bluuebunny/crossref_metadata_2025_split huggingface dataset:
Susceptibility testing alone will not reliably achieve high Helicobacter pylori cure rates: A systematic review and meta‐analysis
Authors: Huang Yu , Chen Jinnan , Ding Zhaohui , Liang Xiao , Lu Hong 
Published: April 2022

AbstractBackground and AimNot all the susceptibility‐guided therapies for Helicobacter pylori (H. pylori) infection achieve excellent eradication rates. The aim of this study was to perform a systematic review and meta‐analysis to identify the optimal regimen for H. pylori treatment based on antibiotic susceptibility.MethodsA systematic search was performed in multiple databases. Studies reporting eradication rates of H. pylori with susceptibility‐guided therapies were selected. Meta‐analysis was conducted to calculate the pooled eradication rate among the treatment regimens.ResultsForty‐eight eligible studies with 101 susceptibility‐guided treatment arms were included. The overall eradication rate in patients harboring susceptible strains was 95.0% (95% CI, 94.1–95.9%), but only 63.4% of treatment arms (64/101) achieved good eradication rates (≥ 90%). Pooled eradication rates in patients with susceptible strains were: 93.4% (95% CI, 92.0–94.8%) for clarithromycin, 99.0% (95% CI, 98.1–100%) for nitroimidazoles and 95.4% (95% CI, 93.6–97.2%) for fluoroquinolones. Among the arms using a triple therapy, 66.7% (28/42) using clarithromycin, 84.2% (16/19) using nitroimidazoles and 70.8% (17/24) using fluoroquinolones achieved good (≥ 90%) eradication rates. Of 13 arms using sequential therapy, ≥ 90% eradication was achieved in 14.3% (1/7) using clarithromycin, 25.0% (1/4) using nitroimidazoles and both arms (2/2) using fluoroquinolones.ConclusionsSusceptibility testing alone seemed insufficient to reliably attain high H. pylori cure rates. The eradication rate in patients with nitroimidazoles susceptible strains was higher than those of fluoroquinolones and clarithromycin.
Association of thyroid autoimmunity with nonalcoholic fatty liver disease in euthyroid middle‐aged subjects: A population‐based study
Authors: Kim Hye Jeong , Park Sang Joon , Park Hyeong Kyu , Byun Dong Won , Suh Kyoil , Yoo Myung Hi 
Published: April 2022

AbstractBackground and AimThe association between thyroid autoimmunity and nonalcoholic fatty liver disease (NAFLD) remains unclear. In this study, we aimed to investigate the relationship between thyroid autoimmunity and NAFLD in a large cohort of euthyroid subjects.MethodsWe analyzed clinical and biochemical data from a nationwide, population‐based, cross‐sectional survey (KNHANES VI). A total of 1589 middle‐aged participants aged 45–65 years, with normal thyroid function, were included in this study. NAFLD was defined as a hepatic steatosis index of > 36. We estimated the odds ratios (ORs) for NAFLD according to anti‐thyroid peroxidase antibody (TPOAb) positivity by using logistic regression models, and adjusted for potential confounders.ResultsOverall, 24% (n = 378) of the subjects had NAFLD. Subjects with NAFLD showed a higher positivity for TPOAb (11% vs 7%, P = 0.014) compared with those without NAFLD. TPOAb positivity was a significant risk factor for NAFLD [OR 1.668, 95% confidence interval (CI) 1.019–2.730, P = 0.042] even after adjusting for confounding variables, including age, sex, household income, education, smoking, alcohol consumption, walking activity, abdominal obesity, elevated blood pressure, dyslipidemia and hyperglycemia. In addition, TPOAb positivity predicted the risk of advanced liver fibrosis (OR 3.112, 95% CI 1.256–7.713, P = 0.014) in subjects with NAFLD, independent of the confounding variables.ConclusionIn euthyroid subjects, thyroid autoimmunity is associated with NAFLD and advanced liver fibrosis, independent of known metabolic risk factors. Large longitudinal studies in the future will help clarify the causality.
The VA Life‐Sustaining Treatment Decisions Initiative: A qualitative analysis of veterans with advanced kidney disease
Authors: Wong Susan P. Y. , Foglia Mary Beth , Cohen Jennifer , Oestreich Taryn , O'Hare Ann M. 
Published: April 2022

AbstractBackgroundDocumentation of patients' goals of care is integral to promoting goal‐concordant care. In 2017, the Department of Veterans Affairs (VA) launched a system‐wide initiative to standardize documentation of patients' preferences for life‐sustaining treatments (LST) and related goals‐of‐care conversations (GoCC) that included using a note template in its national electronic medical record system. We describe implementation of the LST note based on documentation in the medical records of patients with advanced kidney disease, a group that has traditionally experienced highly intensive patterns of care.MethodsWe performed a qualitative analysis of documentation in the VA electronic medical record for a national random sample of 500 adults with advanced kidney disease for whom at least one LST note was completed between July 2018 and March 2019 to identify prominent themes pertaining to the content and context of LST notes.ResultsDuring the observation period, a total of 723 (mean 1.5, range 1–6) LST notes were completed for this cohort. Two themes emerged from the analysis: (1) Reactive approach: LST notes were largely completed in response to medical crises, in which they focused on short‐term goals and preferences rather than patients' broader health and goals, or certain clinical encounters designated by the initiative as “triggering events” for LST note completion; (2) Practitioner‐driven: Documentation suggested that practitioners would attempt to engage patients/surrogates in GoCC to lay out treatment options in order to move care forward, but patients/surrogates sometimes appeared reluctant to engage in GoCC and had difficulty communicating in ways that practitioners could understand.ConclusionsStandardized documentation of patients' treatment preferences and related GoCC was used to inform in‐the‐moment decision‐making during acute illness and certain junctures in care. There is opportunity to expand standardized documentation practices and related GoCC to address patients'/surrogates' broader health concerns and goals and to enhance their engagement in these processes.
Psychotropic medication prescribing trends in a developmental–behavioural clinic during the COVID‐19 pandemic
Authors: Ong Jun J , Roberts Gehan 
Published: April 2022

AimPsychotropic medication prescribing among children with developmental–behavioural and mental health problems appears to be rising globally. We aim to examine the effects of the COVID‐19 pandemic and rapid introduction of telehealth consultations on the prescribing trends and medication change in a large paediatric public hospital developmental–behavioural outpatient service.MethodsData for developmental–behavioural outpatient encounters from 23 March 2019 to 22 March 2021 were extracted from the electronic medical record; representing the 12 months following the conversion to telehealth consultations during the onset of COVID‐19 pandemic and the 12 months prior to this change. Excel and Statistical Package for the Social Sciences were used to calculate percentages and logistic regression to compare psychotropic prescribing trends during both periods.ResultsDuring the pandemic, there were a total of 3201 encounters (92.0% telehealth), compared with 2759 encounters (1.6% telehealth) during the previous year. Despite the higher number of encounters during the pandemic, the rates of encounters with psychotropic medication prescriptions reduced compared to the previous 12 months (19.8% vs. 29.3%). Prescriptions made during COVID‐19 were more likely to be provided at review visits, patients ≥12 years and during consultant led encounters. The reduction in prescriptions involved both new and follow‐up psychotropic medications. The majority of follow‐up medication dosages were left unchanged.ConclusionsPsychotropic prescribing rates were lower during the COVID‐19 pandemic. Fewer new medications were commenced and most medication dosages were unchanged.
Efficacy of mono‐ and multistrain synbiotics supplementation in modifying performance, caecal fermentation, intestinal health, meat and bone quality, and some blood biochemical indices in broilers
Authors: Yalçın Sakine , Ramay Muhammad Shazaib , Güntürkün Oğuz Berk , Yalçın Siddika Songül , Ahlat Ozan , Yalçın Suzan , Özkaya Mustafa 
Published: April 2022

AbstractThe superiority of synbiotics in terms of their biological effects depends primarily on a suitable combination of both components, pro‐biotic and pre‐biotic. The present study was conducted to compare the efficacy of mono‐ and multistrain synbiotics on overall performance, caecal fermentation, intestinal health, meat and bone quality along with some blood biochemical indices in broilers. A total of 231, 1‐day‐old male Ross 308, broiler chicks were randomly assigned to three experimental groups using 11 replicates each and seven chicks/replicate. The dietary treatments included control group with no synbiotic supplementation, monostrain (Maflor) and multistrain (Maflor plus) synbiotic groups with 1 g/kg of added synbiotics each. Synbiotics feeding significantly improved animal performance with a clear impact on meat quality in terms of low‐fat, optimum ultimate pH24, higher water holding capacity, and lower drip and cooking losses. Of the two synbiotics, multistrain seemed to have responded better in modifying small intestinal epithelia and fermentation metabolites, although both synbiotics were comparable in reducing the pathogen load. Load‐bearing capacity of both leg bones (femur and tibia) was also enhanced with synbiotics supplementation, which was also reflected in their mineral profile. The blood serum biochemical analysis showed a reduction in circulating cholesterol and triglycerides levels and an increment in IgA and IgG concentrations. In conclusion, the remarkable efficacy of tested synbiotics in providing higher growth, better meat quality in tandem with the optimum gut environment, lower pathogen load, healthy epithelia, immunomodulation, hypocholesterolemic, and hypotriglyceridemic effects affirms their great potential to be used as feed additives in broiler diets. Contrary to our expectations, the effectiveness of a mono‐strain in comparison to multistrain synbiotic in improving almost all the features investigated was also notable. Further evaluation under challenging conditions should be explicitly conducted to achieve more comprehensive results.
The life cycle and enigmatic egress of coronaviruses
Authors: Prydz Kristian , Saraste Jaakko 
Published: April 2022

AbstractThere has been considerable recent interest in the life cycle of Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2), the causative agent of the Covid‐19 pandemic. Practically every step in CoV replication—from cell attachment and uptake via genome replication and expression to virion assembly has been considered as a specific event that potentially could be targeted by existing or novel drugs. Interference with cellular egress of progeny viruses could also be adopted as a possible therapeutic strategy; however, the situation is complicated by the fact that there is no broad consensus on how CoVs find their way out of their host cells. The viral nucleocapsid, consisting of the genomic RNA complexed with nucleocapsid proteins obtains a membrane envelope during virus budding into the lumen of the intermediate compartment (IC) at the endoplasmic reticulum (ER)–Golgi interface. From here, several alternative routes for CoV extracellular release have been proposed. Strikingly, recent studies have shown that CoV infection leads to the disassembly of the Golgi ribbon and the mobilization of host cell compartments and protein machineries that are known to promote Golgi‐independent trafficking to the cell surface. Here, we discuss the life cycle of CoVs with a special focus on different possible pathways for virus egress.
Identification of histopathological and clinical spectrum of diabetic kidney disease based on an unsupervised hierarchical clustering analysis of elderly autopsy specimens
Authors: Sugimoto Hikaru , Yumura Wako , Yamaguchi Yasuko , Yamanaka Noriko , Hashimoto Seiji , Arai Masahiro , Matsuno Shiho , Shimizu Akira , Arai Tomio , Itabashi Mitsuyo , Takei Takashi 
Published: April 2022

AbstractAimDiabetic kidney disease (DKD), a chronic kidney disease caused by diabetes and other comorbidities, is the leading cause of end‐stage renal disease. The pathogenesis of DKD is diverse and influenced by various causes, some but not all of which cause proteinuria. Some factors such as hypertension can modify DKD. Therefore, the spectrum of DKD is difficult to elucidate and remains unsolved. This study aims to classify and characterize DKD.MethodsWe examined autopsy specimens from type 2 diabetes mellitus (DM) (n = 44) and non‐DM (n = 21) groups.ResultsThe frequency of interstitial fibrosis and tubular atrophy was higher in patients with proteinuric DKD than in those with non‐proteinuric DKD. The presence of polar vasculosis was associated with hypertension in DKD. In addition, an unsupervised hierarchical clustering analysis revealed the spectrum of renal histopathology findings for more‐proteinuric and less‐proteinuric DKD. With changes in the diagnostic criteria for hypertension and advances in antihypertensive drugs, the pathogenesis of DKD may be changing. Furthermore, a decision tree model suggested how diabetes, hypertension, and dyslipidemia interacted in predicting the characteristics of DKD.ConclusionPolar vasculosis is a good indicator of the presence of DM and hypertension. Furthermore, the histopathological and clinical spectrum of DKD were related to the interaction of diabetes, hypertension, and dyslipidemia. These histopathological and clinical results may help to show the range of patient characteristics when conducting clinical trials and could help to determine whether chronic kidney disease is caused by DM or some other cause.
Risk factors for reintubation and mortality among patients who had unplanned extubation
Authors: Chang Ting‐Chia , Cheng Ai‐Chin , Hsing Shu‐Chen , Chan Khee‐Siang , Chou Willy , Chen Chin‐Ming 
Published: April 2022

AbstractBackgroundUnplanned extubation (UE) occurs among 2%–16% of patients with mechanical ventilation (MV). Failed UE requiring reintubation could be associated with several adverse events.AimsThe aim of this study was to investigate the outcomes and prognostic factors of patients with UE in intensive care units (ICUs).MethodsWe prospectively registered the patients who had UE and retrospectively reviewed the electronic medical records for 96‐bed ICUs between 1 January 2009, and 31 December 2020.ResultsA total of 392 patients had UE, and 234 patients (59.7%) were ≥65 years (older adult group). The median Acute Physiology and Chronic Health Evaluation (APACHE) II score were 17 and the median Glasgow Coma Scale score was 10. In total, 205 patients (52.3%) were reintubated within 48 h (due to failed UE) and 75 patients (19.1%) died during hospitalization. Multivariate analyses were performed to evaluate those factors predicting failed UE and mortality. These analyses demonstrated that higher positive end‐expiratory pressure (PEEP) and the admission APACHE II scores predicted failed UE. A higher fraction of inspiration O2 (FiO2) and minute ventilation; lower haemoglobin (Hb); and higher instances of liver cirrhosis, cancer, and failed UE were independently associated with hospital mortality.ConclusionWe concluded that among patients who had UE, higher FiO2 or minute ventilation, or under MV or with lower Hb, liver cirrhosis, cancer, and failed UE tended to have higher mortality.Relevance to Clinical PracticePatients with high disease severity indices who have an increased risk of UE required special attention to techniques to prevent endotracheal tubes from accidental removal.
Modelling the Differing Impacts of Covid‐19 in the UK Labour Market†
Authors: Martin Chris , Okolo Magdalyn 
Published: April 2022

AbstractThis article studies the impact of the Covid‐19 pandemic on graduates and non‐graduates in the United Kingdom. We construct a DSGE model with search frictions that is designed around key features of the UK labour market and simulate the model using an array of shocks, designed to mimic the impact of the Covid‐19 pandemic. We show that our relatively simple macroeconomic model can describe the impact of the pandemic on output, employment and wages. Our results show that the impact of the pandemic on employment and wages was more severe for non‐graduates than for graduates, and that up to 5 million jobs would have been lost in the first wave of the pandemic in the absence of the Job Retention Scheme.
Protein C system in preterm babies with chronic lung disease: Prospective study
Authors: Kamamoto Tomoyuki , Nakajima Yuto , Uchida Yumiko , Nakagawa Takashi , Tonegawa Hitoshi , Tani Yuki , Nishimoto Eri , Takahashi Yukihiro , Nishikubo Toshiya , Nogami Keiji 
Published: April 2022

AbstractBackgroundChronic lung disease (CLD) is a major neonatal pulmonary disorder associated with inflammation. Recent studies have shown that protein C anticoagulant pathways, such as those for protein C (PC), protein S (PS), and thrombomodulin (TM), could be useful indices for reflecting pulmonary injury. However, the involvement of these factors in preterm infants with very low birthweight (VLBW) who have developed CLD remains to be investigated. Here, we investigated whether PC pathway‐related factors could predict the development of CLD in preterm infants with VLBW.MethodsWe collected plasma samples from 26 preterm infants with VLBW (13 each from those with and without CLD) at the time of birth and measured TM, PC, and PS levels in their plasmas. We analyzed prospectively the relationship between these factors in infants with and without CLD.ResultsThere were significant differences in gestational age, birthweight, Apgar score (5 min), and duration of mechanical ventilation between the CLD and non‐CLD groups. No significant differences in the PC and PS levels at birth were observed between the two groups, whereas the TM levels in the CLD group were significantly higher than those in the non‐CLD group (P = 0.013). The TM levels correlated with gestational age and duration of mechanical ventilation. However, covariance analysis demonstrated that gestational age was significantly associated with TM levels, and consequently, development of CLD was not associated with TM level at birth.ConclusionsThrombomodulin, PC, and PS levels at birth could not predict the development of CLD in preterm infants with VLBW.
Directly observed therapy to promote medication adherence in adolescent heart transplant recipients
Authors: Killian Michael O. , Clifford Stephanie , Lustria Mia Liza A. , Skivington Gage L. , Gupta Dipankar 
Published: April 2022

AbstractPurposeHT recipients experience high levels of medication non‐adherence during adolescence. This pilot study examined the acceptability and feasibility of an asynchronous DOT mHealth application among adolescent HT recipients. The app facilitates tracking of patients’ dose‐by‐dose adherence and enables transplant team members to engage patients. The DOT application allows patients to self‐record videos while taking their medication and submit for review. Transplant staff review the videos and communicate with patients to engage and encourage medication adherence.MethodsTen adolescent HT recipients with poor adherence were enrolled into a single‐group, 12‐week pilot study examining the impact of DOT on adherence. Secondary outcomes included self‐report measures from patients and parents concerning HRQOL and adherence barriers. Long‐term health outcomes assessed included AR and hospitalization 6 months following DOT.FindingsAmong 14 adolescent HT patients approached, 10 initiated the DOT intervention. Of these, 8 completed the 12‐week intervention. Patients and caregivers reported high perceptions of acceptability and accessibility. Patients submitted 90.1% of possible videos demonstrating medication doses taken. MLVI values for the 10 patients initiating DOT decreased from 6 months prior to the intervention (2.86 ± 1.83) to 6 months following their involvement (2.08 ± 0.87) representing a 21.7% decrease in non‐adherence, though not statistically significant given the small sample size.ConclusionsResult of this pilot study provides promising insights regarding the feasibility, acceptability, and potential impact of DOT for adolescent HT recipients. Further randomized studies are required to confirm these observations.
An agent‐based model for evaluating reforms of the National Flood Insurance Program: A benchmarked model applied to Jamaica Bay, NYC
Authors: de Ruig Lars Tjitze , Haer Toon , de Moel Hans , Orton Philip , Botzen W. J. Wouter , Aerts Jeroen C. J. H. 
Published: April 2022

AbstractCoastal flood risk is expected to increase as a result of climate change effects, such as sea level rise, and socioeconomic growth. To support policymakers in making adaptation decisions, accurate flood risk assessments that account for the influence of complex adaptation processes on the developments of risks are essential. In this study, we integrate the dynamic adaptive behavior of homeowners within a flood risk modeling framework. Focusing on building‐level adaptation and flood insurance, the agent‐based model (DYNAMO) is benchmarked with empirical data for New York City, USA. The model simulates the National Flood Insurance Program (NFIP) and frequently proposed reforms to evaluate their effectiveness. The model is applied to a case study of Jamaica Bay, NY. Our results indicate that risk‐based premiums can improve insurance penetration rates and the affordability of insurance compared to the baseline NFIP market structure. While a premium discount for disaster risk reduction incentivizes more homeowners to invest in dry‐floodproofing measures, it does not significantly improve affordability. A low interest rate loan for financing risk‐mitigation investments improves the uptake and affordability of dry‐floodproofing measures. The benchmark and sensitivity analyses demonstrate how the behavioral component of our model matches empirical data and provides insights into the underlying theories and choices that autonomous agents make.
A Sociology of Empathy and Shared Understandings: Contextualizing Beliefs and Attitudes on Why People Use Opioids
Authors: Ezell Jerel M. , Olson Brooke , Walters Suzan M. , Friedman Samuel R. , Ouellet Lawrence , Pho Mai T. 
Published: April 2022

AbstractThere has been a steep rise in overdoses and mortality among people who use opioids or who inject drugs (PWUD), including in North America, the United Kingdom, and parts of Eastern Europe, with some of the sharpest increases amassing in rural communities. Currently, the literature lacks a comparative focus on the views and experiences of rural PWUD and professionals who regularly work and interface with them, in terms of their understandings of the rural drug use initiation/relapse trajectory. Considering a renewed sociology of emotions and empathy and the constructs of direct experience (e.g., of personal drug use) versus role‐playing (e.g., envisioning oneself in another's position), we used a modified constant comparison method to analyze interviews conducted with PWUD and professional stakeholders in rural southern Illinois, an opioid overdose hotspot. Findings suggest that rural opioid use is adopted in service of an intricate interplay of sensory, relational, somatic, and psychosocial benefits, with a sharp divergence between PWUD, who express considerable agency in their drug use behaviors, and professionals, who fail to successful role‐play in emphasizing PWUD's limited willpower and “deviant” sociocultural predilection. These dynamics illuminate challenges to advancing nuanced, culturally humble programming to advance public health goals related to the opioid and drug injection epidemic.