bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of Recipient Characteristics Over 3 Decades and Impact on Survival After Lung Transplantation
Authors: Elgharably Haytham , Ayyat Kamal S. , Okamoto Toshihiro , Thuita Lucy , Unai Shinya , Bribriesco Alejandro C. , Yun James J. , Johnston Douglas R. , Ahmad Usman , Murthy Sudish C. , Budev Marie M. , Pettersson Gosta B. , McCurry Kenneth R. 
Published: March 2021

Background.
Lung transplantation (LTx) is a definitive treatment for end-stage lung disease. Herein, we reviewed our center experience over 3 decades to examine the evolution of recipient characteristics and contemporary predictors of survival for LTx.

Methods.
We retrospectively reviewed the data of LTx procedures performed at our institution from January 1990 to January 2019 (n = 1819). The cohort is divided into 3 eras; I: 1990–1998 (n = 152), II: 1999–2008 (n = 521), and III: 2009–2018 (n = 1146). Univariate and multivariate analyses of survival in era III were performed.

Results.
Pulmonary fibrosis has become the leading indication for LTx (13% in era I, 57% in era III). Median recipient age increased (era I: 46 y–era III: 61 y) as well as intraoperative mechanical circulatory support (era I: 0%–era III: 6%). Higher lung allocation score was associated with primary graft dysfunction (P < 0.0001), postoperative extracorporeal mechanical support (P < 0.0001), and in-hospital mortality (P = 0.002). In era III, hypoalbuminemia, thrombocytopenia, and high primary graft dysfunction grade were multivariate predictors of early mortality. The 5-y survival in eras II (55%) and III (55%) were superior to era I (40%, P < 0.001). Risk factors for late mortality in era III included recipient age, chronic allograft dysfunction, renal dysfunction, high model for end-stage liver disease score, and single LTx.

Conclusions.
In this longitudinal single-center study, recipient characteristics have evolved to include sicker patients with greater complexity of procedures and risk for postoperative complications but without significant impact on hospital mortality or long-term survival. With advancing surgical techniques and perioperative management, there is room for further progress in the field.
Preemptive Kidney Transplantation Is Associated With Transplantation Outcomes in Children: Results From the French Kidney Replacement Therapy Registry
Authors: Prezelin-Reydit Mathilde , Madden Iona , Macher Marie-Alice , Salomon Rémi , Sellier-Leclerc Anne-Laure , Roussey Gwenaelle , Lahoche Annie , Garaix Florentine , Decramer Stéphane , Ulinski Tim , Fila Marc , Dunand Olivier , Merieau Elodie , Pongas Marios , Zaloszyc Ariane , Baudouin Véronique , Bérard Etienne , Couchoud Cécile , Leffondré Karen , Harambat Jérôme 
Published: March 2021

Background.
Kidney transplantation (KT) is the optimal treatment for children with end-stage kidney disease. The aim of this study was to evaluate the impact of preemptive kidney transplantation (PKT) and of pretransplant dialysis duration on graft survival among French pediatric kidney transplant recipients.

Methods.
We analyzed all first pediatric kidney-only transplantations performed in France between 1993 and 2012. A Cox multivariable model was used to investigate the association of PKT and pretransplant dialysis time with the hazard of graft failure defined as death, return to dialysis, or retransplant, whichever occurred first.

Results.
Patients (n = 1911) were included, of which 380 (19.8%) received a PKT. Median time of follow-up was 7.0 y. PKT was associated with a 55% reduction of the hazard of graft failure at any time after KT compared with patients transplanted after dialysis (hazard ratio, 0.45; 95% confidence interval, 0.33-0.62), after adjustment for recipient sex and age, primary kidney disease, donor age and type (living or deceased donor), number of HLA mismatches, cold ischemia time, and year of transplantation. A reduction of the hazard of graft failure was found in PKT whatever the compared duration of dialysis, even when <6 mo and whatever the dialysis modality. Results were similar in multiple sensitivity analyses.

Conclusions.
In France, PKT among pediatric patients is associated with a better graft survival when compared with KT after dialysis, even when <6 mo. Based on these findings, we suggest that PKT should be considered as the treatment of choice for children with end-stage kidney disease.
Updates on management of headache in women and transgender women
Authors: Ailani Jessica 
Published: March 2021

Purpose of review
Gender differences exist in headache disorders. A greater understanding of the role of hormones in headache can help the clinician better approach and manage common primary headache disorders.

Recent findings
Recent studies highlight differences in how migraine and cluster headache present in women and men. Updates to the ongoing debate of how to manage the use of hormones in women with migraine, especially with aura, have been well reviewed in the last 18 months. A new meta-analysis evaluates gender differences in response to triptans.

Summary
This review will focus on recent updates on the role of gender and hormones on migraine and cluster headache and how this may influence treatment.
Substance use, mental disorders and COVID-19: a volatile mix
Authors: Marel Christina , Mills Katherine L. , Teesson Maree 
Published: March 2021

Purpose of review
The COVID-19 pandemic and associated restrictions have uniquely and disproportionately affected vulnerable populations. This review summarizes recent evidence on the relationship between psychiatric disorders, substance use disorders and COVID-19, highlighting acute and long-term risks, pharmacotherapy interactions and implications regarding appropriate and timely evidence-based treatment.

Recent findings
Evidence points to a complex relationship between psychiatric and substance use disorders and COVID-19. A range of risk factors associated with psychiatric and substance use disorders increases the risk of exposure to, and complications arising from, the COVID-19 virus. COVID-19 infection has been indicated as having acute and potential long-term impacts on both psychiatric and substance use disorders. Social disruption associated with restrictions imposed to curb transmission has also been identified as a risk factor for new onset of disorders and recurrence and exacerbation of existing conditions.

Summary
Early recognition and intervention are key to preventing chronic disability associated with psychiatric disorders, substance use disorders, and their co-occurrence. It is critical that those most in need of services do not fall through the cracks of our healthcare systems. The pandemic has fast tracked the opportunity for widespread implementation of digital health interventions but ensuring these are accessible and available to all, including our most vulnerable, will be a critical task for our future health and social ecosystems.
Neurological manifestations of patients with mild-to-moderate COVID-19 attending a public hospital in Lima, Peru
Authors: Carcamo Garcia Marco H. , Garcia Choza Diego D. , Salazar Linares Brenda J. , Diaz Monica M. 
Published: March 2021

AbstractObjectiveTo determine the prevalence and characteristics of the most common neurological manifestations in Peruvian patients with mild-to-moderate COVID-19.MethodsWe conducted a single-center prospective, cross-sectional study at an isolation center functioning as a public acute-care hospital during the COVID-19 pandemic in Lima, the capital city of Peru. This was a convenience sample of patients with acute COVID-19 infection and mild-to-moderate respiratory symptoms who presented for hospital admission between September 25 and November 25, 2020. We interviewed participants and collected demographic, medical history and clinical presentation data; all participants underwent a complete physical and neurological examination. Descriptive statistics and prevalence ratios (PR) with corresponding 95% confidence intervals and p-values were calculated to explore between-groups differences.ResultsOf 199 patients with mild-to-moderate COVID-19 enrolled in this study, 83% presented with at least one neurological symptom (mean symptom duration 8 +/-6 days). The most common neurological symptoms were headache (72%), hypogeusia or ageusia (41%), hyposmia or anosmia (40%) and dizziness (34%). Only 2.5% of the cohort had an abnormal neurological examination. The majority (42%) had no prior comorbidities. Presence of at least 1 neurological symptom was independently associated with fever, dyspnea, cough, poor appetite, sore throat, chest tightness or diarrhea, but not with comorbid conditions.ConclusionsThis cross-sectional study found that headaches, and smell and taste dysfunction are common among patients presenting with mild-to-moderate acute COVID-19 in Lima, Peru. International longitudinal studies are needed to determine the long-term neurological sequelae of COVID-19 during the acute and post-infectious period.
Predicting clinical outcomes in the Machine Learning era: The Piacenza score a purely data driven approach for mortality prediction in COVID-19 Pneumonia
Authors: Halasz Geza , Sperti Michela , Villani Matteo , Michelucci Umberto , Agostoni Piergiuseppe , Biagi Andrea , Rossi Luca , Botti Andrea , Mari Chiara , Maccarini Marco , Pura Filippo , Roveda Loris , Nardecchia Alessia , Mottola Emanuele , Nolli Massimo , Salvioni Elisabetta , Mapelli Massimo , Deriu Marco Agostino , Piga Dario , Piepoli Massimo 
Published: March 2021

BackgroundSeveral models have been developed to predict mortality in patients with COVID-19 pneumonia, but only few have demonstrated enough discriminatory capacity. Machine-learning(ML) algorithms represent a novel approach for data-driven prediction of clinical outcomes with advantages over statistical modelling. We developed the Piacenza score, a ML-based score, to predict 30-day mortality in patients with COVID-19 pneumonia.Methods852 patients (mean age 70years, 70%males) were enrolled from February to November 2020. The dataset was randomly splitted into derivation and test. The Piacenza score was obtained through the Naïve Bayes classifier and externally validated on 86 patients. Using a forward-search algorithm the following six features were identified: age; mean corpuscular haemoglobin concentration; PaO2 /FiO2 ratio; temperature; previous stroke; gender. In case one or more of the features are not available for a patient, the model can be re-trained using only the provided features.We also compared the Piacenza score with the 4C score and with a Naïve Bayes algorithm with 14 variables chosen a-priori.ResultsThe Piacenza score showed an AUC of 0.78(95% CI 0.74-0.84, Brier-score 0.19) in the internal validation cohort and 0.79(95% CI 0.68-0.89, Brier-score 0.16) in the external validation cohort showing a comparable accuracy respect to the 4C score and to the Naïve Bayes model with a-priori chosen features, which achieved an AUC of 0.78(95% CI 0.73-0.83, Brier-score 0.26) and 0.80(95% CI 0.75-0.86, Brier-score 0.17) respectively.ConclusionA personalized ML-based score with a purely data driven features selection is feasible and effective to predict mortality in patients with COVID-19 pneumonia.
Details of COVID-19 Disease Mitigation Strategies in 17 K-12 Schools in Wood County, Wisconsin
Authors: Falk Amy , Benda Alison , Falk Peter , Steffen Sarah , DeCoster Mikaela , Gandhi Monica , Høeg Tracy Beth 
Published: March 2021

AbstractImportanceWith the current COVID-19 return-to-school guidelines, over half of America’s K-12 students are being denied access to full time in-person education, leading to harmful academic, emotional and health consequences.ObjectiveTo describe the specific details of mitigation strategies employed at 17 K-12 schools in Wisconsin during a time of exceptionally high COVID-19 community disease prevalence where in-school transmission was minimal. The aim of this report is to assist school districts and governing bodies in developing full-time return to school plans.DesignRetrospective cohortSettingWood County, Wisconsin, August 31–November 29, 2020Participants5,530 students and staff from 17 schools in 4 school districtsMain outcomes and measuresDistancing between primary and secondary students in schoolSchool ventilation detailsMasking among teachersLunch, recess and bussing practicesResults89.3% of elementary students included in our study did not maintain 6 feet of physical distancing in the classroom and 94.8% were within 6 feet in lunchrooms. The majority of secondary students (86.2%) were able to maintain 6 feet of distancing in the classroom but no students were greater than 6 feet in the hallways. 58.8% of schools did not install new ventilation systems prior to the school year. Students ate lunch indoors. Bussing of students continued and all elementary children were allowed to go without masks at recess.Conclusion and relevanceIn the setting of high community COVID-19 disease transmission, 6 feet of distance between elementary students and major ventilation system renovations in primary or secondary schools do not appear to be necessary to minimize disease spread. Requiring masks at recess and prohibiting bussing also appears unnecessary. These findings may inform guidance on the safe reopening of schools and allow for more children to return to in-person schooling.
Network-based Modeling of COVID-19 Dynamics: Early Pandemic Spread in India
Authors: Bhattachayya Rupam , Banerjee Sayantan , Mohammed Shariq , Baladandayuthapani Veera 
Published: March 2021

AbstractModeling the dynamics of COVID-19 pandemic spread is a challenging and relevant problem. Established models for the epidemic spread such as compartmental epidemiological models e.g. Susceptible-Infected-Recovered (SIR) models and its variants, have been discussed extensively in the literature and utilized to forecast the growth of the pandemic across different hot-spots in the world. The standard formulations of SIR models rely upon summary-level data, which may not be able to fully capture the complete dynamics of the pandemic growth. Since the disease spreads from carriers to susceptible individuals via some form of contact, it inherently relies upon a network of individuals for its growth, with edges established via direct interaction, such as shared physical proximity. Using individual-level COVID-19 data from the early days (January 30 to April 15, 2020) of the pandemic in India, and under a network-based SIR model framework, we performed state-specific forecasting under multiple scenarios characterized by the basic reproduction number of COVID-19 across 34 Indian states and union territories. We validated our short-term projections using observed case counts and the long-term projections using national sero-survey findings. Based on healthcare availability data, we also performed projections to assess the burdens on the infrastructure along the spectrum of the pandemic growth. We have developed an interactive dashboard summarizing our results. Our predictions successfully identified the initial hot-spots of India such as Maharashtra and Delhi, and those that emerged later, such as Madhya Pradesh and Kerala. These models have the potential to inform appropriate policies for isolation and mitigation strategies to contain the pandemic, through a phased approach by appropriate resource prioritization and allocation.
Evaluation of serum antibodies against SARS-CoV□2 in healthcare workers who participated in the operation of charter flights for the evacuation of Japanese residents from Hubei Province
Authors: Suzuki Tetsuya , Hayakawa Kayoko , Ainai Akira , Iwata-Yoshikawa Naoko , Sano Kaori , Nagata Noriyo , Suzuki Tadaki , Wakimoto Yuji , Akiyama Yutaro , Miyazato Yusuke , Nakamura Keiji , Ide Satoshi , Nomoto Hidetoshi , Nakamoto Takato , Ota Masayuki , Moriyama Yuki , Sugiki Yuko , Saito Sho , Morioka Shinichiro , Ishikane Masahiro , Kinoshita Noriko , Kutsuna Satoshi , Ohmagari Norio 
Published: March 2021

SummaryThere are several recommendations for the use of personal protective equipment (PPE) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, the selection of appropriate PPE for the current situation remains controversial. We measured serum antibody titers for SARS-CoV-2 in 10 participants who were engaged in the operation of charter flights for the evacuation of Japanese residents from Hubei Province. All participants wore PPE in accordance with Centers for Disease Control and Prevention guidelines. A total of 17 samples were tested, and all were seronegative. Hence, we conclude that the current PPE recommendation is effective to protect healthcare workers from SARS-CoV-2 infection.
The Clinical Genome Resource (ClinGen) Familial Hypercholesterolemia Variant Curation Expert Panel consensus guidelines for LDLR variant classification
Authors: Chora Joana R. , Iacocca Michael A. , Tichy Lukas , Wand Hannah , Kurtz C. Lisa , Zimmermann Heather , Leon Annette , Williams Maggie , Humphries Steve E. , Hooper Amanda J. , Trinder Mark , Brunham Liam R. , Pereira Alexandre Costa , Jannes Cinthia E. , Chen Margaret , Chonis Jessica , Wang Jian , Kim Serra , Johnston Tami , Soucek Premysl , Kramarek Michal , Leigh Sarah E. , Carrie Alain , Sijbrands Eric J. , Hegele Robert A. , Freiberger Tomas , Knowles Joshua W. , Bourbon Mafalda 
Published: March 2021

ABSTRACTPurposeIn 2015, the American College of Medical Genetics and Genomics (ACMG) and the Association for Molecular Pathology (AMP) published consensus standardized guidelines for variant classification in Mendelian disorders. To increase accuracy and consistency, the Clinical Genome Resource (ClinGen) Familial Hypercholesterolemia (FH) Variant Curation Expert Panel (VCEP) was tasked with optimizing the existing ACMG/AMP framework for disease-specific classification in FH. Here, we provide consensus recommendations for the most common FH-causing gene, LDLR, where >2,300 unique FH-associated variants have been identified.MethodsThe multidisciplinary FH VCEP met in person and through frequent emails and conference calls to develop LDLR-specific modifications of ACMG/AMP guidelines. Through iteration, pilot testing, debate and commentary, consensus among experts was reached.ResultsThe consensus LDLR variant modifications to existing ACMG/AMP guidelines include: 1) alteration of population frequency thresholds; 2) delineation of loss-of-function variant types; 3) functional study criteria specifications; 4) co-segregation criteria specifications; and 5) specific use and thresholds for in silico prediction tools, among others.ConclusionEstablishment of these guidelines as the new standard in the clinical laboratory setting will result in a more evidence-based, harmonized method for LDLR variant classification worldwide, thereby improving the care of FH patients.
SGLT2 inhibitors and the risk of diabetic ketoacidosis among adults with Type 2 Diabetes: A systematic review and meta-analysis
Authors: Colacci Michael , Fralick John , Odutayo Ayodele , Fralick Michael 
Published: March 2021

ABSTRACTImportanceThe risk of diabetic ketoacidosis (DKA) with sodium-glucose cotransporter-2 (SGLT2) inhibitors is unclear.ObjectiveTo examine the risk of DKA with SGLT2 inhibitors in both observational studies and large clinical trials.Data SourcesSearches of PubMed, EMBASE and CENTRAL (inception to 15 April 2019) without language restrictions; conference proceedings; and reference lists.Study SelectionRandomized controlled trials and observational studies that quantified the rate of diabetic ketoacidosis with an SGLT2 inhibitor in comparison to another diabetes medication or placebo.Data Extraction and SynthesisTwo independent investigators abstracted study data and assessed the quality of evidence. Data were pooled using random effects models with the Hartung-Knapp-Sidik-Jonkman method.Main Outcome and MeasuresAbsolute event rates and hazard ratios for diabetic ketoacidosis were extracted from each study.ResultsSeven randomized trials encompassing 42,375 participants and five cohort studies encompassing 318,636 participants were selected. Among the 7 randomized controlled trials, the absolute rate of DKA among patients randomized to an SGLT2 inhibitor ranged from 0.6 to 2.2 events per 1000 person years. Four randomized trials were included in the meta-analysis, and compared to placebo or comparator medication, SGLT2 inhibitors had a 2.4-fold higher risk of DKA (Relative Risk⍰[RR] =⍰2.46 [95% CI, 1.16-5.21]; I2⍰=⍰0%; P⍰= 0.54). Among the 5 observational studies, the absolute rate of DKA associated with SGLT2 inhibitor use ranged from 0.6 to 4.9 per 1000 person years and a 1.7-fold higher rate of DKA compared to another diabetes medication (RR⍰=⍰1.74 [95% CI, 1.01-2.93]; I2⍰=⍰45%; P⍰= 0.12).Conclusions and RelevanceIn adults with type 2 diabetes, SGLT2 inhibitors increase the risk of DKA in both observational studies and large randomized clinical trials.RegistrationCRD42019146855Funding SourceNoneKEY MESSAGES‐Case reports and observational studies have suggested that SGLT2 inhibitors may be associated with an increased risk of DKA, but this finding has not been reproduced in older meta-analyses of randomized controlled trials.‐In this systematic review and meta-analysis of randomized trials and observational studies including over 350,000 patients, SGLT2 inhibitors were found to be associated with twice the risk of diabetic ketoacidosis versus placebo or a comparator medication.‐Patients receiving an SGLT2 inhibitors should be counselled on this risk and provided with appropriate sick-day medication management.