bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary exposures in childhood and adulthood and cardiometabolic outcomes: a systematic scoping review
Authors: Lukomskyj Natalya , Allman‐Farinelli Margaret , Shi Yumeng , Rangan Anna 
Published: January 2021

AbstractAssociations between diet and cardiometabolic outcomes are often based on a single measurement of diet in adulthood. Dietary exposures in childhood are thought to influence cardiometabolic disease development and individuals’ diets can change over time, therefore dietary exposure in childhood and over long periods are both important to consider. This scoping review aimed to identify and characterise the literature on associations between diet measured in both childhood and adulthood and cardiometabolic outcomes. Seven databases were searched; eligible evidence sources were original analyses published as a journal article in English. Exposures included measures of dietary intake, diet quality and eating behaviours measured in both childhood and adulthood with at least five years between first and last measurements. Cardiometabolic outcomes included measures of anthropometry, biochemistry, vascular structure/function and disease states/scores. We identified 37 eligible articles from nine cohort studies. Dietary exposures were measured between two and eight times and most often assessed by food frequency questionnaire or diet history. The dietary exposures most frequently examined were protein, fat, carbohydrate, fruit, vegetables, sugar‐sweetened beverages and breakfast. Cardiometabolic outcomes were predominantly based on risk markers. Authors utilised a variety of analytical approaches to transform and analyse repeated measures of diet, providing insights relevant to different lifespan nutrition concepts. The literature on associations between diet in childhood and adulthood and cardiometabolic outcomes is limited, but such studies have great potential to extend our knowledge in ways only possible with repeated measures of diet over time. Further research is needed to develop the evidence base for diet‐disease relationships from a life course perspective, accounting for diet in both childhood and adulthood.
Registered dietitians' perceptions and use of the plant‐based recommendations in the 2019 Canada's Food Guide
Authors: Asher K. E. , Doucet S. , Luke A. 
Published: January 2021

AbstractBackgroundIn 2019, Canada's Food Guide underwent its first transformation in over a decade. The change received considerable attention given the increased focus on plant‐based proteins and the decision to eliminate the milk and alternatives food group. Yet little is known about health professionals' views of these updates. In response, the present study examined Canadian dietitians' attitudes and behaviours towards the guide's expanded plant‐based recommendations.MethodsA pan‐Canadian cross‐sectional online survey was administered from January to March 2020 to currently practicing registered dietitians. The study was pre‐registered, piloted and received ethical approval. Descriptive and inferential statistics were performed and open‐text responses underwent thematic analysis.ResultsIn total, 411 dietitians from 10 provinces and various work settings participated. Most dietitians (82.8%) consider the food guide's recommendation to choose protein foods that come from plants more often is evidence‐based. Compared to its predecessor, dietitians encourage their patients/clients to choose protein foods that come from plants (p < 0.001) and non‐dairy sources of calcium (p < 0.001) significantly more frequently under the new guide. A slight majority of dietitians (57.7%) agree with the decision to omit the standalone milk and alternatives group in favour of bringing dairy into the protein category.ConclusionsCanadian dietitians generally look favourably upon the new plant‐based recommendations and have adjusted their nutrition counselling in response. The findings are considered to be the first to characterise how dietitians view changes to the plant‐based content of one of the most recognisable diet‐related educational tools in Canada.
Generalized essential telangiectasia treated with PDL
Authors: Powell Emily , Markus Ramsey , Malone Cedar H. 
Published: January 2021

AbstractGeneralized essential telangiectasia (GET) is a rare, clinically benign condition but a source of cosmetic concern for affected patients. There is a dearth of publications and known treatment options for GET. This case report reviews the clinical course of a 54‐year‐old woman who presented with a long‐standing history of telangiectatic patches on her dorsal feet and ankles with progressive spread to the lower extremities consistent with GET. The patient proceeded with two pulsed dye laser (PDL) treatments and had complete resolution of her skin findings maintained at her 1.5‐year follow‐up appointment.
An observational study of hypoactive delirium in the post‐anesthesia recovery unit of a pediatric hospital
Authors: Lee‐Archer Paul F. , von Ungern‐Sternberg Britta S. , Reade Michael C. , Law K.C. , Long Deborah 
Published: January 2021

AbstractBackgroundHypoactive delirium is present when an awake child is unaware of his or her surroundings, is unable to focus attention, and appears quiet and withdrawn. This condition has been well‐described in the intensive care setting but has not been extensively studied in the immediate post‐anesthetic period.AimTo determine if hypoactive emergence delirium occurs in the recovery unit of a pediatric hospital, and if so, what proportion of emergence delirium is hypoactive in nature.MethodsWe conducted an observational study using the Cornell Assessment of Pediatric Delirium in a cohort of 4424 children recovered at a tertiary pediatric hospital. The incidence of emergence delirium detected using the Pediatric Anesthetic Emergence Delirium (PAED) scale was also recorded for comparison.ResultsThere were 74 cases of emergence delirium detected during the study period using the Cornell Assessment of Pediatric Delirium (1.7%). Only 57 cases were detected using the Pediatric Anesthetic Emergence Delirium scale. The additional 17 cases detected using the Cornell Assessment of Pediatric Dlirium represent cases of hypoactive delirium. In this cohort of pediatric patients, 23% of all cases of emergence delirium were hypoactive in nature.ConclusionThe significance of hypoactive delirium in this population is unknown; however, previous studies have shown that emergence delirium can result in post‐operative behavior changes and may affect compliance with future episodes of care. However, hypoactive delirium is often missed without active screening. The prevalence detected in this study therefore suggests hypoactive delirium warrants further investigation.
Fontan‐associated plastic bronchitis waitlist and heart transplant outcomes: A PHTS analysis
Authors: Bearl David W. , Cantor Ryan , Koehl Devin , Gossett Jeffrey G. , Bock Matthew J. , Halnon Nancy , Glass Lauren , Exil Vernat , Musselwhite Courtney , Kirklin James K. , Godown Justin , Ravishankar Chitra 
Published: January 2021

AbstractPlastic bronchitis is a rare post‐Fontan complication with limited treatment options. Heart transplantation has evolved as a potential curative option, but outcomes have not been well‐defined. This study aims to assess contemporary waitlist and post‐transplant outcomes in patients with plastic bronchitis. All Fontan patients were identified in the PHTS database (2010 ‐ 2018). Waitlist and post‐transplant outcomes were compared between Fontan patients with and without plastic bronchitis. Competing outcomes and Kaplan‐Meier analyses were used to assess the impact of plastic bronchitis on waitlist and post‐transplant survival. A secondary analysis excluded those with PLE from the comparison cohort. Of 645 Fontan patients listed for heart transplant, 69 (11%) had plastic bronchitis. At listing, patients with plastic bronchitis were younger (8.9 vs 11.1 years, P = .02), but had few other differences in baseline characteristics. A fewer Fontan patients with plastic bronchitis were listed in the more recent era (46 [15.4%] in 2010‐2014 vs 23 [6.6%] in 2015‐2018, P < .01). Overall, there was no difference in waitlist (P = .30) or post‐transplant (P = .66) survival for Fontan patients with and without plastic bronchitis. The results were similar after excluding patients with PLE. Contrary to prior reports, this relatively large series showed that plastic bronchitis did not have a negative impact on survival to or after heart transplantation in Fontan patients. Our study also found a 50% reduction in listing in the current era, which may indicate evolution in management of Fontan patients.
Pediatric discard risk index for predicting pediatric liver allograft discard
Authors: Malik Tahir , Joshi Manasi , Godfrey Elizabeth , Galvan Thao , O’Mahony Christine A. , Cotton Ronald , Goss John , Rana Abbas 
Published: January 2021

AbstractBackgroundOf the 600 pediatric candidates added to the liver waiting list annually, 100 will remain waiting while over 100 liver allografts are discarded, often for subjective reasons.MethodsWe created a risk index to predict discard to better optimize donor supply. We used the UNOS database to retrospectively analyze 17 367 deceased donors (≤18 years old) through univariate and multivariate logistic regression models. Deceased donor clinical characteristics and laboratory values were independent variables with discard being the dependent variable in the analysis. Significant univariate factors (P‐value < .05) comprised the multivariate analysis. Significant variables from the multivariate analysis were incorporated into the pDSRI, producing a risk score for discard.ResultsFrom 17 potential factors, 11 were identified as significant predictors (P < .05) of pediatric liver allograft discard. The most significant risk factors were as follows: DCD; total bilirubin >10 mg/dL, and alanine transaminase (ALT) ≥500 IU/L. The pDSRI has a C‐statistic of 0.846 for the training set and 0.840 for the validation set.ConclusionThe pDSRI uses 11 significant risk factors, including elevated liver function tests, donor demographics, and donor risk/type to accurately predict risk of pediatric liver allograft discard and serve as a tool that may maximize donor yield.
Ultra‐high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study
Authors: Izzetti Rossana , Nisi Marco , Aringhieri Giacomo , Vitali Saverio , Oranges Teresa , Romanelli Marco , Caramella Davide , Graziani Filippo , Gabriele Mario 
Published: January 2021

AbstractObjectivesIntraoral ultra‐high frequency ultrasound (UHFUS) is an emerging technique in oral medicine, due to its possibility to provide submillimeter resolution imaging of superficial mucosal structures. In this study, the potential role of UHFUS in the diagnosis of oral pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) is assessed.Materials and MethodsConsecutive patients with suspected oral PV or MMP were enrolled. All patients underwent clinical examination, laboratory tests, intraoral UHFUS scan, and biopsy. Histology and direct immunofluorescence were set as benchmark for diagnosis confirmation. The sensitivity and specificity of UHFUS compared to histology were assessed. Mann‐Whitney test was performed to evaluate the presence of differences in the echogenicity of PV and MMP. P‐value was set at P < 0.05.ResultsTwenty‐five patients were included. Thirteen patients were diagnosed with PV, and twelve with MMP. The UHFUS features of PV and MMP lesions were described. Image analysis showed statistically significant differences between the echogenicity of PV and MMP lesions (P < 0.05). Good concordance between UHFUS and histology was found. UHFUS showed 75% sensitivity in the diagnosis of PV and 66.7% in the diagnosis of MMP.ConclusionsUHFUS appears a valuable tool in the diagnosis of PV and MMP. Although histology and immunofluorescence remain the gold standard, UHFUS role in the diagnostic algorithm of PV and MMP seems promising as a chair‐side tool consistently enhancing clinical evaluation of oral bullous lesions.
Gait Assessment in College Athletes: Do Concussion History, Symptoms, Gender, and Type of Sport Matter?
Authors: Messerschmidt Emily L. , Hall Eric E. , Ketcham Caroline J. , Patel Kirtida , Vallabhajosula Srikant 
Published: January 2021

Context:Though previous research has focused on examining the effects of concussion history using a dual-task paradigm, the influence of factors like symptoms (unrelated to concussion), gender, and type of sport on gait in college athletes is unknown.Objective:To examine the effect of concussion history, symptoms, gender, and type of sport (noncontact/limited contact/contact) individually on gait among college athletes.Design:Exploratory cross-sectional study.Setting:Laboratory.Participants:In total, 98 varsity athletes (age, 18.3 [1.0] y; height, 1.79 [0.11] m; mass, 77.5 [19.2] kg; 27 with concussion history, 58 reported at least one symptom, 44 females; 8 played noncontact sports and 71 played contact sports) walked under single- and dual-task (walking while counting backward by 7) conditions.Interventions:Not applicable.Main Outcome Measures:Dual-task cost (DTC; % difference between single task and dual task) of gait speed, cadence, step length and width, percentage of swing and double-support phases, symptom score, and total symptom severity score. Independent samplesttests and 1-way analysis of variance were conducted (αvalue = .05).Results:Self-reported concussion history resulted in no significant differences (P > .05). Those who reported symptoms at testing time showed significantly greater DTC of step length (mean difference [MD], 2.7%; 95% confidence interval [CI], 0.3% to 5.1%;P = .012), % of swing phase (MD, 1.0%; 95% CI, −0.2 to 2.1%;P = .042), and % of double-support phase (MD, 3.9%; 95% CI, 0.2% to 7.8%;P = .019). Females demonstrated significantly higher DTC of gait speed (MD, 5.3%; 95% CI, 1.3% to 9.3%;P = .005), cadence (MD, 4.0%; 95% CI, 1.4% to 6.5%;P = .002), % of swing phase (MD, 1.2%; 95% CI, 0.1% to 2.3%;P = .019), and % of double-support phase (MD, 4.1%; 95% CI, 0.4% to 7.9%;P = .018). Noncontact sports athletes had significantly greater step width DTC than contact sports athletes (MD, 14.2%; 95% CI, 0.9% to 27.6%;P = .032).Conclusions:Reporting symptoms at testing time may influence gait under dual-task conditions. Additionally, female athletes showed more gait changes during a dual task. Sports medicine professionals should be aware that these variables, while unrelated to injury, may affect an athlete’s gait upon analysis.
Network graph representation of COVID-19 scientific publications to aid knowledge discovery
Authors: Cernile George , Heritage Trevor , Sebire Neil J , Gordon Ben , Schwering Taralyn , Kazemlou Shana , Borecki Yulia 
Published: January 2021

IntroductionNumerous scientific journal articles related to COVID-19 have been rapidly published, making navigation and understanding of relationships difficult.MethodsA graph network was constructed from the publicly available COVID-19 Open Research Dataset (CORD-19) of COVID-19-related publications using an engine leveraging medical knowledge bases to identify discrete medical concepts and an open-source tool (Gephi) to visualise the network.ResultsThe network shows connections between diseases, medications and procedures identified from the title and abstract of 195 958 COVID-19-related publications (CORD-19 Dataset). Connections between terms with few publications, those unconnected to the main network and those irrelevant were not displayed. Nodes were coloured by knowledge base and the size of the node related to the number of publications containing the term. The data set and visualisations were made publicly accessible via a webtool.ConclusionKnowledge management approaches (text mining and graph networks) can effectively allow rapid navigation and exploration of entity inter-relationships to improve understanding of diseases such as COVID-19.
Comparison of the intraocular pressure following an intravitreal triamcinolone acetonide injection for diabetic macula oedema in vitrectomised and non-vitrectomised eyes
Authors: Orii Yusuke , Gozawa Makoto , Takamura Yoshihiro , Takeuchi Yuko , Morioka Masakazu , Yamada Yutaka , Matsumura Takehiro , Sugimoto Masahiko , Inatani Masaru 
Published: January 2021

PurposeTo compare the intraocular pressure (IOP) after an intravitreal triamcinolone acetonide (IVTA) between vitrectomised and non-vitrectomised eyes in patients with diabetes and diabetic macular oedema (DME).DesignRetrospective comparative studyMethodsMedical records of 157 patients (157 eyes) with type 2 diabetes who received IVTA for DME were reviewed, and the best-corrected visual acuity, IOP and optical central retinal thickness (CRT) were compared preoperatively, at 1, 4, 12 and 24 weeks after IVTA between the vitrectomised and non-vitrectomised groups.ResultsIOP significantly increased at 1 (p<0.0001), 4 (p<0.0001), 8 (p<0.0001), 12 (p=0.0019), 16 (p=0.0006) and 20 weeks (p=0.0191) in the non-vitrectomised group, whereas a significant increase was only observed at 1 (p=0.0003) and 4 weeks (p=0.0006) in the vitrectomised group. ΔIOP, IOP changes from baseline, in the non-vitrectomised group was significantly higher than that in the vitrectomised group at 4 (p=0.0014), 8 (p=0.0081), 12 (p=0.0032) and 16 weeks (p=0.0038). No significant difference was observed in logMAR and CRT at any time point after IVTA between the two groups.ConclusionsAfter an initial IVTA, increased IOP and ΔIOP from the baseline IOP were significantly more frequently observed in the non-vitrectomised than that in the vitrectomised group. IVTA is a safer and more effective treatment option for DME in vitrectomised than that in non-vitrectomised eyes.
Tyrosine kinase inhibitors in chronic myeloid leukaemia and emergent cardiovascular disease
Authors: Leong Darryl , Aghel Nazanin , Hillis Christopher , Siegal Deborah , Karampatos Sarah , Rangarajan Sumathy , Pond Gregory , Seow Hsien 
Published: January 2021

Objectives(1) Describe how the risk of major adverse cardiovascular events (MACE) in individuals with chronic myeloid leukaemia (CML) has evolved; (2) evaluate the risk of MACE associated with the prescription of different CML tyrosine kinase inhibitors (TKI).MethodsA population-based retrospective study including all patients (n=4238) diagnosed with CML in Ontario, Canada between 1986 and 2017 and and age-matched and sex-matched individuals who received healthcare but who did not have CML (controls: n=42 380). The cohort was divided into those entering before 2001 vs from 2001 onwards (when TKIs were introduced). We developed competing risks models to compare time-to-event in CML cases versus controls. We adjusted for baseline comorbidities and present subdistribution HRs and 95% CIs. The relationship between TKI use and MACE was assessed by logistic regression.ResultsBefore 2001 and from 2001 on, patients with CML had a higher crude incidence of MACE than patients without CML (19.8 vs 15.3 and 20.3 vs 12.6 per 1000 person-years, respectively). After adjustment for cardiovascular risk factors, patients with CML had a lower subdistribution hazard for MACE (0.59, 95% CI 0.46 to 0.76) before 2001; but from 2001, the adjusted subdistribution HR for MACE (1.27, 95% CI 0.96 to 1.43) was similar to age-matched and sex-matched patients. The incidence (9.3 vs 13.8 per 1000 person-years) and subdistribution hazard for cardiovascular death (0.43, 95% CI 0.36 to 0.52) were lower in patients with CML than controls before 2001. From 2001 on, the incidence (6.3 vs 5.4 per 1000 person-years) and subdistribution hazard for cardiovascular death (0.99, 95% CI 0.84 to 1.18) were similar to age-matched and sex-matched patients without CML with a higher risk of cerebrovascular events (8.6 vs 5.6 per 1000 person-years; 1.35, 95% CI 1.00 to 1.83) and peripheral arterial events (6.9 vs 3.0 per 1000 person-years; 1.66 95% CI, 1.15 to 2.39) in patients with CML than patients without CML. Compared with imatinib, there was no difference in the risk of MACE among those prescribed dasatinib (OR 0.67, 95% CI 0.41 to 1.10) or nilotinib (OR 1.22, 95% CI 0.70 to 1.97).ConclusionsIn a contemporary CML population, the risk of MACE and cardiovascular death is at least as high as among age-matched and sex-matched patients without CML and may be higher for cerebrovascular and peripheral arterial events. No difference in the risk of MACE between imatinib, dasatinib and nilotinib was observed.
IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe
Authors: Steeds Richard Paul , Messika-Zeitoun David , Thambyrajah Jeetendra , Serra Antonio , Schulz Eberhard , Maly Jiri , Aiello Marco , Rudolph Tanja K , Lloyd Guy , Bortone Alessandro Santo , Clerici Alberto , Delle-Karth Georg , Rieber Johannes , Indolfi Ciro , Mancone Massimo , Belle Loic , Lauten Alexander , Arnold Martin , Bouma Berto J , Lutz Matthias , Deutsch Cornelia , Kurucova Jana , Thoenes Martin , Bramlage Peter , Frey Norbert 
Published: January 2021

AimsThere is an increasing awareness of gender-related differences in patients with severe aortic stenosis and their outcomes after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI).MethodsData from the IMPULSE registry were analysed. Patients with severe aortic stenosis (AS) were enrolled between March 2015 and April 2017 and stratified by gender. A subgroup analysis was performed to assess the impact of age.ResultsOverall, 2171 patients were enrolled, and 48.0% were female. Women were characterised by a higher rate of renal impairment (31.7 vs 23.3%; p<0.001), were at higher surgical risk (EuroSCORE II: 4.5 vs 3.6%; p=0.001) and more often in a critical preoperative state (7.0vs 4.2%; p=0.003). Men had an increased rate of previous cardiac surgery (9.4 vs 4.7%; p<0.001) and a reduced left ventricular ejection fraction (4.9 vs 1.3%; p<0.001). Concomitant mitral and tricuspid valve disease was substantially more common among women. Symptoms were highly prevalent in both women and men (83.6 vs 77.3%; p<0.001). AVR was planned in 1379 cases. Women were more frequently scheduled to undergo TAVI (49.3 vs 41.0%; p<0.001) and less frequently for SAVR (20.3 vs 27.5%; p<0.001).ConclusionsThe present data show that female patients with severe AS have a distinct patient profile and are managed in a different way to males. Gender-based differences in the management of patients with severe AS need to be taken into account more systematically to improve outcomes, especially for women.