bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence, correlates and outcomes of absolute and functional iron deficiency anemia in nondialysis-dependent chronic kidney disease
Authors: Awan Ahmed A , Walther Carl P , Richardson Peter A , Shah Maulin , Winkelmayer Wolfgang C , Navaneethan Sankar D 
Published: August 2019

AbstractBackgroundAnemia is associated with adverse outcomes in those with chronic kidney disease (CKD). We examined the association of absolute and functional iron deficiency anemia (IDA) with adverse outcomes (cardiovascular hospitalization, dialysis and mortality) in those with nondialysis-dependent CKD.MethodsNondialysis-dependent CKD patients followed in the US Veterans Administration with hemoglobin level measured within 90 days of the date of the second estimated glomerular filtration rate &lt;60 mL/min/1.73 m2 were included. Logistic regression, multivariate Cox proportional hazards and Poisson regression models adjusted for demographics and comorbidities were used to assess the prevalence and correlates of absolute [transferrin saturation (TSAT) ≤20%, ferritin &lt;100 ng/mL] and functional (TSA T≤20%, ferritin &gt;100–500 ng/mL) IDA and the associations of absolute and functional IDA with mortality, dialysis and cardiovascular hospitalization.ResultsOf 933 463 patients with CKD, 20.6% had anemia. Among those with anemia, 23.6% of patients had both TSAT and ferritin level measured, of whom 30% had absolute IDA and 19% had functional IDA. Absolute IDA in CKD was not associated with an increased risk of mortality or dialysis but was associated with a higher risk of 1-year {risk ratio [RR] 1.20 [95% confidence interval (CI) 1.12–1.28]} and 2-year cardiovascular hospitalization [RR 1.11 (95% CI 1.05–1.17)]. CKD patients with functional IDA had a higher risk of mortality [hazard ratio (HR) 1.11 (95% CI 1.07–1.14)] along with a higher risk of 1-year [RR 1.21 (95% CI 1.1–1.30)] and 2-year cardiovascular hospitalization [RR 1.13 (95% CI 1.07–1.21)]. Ferritin &gt;500 ng/mL (treated as a separate category) was only associated with an increased risk of mortality [HR 1.38 (95% CI 1.26–1.51)].ConclusionsIn a large population of CKD patients with anemia, absolute and functional IDA were associated with various clinical covariates. Functional IDA was associated with an increased risk of mortality and cardiovascular hospitalization, but absolute IDA was associated only with a higher risk of hospitalization.
Skeletal muscle wasting in chronic kidney disease: the emerging role of microRNAs
Authors: Robinson Kate A , Baker Luke A , Graham-Brown Matthew P M , Watson Emma L 
Published: August 2019

Abstract
Skeletal muscle wasting is a common complication of chronic kidney disease (CKD), characterized by the loss of muscle mass, strength and function, which significantly increases the risk of morbidity and mortality in this population. Numerous complications associated with declining renal function and lifestyle activate catabolic pathways and impair muscle regeneration, resulting in substantial protein wasting. Evidence suggests that increasing skeletal muscle mass improves outcomes in CKD, making this a clinically important research focus. Despite extensive research, the pathogenesis of skeletal muscle wasting is not completely understood. It is widely recognized that microRNAs (miRNAs), a family of short non-coding RNAs, are pivotal in the regulation of skeletal muscle homoeostasis, with significant roles in regulating muscle growth, regeneration and metabolism. The abnormal expression of miRNAs in skeletal muscle during disease has been well described in cellular and animal models of muscle atrophy, and in recent years, the involvement of miRNAs in the regulation of muscle atrophy in CKD has been demonstrated. As this exciting field evolves, there is emerging evidence for the involvement of miRNAs in a beneficial crosstalk system between skeletal muscle and other organs that may potentially limit the progression of CKD. In this article, we describe the pathophysiological mechanisms of muscle wasting and explore the contribution of miRNAs to the development of muscle wasting in CKD. We also discuss advances in our understanding of miRNAs in muscle–organ crosstalk and summarize miRNA-based therapeutics currently in clinical trials.
Networks and systemic risk in the financial system
Authors: Gai Prasanna , Kapadia Sujit 
Published: August 2019

AbstractThe complex web of exposures and interlinkages across the financial system highlights the relevance of network analysis in understanding systemic risk and guiding the design of financial regulation. This paper discusses how network models—and those based on epidemiological approaches in particular—offer a compelling description of the structure of real-world financial systems and shed light on different contagion mechanisms seen during the global financial crisis. We also review how these insights may inform macroprudential risk assessment and policy in the areas of stress-testing the financial system and the regulation of systemically important institutions. The role of non-bank financial intermediation and social networks in shaping financial system risk is also briefly considered.
Accessibility of emergency contraception for adolescents in Quebec community pharmacies
Authors: Soper Katie , Di Meglio Giuseppina 
Published: August 2019

Abstract

Objective
Access to effective contraceptives, including emergency contraception (EC), is critical to reducing unintended adolescent pregnancy. This study evaluates the accessibility of Ln-EC (levonorgestrel EC) for adolescents in Quebec community pharmacies.

Methods
We conducted an anonymous self-administered electronic survey of Quebec community pharmacists between June 1, 2016 and October 31, 2016. Pharmacists were asked about the availability of Ln-EC in their pharmacy, whether they prescribed Ln-EC, and their experience with adolescents who requested Ln-EC.

Results
Five hundred and ninety-one pharmacists responded, with representation from across the province. Ninety-five per cent had Ln-EC in stock. Most pharmacists (90%) reported being comfortable prescribing Ln-EC, though they were less comfortable prescribing to adolescents than to adults (*P&lt;0.001). Pharmacists also reported that cost and confidentiality are barriers to accessing Ln-EC for some adolescents.

Conclusions
This study indicates that availability and pharmacist comfort are not likely to be barriers to Ln-EC use for adolescents. On the other hand, cost and/or confidentiality do represent a barrier for some adolescents. This study lays the groundwork for a national study examining the accessibility of EC for adolescents.
Soccer-related head injuries—analysis of sentinel surveillance data collected by the electronic Canadian Hospitals Injury Reporting and Prevention Program
Authors: Zutrauen Sarah , McFaull Steven , Do Minh T 
Published: August 2019

Abstract

Background
Participating in sports is a great way to gain physical, psychological, and social benefits. However, it also carries the risk of injury. Soccer is one of the most popular sports worldwide, and in recent years, there have been concerns about potential vulnerabilities to head injuries.

Objectives
To investigate soccer-related head injuries (SRHIs), using data from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) surveillance system. Specifically, we aim to compare characteristics of SRHI cases to all head injury cases within the eCHIRPP database.

Methods
Descriptive analyses of emergency department (ED) injury surveillance data (2011 to 2017) for individuals aged 5 to 29 years from all participating eCHIRPP sites. Computation of proportionate injury ratios (PIR) comparing SRHIs to all head injuries reported to eCHIRPP, and 95% confidence intervals (CI).

Results
A total of 3,970 SRHIs were reported to eCHIRPP. Injuries were from contact with another player, the ball, ground, goal-post, and other causes. Of the injuries caused by contact with the ball, 9% were from purposely directing the ball with the head (heading). A higher proportion of concussions (PIR=1.32, 95% confidence interval [CI]: 1.27 to 1.37) and minor closed head injuries (PIR=1.20, 95% CI: 1.15 to 1.26) were observed in soccer players. Higher proportions of head injuries occurred in organized soccer and soccer played outdoors. However, admission to the ED for a SRHI was rare (PIR=0.40, 95% CI: 0.30 to 0.55).

Conclusions
Overall, elevated proportions of brain injuries were observed among soccer players, however, these injuries were unlikely to result in a hospital admission. Moreover, purposely heading the ball contributed to few ED visits.
Perceptions of uncertainties about carrier results identified by exome sequencing in a randomized controlled trial
Authors: Umstead Kendall L , Han Paul K J , Lewis Katie L , Miller Ilana M , Hepler Charlotte L , Thompson Lydia J , Wolfsberg Tyra G , Nguyen Anh-Dao , Fredriksen Mark T , Gibney Gretchen , Turbitt Erin , Biesecker Leslie G , Biesecker Barbara B 
Published: August 2019

Abstract
How individuals perceive uncertainties in sequencing results may affect their clinical utility. The purpose of this study was to explore perceptions of uncertainties in carrier results and how they relate to psychological well-being and health behavior. Post-reproductive adults (N = 462) were randomized to receive carrier results from sequencing through either a web platform or a genetic counselor. On average, participants received two results. Group differences in affective, evaluative, and clinical uncertainties were assessed from baseline to 1 and 6 months; associations with test-specific distress and communication of results were assessed at 6 months. Reductions in affective uncertainty (∆x̅ = 0.78, 95% CI: 0.53, 1.02) and evaluative uncertainty (∆x̅ = 0.69, 95% CI: 0.51, 0.87) followed receipt of results regardless of randomization arm at 1 month. Participants in the web platform arm reported greater clinical uncertainty than those in the genetic counselor arm at 1 and 6 months; this was corroborated by the 1,230 questions asked of the genetic counselor and residual questions reported by those randomized to the web platform. Evaluative uncertainty was associated with a lower likelihood of communicating results to health care providers. Clinical uncertainty was associated with a lower likelihood of communicating results to children. Learning one’s carrier results may reduce perceptions of uncertainties, though web-based return may lead to less reduction in clinical uncertainty in the short term. These findings warrant reinforcement of clinical implications to minimize residual questions and promote appropriate health behavior (communicating results to at-risk relatives in the case of carrier results), especially when testing alternative delivery models.
Subclinical Auditory Neural Deficits in Patients With Type 1 Diabetes Mellitus
Authors: AlJasser Arwa , Uus Kai , Prendergast Garreth , Plack Christopher J. 
Published: August 2019

Objectives:
Diabetes mellitus (DM) is associated with a variety of sensory complications. Very little attention has been given to auditory neuropathic complications in DM. The aim of this study was to determine whether type 1 DM (T1DM) affects neural coding of the rapid temporal fluctuations of sounds, and how any deficits may impact on behavioral performance.

Design:
Participants were 30 young normal-hearing T1DM patients, and 30 age-, sex-, and audiogram-matched healthy controls. Measurements included electrophysiological measures of auditory nerve and brainstem function using the click-evoked auditory brainstem response, and of brainstem neural temporal coding using the sustained frequency-following response (FFR); behavioral tests of temporal coding (interaural phase difference discrimination and the frequency difference limen); tests of speech perception in noise; and self-report measures of auditory disability using the Speech, Spatial and Qualities of Hearing Scale.

Results:
There were no significant differences between T1DM patients and controls in the auditory brainstem response. However, the T1DM group showed significantly reduced FFRs to both temporal envelope and temporal fine structure. The T1DM group also showed significantly higher interaural phase difference and frequency difference limen thresholds, worse speech-in-noise performance, as well as lower overall Speech, Spatial and Qualities scores than the control group.

Conclusions:
These findings suggest that T1DM is associated with degraded neural temporal coding in the brainstem in the absence of an elevation in audiometric threshold, and that the FFR may provide an early indicator of neural damage in T1DM, before any abnormalities can be identified using standard clinical tests. However, the relation between the neural deficits and the behavioral deficits is uncertain.
Pediatric Orthopaedists Are Not Immune: Characterizing Self-reported Burnout Rates Among POSNA Members
Authors: Carter Cordelia W. , Talwalkar Vishwas , Weiss Jennifer M. , Schwend Richard M. , Goldberg Michael J. 
Published: August 2019

Background:
There are no published data characterizing burnout rates for pediatric orthopaedic surgeons. The primary purpose of this study was to identify the rates of self-reported personal and team burnout among members of the Pediatric Orthopaedic Society of North America (POSNA). A secondary aim was to determine whether specific demographic variables were more likely to be associated with self-reported burnout.

Methods:
During its 2018 annual meeting, the POSNA Wellness Taskforce launched a web-based survey in which members were asked to respond to 2 previously validated questions related to personal and team burnout. The survey was distributed by a closed POSNA membership e-mail list and responses were analyzed anonymously. Descriptive statistics were calculated. Pearson χ2 testing was used to analyze differences in burnout rates as a function of age and sex.

Results:
A total of 615 POSNA members completed the survey, a 47% response rate. Overall, 38% reported personal burnout and 46% reported team burnout. Women were more likely to report both personal (P<0.001) and team burnouts (P<0.005). Members aged 40 to 59 years were more likely to report personal burnout, irrespective of sex (P<0.001). Members aged 50 to 59 years were more likely than those in other age groups to report team burnout (P<0.001). There was no significant association found between the presence of burnout and either race, ethnicity, LGBTQ status, or educational background.

Conclusions:
As a group, pediatric orthopaedists report moderately high rates of both personal and team member burnout. Individual-specific factors such as age and sex may play an important role in determining one’s risk for experiencing burnout. Recognizing that burnout affects a significant minority of POSNA members is a crucial first step.

Level of Evidence:
Level III.
Hospitalizations Associated with Respiratory Syncytial Virus and Influenza in Children, Including Children Diagnosed with Asthma
Authors: Goldstein Edward , Finelli Lyn , O’Halloran Alissa , Liu Patrick , Karaca Zeynal , Steiner Claudia A. , Viboud Cecile , Lipsitch Marc 
Published: August 2019

Background:
There is uncertainty about the burden of hospitalization associated with respiratory syncytial virus (RSV) and influenza in children, including those with underlying medical conditions.

Methods:
We applied previously developed methodology to Health Care Cost and Utilization Project hospitalization data and additional data related to asthma diagnosis/previous history in hospitalized children to estimate RSV and influenza-associated hospitalization rates in different subpopulations of US children between 2003 and 2010.

Results:
The estimated average annual rates (per 100,000 children) of RSV-associated hospitalization with a respiratory cause (ICD-9 codes 460–519) present anywhere in the discharge diagnosis were 2,381 (95% CI(2252,2515)) in children <1 year of age; 710.6 (609.1, 809.2) (1 y old); 395 (327.7, 462.4) (2 y old); 211.3 (154.6, 266.8) (3 y old); 111.1 (62.4, 160.1) (4 y old); 72.3 (29.3, 116.4) (5–6 y of age); 35.6 (9.9,62.2) (7–11 y of age); and 39 (17.5, 60.6) (12–17 y of age). The corresponding rates of influenza-associated hospitalization were lower, ranging from 181 (142.5, 220.3) in <1 year old to 17.9 (11.7, 24.2) in 12–17 years of age. The relative risks for RSV-related hospitalization associated with a prior diagnosis of asthma in age groups <5 y ranged between 3.1 (2.1, 4.7) (<1 y old) and 6.7 (4.2, 11.8) (2 y old; the corresponding risks for influenza-related hospitalization ranged from 2.8 (2.1, 4) (<1y old) to 4.9 (3.8, 6.4) (3 y old).

Conclusion:
RSV-associated hospitalization rates in young children are high and decline rapidly with age. There are additional risks for both RSV and influenza hospitalization associated with a prior diagnosis of asthma, with the rates of RSV-related hospitalization in the youngest children diagnosed with asthma being particularly high.
Short-Duration High-Intensity Interval Exercise Training Is More Effective Than Long Duration for Blood Pressure and Arterial Stiffness But Not for Inflammatory Markers and Lipid Profiles in Patients With Stage 1 Hypertension
Authors: Aghaei Bahmanbeglou Neda , Ebrahim Khosrow , Maleki Majid , Nikpajouh Akbar , Ahmadizad Sajad 
Published: August 2019

Purpose:
The present study compared the effects of 2 different high-intensity interval training (HIIT) protocols on arterial stiffness, lipid profiles, and inflammatory markers in hypertensive patients.

Methods:
Thirty hypertensive (stage 1) patients, aged 48.0 ± 3.2 yr, were randomly allocated to the short-duration HIIT (SDHIIT, n = 10), long-duration HIIT (LDHIIT, n = 10), and control (n = 10) groups. After a 2-wk preparatory phase of continuous mild training, patients in the SDHIIT group performed 8 wk of HIIT including 27 repetitions of 30-sec activity at 80% to 100% of

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2peak interspersed with 30-sec passive/active (10%-20% of

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2peak) recovery. Patients in the LDHIIT group performed 8 wk of HIIT, 32 min/session including 4 repetitions of 4-min activity at 75% to 90% of

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2peak interspersed with 4-min passive/active (15%-30% of

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2peak) recovery. Blood pressure (BP), pulse wave velocity (PWV), inflammatory markers, and lipid profiles were measured before and after training.

Results:
Significant (P < .05) reductions in systolic blood pressure and PWV were found following 2 training protocols, though, only the changes in PWV following the SDHIIT were significantly different than those in the LDHIIT and control groups. Interleukin-6 and triglycerides decreased and interleukin-10 increased significantly (P < .01) following both HIIT programs, whereas the differences between the 2 training protocols were not statistically significant. C-reactive protein and lipids did not change significantly following HIIT.

Conclusions:
Performing HIIT improves systolic blood pressure and inflammatory markers in patients with stage 1 hypertension irrespective of the HIIT intensity and duration, and PWV improvement is intensity related.
Disrupted Glycocalyx as a Source of Ocular Surface Biomarkers
Authors: Argüeso Pablo 
Published: August 2019

Abstract:
The glycocalyx is a dense and diverse coat of glycans and glycoconjugates responsible for maintaining cell surface integrity and regulating the interaction of cells with the external environment. Transmembrane mucins such as MUC1 and MUC16 comprise a major component of the epithelial glycocalyx and are currently used to monitor disease progression in cancer. At the ocular surface, multiple lines of evidence indicate that abnormal expression of the enzymes responsible for glycan biosynthesis during pathological conditions impairs the glycosylation of transmembrane mucins. It is now becoming clear that these changes contribute to modify the interaction of mucins with galectin-3, a multimeric lectin crucial for preserving the ocular surface epithelial barrier. This review highlights the potential of using the epithelial glycocalyx as a reliable source for the generation of biomarkers to diagnose and monitor ocular surface disease.
Long-term Immunogenicity and Safety of the AS04-adjuvanted Human Papillomavirus–16/18 Vaccine in Four- to Six-year-old Girls
Authors: Lin Lan , Macias Parra Mercedes , Sierra Victor Y. , Salas Cespedes Albino , Granados Maria Angelica , Luque Adriana , Karkada Naveen , Castrejon Alba Maria Mercedes , Romano-Mazzotti Luis , Borys Dorota , Struyf Frank 
Published: August 2019

Background:
The burden of human papillomavirus (HPV) diseases is high in Latin America. HPV vaccines licensed from 2006 onwards offer protection against most HPV-related cancers, especially when introduced into national immunization programs. Barriers to optimal vaccine uptake are, however, lowering the impact of adolescent HPV vaccination programs. Immunization of children might overcome these barriers and be a strategy of choice for some countries.

Methods:
This multicenter phase III randomized, controlled, single-blind study (NCT01627561) was conducted in Colombia, Mexico and Panama to assess safety and immunogenicity of 2-dose vaccination with AS04-adjuvanted HPV-16/18 vaccine in girls 4–6 years of age. We report safety outcomes and anti–HPV-16/18 antibody titers measured by enzyme-linked immunosorbent assay in HPV-vaccinated girls that were followed over a 36-month period.

Results:
Over 36 months (ie, 30 months after the second vaccine dose), among 74 girls included in the HPV group, 1 serious adverse event unrelated to vaccination has been reported. No withdrawal because of (serious) adverse events has been reported. At month 36, all girls in the per-protocol–cohort were still seropositive for anti–HPV-16 and anti–HPV-18 with geometric mean concentrations of 1680.6 and 536.4 enzyme-linked immunosorbent assay units/mL, respectively.

Conclusions:
The AS04-adjuvanted HPV-16/18 vaccine administered according to a 2-dose schedule to girls 4–6 years of age induced a high and sustained immunologic response with an acceptable safety profile during the 30 months following vaccination.
Scholarship in Neuroscience Nursing
Authors: Hickey Joanne , Duffy Lisa V. , Hinkle Janice L. , Prendergast Virginia , Rhudy Lori M. , Sullivan Cindy , Villanueva Nancy E. 
Published: August 2019

ABSTRACT

BACKGROUND: Scholarship is a hallmark of all professions and includes research and practice scholarship. Building the science for practice and care is a major responsibility of each profession. METHODS: The purpose of this article is to define clinical science as it applies to neuroscience nursing as well as to establish the foundation for the work of the Clinical Science Committee of the American Association of Neuroscience Nursing. CONCLUSIONS: Research scholars conduct investigations for discovery of new knowledge. Practice scholars develop clinical knowledge through clinical practice and experience and an inquiring mindset that questions why and how certain methods or processes contribute to the achievement of certain outcomes; they look for better ways to improve processes of care and practice that will achieve optimal evidence-based outcomes. Scholarship in both research and practice domains is critical to the advancement of neuroscience nursing. Many opportunities exist for neuroscience nurses to contribute to clinical science.