bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Number of Intravenous Antipseudomonal Antibiotics and Clinical Outcomes of Pediatric Cystic Fibrosis Pulmonary Exacerbations
Authors: Cogen Jonathan D , Faino Anna V , Onchiri Frankline , Hoffman Lucas R , Kronman Matthew P , Nichols David P , Rosenfeld Margaret , Gibson Ronald L 
Published: June 2021

Abstract

Background
Pulmonary exacerbations (PEx) in people with cystic fibrosis (PwCF) are associated with significant morbidity. While standard PEx treatment for PwCF with Pseudomonas aeruginosa infection includes two IV antipseudomonal antibiotics, little evidence exists to recommend this approach. This study aimed to compare clinical outcomes of single versus double antipseudomonal antibiotic use for PEx treatment.

Methods
Retrospective cohort study using the linked CF Foundation Patient Registry-Pediatric Health Information System dataset. PwCF were included if hospitalized between 2007 and 2018 and 6–21 years of age. Regression modeling accounting for repeated measures was used to compare lung function outcomes between single versus double IV antipseudomonal antibiotic regimens using propensity-score weighting to adjust for relevant confounding factors.

Results
Among 10,660 PwCF in the dataset, we analyzed 2,578 PEx from 1,080 PwCF, of which 455 and 2,123 PEx were treated with 1 versus 2 IV antipseudomonal antibiotics, respectively. We identified no significant differences between PEx treated with 1 versus 2 IV antipseudomonal antibiotics either in change between pre- and post-PEx percent predicted forced expiratory volume in one second (ppFEV1) (–0.84%, [95% CI –2.25, 0.56]; P = 0.24), odds of returning to ≥90% of baseline ppFEV1 within 3 months following PEx (Odds Ratio 0.83, [95% CI 0.61, 1.13]; P = 0.24) or time to next PEx requiring IV antibiotics (Hazard Ratio 1.04, [95% CI 0.87, 1.24]; P = 0.69).

Conclusions
Use of 2 IV antipseudomonal antibiotics for PEx treatment in young PwCF was not associated with greater improvements in measured respiratory and clinical outcomes compared to treatment with 1 IV antipseudomonal antibiotic.
Male Sex Is Associated With Worse Microbiological and Clinical Outcomes Following Tuberculosis Treatment: A Retrospective Cohort Study, a Systematic Review of the Literature, and Meta-analysis
Authors: Chidambaram Vignesh , Tun Nyan Lynn , Majella Marie Gilbert , Ruelas Castillo Jennie , Ayeh Samuel K , Kumar Amudha , Neupane Pranita , Sivakumar Ranjith Kumar , Win Ei Phyo , Abbey Enoch J , Wang Siqing , Zimmerman Alyssa , Blanck Jaime , Gupte Akshay , Wang Jann-Yuan , Karakousis Petros C 
Published: June 2021

Abstract

Background
Although the incidence of tuberculosis is higher in men than in women, the relationship of sex with tuberculosis treatment outcomes has not been adequately studied.

Methods
We performed a retrospective cohort study and a systematic review and meta-analysis of observational studies during the last 10 years to assess sex differences in clinical and microbiological outcomes in tuberculosis.

Results
In our cohort of 2894 Taiwanese patients with drug-susceptible pulmonary tuberculosis (1975 male and 919 female), male patients had higher adjusted hazards of 9-month mortality due to all causes (hazard ratio, 1.43 [95% confidence interval (CI), 1.03–1.98]) and infections (1.70 [1.09–2.64]) and higher adjusted odds of 2-month sputum culture positivity (odds ratio [OR], 1.56 [95% CI, 1.05–2.33]) compared with female patients. Smear positivity at 2 months did not differ significantly (OR, 1.27 [95% CI, .71–2.27]) between the sexes. Among 7896 articles retrieved, 398 were included in our systematic review describing a total of 3 957 216 patients. The odds of all-cause mortality were higher in men than in women in the pooled unadjusted (OR, 1.26 [95% CI, 1.19–1.34]) and adjusted (1.31 [1.18–1.45]) analyses. Men had higher pooled odds of sputum culture (OR, 1.44 [95% CI, 1.14–1.81]) and sputum smear (1.58 [1.41–1.77]) positivity, both at the end of the intensive phase and on completion of treatment.

Conclusions
Our retrospective cohort showed that male patients with tuberculosis have higher 9-month all-cause and infection-related mortality, with higher 2-month sputum culture positivity after adjustment for confounding factors. In our meta-analysis, male patients showed higher all-cause and tuberculosis-related mortality and higher sputum culture and smear positivity rates during and after tuberculosis treatment.
Prevalence and Impact of Obesity on Disease-specific Outcomes in a Population-based Cohort of Patients with Ulcerative Colitis
Authors: Johnson Amanda M , Harmsen W Scott , Aniwan Satimai , Tremaine William J , Abu Dayyeh Barham K , Loftus Edward V 
Published: June 2021

Abstract

Background and Aims
There remains a historical misconception that inflammatory bowel disease [IBD] patients are underweight. However, recent data suggest rates of obesity in IBD parallel to those of the general population. The impact obesity has on the natural history of IBD is unclear. We aimed to determine obesity rates at the time of IBD diagnosis in a population-based cohort of ulcerative colitis [UC] patients.

Methods
Chart review was performed on patients diagnosed with UC over 1970–2010. Data were collected on demographics, body mass index [BMI], disease characteristics, IBD-specific hospitalisations, intestinal resection, and corticosteroid use. The proportion of patients who were obese at the time of their diagnosis was evaluated over time, and survival free of IBD-related complications was assessed using Kaplan-Meier survival analysis.

Results
A total of 417 adults were diagnosed with UC over 1970–2010, 55.4% of whom were classified as either overweight [34.8%] or obese [20.6%]. The prevalence of obesity increased 2–3-fold over the 40-year study period. Obese patients had a 72% increased risk of hospitalisation (hazard ratio [HR],1.72; 95% confidence interval [CI], 1.10–2.71; p = 0.018) when compared with normal weight patients. Additionally, with each incremental increase in BMI by 1 kg/m2, the risk of hospitalisation increased by 5% [HR,1.05; 95% CI, 1.01–1.08; p = 0.008] and risk of corticosteroid use increased by 2.6% [HR,1.026; 95% CI, 1.00–1.05; p = 0.05].

Conclusions
The prevalence of obesity in the UC population is increasing and may have negative prognostic implications, specifically regarding risk of future hospitalisation and corticosteroid use. Additional prospective studies are necessary to more clearly define these associations.
Left atrial appendage occlusion in the UK: prospective registry and data linkage to Hospital Episode Statistics
Authors: Willits Iain , Keltie Kim , Linker Nicholas , de Belder Mark , Henderson Robert , Patrick Hannah , Powell Helen , Berry Lee , Urwin Samuel G , Cole Helen , Sims Andrew J 
Published: June 2021

Abstract

Aims
Non-valvular atrial fibrillation (AF) greatly increases the risk of ischaemic stroke. For people with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) provides a non-pharmacological management alternative. The aim of this study was to measure the procedural safety and longer-term effectiveness of LAAO for AF in a UK setting.

Methods and results
This was a prospective, single-armed registry of patients with AF for whom anticoagulation was unsuitable. Registry data were collected between October 2014 and April 2018 and linked to routine data sources for follow-up. Data from 583 LAAO procedures were entered into the registry, of which 537 (from 525 patients) were eligible for inclusion (median CHA2DS2-VASc score 4). A closure device was successfully implanted in 93.4% of cases, with a procedural success rate (device implanted without major complication) of 88.9%. Five patients (1.0%) died in hospital. During follow-up [median 729 (Q1:Q3, 523:913) days] 45 patients experienced neurological events; 33 of which were ischaemic. The ischaemic neurological event rate was 3.3 (1.6–5.0)% at 1 year (n = 387) and 7.0 (4.3–9.6)% at 2 years (n = 196). There were significant improvements in overall patient health (via Visual Analogue Scale) measured at 6 weeks and 6 months, but no significant improvements observed in patient utility over time.

Conclusion
The findings of our study suggest that LAAO is not without procedural risk, but that this risk may be justified in high-risk patients with AF who cannot take an anticoagulant. Moreover, the data do not provide support for more widespread use of LAAO as the complication rate was relatively high and would be difficult to justify in many patients with AF who tolerate anticoagulation.
Facial paralysis and vaccinations: a vaccine adverse event reporting system review
Authors: Ahsanuddin Salma , Nasser Wissam , Roy Savannah C , Povolotskiy Roman , Paskhover Boris 
Published: June 2021

Abstract

Background
Vaccinations are a cornerstone of preventative medicine in the USA. However, growing concerns regarding facial nerve palsy following vaccination exist.

Objective
This study aims to assess the occurrence of facial palsy as reported by the Vaccine Adverse Event Reporting System (VAERS) database.

Methods
A retrospective analysis of the VAERS database was performed for cases of ‘Facial Palsy’, ‘Bell’s Palsy’, ‘Facial Paralysis’ and ‘Ramsay Hunt Syndrome’ between 2009 and 2018. Subgroup analysis was performed to determine gender, age, history of facial palsy, type of vaccine used, number of days until onset of symptoms and overall facial palsy rate.

Results
Nine hundred and forty-four entries met our inclusion criteria with 961 vaccine administrations resulting in facial paralysis. Facial palsy following vaccinations was evenly distributed across all age cohorts with two peaks between 60 and 74 years old and between 0 and 14 years old. Most patients were female (N = 526, 55.7%) without a reported history of facial palsy (N = 923, 97.8%). In 2009, reported incidence rate was 0.53%, as compared with 0.23% in 2018. The influenza vaccine had the greatest number of cases (N = 166, 17.3%), followed by the varicella (N = 87, 9.1%) and human papillomavirus vaccines (N = 47, 4.9%).

Conclusions
With the SARS-CoV-2 pandemic and recent approvals of the vaccinations, there is growing concern of facial palsy following vaccination. Although it is a known adverse event following vaccination, the likelihood of facial palsy following vaccination is low, with only 0.26% of overall reported cases over a 10-year span.
Spatial abundance and distribution of picocyanobacterial communities in two contrasting lakes revealed using environmental DNA metabarcoding
Authors: Schallenberg Lena A , Pearman John K , Burns Carolyn W , Wood Susanna A 
Published: June 2021

ABSTRACTFreshwater picocyanobacteria (Pcy) are important yet understudied components of lake ecosystems. Most previous studies have relied on cell abundances to assess Pcy dynamics in largely oligotrophic lakes, while little is known about spatial diversity and dynamics across different lake types. In the present study we assessed the horizontal-spatial abundance and community structure of Pcy in two contrasting (oligotrophic and hypertrophic) New Zealand lakes using epifluorescence microscopy and 16S rRNA metabarcoding. Pcy abundance and community composition differed significantly both between and within the oligotrophic and hypertrophic lakes. While spatial variability was observed in both study lakes, these differences were particularly pronounced in the oligotrophic, morphometrically complex Lake Wanaka where cell abundances were typically higher in bays than open-water sites and community structure differed significantly between sites. Community structuring appeared to be driven by localised environmental conditions, with different factors influencing each lake. These results suggest that single spot-samples are insufficient to gain an understanding of Pcy dynamics and consequently, phytoplankton dynamics in lakes.
Understanding the experience of the implementer: teachers' perspectives on implementing a classroom-based nutrition education program
Authors: Bergling Emily , Pendleton Divyani , Owen Heather , Shore Emily , Risendal Betsy , Harpin Scott , Whitesell Nancy , Puma Jini 
Published: June 2021

Abstract
School-based programs are widely implemented to combat childhood obesity, but these programs have mixed results. Dissemination and implementation science approaches to evaluation using qualitative methods can provide more robust details about program functioning that may be able to help explain the variation in the impact of these programs. Fourteen in-depth interviews were conducted with classroom teachers implementing a school-based program, the Integrated Nutrition Education Program (INEP), to explore their experience. Factors related to organization, individual and intervention levels emerged as facilitators and barriers to program implementation. Key factors were school culture at the organization level, individual perception and belief in the intervention at the individual level and program content, perceived complexity and adaptability at the intervention level. Socioeconomic status of the community and family involvement were contextual factors identified across all levels. Findings from this qualitative evaluation can be used for the quality improvement of INEP, but beyond this these can also be informative for other school-based programs to promote adoption, implementation and maintenance.
Codimension One Foliations with Numerically Trivial Canonical Class on Singular Spaces II
Authors: Druel Stéphane , Ou Wenhao 
Published: June 2021

Abstract
In this article, we give the structure of codimension one foliations with canonical singularities and numerically trivial canonical class on varieties with klt singularities. Building on recent works of Spicer, Cascini—Spicer and Spicer—Svaldi, we then describe the birational geometry of rank two foliations with canonical singularities and canonical class of numerical dimension zero on complex projective three-folds.
Dietary omega-3 fatty acid supplementation does not impair vitamin E status or promote lipid peroxidation in growing horses
Authors: White-Springer Sarah H , Vineyard Kelly R , Kivipelto Jan , Warren Lori K 
Published: June 2021

AbstractOmega-3 (n-3; ω-3) fatty acids (FA) are often included in the diet for their potential health benefits. However, because oxidative potential is increased with the degree of unsaturation in vitro, polyunsaturated FA such as eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) may be at increased risk of lipid peroxidation. We aimed to determine the effects of dietary n-3 FA supplementation on antioxidant status and lipid peroxidation in yearling horses. Quarter Horses (mean ± SEM; 14.6 ± 0.2 mo) were randomly assigned to receive no n-3 FA supplementation (CON; n = 6) or 60 mg n-3/kg body weight from milled flaxseed (FLAX; n = 6) or encapsulated fish oil (FISH; n = 6). All horses received a basal diet of mixed grain concentrate fed individually at 1.5% body weight (dry matter basis) and ad libitum bahiagrass pasture forage. Blood samples were obtained before and after 70 d of supplementation to evaluate vitamin E, selenium, lipids, antioxidant status, and oxidative stress. Data were analyzed using a mixed model ANOVA with repeated measures. Supplementation with n-3 FA did not reduce serum vitamin E or Se and, in fact, elevated (P ≤ 0.0003) vitamin E status in FISH horses. At day 70, serum triglycerides were lower in FISH and FLAX horses than CON horses (P ≤ 0.02) and F2-isoprostanes were lower in FISH than CON horses (P = 0.0002). Dietary n-3 FA had no effect on cholesterol, reduced and oxidized glutathione, glutathione peroxidase, and thiobarbituric acid-reactive substances. In growing horses fed to meet their vitamin E requirements, supplementation with 60 mg n-3/kg body weight did not negatively affect vitamin E status or promote lipid peroxidation. Elevated vitamin E status in horses fed FISH, coupled with lower serum F2-isoprostanes, further suggest that the longer-chain, highly unsaturated n-3 FA, EPA and DHA, may actually attenuate lipid peroxidation.
Overexpression and characterization of Escherichia coli dihydropyrimidine dehydrogenase: a four iron-sulphur cluster containing flavoprotein
Authors: Yoshioka Hiroshi , Ishida Tetsuo , Mihara Hisaaki 
Published: June 2021

Abstract
Escherichia coli dihydropyrimidine dehydrogenase (EcDPD) catalyses the NADH-dependent reduction of uracil and thymine to the corresponding 5,6-dihydropyrimidines to control their metabolite pools. EcDPD consists of two subunits, PreT and PreA, and requires FAD, FMN and Fe-S clusters for activity. Recombinant EcDPD with a C-terminal His6-tagged-PreA subunit was overproduced in a DPD-lacking E. coli cells with augmented Fe-S cluster synthesis. Anaerobic purification resulted in purified enzyme with a specific activity of 13 μmol min−1 mg−1. The purified EcDPD was a heterotetramer and contained 0.81 FAD, 0.99 FMN, 14 acid-labile sulphur and 15 iron per PreT-PreA dimer. The enzyme exhibited Michaelis–Menten kinetics for both the forward and reverse reactions, which is distinct from mammalian DPDs showing substrate inhibition kinetics. For uracil reduction, the kcat, kcat/KNADH and kcat/Kuracil values were constant over the pH range of 5.5–10. For dihydrouracil (DHU) dehydrogenation, the pH-dependence of the kcat and kcat/KNAD+ values indicated that a residue with a pKa of 6.6 must be deprotonated for activity. Biochemical and kinetic comparisons with pig DPD revealed that protonation sates of the catalytically competent forms of EcDPD are distinct from those of pig enzyme.
Hiding in the Crowd: Secrecy Compels Consumer Conformity
Authors: He Dongjin , Jiang Yuwei , Gorn Gerald J 
Published: June 2021

Abstract
This research investigates how secrecy (i.e., a state in which people have an active intention to conceal information from others) affects individuals’ consumption behavior. Six studies reveal that making consumers’ secrets salient increases their tendency to conform in their consumption and show that this effect is driven by the desire to avoid social attention. This effect is moderated by consumers’ perceived self-control capacity. This research uncovers a novel downstream consequence of secrecy on consumer behavior and provides insight into when conforming consumption can serve as a strategy to help consumers avoid unwanted social attention. This research has important practical implications concerning using notions of secrecy in marketing strategies and promoting conforming products.
Using Risk Stratification to Optimize Mammography Screening in Chinese Women
Authors: Leung Kathy , Wu Joseph T , Wong Irene Oi-ling , Shu Xiao-Ou , Zheng Wei , Wen Wanqing , Khoo Ui-Soon , Ngan Roger , Kwong Ava , Leung Gabriel M 
Published: June 2021

Abstract

Background
The cost-effectiveness of mammography screening among Chinese women remains contentious. Here, we characterized breast cancer (BC) epidemiology in Hong Kong and evaluated the cost-effectiveness of personalized risk-based screening.

Methods
We used the Hong Kong Breast Cancer Study (a case-control study with 3501 cases and 3610 controls) and Hong Kong Cancer Registry to develop a risk stratification model based on well-documented risk factors. We used the Shanghai Breast Cancer Study to validate the model. We considered risk-based programs with different screening age ranges and risk thresholds under which women were eligible to join if their remaining BC risk at the starting age exceeded the threshold.

Results
The lifetime risk (15-99 years) of BC ranged from 1.8% to 26.6% with a mean of 6.8%. Biennial screening was most cost-effective when the starting age was 44 years, and screening from age 44 to 69 years would reduce breast cancer mortality by 25.4% (95% credible interval [CrI] = 20.5%-29.4%) for all risk strata. If the risk threshold for this screening program was 8.4% (the average remaining BC risk among US women at their recommended starting age of 50 years), the coverage was 25.8%, and the incremental cost-effectiveness ratio (ICER) was US$18 151 (95% CrI = $10 408-$27 663) per quality-of-life-year (QALY) compared with no screening. The ICER of universal screening was $34 953 (95% CrI = $22 820-$50 268) and $48 303 (95% CrI = $32 210-$68 000) per QALY compared with no screening and risk-based screening with 8.4% threshold, respectively.

Conclusion
Organized BC screening in Chinese women should commence as risk-based programs. Outcome data (e.g., QALY loss because of false-positive mammograms) should be systemically collected for optimizing the risk threshold.
Locating LAWS: Lethal Autonomous Weapons, Epistemic Space, and “Meaningful Human” Control
Authors: Williams John 
Published: June 2021

AbstractThis paper analyzes the excessive epistemic narrowing of debate about lethal autonomous weapon systems (LAWS), and specifically the concept of meaningful human control, which has emerged as central to regulatory debates in both the scholarly literature and policy fora. Through reviewing work drawing on international relations, security studies, international law and ethics, and technology policy, I argue all share a common epistemological position. This draws on a philosophical and analytical tradition that is Western and modernist, and places a “meaningful human” at the center of debates over controlling LAWS who reflects archetypes associated with a Western, rational, white, male. This epistemological location, I argue, excludes epistemological perspectives relevant to communities who both are most likely to experience LAWS, because they live in areas where deployment is most likely, and have the greatest experience of the effects of key LAWS precursors, such as unmanned aerial vehicles. Drawing on insights from decolonial approaches, I establish a research agenda that challenges this epistemological closure and looks to relocate debates about meaningful human control over LAWS in research that makes space for far more diverse perspectives on a crucial issue that may shape humankind's common future.
Norm Contestation and Pragmatic Ethics: Evaluating the Rebuilding Norm in Libya
Authors: Donovan Outi 
Published: June 2021

Abstract
Approaches variously described as critical, reflexive, postpositivist, and agonistic constructivism reject the idea that the meaning of a norm can be fixed. These approaches look instead to the role that discursive practice plays in repeatedly constructing meaning. While the focus on how discourse shapes the meaning of a norm can tell us something about the ongoing social significance of that norm, it does not answer the question of whether that norm is normatively appropriate. Taking its cue from pragmatic ethics, this paper addresses the above limitation in the existing scholarship. It does so by not only tracing norms’ meanings in use, but also crucially evaluating the extent to which they are useful in alleviating the social problems they were designed to address. The theoretical argument is illustrated by examining the meanings in use of the rebuilding norm in the aftermath of the 2011 humanitarian intervention in Libya; how was the norm understood and practiced? What were the consequences of such meanings in use? I argue that this type of analysis can significantly improve our understanding of normative outcomes of norm contestation processes by bringing to the fore the practical consequences of norms, their various meanings, and the political environment within which they are enacted.