bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative risk of fracture in community‐dwelling older adults initiating suvorexant versus Z‐drugs: Results from LIFE study
Authors: Adomi Motohiko , Maeda Megumi , Murata Fumiko , Fukuda Haruhisa 
Published: October 2022

AbstractBackgroundAn increased risk of fracture has been reported in older adults taking hypnotics. However, few studies have reported the comparative safety of hypnotics with different mechanisms of action. We examined the risk of fracture in older adults initiating suvorexant compared to those initiating Z‐drugs.MethodsWe conducted a retrospective cohort study using a claims database within a longevity improvement and fair evidence (LIFE) study in Japan (1.5 million beneficiaries). People aged ≥65 years were included in this study. Exposure was defined as the initiation of either suvorexant or Z‐drugs (eszopiclone, zolpidem, or zopiclone). The evaluated outcomes were hip fracture and all‐cause fracture requiring hospitalization. We used inverse probability of treatment weights to adjust for confounding and followed the incidence of the outcome for three different periods: 30, 90, and 365 days. Cox proportional hazards models were fitted to the weighted population to estimate hazard ratios (HRs). Sensitivity analyses were performed with narrowed outcome definitions and inverse probability of censoring weights.ResultsWe identified 16,148 suvorexant new users and 54,327 Z‐drugs new users. During the 30‐day follow‐up, 21 (16.6 events per 1000 person‐years) and 53 hip fractures (12.2 events per 1000 person‐years) were identified among suvorexant and Z‐drugs new users, respectively (HR: 1.01, 95% confidence interval [CI]: 0.58–1.76). The analysis for all‐cause fracture showed an HR of 1.03 (95% CI: 0.78–1.36). Extended follow‐up (90 and 365 days) showed similar results for both outcomes. Sensitivity analyses showed consistent results except for an increased risk of all‐cause fracture requiring surgery (HR: 1.41, 95% CI: 0.87–2.29) during the 30‐day follow‐up.ConclusionsThis is the first study to show that suvorexant has a generally comparable risk of fracture as compared to Z‐drugs. Further research is needed to investigate the potential short‐term increased risk of all‐cause fracture requiring surgery among suvorexant initiators.
Rifaximin protects against circadian rhythm disruption–induced cognitive impairment through preventing gut barrier damage and neuroinflammation
Authors: Meng Dongli , Yang Mengzhe , Hu Lilin , Liu Tonglin , Zhang Huiliang , Sun Xuying , Wang Xiaochuan , Chen Yu , Jin Yu , Liu Rong 
Published: October 2022

AbstractCircadian rhythm disruption (CRD) is a potential risk factor for developing Alzheimer's disease (AD). However, the mechanistic link between CRD and AD is still not fully understood. CRD may lead to intestinal barrier impairment. Several studies in animals and humans suggest a connection between gut microbiota disturbance, intestinal barrier damage and neurodegenerative diseases. In this study, we investigated the effect of CRD on cognition in mice and explored the role of intestinal barrier and inflammatory responses in this process. CRD modulates the composition of gut microbiota, impairs intestinal barrier integrity, and induces both peripheral and central inflammation and cognitive impairment in mice. Rifaximin, a non‐absorbable antibiotic which modulates the gut microbial composition and increases intestinal barrier integrity, effectively suppresses inflammatory responses, and rescues cognitive impairment induced by CRD. Furthermore, the impairment in hippocampal neurogenesis, tau hyperphosphorylation, and loss in synaptic proteins in CRD mice is also reversed by Rifaximin. These data identify that the impaired intestinal barrier integrity related to gut microbiota disturbance plays a key role in CRD‐induced inflammatory responses and cognitive impairments in mice, and Rifaximin is effective in preventing CRD‐induced cognitive deficit through protecting the gut barrier and ameliorating neuroinflammation.image
Delayed egg introduction beyond infancy and increased egg allergy risk in childhood
Authors: Martone Giulia M , Lehman Heather K , Rideout Todd C , Choudhary Divya , Cameron Claire E , Oken Emily , Rifas‐Shiman Sheryl L , Camargo Carlos A , Gold Diane R , Wen Xiaozhong 
Published: October 2022

AimEgg is a major food allergen in childhood. Recent studies suggest that early introduction of allergenic foods can decrease the risk of developing egg allergy. The impact of early egg introduction in the general population is unclear. We examined associations between age of infant egg introduction and childhood egg allergy outcomes in a general population.MethodsThe study population consisted of 1217 neonates from Project Viva, a longitudinal pre‐birth cohort in eastern Massachusetts area, USA. Mothers reported age of infant egg introduction and child egg allergy using questionnaires and specific IgE to egg white was assayed. We estimated associations between age of infant egg introduction and egg allergy outcomes using Log‐binomial regression models, adjusting for socio‐demographics and health confounders.ResultsEgg allergy at 2 years was significantly higher (8.0% vs. 1.4%, P < 0.0001) in children who had delayed egg introduction beyond infancy, compared with children who were introduced to egg during infancy (adjusted relative risk or aRR 7.58; 95% CI 3.08, 18.61). At 12 years, the risk of egg allergy remained significantly higher (3.9% vs. 1.1%, P = 0.048) in children with delayed egg introduction compared with children introduced to egg during infancy (aRR 4.07; 95% CI 1.20, 13.87).ConclusionsInfants with delayed introduction of eggs after 12 months had increased risk of egg allergy in childhood (2 years) and the relationship persisted in early adolescence (12 years). Our findings suggest that introduction to eggs before 12 months could contribute to the prevention of egg allergy.
Frequency and risk factors for cognitive dysfunction in peritoneal dialysis patients
Authors: Gamage Isuru , Dhar Arup , Tregaskis Peter , Wilson Scott 
Published: October 2022

AbstractObjectiveThere is limited data on cognition in patients undergoing peritoneal dialysis (PD). We assessed prevalence and associated risk factors of neurocognitive impairment (NCI) in PD patients.Design and MethodsA cross‐sectional cohort study of 149 PD patients at a single centre between 2016 and 2020 who underwent neurocognitive screening at defined intervals by Addenbrooke's Cognitive Examination – Revised (ACE‐R) with incorporated Mini‐Mental State Examination (MMSE). Paired‐sample t‐test was used to compare cognitive performance to the general population and compare cohorts for dichotomous risk factors. Residual renal function (RRF) and clearance kinetics were evaluated using local regression models. Sub‐analysis was performed in patients with cerebrovascular disease (CVD).ResultsPatients on PD performed poorly in ACE‐R screening compared to population norms, with discrepancy in all cognitive domains. In patients without CVD, attention and language domains were comparable to norms. The MMSE detected cognitive impairment in 2% of studied patients, significantly fewer than when the ACE‐R was applied (32%). Age, gender, diabetic status and depression were associated with lower neurocognitive screening performance (p < .05). Dialysis vintage beyond 12 months conferred poorer cognitive performance. RRF correlated with cognitive performance.ConclusionPatients on PD have higher prevalence of NCI than the general population, primarily with impairments in memory, fluency and visuospatial reasoning. CVD confers poorer performance in attention and language domains. The MMSE is ineffective in detecting subtle NCI in this population compared with ACE‐R. Risk factors for NCI include age, gender, diabetic status, depression and vintage beyond 12 months. Protective factors include RRF.
The impact of oil prices on world trade
Authors: Brancaccio Giulia , Kalouptsidi Myrto , Papageorgiou Theodore 
Published: October 2022

AbstractIn this article, we investigate the importance of fuel costs in shaping trade. We use AIS data on ship locations and transaction‐level shipping prices, along with a dynamic model describing the shipping industry, to measure the elasticity of bulk goods trade with respect to ship fuel costs. We find that the average estimated elasticity is 0.35, but ranges from 0.1 to about 1.2 depending on the level of the fuel cost. The pass‐through of fuel costs to transport costs is low, at 0.17. Strikingly, this elasticity features a pronounced asymmetry in low versus high oil prices. As fuel costs decline, the elasticity plateaus and further declines have little impact on trade. This “flattening out” of the elasticity is attributed to the equilibrium of the transportation sector and in particular the changes in the relative bargaining positions of ships and exporters. Finally, we use the estimated elasticity to assess the importance of ship design on trade flows: if the large fuel efficiency gains achieved in the 1980s had not been realized, trade would be 12% lower today.
Social risks and active social citizenship—A cross‐national comparison of long‐term care policies for older people in European welfare states
Authors: Eggers Thurid 
Published: October 2022

AbstractDue to demographic ageing, many welfare states have restructured their long‐term care (LTC) policies by simultaneously extending older people's social rights to publicly‐funded care and strengthening their active role in handling their care situation. By doing so, they are increasingly constructing older people as active social citizens. However, the consequences of this shift for older people's social risks are controversial and whether it comes at the cost of public responsibility for ensuring sufficient care provision. Therefore, this study investigates to what extent European welfare states differ in terms of how they conceptualise older people as active social citizens in their LTC policies and how these differences affect older people's social risks. It introduces an innovative typology to classify LTC policies with respect to different approaches towards active social citizenship and related social risks. It applies this approach to a cross‐national comparison of five European countries using data on LTC policy regulations, comparative policy databases and secondary literature. The findings indicate that European LTC policies promote active social citizenship to different degrees and that we have to consider whether strengthening older people's active role coexists with generous social rights to publicly‐funded care in order to understand the consequences for their social risks.
Three-Dimensional Printing of Highly Conducting PEDOT: PSS-Based Polymers
Authors: Wang Xinnian , Plog Jevon , Lichade Ketki M. , Yarin Alexander L. , Pan Yayue 
Published: October 2022

Abstract
Poly(3,4-ethylenedioxythiophene):poly(styrenesulfonic acid) (PEDOT:PSS) is one of the most successful conducting polymers for electronic applications. Most commonly, the spin coating process is used to fabricate PEDOT:PSS thin films from an aqueous solution, yet it is unsuitable for fabricating complicated two-dimensional (2D) structures. Extrusion-based additive manufacturing (AM) processes have been investigated for 3D printing PEDOT:PSS-based polymers with free-form architecture. However, such methods imply strict requirements on the rheological properties of materials and, as a result, have limited choices of appropriate materials. In the past, additives have been added to improve the 3D printing processability of PEDOT:PSS materials, which, however, usually deteriorate the electrical conductivity. This article reports a new type of PEDOT:PSS material capable of addressing the previously listed challenges and characterized by high processability and electrical conductivity (72 S/cm). In addition, a novel extrusion-based AM technology, electrostatically-assisted direct ink writing (eDIW), is investigated for printing materials containing PEDOT:PSS. The eDIW method prints lines at micro-scale resolution at an ultra-high speed (1.72 m/s). This combination is often deemed impossible in the framework of classical extrusion-based AM techniques. This work lays the foundation for future explorations of applications of PEDOT:PSS-based conducting polymers in fields that require superb properties and custom geometry, which were conventionally impossible.
Optic ataxia in a patient with HaNDL syndrome
Authors: Rivas Ruvalcaba Francisco , Moreno-Cortez Katia Mabiel , Badial-Ochoa Sandra , Rodriguez-Leyva Ildefonso 
Published: October 2022

We present a woman in her 40s who arrived at the emergency room with hypertension and optic ataxia. Her medical history is only relevant for obesity. Her lumbar puncture revealed high intracranial pressure and lymphocytic pleocytosis, and her neuroimaging tests, including angiography and venography, were normal. The patient improved after a cerebrospinal fluid drainage with a lumbar puncture, and her clinical manifestations resolved in parallel to the lymphocytic pleocytosis.The patient was diagnosed with a syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis and fully recovered 21 days after her discharge.
Real-world clinical and molecular management of 50 prospective patients with microphthalmia, anophthalmia and/or ocular coloboma
Authors: Harding Philippa , Gore Sri , Malka Samantha , Rajkumar Jayashree , Oluonye Ngozi , Moosajee Mariya 
Published: October 2022

Background/aims
Microphthalmia, anophthalmia and coloboma (MAC) are clinically and genetically heterogenous rare developmental eye conditions, which contribute to a significant proportion of childhood blindness worldwide. Clear understanding of MAC aetiology and comorbidities is essential to providing patients with appropriate care. However, current management is unstandardised and molecular diagnostic rates remain low, particularly in those with unilateral presentation. To further understanding of clinical and genetic management of patients with MAC, we charted their real-world experience to ascertain optimal management pathways and yield from molecular analysis.

Methods
A prospective cohort study of consecutive patients with MAC referred to the ocular genetics service at Moorfields Eye Hospital between 2017–2020.

Results

Clinical analysis of 50 MAC patients (15 microphthalmia; 2 anophthalmia; 11 coloboma; and 22 mixed) from 44 unrelated families found 44% had additional ocular features (complex) and 34% had systemic involvement, most frequently intellectual/developmental delay (8/17). Molecular analysis of 39 families using targeted gene panels, whole genome sequencing and microarray comparative genomic hybridisation identified genetic causes in, 28% including novel variants in six known MAC genes (
SOX2
,
KMT2D
,
MAB21L2
,
ALDH1A3
,
BCOR
and
FOXE3
), and a molecular diagnostic rate of 33% for both bilateral and unilateral cohorts. New phenotypic associations were found for
FOXE3
(bilateral sensorineural hearing loss) and
MAB21L2
(unilateral microphthalmia).

Conclusion
This study highlights the importance of thorough clinical and molecular phenotyping of MAC patients to provide appropriate multidisciplinary care. Routine genetic testing for both unilateral and bilateral cases in the clinic may increase diagnostic rates in the future, helping elucidate genotype–phenotype correlations and informing genetic counselling.
Emulating the GRADE trial using real world data: retrospective comparative effectiveness study
Authors: Deng Yihong , Polley Eric C , Wallach Joshua D , Dhruva Sanket S , Herrin Jeph , Quinto Kenneth , Gandotra Charu , Crown William , Noseworthy Peter , Yao Xiaoxi , Lyon Timothy D , Shah Nilay D , Ross Joseph S , McCoy Rozalina G 
Published: October 2022

Abstract

Objective

To emulate the GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study) trial using real world data before its publication. GRADE directly compared second line glucose lowering drugs for their ability to lower glycated hemoglobin A
1c
(HbA
1c
).

Design
Observational study.

Setting
OptumLabs® Data Warehouse (OLDW), a nationwide claims database in the US, 25 January 2010 to 30 June 2019.

Participants

Adults with type 2 diabetes and HbA
1c
6.8-8.5% while using metformin monotherapy, identified according to the GRADE trial specifications, who also used glimepiride, liraglutide, sitagliptin, or insulin glargine.

Main outcome measures

The primary outcome was time to HbA
1c
≥7.0%. Secondary outcomes were time to HbA
1c
>7.5%, incident microvascular complications, incident macrovascular complications, adverse events, all cause hospital admissions, and all cause mortality. Propensity scores were estimated using the gradient boosting machine method, and inverse propensity score weighting was used to emulate randomization of the treatment groups, which were then compared using Cox proportional hazards regression.

Results

8252 people were identified (19.7% of adults starting the study drugs in OLDW) who met eligibility criteria for the GRADE trial (glimepiride arm=4318, liraglutide arm=690, sitagliptin arm=2993, glargine arm=251). The glargine arm was excluded from analyses owing to small sample size. Median times to HbA
1c
≥7.0% were 442 days (95% confidence interval 394 to 480 days) for glimepiride, 764 (741 to not calculable) days for liraglutide, and 427 (380 to 483) days for sitagliptin. Liraglutide was associated with lower risk of reaching HbA
1c
≥7.0% compared with glimepiride (hazard ratio 0.57, 95% confidence interval 0.43 to 0.75) and sitagliptin (0.55, 0.41 to 0.73). Results were consistent for the secondary outcome of time to HbA
1c
>7.5%. No significant differences were observed among treatment groups for the remaining secondary outcomes.

Conclusions
In this emulation of the GRADE trial, liraglutide was statistically significantly more effective at maintaining glycemic control than glimepiride or sitagliptin when added to metformin monotherapy. Generating timely evidence on medical treatments using real world data as a complement to prospective trials is of value.
Waning of vaccine effectiveness against moderate and severe covid-19 among adults in the US from the VISION network: test negative, case-control study
Authors: Ferdinands Jill M , Rao Suchitra , Dixon Brian E , Mitchell Patrick K , DeSilva Malini B , Irving Stephanie A , Lewis Ned , Natarajan Karthik , Stenehjem Edward , Grannis Shaun J , Han Jungmi , McEvoy Charlene , Ong Toan C , Naleway Allison L , Reese Sarah E , Embi Peter J , Dascomb Kristin , Klein Nicola P , Griggs Eric P , Liao I-Chia , Yang Duck-Hye , Fadel William F , Grisel Nancy , Goddard Kristin , Patel Palak , Murthy Kempapura , Birch Rebecca , Valvi Nimish R , Arndorfer Julie , Zerbo Ousseny , Dickerson Monica , Raiyani Chandni , Williams Jeremiah , Bozio Catherine H , Blanton Lenee , Link-Gelles Ruth , Barron Michelle A , Gaglani Manjusha , Thompson Mark G , Fireman Bruce 
Published: October 2022

Abstract

Objective
To estimate the effectiveness of mRNA vaccines against moderate and severe covid-19 in adults by time since second, third, or fourth doses, and by age and immunocompromised status.

Design
Test negative case-control study.

Setting
Hospitals, emergency departments, and urgent care clinics in 10 US states, 17 January 2021 to 12 July 2022.

Participants
893 461 adults (≥18 years) admitted to one of 261 hospitals or to one of 272 emergency department or 119 urgent care centers for covid-like illness tested for SARS-CoV-2.

Main outcome measures
The main outcome was waning of vaccine effectiveness with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine during the omicron and delta periods, and the period before delta was dominant using logistic regression conditioned on calendar week and geographic area while adjusting for age, race, ethnicity, local virus circulation, immunocompromised status, and likelihood of being vaccinated.

Results
45 903 people admitted to hospital with covid-19 (cases) were compared with 213 103 people with covid-like illness who tested negative for SARS-CoV-2 (controls), and 103 287 people admitted to emergency department or urgent care with covid-19 (cases) were compared with 531 168 people with covid-like illness who tested negative for SARS-CoV-2. In the omicron period, vaccine effectiveness against covid-19 requiring admission to hospital was 89% (95% confidence interval 88% to 90%) within two months after dose 3 but waned to 66% (63% to 68%) by four to five months. Vaccine effectiveness of three doses against emergency department or urgent care visits was 83% (82% to 84%) initially but waned to 46% (44% to 49%) by four to five months. Waning was evident in all subgroups, including young adults and individuals who were not immunocompromised; although waning was morein people who were immunocompromised. Vaccine effectiveness increased among most groups after a fourth dose in whom this booster was recommended.

Conclusions
Effectiveness of mRNA vaccines against moderate and severe covid-19 waned with time after vaccination. The findings support recommendations for a booster dose after a primary series and consideration of additional booster doses.
Metabolic syndrome and its components are associated with non-arteritic anterior ischaemic optic neuropathy
Authors: Kohli Darrell , Wu Kristi Y , White Launia J , Hodge David O , Chen John J , Roddy Gavin W 
Published: October 2022

PurposeTo determine whether metabolic syndrome (MetS) is a risk factor for various forms of optic neuropathy including non-arteritic anterior ischaemic optic neuropathy (NAION).MethodsThis population-based analysis identified patients ≥40 years of age in Olmsted County, Minnesota, USA using the Rochester Epidemiology Project 2005–2018. Patients with MetS were identified if three or more of the five standard criteria for diagnosing MetS were present: systemic hypertension, hyperglycaemia, hypertriglyceridaemia, reduced high-density lipoprotein cholesterol (hypoalphalipoproteinaemia) and central adiposity defined by increased body mass index. Charts of patients identified as having an optic neuropathy were reviewed to record specific diagnoses and compared with patients without ocular pathology other than cataract. The odds ratio (OR) of association with MetS was calculated and adjusted for age, sex and race with multivariate analysis for the various optic neuropathies.ResultsPatients with MetS were more likely to have an optic neuropathy than those without (OR 2.2, p<0.001). After adjusting for age, sex and race, the only optic neuropathy found to be significantly associated with MetS was NAION (OR 6.17, p=0.002). For patients with NAION, though each individual component of MetS was individually significantly associated with MetS, further analysis suggested that hypertriglyceridaemia, hypoalphalipoproteinaemia and hyperglycaemia were likely the key drivers in the overall significance between NAION and MetS.ConclusionPatients with MetS were more likely to have NAION. Further studies are needed to determine whether MetS is a modifiable risk factor for NAION.