bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in the Risk of Barrett’s Esophagus Associated With the Metabolic Effects of Obesity
Authors: Kendall Bradley J. , Macdonald Graeme A. , Prins Johannes B. , O’Brien Suzanne , Thrift Aaron P. , Whiteman David C. 
Published: December 2019

Goal:
The goal of this study was to determine if there is an association between the insulin–insulin-like growth factor axis, the metabolic syndrome (MetS), type 2 diabetes mellitus and risk of Barrett’s esophagus (BE), and if these associations are modified by sex.

Background:
BE is more common in males. Gastroesophageal reflux disease, the major risk factor for BE occurs at similar frequencies in both sexes, suggesting that sex-related factors such as the metabolic effects of abdominal obesity may be important in the causation of BE.

Materials and Methods:
A structured interview, anthropometric measures, and fasting blood were collected within a population-based case-control study. We recruited 227 BE cases (70% male) and 241 population controls, frequency matched by age and sex. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for association with BE using multivariable logistic regression models.

Results:
Hyperinsulinemia (highest vs. lowest tertile, OR=1.9; 95% CI: 1.2-3.1), Homeostatic Model Assessment of Insulin Resistance (OR=1.9; 95% CI: 1.2-3.1) and the MetS (OR=1.8; 95% CI: 1.2-2.6) were independently associated with an increased risk of BE. With each additional MetS criterion, there was a 20% increased risk of BE (OR=1.2; 95% CI: 1.0-1.4). When stratified by sex, these associations were found in males but not females. We found no association with serum measures of insulin-like growth factors or interleukin-6 and risk of BE.

Conclusion:
Hyperinsulinemia, insulin resistance, and the MetS are associated with the risk of BE in males but not females, suggesting these factors may contribute to the higher prevalence of BE in males.
Refeeding syndrome: update and clinical advice for prevention, diagnosis and treatment
Authors: Friedli Natalie , Odermatt Jonas , Reber Emilie , Schuetz Philipp , Stanga Zeno 
Published: December 2019

Purpose of review
The aim of this review is to provide a brief overview of the refeeding syndrome, to discuss more recent advice on diagnosis and treatment, and to raise awareness of this still poorly understood metabolic condition.

Recent findings
To date, evidence regarding the refeeding syndrome has been very limited. A number of reviews and case reports exist, but only a few are randomized trials. Recently, it has been shown that the vast majority of physicians are unaware of this metabolic condition. Precise guidelines for diagnosis and treatment of this syndrome were lacking for a long time. Now, a consensus statement is available, providing guidance from experts in the field on the management of patients at increased risk of refeeding syndrome (RFS) receiving nutritional therapy.

Summary
Due to the increased use of nutritional therapy in inpatient settings, physicians should be aware of possible side effects, particularly in connection with the refeeding syndrome. In this context, every patient should undergo a risk assessment for refeeding syndrome and stratification before starting nutritional therapy. For patients at high risk, nutritional support should be administered with adapted energy and fluid support during the replenishment phase. In addition, the occurrence of RFS during nutritional therapy must be continuously evaluated, and appropriate steps taken if necessary.
The Lived Experience of Persons With Malignant Pleural Mesothelioma in the United States
Authors: Walker Suzanne L. , Crist Janice D. , Shea Kimberly , Holland Sara , Cacchione Pamela Z. 
Published: December 2019

Background
Malignant pleural mesothelioma (MPM) is a rare but deadly cancer. Although there is an emerging picture of the individual MPM experience, the United States is underrepresented in this literature. With the United States contributing more deaths from MPM than any other country, findings from this study will enhance a global body of literature on the lived experience of this devastating cancer.

Objective
The aims of this descriptive phenomenological research study were to explore the lived experience of MPM in the United States and identify unmet patient needs.

Interventions/Methods
This was a descriptive phenomenology study employing semi-structured individual interviews with persons with MPM.

Results
A total of 7 persons with MPM from a large northeastern US medical center participated. Three major themes about the MPM lived experience emerged: (1) uncertainty/worry about the future, (2) value in relationships, and (3) adapting to a new norm.

Conclusions
Findings from this study are consistent with other MPM research, noting a high symptom burden, lifestyle changes, and feelings of uncertainty about the future. However, participants also expressed feelings of hope and optimism. Particularly salient to the MPM experience was the role of communication with the healthcare team as well as other persons with MPM.

Implications for Practice
Timely, coordinated, and personalized care as well as skilled communication should be the cornerstone of care for persons with MPM. Supportive care strategies that address uncertainty, the high symptom burden, feelings of isolation, and existential concerns are also integral to quality care.
Obstructive Sleep Apnea and Keratoconus: A Systematic Review and Meta-analysis
Authors: Pellegrini Marco , Bernabei Federico , Friehmann Asaf , Giannaccare Giuseppe 
Published: December 2019

BACKGROUND
Despite the increasing number of studies focused on the association between obstructive sleep apnea (OSA) and keratoconus (KC), to date, no comprehensive meta-analysis or systematic review was published.

OBJECTIVE
The objective of this study was to evaluate the association between OSA and KC.

DATA SOURCES
Sources of data were PubMed, Scopus, and Web of Science databases.

STUDY ELIGIBILITY CRITERIA
The criteria for study eligibility were case-control studies and cohort studies reporting data on the association of OSA with KC with risk ratio, odds ratio, or hazard ratio with 95% confidence intervals or sufficient raw data for calculation.

STUDY APPRAISAL AND SYNTHESIS METHODS
Meta-analysis was conducted with a random-effects model using odds ratio with 95% confidence interval as the effect size. Heterogeneity was evaluated using the Q and I
2 tests. Sensitivity analysis and assessment of publication bias were performed.

RESULTS
Five studies (four case-control studies and one cohort study) published between 2012 and 2016 and involving 33,844 subjects (16,922 patients with KC, 16,922 controls) were included in this meta-analysis. A significant association between OSA and KC has been shown (pooled odds ratio, 1.841; 95% confidence interval, 1.163 to 2.914; P = .009). A significant heterogeneity was observed (Q = 15.8, I
2 = 74.6%). There was no evidence of significant publication bias (P = .07). The sensitivity analyses indicated the stability of results.

LIMITATIONS
Heterogeneity across the studies was observed. Data from four hospital-based case-control studies and one large population-based cohort study were combined. Most of the included studies ascertained OSA by the Berlin Questionnaire, which is a screening tool.

CONCLUSIONS
This meta-analysis provides significant evidence that OSA is associated with KC. Therefore, a proper screening for OSA is warned for KC patients for the prevention of various cardiovascular comorbidities. Further prospective studies are warranted to explore more in-depth the casual relationship between the two conditions.
A Descriptive Analysis of Pediatric Prehospital Refusal of Medical Assistance Within a Single Service Provider System
Authors: Mix Felicia M. , Myers Lucas A. , Luke Anurahda , Sztajnkrycer Matthew D. 
Published: December 2019

Objectives
Pediatric refusal of medical assistance (RMA) is a potentially high-risk event with implications for both individual patient outcomes and greater emergency medical services system efficiency. The purpose of this study was to describe characteristics of pediatric RMA calls and outcomes.

Methods
Single emergency medical services agency retrospective study of calls between January 1, 2011, and December 31, 2015, for pediatric patients resulting in RMA was performed. Dispatch complaint-matched case-control group was generated from transported patients.

Results
The percentage of pediatric calls that resulted in RMA was 12.7%, compared with 5% adult calls (P < 0.0001). The 3 most common RMA dispatch complaints were seizures, difficulty breathing, and traffic accidents. Furthermore, 65.1% pediatric RMA calls were emergently dispatched, compared with 56.4% of transported pediatric patients (P = 0.01). Medical control was contacted for 4.6% RMA calls. The average ± SD word count for RMA patient care narratives was 179 ± 99 words, compared with 164 ± 139 words for controls (P = 0.11). Documentation of risk-benefit discussion occurred in 28.6% RMA narratives. Outcome data were available for 83.8% RMA patients. The percentage of RMA patients with documented alternative plans who completed the alternative plan was 61.6%. Within 72 hours of RMA, 5.0% of calls with known outcome resulted in unexpected emergency department visit. No unexpected emergency department visits resulted in admission. Five percent of RMA patients were admitted; 1 patient was admitted to the intensive care unit. No emergent surgeries or deaths occurred during the study period.

Conclusions
Pediatric RMA is common within our study population, and two thirds involve emergent dispatch. Although outcomes are generally good, refusal documentation is sparse and medical control is seldom contacted. Multiple opportunities for systems improvement exist.
Preexposure prophylaxis for men who have sex with men in the Netherlands: impact on HIV and Neisseria gonorrhoeae transmission and cost-effectiveness
Authors: Reitsema Maarten , Hoek Albert Jan van , van der Loeff Maarten Schim , Hoornenborg Elske , van Sighem Ard , Wallinga Jacco , van Benthem Birgit , Xiridou Maria 
Published: December 2019

Objectives:
To assess the impact of a preexposure prophylaxis (PrEP) programme for high-risk men who have sex with men (MSM), which includes gonorrhoea testing and treatment, on the transmission of HIV and Neisseria among MSM in the Netherlands and the cost-effectiveness of such programme with and without risk compensation (in the form of reduced condom use).

Methods:
We developed a stochastic agent-based transmission model of HIV and gonorrhoea. We simulated a capped (max 2.5% of MSM) and uncapped (5.5% of MSM in 2018 declining to 3% in 2027) daily PrEP programme for high-risk MSM, with 3-monthly HIV and gonorrhoea testing, with and without risk compensation. Epidemiological outcomes were calculated from the transmission model and used in an economic model to calculate costs, quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios (ICER), over 2018–2027, taking a healthcare payer perspective.

Results:
Without risk compensation, PrEP can lead to a reduction of 61 or 49% in the total number of new HIV infections in 2018–2027, if the programme is uncapped or capped to 2.5% of MSM, respectively. With risk compensation, this reduction can be 63 or 46% in the uncapped and capped programmes, respectively. In all scenarios, gonorrhoea prevalence decreased after introducing PrEP. Without risk compensation, 92% of simulations were cost-effective (of which 52% cost-saving). With risk compensation, 73% of simulations were cost-effective (of which 23% was cost-saving).

Conclusion:
A nationwide PrEP programme for high-risk MSM can result in substantial reductions in HIV and gonorrhoea transmission and be cost-effective, even with risk compensation.
Peripheral Donor-specific Antibodies Are Associated With Histology and Cellular Subtypes in Protocol Liver Biopsies of Pediatric Recipients
Authors: Cousin Vladimir L. , Rougemont Anne-Laure , Rubbia-Brandt Laura , Wildhaber Barbara E. , Villard Jean , Ferrari-Lacraz Sylvie , McLin Valérie A. 
Published: December 2019

Background.
The cellular infiltrate in protocol liver biopsies (PB) following pediatric liver transplantation remains mostly uncharacterized, yet there is increasing concern about the role of inflammation and fibrosis in long-term liver allografts. We aimed to define cell types in PB and to analyze their relationship with donor-specific antibodies (DSA) and histological phenotype.

Methods.
PB were performed at least 1 year after transplantation. We identified 4 phenotypes: normal, fibrosis, inflammation, inflammation with fibrosis. Cell types were counted after immunostaining for CD3, CD4, CD8, CD68, CD20, MUM1, and FoxP3.

Results.
Forty-four patients underwent 1 PB between 2000 and 2015. Eleven percent (5/44) of PB displayed normal histology, 13.6% (6/44) fibrosis, 34.1% (15/44) inflammation, and 40.9% (18/44) inflammation and fibrosis. The main cell types in the portal tracts and lobules were CD3+ and CD68+ cells. Frequency of de novo DSA was 63% (27/44). The presence of CD8+ cells in the lobules was associated with fibrosis. Inflammation and fibrosis in PB were associated with the presence of circulating de novo DSA, number of de novo DSA, and C1q binding activity when compared to other phenotypes.

Conclusions.
T cells (CD3+) and macrophages (CD68+) were the most prevalent cell-types in PB. In the presence of inflammation, portal tracts were enriched in CD3+, CD20+ but displayed fewer CD68+. This coincided with the presence and number of de novo DSA. How these cellular and humoral actors interact is unclear, but peripheral DSA may be a marker of immune cellular activity in the seemingly quiescent allograft.
Contrast-Induced Encephalopathy Resulting From Use of Ioversol and Iopromide
Authors: Zhang Guilian , Wang Heying , Zhao Lili , Li Tao , Sun Man , Zhang Yiheng , Hu Hua , Teng Guoliang , Chen Jingju , Jian Yating , Liu Jiao 
Published: December 2019

Background
Contrast-induced encephalopathy (CIE) is a rare disease, whose etiology and risk factors remain unclear and need investigation.

Methods
We collected 7 CIE cases from 2646 patients injected with ioversol and 5 CIE cases from 526 patients injected with iopromide, all of whom underwent neurointervention surgery in our regional centers. The incidence of CIE, its characteristics, and risks were analyzed in both groups.

Results
The overall incidence of CIE was 0.38%, specifically 0.95% and 0.26% in the iopromide and ioversol groups, respectively; the former incidence was significantly higher than the latter (P = 0.029). The risk of CIE with iopromide was 3.567 to 3.618 times higher than that with ioversol (single-factor analysis odds ratio [OR], 3.618; 95% confidence interval [CI], 1.144–11.443; P = 0.029; multifactor analysis OR, 3.567 (95% CI, 0.827–15.379); P = 0.088). Moreover, acute cerebral infarction was an independent risk factor for CIE (OR, 4.024; 95% CI, 1.137–14.236; P = 0.031). Contrast-induced encephalopathy could occur within 5 minutes after injecting contrast media. The CIE characteristics differed according to the medium. In the ioversol group, the most common characteristic was visual disorder (71.43%), whereas in the iopromide group, the most common characteristic was delirium (100%).

Conclusions
Compared with ioversol, iopromide appeared more likely to lead to CIE. Acute cerebral infarction was an independent risk factor for CIE. The earliest CIE onset was within 5 minutes after injecting contrast. The characteristics of CIE varied significantly for different contrast media.
Hospital admission with non-alcoholic fatty liver disease is associated with increased all-cause mortality independent of cardiovascular risk factors
Authors: Mann Jake P. , Carter Paul , Armstrong Matthew J. , Abdelaziz Hesham K , Uppal Hardeep , Patel Billal , Chandran Suresh , More Ranjit , Newsome Philip N. , Potluri Rahul 
Published: December 2019

AbstractBackgroundNon-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. We aimed to assess mortality in NAFLD when adjusting for CVD in a ‘real world’ cohort of inpatients.MethodsRetrospective study of hospitalised patients with 14-years follow-up. NAFL (non-alcoholi c fatty liver), non-alcoholic steatohepatitis (NASH), and NAFLD-cirrhosis groups were defined by ICD-10 codes using ACALM methodology. Cases were age-/sex-matched 1:10 with non-NAFLD hospitalised patients from the ACALM registry. All-cause mortality was compared between groups using cox regression adjusted for CVD and metabolic syndrome risk factors.ResultsWe identified 1238 patients with NAFL, 105 with NASH and 1235 with NAFLD-cirrhosis. There was an increasing burden of cardiovascular disease with progression from NAFL to NASH to cirrhosis. After adjustment for demographics, metabolic syndrome components and cardiovascular disease, patients with NAFL, NASH, and cirrhosis all had increased all-cause mortality (HR 1.3 (CI 1.1-1.5), HR 1.5 (CI 1.0-2.3) and HR 3.5 (CI 3.3-3.9), respectively). Hepatic decompensation (NAFL HR 8.0 (CI 6.1-10.4), NASH HR 6.5 (2.7-15.4) and cirrhosis HR 85.8 (CI 72-104)), and hepatocellular carcinoma were increased in all NAFLD groups.ConclusionThere is a high burden of cardiovascular disease in NAFLD-cirrhosis patients. From a large “real-life” non-specialist registry of hospitalized patients, NAFLD patients have increased overall mortality and rate of liver-related complications compared to controls after adjusting for cardiovascular disease.
Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis
Authors: Shiferaw Wondimeneh Shibabaw , Aynalem Yared Asmare , Akalu Tadesse Yirga , Petrucka Pammla Margaret 
Published: December 2019

AbstractBackgroundDespite being a preventable complication of surgical procedures, surgical site infections (SSIs) continue to threaten public health with significant impacts on the patients and the health-care human and financial resources. With millions affected globally, there issignificant variation in the primary studies on the prevalence of SSIs in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of SSI and its associated factors among postoperative patients in Ethiopia.MethodsPubMed, Scopus, Psyinfo, African Journals Online, and Google Scholar were searched for studies that looked at SSI in postoperative patients. A funnel plot and Egger’s regression test were used to determine publication bias. The I2statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size, odds ratios (ORs), and 95% confidence interval (CIs) across studies. The subgroup analysis was conducted by region, sample size, and year of publication. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. Analysis was done using STATA™ Version 14 software.ResultA total of 24 studies with 13,136 study participants were included in this study. The estimated pooled prevalence of SSI in Ethiopia was 12.3% (95% CI: 10.19, 14.42). Duration of surgery > 1 hour (AOR = 1.78; 95% CI: 1.08 –2.94), diabetes mellitus (AOR = 3.25; 95% CI: 1.51–6.99), American Society of Anaesthesiologists score >1 (AOR = 2.51; 95% CI: 1.07–5.91), previous surgery (AOR = 2.5; 95% CI: 1.77–3.53), clean-contaminated wound (AOR = 2.15; 95% CI: 1.52–3.04), and preoperative hospital stay > 7 day (AOR = 5.76; 95% CI: 1.15–28.86), were significantly associated with SSI.ConclusionThe prevalence of SSI among postoperative patients in Ethiopia remains high with a pooled prevalence of 12.3% in 24 extracted studies. Therefore, situation based interventions and region context-specific preventive strategies should be developed to reduce the prevalence of SSI among postoperative patients.
Statistical inference for association studies using electronic health records: handling both selection bias and outcome misclassification
Authors: Beesley Lauren J. , Mukherjee Bhramar 
Published: December 2019

AbstractHealth research using electronic health records (EHR) has gained popularity, but misclassification of EHR-derived disease status and lack of representativeness of the study sample can result in substantial bias in effect estimates and can impact power and type I error. In this paper, we develop new strategies for handling disease status misclassification and selection bias in EHR-based association studies. We first focus on each type of bias separately. For misclassification, we propose three novel likelihood-based bias correction strategies. A distinguishing feature of the EHR setting is that misclassification may berelated to patient-specific factors, and the proposed methods leverage data in the EHR to estimate misclassification rateswithout gold standard labels. For addressing selection bias, we describe how calibration and inverse probability weighting methods from the survey sampling literature can be extended and applied to the EHR setting.Addressing misclassification and selection biases simultaneously is a more challenging problem than dealing with each on its own, and we propose several new strategies to address this situation. For all methods proposed, we derive valid standard errors and provide software for implementation. We provide a new suite of statistical estimation and inference strategies for addressing misclassification and selection bias simultaneously that is tailored to problems arising in EHR data analysis. We apply these methods to data from The Michigan Genomics Initiative (MGI), a longitudinal EHR-linked biorepository.
Quantifying the dynamics of pig movements improves targeted disease surveillance and control plans
Authors: Machado Gustavo , Galvis Jason Ardila , Nunes Lopes Francisco Paulo , Voges Joana , Rosa Medeiros Antônio Augusto , Cárdenas Nicolas Cespedes 
Published: December 2019

SummaryTracking animal movements over time can fundamentally determine the success of disease control interventions throughout targeting farms that are tightly connected. In commercial pig production, animals are transported between farms based on growth stages, thus it generates time-varying contact networks that will influence the dynamics of disease spread. Still, risk-based surveillance strategies are mostly based on a static network. In this study, we reconstructed the static and temporal pig networks of one Brazilian state from 2017 to 2018, comprising 351,519 movements and 48 million transported pigs. The static networks failed to capture time-respecting movement pathways. Therefore, we propose a time-dependent network susceptible-infected (SI) model to simulate the temporal spread of an epidemic over the pig network globally through the temporal movement of animals among farms, and locally with a stochastic compartmental model in each farm, configured to calculate the minimum number of target farms needed to achieve effective disease control. In addition, we propagated disease on the pig temporal network to calculate the cumulative contacts as a proxy of epidemic sizes and evaluated the impact of network-based disease control strategies. The results show that targeting the first 1,000 farms ranked by degree would be sufficient and feasible to diminish disease spread considerably. Our finding also suggested that assuming a worst-case scenario in which every movement transmit disease, pursuing farms by degree would limit the transmission to up to 29 farms over the two years period, which is lower than the number of infected farms for random surveillance, with epidemic sizes of 2,593 farms. The top 1,000 farms could benefit from enhanced biosecurity plans and improved surveillance, which constitute important next steps in strategizing targeted disease control interventions. Overall, the proposed modeling framework provides a parsimonious solution for targeted disease surveillance when temporal movement data is available.