the patient was lost to follow up. All shoulders were evaluated for glenohumeral bone loss using the best-fit circle technique on the sagittal enface MRI. The primary outcomes of interest were recurrent instability and revision stabilization. Recurrent instability was defined as the presence of a recurrent pain limiting activities with physical exam consistent with recurrent posterior instability per clinical notes in the electronic medical record. Rates of recurrence and revision were calculated among the full cohort among patients with available 1-year or 5-year follow up. Patient and procedure characteristics were compared by BC or LD group using two sample t-tests or Chi-square tests.

Results:

A total of 147 shoulders with a mean age of 22.6 years (4.82 SD) underwent isolated arthroscopic repair and were followed for a mean 6.93 (3.29 SD) years. The overall recurrent instability and revisions rates were 16% (23/147) and 12% (18/147), respectively. With respect to surgical position, there was no significant difference in recurrence or revision (p-value >0.05). With respect to patient age, anchor number, and bone loss there was no significant difference in recurrence or revision with respect to patient age (p-value >0.05).

Conclusions:

Among fellowship-trained orthopaedic surgeons, there was no difference in rates of recurrent instability and revision surgery after performing arthroscopic stabilization for isolated posterior shoulder instability in a high demand population in either the BC or LD position.
Poster 193: Increased Hip Distractability in the Revision Hip Arthroscopy Setting: A Comparison Between Revision and Native Contralateral Hips with an Intra-Operative Axial Stress Exam Under Anesthesia
Authors: Tomasevich Kelly , Ohlsen Suzanna , O Dillon , Featherall Joseph , Aoki Stephen , Mortensen Alexander
Published: July 2022

Objectives:

Hip instability secondary to capsular insufficiency is a cause of persistent pain and/or functional disability following primary hip arthroscopy in a poorly defined subset of patients. Further, an easily distractible hip exam under anesthesia is a finding that has been described in the diagnosis of hip instability; however, the exam has relied on subjective findings of a perceived looseness and has lacked objective criteria. The purpose of this study was to compare intraoperative hip joint distractibility between hips that previously underwent arthroscopic surgery and the contralateral hip with no history of surgical manipulation.

Methods:

Patients undergoing revision hip arthroscopy between April 2019 and December 2020, who previously underwent arthroscopic hip surgery for femoroacetabular impingement syndrome, were prospectively enrolled. Exclusion criteria was any contralateral hip surgery. Prior to instrumentation, fluoroscopic images of both hips were obtained at 25 lb traction intervals up to 100 lbs. Total joint space and distraction were measured at each traction interval. (Figure 1) Distraction was calculated as the difference between the baseline joint space and the total joint space at each subsequent traction interval. (Figure 2) Wilcoxon signed ranks tests and McNemar tests were used to compare distraction between revision and native contralateral hips.

Results:

Forty-seven patients were included. Mean distraction of operative hips was significantly greater than mean distraction of non-operative hips at traction intervals of 50 lbs (2.13 vs. 1.04 mm, p = 0.002), 75 lbs (6.39 vs. 3.70 mm, p < 0.001), and 100 lbs (8.24 vs. 5.39, p < 0.001) (Figure 3). Mean total joint space of operative hips was significantly greater than mean total joint space of non-operative hips at traction intervals of 50 lbs (6.60 vs. 5.39 mm, p < 0.001), 75 lbs (10.86 vs. 8.05 mm, p < 0.001), and 100 lbs (12.73 vs. 9.73, p < 0.001). A higher percentage of operative hips achieved all distraction thresholds, in 2-mm intervals up to 10-mm, at each traction interval (Table 1).

Conclusions:

In the majority of patients undergoing revision hip arthroscopy, previous arthroscopic hip surgery increases axial distractibility of the hip joint compared to the native contralateral hip at axial traction forces of 50-100 lbs. Increased axial distractibility following hip arthroscopy may be suggestive of hip instability, and can be assessed on a stress exam under anesthesia. [Table: see text]
Poster 215: Application of Machine Learning for Predicting Opioid Use After Arthroscopic Meniscal Surgery
Authors: Jildeh Toufic , Chaudhry Farhan , Abbas Muhammad , Mahmoud Ossama , Turner Elizabeth , Hengy Meredith , Okoroha Kelechi , Castle Joshua
Published: July 2022

Objectives:

To identify predictive factors for continued opioid prescriptions after arthroscopic meniscal resection or repair and develop a predictive machine learning model.

Methods:

Patients undergoing arthroscopic meniscal surgery between August 2013 and February 2017 at a single institution were retrospectively identified. Patient demographic variables were recorded including age, sex, body mass index, and history of chronic opioid usage (> 1 month). Procedural details were recorded such as concomitant procedures, primary versus revision, and whether a partial debridement or a repair was performed. Intraoperative arthritis severity was measured using the Outerbridge Classification. Types of opioid medications prescribed and in which months were documented. For primary analysis, we used a multivariate Cox-Regression model. We then created a naïve Bayesian model, a machine learning classifier that utilizes Bayes’ theorem with an assumption of independence between the variables collected. The model randomly selected 70% of the sample to be trained on while 30% were tested.

Results:

A total of 735 patient were reviewed. Postoperative opioid refills occurred in 98 patients (16.9%). Using multivariate logistic modeling, independent risk factors for opioid refills included Male sex, larger BMI, chronic preoperative opioid use while meniscus resection demonstrated decreased likelihood of refills. Concomitant procedures, revisions, and presence of arthritis graded by the Outerbridge classification were not significant predictors of opioid refills. The Naïve Bayesian model for extended postoperative opioid use demonstrated good fit with our cohort with an area under the curve of 0.79, sensitivity of 94.5%, PPV of 83%, and a detection rate of 78.2%.

Conclusions:

After arthroscopic meniscus surgery, preoperative opioid consumption had the strongest association with sustained opioid use >1 month. Intraoperative arthritis was not an independent risk factor for continued refills. A novel machine learning algorithm performed with high accuracy and predictive ability to identify patients filling additional narcotic prescriptions after surgery. [Figure: see text][Table: see text]
Poster 267: The Impact of Posterior Malleolar Fixation on Syndesmotic Stability
Authors: Bryniarski Anna , Brady Alex , Miles Jon , Dornan Grant , Radsen Jan , Fossum Bradley , Haytmanek C. Thomas , Husebye Elisabeth , Clanton Thomas , Stake Ingrid
Published: July 2022

Objectives:

Trans-syndesmotic fixation with suture buttons, posterior malleolar fixation (PMF) with screws and anterior inferior tibiofibular ligament (AITFL) augmentation with suture tape have all been suggested as potential treatments in the setting of a malleolar fracture. However, there is no consensus on the optimal treatment for small vs. large malleolar fractures. The purpose of this study was to determine which combination of: 1) posterior malleolar screw fixation, 2) syndesmotic fixation with suture button (SB), and 3) AITFL augmentation with suture tape (ST) best restored native tibio-fibular and ankle joint kinematics following a small and large posterior malleolar fracture.

Methods:

Twenty fresh frozen cadaveric lower leg specimens were divided into two groups and underwent biomechanical testing using a 6-degrees-of-freedom robotic arm in 7 states: 1) Native, 2) Syndesmosis Injury + Malleolar Fracture (Group 1: small fracture, Group 2: large fracture) 3) Screw fixation, 4) Screw + Suture Tape Augmentation, 5) Screw + Suture Tape Augmentation + Suture Button, 6) Suture Button + Suture Tape Augmentation, 7) Suture Button. Four biomechanical tests were performed at neutral and at 30 degrees of plantarflexion: 1) Internal Rotation, 2) External Rotation, 3) Lateral Drawer, 4) Posterior Drawer. The position of the tibia, fibula and talus were continuously recorded using a 5-camera motion capture system.

Results:

No differences were found in the efficacy of treatments between the small fracture and large fracture groups. In the external rotation test, screws with ST augmentation resulted in best stability of the fibula and ankle joint. In the internal rotation test, all repairs that included posterior malleolar screws stabilized the fibula and ankle. Posterior and lateral drawer of the foot resulted in only small differences between the intact and malleolar fracture states.

Conclusions:

Posterior malleolar fixation resulted in higher syndesmotic stability compared to trans-syndesmotic fixation with SBs. AITFL augmentation with ST provided additional external rotation stability when combined with screw fixation. Posterior malleolar screw fixation with AITFL augmentation using ST may be the preferred surgical method when treating patients with acute ankle injury involving an unstable syndesmosis injury and a posterior malleolar fragment. [Figure: see text][Figure: see text]
Green and blue spaces and lung function in the Generation XXI cohort: a life-course approach
Authors: Queiroz Almeida Diogo , Paciência Inês , Moreira Carla , Cavaleiro Rufo João , Moreira André , Santos Ana Cristina , Barros Henrique , Ribeiro Ana Isabel
Published: July 2022

Background

Exposure to natural environments may affect respiratory health. This study examined the association of exposure to green and blue spaces with lung function in children, and assessed the mediation effect of air pollution and physical activity.

Methods

The study used data from the Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). Residential Normalised Difference Vegetation Index (NDVI) at different buffers (100, 250 and 500 m), the accessibility to urban green spaces (UGS) within 400 and 800 m and the minimum distance to the nearest UGS and to the nearest blue spaces were assessed at birth, 4, 7 and 10 years of age. Three life-course measures were calculated: averaged exposure, early-life exposure (birth) and exposure trend over time (change in exposure). Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and forced expiratory flow between 25% and 75% of FVC (FEF25–75%) at 10 years were used as outcomes. To assess associations, linear regression models and path analysis were used.

Results

This study included 3278 children. The adjusted models showed that increasing the NDVI exposure over time within 100 m of the child's residence was associated with higher values of FEV1(L) and FEF25–75%(L·s−1) (β 0.01, 95% CI 0.0002–0.03 and β 0.02, 95% CI 0.001–0.05, respectively). No significant associations were observed for the remaining measures of exposure, and no mediation effect was found for pollution or physical activity.

Conclusion

Increasing exposure to greenness at close proximity from residences was associated with improved lung function. While the mechanism remains unknown, this study brings evidence that city greening may improve children's respiratory health.
Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis
Authors: Cabrera-Sanchez Javier , Cuba Vicente , Vega Victor , Van der Stuyft Patrick , Otero Larissa
Published: July 2022

Introduction:

People with tuberculosis experience long-term health effects beyond cure, including chronic respiratory diseases. We investigated whether tuberculosis is a risk factor for subsequent lung cancer.

Methods:

We searched PubMed, Scopus, Cochrane, Latin American and Caribbean Health Sciences Literature and the Scientific Electronic Library Online for cohort and case–control studies providing effect estimates for the association between tuberculosis and subsequent lung cancer. We pooled estimates through random-effects meta-analysis. The study was registered in PROSPERO (CDR42020178362).

Results:

Out of 6240 records, we included 29 cohort and 44 case–control studies. Pooled estimates adjusted for age and smoking (assessed quantitatively) were hazard ratio (HR) 1.51 (95% CI 1.30–1.76, I2=81%; five studies) and OR 1.74 (95% CI 1.42–2.13, I2=59%; 19 studies). The occurrence of lung cancer was increased for 2 years after tuberculosis diagnosis (HR 5.01, 95% CI 3.64–6.89; two studies), but decreased thereafter. Most studies were retrospective, had moderate to high risk of bias, and did not control for passive smoking, environmental exposure and socioeconomic status. Heterogeneity was high.

Conclusion:

We document an association between tuberculosis and lung cancer occurrence, particularly in, but not limited to, the first 2 years after tuberculosis diagnosis. Some cancer cases may have been present at the time of tuberculosis diagnosis and therefore causality cannot be ascertained. Prospective studies controlling for key confounding factors are needed to identify which tuberculosis patients are at the highest risk, as well as cost-effective approaches to mitigate such risk.
A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study
Authors: Verburg Arie C. , van Dulmen Simone A. , Kiers Henri , Nijhuis-van der Sanden Maria W.G. , van der Wees Philip J.
Published: July 2022

Aim

To estimate the comparability and discriminability of outcome-based quality indicators by performing a practice test in Dutch physical therapy primary care, and to select a core set of outcome-based quality indicators that are well accepted by physical therapists based on their perceived added value as a quality improvement tool.

Methods

First, a list of potential quality indicators was defined, followed by determination of the comparability (case-mix adjusted multilevel analysis) and discriminability (intraclass correlation coefficient (ICC)). Second, focus group meetings were conducted with stakeholders (physical therapists and senior researchers) to select a core set of quality indicators.

Results

Overall, 229 physical therapists from 137 practices provided 2651 treatment episodes. Comparability: in 10 of the 11 case-mix adjusted models, the ICC increased compared with the intercept-only model. Discriminability: the ICC ranged between 0.01 and 0.34, with five of the 11 ICCs being >0.10. The majority of physical therapists in each focus group preferred the inclusion of seven quality indicators in the core set, including three process and four outcome indicators based upon the 6-min walk test (6MWT), the Clinical COPD Questionnaire (CCQ), and the determination of quadriceps strength using a hand-held dynamometer.

Conclusion

This is the first study to describe the comparability and discriminability of the outcome-based quality indicators selected for patients with COPD treated in primary care physical therapy practices. Future research should focus on increasing data collection in daily practice and on the development of tangible methods to use as the core set of a quality improvement tool.
Infant tidal flow–volume parameters and arousal state
Authors: Bains Karen Eline Stensby , Färdig Martin , Gudmundsdóttir Hrefna Katrín , Almqvist Catarina , Hedlin Gunilla , Nordhagen Live S. , Rehbinder Eva M. , Skjerven Håvard O. , Söderhäll Cilla , Vettukattil Riyas , Nordlund Björn , Lødrup Carlsen Karin C.
Published: July 2022

Background

Infant lung function can be assessed with tidal flow–volume (TFV) loops. While TFV loops can be measured in both awake and sleeping infants, the influence of arousal state in early infancy is not established. The aim of the present study was to determine whether TFV loop parameters in healthy infants differed while awake compared to the sleeping state at 3 months of age.

Methods

From the population-based Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) birth cohort, 91 infants had reproducible TFV loops measured with Exhalyzer®D in both the awake and sleeping state at 3 months of age. The TFV loops were manually selected according to a standardised procedure. The ratio of time to peak tidal expiratory flow (tPTEF) to expiratory time (tE) and the corresponding volume ratio (VPTEF/VE), as well as tidal volume (VT) and respiratory rate were compared using nonparametric tests.

Results

The mean (95% CI)tPTEF/tEwas significantly higher while awake compared to the sleeping state: 0.39 (0.37–0.41)versus0.28 (0.27–0.29); with the correspondingVPTEF/VEof 0.38 (0.36–0.40)versus0.29 (0.28–0.30). TheVTwas similar, while the respiratory rate was higher while awake compared to the sleeping state: 53 (51–56) breaths·min−1versus38 (36–40) breaths·min−1.

Conclusion

HighertPTEF/tE,VPTEF/VEand respiratory rate, but similarVTwhile awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.
Blueprint for harmonising unstandardised disease registries to allow federated data analysis: prepare for the future
Authors: Kroes Johannes A. , Bansal Aruna T. , Berret Emmanuelle , Christian Nils , Kremer Andreas , Alloni Anna , Gabetta Matteo , Marshall Chris , Wagers Scott , Djukanovic Ratko , Porsbjerg Celeste , Hamerlijnck Dominique , Fulton Olivia , ten Brinke Anneke , Bel Elisabeth H. , Sont Jacob K.
Published: July 2022

Real-world evidence from multinational disease registries is becoming increasingly important not only for confirming the results of randomised controlled trials, but also for identifying phenotypes, monitoring disease progression, predicting response to new drugs and early detection of rare side-effects. With new open-access technologies, it has become feasible to harmonise patient data from different disease registries and use it for data analysis without compromising privacy rules. Here, we provide a blueprint for how a clinical research collaboration can successfully use real-world data from existing disease registries to perform federated analyses. We describe how the European severe asthma clinical research collaboration SHARP (Severe Heterogeneous Asthma Research collaboration, Patient-centred) fulfilled the harmonisation process from nonstandardised clinical registry data to the Observational Medical Outcomes Partnership Common Data Model and built a strong network of collaborators from multiple disciplines and countries. The blueprint covers organisational, financial, conceptual, technical, analytical and research aspects, and discusses both the challenges and the lessons learned. All in all, setting up a federated data network is a complex process that requires thorough preparation, but above all, it is a worthwhile investment for all clinical research collaborations, especially in view of the emerging applications of artificial intelligence and federated learning.
Optimization of acute medication use following eptinezumab initiation during a migraine attack: post hoc analysis of the RELIEF study
Authors: Cady Roger , Lipton Richard B. , Buse Dawn C. , Josiassen Mette Krog , Lindsten Annika , Ettrup Anders
Published: July 2022

Background

The benefits of preventive treatment on the effectiveness of migraine management have rarely been examined. This post hoc analysis investigated the impact of eptinezumab on the optimization of acute medication effectiveness using the 4-item Migraine Treatment Optimization Questionnaire (mTOQ-4) to measure acute medication optimization over 4 weeks post-infusion.

Methods

RELIEF was a 12-week, phase 3, multicenter, parallel-group, double-blind, placebo-controlled clinical trial conducted in patients aged 18–75 years with a ≥ 1-year history of migraine and 4–15 migraine days per month in the 3 months prior to screening. Patients were randomized 1:1 to a 30-min infusion of eptinezumab 100 mg or placebo within 1–6 h of a qualifying migraine attack. The mTOQ-6 and 6-item Headache Impact Test (HIT-6) were administered at screening visit and week 4. From the mTOQ-6, we calculated the mTOQ-4 using the following items: “2-h pain free,” “24-h relief,” “able to plan,” and “feeling in control” to measure acute medication optimization.

Results

A total of 238 patients received eptinezumab 100 mg and 226 provided week 4 data; 242 received placebo and 232 provided week 4 data. In the eptinezumab arm, the proportion of patients with moderate/maximal optimization increased from 31.4% at baseline to 58.0% (26.6 percentage point increase) at week 4. The corresponding proportions in the placebo group were 40.5% to 50.4% (9.9 percentage point increase). Eptinezumab treatment was associated with numerically larger improvements in HIT-6 at week 4. Relative improvements with eptinezumab vs. placebo from baseline to week 4 in HIT-6 were greater in those with poor treatment optimization at baseline.

Conclusions

In comparison with placebo, treatment with eptinezumab was associated with improvements in acute medication optimization as measured by mTOQ and reductions in headache impact, as measured by HIT-6. These benefits were greater in those with poor acute treatment optimization prior to preventive treatment with eptinezumab.

Trial registration

ClinicalTrials.gov identifier: NCT04152083.
Gut microbiota and host genetics contribute to the phenotypic variation of digestive and feed efficiency traits in growing pigs fed a conventional and a high fiber diet
Authors: Déru Vanille , Tiezzi Francesco , Carillier-Jacquin Céline , Blanchet Benoit , Cauquil Laurent , Zemb Olivier , Bouquet Alban , Maltecca Christian , Gilbert Hélène
Published: July 2022

Background

Breeding pigs that can efficiently digest alternative diets with increased fiber content is a viable strategy to mitigate the feed cost in pig production. This study aimed at determining the contribution of the gut microbiota and host genetics to the phenotypic variability of digestive efficiency (DE) traits, such as digestibility coefficients of energy, organic matter and nitrogen, feed efficiency (FE) traits (feed conversion ratio and residual feed intake) and growth traits (average daily gain and daily feed intake). Data were available for 791 pigs fed a conventional diet and 735 of their full-sibs fed a high-fiber diet. Fecal samples were collected at 16 weeks of age to sequence the V3–V4 regions of the 16S ribosomal RNA gene and predict DE with near-infrared spectrometry. The proportions of phenotypic variance explained by the microbiota (microbiability) were estimated under three OTU filtering scenarios. Then, microbiability and heritability were estimated independently (models Micro and Gen) and jointly (model Micro+Gen) using a Bayesian approach for all traits. Breeding values were estimated in models Gen and Micro+Gen.

Results

Differences in microbiability estimates were significant between the two extreme filtering scenarios (14,366 and 803 OTU) within diets, but only for all DE. With the intermediate filtering scenario (2399 OTU) and for DE, microbiability was higher (> 0.44) than heritability (< 0.32) under both diets. For two of the DE traits, microbiability was significantly higher under the high-fiber diet (0.67 ± 0.06 and 0.68 ± 0.06) than under the conventional diet (0.44 ± 0.06). For growth and FE, heritability was higher (from 0.26 ± 0.06 to 0.44 ± 0.07) than microbiability (from 0.17 ± 0.05 to 0.35 ± 0.06). Microbiability and heritability estimates obtained with the Micro+Gen model did not significantly differ from those with the Micro and Gen models for all traits. Finally, based on their estimated breeding values, pigs ranked differently between the Gen and Micro+Gen models, only for the DE traits under both diets.

Conclusions

The microbiota explained a significant proportion of the phenotypic variance of the DE traits, which was even larger than that explained by the host genetics. Thus, the use of microbiota information could improve the selection of DE traits, and to a lesser extent, of growth and FE traits. In addition, our results show that, at least for DE traits, filtering OTU is an important step and influences the microbiability.
Mortality and complications after percutaneous endoscopic gastrostomy: a retrospective multicentre study
Authors: Stenberg K. , Eriksson A. , Odensten C. , Darehed D.
Published: July 2022

Background

Percutaneous endoscopic gastrostomy (PEG) is the method of choice for patients in need of long-term nutritional support or gastric decompression. Although it is considered safe, complications and relatively high mortality rates have been reported. We aimed to identify risk factors for complications and mortality after PEG in routine healthcare.

Methods

This retrospective study included all adult patients who received a PEG between 2013 and 2019 in Region Norrbotten, Sweden.

Results

389 patients were included. The median age was 72 years, 176 (45%) were women and 281 (72%) patients received their PEG due to neurological disease. All-cause mortality was 15% at 30 days and 28% at 90 days. Malignancy as the indication for PEG was associated with increased mortality at 90 days (OR 4.41, 95% CI 2.20–8.88). Other factors significantly associated with increased mortality were older age, female sex, diabetes mellitus, heart failure, lower body mass index and higher C-reactive protein levels. Minor and major complications within 30 days occurred in 11% and 15% of the patients, respectively. Diabetes increased the risk of minor complications (OR 2.61, 95% CI 1.04–6.55), while those aged 75 + years were at an increased risk of major complications, compared to those younger than 65 years (OR 2.23, 95% CI 1.02–4.85).

Conclusions

The increased risk of death among women and patients with malignancy indicate that these patients could benefit from earlier referral for PEG. Additionally, we found that age, diabetes, heart failure, C-reactive protein and body mass index all impact the risk of adverse outcomes.
Antibody waning after immunosuppressive chemotherapy and immunomodulators, re-immunization considerations in pediatric patients with malignancy and chronic immune thrombocytopenic purpura
Authors: Abdolkarimi Babak , Amanati Ali , Molavi Vardanjani Hossein , ‏Jamshidi Safura‏ , Tabaeian Seid Amir Pasha
Published: July 2022

Introduction

Immunosuppressive chemotherapy increase the risk of vaccine-preventable infectious diseases in children; nevertheless, chemotherapy may result in delay or miss updated immunization schedules. The predictable antibody waning after incomplete primary immunization series may be intensified at the end of chemotherapy. This study aimed to investigate post-chemotherapy vaccine immunity waning at the end of immunosuppressive therapy in children with malignancy and hematologic disorders.

Materials and methods

Children with malignancies and hematologic disorders including chronic immune thrombocytopenic purpura (ITP) younger than 18 years old were enrolled from September 2015 to August 2019. Eligible patients who completed their treatment protocol for at least 6 months were recruited. The patient information, including sex, age at the date of diagnosis, number of chemotherapy sessions, underlying disease, and vaccination history, was taken by chart review using predefined questionnaires. The patient’s blood samples were obtained, and serum IgG antibody titer checked against diphtheria, tetanus, hepatitis B virus (HBV), mumps, measles, and rubella (MMR) were measured by enzyme-linked immunosorbent assay (ELISA).

Results

110 children receiving immunosuppressive chemotherapy were recruited. Forty-four (40%) of the children tested were girls and 66 (60%) were boys. The mean age of patients was 5.5 years with a range of 2 to 13 years. Of 110 studied children, 27.3% were seronegative for all antibodies. On average, patients undergo 19 episodes of chemotherapy. The mean chemotherapy sessions were significantly greater in children who were seronegative for all tested antibodies (mean: 36.2, 95% CI 33.16 to 39.24, p-value < 0.001). No statistically significant differences were observed regarding the patient’s sex and age between the seropositive and seronegative groups (p-value 0.513 and 0.060, respectively). Based on Poisson regression model analysis, the female gender was associated with 37% lower odds of seronegativity (incidence rate ratio (IIR): 0.63; [95% conf. interval: 0.39 to 1.01, p-value: 0.55]), while chemotherapy sessions 30 or more was associated with significant odds of seronegativity for all tested vaccines (IIR: 25.41; [95% conf. interval: 6.42 to 100.57, p-value < 0.001]).

Conclusion

Our results reemphasized planned catchup immunization in children undergoing immunosuppressive chemotherapy for malignancy, especially against tetanus, diphtheria, and hepatitis B at least 6 months after the end of chemotherapy sessions.
Ethnic differences on long term outcomes of polypoidal choroidal vasculopathy after predominantly bevacizumab monotherapy
Authors: Yap Aaron , Wang Nancy , Squirrell David
Published: July 2022

Background

A 3-year single-centre, retrospective, comparative, non-randomized cohort study to describe the long-term outcomes of treatment-naïve, Caucasian and non-Caucasian eyes with polypoidal choroidal vasculopathy (PCV) after treatment with predominantly Bevacizumab monotherapy or in combination with rescue photodynamic therapy (PDT).

Methods

Demographics, visual outcomes, optical coherence tomography (OCT) and treatment data were collected up to 3 years after the first visit. Stratified analysis according to ethnicity and baseline vision was performed to identify factors predictive of long-term visual improvement and maintenance.

Results

A total of 89 eyes with PCV were identified, of which 14 received rescue verteporfin PDT. There was an equal distribution between Caucasian and non-Caucasian individuals. Non-Caucasians present at a younger age (67.3 vs. 76.0 years, p = 0.002), have a higher proportion of foveal involvement (80.9%, vs.54.2% p = 0.007), choroidal hyperpermeability (50% vs 25.8%, p = 0.013) and lower baseline visual acuity (53.1 vs. 63.3 letters, p = 0.008). Mean visual acuity (VA) gain was + 8.9 letters and + 5.0 letters at 1 and 3 years of follow-up, respectively. Non-Caucasian individuals had a lower mean final visual acuity (VA) (54.7 vs. 70.5, respectively; P < 0.001) and net gain in VA (+ 2.0 vs. + 7.6 letters, p = 0.581) compared to Caucasian individuals. The mean total number of injections given over 3 years was 14.

Conclusions

Most patients treated with predominantly Bevacizumab anti-vascular endothelial growth factor (VEGF) monotherapy achieved sustained visual acuity gains out to 3 years. Due to ethnic-specific differences in presenting PCV phenotypes, non-Caucasians presented with lower baseline VA and had poorer long-term visual outcomes.
The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis
Authors: Xu Dan , Zhou Xueying , Wang Junfei , Cao Xi , Liu Tao
Published: July 2022

Background

The gonadotropin-releasing hormone (GnRH) stimulation test is time-consuming, invasive, and costly. However, it is the diagnostic gold standard for central precocious puberty (CPP), which in girls is defined as the onset of secondary sexual characteristics before the age of 8 years accompanied by breast buds, accelerated growth, and advanced bone age. This meta-analysis was performed to compare the diagnostic value of urinary gonadotropins and the GnRH stimulation test for CPP.

Methods

We searched six databases for relevant literature. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we estimated the sensitivity, specificity, area under the summary receiver operating characteristic curve (AUC), and publication bias.

Results

Six eligible trials fulfilled the inclusion criteria. In the meta-analysis of urinary luteinizing hormone (ULH), after excluding the data of one study, we obtained an AUC of 0.90 (sensitivity = 0.81, specificity = 0.85). The meta-analysis of the ULH to urinary follicle-stimulating hormone (UFSH) ratio revealed an AUC of 0.8116 (sensitivity = 0.79, specificity = 0.84).

Conclusion

Both the ULH level and ULH:UFSH ratio are effective and available approaches for CPP diagnosis.

Trial Registration

INPLASY 2021120076.