bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in pain management among transgender patients presenting to the emergency department for abdominal pain
Authors: Engstrom Kellyn , Bellolio Fernanda , Jeffery Molly Moore , Sutherland Sara C. , Carpenter Kayla P. , Jackson Gia , Cole Kristin , Chedid Victor , Davidge‐Pitts Caroline J. , Sunga Kharmene L. , Gonzalez Cesar , Brown Caitlin S. 
Published: October 2024

AbstractObjectiveTransgender and gender‐diverse (TGD) individuals have a gender identity or expression that differs from the sex assigned to them at birth. They are an underserved population who experience health care inequities. Our primary objective was to identify if there are treatment differences between TGD and cisgender lesbian/gay/bisexual/queer (LGBQ) or heterosexual individuals presenting with abdominal pain to the emergency department (ED).MethodsRetrospective observational cohort study of patients ≥12 years of age presenting to 21 EDs within a health care system with a chief complaint of abdominal pain between 2018 and 2022. TGD patients were matched 1:1:1:1 to cisgender LGBQ women and men and cisgender heterosexual women and men, respectively. Propensity score matching covariates included age, ED site, mental health history, and gastrointestinal history. The primary outcome was pain assessment within 60 min of arrival. The secondary outcome was analgesics administered in the ED.ResultsWe identified 300 TGD patients, of whom 300 TGD patients were successfully matched for a total cohort of 1300 patients. The median (IQR) age was 25 (20–32) years and most patients were treated in a community ED (58.2%). There was no difference between groups in pain assessment within 60 min of arrival (59.0% TGD vs. 63.2% non TGD, p = 0.19). There were no differences in the number of times pain was assessed (median [IQR] 2 [1–3] vs. 2 [1–4], p = 0.31) or the severity of pain between groups (5.5 [4–7] vs. 6 [4–7], p = 0.11). TGD patients were more likely to receive nonsteroidal anti‐inflammatory drugs (32.0% vs. 24.9%, p = 0.015) and less likely to receive opioids than non‐TGD patients (24.7% vs. 36.9%, p = <0.001). TGD and nonbinary patients, along with LGBQ cisgender women (24.7%) and heterosexual cisgender women (34%), were less likely to receive opioids than LGBQ cisgender men (54%) and heterosexual cisgender men (42.3%, p < 0.01).ConclusionThere was no difference in frequency of pain assessment, regardless of gender identity or sexual orientation. More cisgender men, compared to TGD and cisgender women, received opioids for their pain.
Not all types of depressed patients who persist with their antidepressant treatment improve in side effect complaints: A comparison of treatment completers and dropouts in the STAR*D trial
Authors: Kim Thomas T. , Xu Colin 
Published: October 2024

AbstractIntroductionThere is a “traditional belief” that antidepressant side effect complaints improve with medication persistence; however, support for this theory has remained inconclusive. We aimed to examine if side effect complaints improved over time by modeling the relationship between side effect complaints and time at dropout for patients receiving citalopram during the first level of acute treatment in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.MethodsWe categorized the 2833 patients into five patterns by week of dropout. We used pattern‐mixture modeling to model change in side effect complaints (frequency, intensity, and burden) over the 12‐week course of treatment, while accounting for attrition and depressive severity. Using post‐hoc linear contrasts, we compared the attrition patterns with the completers' pattern for severity of side effect complaints at each respective last visit prior to dropout as well as averaged side effect complaints across the duration of treatment. We also reported frequencies and tolerability of side effects for nine organ/function systems over the course of treatment.ResultsPatients who dropped out early exhibited worsening side effect burden and patients who dropped out later showed improvements in side effect frequency and intensity. Treatment completers improved in all side effect complaints over the course of treatment. Early attrition patterns had more severe side effect complaints for both tests of post‐hoc linear contrasts than later attrition patterns and completers.ConclusionsSide effect complaints from antidepressant treatment improve over time, but only for some types of patients. As a precaution for early dropout, clinicians should monitor patients who exhibit worsening and more severe side effect complaints—especially in the first 6 weeks of antidepressant treatment. In addition, clinicians may want to consider changing the type of treatment early on for these patients, rather than encouraging them to persist with their current medication.
Navigating new norms: Addiction specialists' perspectives on opioid use disorder treatments and policy challenges in the fentanyl era
Authors: Weleff Jeremy , Christian Nicholaus J. , Wang James X. , Singh Mohit , De Aquino Joao P. , Saxon Andrew J. , Vassallo Gabriela Garcia 
Published: October 2024

AbstractBackground and ObjectivesAmidst increasing opioid‐related overdoses in the USA, opioid use disorder (OUD) treatment has seen few novel treatments emerge. High‐potency synthetic opioids (HPSOs) have altered clinical approaches, prompting evaluation of existing medications for opioid use disorder (MOUD) and interest in slow‐release oral morphine (SROM) as another therapeutic option. Here we survey addiction specialists on the influence of HPSOs on clinical practice, views on current MOUD regulations, and openness to novel therapies such as SROM.MethodsAnonymous, online survey conducted at a national conference of addiction specialists (N = 91). Pearson χ2 tests and Fisher's exact tests to compare respondent characteristics.ResultsApproximately 89% of respondents (N = 91) acknowledge that HPSOs shifted addiction treatment in recent years, with 86% modifying their MOUD prescribing accordingly. Moreover, 84% report having patients who could benefit from other full opioid agonists beyond methadone for OUD management. Many report off‐label prescribing of full agonist opioids other than methadone for withdrawal symptoms or initiating MOUD. Eighty percent reported being in favor of incorporating SROM as a third‐line monotherapy for OUD.Discussion and ConclusionThis sample of addiction specialists supports innovative alternatives for MOUD in the USA to combat the challenges posed by fentanyl and related HPSOs. Future work should further addiction specialists' opinions on barriers to OUD treatment and exploration of these international strategies in the USA.Scientific SignificanceThis appears to be the first study exploring addiction specialists' perspectives on regulatory barriers to OUD treatment and their willingness to uptake internationally adopted strategies such as SROM.
Bidirectional Mendelian Randomization Reveals Causal Effects of Immune Cell Traits on Endometriosis Risk
Authors: Wang Ying , Sun Fenyong , Wu Han , Yue Chaoyan , Man Qiuhong 
Published: October 2024

ABSTRACTPurposePrevious studies have identified associations between immune cell traits and endometriosis, but the causality of these relationships remains uncertain. In this study, we utilized Mendelian randomization (MR) to investigate the causal relationship between immune cell traits and endometriosis for the first time.MethodsSeven hundred and thirty‐one immune cell signatures associated with single‐nucleotide polymorphisms (SNPs) were extracted from a published genome‐wide association study (GWAS) involving 472 174 individuals, while endometriosis data, including four stages and seven subtypes, were obtained from the FinnGen consortium. Four methods were used for MR. The causal effect of immune cell traits on endometriosis was explored after Bonferroni correction.ResultsSignificant causal relationship included 92 immune cell traits distributed among B cell (28 cells), cDC (2 cells), maturation stages of T cell (10 cells), monocyte (12 cells), Myeloid cell (5 cells), TBNK (13 cells), and Treg panels (22 cells). One of the most significant findings is that for every 1‐standard deviation (SD) increase in CD8 on Central Memory CD8+ T cell, the risks of developing endometriosis of the fallopian tube increased by 72%. In the reverse MR analysis, a one‐unit increase in the log odds of endometriosis of the ovary risk corresponded to a decrease in the absolute count of CD4+ CD8dim T cell by 0.10.ConclusionThis study represents the first comprehensive evaluation of the causal effects of immune cell traits on the risk/protection of different stages/subtypes of endometriosis. The findings highlight the complex and significant role of immune‐derived factors in the pathogenesis of the disease.
Effects of various levels of coated cysteamine hydrochloride in the diet on feed intake, digestibility, ruminal fermentation, and blood metabolites in growing Charolais crossbred cattle
Authors: Meenongyai Watcharawit , Wongpanit Kannika , Phongkaew Piyamas , Khejornsart Pichad , Kamkuan Pramoet , Khamngamdi Phongphet , Kokaew Nattawut , Papsaree Sahapap , Tammanoi Chayanun , Namwongsa Nuttawut , Phungkrathok Natthaphon , Srijan Artsani , Siriket Chakkrit , Waramit Naroon , Modak Tanmay , Rahman Md Abdur , Siam Md Sifat Habib , Kabir A. K. M. Ahsan , Manabe Noboru 
Published: October 2024

AbstractThis study investigated the impact of different levels of coated cysteamine hydrochloride (CSH) supplementation on ruminal fermentation, nutrient digestibility, and blood metabolites in Charolais cross bulls. Twelve bulls were allotted to three feeding treatments in a replicated 3 × 3 Latin square design: 0% CSH (control), 0.5% CSH, and 1.0% CSH in concentrate. Animals were fed concentrate at 1.5% of body weight. Dry matter intake (DMI) and DMI as a percentage of body weight showed no significant differences among treatments (p > 0.10). Nutrient digestibility was consistent across treatments, except for a slight decrease in NDF digestibility with 1% CSH (p = 0.07). Ruminal pH, ammonia nitrogen, volatile fatty acid (VFA) proportions, and total VFA concentration were similar among treatments (p > 0.05). Total bacteria, fungal zoospores, and protozoa populations in the rumen did not vary significantly (p > 0.05). Blood glucose and triglyceride concentrations remained stable (p > 0.05), while blood urea nitrogen (BUN) levels were higher in CSH‐supplemented groups (p < 0.05). In conclusion, incorporating CSH levels ranging from 0.5% to 1.0% into the diet did not adversely affect feed intake, ruminal fermentation, or microbial populations. Additionally, 1.0% CSH improved BUN concentration in growing Charolais cross bulls.
The impact of starting dose on overall survival in myelofibrosis patients treated with ruxolitinib: A prospective real‐world study on AIFA monitoring registries
Authors: Breccia Massimo , Celant Simone , Palandri Francesca , Passamonti Francesco , Olimpieri Pier Paolo , Summa Valentina , Guarcello Annalisa , Palumbo Giuseppe Alberto , Pane Fabrizio , Guglielmelli Paola , Corradini Paolo , Russo Pierluigi 
Published: October 2024

SummaryRuxolitinib is a JAK1/JAK2 inhibitor approved for the treatment of myelofibrosis (MF)‐related splenomegaly or symptoms. The recommended starting dose depends on platelet count, regardless of haemoglobin level at baseline. In the recent years, an overall survival (OS) advantage was reported in patients treated with ruxolitinib compared with best available therapy. We analysed a large Italian cohort of 3494 patients identified by Agenzia Italiana del Farmaco (AIFA) monitoring registries. Of them, 2337 (66.9%) started at reduced dose: these patients were older (median age 70 vs. 67), with increased incidence of large splenomegaly (longitudinal diameter 20 vs. 19.1 cm, median volume 1064 cm3 vs. 1016 cm3), with higher IPSS risk (30.9% vs. 26.1%), and worse ECOG score (more than 1 in 14.3% vs. 9.8%). After balancing for baseline characteristics, Kaplan–Meier analysis showed a median OS of 78.2 months (95% CI 65.9–89) for patients who started at full dose and 52.6 (95% CI 49–56.6) months for patients who started with reduced dose (p < 0.001). Group analysis also showed a substantial difference in patients with intermediate‐2 and high IPSS risk. The majority of MF patients in real‐world analysis started with a reduced dose of ruxolitinib, which is associated with less favourable outcomes.
Allergen Immunotherapy for the Prevention and Treatment of Asthma
Authors: Batard Thierry , Taillé Camille , Guilleminault Laurent , Bozek Andrzej , Floch Véronique Bordas‐Le , Pfaar Oliver , Canonica Walter G. , Akdis Cezmi , Shamji Mohamed H. , Mascarell Laurent 
Published: October 2024

ABSTRACTAllergic asthma is the predominant phenotype among asthmatics. Although conventional pharmacotherapy is a central component in the management of asthma, it does not enable control of asthma symptoms in all patients. In recent decades, some uncontrolled asthmatic patients, especially those with allergic asthma, have benefited from biological therapies. However, biologics do not address all the unmet needs left by conventional pharmacotherapy. Furthermore, it is noteworthy that neither conventional pharmacotherapy nor biological therapies have disease‐modifying properties. In this context, allergen immunotherapy (AIT) represents an indispensable component of the therapeutic arsenal against allergic asthma, due to its disease‐modifying immunological effects. In this review article, funded by an AIT manufacturer, we find clinical trials support AIT as the only treatment option able both to improve allergic asthma symptoms and to prevent the onset and worsening of the condition. For patients with severe asthma or other safety concerns, the combination of AIT and biologics offers very promising new treatment modalities for the management of allergic asthma.Trial Registration: clinicaltrials.gov identifier: NCT06027073
Anti‐Thymocyte Globulin as a Therapy for Chronic Lung Allograft Dysfunction: A Single‐Center Experience
Authors: Dunn Colin T. , Brandon William , Jacob Alan , Zhang Song , Gao Ang , Torres Fernando , Lawrence Adrian , Timofte Irina , Bollineni Srinivas , Mohanka Manish , Wait Michael , Peltz Matthias , Heid Christopher , Huffman Lynn , Ring Steve , Murala John , Keshavamurthy Suresh , Weston Alex Jaye , Kaza Vaidehi 
Published: October 2024

ABSTRACTIntroductionAnti‐thymocyte globulin (ATG) is a polyclonal antibody formulation which has been used as a second‐line therapy for chronic lung allograft dysfunction (CLAD). Limited data exist evaluating its efficacy; however, several single‐center retrospective studies have variably demonstrated either improvement or stabilization of spirometry parameters after administration of ATG. ATG has been in use at UT Southwestern for treatment of CLAD since at least 2010; here, we seek to evaluate the effectiveness of this intervention at our center. MethodsA retrospective chart review was conducted of a total of 136 patients who underwent lung transplantation at UT Southwestern Medical Center between 2010 and 2022. Of these, 72 patients had received ATG specifically for treatment of CLAD, and the remaining 64 had never received ATG. Two separate analyses were performed: in the first, among those who received ATG for CLAD, spirometry data from the 6 months preceding and following ATG administration were reviewed and rates of change in FEV1 were calculated for each time period. Descriptive statistics were performed to summarize the baseline clinical characteristics and outcomes after ATG, with patients classified as having either a full response (positive rate of change in FEV1) or partial response (>20% attenuation in rate of FEV1 decline) to ATG. In the second analysis, survival was described among those who received ATG for CLAD and comparison was provided between propensity‐score matched cohorts from the ATG and non‐ATG groups.ResultsOf the 63 patients who received ATG for treatment of CLAD (and had adequate spirometry measurements available to trend FEV1), 49 (77.8%) had at least a partial response to therapy; 8 (12.7%) experienced an overall improvement in FEV1. Response to ATG was found to be associated with a more rapid rate of pre‐ATG decline in FEV1; no other baseline parameters were found to be predictive of a response to ATG. Median post‐CLAD graft survival was 31.7 months among those who received ATG, and only baseline absolute neutrophil count was found to be associated with worse post‐CLAD graft survival among this group.ConclusionAnti‐thymocyte globulin therapy, when given for CLAD, was associated with at least a modest attenuation in rate of FEV1 decline in most patients but only rarely preceded an absolute improvement in FEV1. Further study is warranted to better define the role for ATG in treatment of CLAD, a challenging disease state with limited therapeutics available.
Independent Risk Factors and Economic Burden Associated With Delayed Extubation Following Pediatric Liver Transplantation
Authors: Virk Manpreet K. , Coss‐Bu Jorge , Mian Muhammad Umair M. , Nguyen Galvan Nhu Thao , Sabapathy Divya , Castro Danny , Fogarty Thomas , Hosek Kathleen , Beel Elizabeth Rossmann , Schackman Julie , Harpavat Sanjiv , Goss John , Desai Moreshwar S. 
Published: October 2024

ABSTRACTBackgroundSuccessful early extubation (EE) after liver transplant (LT) has been shown to reduce intensive care unit (ICU) and hospital length of stay and infectious, vascular, and sedation‐related complications in adults. EE may not always be feasible in children, and many may require prolonged mechanical ventilation. Limited data exists regarding the candidacy of EE, risk factors, consequences, and hospital costs of delayed extubation (DE) in pediatric LT.MethodsWe conducted a retrospective review to investigate predictive factors and associated costs of EE and DE in infants and children after orthotopic LT at our institution between 2011 and 2021.ResultsOf 338 LT (median age 39 months, 54% females), 246 (73%) had EE (within 24 h of LT), while 27% had DE. Age < 1 year (p = 0.0019), diagnosis of biliary atresia (0.02), abnormal pre‐LT echocardiogram (0.02), and patients with ongoing hospital admission before LT (0.0001) were independently associated with DE. Hospital costs were significantly (∼3‐fold) higher (p < 0.0001) in the DE group. In addition, factors associated with increased total hospital costs were age < 1 year and hospitalization before LT.ConclusionEE post‐LT is feasible and merits a trial. The prevalence of DE though modest is associated with increased resource utilization and hospital costs. Children who can be extubated early and those at risk for DE can be identified pre‐operatively for optimal planning and allocation of resources.
Vaping to quit smoking: Qualitative study of people receiving opioid agonist treatment
Authors: Kypri Kypros , Austin Emma , Jackson Melissa , Wright Kirsten , Shui Amanda , Li Andrew , Sathasivam Vinogi , Bonevski Billie , Dunlop Adrian J. 
Published: October 2024

AbstractIntroductionMost patients receiving opioid agonist treatment (OAT) smoke tobacco. Approved cessation interventions are less effective in this group than the wider population. We investigated how people on OAT experience nicotine vaping to quit smoking.MethodsPatients on OAT randomised to the vaping arm of a smoking cessation trial were invited to participate in structured interviews incorporating broad pre‐determined themes. A qualitative descriptive approach employing template analysis was used. Four authors coded transcripts, discussed discrepancies, modified the template using both inductive and deductive approaches. Authors made explicit their starting orientations and independent authors sought disconfirmatory data in a subsequent round of analysis.ResultsFour women and eight men (median age 44 years) participated, including four who identified as Aboriginal. Participants reported vaping as cheaper, more acceptable and less stigmatising than smoking but expressed concerns about ongoing accessibility due to the Australian prescription access model. Some found it technically challenging at first, but not more so than standard nicotine replacement therapies. Participants gave accounts of craving and withdrawal experiences, including supplementary use of nicotine patches, and compulsions to vape frequently and intensely, potentially indicating need for higher nicotine dosage. Participants generally reported that vaping helped them quit smoking, though some worried about swapping nicotine addictions. Others were glad to be using a lower‐risk alternative.Discussion and ConclusionsThis group reported varied experiences of nicotine vaping but were mainly optimistic that it could help them and others quit smoking. This was despite initial nicotine cravings and concerns about remaining addicted long‐term.
Adaptation patterns and their associations with mismatch negativity: An electroencephalogram (EEG) study with controlled expectations
Authors: Wong Brian W. L. , Huo Shuting , Maurer Urs 
Published: October 2024

AbstractAdaptation refers to the decreased neural response that occurs after repeated exposure to a stimulus. While many electroencephalogram (EEG) studies have investigated adaptation by using either single or multiple repetitions, the adaptation patterns under controlled expectations manifested in the two main auditory components, N1 and P2, are still largely unknown. Additionally, although multiple repetitions are commonly used in mismatch negativity (MMN) experiments, it is unclear how adaptation at different time windows contributes to this phenomenon. In this study, we conducted an EEG experiment with 37 healthy adults using a random stimulus arrangement and extended tone sequences to control expectations. We tracked the amplitudes of the N1 and P2 components across the first 10 tones to examine adaptation patterns. Our findings revealed an L‐shaped adaptation pattern characterised by a significant decrease in N1 amplitude after the first repetition (N1 initial adaptation), followed by a continuous, linear increase in P2 amplitude after the first repetition (P2 subsequent adaptation), possibly indicating model adjustment. Regression analysis demonstrated that the peak amplitudes of both the N1 initial adaptation and the P2 subsequent adaptation significantly accounted for variance in MMN amplitude. These results suggest distinct adaptation patterns for multiple repetitions across different components and indicate that the MMN reflects a combination of two processes: the initial adaptation in the N1 and a continuous model adjustment effect in the P2. Understanding these processes separately could have implications for models of cognitive processing and clinical disorders.