bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Environmental Crude Oil Pollution on Newborn Birth Outcomes: A Retrospective Cohort Study
Authors: ELEKE Chinemerem , NGBALA-OKPABI Sabinah Obele , OGAJI Daprim , AGU Ifeyinwa S. , BEMPONG-ELEKE Esther N. 
Published: May 2021

ABSTRACT

Background
The World Health Organization encourages countries to improve birth outcomes to reduce rates of neonatal mortality and morbidity.

Purpose
This study was designed to examine the effect of environmental crude oil pollution on newborn birth outcomes in Rivers State, Nigeria.

Methods
A retrospective cohort design was used to examine the effects of exposure to oil pollution on birth outcomes using facility-based records. K-Dere (an oil-polluted community) served as the exposure group, whereas birth records from Iriebe served as the comparison group. A sample size of 338 systematically selected birth records was examined (169 records for each arm of the study). A data extraction sheet was used for data collection. Data were analyzed using descriptive and inferential statistics at p < .05.

Results
The risk of preterm birth was significantly higher in the exposed group (16% vs. 7.7%, relative risk = 2.08, 95% CI [1.11, 3.89], p = .018). At 6 weeks after birth, newborns in the exposed group weighed significantly less (4.64 ± 0.82 vs. 4.85 ± 0.92 kg, p = .032) and reported significantly higher incidence of morbidity compared with the newborns in the comparison group (relative risk = 3.03, 95% CI [2.20, 4.19], p < .001).

Conclusions
The oil-polluted area examined in this study was found to have a higher risk of preterm birth, a slower rate of newborn growth, and a higher rate of newborn morbidity than the non-oil-polluted area at 6 weeks after birth. Stakeholders should sustain efforts to remediate the environment in polluted regions and prevent oil pollution. Future research should investigate the mechanisms of the observed toxicological effects and the targeted protection of vulnerable groups in oil-polluted communities.
Postinfection Irritable Bowel Syndrome Following Clostridioides difficile Infection
Authors: Saha Srishti , Sehgal Kanika , Singh Sumitabh , Grover Madhusudan , Pardi Darrell , Khanna Sahil 
Published: May 2021

Background:
Postinfection irritable bowel syndrome (PI-IBS) affects ~14% patients after acute bacterial enterocolitis.

Aim:
The aim of this study was to conduct a systematic review and meta-analysis to find the prevalence of PI-IBS following Clostridioides difficile infection (CDI).

Methods:
We systematically searched Medline, Embase, and Web of Science from inception through January 20, 2020 for cohort studies assessing PI-IBS following CDI. Primary outcome was pooled prevalence calculated using inverse variance heterogeneity model [MetaXL (v. 5.3)]. A priori subgroup analyses were done [by irritable bowel syndrome (IBS) diagnostic criteria-Rome vs. others, time of IBS diagnosis-<6 or >6 mo, exclusion or inclusion of pre-existing IBS and CDI treatment-antibiotic with fecal microbiota transplantation vs. antibiotic only]. Heterogeneity was considered substantial if I
2>50%.

Results:
From 2007 to 2019, 15 studies were included (10 prospective, 5 retrospective; 9 full-text, 6 abstracts). Data from 1218 patients were included in the quantitative analysis. Risk of bias was low in 7, medium in 4 and high in 4 studies. Pooled prevalence of PI-IBS was 21.1% (95% confidence interval, 8.2%-35.7%), I
2=96%. Common PI-IBS subtypes were diarrhea-predominant in 46.3% (50) patients, and mixed in 33.3% (36) patients. Subgroup analyses by IBS diagnostic criteria, time of IBS diagnosis or CDI treatment did not significantly change the primary outcome (all P>0.05), nor decrease heterogeneity. Funnel plot analysis revealed publication bias.

Conclusions:
Over 20% of patients develop PI-IBS after CDI. Factors such as diagnostic criteria for IBS and CDI treatment did not affect prevalence, though small numbers limit the confidence in these conclusions. Larger, well conducted studies are needed to study PI-IBS in CDI.
Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis
Authors: Lieber Sarah R. , Jiang Yue , Moon Andrew , Barritt Alfred S. 
Published: May 2021

Background:
In an aging population with cardiovascular comorbidities, anticoagulant (AC), antiplatelet (AP), and nonsteroidal anti-inflammatory drug (NSAID) use are increasing. It remains unclear whether these agents pose increased bleeding risk in cirrhosis. This study aimed to assess the association between these medications and bleeding and portal hypertension complications in cirrhosis.

Methods:
The IMS PharMetrics database was used to identify privately insured adults diagnosed with cirrhosis from 2007 to 2015, stratified as compensated or decompensated based on the presence of portal hypertensive complications 1 year before cirrhosis diagnosis. Bleeding or decompensation outcomes were assessed 6 to 18 months after cirrhosis diagnosis using a landmark analysis design. Multivariable Cox proportional hazards regression modeling assessed associations between AC, AP, and NSAID drug exposures and outcomes adjusting for covariates.

Results:
A total of 18,070 cirrhosis patients were analyzed; 57% male; 74% ages 50 to 64 years; 34% with a prior decompensation. Overall, 377 (2%) had claims for ACs; 385 (2%) APs; and 1231 (7%) NSAIDs. APs were associated with increased bleeding [adjusted hazard ratio (aHR)=1.31; 95% confidence interval (CI): 1.00, 1.72] and decompensation events (aHR=1.44; 95% CI: 1.06, 1.95) in a 9-month landmark analysis. NSAIDs were significantly associated with bleeding events (aHR=1.29; 95% CI: 1.06, 1.57) on 3-month landmark analysis. No statistically significant associations were seen between ACs and bleeding or decompensation outcomes in adjusted analyses.

Conclusions:
AP use was associated with increased bleeding and decompensation events among privately insured patients with cirrhosis. NSAID use was associated with significant early bleeding, but not decompensations. Lastly ACs were not associated with bleeding or decompensation outcomes.
Effect of Adding Intravenous Somatostatin to Rectal Indomethacin on Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis in High-risk Patients
Authors: Norouzi Alireza , Ghasem Poori Eshrat , Kaabe Sajjad , Norouzi Zahra , Sohrabi Ahmad , Amlashi Fazel I. , Tavasoli Samaneh , Besharat Sima , Ezabadi Zahra , Amiriani Taghi 
Published: May 2021

Background:Endoscopic retrograde cholangiopancreatography (ERCP) has an important role in the treatment of pancreaticobiliary disorders.Goals:Considering the high prevalence and importance of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) and the controversial findings, we aimed to determine the effect of adding intravenous somatostatin to rectal indomethacin on the incidence of PEP in high-risk patients.Study:In this prospective study, 530 patients underwent ERCP during March 2018 and February 2019. Patients were randomized into 2 groups. The intervention group received a bolus injection of 250 μg somatostatin followed by an infusion of 500 μg of somatostatin for 2 hours. In both groups, 100 mg of pre-ERCP suppository indomethacin was administrated. All patients were screened for PEP symptoms and signs for 24 hours after ERCP (Iranian Registry of Clinical Trials code: IRCT20080921001264N11).Results:A total of 376 patients were finally analyzed. PEP was the most common adverse event with 50 (13.2%) episodes, including 21 (5.5%) mild, 23 (6.1%) moderate, and 6 (1.2%) severe. The rate of PEP was 15.2% in the control group and 11.4% in the intervention group (P=0.666). The incidence of post-ERCP hyperamylasemia was 21.7% in the control group and 18.2% in the intervention group (P=0.395). No death occurred.Conclusions:In this study administration of somatostatin plus indomethacin could safely reduce the rate of post-ERCP hyperamylasemia and PEP in the intervention group compared with the control group, but the differences were not significant. Further studies with larger sample sizes are required.
Efficacy of Hemospray (TC-325) in the Treatment of Gastrointestinal Bleeding
Authors: Chahal Daljeet , Sidhu Hasrit , Zhao Billy , Jogendran Manisha , Dahiya Monica , Tandon Parul , Donnellan Fergal 
Published: May 2021

Background:
Hemospray (TC-325) is now approved for use in gastrointestinal bleeding. Data regarding their use pattern, efficacy, complications, and impact on clinical outcomes is limited.

Methods:
Electronic search from relevant databases was conducted up to January 2019. Etiologies, therapy characteristics, hemostasis rates, rebleed rates, additional procedures, complications and mortality rates were extracted and pooled.

Results:
Twenty-seven articles were included for analysis (n=1916). Pooled hemostasis was 94.5%. Pooled rebleed rate within 3 days was 9.9%, and within 30 days 17.6%. Pooled repeat Hemospray use was 13.6%. Radiology guided embolization was required with rate of 3.3% and surgery at rate of 4.7%. Rate of adverse events directly attributable to Hemospray was 0.7%. 30-day mortality was 11.8%. Comparison of conventional endoscopic therapy to Hemospray augmented therapy demonstrated that Hemospray therapy had increased immediate hemostasis [odds ratio (OR) 4.40]. There was no difference in rate of rebleeding at 8 days (OR 0.52) or overall mortality at 30 days (OR 0.53). Benign nonvariceal bleeds, malignant bleeds, and postprocedural bleeds had similar rates of hemostasis but rebleed rate at 30 days was less for postprocedural bleeding.

Conclusions:
The addition of Hemospray to conventional therapy appears to increase immediate hemostasis but does not decrease rebleeding or mortality. As such, the use of Hemospray will likely be limited to clinical situations requiring urgent, but temporary, hemostasis to bridge to more definitive therapy.
Association Between Mode of Delivery of the Breech Fetus and Hospitalizations Due to Inflammatory Bowel Disease During Childhood
Authors: Zamstein Omri , Glusman Bendersky Ahinoam , Sheiner Eyal , Landau Daniella , Levy Amalia 
Published: May 2021

Background and Goals:
While evidence suggests short-term benefits in neonatal morbidity and mortality from cesarean delivery of the fetus in breech presentation, the long-term implications for the offspring are less clear. To assess the implications of the mode of delivery on offspring’s health, we have evaluated the long-term gastrointestinal (GI) morbidity of offspring with a breech presentation delivered in either way.

Materials and Methods:
A population-based retrospective cohort study including singleton deliveries in breech presentation occurring between 1991 and 2014 at a tertiary referral hospital. Incidence of hospitalizations of the offspring up to the age of 18 years involving GI morbidity was compared between those delivered via cesarean section or vaginally. A Kaplan-Meier survival curve compared cumulative GI morbidity. A Weibull parametric survival model controlled for confounders while accounting for repeated occurrence of mothers and dependence among siblings.

Results:
Overall, 86.9% (n=6376) of the 7337 fetuses in breech presentation, were delivered abdominally. Hospitalizations involving GI morbidity were higher in offspring delivered by cesarean section, specifically due to inflammatory bowel disease (IBD). Kaplan-Meier survival curve revealed the higher cumulative incidence of total GI morbidity and IBD specifically in the cesarean delivery group (P<0.001 and P=0.004, respectively). Using a Weibull parametric while controlling for relevant confounders, cesarean delivery emerged as an independent risk factor for long-term IBD-related morbidity of the offspring delivered in breech presentation (adjusted hazard ratio=3.18, 95% confidence interval: 1.47-6.87, P=0.003).

Conclusion:
Cesarean delivery is associated with higher rates of hospitalizations due to IBD and total GI morbidity during childhood in term singleton in breech presentation.
Initial Results of Laparoscopic Proximal Gastrectomy With Double-tract Reconstruction Using Oblique Jejunogastrostomy Method on the Long-term Outcome of Postoperative Nutritional Status: A Propensity Score-matched Study
Authors: Kimura Kotaro , Ebihara Yuma , Tanaka Kimitaka , Nakanishi Yoshitsugu , Asano Toshimichi , Noji Takehiro , Kurashima Yo , Murakami Soichi , Nakamura Toru , Tsuchikawa Takahiro , Okamura Keisuke , Shichinohe Toshiaki , Hirano Satoshi 
Published: May 2021

Background:
The aim of this study was to evaluate the long-term nutritional state of patients with gastric cancer who underwent laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) using oblique jejunogastrostomy method (OJG).

Methods:
Medical records of 38 patients who underwent LPG-DTR using OJG (21 patients) or laparoscopic total gastrectomy with Roux-en-Y reconstruction (LTG-RY) (17 patients) between October 2011 and March 2018 were retrospectively reviewed. In these patients, clinicopathologic variables were analyzed using propensity score matching for age, sex, body mass index, American Society of Anesthesiologists physical state, clinical stage, and lymph node dissection. Operative outcomes and postoperative nutritional status were compared between the 2 groups.

Results:
A total of 16 patients were matched to analyze the LPG-DTR and LTG-RY groups. The serum hemoglobin, total protein, and albumin levels at 12 months postoperatively (P=0.008, 0.034, and 0.049) and serum hemoglobin level at 24 months (P=0.025) in the LPG-DTR group was significantly superior to those in the LTG-RY group.

Conclusions:
The postoperative nutritional status as long-term outcomes of patients who underwent LPG-DTR using OJG was significantly superior to those who underwent LTG-RY. The results hereby presented suggest that LPG-DTR using OJG for gastric cancer produces better postoperative nutritional status.
Autologous Hematopoietic Stem Cell Transplantation for Liver Transplant Recipients With Recurrent Primary Sclerosing Cholangitis: A Pilot Study
Authors: Chruscinski Andrzej , Juvet Stephen , Moshkelgosha Sajad , Renner Eberhard , Lilly Leslie , Selzner Nazia , Bredeson Christopher , Grant David , Adeyi Oyedele , Fischer Sandra , Demetris Anthony J. , Zhang Jianhua , Epstein Maor , Macarthur Meaghan , Clement Anne Marie , Khalili Korosh , Allan David , Altouri Sultan , Bence-Bruckler Isabelle , Cattral Mark , Fulcher Jill , Galvin Zita , Ghanekar Anand , Greig Paul , Huebsch Lothar , Humar Atul , Kew Andrea , Kekre Natasha , Kim Tae Kyoung , McDiarmid Sheryl , Martin Lisa , McGilvray Ian , Sabloff Mitchell , Sapisochin Gonzalo , Selzner Markus , Smith Robert , Tinckam Kathryn , Yi Tae Joon , Levy Gary , Atkins Harold 
Published: May 2021

Background.
Primary sclerosing cholangitis (PSC) is an indication for liver transplantation, but recurrence after liver transplantation is associated with poor outcomes often requiring repeat transplantation. We investigated whether autologous hematopoietic stem cell transplantation (aHSCT) could be used to stop progression of recurrent PSC and promote operational tolerance.

Methods.
Twelve patients with recurrent PSC were fully evaluated and 5 were selected for aHSCT. Autologous hematopoietic stem cells were collected, purified by CD34 immunomagnetic selection, and cryopreserved. Immunoablation using busulfan, cyclophosphamide, and rabbit antithymocyte globulin was followed by aHSCT. The primary endpoint of the study was the establishment of operational tolerance defined as lack of biochemical, histologic, and clinical evidence of rejection while off immunosuppression at 2 y post-aHSCT.

Results.
Two of the 5 patients achieved operational tolerance with no clinical or histologic evidence of PSC progression or allorejection. A third patient developed sinusoidal obstruction syndrome following aHSCT requiring repeat liver transplantation but has no evidence of PSC recurrence while on sirolimus monotherapy now >3 y after aHSCT. A fourth patient was weaned off immunosuppression but died 212 d after aHSCT from pericardial constriction. A fifth patient died from multiorgan failure. Immunosuppression-free allograft acceptance was associated with deletion of T-cell clones, loss of autoantibodies, and increases in regulatory T cells, transitional B cells, and programmed cell death protein-1 expressing CD8+ T cells in the 2 long-term survivors.

Conclusions.
Although operational tolerance occurred following aHSCT, the high morbidity and mortality observed render this specific protocol unsuitable for clinical adoption.
A step forward, but still inadequate: Australian health professionals’ views on the genetics and life insurance moratorium
Authors: Tiller Jane , Keogh Louise , McInerney-Leo Aideen , Belcher Andrea , Barlow-Stewart Kristine , Boughtwood Tiffany , Gleeson Penny , Dowling Grace , Prince Anya E.R. , Bombard Yvonne , Joly Yann , Delatycki Martin B , Winship Ingrid , Otlowski Margaret , Lacaze Paul 
Published: May 2021

ABSTRACTBackgroundIn 2019, the Australian life insurance industry introduced a partial moratorium (ban) limiting the use of genetic test results in life insurance underwriting. The moratorium is industry self-regulated and applies only to policies below certain financial limits (eg AUD$500,000 of life cover).MethodsWe surveyed Australian health professionals (HPs) who discuss genetic testing with patients, to assess knowledge of the moratorium; reported patient experiences since its commencement; and HP views regarding regulation of genetic discrimination (GD) in Australia.ResultsBetween April-June 2020, 166 eligible HPs responded to the online survey. Of these, 86% were aware of the moratorium, but <50% had attended related training/information sessions. Only 16% answered all knowledge questions correctly, yet 69% believed they had sufficient knowledge to advise patients. Genetics HPs’ awareness and knowledge were better than non-genetics HPs’ (p<0.05). There was some reported decrease in patients delaying/declining testing after the moratorium’s introduction, however 42% of HPs disagreed that patients were more willing to have testing post-moratorium. Although many (76%) felt the moratorium resolved some GD concerns, most (88%) still have concerns, primarily around self-regulation, financial limits and the moratorium’s temporary nature. Almost half (49%) of HPs reported being dissatisfied with the moratorium as a solution to GD. The majority (95%) felt government oversight is required, and 93% felt specific Australian legislation regarding GD is required.ConclusionWhile the current Australian moratorium is considered a step forward, most HPs believe it falls short of an adequate long-term regulatory solution to GD in life insurance.
Intrinsic capacity predicts negative health outcomes in older adults
Authors: Stolz Erwin , Mayerl Hannes , Freidl Wolfgang , Roller-Wirnsberger Regina , Gill Thomas M. 
Published: May 2021

AbstractBACKGROUNDMonitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the WHO as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes.METHODSBased on 4,751 repeated observations of IC (range=0-100) during 21 years of follow-up among 754 older adults 70+ years, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic ADL disability, long-term nursing home stay, and mortality using joint models for longitudinal and time-to-event data.RESULTSAverage IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for socio-demographics and chronic diseases, a one-point lower IC value was associated with a 7% increase in the risk of ADL disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to three repeated measurements of IC ranged between moderate and good (AUC = 0.76-0.82).DISCUSSIONOur study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.
Variant-specific SARS-CoV-2 within-host kinetics
Authors: Elie Baptiste , Roquebert Bénédicte , Sofonea Mircea T. , Trombert-Paolantoni Sabine , Foulongne Vincent , Guedj Jérémie , Haim-Boukobza Stpéhanie , Alizon Samuel 
Published: May 2021

AbstractSince early 2021, SARS-CoV-2 variants of concern (VOCs) have been causing epidemic rebounds in many countries. Their properties are well characterised at the epidemiological level but the potential underlying within-host determinants remain poorly understood. We analyse a longitudinal cohort of 6,944 individuals with 14,304 cycle threshold (Ct) values of qPCR VOC screening tests performed in the general population and hospitals in France between February 6 and August 21, 2021. To convert Ct values into numbers of virus copies, we performed an additional analysis using droplet digital PCR (ddPCR). We find that the number of viral genome copies reaches a higher peak value and has a slower decay rate in infections caused by Alpha variant compared to that caused by historical lineages. Following the evidence that viral genome copies in upper respiratory tract swabs are informative on contagiousness, we show that the kinetics of the Alpha variant translate into significantly higher transmission potentials, especially in older populations. Finally, comparing infections caused by the Alpha and Delta variants, we find no significant difference in the peak viral copy number. These results highlight that some of the differences between variants may be detected in virus load variations.
Strategies to Mitigate COVID-19 Resurgence Assuming Immunity Waning: A Study for Karnataka, India
Authors: Adiga Aniruddha , Athreya Siva , Lewis Bryan , Marathe Madhav V. , Rathod Nihesh , Sundaresan Rajesh , Swarup Samarth , Venkatramanan Srinivasan , Yasodharan Sarath 
Published: May 2021

AbstractCOVID-19 vaccination is being rolled out among the general population in India. Spatial heterogeneities exist in seroprevalence and active infections across India. Using a spatially explicit age-stratified model of Karnataka at the district level, we study three spatial vaccination allocation strategies under different vaccination capacities and a variety of non-pharmaceutical intervention (NPI) scenarios. The models are initialised using on-the-ground datasets that capture reported cases, seroprevalence estimates, seroreversion and vaccine rollout plans. The three vaccination strategies we consider are allocation in proportion to the district populations, allocation in inverse proportion to the seroprevalence estimates, and allocation in proportion to the case-incidence rates during a reference period.The results suggest that the effectiveness of these strategies (in terms of cumulative cases at the end of a four-month horizon) are within 2% of each other, with allocation in proportion to population doing marginally better at the state level. The results suggest that the allocation schemes are robust and thus the focus should be on the easy to implement scheme based on population. Our immunity waning model predicts the possibility of a subsequent resurgence even under relatively strong NPIs. Finally, given a per-day vaccination capacity, our results suggest the level of NPIs needed for the healthcare infrastructure to handle a surge.