bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a multi‐species‐specific PCR panel to diagnose patients with suspected postoperative bacterial endophthalmitis
Authors: van Halsema Justin , Jansen Ruud , Heineken Adriaan , van Ossewaarde Tjaco M. , Meester‐Smoor Magda A. , van Meurs Jan C. 
Published: July 2021

AbstractIntroductionCurrently, patients suspected of endophthalmitis are referred to a tertiary centre for a vitreous biopsy and bacterial culture, thereby causing a treatment delay for the intravitreal antibiotics injection. We developed a new diagnostic tool, multi‐mono‐PCR (mm‐PCR), not requiring viable bacteria, allowing antibiotic injection without delay. Performance of mm‐PCR was tested on biopsies from patients with suspected postoperative endophthalmitis with known bacterial culture results.MethodsMost frequently occurring pathogens in endophthalmitis were determined using published data and treatment logs of endophthalmitis patient of the Rotterdam Eye Hospital.Vitreous biopsies from patients with suspected endophthalmitis were aliquoted in two parts. One part was sent out for bacterial culture and another was stored at −80°C for mm‐PCR analysis and, as a backup, also by panbacterial PCR. Twelve vitreous samples from patients not suspected of having endophthalmitis were added as control samples.ResultsConcordancy between bacterial culture and mm‐PCR was 89% (24 of 27). All twelve control samples were negative. In three nonconcordant samples, the PCR results were most likely the correct ones.Conclusionmm‐PCR results are highly concordant with bacterial culture. mm‐PCR with panbacterial PCR as backup could be considered a diagnostic tool in patients with endophthalmitis, which would allow us to reverse the order of diagnosis and treatment while maintaining diagnostic surveillance, thereby preventing treatment delay.
Alcohol‐associated liver disease in the United States is associated with severe forms of disease among young, females and Hispanics
Authors: Singal Ashwani K. , Arsalan Arshad , Dunn Winston , Arab Juan P. , Wong Robert J. , Kuo Yong‐Fang , Kamath Patrick S. , Shah Vijay H. 
Published: July 2021

SummaryBackgroundAlcohol use and alcohol‐associated liver disease (ALD) burden are increasing in young individuals.AimTo assess host factors associated with this burden.MethodsNational Health and Nutrition Examination Survey (NHANES), National Inpatient Sample (NIS), and United Network for Organ Sharing (UNOS) databases (2006‐2016) were used to identify individuals with harmful alcohol use, ALD‐related admissions, and ALD‐related LT listings respectively.ResultsOf 15 981 subjects in NHANES database, weighted prevalence of harmful alcohol use was 17.7%, 29.3% in <35 years (G1) versus 16.9% in 35‐64 years (G2) versus 5.1% in ≥65 years (G3). Alcohol use was about 11 and 4.7 folds higher in G1 and G2 versus G3, respectively. Male gender and Hispanic race associated with harmful alcohol use. Of 593 600 ALD admissions (5%, 77%, and 18% in G1‐G3 respectively), acute on chronic liver failure (ACLF) occurred in 7.2%, (7.2 in G2 vs 6.7% in G1 and G3, P < 0.001). After controlling for other variables, ACLF development among ALD hospitalizations was higher by 14% and 10% in G1 and G2 versus G3, respectively. Female gender and Hispanic race were associated with increased ACLF risk by 8% and 17% respectively. Of 20,245 ALD LT listings (3.4%, 84.4%, and 12.2% in G1‐G3 respectively), ACLF occurred in 28% candidates. Risk of severe (grade 2 or 3) ACLF was higher by about 1.7 fold in G1, 1.5 fold in females and 20% in Hispanics.ConclusionYoung age, female gender, and Hispanic race are independently associated with ALD‐related burden and ACLF in the United States. If these findings are validated in prospective studies, strategies will be needed to reduce alcohol use in high risk individuals to reduce burden from ALD.
Systematic review with meta‐analysis: The effects of non‐steroidal anti‐inflammatory drugs and anti‐platelet therapy on the incidence and recurrence of hepatocellular carcinoma
Authors: Tan Regina Zi Hwei , Lockart Ian , Abdel Shaheed Christina , Danta Mark 
Published: July 2021

SummaryBackgroundChemoprevention with NSAIDs, including aspirin, and anti‐platelet therapy (APT), has been suggested to reduce the incidence and recurrence of hepatocellular carcinoma (HCC).AimTo determine by meta‐analysis whether NSAIDs and APT use affected HCC incidence, HCC recurrence and liver‐related mortality in at‐risk populations with chronic liver disease.MethodElectronic databases including Pubmed, Scopus, Medline, Embase and Cochrane Library were searched (from inception to 31 May 2021) for eligible studies evaluating the impacts of NSAID or APT use on HCC incidence, recurrence and mortality. Data on HCC incidence, recurrence, liver‐related mortality or bleeding complications had to be available. Studies were included if they evaluated adults with hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol‐related liver disease (ALD) or nonalcoholic steatohepatitis that were administered at least one NSAID or APT for a defined period of time and were followed for at least 6 months. The primary outcome was HCC incidence. Secondary outcomes included: HCC recurrence, liver‐related mortality and bleeding complications. Data were pooled using a random effects model with hazard ratios (HRs) or odds ratio (OR), and 95% confidence intervals (CIs) presented.ResultsOf 3773 articles screened, 19 studies were included, with a total of 147 283 participants. Aspirin use reduced the risk of HCC incidence (HR: 0.51, 95% CI: 0.36‐0.72); and improved liver‐related mortality (OR: 0.32, 95% CI: 0.15‐0.70), with a small increased risk of gastrointestinal bleeding events (OR: 1.32, 95% CI: 1.08‐1.94). With respect to HCC recurrence following treatment, analysis of all aspirin and NSAID treatment (including; aspirin only; non‐aspirin NSAIDs only; and combination NSAIDs groups) was associated with a decreased risk of HCC recurrence (HR: 0.80, 95% CI: 0.75‐0.86). By stratified analysis, only the non‐aspirin NSAID group showed significant risk reduction (HR: 0.73, 95% CI: 0.63‐0.84).ConclusionThe study supports the use of aspirin in at‐risk individuals to reduce the incidence of HCC and liver‐related mortality. HCC recurrence following treatment was lower with NSAID treatment.
Continued 5ASA use after initiation of anti‐TNF or immunomodulator confers no benefit in IBD: a population‐based study
Authors: Bernstein Charles N. , Tenakoon Aruni , Singh Harminder , Targownik Laura E. 
Published: July 2021

SummaryBackgroundWith the advent of biological therapy in IBD, it is uncertain to what extent 5aminosalicylates (5ASA) are used.AimsTo explore whether or not 5ASA is continued once biological or immunomodulator therapy is initiated, and the outcomes in those who continued the 5ASAs.MethodsWe conducted a retrospective cohort study using the population‐based University of Manitoba IBD Epidemiologic Database which includes prescription drug dispensation from 1996 through 2018. We assessed outcomes among 5ASA users who continued versus discontinued 5ASA after initiation of anti‐TNF therapy or immunomodulators.ResultsIn all, 8379 (77%) of persons with IBD received at least one 5ASA dispensation (85% of ulcerative colitis, UC and 68% of Crohn’s disease, CD). There was a reduction in later years, particularly for CD. The most common pattern of 5ASA use was intermittent at 65.1% (stopping and restarting use) versus one‐time (4.1%), previous continuous (13.8%) and persistent (17%). Among the total IBD population use was 59% oral, 3% rectal and 14% combination. Of all 5ASA starts, only 25% were continued longer than 20 months. After immunomodulator or anti‐TNF initiation, there was no difference in either UC or CD for negative outcomes (hospitalisation, surgery, corticosteroid starts, colorectal cancers or drug‐related adverse events) between those who continued 5ASA versus those who discontinued.Conclusions5ASA remains commonly prescribed in UC and CD. Rates of persistent use in UC are low. Once an anti‐TNF or immunomodulator is initiated, continuation of 5ASA seems to add no benefit.
The osteohistological variability in the evolution of basal avialans
Authors: Monfroy Quentin T. , Kundrát Martin 
Published: July 2021

AbstractBasal avialans have been the focus of numerous histological studies in the past decade, from which different osteohistological patterns have been described. In this review, we look at the osteohistology in selected specimens from the four major avian groups: the long‐tailed Avialae (Archaeopteryxand Jeholornithiformes), basal Pygostylia, Enantiornithes and Euornithes. Developmental and evolutionary changes in the three major bone layers are observed throughout the bone cortex of the limbs, may it be interspecific or intraspecific. Most noteworthy is the adaptive change from the overall lamellar/parallel‐fibered bone tissue to a fibrolamellar complex in the mid‐cortex as of the basal Pygostylia, potentially even as of the Jeholornithiformes. This change is generally associated with an increase in the density and complexity of the neurovascular network. Another evolutionary‐developmental feature is the progressive loss of post‐natal growth marks as of the non‐ornithurine Euornithes, indicative of uninterrupted bone growth as observed in extant Neornithes. Our comparisons of the osteohistological patterns allow us to better determine how and when specific features typical observed in the avian crown group developed, associated with external and internal factors, and how they lead to what is commonly observed in extant Neornithes.
Mutualistic relationships in marine angiosperms: Enhanced germination of seeds by mega‐herbivores
Authors: Tol Samantha J. , Jarvis Jessie C. , York Paul H. , Congdon Bradley C. , Coles Robert G. 
Published: July 2021

AbstractAngiosperms have co‐evolved with animals over thousands of years leading to an array of mutualistic relationships. Passage of plant seeds through animal intestines leads to an important mutualism providing the animal with food and the plant with seed dispersal and enhanced germination. This phenomenon is well studied in terrestrial angiosperms, but there is less research in aquatic environments. We studied the effect of gut passage in marine mega‐herbivores (green sea turtles and dugongs) on seed germination for a common Australian seagrass, Zostera muelleri.We collected fecal samples likely to contain seeds, as well as seagrass seeds from plants at two coastal seagrass meadows in the central Great Barrier Reef World Heritage Area, Australia. Seeds collected from feces and plants were subjected to germination trials across different temperature treatments: low (19°C), medium (26°C), and high (32°C). We found excreted seeds had a significantly greater germination probability (two to four times greater) and germinated significantly faster (18–61% faster) than seeds from the plant. Excreted seeds which had not germinated at the end of the experiment were significantly less likely to be viable compared with seeds taken from the plant. Seeds released from the plant have a slow germination and low germination probability compared with excreted seeds, but retain a high percentage of seed viability. Our study is the first record of marine mega‐herbivores enhancing germination of Z. muelleri seeds. By transporting seeds to new locations and enhancing germination, these animals are important in seagrass resilience and connectivity among metapopulations.
The Relation Between Cognitive Abilities and the Distribution of Semantic Features Across Speech and Gesture in 4‐year‐olds
Authors: Abramov Olga , Kern Friederike , Koutalidis Sofia , Mertens Ulrich , Rohlfing Katharina , Kopp Stefan 
Published: July 2021

AbstractWhen young children learn to use language, they start to use their hands in co‐verbal gesturing. There are, however, considerable differences between children, and it is not completely understood what these individual differences are due to. We studied how children at 4 years of age employ speech and iconic gestures to convey meaning in different kinds of spatial event descriptions, and how this relates to their cognitive abilities. Focusing on spontaneous illustrations of actions, we applied a semantic feature (SF) analysis to characterize combinations of speech and gesture meaning and related them to the child's visual‐spatial abilities or abstract/concrete reasoning abilities (measured using the standardized SON‐R test). Results show that children with higher cognitive abilities convey significantly more meaning via gesture and less solely via speech. These findings suggest that young children's use of cospeech representational gesturing is positively related to their mental representation and reasoning abilities.
Climate risk and corporate tax avoidance: International evidence
Authors: Ni Yingzhao , Chen Zhian , Li Donghui , Yang Shijie 
Published: July 2021

AbstractResearch Question/IssueThis study investigates the relationship between climate risk and corporate tax avoidance. Previous studies on this relationship generate mixed results, theoretically and empirically. Our study addresses this empirical question by providing new evidence using a large international sample and a novel proxy for climate risk.Research Findings/InsightsThe empirical results show that higher climate risk is associated with higher tax avoidance. Mechanism analyses show that this positive association is due to the incentive to reserve cash in response to tightened financial constraints, rather than tax deductions granted by governments. This result is more pronounced in countries or regions that have poorer corporate governance and information environments, lower economic development, and a more uncertain policy environment.Theoretical/Academic ImplicationsOur evidence highlights the importance of considering the role of climate risk in corporate tax policies and of comparing the link between climate risk and tax avoidance across countries.Practitioner/Policy ImplicationsEchoing environmental non‐governmental organizations' (NGOs) recent call on governments to strengthen tax administration, our study has policy implications that emphasize the necessity for policymakers to consider the link between climate risk and tax avoidance.
Sit‐to‐stand training for self‐care and mobility in children with cerebral palsy: a randomized controlled trial
Authors: Chaovalit Sirawee , Dodd Karen J , Taylor Nicholas F 
Published: July 2021

AimTo investigate if a sit‐to‐stand exercise programme for children with cerebral palsy (CP) would improve self‐care and mobility.MethodThirty‐eight children with CP (19 males, 19 females; mean age 8y 0mo, SD 2y 4mo, age range 4y 0mo–12y 4mo) classified in Gross Motor Function Classification System (GMFCS) levels III and IV and their caregivers were randomly allocated to sit‐to‐stand training plus routine physiotherapy (balance and gait training) or routine physiotherapy only (controls). Task‐specific sit‐to‐stand training was completed five times a week for 6 weeks under physiotherapist (twice weekly) and caregiver (three times weekly) supervision. Blinded outcome assessments at week 7 were the self‐care and mobility domains of the Functional Independence Measure for Children, Five Times Sit‐to‐Stand Test (FTSST), and Modified Caregiver Strain Index (MCSI).ResultsThe sit‐to‐stand group self‐care increased by 2.2 units (95% confidence interval [CI] 1.3–3.1) and mobility increased by 2.2 units (95% CI 1.4–3.0) compared to the control group. In the sit‐to‐stand group, the FTSST was reduced by 4.0 seconds (95% CI −4.7 to −3.2) and the MCSI was reduced by 0.8 units (95% CI −1.2 to −0.4) compared to the control group.InterpretationA sit‐to‐stand exercise programme for children with CP classified in GMFCS levels III and IV improved sit‐to‐stand performance and resulted in small improvements in self‐care and mobility, while reducing caregiver strain.
What this paper adds

Sit‐to‐stand training improved independence in self‐care and mobility for children with cerebral palsy (CP).

Home‐based sit‐to‐stand training programmes for children with CP can reduce the burden on supervising caregivers.
Nutritional screening of children and adolescents with cerebral palsy: a scoping review
Authors: Sørensen Sarah J , Brekke Ghita , Kok Karin , Sørensen Jette L , Born Alfred P , Mølgaard Christian , Høi‐Hansen Christina E 
Published: July 2021

AimTo examine nutritional screening methods for children and adolescents with cerebral palsy.MethodA scoping review was performed using established methodologies. In June 2020 we searched PubMed, Embase, CINAHL Complete, and the Cochrane Central Register of Controlled Trials to identify articles on tools/methods for nutritional screening of our target groups.ResultsThirty studies were included, containing various tools/methods used to identify under‐ and/or overnutrition by weight/height, circumferences, skinfolds, questionnaires, and/or technically advanced or invasive methods. Questionnaires, weight/height, circumferences, and skinfolds were considered feasible based on clinical utility, whereas bioelectrical impedance analysis and blood samples were not.InterpretationWe identified two screening tools for undernutrition that include no physical measurements, but did not find any screening tools for overweight and obesity. Most of the studies recommended one or more methods, indicating that determining nutritional status most likely includes a combination of methods, not all of which may be feasible in clinical practice.What this paper addsNo nutritional screening tool using anthropometry or body composition was discovered.Heterogenous methods to identify under‐ and/or overnutrition are recommended.Preferable methods for nutritional screening include assessment of body composition.A validated nutritional screening tool for identification of overweight is warranted.
Genetic convergence of developmental and epileptic encephalopathies and intellectual disability
Authors: Carvill Gemma L , Jansen Sandra , Lacroix Amy , Zemel Matthew , Mehaffey Michele , De Vries Petra , Brunner Han G , Scheffer Ingrid E , De Vries Bert B A , Vissers Lisenka E L M , Mefford Heather C 
Published: July 2021

AimTo determine whether genes that cause developmental and epileptic encephalopathies (DEEs) are more commonly implicated in intellectual disability with epilepsy as a comorbid feature than in intellectual disability only.MethodWe performed targeted resequencing of 18 genes commonly implicated in DEEs in a cohort of 830 patients with intellectual disability (59% male) and 393 patients with DEEs (52% male).ResultsWe observed a significant enrichment of pathogenic/likely pathogenic variants in patients with epilepsy and intellectual disability (16 out of 159 in seven genes) compared with intellectual disability only (2 out of 671) (p<1.86×10−10, odds ratio 37.22, 95% confidence interval 8.60–337.0).InterpretationWe identified seven genes that are more likely to cause epilepsy and intellectual disability than intellectual disability only. Conversely, two genes, GRIN2B and SCN2A, can be implicated in intellectual disability without epilepsy; in these instances intellectual disability is not a secondary consequence of ongoing seizures but rather a primary cause.
What this paper adds

A subset of genes are more commonly implicated in epilepsy than other neurodevelopmental disorders.

GRIN2B and SCN2A are implicated in intellectual disability and epilepsy independently.
Dysautonomia and functional impairment in rare developmental and epileptic encephalopathies: the other nervous system
Authors: Berg Anne T , Coffman Keith , Gaebler‐Spira Deborah 
Published: July 2021

AimTo determine whether functional impairments and autonomic symptoms are correlated in young people with developmental and epileptic encephalopathies (DEEs).MethodCross‐sectional, online surveys (2018–2020) of parents recruited from family groups obtained information on several aspects of children’s conditions including functional abilities (mobility, hand use, eating, and communication), 18 autonomic symptoms in six groups (cardiac, respiratory, sweating, temperature, gastrointestinal, and other), and parental stress. Bivariate and multivariable logistic regression analyses examined associations of dysautonomias with functional impairment, adjusted for type of DEE and age.ResultsOf 313 participants with full information on function and dysautonomias, 156 (50%) were females. The median age was 8 years (interquartile range 4–12y); 255 (81%) participants had symptoms in at least one autonomic symptom group; 283 (90%) had impairment in at least one functional domain. The number of functional impairment domains and of autonomic symptom groups varied significantly across DEE groups (both p<0.001). The number of functional impairment domains and of autonomic symptom groups were correlated (Spearman’s r=0.35, p<0.001) on bivariate and multivariable analysis adjusted for DEE group and age. Parental stress was also independently correlated with dysautonomias (p<0.001).InterpretationParent‐reported dysautonomias are common in children with DEEs. They correlate with extent of functional impairment and may contribute to caregiver stress.
What this paper adds

Dysautonomic symptoms are common in young people with developmental and epileptic encephalopathies (DEEs).

Burden of dysautonomias is strongly correlated with burden of functional impairments.

Aspects of dysautonomic function may provide biomarkers of DEE disease severity.
Levetiracetam dosing in patients receiving continuous renal replacement therapy
Authors: Chaijamorn Weerachai , Charoensareerat Taniya , Rungkitwattanakul Dhakrit , Phunpon Sathian , Sathienluckana Thanompong , Srisawat Nattachai , Pattharachayakul Sutthiporn 
Published: July 2021

AbstractObjectiveThe study was aimed to define appropriate levetiracetam dosing regimens from available published pharmacokinetics (PK) studies in critically ill patients with and without cirrhosis receiving continuous renal replacement therapy (CRRT) via Monte Carlo simulation (MCS).MethodsMathematical pharmacokinetic models were developed using published demographic and PK data in adult critically ill patients with known variability and correlations between PK parameters. CRRT modalities (continuous venovenous hemofiltration and continuous venovenous hemodialysis) with different effluent rates were modeled. Levetiracetam regimens from available clinical resources were evaluated on the probability of target attainment (PTA) using pharmacodynamics (PD) target of the trough concentrations and area under the time‐concentration curve within a range of 6–20 mg/L and 222–666 mg × hour/L for the initial 72 hours of therapy, respectively. Optimal regimens were defined from regimens that yielded the highest PTA. Each regimen was tested in a group of different 10,000 virtual patients.ResultsOur results showed the optimal levetiracetam dosing regimen of 750–1000 mg every 12 hours is recommended for adult patients receiving both CRRT modalities with two different effluent rates of 25 and 35 mL/kg/h. Child‐Pugh class C cirrhotic patients undergoing CRRT required lower dosing regimens of 500–750 mg every 12 ours due to smaller non‐renal clearance. Of interest, some of literature‐based dosing regimens were not able to attain the PK and PD targets.SignificanceVolume of distribution, non‐renal clearance, CRRT clearance, and body weight were significantly correlated with the PTA targets. Dosing adaptation in this vulnerable population should be concerned. Clinical validation of our finding is absolutely needed.