bluuebunny/crossref_metadata_2025_split huggingface dataset:
A217 TREATMENT ADHERENCE OF CHRONIC HEPATITIS B PATIENTS WITH HEPATOCELLULAR CARCINOMA FROM THE CANHEPB NETWORK
Authors: Rahman S H , Scharr Y , Jeyaparan J , Manko A , Coffin C S , Congly S E , Ramji A , Fung S , Cooper C , Ma M , Bailey R , Minuk G , Wong A , Doucette K , Elkhashab M , Wong P , Brahmania M 
Published: February 2022

Abstract

Background
Chronic hepatitis B (CHB) is the most common cause of hepatocellular carcinoma (HCC) worldwide.

Aims
The primary aim of this study is to explore the degree of treatment adherence to the American Association For The Study of Liver Disease (AASLD) HCC treatment guidelines for patients with CHB-HCC.

Methods
This is a retrospective, cross-sectional study of available data (2005–2020) in patients mono-infected with CHB collected from the Canadian HBV Network; a national consortium across 8 Canadian provinces. We analyzed data using descriptive statistics along with parametric and nonparametric statistical methods with a significance level of p &lt; 0.05.

Results
Of the 6500 patients, 132 (2.0%) patients met inclusion criteria. The median age was 64 (IQR: 53.5- 71.5) with 101 (76%) being male. The median ALT was 40 (IQR: 26–59.5) and the median tumor number was 1(IQR: 1- 2) with a median tumor size of 2.6 cm (IQR: 1.9- 4.5). 98 (74.5%) patients were HBeAg negative with a median viral load of 3.8 logs (IQR 1.9 – 5.8). 58 (43%) patients had cirrhosis at diagnosis. 36% of patients were diagnosed with HCC on their first screening imaging whereas 39% were found to have HCC on repeated surveillance imaging. 116 (87.9%) were on treatment at the time of diagnosis or after (70 (60.3%) NA and 46 (39%) Combination therapy with double NA or NA plus interferon). Out of the 132 patients, BCLC stage 0, A, B, and C represented 30 (23%), 42 (32%), 17 (13%), and 5 (4%) patients, respectively, with 38 (28%) patients with unknown BCLC stage. The overall adherence to AASLD guidelines was 61%. The HCC treatment adherence rate for patients with BCLC stage 0, A, B were 63%, 97.5%, and 23.5%, respectively. BCLC stages C and D did not have a sufficient sample size for analysis. The adherence rate ranged from 53% (Eastern Canada) to 71% (Western Canada) across Canada.

Conclusions
In this retrospective nationwide cohort study of patients with CHB-related HCC, the overall treatment adherence rate to AASLD guidelines was low with notable regional differences. Further analysis will determine the cause of regional differences.

Funding Agencies
None
A223 THE CHAIR STAND TEST IS A RELIABLE FRAILTY METRIC FOR PREDICTING WAITLIST MORBIDITY AND MORTALITY IN PATIENTS WITH CIRRHOSIS
Authors: Nguyen V V , Wang S , Whitlock R , Xu C , Taneja S , Singh S , Abraldes J , Burak K , Bailey R , Lai J , Tandon P 
Published: February 2022

Abstract

Background
Frailty is defined as a clinical state of increased vulnerability to health and age associated stressors. The liver frailty index (LFI), composed of grip strength, chair stand and balance testing, is an accepted predictor of morbidity and mortality in cirrhosis. With the need for COVID-19 related social distancing, many appointments are being carried out virtually. The chair stand subcomponent of the LFI has the potential to be evaluated virtually, with a high reliability as compared to in-person testing noted in other disease populations.

Aims
To determine if the chair stand test is an independent predictor of morbidity and mortality in patients with cirrhosis.

Methods
822 adult patients with cirrhosis were prospectively enrolled from five centers (3 in Canada, 1 in the United States, and 1 in India). Inclusion criteria included adult patients with cirrhosis. 787 of these patients completed a chair stand test at baseline, measured as the time (seconds) a patient takes to rise from sitting with their arms folded across their chest five times (measured in-person). The times were divided into 3 categories: &gt;15 seconds, between 10 and 15 seconds, and &lt;10 seconds. Patients who could not complete 5 chair stands were classified in the &gt;15 seconds category. Primary outcome was all-cause mortality. Secondary outcome was unplanned all-cause hospital admission. Fine-Gray proportional hazard regression models were used to evaluate the association between the chair stand time and the outcomes. We adjusted for baseline age, sex, and MELD score and accounted for liver transplantation as a competing risk. Cumulative incidence functions were used to create a graphical representation of the survival analysis.

Results
Patients were divided into three groups: group 1, &lt;10 seconds (n = 276); group 2, 10–15 seconds (n = 290); and group 3, &gt;15 seconds (n = 221). Mortality was increased in group 3 in comparison to group 1 (HR 3.21, 95% CI: 2.16–4.78, p&lt;0.001). Similarly, the hazard of non-elective hospitalizations was higher in group 3 in comparison to group 1 (HR 2.24, 95% CI: 1.73–2.91, p&lt;0.001). Overall, patients with chair stand times greater than 15 seconds had increased all-cause mortality (HR 2.78, 95% CI 2.01–3.83, p&lt;0.001) and non-elective hospitalizations (HR 1.84, 95% CI 1.48–2.29, p&lt;0.001) when compared to patients with times less than 15 seconds.

Conclusions
A time to complete 5 chair stands of &gt;15 seconds predicts morbidity and mortality in patients with cirrhosis. This test shows promise as a frailty measure that could be evaluated over a virtual platform.

Funding Agencies
None
A226 SEX-BASED DISPARITY COMPLICATIONS FOLLOWING LIVER TRANSPLANTATION
Authors: Singh N , Chow J , Ebadi M , Ma M , Montano-Loza A J , Bhanji R 
Published: February 2022

Abstract

Background
Sex-based disparity exists in liver transplantation (LT) with women being disadvantaged at every stage of the process starting from assessment to post transplantation (Bryce et al., 2009). The reasons for this are multifactorial and include biological disparities, psychosocial, and allocation inequalities (Burra et al., 2013).

Aims
The purpose of this study was to identify differences in immediate or long-term complications post-LT by sex.

Methods
We analyzed 702 patients who underwent LT at the University of Alberta from 2002 to 2015. Patients aged &lt; 18 years or requiring a repeat or multivisceral transplant were excluded. Renal dysfunction was defined according to the KDIGO criteria. Cardiovascular disease (CVD) was defined as hospitalization for or death from coronary artery disease, cardiac arrest or cerebrovascular disease.

Results
Male patients comprised 69% of the population. Time on the waitlist was similar for men (9.3 ± 11.7 months) and women (9.9 ± 12.3 months; p=0.57). Both sexes were comparable in age (males: 53 ± 10 years; females: 52 ± 11 years; p=0.19), MELD (males: 18 ± 9; females: 19 ± 10; p=0.16) and BMI (males: 27.7 ± 5.7 kg/m2; females: 27.3 ± 6.6 kg/m2; p=0.58). Women had lower creatinine pre-LT (males: 1.1 ± 0.60 mg/dL; females 0.96 ± 0.51 mg/dL; p&lt;0.01). There were no differences in donor age, sex or BMI. Women had significantly longer hospital length of stay (males: 18 days [IQR: 11, 32]; females: 25 days [IQR: 14, 43]; p &lt;0.001). There was no difference in risk of acute kidney injury (OR 1.4 [95% CI: 0.98, 2.1]; p=0.06), infection (OR 1.1 [95% CI: 0.8, 1.5]; p=0.52) or rejection episodes (OR 1.1 [95% CI: 0.8, 1.5]; p=0.74) following LT. Women had a higher risk of CKD post-LT (OR 2.3 [95% CI: 1.6, 3.2]; p&lt;0.0001). There was no difference in de-novo diabetes (males: 22%; females: 16%; p=0.10), hypertension (males: 45%; females: 48%; p=0.41), dyslipidemia (males: 37%; females: 39%; p=0.67) and CVD (males: 20%; females: 19%; p=0.84) post-LT. Graft (males: 11.4 ± 0.4 years; females: 11.8 ± 0.5 years; p=0.32) and patient survival (males: 11.8 ± 0.4 years; females: 12.4 ± 0.5 years; p=0.18) were similar over a median follow up of 6.3 years [IQR: 3.5, 9.9].

Conclusions
Women spend a longer time in hospital and are at an increased risk of CKD following LT. Despite these differences, overall graft and patient survival are comparable. Our data suggest the disparity between sexes likely exists pre-LT and females that undergo LT have similar outcomes to their male counterparts.

Funding Agencies
None
A230 THE ROLE OF THE MICROBIOTA IN NOCICEPTOR DEVELOPMENT AND PAIN SENSITIVITY
Authors: Abdullah N , Defaye M , Hassan A , Cumenal M , Iftinca M , Young D , Ohland C L , Dufour A , McCoy K , Altier C 
Published: February 2022

Abstract

Background
Pain is the most common cause of disability in IBD. What causes inter-individual variability in chronic pain after successful treatment of inflammation remains elusive. We have shown that activation of TRPV1+ colonic nociceptors is essential for the establishment of persistent pain in DSS colitis. Nociceptor development coincides with microbial colonization, while early life dysbiosis can lead to visceral hypersensitivity in adulthood. Whether the microbiota dictates nociceptor development and pain susceptibility remains unknown. Here we test the hypothesis that the microbiota programs nociceptor specification during early development, rendering them more susceptible to sensitization later in life. We have identified the aryl hydrocarbon receptor (AHR) that senses bacterial-derived metabolites as a candidate target that orchestrates transcriptional regulation in nociceptors.

Aims
We investigated the developmental regulation of nociceptors by the microbiome and how it influences pain sensitivity. We will determine the effects of AHR activation on nociceptor lineage and function as well as the long term impact of AHR signaling on pain sensitivity.

Methods
We have developed a germ-free (GF) TRPV1-GFP reporter mouse that was used to phenotype and visualise TRPV1+ nociceptors in the absence of a microbiota. We will isolate TRPV1+ neurons by FACS to identify genes that are under the control of the microbiota and to characterise the phosphoproteome of TRPV1+ nociceptors in GF conditions. Finally, we will investigate the role of AHR signaling in nociceptors both acutely and during development.

Results
We showed a reduction in thermal pain threshold and a reduction in capsaicin test responses in GF mice. The number and size of DRG neurons was unchanged in GF mice. Examination of molecular markers for peptidergic (CGRP) and non-peptidergic (IB4) neurons did not show a difference. Finally, there was no difference in the expression of TRPV1, suggesting post-translational modification of the channel. In cultured DRG neurons, we found a decrease in capsaicin induced action potentials and a decrease in the amplitude of the capsaicin response in GF mice. Using RNAscope, we showed that TRPV1+ neurons express AHR.

Conclusions
Our results highlight the importance of bacterial composition in regulating the development of nociceptors and pain sensitivity in adulthood. Furthermore, we are the first to demonstrate the expression of AHR in sensory neurons. These findings point to a role of the microbiota in programming nociceptors during development. My work will advance our understanding of the role of commensal bacteria in regulating pain and could lead to recommendations for the treatment of neonates in early life to reduce their risk of developing chronic pain later in life.

Funding Agencies
CAG, CIHR
A249 RETROSPECTIVE CHART REVIEW OF PATIENTS WITH MALNUTRITION REQUIRING ADVANCED NUTRITIONAL SUPPORT POST BARIATRIC SURGERY
Authors: Tsang L , Fredriksen M , Jin J , Gramlich L 
Published: February 2022

Abstract

Background
Obesity is a global pandemic with a steady increase in global BMI since 1975. Bariatric surgery is an effective treatment for patients with severe obesity in order to sustain long-term weight loss and reduce comorbidity burden and mortality associated with obesity. However, post-bariatric surgery patients face nutritional complications ranging from micronutrient deficiencies to intestinal failure requiring total parenteral nutrition (TPN). From our institution of home TPN patients, 6.4% of patients had bariatric surgery. Intestinal failure is a burdensome diagnosis for patients, and there is a paucity of literature characterizing patients post-bariatric surgery who develop intestinal failure.

Aims
We aim to identify the patient characteristics, surgical details, and nutritional traits that predisposed patients to developing intestinal failure requiring advanced nutritional support.

Methods
This is a retrospective chart review of 48 patient admitted to the Royal Alexandra Hospital post-bariatric surgery for nutritional support and followed by the TPN program dieticians and nurses.

Results
Our results show the mean BMI was 49.94 kg/m2 pre-bariatric surgery. Interestingly, the mean BMI at time of hospitalization for bariatric-surgery related complications was 33.210 kg/m2 which is classified as overweight but most of patients were severely malnourished with SGA C (43.8%), SGA B (29.17%), and 8.3% were SGA A. Patients requiring parenteral nutrition post-bariatric surgery are mostly female, developed barriers to oral intake, 15% engaged in medical tourism, 58.3% had an underlying mental health diagnosis, and only 18.8% were on a multivitamin even though it is standard of post-bariatric surgery care. The time between initial bariatric surgery to hospital admission was 11.2 years, and most required ≥1 revisional surgery. The mean age at bariatric surgery was 33.2-years old and the average age at initial hospitalization was 48.9-years old. Patients requiring ≥2 admissions had vertical band gastroplasty or sleeve gastrectomy (both 36.8%) while 21.1% had Roux-en-Y gastric bypass. Of these patients, 39.6% of patients required ≥2 hospital admissions and the mean total days spent in hospital was 57.15 days. While these complications are uncommon, these patients result in multiple prolonged hospitalizations and can be difficult to manage.

Conclusions
Overall, the results of our study will allow the multidisciplinary teams that care for post-bariatric surgery patients to identify patients at risk of intestinal failure and potentially intervene with early enrollment into home nutrition program. With increasing awareness, patients at higher risk can be closely monitored in order to prevent micronutrient deficiencies before they progress to intestinal failure and require lifetime parenteral nutrition.

Funding Agencies
None
Rapid Evolution of Seed Dormancy During Sunflower De-Domestication
Authors: Hernández Fernando , Vercellino Roman B , Pandolfo Claudio , Mandel Jennifer R , Presotto Alejandro 
Published: February 2022

AbstractHybridization between crops and their wild relatives may promote the evolution of de-domesticated (feral) weeds. Wild sunflower (Helianthus annuus L.) is typically found in ruderal environments, but crop–wild hybridization may facilitate the evolution of weedy populations. Using 1 crop-specific mitochondrial marker (CMS-PET1) and 14 nuclear SSR markers, we studied the origin and genetic diversity of a recently discovered weedy population of sunflower (named BRW). Then, using a resurrection approach, we tested for rapid evolution of weedy traits (seed dormancy, herbicide resistance, and competitive ability) by sampling weedy and wild populations 10 years apart (2007 and 2017). All the weedy plants present the CMS-PET1 cytotype, confirming their feral origin. At the nuclear markers, BRW showed higher genetic diversity than the cultivated lines and low differentiation with one wild population, suggesting that wild hybridization increased their genetic diversity. We found support for rapid evolution towards higher seed dormancy, but not for higher competitive ability or herbicide resistance. Our results highlight the importance of seed dormancy during the earliest stages of adaptation and show that crop–wild hybrids can evolve quickly in agricultural environments.
Open the Doors: Towards Complete Freedom of Movement for Human Rights Defenders in Exile in Uganda
Authors: White Nastassja , Agostini Nicolas , Bandera Memory , Bikanda Joseph , Grandolfo Francesca , Hakizimana Janvier , Kabachwezi Estella , Netuwa Tabitha , Nsiku Leon , Shire Hassan 
Published: February 2022

AbstractUganda attracts the highest number of migrants, refugees, and asylum-seekers in the East and Horn of Africa sub-region. Factors including an ‘open door’ policy, relative political stability, and a central geographical location have contributed to Uganda becoming an attractive hub for human rights defenders. The right to freedom of movement is enshrined in all significant human rights treaties and many regional and sub-regional economic treaties, including the one establishing the East African Community. However, in practice many exiled human rights defenders and refugees face various obstacles to move freely.This article explores the scope and meaning of freedom of movement into, within, and out of Uganda. Uganda remains one of, if not the most open country in the region for asylum-seekers, where everyone, including refugees and exiled human rights defenders, may move and settle wherever they choose. However, the majority of human rights defenders struggle to leave Uganda as they usually do not possess a national passport. While Convention Travel Documents, or refugee passports, are provided for under Ugandan and international refugee law, they are elusive in the refugee community and the majority of those interviewed face overwhelming challenges in obtaining one. This leaves many feeling hopeless and not in control of their own future or opportunities, as they are unable to travel within the East African Community, or beyond, for any reason. In particular, women human rights defenders and those who identified as, or advocated for the LGBTIQ (lesbian, gay, bisexual, transgender, intersex and queer) community, face compounded difficulties when moving within and out of Uganda, including arbitrary restrictions by authorities, violations by private actors, and protection concerns when moving.
Measuring Clinical, Biological, and Behavioral Variables to Elucidate Trajectories of Patient-Reported Outcomes: The PROFILES Registry
Authors: van de Poll-Franse Lonneke V , Horevoorts Nicole , Schoormans Dounya , Beijer Sandra , Ezendam Nicole P M , Husson Olga , Oerlemans Simone , Schagen Sanne B , Hageman Geja J , Van Deun Katrijn , van den Hurk Corina , van Eenbergen Mies , Mols Floortje ,   the PROFILES Registry Group, Rooij Belle de , Raijmakers Natasja , Vlooswijk Carla , Bonhof Cynthia , Ekels Afke , Hoedjes Meeke , van Cappellen – van Maldegem S J M , Ham Laurien , van de Graaf Danielle , van Roij Janneke 
Published: February 2022

AbstractTo take cancer survivorship research to the next level, it’s important to gain insight in trajectories of changing patient-reported outcomes and impaired recovery after cancer. This is needed as the number of survivors is increasing and a large proportion is confronted with changing health after treatment. Mechanistic research can facilitate the development of personalized risk-stratified follow-up care and tailored interventions to promote healthy cancer survivorship. We describe how these trajectories can be studied by taking the recently extended Dutch population-based Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES) registry as an example. PROFILES combines longitudinal assessment of patient-reported outcomes with novel, ambulatory and objective measures (eg, activity trackers, blood draws, hair samples, online food diaries, online cognitive tests, weighing scales, online symptoms assessment), and cancer registry and pharmacy databases. Furthermore, we discuss methods to optimize the use of a multidomain data collection–like return of individual results to participants, which may improve not only patient empowerment but also long-term cohort retention. Also, advanced statistical methods are needed to handle high-dimensional longitudinal data (with missing values) and provide insight into trajectories of changing patient-reported outcomes after cancer. Our coded data can be used by academic researchers around the world. Registries like PROFILES, which go beyond boundaries of disciplines and institutions, will contribute to better predictions of who will experience changes and why. This is needed to prevent and mitigate long-term and late effects of cancer treatment and to identify new interventions to promote health.
Assessment of internal exposure to 131I and short-lived radioiodine isotopes and associated uncertainties in the Ukrainian cohort of persons exposed in utero
Authors: Masiuk Sergii , Chepurny Mykola , Buderatska Valentyna , Ivanova Olga , Boiko Zulfira , Zhadan Natalia , Hatch Maureen , Cahoon Elizabeth K , Zamotayeva Galyna , Shpak Victor , Tronko Mykola , Drozdovitch Vladimir 
Published: February 2022

Abstract
This study revised the thyroid doses for 2582 Ukrainian in utero cohort members exposed to Chornobyl fallout (the Ukrainian in utero cohort) based on revision of: (i) 131I thyroid activity measured in the Ukrainian population, (ii) thyroid dosimetry system for entire Ukraine, and (iii) 131I ground deposition densities in Ukraine. Other major improvements included: (i) assessment of uncertainties in the thyroid doses considering shared and unshared error, and (ii) accounting for intake of short-lived radioisotopes of tellurium and iodine (132Te+132I and 133I). Intake of 131I was the major pathway for thyroid exposure, its median contribution to the thyroid dose was 97.4%. The mean prenatal and postnatal thyroid dose from 131I was 87 mGy (median = 17 mGy), higher than previous deterministic dose of 72 mGy (median = 12 mGy). For 39 individuals (1.5%) the dose exceeded 1.0 Gy, while the highest dose among the cohort members was 2.7 Gy. The geometric standard deviation (GSD) of 1000 individual stochastic doses varied from 1.9 to 5.2 with a mean of 3.1 and a median of 3.2. The lowest uncertainty (mean GSD = 2.3, median GSD = 2.2) was found for the subjects whose mothers were measured for 131I thyroid activity, while for individuals, whose mothers were not measured, the mean and median GSDs were 3.4. Uncertainties in thyroid doses were driven by shared errors associated with the parameters of the ecological model.
Participation as Confrontation: Resistance Within and Outside the Mesas de Participación Established for IDPs in Colombia
Authors: Schouw Iversen Karen 
Published: February 2022

Abstract
This article discusses resistance related to the mesas de participación—invited participatory spaces established for internally displaced persons (IDPs) in Colombia. While the existing literature on participation has shown that such spaces can enhance stability and delegitimize dissent, this article foregrounds these spaces’ political ambivalence, pointing to the resistance they facilitate. Drawing on fieldwork conducted in Bogotá between October 2017 and August 2018, the article argues that the mesas have paved the way for two kinds of resistance. First, they have engendered resistance around the meaning of participation itself. Second, IDPs have utilized opportunities conferred by the mesas to strengthen ‘confrontational collective action’ in the form of occupations and protests outside of these government-sponsored spaces. By highlighting the connections that exist between resistance happening within and outside institutional spaces, the article contributes both to a growing body of literature that has emphasized the agency of IDPs in Colombia and, more broadly, to the literature on forced migrants’ participation.
A Cautionary Note on the Hanurav–Vijayan Sampling Algorithm
Authors: Chauvet Guillaume 
Published: February 2022

AbstractWe consider the Hanurav–Vijayan (HV) sampling design, which is the default method programmed in the SURVEYSELECT procedure of the SAS software. We prove that it is equivalent to the Sunter procedure but is capable of handling any set of inclusion probabilities. We prove that the Horvitz–Thompson (HT) estimator is not generally consistent under this sampling design. We propose a conditional HT estimator and prove its consistency under a nonstandard assumption on the first-order inclusion probabilities. Since this assumption seems difficult to control in practice, we recommend not to use the HV sampling design.