bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of CETP inhibitors on new-onset diabetes: a systematic review and meta-analysis
Authors: Dangas Katerina , Navar Ann-Marie , Kastelein John J P 
Published: April 2022

Abstract

Background
Despite the increasing prevalence of type 2 diabetes mellitus (T2DM), limited pharmacologic options are available for prevention. Cholesteryl ester transfer protein inhibitors (CETPis) have been studied primarily as a therapy to reduce cardiovascular disease, but have also been shown to reduce new-onset diabetes. As new trial data have become available, this meta-analysis examines the effect of CETP inhibitors on new-onset diabetes and related glycaemic measures.

Methods and results
We searched MEDLINE, EMBASE, and Cochrane databases (all articles until 4 March, 2021) for randomised controlled trials (RCT) ≥1-year duration, with at least 500 participants, comparing CETPi to placebo, and that reported data on new-onset diabetes or related glycaemic measures [haemoglobin A1C (HbA1C), fasting plasma glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)]. A fixed effects meta-analysis model was applied to all eligible studies to quantify the effect of CETPi therapy on new-onset diabetes. Four RCTs (n = 75 102) were eligible for quantitative analysis of the effect of CETPi on new-onset diabetes. CETPis were found to significantly decrease the risk of new-onset diabetes by 16% (RR: 0.84; 95% CI: 0.78, 0.91; P &lt; 0.001), with low between-trial heterogeneity (I2 = 4.1%). Glycaemic measures were also significantly improved or trended towards improvement in those with and without diabetes across most trials.

Conclusion
Although RCTs have shown mixed results regarding the impact of CETPi on cardiovascular disease, they have shown a consistent reduction in the risk of new-onset diabetes with CETPi therapy. Future trials of CETPis and potentially other HDL-raising agents should therefore specify new-onset diabetes and reversal of existing T2DM as secondary endpoints.
Impact of hypoxemia and re-interventions on clinical outcomes after bidirectional cavopulmonary shunt
Authors: Kido Takashi , Euringer Caecilia , Burri Melchior , Vodiskar Janez , Strbad Martina , Cleuziou Julie , Ruf Bettina , Ewert Peter , Hager Alfred , Hörer Jürgen , Ono Masamichi 
Published: April 2022

Abstract

OBJECTIVES
We sought to investigate the impact of early postoperative low arterial oxygen saturation on mortality and morbidity after bidirectional cavopulmonary shunt (BCPS).

METHODS
The medical records of all patients who underwent BCPS between 2013 and 2018 were reviewed.

RESULTS
A total of 164 patients were included in this study. Forty-seven patients underwent reintervention during hospital stay at median 7 days after BCPS. Before reintervention, 30 patients were intubated or had SpO2 of &lt;75%. All re-interventions for Glenn pathway obstruction and 4 out of 5 venovenous coil embolization resulted in hospital discharge, while high mortality was observed after other re-interventions (atrioventricular valve surgery, thrombolysis, systemic ventricular outflow obstruction relief, extracorporeal membrane oxygenation implantation and diaphragmatic plication). Additional aortopulmonary shunt with pulmonary artery discontinuation was performed in 8 patients who showed severe cyanosis with median SpO2 of 59% under maximal ventilation support. In the univariable Cox regression analysis, the associated factors for mortality before total cavopulmonary connection were reduced ventricular function [hazard ratio (HR) 6.89, 95% confidence interval (CI) 1.76–26.9, P-value 0.006], greater than moderate atrioventricular valve regurgitation (HR 5.89, 95% CI 1.70–20.4, P-value 0.005), SpO2 1 h after extubation (HR 0.87, 95% CI 0.80–0.96, P-value 0.004) and mean pulmonary artery pressure 1 h after extubation (HR 1.14, 95% CI 1.02–1.26, P-value 0.016).

CONCLUSIONS
After BCPS, unacceptable cyanosis persisted with various aetiologies. Low arterial oxygen saturation within 1 h after extubation is significantly associated with high mortality after BCPS.
Overdominant and partially dominant mutations drive clonal adaptation in diploidSaccharomyces cerevisiae
Authors: Aggeli Dimitra , Marad Daniel A , Liu Xianan , Buskirk Sean W , Levy Sasha F , Lang Gregory I 
Published: April 2022

AbstractIdentification of adaptive targets in experimental evolution typically relies on extensive replication and genetic reconstruction. An alternative approach is to directly assay all mutations in an evolved clone by generating pools of segregants that contain random combinations of evolved mutations. Here, we apply this method to 6 Saccharomyces cerevisiae clones isolated from 4 diploid populations that were clonally evolved for 2,000 generations in rich glucose medium. Each clone contains 17–26 mutations relative to the ancestor. We derived intermediate genotypes between the founder and the evolved clones by bulk mating sporulated cultures of the evolved clones to a barcoded haploid version of the ancestor. We competed the resulting barcoded diploids en masse and quantified fitness in the experimental and alternative environments by barcode sequencing. We estimated average fitness effects of evolved mutations using barcode-based fitness assays and whole-genome sequencing for a subset of segregants. In contrast to our previous work with haploid evolved clones, we find that diploids carry fewer beneficial mutations, with modest fitness effects (up to 5.4%) in the environment in which they arose. In agreement with theoretical expectations, reconstruction experiments show that all mutations with a detectable fitness effect manifest some degree of dominance over the ancestral allele, and most are overdominant. Genotypes with lower fitness effects in alternative environments allowed us to identify conditions that drive adaptation in our system.
Accuracy of Serum Leucine-Rich Alpha-2 Glycoprotein in Evaluating Endoscopic Disease Activity in Crohn’s Disease
Authors: Kawamura Tatsuya , Yamamura Takeshi , Nakamura Masanao , Maeda Keiko , Sawada Tsunaki , Ishikawa Eri , Iida Tadashi , Mizutani Yasuyuki , Ishikawa Takuya , Kakushima Naomi , Furukawa Kazuhiro , Ohno Eizaburo , Honda Takashi , Kawashima Hiroki , Ishigami Masatoshi 
Published: April 2022

Abstract

Background
Mucosal healing, confirmed by endoscopic evaluation, is the long-term goal of treatment for Crohn’s disease (CD). Leucine-rich alpha-2 glycoprotein (LRG) is a new serum biomarker correlated with disease activity in inflammatory bowel disease. However, studies evaluating its relationship with CD, particularly in the context of small intestinal lesions, are scarce. The aim of this study was to investigate the accuracy of LRG in assessing endoscopic activity, especially remission, in patients with CD.

Methods
Between July 2020 and March 2021, 72 patients with CD who underwent LRG testing and double-balloon endoscopy at the same time were included. Endoscopic activity was evaluated using the applied Simple Endoscopic Score for Crohn’s disease, including small intestine lesions. The relationship of LRG with clinical symptoms and endoscopic activity was assessed, and its predictive accuracy was evaluated.

Results
Leucine-rich alpha-2 glycoprotein showed a significant positive correlation with endoscopic activity (r = 0.619, P &lt; .001), even in patients with active lesions in the small intestine (r = 0.626, P &lt; .001). Multivariate logistic regression revealed that LRG was the only factor associated with endoscopic remission. An LRG cutoff value of 8.9 μg/mL had a sensitivity of 93.3%; specificity of 83.3%; positive predictive value of 96.6%; negative predictive value of 71.4%; accuracy of 91.7%; and area under the curve of 0.904 for the prediction of endoscopic remission.

Conclusions
Leucine-rich alpha-2 glycoprotein can be used in assessing endoscopic activity and is a reliable marker of endoscopic remission in CD patients. It can be an intermediate target in the treatment of CD.
The Court of Justice of the European Union: A Human Rights Institution?
Authors: Rosas Allan 
Published: April 2022

Abstract
While the original basic treaties establishing the European Communities were more or less silent on the need to respect human rights or fundamental rights, the Court of Justice of the European Communities (now the European Court of Justice) gradually came to the understanding that the principle of primacy of Community law could not in the long run be imposed against national constitutional bills of rights unless Community law itself provided some guarantees for the protection of fundamental rights. Today, fundamental rights have become part and parcel of the day-to-day work of the Court and there are even people who seem to think that the Court takes fundamental rights all too seriously. Recapitulating the general development of fundamental rights in EU law and the EU’s accession to the European Convention on Human Rights, as well as comparing Luxembourg’s and the European Court of Human Rights’ case law and legal regimes, this article argues that the European Court of Justice is not a human rights court. It is but a judicial body charged with the task of ensuring that the law—which includes a vast and heterogeneous set of rules adopted and applied within a constitutional order which is quite different from the ECHR system—is observed, as required by Article 19(1) TEU.
Sociodemographics, Health Competence, and Transition Readiness Among Adolescent/Young Adult Cancer Survivors
Authors: Prussien Kemar V , Barakat Lamia P , Darabos Katie , Psihogios Alexandra M , King-Dowling Sara , O’Hagan Bridget , Tucker Carole , Li Yimei , Hobbie Wendy , Ginsberg Jill , Szalda Dava , Hill-Kayser Christine , Schwartz Lisa A 
Published: April 2022

Abstract

Objective
Fewer than one-third of childhood cancer survivors receive follow-up from an adult provider, and adolescent and young adults (AYAs) from structurally minoritized sociodemographic groups often face health disparities that can impact transition to adult-oriented care. The primary aim of this study was to determine the relation among sociodemographic factors, cumulative effects, and transition beliefs/expectations and goals, and the moderating role of health competence beliefs in AYA survivors of childhood cancer.

Methods
A total of 195 AYAs (aged 15–29) reported sociodemographic information, completed the Transition Readiness Inventory assessing positive beliefs/expectations and goals related to transition, and completed the Health Competence Beliefs Inventory assessing health perceptions, healthcare satisfaction, cognitive competence, and autonomy. A cumulative sociodemographic factor variable was computed to investigate the potential additive effects of multiple sociodemographic factors associated with disparities. T-tests, Pearson correlations, and multivariate linear regressions were used.

Results
Cumulative sociodemographic factors were not related to transition readiness, and insurance type was the only factor associated with health competence beliefs and transition readiness, such that AYAs with public insurance reported lower healthcare satisfaction, cognitive competence, and transition goals relative to those with private insurance. There were no interaction effects; however, health competence beliefs were significantly associated with transition beliefs/expectations and goals.

Conclusion
Public insurance is a barrier to holding positive beliefs/expectations and goals about transition, yet other sociodemographic factors associated with risks for poor transfer were not related to transition readiness. Multi-level interventions to reduce disparities and improve transition readiness should target health competence beliefs and barriers created by insurance.
Magnetic dynamos in white dwarfs – III. Explaining the occurrence of strong magnetic fields in close double white dwarfs
Authors: Schreiber Matthias R , Belloni Diogo , Zorotovic Monica , Zapata Sarai , Gänsicke Boris T , Parsons Steven G 
Published: April 2022

ABSTRACT
The origin of strong ($\stackrel{\gt }{\scriptstyle \sim }1\,\mathrm{ MG}$) magnetic fields in white dwarfs has been a puzzle for decades. Recently, a dynamo mechanism operating in rapidly rotating and crystallizing white dwarfs has been suggested to explain the occurrence rates of strong magnetic fields in white dwarfs with close low-mass main-sequence star companions. Here, we investigate whether the same mechanism may produce strong magnetic fields in close double white dwarfs. The only known strongly magnetic white dwarf that is part of a close double white dwarf system, the magnetic component of NLTT 12758, is rapidly rotating and likely crystallizing and therefore the proposed dynamo mechanism represents an excellent scenario for the origin of its magnetic field. Presenting a revised formation scenario for NLTT 12758, we find a natural explanation for the rapid rotation of the magnetic component. We furthermore show that it is not surprising that strong magnetic fields have not been detected in all other known double white dwarfs. We therefore conclude that the incidence of magnetic fields in close double white dwarfs supports the idea that a rotation- and crystallization-driven dynamo plays a major role in the generation of strong magnetic fields in white dwarfs.
Incorporating Intersectionality as a Framework for Equity-Minded Tobacco Control Research: A Call for Collective Action Toward a Paradigm Shift
Authors: Tan Andy S L , Hinds Josephine T , Smith Philip H , Antin Tamar , Lee Juliet P , Ostroff Jamie S , Patten Christi , Rose Shyanika W , Sheffer Christine E , Fagan Pebbles 
Published: April 2022

Abstract

Introduction
To eliminate tobacco-related disparities, tobacco control research would benefit from a paradigm shift. Intersectionality, a framework pioneered by Kimberlé Crenshaw in late 1980s, has the potential to improve our understanding of why and how certain social groups are disproportionately harmed by commercial tobacco use, and improve our ability to address persistent tobacco-related health disparities.

Aims and Methods
In this commentary, we outline the rationale and recommendations for incorporating intersectionality into equity-minded tobacco control research. These recommendations arose from intersectionality webinars organized by the Health Disparities (now Health Equity) Network of the Society for Research on Nicotine & Tobacco (SRNT) in 2019 and 2020.

Results
Specifically, we propose that eliminating tobacco-related disparities through intersectionality-informed research requires a multilevel, multipronged approach. We summarize priority actions for the tobacco control research field to achieve health equity through the intersectionality framework including acknowledging that structural factors, racism and power dynamics shape lived experiences, integrating critical theoretical frameworks and intersectionality scholarship into research questions, and embracing collaborative community-based approaches at every level of the research process.

Conclusions
Through these actions, our field can take concrete steps to fundamentally improve our approach to conducting research to achieve health equity.

Implications
Intersectionality is a valuable tool to align our field with our pursuit of health equity. The recommendations aim to improve methods of equity-focused tobacco control, prompt ongoing dialogue on the utility of this tool, and shift paradigms in how the research process is conducted at every level among stakeholders, including researchers, journal editors and reviewers, funders, practitioners, and policy makers.
Schlieren Phenomenon for Identification of Lymphorrhea Point
Authors: Sotsuka Yohei , Wakatsuki Hanako , Matsuda Ken 
Published: April 2022

Summary:
Surgical invasion of the lymphatic system can lead to lymphorrhea. Lymphorrhea is first treated conservatively, but is often refractory and subsequently treated surgically. In surgery, it is difficult to identify the lymphatic leak points visually. In this study, we observed the schlieren phenomenon based on the difference in the refractive index between glucose solution and lymph fluid, and were able to easily identify the site of the lymphatic leakage in real time and treat lymphorrhea.
A MULTICENTER REVIEW EVALUATING THE RISK OF RHEGMATOGENOUS RETINAL DETACHMENT POST ENDOPHTHALMITIS
Authors: Nanji Keean , Kherani Imaan , Khan Mohammad , Williams Geoff , Muni Rajeev H. , Chaudhary Varun , Kherani Amin 
Published: April 2022

Purpose:
To describe the characteristics of rhegmatogenous retinal detachments (RDs) that developed after endophthalmitis and to provide insight regarding incidence, management, and outcomes.

Methods:
Retrospective chart review of consecutive patients diagnosed with endophthalmitis at two Canadian institutions and from one surgeon at a third center over a 10-year period.

Results:
Three hundred sixteen eyes presented with endophthalmitis of which 32 (10%) were complicated by subsequent RD. The mean age (SD) of patients was 72.0 (13.77) years. Intravitreal injections (33%) and cataract surgery (31%) were the most common inciting events for the endophthalmitis. Cases were managed with tap and inject (16%), vitrectomy (30%), or both (47%). There were no differences in the rate of RD when comparing the inciting events, microbial growth, or management approaches. Baseline visual acuity was the only predictor of RD (P = 0.009). There was an improvement in visual acuity following management of the RD (logarithm of the minimum angle of resolution 2.33 vs. 1.69 or Snellen hand motion vs. 20/980, P = 0.009), but final visual acuity in these patients was worse than in those who did not develop RD (logarithm of the minimum angle of resolution 1.69 vs. 1.27 or Snellen 20/980 vs. 20/372, P = 0.029).

Conclusion:
All patients with RD post endophthalmitis required additional surgery, and functional outcomes remained poor. Nevertheless, repair of these RDs can preserve some vision and be globe saving.
Risk Factors for Sepsis-Associated Acute Kidney Injury in the PICU: A Retrospective Cohort Study
Authors: Ninmer Emily K. , Charlton Jennifer R. , Spaeder Michael C. 
Published: April 2022

OBJECTIVES:
Acute kidney injury (AKI), particularly of greater severity and longer duration, is associated with increased morbidity and mortality in the pediatric population. AKI frequently occurs during sepsis, yet the knowledge of risk factors for sepsis-associated AKI in the PICU is limited. We aimed to identify risk factors for AKI that develops or persists after 72 hours from sepsis recognition in pediatric patients with severe sepsis.

DESIGN:
Retrospective cohort study.

SETTING:
PICU at an academic, tertiary-care center.

PATIENTS:
Children greater than 1 month and less than or equal to 18 years with severe sepsis in the combined cardiac and medical/surgical PICU between December 1, 2013, and December 31, 2020, at the University of Virginia Children’s Hospital.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The cohort included 124 patients with severe sepsis with 33 patients (27%) who were postcardiac surgery with cardiopulmonary bypass. AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The primary outcome was severe AKI, defined as KDIGO stage 2 or 3 AKI present at any point between days 3 and 7 after sepsis recognition. Severe AKI was present in 25 patients (20%). Factors independently associated with severe AKI were maximum vasoactive-inotropic score (VIS) within 48 hours after sepsis recognition and fluid overload. The presence of severe AKI was associated with increased inhospital mortality.

CONCLUSIONS:
In children with severe sepsis, the degree of hemodynamic support as measured by the VIS and the presence of fluid overload may identify patients at increased risk of developing severe AKI.
Pediatric Emergency Medicine Physicians' Perspectives on Emergency Care of Children With Medical Complexity
Authors: Pulcini Christian D. , Dubuque Amy , Lamberson Miles , Macy Michelle L. , Mistry Rakesh D. , Pruitt Christopher M. , Schnadower David , Zorc Joseph J. , Stevens Martha W. 
Published: April 2022

Objective
Children with medical complexity (CMC) compose 1% of the pediatric population but account for 20% of pediatric emergency department (ED) visits. Previous descriptions of challenges and interventions to ensure quality of care are limited. Our objective was to elicit pediatric emergency medicine (PEM) physicians' perspectives on challenges and opportunities for improvement of emergency care of CMC, with a focus on emergency information forms (EIFs).

Methods
We conducted a web-based survey of PEM physicians participating the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. The survey was designed using an expert panel, and subsequently piloted and revised to an 18-item survey. Data were analyzed with descriptive statistics.

Results
One hundred fifty-one of 495 respondents (30%) completed the survey. Most respondents (62.9%) reported caring for >10 CMC per month. Whereas overall medical fragility and time constraints were major contributors to the challenges of caring for CMC in the ED, communication with known providers and shared care plans were identified as particularly helpful. Most respondents did not report routine use of EIFs. Anticipated emergencies/action plan was deemed the most important component of EIFs.

Conclusions
Most PEM physicians view the care for CMC in the ED as challenging despite practicing in high-resource environments. Further research is needed to develop and implement strategies to improve care of CMC in the ED. Understanding experiences of providers in general ED settings is also an important next step given that 80% of CMC present for emergency care outside of major children's hospitals.
A Multistate Survey of Pediatric Emergency Care Coordinator Activities
Authors: Samuels-Kalow Margaret E. , Boggs Krislyn M. , Alpern Elizabeth R. , Camargo Carlos A. 
Published: April 2022

Background
Pediatric emergency care coordinators (PECCs) are associated with pediatric readiness of emergency departments (EDs). National organizations have called for PECCs in all EDs. Although the National Pediatric Readiness Program provides a list of suggested tasks for each PECC, little is known about implementation. Our objective was to describe the role of PECCs in EDs.

Methods
We analyzed data from the 2019 National ED Inventory—USA to identify EDs with PECCs in 8 states (Arkansas, Florida, Iowa, Maryland, Nebraska, New York, Vermont, and Wisconsin). We called each ED that reported having a PECC to administer a standardized survey assessing NRPP tasks, specifically quality improvement (QI), education provision, skill verification, equipment responsibilities, and how many hours the PECC devoted to the role.

Results
Of the 201 of 830 EDs (24%) that reported a PECC, 167 (83%) completed the survey, with >80% response rate in each state. Of these, 153 EDs (92%) confirmed a PECC, and during the past year, 81% participated in QI initiatives, 93% provided pediatric education, 90% verified staff skills, and 90% were responsible for ensuring medications, equipment, supplies, and resources for children. The median number of hours per week that PECCs devoted to this role was 12 (interquartile range, 5–40). There was wide variation between states (eg, 50% of PECCs in Vermont participating in QI activities, as compared with 100% in Nebraska).

Conclusions
Most PECCs report participating in the suggested National Pediatric Readiness Program tasks, although there was variation by state. Future directions for this work include assessing the association between PECC tasks and patient outcomes.