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  • 1
    Online Resource
    Online Resource
    Benzodiazepine administration patterns before escalation to second‐line medications in pediatric refractory convulsive status epilepticus
    Wiley ; 2021
    In:  Epilepsia Vol. 62, No. 11 ( 2021-11), p. 2766-2777
    Details
    In: Epilepsia, Wiley, Vol. 62, No. 11 ( 2021-11), p. 2766-2777
    Abstract: This study was undertaken to evaluate benzodiazepine (BZD) administration patterns before transitioning to non‐BZD antiseizure medication (ASM) in pediatric patients with refractory convulsive status epilepticus (rSE). Methods This retrospective multicenter study in the United States and Canada used prospectively collected observational data from children admitted with rSE between 2011 and 2020. Outcome variables were the number of BZDs given before the first non‐BZD ASM, and the number of BZDs administered after 30 and 45 min from seizure onset and before escalating to non‐BZD ASM. Results We included 293 patients with a median (interquartile range) age of 3.8 (1.3–9.3) years. Thirty‐six percent received more than two BZDs before escalating, and the later the treatment initiation was after seizure onset, the less likely patients were to receive multiple BZD doses before transitioning (incidence rate ratio [IRR] = .998, 95% confidence interval [CI] = .997–.999 per minute, p  = .01). Patients received BZDs beyond 30 and 45 min in 57.3% and 44.0% of cases, respectively. Patients with out‐of‐hospital seizure onset were more likely to receive more doses of BZDs beyond 30 min (IRR = 2.43, 95% CI = 1.73–3.46, p   〈  .0001) and beyond 45 min (IRR = 3.75, 95% CI = 2.40–6.03, p   〈  .0001) compared to patients with in‐hospital seizure onset. Intermittent SE was a risk factor for more BZDs administered beyond 45 min compared to continuous SE (IRR = 1.44, 95% CI = 1.01–2.06, p  = .04). Forty‐seven percent of patients ( n  = 94) with out‐of‐hospital onset did not receive treatment before hospital arrival. Among patients with out‐of‐hospital onset who received at least two BZDs before hospital arrival ( n  = 54), 48.1% received additional BZDs at hospital arrival. Significance Failure to escalate from BZDs to non‐BZD ASMs occurs mainly in out‐of‐hospital rSE onset. Delays in the implementation of medical guidelines may be reduced by initiating treatment before hospital arrival and facilitating a transition to non‐BZD ASMs after two BZD doses during handoffs between prehospital and in‐hospital settings.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v62.11
    DOI: 10.1111/epi.17043
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2002194-X
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  • 2
    Online Resource
    Online Resource
    Strong trait correlation and phylogenetic signal in North American ground beetle (Carabidae) morphology
    Wiley ; 2021
    In:  Ecosphere Vol. 12, No. 11 ( 2021-11)
    Details
    In: Ecosphere, Wiley, Vol. 12, No. 11 ( 2021-11)
    Abstract: Functional traits mediate species' responses to, and roles within, their environment and are constrained by evolutionary history. While we have a strong understanding of trait evolution for macro‐taxa such as birds and mammals, our understanding of invertebrates is comparatively limited. Here, we address this gap in North American beetles with a sample of ground beetles (Carabidae), leveraging a large‐scale collection and digitization effort by the National Ecological Observatory Network (NEON). For 154 ground beetle species, we measured seven morphological traits, which we placed into a recently developed effect–response framework that characterizes traits by how they predict species' effects on their ecosystems or responses to environmental stressors. We then used cytochrome oxidase 1 sequences from the same specimens to generate a phylogeny and tested the evolutionary tempo and mode of the traits. We found strong phylogenetic signal in, and correlations among, ground beetle morphological traits. These results indicate that, for these species, beetle body shape trait evolution is constrained, and phylogenetic inertia is a stronger driver of beetle traits than (recent) environmental responses. Strong correlations among effect and response traits suggest that future environmental drivers are likely to affect both ecological composition and functioning in these beetles.
    Type of Medium: Online Resource
    ISSN: 2150-8925 , 2150-8925
    URL: Issue
    URL: Article
    DOI: 10.1002/ecs2.v12.11
    DOI: 10.1002/ecs2.3832
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2572257-8
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  • 3
    Online Resource
    Online Resource
    Design and implementation of electronic health record common data elements for pediatric epilepsy: Foundations for a learning health care system
    Wiley ; 2021
    In:  Epilepsia Vol. 62, No. 1 ( 2021-01), p. 198-216
    Details
    In: Epilepsia, Wiley, Vol. 62, No. 1 ( 2021-01), p. 198-216
    Abstract: Common data elements (CDEs) are standardized questions and answer choices that allow aggregation, analysis, and comparison of observations from multiple sources. Clinical CDEs are foundational for learning health care systems, a data‐driven approach to health care focused on continuous improvement of outcomes. We aimed to create clinical CDEs for pediatric epilepsy. Methods A multiple stakeholder group (clinicians, researchers, parents, caregivers, advocates, and electronic health record [EHR] vendors) developed clinical CDEs for routine care of children with epilepsy. Initial drafts drew from clinical epilepsy note templates, CDEs created for clinical research, items in existing registries, consensus documents and guidelines, quality metrics, and outcomes needed for demonstration projects. The CDEs were refined through discussion and field testing. We describe the development process, rationale for CDE selection, findings from piloting, and the CDEs themselves. We also describe early implementation, including experience with EHR systems and compatibility with the International League Against Epilepsy classification of seizure types. Results Common data elements were drafted in August 2017 and finalized in January 2020. Prioritized outcomes included seizure control, seizure freedom, American Academy of Neurology quality measures, presence of common comorbidities, and quality of life. The CDEs were piloted at 224 visits at 10 centers. The final CDEs included 36 questions in nine sections (number of questions): diagnosis (1), seizure frequency (9), quality of life (2), epilepsy history (6), etiology (8), comorbidities (2), treatment (2), process measures (5), and longitudinal history notes (1). Seizures are categorized as generalized tonic‐clonic (regardless of onset), motor, nonmotor, and epileptic spasms. Focality is collected as epilepsy type rather than seizure type. Seizure frequency is measured in nine levels (all used during piloting). The CDEs were implemented in three vendor systems. Early clinical adoption included 1294 encounters at one center. Significance We created, piloted, refined, finalized, and implemented a novel set of clinical CDEs for pediatric epilepsy.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v62.1
    DOI: 10.1111/epi.16733
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2002194-X
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  • 4
    Online Resource
    Online Resource
    High and normal oleic runner‐type peanut cultivar by year effects on seed germination and vigor response to temperature
    Wiley ; 2022
    In:  Agronomy Journal Vol. 114, No. 4 ( 2022-07), p. 2364-2374
    Details
    In: Agronomy Journal, Wiley, Vol. 114, No. 4 ( 2022-07), p. 2364-2374
    Abstract: Thermal gradient testing can be used for peanut seed germination. High oleic and normal oleic peanut cultivars exhibited stability in germination‐related variables. High oleic and normal oleic cultivars may exhibit phenotypic variation, but genotypic consistency.
    Type of Medium: Online Resource
    ISSN: 0002-1962 , 1435-0645
    URL: Issue
    URL: Article
    DOI: 10.1002/agj2.v114.4
    DOI: 10.1002/agj2.21126
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1471598-3
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  • 5
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    Online Resource
    The Effect of Fracture Recency on Observed 10‐Year Fracture Probability: A Registry‐Based Cohort Study
    Wiley ; 2022
    In:  Journal of Bone and Mineral Research Vol. 37, No. 5 ( 2022-05), p. 848-855
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 37, No. 5 ( 2022-05), p. 848-855
    Abstract: FRAX estimates 10‐year fracture major osteoporotic fracture (MOF) and hip fracture probability from multiple risk factors. FRAX does not consider prior fracture site or time since fracture. Fracture risk is greater in the initial 2‐year post‐fracture period (imminent risk), implying that FRAX may underestimate risk in this setting. We used the population‐based Manitoba Bone Mineral Density (BMD) Program registry to examine the effect of fracture recency and site on incident fracture risk predictions using FRAX. We identified women aged 40 years or older with baseline BMD and FRAX scores. Observed fracture outcomes to 10 years were compared with predicted 10‐year fracture probability stratified by prior fracture status: none, recent ( 〈 2 years [median 0.3 years]), and remote (≥2 years [median 10.6 years] ). For women with recent fractures, we also examined proposed multipliers to adjust FRAX for the effect of fracture recency and site. The cohort comprised 33,465 women aged 40 to 64 years (1897 recent fracture, 2120 remote fracture) and 33,806 women aged ≥65 years (2365 fracture, 4135 remote fracture). Observed fracture probability was consistent with predicted probability in most analyses. In women aged 40 to 64 years, there was a significant effect of recent vertebral and humerus fracture on MOF (observed to predicted 1.61 and 1.48, respectively), but these effects were still lower than the proposed multipliers (2.32 and 1.67, respectively). No significant effect of fracture recency was found after hip or forearm fracture in either age group. Our findings contribute to accumulating evidence of the importance of recent fracture. The effect of fracture recency was not consistent across fracture sites and with a lower magnitude than previously reported. Further quantification of effect size and specificity in additional independent cohorts is warranted to validate and refine recent‐fracture multipliers in fracture risk assessment. © 2022 American Society for Bone and Mineral Research (ASBMR).
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v37.5
    DOI: 10.1002/jbmr.4526
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2008867-X
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  • 6
    Online Resource
    Online Resource
    Performance of FRAX in Men With Prostate Cancer: A Registry‐Based Cohort Study
    Wiley ; 2023
    In:  Journal of Bone and Mineral Research Vol. 38, No. 5 ( 2023-05), p. 659-664
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 38, No. 5 ( 2023-05), p. 659-664
    Abstract: The Fracture Risk Assessment Tool (FRAX®) was created to predict major osteoporotic fractures (MOF) and hip fractures in the general population. Whether FRAX accurately predicts fractures in men with prostate cancer is unknown. Our objective was to assess the performance of FRAX for predicting incident fractures in men with prostate cancer. Men from the Manitoba Bone Mineral Density (BMD) Registry (1996–2018) with prostate cancer diagnoses in the 3 years prior to dual‐energy X‐ray absorptiometry (DXA) were identified. FRAX scores with and without BMD were calculated. From population‐based healthcare data we identified incident MOF, hip fracture, any osteoporotic fracture and death from the date of BMD testing to March 31, 2018. Cox regression was performed to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) per standard deviation increase in FRAX score. Observed 10‐year probability (estimated with competing risk of mortality) was compared with 10‐year FRAX‐predicted fracture probability to assess calibration. The study population included 684 men with prostate cancer (mean age 74.6 years) and 8608 men without prostate cancer (mean age 65.5 years). FRAX stratified risk for MOF (HR 1.91, 95% CI 1.48–2.45 with BMD; HR 1.96, 95% CI 1.43–2.69 without BMD) and hip fracture (HR 3.37, 95% CI 1.90–6.01 with BMD; HR 4.58, 95% CI 2.17–9.67 without BMD) in men with prostate cancer. There was no effect modification observed with prostate cancer status or current androgen deprivation therapy. Observed 10‐year fracture probability in men with prostate cancer showed good agreement with FRAX with and without BMD included in the calculation (observed/predicted calibration ratios MOF 0.97, hip 1.00 with BMD; MOF 0.92, hip 0.93 with BMD). In conclusion, FRAX reliably predicts incident fractures in men with prostate cancer. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v38.5
    DOI: 10.1002/jbmr.4793
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008867-X
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  • 7
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    Online Resource
    Effect of BMI‐Discordant Abdominal Tissue Thickness on Fracture Probability: A Registry‐Based Study
    Wiley ; 2023
    In:  Journal of Bone and Mineral Research
    Details
    In: Journal of Bone and Mineral Research, Wiley
    Abstract: FRAX®, which is used to assess fracture probability, considers body mass index (BMI) but BMI may not reflect individual variation in body composition and distribution. We examined the effect of BMI‐discordant abdominal thickness on FRAX‐derived fracture probability for major osteoporotic fracture (MOF) and hip fracture. We studied 73,105 individuals, mean age 64.2 years. During mean 8.7 years, 7048 (9.6%) individuals sustained incident MOF, including 2155 (3.0%) hip fractures. We defined abdominal thickness index (ATI) as the difference between abdominal thickness measured by DXA and thickness predicted by BMI using sex‐stratified regression. ATI was categorized from lower ( 〈 −2 cm, −2 to −1 cm) to higher (1 to 2 cm, 〉 +2 cm) with referent around zero (−1 to +1 cm). Adjusted for FRAX probability, increasing ATI was associated with incident MOF and hip fracture (p  〈  0.001). For the highest ATI category, MOF risk was increased (HR 1.23, 95% CI 1.12–1.35) independent of FRAX probability. Similar findings were noted for hip fracture probability (HR 1.28, 95% CI 1.09–1.51). There was significant age‐interaction with much larger effects prior to age 65 years (HR 1.44, 95% CI 1.23–1.69 for MOF; 2.29, 95% CI 1.65–3.18 for hip fracture). In contrast, for the subset of individuals with diabetes there was also increased risk for those in the lowest ATI category (HR 1.73, 95% CI 1.12–2.65 for MOF, 2.81, 95% CI 1.59–4.97 for hip fracture). Calibration plots across ATI categories demonstrated deviation from the line of identity in women (calibration slope 2.26 for MOF, 2.83 for hip fracture). An effect of ATI was not seen in men, but this was inconclusive as the sex‐interaction terms did not show significant effect modification. In conclusion, these data support the need to investigate increased abdominal thickness beyond that predicted by BMI and sex as a FRAX‐independent risk factor for fracture. This article is protected by copyright. All rights reserved.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Article
    DOI: 10.1002/jbmr.4919
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008867-X
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  • 8
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    Online Resource
    Long‐term outcomes of pexidartinib in tenosynovial giant cell tumors
    Wiley ; 2021
    In:  Cancer Vol. 127, No. 6 ( 2021-03-15), p. 884-893
    Details
    In: Cancer, Wiley, Vol. 127, No. 6 ( 2021-03-15), p. 884-893
    Abstract: This analysis further illustrates that systemic therapy targeting the CSF1/CSF1R pathway is an effective therapeutic strategy in patients with tenosynovial giant cell tumor. Because of the limited availability of long‐term prospective data for tenosynovial giant cell tumor, these findings are encouraging and demonstrate the overall long‐term benefit of continued treatment with pexidartinib.
    Type of Medium: Online Resource
    ISSN: 0008-543X , 1097-0142
    URL: Issue
    URL: Article
    DOI: 10.1002/cncr.v127.6
    DOI: 10.1002/cncr.33312
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1479932-7
    detail.hit.zdb_id: 2599218-1
    detail.hit.zdb_id: 2594979-2
    detail.hit.zdb_id: 1429-1
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  • 9
    Online Resource
    Online Resource
    Factors associated with long‐term outcomes in pediatric refractory status epilepticus
    Wiley ; 2021
    In:  Epilepsia Vol. 62, No. 9 ( 2021-09), p. 2190-2204
    Details
    In: Epilepsia, Wiley, Vol. 62, No. 9 ( 2021-09), p. 2190-2204
    Abstract: This study was undertaken to describe long‐term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors associated with new neurological deficits after RSE. Methods We performed retrospective analyses of prospectively collected observational data from June 2011 to March 2020 on pediatric patients with RSE. We analyzed clinical outcomes from at least 30 days after RSE and, in a subanalysis, we assessed developmental outcomes and evaluated risk factors in previously normally developed patients. Results Follow‐up data on outcomes were available in 276 patients (56.5% males). The median (interquartile range [IQR]) follow‐up duration was 1.6 (.9–2.7) years. The in‐hospital mortality rate was 4% (16/403 patients), and 15 (5.4%) patients had died after hospital discharge. One hundred sixty‐six (62.9%) patients had subsequent unprovoked seizures, and 44 (16.9%) patients had a repeated RSE episode. Among 116 patients with normal development before RSE, 42 of 107 (39.3%) patients with available data had new neurological deficits (cognitive, behavioral, or motor). Patients with new deficits had longer median (IQR) electroclinical RSE duration than patients without new deficits (10.3 [2.1–134.5] h vs. 4 [1.6–16] h, p  =  .011, adjusted odds ratio = 1.003, 95% confidence interval = 1.0008–1.0069, p  =  .027). The proportion of patients with an unfavorable functional outcome (Glasgow Outcome Scale‐Extended score ≥ 4) was 22 of 90 (24.4%), and they were more likely to have received a continuous infusion. Significance About one third of patients without prior epilepsy developed recurrent unprovoked seizures after the RSE episode. In previously normally developing patients, 39% presented with new deficits during follow‐up, with longer electroclinical RSE duration as a predictor.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v62.9
    DOI: 10.1111/epi.16984
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2002194-X
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  • 10
    Online Resource
    Online Resource
    Effect of Discordant Hip Bone Density on Incident Fracture Risk: A Registry‐Based Cohort Study
    Wiley ; 2022
    In:  Journal of Bone and Mineral Research Vol. 37, No. 10 ( 2022-10), p. 2018-2024
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 37, No. 10 ( 2022-10), p. 2018-2024
    Abstract: The Fracture Risk Assessment Tool (FRAX®) combines clinical risk factors and optionally femoral neck bone density to estimate major osteoporotic fracture (MOF) and hip fracture probability. Hip dual‐energy X‐ray absorptiometry (DXA) simultaneously measures the trochanter and total hip, but these regions are not considered by FRAX. Our aim was to determine whether discordance in trochanter and total hip bone density (defined as ≥1 T ‐score difference from the femoral neck) affects fracture risk adjusted for fracture probability. Using the Manitoba bone density registry, we identified 84,773 women and men age 40 years or older undergoing baseline hip DXA. The outcomes were incident MOF and hip fracture. Cox regression hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for baseline fracture probability were used to test the association between hip T ‐score discordance and incident fractures. Hip T ‐score discordance affected more than one in five subjects (trochanter lower in 3.9%, higher in 14.2%; total hip lower in 0.3%, higher in 14.9%). After mean 8.8 years there were 8444 incident MOF including 2664 hip fractures. Discordantly lower trochanter and lower total hip T ‐score (≥1 below femoral neck) was associated with increased risk for MOF (adjusted HRs 1.47 and 1.60) and hip fracture (HRs 1.85 and 2.12), while discordantly higher trochanter and total hip T ‐score (≥1 above femoral neck) was associated with lower risk for MOF (HRs 0.83 and 0.71) and hip fracture (HRs 0.79 and 0.68). In models that examined the trochanter and total hip simultaneously, discordantly lower trochanter T ‐score was associated with increased incident MOF and hip fracture risk (HRs 1.43 and 1.79) whereas discordantly higher total hip T ‐score was associated with lower risk (HRs 0.73 and 0.75). In conclusion, trochanter and total hip regions frequently show T ‐scores that are discordant with the femoral neck. This information strongly affects incident fracture risk independent of fracture probability scores computed with femoral neck bone density. © 2022 American Society for Bone and Mineral Research (ASBMR).
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v37.10
    DOI: 10.1002/jbmr.4672
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2008867-X
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