bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying distinct trajectories of acute otitis media in children: A prospective cohort study
Authors: van Ingen Gijs , le Clercq Carlijn M. P. , Jaddoe Vincent W. V. , Moll Henriette A. , Duijts Liesbeth , Raat Hein , Baatenburg de Jong Robert J. , van der Schroeff Marc P. 
Published: February 2021

AbstractObjectivesTo identify possibly distinct acute otitis media (AOM) trajectories in childhood and identify determinants associated with specific AOM trajectories. To explore which child will become prone to recurrent AOM episodes and which will not.DesignPopulation‐based prospective cohort study among 7863 children from birth until 10 years and their mothers.MethodsThis study was embedded in the Generation R Study: a population‐based prospective cohort study. Data on AOM and determinants were collected by repeated parental questionnaires. Distinct AOM trajectories within the population were identified with latent‐class analyses. Next, using multivariate analysis we checked whether specific determinants were associated with specific trajectories.ResultsThree distinct trajectories were identified; that is, non–otitis prone, early AOM—that is children who suffered AOM episodes until 3 years of age but not beyond, and persistent AOM—that is children who remained otitis‐prone. Male gender (OR: 1.26, CI: 1.11‐1.43) and day‐care attendance (OR: 1.31, CI: 1.06‐1.60) were associated with increased odds of early AOM. Breastfeeding was beneficial for children in both the early‐AOM and persistent‐AOM trajectories (OR: 0.78 and 0.77, respectively). Birth in the summer or autumn as compared with birth in the spring decreased odds of AOM only in the persistent‐AOM trajectory. Half of all AOM‐prone children recovered after the age of 3 years.ConclusionSpecific determinants are associated with different AOM trajectories. Future research is needed to better predict which child will remain otitis‐prone and which recovers after the age of 3 years to better tailor treatment towards the needs of the individual child.
COVID‐19 in hospitalized liver transplant recipients: An early systematic review and meta‐analysis
Authors: Jayant Kumar , Reccia Isabella , Virdis Francesco , Pyda Jordan S. , Bachul Piotr J. , di Sabato Diego , Barth Rolf N. , Fung John , Baker Talia , Witkowski Piotr 
Published: February 2021

AbstractAdverse clinical outcomes related to SARS‐CoV‐2 infection among liver transplant (LTx) recipients remain undefined. We performed a meta‐analysis to determine the pooled prevalence of outcomes among hospitalized LTx recipients with COVID‐19. A database search of literature published between December 1, 2019, and November 20, 2020, was performed per PRISMA guidelines. Twelve studies comprising 517 hospitalized LTx recipients with COVID‐19 were analyzed. Common presenting symptoms were fever (71%), cough (62%), dyspnea (48%), and diarrhea (28%). Approximately 77% (95% CI, 61%‐93%) of LTx recipients had a history of liver cirrhosis. The most prevalent comorbidities were hypertension (55%), diabetes (45%), and cardiac disease (21%). In‐hospital mortality was 20% (95% CI, 13%‐28%) and rose to 41% (95% CI, 19%‐63%) (P < 0.00) with ICU admission. Additional subgroup analysis demonstrated a higher mortality risk in the elderly (>60‐65 years) (OR 4.26; 95% CI, 2.14‐8.49). There was no correlation in respect to sex or time since transplant. In summary, LTx recipients with COVID‐19 had a high prevalence of dyspnea and gastrointestinal symptoms. In‐hospital mortality was comparable to non‐transplant populations with similar comorbidities but appeared to be less than what is reported elsewhere for cirrhotic patients (26%‐40%). Importantly, the observed high case fatality in the elderly could be due to age‐associated comorbidities.
The relationship between marijuana use and psychosocial variables in living kidney donor candidates
Authors: Loiselle Marci M. , Gulin Shaina , Rose Terra , Burker Eileen , Bolger Lauren , Smith Patrick 
Published: February 2021

AbstractBackgroundWe investigate whether marijuana use in living kidney donor candidates is associated with psychosocial risk factors that place donors at higher risk for adverse outcomes and the unique associations between marijuana use and donor candidacy.MethodsMedical records of 757 living kidney donor candidates were reviewed. Patients were grouped into marijuana users/abstainers; demographic, psychiatric, and substance use variables were compared. Multivariate logistic regression assessed the independent association of marijuana use on committee approval for donation.ResultsMarijuana use was associated with lack of health insurance, legal history, lower education level, active and history of substance use disorder, active psychiatric disorder, history of multiple psychiatric diagnoses, and history of suicidality. Marijuana users were also more likely to be young, male, unmarried, and less likely to be approved for donation by the multidisciplinary selection committee. This latter association persisted in multivariate models.ConclusionsThis is the first study to show that marijuana use is associated with psychosocial factors that could impact behavioral adherence following kidney donation, while reducing chances of committee approval for kidney donation. Special attention to potential overlay between psychosocial risk factors and marijuana use should be considered when evaluating kidney donors, particularly in context of increasingly legal use.
Non‐medical prescription opioid use and in‐hospital illicit drug use among people who use drugs
Authors: Parmar Gurjit S. , Hayashi Kanna , Nolan Seonaid , Milloy M.‐J. , DeBeck Kora , Shulha Hennady P. , Kerr Thomas , Ti Lianping 
Published: February 2021

AbstractIntroductionIllicit drug use while admitted to hospital is common amongst people who use drugs. Furthermore, non‐medical prescription opioid use (NMPOU) is increasingly being used by this population. This study was undertaken to investigate the relationship between NMPOU and having ever reported using illicit drugs in the hospital.MethodsThis study was a cross‐sectional study design based on data derived from participants enrolled in three Canadian prospective cohort studies between December 2011 and November 2016. Using bivariable and multivariable logistic regression analyses, we examined the relationship between NMPOU and having ever reported illicit drug use in the hospital.ResultsAmong the 1865 participants (951 male, 471 female) enrolled in the studies, 1422 (76.25%) met the inclusion criteria of having ever been hospitalised. Of these, 436 (30.7%) had used illicit drugs while in the hospital. In multivariable analyses, after adjusting for various confounders, we found a positive relationship between the percentage of reporting at least daily NMPOU in the past 6 months during the cohort study period and illicit drug use in the hospital (adjusted odds ratio 3.42; 95% confidence interval 1.46–8.02).Discussion and ConclusionsAmong our sample, more persistent NMPOU was positively associated with having reported in‐hospital illicit drug use. Our findings point to the need for better identification and management of opioid use disorder in acute care settings to reduce in‐hospital illicit drug use, and to offer evidence‐based medical treatments to achieve the most optimal outcomes for patients.
Prenatal valproate exposure and adverse neurodevelopmental outcomes: Does sex matter?
Authors: Honybun Eliza , Thwaites Rebecca , Malpas Charles B. , Rayner Genevieve , Anderson Alison , Graham Janet , Hitchcock Alison , O’Brien Terence J. , Vajda Frank J. E. , Perucca Piero 
Published: February 2021

AbstractObjectivePrenatal exposure to the antiepileptic drug (AED) valproic acid (VPA) is associated with an increased risk of impaired postnatal neurodevelopment, including autism spectrum disorder (ASD) and attention‐deficit/hyperactivity disorder (ADHD). We aimed to evaluate the influence of sex and drug dosage on the association between prenatal VPA exposure and postnatal behavioral outcomes.MethodsThe Australian Pregnancy Register of AEDs was interrogated to identify children aged 4–11 years prenatally exposed to AEDs. Parents reported on their child's behavior using the Autism Spectrum Quotient–Children's Version and the National Institute for Children's Health Quality Vanderbilt Assessment Scale for ADHD. General linear mixed‐effects models were used to investigate the relationship between clinicodemographic variables and psychometric scores.ResultsA total of 121 children were studied: 54 prenatally exposed to VPA (28 males, 26 females; mean dose ± SD: 644 ± 310 mg/day) and 67 exposed to other AEDs. There was a main effect of sex showing higher ASD scores in males compared to females (p = .006). An interaction between sex and VPA exposure revealed that males had higher ASD symptoms among children exposed to AEDs other than VPA (p = .01); however, this typical sex dynamic was not evident in VPA‐exposed children. There was no evidence of any dose–response relationship between VPA exposure and ASD symptoms. Males had higher ADHD scores compared to females, but there was no evidence for a link between ADHD symptoms and VPA exposure.SignificancePrenatal VPA exposure seems to negate the usual male sex‐related predominance in the incidence of ASD. These initial findings deepen the concept of VPA as a "behavioral teratogen" by indicating that its effect might be influenced by sex, with females appearing particularly sensitive to the effects of VPA. No association between VPA doses and adverse postnatal behavioral outcomes was detected, possibly related to the low VPA doses used in this study.
Investigating the pathogenesis of high‐serum gamma‐glutamyl transferase activity in Thoroughbred racehorses: A series of case‐control studies
Authors: Mann Sabine , Ramsay Joshua D. , Wakshlag Joseph J. , Stokol Tracy , Reed Steven , Divers Thomas J. 
Published: February 2021

AbstractBackgroundHigh‐serum γ‐Glutamyl Transferase (GGT) activity has been associated with and thought to be a marker of maladaptation to training and possibly poor performance in racehorses, but the cause is unknown.ObjectivesTo investigate possible metabolic and infectious causes for the high GGT syndrome.Study designPilot case‐control study and nested case‐control study.MethodsThe case‐control study in 2017 included 16 horses (8 cases and 8 controls with median [range] serum GGT 82 [74‐148] and 22 [19‐28] IU/L, respectively) from the same stable. In 2018, similar testing was performed in a nested case‐control study that identified 27 case (serum GGT 50 ≥ IU/L)‐control pairs from three stables for further testing. Serum liver chemistries, selenium measurements, viral PCR and metabolomics were performed.ResultsNo differences were found in frequency of detection of viral RNA/DNA or copy numbers for equine hepacivirus (EqHV) and parvovirus‐hepatitis (EqPV‐H) between cases and controls. Mild increases in hepatocellular injury and cholestatic markers in case vs control horses suggested a degree of liver disease in a subset of cases. Metabolomic and individual bile acid testing showed differences in cases compared with controls, including increased abundance of pyroglutamic acid and taurine‐conjugated bile acids, and reduced abundance of Vitamin B6. Selenium concentrations, although within or above the reference intervals, were also lower in case horses in both studies.Main limitationsObservational study design did not allow us to make causal inferences.ConclusionsWe conclude that high GGT syndrome is likely a complex metabolic disorder and that viral hepatitis was not identified as a cause for this syndrome in this cohort of racehorses. Our results support a contribution of oxidative stress and cholestasis in its pathophysiology.
Riparian forests can mitigate warming and ecological degradation of agricultural headwater streams
Authors: Turunen Jarno , Elbrecht Vasco , Steinke Dirk , Aroviita Jukka 
Published: February 2021

Abstract

Riparian forests are commonly advocated as a key management option to mitigate the effects of agriculture on headwater stream biodiversity and ecosystem functions. However, the benefits of riparian forests might be reduced by uninterrupted catchment‐scale pollution.

We studied the effects of riparian land use on multiple ecological endpoints in headwater streams in an agricultural landscape. We studied stream habitat characteristics, water temperature and algal accrual, and macrophyte, benthic macroinvertebrate and fish communities in 11 paired forested and open agricultural headwater stream reaches that differed in their extent of riparian forest cover but had similar water quality.

Hydromorphological habitat quality was higher in forested reaches than in open reaches. Riparian forest had a strong effect on the summer water temperature regime, with maximum and mean water temperatures and temperature variation in forested reaches substantially lower than in open reaches.

Macrophyte communities differed between forested and open reaches. The mean abundance of bryophytes was higher in forested reaches but the difference to open reaches was only marginally significant, whereas graminoids were significantly more abundant in open reaches. Within‐stream dissimilarity of benthic macroinvertebrate community structure was significantly related to the difference in riparian land use between reach pairs. The relative DNA sequence abundance of pollution‐sensitive Ephemeroptera, Plecoptera, and Trichoptera species tended to be higher in forested reaches than in open reaches. Finally, fish densities were not significantly different between forested and open reaches, although densities were higher in forested reaches.

This unequivocal evidence for the ecological benefits of forested riparian reaches in agricultural headwater streams suggests that riparian forest can partly mitigate the adverse impacts of agricultural diffuse pollution on biota. The strong effect of forests on stream water temperature suggest that riparian forest could also mitigate harmful effects on headwater stream biodiversity and ecosystem functions of the predicted more frequent high summer temperatures.
Functional and joint evaluation in a prospective cohort of patients with severe haemophilia
Authors: Ribeiro Alexandre Jorge Teixeira , Amorim Fábio Ferreira , Soares Beatriz Mac Dowell , Santana Levy Aniceto , Imoto Aline Mizusaki 
Published: February 2021

AbstractIntroductionArthropathy is the main morbidity of haemophilia. Periodic joint health assessment enables a better understanding of the limitations of these patients.ObjectiveTo evaluate the functional and joint performance in patients with haemophilia at one‐year follow‐up, as well as its association with prophylactic treatment and attendance at scheduled consultations at a haemophilia treatment centre.MethodsThis prospective cohort study included patients with severe haemophilia aged 7 years or more and treated at Fundação Hemocentro de Brasília, Brazil, from January 2014 to December 2018. The Hemophilia Joint Health Score and Functional Independence Score in Hemophilia were assessed at the first consultation and after a one‐year follow‐up.ResultsThe study included 69 patients. The mean age at study recruitment was 22.5 ± 4.5 years, 62.3% of patients aged 18 years or older, and 29 patients were receiving primary prophylaxis (38.0%). There was a positive correlation between HJHS and age and a negative correlation between FISH and age. The worsening HJHS was associated with non‐primary prophylaxis and non‐attendance at scheduled multidisciplinary consultations. The worsening FISH was associated with non‐primary prophylaxis. The correlation between FISH and treatment adherence was significant for the delta.ConclusionThe older the patient with haemophilia, the higher the probability of a worsening of the HJHS. In the presence of more arthropathies, the older the patient, the worse the FISH. Patients receiving primary prophylaxis show better results in the HJHS and FISH when compared to patients receiving secondary prophylaxis and/or on‐demand treatment.
Trends in coagulation factor replacement therapy and medical costs in patients with haemophilia in Taiwan: A population‐based, 15‐year analysis
Authors: Hsieh Miyuki Hsing‐Chun , Chiou Shyh‐Shin , Liao Tzu‐Chi , Kao Yang Yea‐Huei , Lai Edward Chia‐Cheng 
Published: February 2021

AbstractIntroductionTaiwan's National Health Insurance Program approved reimbursement of prophylactic coagulation factor replacement therapy (CFRT) for patients with haemophilia (PWH) in 2014.AimTo examine 15‐year trends and the impact of reimbursement for prophylactic CFRT on its utilization and related medical costs for PWH.MethodsWe analysed Taiwan's National Health Insurance Database from 2003 to 2017. We included patients with haemophilia A (PWHA) or B (PWHB) receiving coagulating factor. Female patients were excluded because of small sample size. We analysed annual consumption of CFRT units and medical costs. High proportion of days covered (PDC) with CFRT served as an indicator for prophylactic treatment since it reflects routine use of CFRT. We applied interrupted time series analysis (ITSA) to evaluate the impact of reimbursement for prophylactic CFRT on usage patterns and medical costs.ResultsWe included 896 male PWHA and 181 male PWHB, with 38.1% and 37.0% aged under 18 years, respectively. By ITSA, we found the trends in coagulation factor consumption and PDC significantly increased after reimbursement for prophylactic CFRT in both PWHA and PWHB (p values for trend change <0.05). The overall medical costs per patient increased with increasing consumption of coagulation factor; however, ITSA revealed non‐CFRT cost decreased after reimbursement of prophylactic CFRT for both PWHA and PWHB (p values <.05).ConclusionReimbursement for prophylactic CFRT facilitated growth in rates of prophylactic CFRT and increased related costs, but curbed rising non‐CFRT costs. These findings provide strong grounds for future cost‐effectiveness studies to leverage prophylactic CFRT for its therapeutic benefits.
Incidence of von Willebrand disease in Denmark, 1995‐2016: A cohort study
Authors: Laursen Anne Sofie Dam , Rasmussen Thomas Bøjer , Chiu Gretchen R. , Brouwer Emily S. , Poulsen Lone Hvitfeldt , Mikkelsen Ellen Margrethe 
Published: February 2021

AbstractIntroductionInformation about temporal development of von Willebrand disease (VWD) incidence at a population level is scarce. To our knowledge, no study has described the incidence of VWD at a population level.AimTo estimate overall and annual incidence rates of hospital diagnosed VWD in Denmark between 1995 and 2016 as well as the frequency of hospital treated bleeding episodes before and after VWD diagnosis.MethodsA registry‐based cohort study that included all Danish patients with a first diagnosis of VWD in Denmark, identified in the Danish National Patient Registry through 1995‐2016.ResultsWe identified 1,035 patients with a diagnosis of VWD. The overall incidence rate of VWD in 1995‐2016 was 8.6 (95% CI: 8.1‐9.2). The annual age‐standardized incidence rate per 100 000 person‐years varied between 4.1 (95% CI: 2.4‐5.9) in 1998 and 16.7 (95% CI: 13.1‐20.3) in 2005. A prominent peak in rates appeared from 2002 to 2008. One and five years before VWD diagnosis, 6% and 11.5% of the patients had at least one hospital treated bleeding episode. One and five years after diagnosis, the corresponding percentages were 7.9% and 13.4%.ConclusionThese results are the first population‐based estimates of VWD incidence. The incidence may be underestimated because asymptomatic individuals may not be diagnosed. The observed peak in incidence from 2002‐2008 may be explained by increased medical attention, leading to more patients being diagnosed, rather than an actual increase in VWD incidence. However, overall, we observed no systematic changes in VWD incidence over the study period.
Real‐world efficacy, tolerability, and safety of ubrogepant
Authors: Chiang Chia‐Chun , Arca Karissa N. , Dunn Rachel B. , Girardo Marlene E. , Quillen Jaxon K. , Dodick David W. , Starling Amaal J. 
Published: February 2021

AbstractObjectiveTo assess the real‐world efficacy, tolerability, and safety of ubrogepant in a tertiary headache center.BackgroundThe efficacy and safety of ubrogepant for the acute treatment of migraine were established in phase 3 randomized controlled trials. However, there is no real‐world data of patient experience with ubrogepant in a population in which the majority of patients have chronic migraine, multiple prior unsuccessful treatments, complex medical comorbidities, and concurrent use of other migraine‐specific medications.MethodThis was a post‐market cohort study conducted at Mayo Clinic Arizona. All patients prescribed ubrogepant were tracked and contacted 1–3 months after the prescription to answer a list of standardized questions. Demographic information and additional headache history were obtained from chart review.ResultsWe obtained eligible questionnaire responses from 106 patients. Chronic migraine accounted for 92/106 (86.8%) of the population. Complete headache freedom (from mild/moderate/severe to no pain) and headache relief (from moderate/severe to mild/no pain or mild to no pain) for ≥75% of all treated attacks at 2 hours after taking ubrogepant were achieved in 20/105 (19.0%) and 50/105 (47.6%) patients, respectively. A total of 33/106 (31.1%) patients reported being “very satisfied” with ubrogepant. Adverse events were reported in 42/106 (39.6%) patients, including fatigue in 29/106 (27.4%), dry mouth in 8/106 (7.5%), nausea/vomiting in 7/106 (6.6%), constipation in 5/106 (4.7%), dizziness in 3/106 (2.8%), and other adverse events in 7/106 (6.6%). Predictive factors for being a “good responder” to ubrogepant, defined as headache relief for ≥75% of all treated attacks at 2 hours after taking ubrogepant, included migraine with aura, episodic migraine, <5 prior unsuccessful preventive or acute treatment trials. Additionally, prior treatment responses to a CGRP monoclonal antibody and onabotulinumtoxinA injections are predictive of treatment responses and patient satisfaction to ubrogepant. For the 62/106 (58.5%) patients concurrently using a CGRP monoclonal antibody, there was no difference in the “good responder” rate or adverse event rate compared to those who were not on a CGRP monoclonal antibody, though the rate of moderate, as opposed to mild adverse events was higher, 11/62 (47.8%) versus 3/44 (17.6%),p = 0.048. Additionally, 16 patients had a history of significant cardiovascular or cerebrovascular diseases. No severe adverse events were reported in any patient.ConclusionOur study confirms and extends the efficacy profile and tolerability of ubrogepant in a real‐world tertiary headache clinic and identifies factors that may predict efficacy. Adverse event rates were higher than reported in clinical trials. Further studies are needed to confirm these findings and to evaluate the long‐term efficacy and safety of ubrogepant.