bluuebunny/crossref_metadata_2025_split huggingface dataset:
Network meta-analysis and trial sequential analysis for atrial fibrillation patients receiving PCI or with ACS
Authors: Yang Shu-Mei , Huang Chi-Jung , Chen Chen-Huan , Yu Wen-Chung , Sung Shih-Hsien , Guo Chao-Yu , Chuang Shao-Yuan , Cheng Hao-Min , Chiang Chern-En 
Published: November 2021

Background:
In patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI), choosing the most appropriate antithrombotic treatment remains a dilemma. We aimed to compare the relative efficacy and safety outcomes of antithrombotic drugs in patients with AF after undergoing PCI or ACS.

Methods:
Randomized controlled trials were systematically searched on PubMed, EMBASE, and the Cochrane Library. Five studies (11,532 patients) were included in the network meta-analysis. Trial sequential analysis (TSA) was performed to assess the reliability and conclusiveness of the meta-analysis comparing the dual antithrombotic therapy strategies with the triple antithrombotic therapy strategy.

Results:
Compared with vitamin K antagonist + dual antiplatelet therapy, novel oral anticoagulant (NOAC) + P2Y12 inhibitor was associated with a significantly better trial-defined primary safety outcome (odds ratio: 0.53; 95% CI, 0.31-0.90) and the lowest probability of thrombolysis in myocardial infarction major bleeding and intracranial hemorrhage using the cumulative ranking technique. In patients omitting aspirin, TSA demonstrated conclusive evidence with significant decreases in all safety outcomes and inconclusive evidence with a nonsignificant increase in in-stent thrombosis (risk ratio: 1.32; TSA-adjusted 95% CI, 0.54-3.24) and myocardial infarction (risk ratio: 1.19; TSA-adjusted 95% CI, 0.84-1.68).

Conclusions:
In patients with AF receiving PCI or with ACS, NOAC + P2Y12 inhibitor was associated with the lowest bleeding risk but resulted in a statistically nonsignificant, numerically greater risk for stent thrombosis and myocardial infarction, suggesting that triple antithrombotic therapy should still be an option for certain patients at a high risk of stent thrombosis or myocardial infarction.
The Mediating Role of Social Support and Resilience Between HIV-Related Stigmas and Patient Activation Among Young Black Women Living With HIV in the Southern United States: A Cross-sectional Study
Authors: Chapman Lambert Crystal , Fazeli Pariya L. , Yigit Ibrahim , Elopre Latesha , King Kiko , Kempf Mirjam-Colette , Guthrie Barbara , Mugavero Michael J. 
Published: November 2021

Abstract
Little is known about the construct of patient activation for engaging in favorable self-management behaviors in people with HIV. We conducted a cross-sectional study among young Black women with HIV (n = 84) to examine the association between stigma and patient activation and the mediating role of social support and resilience. Social support mediated the relationship between the following dimensions of stigma and patient activation: internalized (β = −0.20, SE = 0.08, CI [−0.369 to −0.071]) and anticipated in health care settings (β = −0.06, SE = 0.04, CI [−0.177 to −0.001]). Resilience mediated the relationship between the following dimensions of stigma and patient activation: anticipated in health care (β = −0.20, SE = 0.08, CI [−0.387 to −0.057]) and community settings (β = −0.15, SE = 0.08, CI [−0.318 to −0.017]), and enacted in community settings (β = −0.14, SE = 0.09, CI [−0.332 to −0.001]). Our findings suggest intrapersonal and interpersonal mechanisms by which various dimensions of stigma contribute to patient activation, thus identifying social support, resilience, and patient activation as potential intervention targets.
“You Don't Want Your Parents Knowing That You're Taking Pre-exposure Prophylaxis”: Pre-exposure Prophylaxis Stigma Among Black and Latinx Adolescents
Authors: Rao Sharanya , Albritton Tashuna , Pina Paulo , Liang Yilin , Taggart Tamara 
Published: November 2021

Abstract
Pre-exposure prophylaxis (PrEP) stigma is an understudied barrier to PrEP uptake among Black and Latinx adolescents. U.S. Black and Latinx adolescents (13–17 years) completed an online survey or participated in focus groups/interviews. Associations between PrEP stigma, PrEP disclosure, and provider-initiated PrEP discussion preferences were examined using logistic-regression models. Qualitative data provided further context to quantitative findings. The survey sample included 208 adolescents (53% female; 58% Latinx; M = 15 years), with 98% endorsing PrEP stigma. The qualitative sample included 26 adolescents (54% female; 34% Latinx; M = 15 years). PrEP stigma was associated with lower odds of PrEP disclosure to parents/guardians, and preference for health care providers to initiate PrEP-related discussions only with patients the provider judged to be at high risk for HIV. Qualitative data supported quantitative results: Adolescents endorsed multiple negative stereotypes about PrEP users. Mitigating PrEP stigma among Black and Latinx adolescents is an important step in overcoming challenges related to PrEP uptake.
Injuries and Concussions in Female High School Rugby: Prevention is Worth a Try
Authors: Shill Isla J. , West Stephen W. , Sick Stacy , Schneider Kathryn , Hagel Brent E. , Pasanen Kati , Wiley James Preston , Emery Carolyn A. , Black Amanda M. 
Published: November 2021

Objectives:
To describe injury and concussion rates and mechanisms in female high school rugby players.

Design:
Two-year prospective cohort study.

Setting:
High school rugby.

Participants:
Participants included 214 female High school rugby players (year 1) and 207 female High school players (year 2) from the Calgary Senior High School Athletics Association 2018 and 2019 rugby competition.

Intervention:
None.

Main Outcome Measures:
Match and training injury and concussion. Injury definition included any injury resulting in time loss, inability to complete a session, and/or requiring medical attention. Details of reported injuries were collected on injury report forms and validated by a certified athletic therapist on a validated online injury surveillance platform. Exposure hours for players were tracked using paper or virtual weekly exposure forms by team designates.

Results:
A match incidence rate (IR) = 93.7 injuries/1000 match hours (95% confidence intervals (CI): 78.6-11.7) and training IR = 5.3 injuries/1000 training hours (95% CI: 4.0-6.9) were estimated. The tackle accounted for 109 (70%) match and 37 (44%) training injuries. Tackling was the most frequent mechanism of injury (IR = 37.5 injuries/1000 match hours, 95% CI: 27.5-51.8 and 1.2 injuries/1000 training hours, 95% CI: 0.7-2.4). Sixty-two match concussions (IR = 37.5 concussions/1000 match hours, 95% CI: 26.8-52.3) and 16 training concussions (IR = 1.0 concussions/1000 training hours, 95% CI: 0.7-1.4) occurred. Of 78 reported concussions, 78% for match and 56% for training were physician diagnosed. Tackling was the most frequent mechanism of concussion in matches (IR = 18.1 concussions/1000 match hours, 95% CI:11.4-28.6).

Conclusions:
Injury and concussion rates in female high school rugby are high. The tackle accounted for the highest proportion of injuries. Prevention strategies (eg, tackle policy change, tackle-training programs, and neuromuscular training) should be explored to increase sport safety.
Combination of Autologous Fat Grafting and Negative-Pressure Wound Therapy for the Treatment of Scalp Linear Scleroderma
Authors: Chicco Maria , Ahmadi Ali R. , Lin Fu-Yu , Cheng Hsu-Tang , Lee Min-Min 
Published: November 2021

Abstract:
Scalp linear scleroderma (LSc) is a subtype of localized scleroderma which typically affects young patients and which can be severely disfiguring. Traditional treatment options include bone grafting or tissue expansion. in this report, we present the case of a patient with scalp LSc successfully treated with scar release, autologous fat grafting, and negative-pressure wound therapy (NPWT). A 55-year-old female, with a history of craniectomy for a benign sellar tumor 10 years previously, developed LSc over the frontal scalp with exposure of titanium plates and screws. She was treated with removal of metalwork, scar release, autologous fat grafting from the abdominal wall and immediate application of NPWT. At 3-month postoperative follow-up, the appearance of the depressed lesion and of its margins had significantly improved. Our experience suggests that the combination of autologous fat grafting and NPWT is an effective treatment modality for scalp LSc.
Antifibrinolytics Are Not Associated With Reduced Blood Loss in Minimally-Invasive Endoscopic-Assisted Craniectomy for Repair of Single-Suture Craniosynostosis
Authors: Sobey Jenna H. , Menser Carrie C. , Hartzog Anna J. , Hocking Kyle M. , Niconchuk Jonathan A. , Bonfield Christopher M. , Stricker Paul A. , Reddy Srijaya K. 
Published: November 2021

Abstract:
Minimally-invasive endoscopic-assisted craniectomy (EAC) achieves similar functional and cosmetic outcomes, whereas reducing morbidity risk that is often associated with complex cranial vault reconstruction. Antifibrinolytics (AF) usage to limit blood loss and transfusion requirements during complex cranial vault reconstruction has been studied extensively; however, studies are limited for AF therapy in EAC. The aim of this single-center retrospective observational cohort pilot study was to evaluate whether the use of AF was associated with reduced blood loss in infants undergoing EAC. The authors hypothesized that there would be no difference in blood loss between patients who received AF and those that did not receive AF during EAC. Non-syndromic patients who underwent single-suture EAC were retrospectively evaluated. Primary outcome measure was intraoperative calculated blood loss (mL/kg). Secondary outcome measures included perioperative red blood cells transfusion volumes, number of blood donor exposures, and pediatric intensive care unit and total hospital length of stay. Study cohort demographic and outcome data were analyzed; Fisher exact test was used for categorical data, Student t test was used for continuous data. A P value of <0.05 was considered statistically significant. Forty-nine EAC patients were included in the study with 34 patients in the AF cohort and 15 patients in the non-AF cohort. There were no significant differences in demographics between the 2 groups. Additionally, there was no significant difference in intraoperative calculated blood loss or any secondary outcome measure. In our single-suture EAC study cohorts, AF administration was not associated with a decrease in blood loss when compared to those that did not receive AF therapy.
The impact of chemosensory dysfunctions on weight loss
Authors: Daskalou Dimitrios , Hsieh Julien W. , Hugentobler Marianne , Landis Basile N. 
Published: November 2021

AbstractBackgroundThe role of chemosensory senses (olfaction, taste, and trigeminal) is crucial, and their dysfunctions profoundly affect the quality of life, potentially impacting eating behaviors. However, it is unclear which chemosensory symptoms could lead to undernutrition. This study aims to investigate which findings in patients’ smell and taste workup are predictors of weight loss.MethodsThis is a retrospective study based on a validated questionnaire consecutively given to adult patients presented in smell and taste consultations during a 10-year period. Psychophysical tests were used to measure chemosensory function (Sniffin’ Sticks, taste powder, and Taste Strips tests).ResultsWe included 554 patients (307 females) with a median age of 51 years (IQR 23). Among them, 76 (13.7%) reported involuntary weight loss due to chemosensory disorders occurred over periods ranging from 3 to 36 months. We found that the odds of losing weight were 2.1 times higher when patients reported changes in aroma perception (p-value=0.012; 95% CI 1.15 - 3.83). Parosmia, but not phantosmia nor smell loss, was a significant predictor of weight loss (OR 2.22; p-value=0.015; 95% CI 1.17 - 4.2). Furthermore, the duration of symptoms for more than two years was protective for weight loss (OR 0.44; p-value=0.014; 95% CI 0.23 - 0.85). Regarding putative etiologies, post-traumatic chemosensory dysfunction was also a significant predictor (OR 2.08; p-value=0.039; 95% CI 1.04 - 4.16). Concerning psychophysical tests, we found that the probability of a patient to present weight loss increased by 8% for every 1-unit reduction in Taste Strips score (p-value=0.006; 95% CI 0.87 - 0.98).ConclusionWe recommend investigating weight loss in smell and taste consultations, especially when patients report changes in aroma perception, parosmia, duration of symptoms for less than two years, head injury, and when low Taste Strips score is measured.
Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in the general child population: a Japanese birth cohort study
Authors: Dinkler Lisa , Yasumitsu-Lovell Kahoko , Eitoku Masamitsu , Fujieda Mikiya , Suganuma Narufumi , Hatakenaka Yuhei , Hadjikhani Nouchine , Bryant-Waugh Rachel , Råstam Maria , Gillberg Christopher 
Published: November 2021

AbstractBackgroundAn overrepresentation of neurodevelopmental disorders (NDDs) has been observed in individuals with avoidant/restrictive food intake disorder (ARFID). Previous studies on the association between ARFID and NDDs are limited to cross-sectional data from clinical samples of small size. This study aimed to extend previous research by using prospectively collected data in children from a general population sample. We examined the occurrence and predictive power of early neurodevelopmental problems in 4–7-year-old children with suspected ARFID.MethodsData were collected via parent-report in 3,728 children born between 2011 and 2014 in Kochi prefecture, a sub-sample of the Japan Environment and Children’s Study (JECS). Neurodevelopmental problems were assessed with several instruments at different time points between 0.5 and 3 years of age as part of the JECS. In an add-on study, ARFID was identified cross-sectionally (between 4 and 7 years of age) using a newly developed screening tool.ResultsCirca 3% of children at high risk for NDDs in preschool age screened positive for ARFID between age 4 and 7 years, reflecting a three times increased risk of suspected ARFID. A fifth (20.8%) of children with suspected ARFID had likely NDDs, compared to 8.6% of children without suspected ARFID. Developmental delay trajectories of children with and without suspected ARFID started to divert after the age of 6 months. Only 2.2% of children with early feeding problems later screened positive for ARFID. The inclusion of neurodevelopmental problems improved the prediction of later ARFID.ConclusionsThe results mirror the previously observed overrepresentation of NDDs in ARFID populations, although to a weaker extent. In non-clinical populations, early feeding problems are common and rarely develop into ARFID, however, our findings imply that they should be monitored closely in children with high neurodevelopmental risk in order to prevent ARFID.
Once-daily feeding is associated with better health in companion dogs: Results from the Dog Aging Project
Authors: Bray Emily E. , Zheng Zihan , Tolbert M. Katherine , McCoy Brianah M. ,   Dog Aging Project Consortium, Kaeberlein Matt , Kerr Kathleen F. 
Published: November 2021

AbstractA variety of diets have been studied for possible anti-aging effects. In particular, studies of intermittent fasting and time-restricted feeding in laboratory rodents have found evidence of beneficial health outcomes. Companion dogs represent a unique opportunity to study diet in a large mammal that shares human environments. The Dog Aging Project has been collecting data on thousands of companion dogs of all different ages, sizes, and breeds since 2019. We leveraged this diverse cross-sectional dataset to investigate associations between feeding frequency and cognitive function (n = 10,474) as well as nine broad categories of health conditions (n = 24,238). Controlling for sex, age, breed, and other potential confounders, we found that dogs fed once daily rather than more frequently had lower mean scores on a cognitive dysfunction scale, and lower odds of having gastrointestinal, dental, orthopedic, kidney/urinary, and liver/pancreas disorders. Therefore, we find that once-daily feeding is associated with better health in multiple domains. Future research with longitudinal data can provide stronger evidence for a possible causal effect of feeding frequency on health in companion dogs.
Evaluation of methods for whole genome sequencing of Enterococcus faecium in a diagnostic laboratory
Authors: Raven Kathy E. , Leek Danielle , Blane Beth , Girgis Sophia T. , Akram Asha , Brown Nicholas , Peacock Sharon J. 
Published: November 2021

AbstractEnterococcus faecium is an important nosocomial pathogen associated with hospital transmission and outbreaks. Based on growing evidence that bacterial whole genome sequencing enhances hospital outbreak investigation of other bacterial species, our aim was to develop and evaluate methods for low volume clinical sequencing of E. faecium. Using a test panel of 22 E. faecium isolates associated previously with hospital transmission, we developed laboratory protocols for DNA extraction and library preparation, which in combination with the Illumina MiniSeq can generate sequence data within 24 hours. The final laboratory protocol took 3.5 hours and showed 98% reproducibility in producing sufficient DNA for sequencing. Repeatability and reproducibility assays based on the laboratory protocol and sequencing demonstrated 100% accuracy in assigning species, sequence type (ST) and (when present) detecting vanA or vanB, with all isolates passing the quality control metrics. Minor variation was detected in base calling of the same isolate genome when tested repeatedly due to variations in mapping and base calling, but application of a SNP cut-off (≤15 SNPs) to assign isolates to outbreak clusters showed 100% reproducibility. An evaluation of contamination showed that controls and test E. faecium sequence files contained <0.34% and <2.12% of fragments matching another species, respectively. Deliberate contamination experiments confirmed that this was insufficient to impact on data interpretation. Further work is required to develop informatic tools prior to implementation into clinical practice.ImportanceEnterococcus faecium is a leading cause of hospital infections, particularly in the immunocompromised, and has been shown to be associated with hospital transmissions. Whole-genome sequencing is a highly discriminatory technique that has been shown to be capable of identifying transmissions that may otherwise go undetected by conventional infection control methods. This could be a powerful adjunct to infection control, since previous studies have shown that there are numerous hospital outbreaks of E. faecium, which can extend over multiple wards and years. In this study, we developed and evaluated laboratory methods for low volume clinical sequencing of E. faecium, to allow uptake in smaller local diagnostic laboratories. We demonstrated that sequencing could be performed within 24-48 hours of the sample flagging positive. This would allow a more rapid turnaround time, compared to sending isolates to the reference laboratory, providing an opportunity for infection control to act earlier to prevent further transmission.
Comparing the performance of risk stratification scores in Brugada syndrome: a multi-centre study
Authors: Lee Sharen , Zhou Jiandong , Bazoukis George , Letsas Konstantinos P , Liu Tong , Wong Wing Tak , Wong Ian Chi Kei , Mok Ngai Shing , Mak Chloe , Zhang Qingpeng , Tse Gary 
Published: November 2021

AbstractIntroductionThe management of Brugada Syndrome (BrS) patients at intermediate risk of arrhythmic events remains controversial. The present study evaluated the predictive performance of different risk scores in an Asian BrS population and its intermediate risk subgroup.MethodsThis is a retrospective territory-wide cohort study of consecutive patients diagnosed with BrS from January 1st, 1997 to June 20th, 2020 in Hong Kong. The primary outcome is sustained ventricular tachyarrhythmias. A novel predictive score was developed. Machine learning-based nearest neighbor and Gaussian Naïve Bayes models were also developed. The area under the receiver operator characteristic (ROC) curve (AUC) was compared between the different scores.ResultsThe cohort consists of 548 consecutive BrS patients (7% female, age at diagnosis: 50±16 years old, follow-up duration: 84±55 months). For risk stratification in the whole BrS cohort, the score developed by Sieira et al. showed the best performance with an AUC of 0.805, followed by the Shanghai score (0.698), and the scores by Okamura et al. (0.667), Delise et al. (0.661), Letsas et al. (0.656) and Honarbakhsh et al. (0.592). A novel risk score was developed based on variables and weighting from the best performing score (the Sieira score), with the inclusion of additional variables significant on univariable Cox regression (arrhythmias other than ventricular tachyarrhythmias, early repolarization pattern in the peripheral leads, aVR sign, S-wave in lead I and QTc ≥436 ms). This score has the highest AUC of 0.855 (95% CI: 0.808-0.901). The Gaussian Naïve Bayes model demonstrated the best performance (AUC: 0.97) compared to logistic regression and nearest neighbor models.ConclusionThe inclusion of investigation results and more complex models are needed to improve the predictive performance of risk scores in the intermediate risk BrS population.
Genome wide association study of human bacteremia Escherichia coli isolates identifies genetic determinants for the portal of entry but not fatal outcome
Authors: Denamur Erick , Condamine Bénédicte , Esposito-Farèse Marina , Royer Guilhem , Clermont Olivier , Laouenan Cédric , Lefort Agnès , de Lastours Victoire , Galardini Marco ,   the COLIBAFI,   SEPTICOLI groups
Published: November 2021

AbstractEscherichia coli is an important cause of bloodstream infections (BSI), which is of concern given its high mortality and increasing worldwide prevalence. Finding bacterial genetic variants that might contribute to patient death is of interest to better understand its mechanism and implement diagnostic methods that specifically look for those factors. E. coli samples isolated from patients with BSI are an ideal dataset to systematically search for those variants, as long as the influence of host factors such as comorbidities are taken into account. Here we performed a genome-wide association study (GWAS) using data from 910 patients with E. coli BSI from hospitals in Paris, France; we looked for associations between bacterial genetic variants and three patient outcomes (death at 28 days, septic shock and admission to intensive care unit), as well as two portals of entry (urinary and digestive tract), using various clinical variables from each patient to account for host factors. We did not find any associations between genetic variants and patient outcomes, potentially confirming the strong influence of host factors in influencing the course of BSI; we however found a strong association between the papGII/papGIII operon and entrance of E. coli through the urinary tract, which demonstrates the power of bacterial GWAS even when applied to actual clinical data. Despite the lack of associations between E. coli genetic variants and patient outcomes, we estimate that increasing the sample size by one order of magnitude could lead to the discovery of some putative causal variants. The adoption of bacterial genome sequencing of clinical isolates might eventually lead to the elucidation of the mechanisms behind BSI progression and the development of sequence-based diagnostics.