bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician perception of long‐term survival at the point of critical care discharge: a prospective cohort study
Authors: Morton B. , Penston V. , McHale P. , Hungerford D. , Dempsey G. 
Published: May 2020

SummaryCritical care survivors suffer persistent morbidity and increased risk of mortality as compared with the general population. Nevertheless, there are no standardised tools to identify at‐risk patients. Our aim was to establish whether the Sabadell score, a simple tool applied by the treating clinician upon critical care discharge, was independently associated with 5‐year mortality through a prospective observational cohort study of adults admitted to a general critical care unit. The Sabadell score, which is a measure of clinician‐assigned survival perception, was applied to all patients from September 2011 to December 2017. The primary outcome was 5‐year mortality, assessed using a multivariable flexible parametric survival analysis adjusted for baseline characteristics and clinically relevant covariates. We studied 5954 patients with a minimum of 18 months follow‐up. Mean (SD) age was 59.5 (17.0) years and 3397 (57.1%) patients were men. We categorised 2287 (38.4%) patients as Sadabell 0; 2854 (47.9%) as Sadabell 1; 629 (10.5%) as Sadabell 2; and 183 (3.1%) as Sadabell 3. Adjusted hazard ratios for mortality were 2.1 (95%CI 1.9–2.4); 4.0 (95%CI 3.4–4.6); and 21.0 (95%CI 17.2–25.7), respectively. Sabadell 3 patients had 99.9%, 99.5%, 98.5% and 87.4% mortality at 5 years for patients in the age brackets ≥ 80, 60–79, 40–59 and 16–39 years, respectively. Sabadell 2 patients had 71.0%, 52.7%, 44.8% and 23.7% 5‐year mortality for these same age categories. The Sabadell score was independently associated with 5‐year survival after critical care discharge. These findings can be used to guide provision of increased support for patients after critical care discharge and/or informed discussions with patients and relatives about dying to ascertain their future wishes.
Outcomes after hepatic encephalopathy in population‐based cohorts of patients with cirrhosis
Authors: Tapper Elliot B. , Aberasturi Devin , Zhao Zhe , Hsu Chia‐Yang , Parikh Neehar D. 
Published: May 2020

SummaryBackgroundHepatic encephalopathy is a devastating complication of cirrhosis.AimTo describe the outcomes after developing hepatic encephalopathy among contemporary, aging patients.MethodsWe examined data for a 20% random sample of United States Medicare enrolees with cirrhosis and Part D prescription coverage from 2008 to 2014. Among 49 164 persons with hepatic encephalopathy, we evaluated the associations with transplant‐free survival using Cox proportional hazard models with time‐varying covariates (hazard ratios, HR) and incidence rate ratios (IRR) for healthcare utilisation measured in hospital‐days and 30‐day readmissions per person‐year. We validated our findings in an external cohort of 2184 privately insured patients with complete laboratory values.ResultsHepatic encephalopathy was associated with median survivals of 0.95 and 2.5 years for those ≥65 or <65 years old and 1.1 versus 3.9 years for those with and without ascites. Non‐alcoholic fatty‐liver disease posed the highest adjusted risk of death among aetiologies, HR 1.07 95% CI (1.02, 1.12). Both gastroenterology consultation and rifaximin utilisation were associated with lower mortality, respective adjusted‐HR 0.73 95% CI (0.67, 0.80) and 0.40 95% CI (0.39, 0.42). Thirty‐day readmissions were fewer for patients seen by gastroenterologists (0.71 95% CI [0.57‐0.88]) and taking rifaximin (0.18 95% CI [0.08‐0.40]). Lactulose alone was associated with fewer hospital‐days, IRR 0.31 95% CI (0.30‐0.32), than rifaximin alone, 0.49 95% CI (0.45‐0.53), but the optimal therapy combination was lactulose/rifaximin, IRR 0.28 95% CI (0.27‐0.30). These findings were validated in the privately insured cohort adjusting for model for endstage liver disease‐sodium score and serum albumin.ConclusionsHepatic encephalopathy remains morbid and associated with poor outcomes among contemporary patients. Gastroenterology consultation and combination lactulose‐rifaximin are both associated with improved outcomes. These data inform the development of care coordination efforts for subjects with cirrhosis.
Predicted efficacy of a pharmacogenetic passport for inflammatory bowel disease
Authors: Bangma Amber , Voskuil Michiel D. , Uniken Venema Werna T. C. , Brugge Harm , Hu Shixian , Lanting Pauline , Franke Lude , Dijkstra Gerard , Festen Eleonora A. M. , Weersma Rinse K. 
Published: May 2020

SummaryBackgroundHigh inter‐individual variability in therapeutic response to drugs used in the management of Inflammatory Bowel Disease (IBD) leads to high morbidity and high costs. Genetic variants predictive of thiopurine‐induced myelosuppression, thiopurine‐induced pancreatitis and immunogenicity of Tumour Necrosis Factor alpha (TNFα) antagonists have been identified, but uptake of pre‐treatment pharmacogenetic testing into clinical guidelines has been slow.AimTo explore the efficacy of a pharmacogenetic passport for IBD that includes multiple pharmacogenetic predictors of response.MethodsPatients with IBD exposed to thiopurines and/or TNFα antagonists were retrospectively evaluated for the presence of thiopurine toxicity and/or immunogenicity of TNFα antagonists. All patients were genotyped using both whole‐exome sequencing and the Illumina Global Screening Array. An in‐house‐developed computational pipeline translated genetic data into an IBD pharmacogenetic passport that predicted risks for thiopurine toxicity and immunogenicity of TNFα antagonists per patient. Using pharmacogenetic‐guided treatment guidelines, we calculated clinical efficacy estimates for pharmacogenetic testing for IBD.ResultsAmong 710 patients with IBD exposed to thiopurines and/or TNFα antagonists, 150 adverse drug responses occurred and our pharmacogenetic passport would have predicted 54 (36%) of these. Using a pharmacogenetic passport for IBD that includes genetic variants predictive of thiopurine‐induced myelosuppression, thiopurine‐induced pancreatitis, and immunogenicity of TNFα antagonists, 24 patients need to be genotyped to prevent one of these adverse drug responses.ConclusionsThis study highlights the clinical efficacy of a pharmacogenetic passport for IBD. Implementation of such a pharmacogenetic passport into clinical management of IBD may contribute to a reduction in adverse drug responses.
Effects of moisture content and additives on the ensiling quality and vitamins changes of alfalfa silage with or without rain damage
Authors: Wang Bing , Yu Zhu 
Published: May 2020

ABSTRACTWe investigated the effects of moisture, rain damage, and additives on fermentation quality and vitamins change in alfalfa (Medicago sativa L.) silage. Two moisture content alfalfa (53 and 72% moisture content) were received artificial rain damage. Then, the formic acid and L. plantarum (LP) + sucrose were added. After 30 days, silos were opened. The significant interaction between rain damage and moisture content were found for nutrients and fermentation characteristics in alfalfa silage, which showed more rain damage effects occurred in 53% moisture content rather than in 72% moisture content material. Treatment with LP + sucrose had lower pH value, ammonia‐N/total N, and higher lactic acid content compared to the other additives. The concentrations of α‐tocopherol and phylloquinone increased, but thiamine, riboflavin, and ascorbic acid decreased in alfalfa silage treated with LP + sucrose, especially when the alfalfa was subjected to rain damage. The highly significant correlations were found between pantothenic acid (VB5) and pH, and between VB5 and lactic acid. The improvements in fermentation quality by adding of LP + sucrose was observed after rain damage for either 53% or 72% moisture alfalfa, which can be a guideline for forage processor who ensiles alfalfa after rain damage.
Highways are a threat for giant armadillos that underpasses can mitigate
Authors: Banhos Aureo , Fontes Bruno L. , Yogui Débora Regina , Alves Mario Henrique , Ardente Natália Carneiro , Valls Renata , Barreto Lucas Mendes , Damásio Lucas , Ferreguetti Átilla Colombo , Carvalho Andréa Siqueira , Schettino Vitor Roberto , Santos Alexandre Rosa dos , Bergallo Helena Godoy , Srbek‐Araujo Ana Carolina , Medici Emilia Patrícia , Canena Ariel , Desbiez Arnaud L.J. 
Published: May 2020

AbstractWe report 24 records of giant armadillo roadkill on Brazilian highways in the Cerrado, Pantanal and Amazon biomes illustrating that highways are a threat to this species. However, we also documented the species using underpasses, demonstrating that these structures could help to reduce the risk of roadkill for giant armadillos.Abstract in Portuguese is available with online material
Future burden of vision loss in Australia: Projections from the National Eye Health Survey
Authors: Foreman Joshua , Keel Stuart , McGuiness Myra , Liew Danny , van Wijngaarden Peter , Taylor Hugh R. , Dirani Mohamed 
Published: May 2020

AbstractImportanceProjections of Australia's future burden of vision loss will inform eye health service delivery.BackgroundThis study aimed to forecast bilateral vision loss in Australia from 2020 to 2050.DesignPopulation‐based survey.ParticipantsIndigenous and non‐indigenous Australians (n = 4253) aged ≥50 years from the National Eye Health Survey (NEHS, 2015‐2016).MethodsUsing the age‐and‐sex‐stratified prevalence of vision loss (better eye visual acuity <6/12) from the NEHS, the prevalence of, and number of people aged ≥50 years with, vision loss were forecast to 2050 using Australian census projections.Main outcome measurePrevalence of, and number of Australians with, vision loss from 2020 to 2050.ResultsThe prevalence of vision loss is predicted to increase from 6.7% to 7.5% by 2050. Owing to population dynamics, the estimated number of Australians ≥50 years old with vision loss will nearly double from 532 386 in 2016 to 1 015 021 in 2050. The greatest increase in vision loss is expected to occur in those aged ≥80 years (2.6‐fold, 2016 = 144 240; 2050 = 376 296). The number of people with uncorrected refractive error is projected to increase 1.7‐fold, from 331 914 in 2016 to 578 969 in 2050.Conclusions and relevanceDue to population growth and ageing, the future burden of vision loss in Australia is likely to increase, but the magnitude of this change is uncertain due to a lack of available data on some relevant input variables. Nonetheless, efforts are required to ensure early detection and treatment of major eye conditions, particularly treatable conditions such as uncorrected refractive error and cataract.
Wolves are back: Sociopolitical identity and opinions on management of Canis lupus
Authors: Hamilton Lawrence C. , Lambert Joanna E. , Lawhon Lydia Anne , Salerno Jonathan , Hartter Joel 
Published: May 2020

AbstractGray wolves (Canis lupus) were eliminated from the state of Oregon in the middle of the 20th century. By the early 21st century, wolves had returned to the northeast corner of the state, dispersing from populations reintroduced in Idaho and Wyoming. On a series of random‐sample telephone surveys (2011–2018), we asked more than 3,000 northeast Oregon residents about their preferences concerning wolf management strategies. One‐third of the respondents said that wolves should be eliminated from this region. Sociopolitical identity dominated other individual characteristics including age, education, years resident, and forestland ownership in predicting wolf‐management views. Political effects appear even stronger when our indicator distinguishes the most conservative, and further intensify when most of the respondent's friends belong to the same party. This strong influence of sociopolitical identity echoes findings from the broader literature on environmental concern, but adds a new and policy‐relevant element to wolf‐attitude research. As wolves expand throughout the west, and new states consider reintroduction, state and federal wildlife managers face deeply rooted opposition. Managers must consider a range of strategies to manage wolves while working with community leaders in wolf‐occupied areas to determine management options.
Heart failure and chronic kidney disease manifestation and mortality risk associations in type 2 diabetes: A large multinational cohort study
Authors: Birkeland Kåre I. , Bodegard Johan , Eriksson Jan W. , Norhammar Anna , Haller Hermann , Linssen Gerard C.M. , Banerjee Amitava , Thuresson Marcus , Okami Suguru , Garal‐Pantaler Elena , Overbeek Jetty , Mamza Jil Billy , Zhang Ruiqi , Yajima Toshitaka , Komuro Issei , Kadowaki Takashi 
Published: May 2020

AbstractAimsTo examine the manifestation of cardiovascular or renal disease (CVRD) in patients with type 2 diabetes (T2D) initially free from CVRD as well as the mortality risks associated with these diseases.MethodsPatients free from CVRD were identified from healthcare records in England, Germany, Japan, the Netherlands, Norway and Sweden at a fixed date. CVRD manifestation was defined by first diagnosis of cardiorenal disease, or a stroke, myocardial infarction (MI) or peripheral artery disease (PAD) event. The mortality risk associated with single CVRD history of heart failure (HF), chronic kidney disease (CKD), MI, stroke or PAD was compared with that associated with CVRD‐free status.ResultsOf 1 177 896 patients with T2D, 772 336 (66%) were CVRD‐free and followed for a mean of 4.5 years. A total of 137 081 patients (18%) developed a first CVRD manifestation, represented by CKD (36%), HF (24%), stroke (16%), MI (14%) and PAD (10%). HF or CKD was associated with increased cardiovascular and all‐cause mortality risk: hazard ratio (HR) 2.02 (95% confidence interval [CI] 1.75–2.33) and HR 2.05 (95% CI 1.82–2.32), respectively. HF and CKD were separately associated with significantly increased mortality risks, and the combination was associated with the highest cardiovascular and all‐cause mortality risk: HRs 3.91 (95% CI 3.02–5.07) and 3.14 (95% CI 2.90–3.40), respectively.ConclusionIn a large multinational study of >750 000 CVRD‐free patients with T2D, HF and CKD were consistently the most frequent first cardiovascular disease manifestations and were also associated with increased mortality risks. These novel findings show these cardiorenal diseases to be important and serious complications requiring improved preventive strategies.
Sodium‐glucose co‐transporter‐2 inhibitors and the risk of diabetic ketoacidosis in patients with type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials
Authors: Liu Jiali , Li Ling , Li Sheyu , Wang Yuning , Qin Xuan , Deng Ke , Liu Yanmei , Zou Kang , Sun Xin 
Published: May 2020

AbstractAimTo assess the effects of sodium‐glucoseco‐transporter‐2 (SGLT2) inhibitors on diabetic ketoacidosis (DKA) in patients with type 2 diabetes.Materials and MethodsWe searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov from inception to 13 June 2019 for randomized controlled trials (RCTs) that compared SGLT2 inhibitors with control in patients with type 2 diabetes. Paired reviewers independently screened citations, assessed the risk of bias and extracted data. Peto's method was used as the primary approach to pool the effect of SGLT2 inhibitors on DKA. Sensitivity analyses with the alternative effect measure (risk ratio) or pooling method (Mantel–Haenszel), the use of continuity correction of 0.5 for zero‐event trials or a generalized linear mixed model were conducted. Six preplanned subgroup analyses were performed to explore heterogeneity. The grading of recommendations assessment, development and evaluation (GRADE) approach was used to rate the quality of evidence.ResultsA total of 39 RCTs were included, involving 60 580 patients and 85 DKA events. SGLT2 inhibitors were statistically associated with an increased risk of DKA versus control (SGLT2 inhibitors: 62/34 961 [0.18%] vs. control: 23/25 211 [0.09%], Peto odds ratio [OR] 2.13, 95% confidence interval [CI] 1.38 to 3.27, I2 = 8%; RD 1.7 more events, 95% CI 0.6 more to 3.4 more events per 1000 over 5 years; high‐quality evidence). Sensitivity analyses showed similar results. The subgroup analyses by mean age (interaction P = 0 .02) and length of follow‐up (interaction P = 0 .03) showed a larger relative effect among older patients (aged ≥60 years) and those with longer use of SGLT2 inhibitors (>52 weeks).ConclusionsHigh‐quality evidence suggests that SGLT2 inhibitors may increase the risk of DKA in patients with type 2 diabetes. The apparent differences in treatment effects among patients of a different age or follow‐up were probable, suggesting the advisability of caution in patients with long‐term use of SGLT2 inhibitors or in older patients.
Neonatal vitamin D status and risk of childhood epilepsy
Authors: Specht Ina O. , Thorsteinsdottir Fanney , Walker Karen Christina , Olsen Jørn , Heitmann Berit L 
Published: May 2020

AbstractObjectiveEpilepsy is a nervous system abnormality that may be caused by unknown exposures during fetal development. Studies have shown neuroprotective effects of early exposure to vitamin D in other neurological disorders, and seasonal variation in birth of children with epilepsy. We aimed to investigate if neonatal 25(OH)D3was associated with risk of childhood epilepsy.MethodsThis case‐cohort study compared neonatal 25(OH)D3levels from children with epilepsy (n = 403) and a random selected cohort of controls (n = 1163), assessing the hazard of first epilepsy diagnosis between 1 and 4 years of age from a weighted Cox proportional hazard model. Analyses were adjusted for parental education, maternal age, maternal epilepsy, maternal ethnicity, and gestational age, and additionally for season of birth and smoking during pregnancy.ResultsThe mean (standard deviation [SD]) of neonatal 25(OH)D3levels were 30.8(19.6) nmol/L among cases and 28.5(19.4) nmol/L among the cohort. The hazard ratio (HR) of epilepsy was in a dose‐response patternhigheramong children from the highest neonatal 25(OH)D3quintiles (P‐trend = .004). Results were unchanged after including season of birth in the analysis, where a significantly higher HR of epilepsy was observed among children in the two highest quintiles compared to children in the lowest quintile (Q4: HRadj 1.62, 95% CI 1.07‐2.47 and Q5: HRadj 1.86, 95% CI 1.21‐2.86).SignificanceIn this study, the risk of childhood epilepsy increased with neonatal 25(OH)D3categories in a dose‐response pattern, suggesting an association between a high neonatal 25(OH)D3and the risk of childhood epilepsy. Considering that adjusting for season of birth strengthened the results, we conclude that maternal intake of vitamin D, and not vitamin D from sun exposure, was the vitamin D source associated with epilepsy. Although we cannot, in the present study, control for compounds in the diet like pollutants or heavy metals, which may correlate with dietary vitamin D, future studies investigating fetal origin of epilepsy should focus on compounds correlating with vitamin D.
Cognitive phenotypes in temporal lobe epilepsy utilizing data‐ and clinically driven approaches: Moving toward a new taxonomy
Authors: Reyes Anny , Kaestner Erik , Ferguson Lisa , Jones Jana E. , Seidenberg Michael , Barr William B. , Busch Robyn M. , Hermann Bruce P. , McDonald Carrie R. 
Published: May 2020

AbstractObjectiveTo identify cognitive phenotypes in temporal lobe epilepsy (TLE) and test their reproducibility in a large, multi‐site cohort of patients using both data‐driven and clinically driven approaches.MethodFour‐hundred seven patients with TLE who underwent a comprehensive neuropsychological evaluation at one of four epilepsy centers were included. Scores on tests of verbal memory, naming, fluency, executive function, and psychomotor speed were converted into z‐scores based on 151 healthy controls (HCs). For the data‐driven method, cluster analysis (k‐means) was used to determine the optimal number of clusters. For the clinically driven method, impairment was defined as >1.5 standard deviations below the mean of the HC, and patients were classified into groups based on the pattern of impairment.ResultsCluster analysis revealed a three‐cluster solution characterized by (a) generalized impairment (29%), (b) language and memory impairment (28%), and (c) no impairment (43%). Based on the clinical criteria, the same broad categories were identified, but with a different distribution: (a) generalized impairment (37%), (b) language and memory impairment (30%), and (c) no impairment (33%). There was a 82.6% concordance rate with good agreement (κ = .716) between the methods. Forty‐eight patients classified as having a normal profile based on cluster analysis were classified as having generalized impairment (n = 16) or an isolated language/memory impairment (n = 32) based on the clinical criteria. Patients with generalized impairment had a longer disease duration and patients with no impairment had more years of education. However, patients demonstrating the classic TLE profile (ie, language and memory impairment) were not more likely to have an earlier age at onset or mesial temporal sclerosis.SignificanceWe validate previous findings from single‐site studies that have identified three unique cognitive phenotypes in TLE and offer a means of translating the patterns into a clinical diagnostic criteria, representing a novel taxonomy of neuropsychological status in TLE.
Using asexual vertebrates to study genome evolution and animal physiology: Banded (Fundulus diaphanus) x Common Killifish (F. heteroclitus) hybrid lineages as a model system
Authors: Dalziel Anne C. , Tirbhowan Svetlana , Drapeau Hayley F. , Power Claude , Jonah Lauren S. , Gbotsyo Yayra A. , Dion‐Côté Anne‐Marie 
Published: May 2020

AbstractWild, asexual, vertebrate hybrids have many characteristics that make them good model systems for studying how genomes evolve and epigenetic modifications influence animal physiology. In particular, the formation of asexual hybrid lineages is a form of reproductive incompatibility, but we know little about the genetic and genomic mechanisms by which this mode of reproductive isolation proceeds in animals. Asexual lineages also provide researchers with the ability to produce genetically identical individuals, enabling the study of autonomous epigenetic modifications without the confounds of genetic variation. Here, we briefly review the cellular and molecular mechanisms leading to asexual reproduction in vertebrates and the known genetic and epigenetic consequences of the loss of sex. We then specifically discuss what is known about asexual lineages ofFundulus diaphanus x F. heteroclitusto highlight gaps in our knowledge of the biology of these clones. Our preliminary studies ofF. diaphanusandF. heteroclituskaryotypes from Porter's Lake (Nova Scotia, Canada) agree with data from other populations, suggesting a conserved interspecific chromosomal arrangement. In addition, genetic analyses suggest that: (a) the same major clonal lineage (Clone A) ofF. diaphanus x F. heteroclitushas remained dominant over the past decade, (b) some minor clones have also persisted, (c) new clones may have recently formed, and iv) wild clones still mainly descend fromF. diaphanus♀ x F. heteroclitus♂crosses (96% in 2017–2018). These data suggest that clone formation may be a relatively rare, but continuous process, and there are persistent environmental or genetic factors causing a bias in cross direction. We end by describing our current research on the genomic causes and consequences of a transition to asexuality and the potential physiological consequences of epigenetic variation.