bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Impact and Cost-Effectiveness of Condomless-Sex–Concentrated PrEP in KwaZulu-Natal Accounting for Drug Resistance
Authors: Phillips Andrew N , Cambiano Valentina , Johnson Leigh , Nakagawa Fumiyo , Homan Rick , Meyer-Rath Gesine , Rehle Thomas , Tanser Frank , Moyo Sizulu , Shahmanesh Maryam , Castor Delivette , Russell Elizabeth , Jamieson Lise , Bansi-Matharu Loveleen , Shroufi Amir , Barnabas Ruanne V , Parikh Urvi M , Mellors John W , Revill Paul
Published: December 2019

Introduction

Oral preexposure prophylaxis (PrEP) in the form of tenofovir-disoproxil-fumarate/emtricitabine is being implemented in selected sites in South Africa. Addressing outstanding questions on PrEP cost-effectiveness can inform further implementation.

Methods

We calibrated an individual-based model to KwaZulu-Natal to predict the impact and cost-effectiveness of PrEP, with use concentrated in periods of condomless sex, accounting for effects on drug resistance. We consider (1) PrEP availability for adolescent girls and young women aged 15–24 years and female sex workers, and (2) availability for everyone aged 15–64 years. Our primary analysis represents a level of PrEP use hypothesized to be attainable by future PrEP programs.

Results

In the context of PrEP use in adults aged 15–64 years, there was a predicted 33% reduction in incidence and 36% reduction in women aged 15–24 years. PrEP was cost-effective, including in a range of sensitivity analyses, although with substantially reduced (cost) effectiveness under a policy of ART initiation with efavirenz- rather than dolutegravir-based regimens due to PrEP undermining ART effectiveness by increasing HIV drug resistance.

Conclusions

PrEP use concentrated during time periods of condomless sex has the potential to substantively impact HIV incidence and be cost-effective.
Does age have an impact on acute mountain sickness? A systematic review
Authors: Gianfredi Vincenza , Albano Luciana , Basnyat Buddha , Ferrara Pietro
Published: December 2019

Acute mountain sickness (AMS) is the most common form of illness at high altitude; however, it is still unclear whether age is a protective factor or a risk factor for the development of AMS in travellers. In recent decades, the number of travellers aged 60 years or older is increasing. Thus, the care of older travellers is a long-standing issue in travel medicine. This study aims to systematically review the current state of knowledge related to the effect of old age on the risk of AMS. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used, and the following databases were consulted: PubMed/Medline, Embase, Europe PubMed Central (EuropePMC), World Health Organization Library Database (WHOLIS) and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). The search yielded a total of 532 articles, of which 25 met the inclusion criteria, corresponding to 26 reports. Although the approaches, methods and quality were heterogeneous among the included studies, 12 reported a negative correlation between AMS prevalence and age, 11 detected no relationship and three papers indicated that the age of AMS subjects was significantly higher than controls. Despite these differences, old age does not seem to be a contraindication for travelling at high altitude. Thus, the presented synthesis will be useful for health professionals in travel medicine to better tailor their appropriate care for older adults who travel to destinations at high altitude.
Cosmological simulations of massive black hole seeds: predictions for next-generation electromagnetic and gravitational wave observations
Authors: DeGraf C , Sijacki D
Published: December 2019

We study how statistical properties of supermassive black holes depend on the frequency and conditions for massive seed formation in cosmological simulations of structure formation. We develop a novel method to recalculate detailed growth histories and merger trees of black holes within the framework of the Illustris simulation for several seed formation models, including a physically motivated model where black hole seeds only form in progenitor galaxies that conform to the conditions for direct collapse black hole formation. While all seed models considered here are in a broad agreement with present observational constraints on black hole populations from optical, UV, and X-ray studies, we find that they lead to widely different black hole number densities and halo occupation fractions, which are currently observationally unconstrained. In terms of future electromagnetic spectrum observations, the faint-end quasar luminosity function and the low-mass-end black hole–host galaxy scaling relations are very sensitive to the specific massive seed prescription. Specifically, the direct collapse model exhibits a seeding efficiency that decreases rapidly with cosmic time and produces much fewer black holes in low-mass galaxies, in contrast to the original Illustris simulation. We further find that the total black hole merger rate varies by more than one order of magnitude for different seed models, with the redshift evolution of the chirp mass changing as well. Supermassive black hole merger detections with LISA and International Pulsar Timing Array may hence provide the most direct means of constraining massive black hole seed formation in the early Universe.
Climate bistability of Earth-like exoplanets
Authors: Murante Giuseppe , Provenzale Antonello , Vladilo Giovanni , Taffoni Giuliano , Silva Laura , Palazzi Elisa , Hardenberg Jost von , Maris Michele , Londero Elisa , Knapic Cristina , Zorba Sonia
Published: December 2019

Before about 500 million years ago, most probably our planet experienced temporary snowball conditions, with continental and sea ices covering a large fraction of its surface. This points to a potential bistability of Earth’s climate that can have at least two different (statistical) equilibrium states for the same external forcing (i.e. solar radiation). Here, we explore the probability of finding bistable climates in Earth-like exoplanets and consider the properties of planetary climates obtained by varying the semimajor orbital axis (thus, received stellar radiation), eccentricity and obliquity, and atmospheric pressure. To this goal, we use the Earth-like planet surface temperature model (ESTM), an extension of one-dimensional Energy Balance Models developed to provide a numerically efficient climate estimator for parameter sensitivity studies and long climatic simulations. After verifying that the ESTM is able to reproduce Earth climate bistability, we identify the range of parameter space where climate bistability is detected. An intriguing result of this work is that the planetary conditions that support climate bistability are remarkably similar to those required for the sustenance of complex, multicellular life on the planetary surface. The interpretation of this result deserves further investigation, given its relevance for the potential distribution of life in exoplanetary systems.
Eccentric Training Changes the Pressure Pain and Stiffness Maps of the Upper Trapezius in Females with Chronic Neck-Shoulder Pain: A Preliminary Study
Authors: Heredia-Rizo Alberto Marcos , Petersen Kristian Kjær , Arendt-Nielsen Lars , Madeleine Pascal
Published: December 2019

Objective

Between 50% and 67% of adults suffer from neck-shoulder pain, which may be associated with increased stiffness of neck muscles. We assessed pressure pain sensitivity and muscle stiffness maps of the upper trapezius in female computer users with and without chronic neck-shoulder pain and investigated the effects of eccentric training on females with neck-shoulder pain.

Design

Cross-sectional (part 1) and open-label (part 2) study.

Setting

University.

Subjects

Twenty females with neck-shoulder pain were compared with 20 controls (part 1). In part 2, neck-shoulder pain participants followed a five-week unilateral upper trapezius eccentric training program.

Methods

Topographical maps of pressure pain thresholds (pressure algometer) and muscle stiffness (myotonometer), using a 15-point grid covering myotendinous and muscle belly sites, and shoulder elevation force and range of elevation (dynamometer) were assessed at baseline and after training.

Results

There were no differences in pressure pain thresholds between sites (P = 0.243) or groups (P = 0.068), and there were significant differences in stiffness between myotendinous and muscle belly sites (P < 0.001) but not groups (P = 0.273). After training, pressure pain thresholds increased, stiffness decreased (P < 0.005), and shoulder elevation force and range of elevation improved (P < 0.001).

Conclusions

The lack of differences in upper trapezius pressure pain sensitivity and stiffness between females with or without neck-shoulder pain confirms no clear etiology among computer users reporting neck-shoulder pain. A five-week eccentric training protocol showed positive effects on pressure pain sensitivity, stiffness, shoulder force, and range of motion.
Fear Avoidance Beliefs and Kinesiophobia Are Presented in Athletes who Suffer from Gastrocnemius Chronic Myofascial Pain
Authors: San-Antolín Marta , Rodríguez-Sanz David , Vicente-Campos Davinia , Palomo-López Patricia , Romero-Morales Carlos , Benito-de-Pedro María , López-López Daniel , Calvo-Lobo César
Published: December 2019

Objective

To compare and predict kinesiophobia and fear avoidance beliefs between athletes with gastrocnemius myofascial pain syndrome (MPS) and healthy athletes.

Design

Case–control.

Setting

Outpatient clinic.

Subjects

Fifty athletes were divided into athletes with chronic gastrocnemius MPS (N = 25) and healthy athletes (N = 25).

Methods

Kinesiophobia symptoms total and domain scores (harm and activity avoidance) and levels were determined by the Tampa Scale of Kinesiophobia (TSK-11). Fear avoidance beliefs total and domain scores (physical and working activities) were measured by the Fear Avoidance Beliefs Questionnaire (FABQ).

Results

Significant differences (P < 0.05) with a large effect size (d = 0.81–4.22) were found between both groups, with greater kinesiophobia symptom scores for the TSK-11 activity avoidance domain and total scores, and greater fear avoidance beliefs scores for the FABQ physical and working activities domains and total scores of athletes with gastrocnemius MPS with respect to healthy athletes. TSK-11 total score showed a prediction model (R2 = 0.256) based on the FABQ total score. The FABQ total score showed a prediction model (R2 = 0.741) based on gastrocnemius MPS presence (R2 = 0.665), levels of kinesiophobia (R2 = 0.052), and height (R2 = 0.025).

Conclusions

Greater kinesiophobia levels, greater total and activity avoidance domain scores (but not for the harm domain), and greater fear avoidance beliefs total and domain scores (work and physical activity) were shown for athletes with gastrocnemius MPS vs healthy athletes. Higher kinesiophobia symptoms were predicted by greater fear avoidance beliefs in athletes. Greater fear avoidance beliefs were predicted by the presence of gastrocnemius MPS, higher levels of kinesiophobia, and lower height in athletes.
Clough, Emerson, and Knowingness
Authors: McGhee Fergus
Published: December 2019

The poetry of Arthur Hugh Clough has tended to be read in dialogue with the writings of his friend and critic, Matthew Arnold. This essay explores how bringing Clough’s work into conversation with that of a very different friend, Ralph Waldo Emerson, offers to cast his intellectual affinities and poetic technique in a new light. Interweaving close readings of Clough’s verse with detailed attention to the essays he is known to have read and admired, I trace how Clough adapts and revises Emerson’s critique of ‘knowingness’. Beginning by tracing the history of this term in nineteenth-century literature and culture, I argue that Clough’s Dipsychus shapes an Emersonian ethic and aesthetic of encounter as an alternative to complacent and proprietorial forms of knowing. Turning to the rest of Clough’s oeuvre, especially Amours de Voyage, I then consider how fantasies of the future are central to what it means to be knowing about oneself, and examine how Clough applies poetic pressure to Emerson’s conviction that ‘A man … never rises so high as when he knows not whither he is going’.
Association of Diabetes and Other Clinical and Sociodemographic Factors With Guideline-concordant Breast Cancer Treatment for Breast Cancer
Authors: Gold Heather T. , Shao Huibo , Oratz Ruth , Yu Onchee , Hammer Marilyn , Richardson Stephen , Boudreau Denise
Published: December 2019

Background:

Women with breast cancer have worse health outcomes with co-occurring type 2 diabetes, possibly due to suboptimal breast cancer treatment.

Methods:

We created a cohort of women ages 66 to 85 y with stage I to III breast cancer from 1993 to 2012 from an integrated health care delivery system (n=1612) and fee-for-service Medicare beneficiaries (n=98,915), linked to Surveillance, Epidemiology, and End Results (SEER) data (total n=100,527). We evaluated associations between type 2 diabetes and other factors with undergoing guideline-concordant cancer treatment. We estimated χ2 tests for univariate analysis and relative risks (RRs) using multivariable log-binomial models for outcomes of (1) overall guideline-concordant treatment, (2) definitive surgical therapy (mastectomy or lumpectomy with radiation), (3) chemotherapy if indicated, and (4) endocrine therapy.

Results:

Our cohort included 60% of subjects with stage 1 tumors, one quarter below 70 years old, 23% had diabetes, 35% underwent overall guideline-concordant treatment, 24% chemotherapy, and 83% endocrine therapy. Women with diabetes were less likely to undergo overall guideline-concordant treatment (RR: 0.96; 95% confidence interval: 0.94-0.98), and only slightly less likely to undergo guideline-concordant definitive surgical therapy (RR: 0.99; 95% confidence interval: 0.99-1.00). No differences were found for chemotherapy or endocrine therapy. Other factors significantly associated with a lower risk of guideline-concordant care were cancer stages II to III (vs. I; RR=0.47-0.69, P<0.0001), older age (vs. 66 to 69 y; RR=0.56-0.90, P<0.0001), higher comorbidity burden, and Medicaid dual-eligibility.

Conclusions:

Diabetes was associated with lower adherence to overall guideline-concordant breast cancer treatment. However, higher stage, older age, higher comorbidity burden, and Medicaid insurance were more strongly associated with lower use of guideline-concordant treatment. Given the heavy burden of breast cancer and diabetes, long-term outcomes analysis should consider guideline-concordant treatment.

Impact:

Other factors besides diabetes are more strongly associated with guideline-concordant breast cancer treatment.
Effects of menopause on sleep quality and sleep disorders: Canadian Longitudinal Study on Aging
Authors: Zolfaghari Sheida , Yao Chun , Thompson Cynthia , Gosselin Nadia , Desautels Alex , Dang-Vu Thien Thanh , Postuma Ronald B. , Carrier Julie
Published: December 2019

Objectives:

Sleep complaints are common during the menopause transition. However, it is difficult to disentangle changes in sleep related to aging from those directly due to menopause. We compared sleep disorders in 45 to 60-year-old women in a large population-based study, according to menopausal status.

Methods:

Women aged between 45 and 60 years who self-reported menopausal status were selected from the Canadian Longitudinal Study of Aging, excluding those with prior hysterectomy. Participants completed assessments for overall sleep satisfaction, hours of daily sleep, sleep-onset insomnia, sleep-maintenance insomnia, daytime somnolence, rapid eye movement sleep behavior disorder (RBD), restless leg syndrome (RLS), and obstructive sleep apnea (OSA). Each sleep variable was compared between postmenopausal and pre/perimenopausal women using multivariate regression, adjusting for potential confounders.

Results:

Among 6,179 women included, 3,713 (60.1%; age 55.7 ± 3.3 years) were postmenopausal and 2,466 (39.9%) were pre/perimenopausal (age 49.80 ± 3.1 years). Compared with pre/perimenopausal women, postmenopausal women were more often reported requiring ≥30 minutes to fall asleep (20.4% vs 15.5%; adjusted odds ratio [AOR] 1.24, 95% confidence interval [CI] 1.00-1.53) and were more likely to meet criteria for possible sleep-onset insomnia disorder (10.8% vs 7.3%; AOR 1.51, 95% CI 1.07-2.12). Postmenopausal women were also more likely to screen positive for OSA (14.6% vs 10.4%; AOR 1.48, 95% CI 1.14-1.92). The two groups did not differ on sleep dissatisfaction (32.4% vs 29%), daytime somnolence disorder (1.6% vs 1.3%), sleep-maintenance insomnia disorder (17% vs 14.5%), RLS (23.5% vs 20.9%), or RBD (3.9% vs 4.0%).

Conclusions:

Menopause is associated with increased sleep-onset insomnia. Postmenopausal women also are more likely to screen positive for OSA. However, menopausal status is not associated with sleep maintenance, somnolence, or RLS, and RBD.

Video Summary:
http://links.lww.com/MENO/A501.
Socioeconomic Disparities in Cardiovascular Health in South Korea
Authors: Lee Chi-Young , Im Eun-Ok
Published: December 2019

Background

To improve the cardiovascular health of those with socioeconomic disadvantages, the nature of their disparities must be explored to inform targeted interventions for this group. However, these efforts have been scarce in all areas of nursing research and practice in South Korea.

Objective

This systematic review aims to examine the nature of socioeconomic disparities in cardiovascular health in South Korea.

Methods

Multiple electronic databases including PubMed, CINAHL, EMBASE, and Cochrane (2009–2019.06) were searched. A total of 42 articles published in English or Korean that examined socioeconomic disparities in cardiovascular health in South Korea were selected, reviewed, and analyzed using a narrative synthesis.

Results

Socioeconomic disparities existed in cardiovascular health among Korean populations across the disease continuum from risk factors to mortality. The magnitudes, directions, and significance of the observed associations between socioeconomic status and cardiovascular health varied by socioeconomic status indicators, gender, and age groups. Five studies (12%) explained the mediation and moderation of multiple factors to the associations.

Conclusion

This body of knowledge will serve as a basis to inform strategies, interventions, or policies to reduce disparities in cardiovascular health.
Motivational Interviewing and Self-care Practices in Adult Patients With Heart Failure
Authors: Sokalski Tamara , Hayden K. Alix , Raffin Bouchal Shelley , Singh Pavneet , King-Shier Kathryn
Published: December 2019

Background

Heart failure contributes to frequent hospitalizations, large healthcare costs, and high mortality. Heart failure management includes patient adherence to strict self-care practices (ie, symptom recognition, limiting sodium and fluids, monitoring weight, maintaining an active lifestyle, and medication adherence as well as monitoring other medical conditions). These practices can be difficult to enact and maintain. Motivational interviewing, although not studied extensively in patients with heart failure, may enhance patients' abilities to enact and maintain self-care practices.

Objective

The aim of this study was to examine the effectiveness of motivational interviewing on self-care practices in the adult population with heart failure.

Methods

We conducted a narrative systematic review of peer-reviewed research literature focused on motivational interviewing in adult patients with heart failure. The following databases were searched from database inception to March 2019: MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, ERIC, Educational Resource Complete, and Scopus. Of 1158 citations retrieved, 7 studies met the inclusion criteria.

Results

Outcomes were focused on self-care adherence (ie, maintenance, management, confidence), physical activity/exercise, and knowledge of self-care. Motivational interviewing has been effectively used either alone or in combination with other therapies and has been used in-home, over the telephone, and in hospital/clinic settings, although face-to-face interventions seem to be more effective. A number of limitations were noted in the included studies.

Conclusion

Motivational interviewing is a potentially effective adjunct to enhance self-care practices in patients with heart failure. Further high-quality research is needed to support changes in clinical practice.
Factors Associated With Hospital Admissions and Readmissions in Patients With Gastroparesis Using the Nationwide Readmission Database
Authors: Shahsavari Dariush , Zhao Huaqing , Ehrlich Adam C. , Zoll Bryan E. , Lu Xiaoning , Malik Zubair , Parkman Henry P.
Published: December 2019

Background:

Gastroparesis can be associated with severe symptoms. Health care utilization for gastroparesis has increased in part due to an increase in hospital admissions.

Goals:

To characterize patients admitted for gastroparesis-related symptoms and determine risk factors associated with 30-day readmissions.

Study:

The Nationwide Readmission Database (NRD) for the year 2014 was used to identify patients admitted to hospitals using the International Classification of Diseases (ICD)-9 code for gastroparesis as primary diagnosis or as the secondary diagnosis with first diagnosis code of a gastroparesisrelated symptom. Logistic regression was used to determine risk factors associated with 30-day readmission.

Results:

There were 5268 gastroparesis patients admitted with the average length of stay (LOS) of 5.4±6.6 days. Age averaged 48.9±18.1 years, 73.8% were female individuals, and 31% had diabetes. Inpatient mortality was 0.4%. The overall 30-day readmission rate was 6.2%. Longer LOS [odds ratio (OR)=1.4; 95% confidence interval (CI), 1.0-1.9], younger age, drug abuse (OR=1.6; 95% CI, 1.2-2.2), and marijuana use (OR=1.7; 95% CI, 1.0-2.7) were associated with increased risk of 30-day readmission. Female gender (P=0.083), opioid use (P=0.057), and admission to larger hospital (P=0.070) showed a trend toward higher readmission rates. Older patients, and patients with hypertension and diabetes showed lower rates of readmission.

Conclusions:

Use of the Nationwide Readmission Database (NRD) allows better understanding of gastroparesis admissions and readmissions. Average hospital stay was 5.4 days with 0.4% mortality rate. Overall 30-day readmission rate was 6.2%. Higher LOS, drug abuse, and marijuana use increased the 30-day readmission rate. Diabetes, hypertension, and older age were associated with lower readmissions.
Detection Measures for Colonoscopy
Authors: Rex Douglas K.
Published: December 2019

The adenoma detection rate (ADR) was first proposed by the US Multi-Society Task Force on Colorectal Cancer in 2002 and, subsequently, has been validated as a strong predictor of colorectal cancer risk after colonoscopy. ADR is now widely considered the most important quality measure in colonoscopy. ADR is a surrogate for missed lesions and for cancer incidence after colonoscopy. ADR has weaknesses, and multiple other detection targets have been evaluated as alternatives. This review discusses the history of ADR, the strength and weaknesses of ADR, and proposed alternatives to ADR. Of the alternatives, adenomas per colonoscopy has the most advantages with limited disadvantages relative to ADR and has some potential to eventually replace ADR.
Climate change and respiratory diseases: a 2020 perspective
Authors: Joshi Manish , Goraya Harmeen , Joshi Anita , Bartter Thaddeus
Published: December 2019

Purpose of review

To present an overview of the impact of climate change upon human respiratory health.

Recent findings

Climate change involves two major types of change. First, there is overall progressive warming. Second, there is increased variability/unpredictability in weather patterns. Both types of change impact negatively upon human respiratory health. Worsening air quality and increased allergens can worsen existing disease. Climate-related changes in allergens and in vectors for infection can cause new disease. Redundant sophisticated studies have projected marked increases in respiratory morbidity and mortality throughout the world as a direct result of climate change. This article summarizes some of those studies.

The clarity of our vision with respect to the dramatic impact of climate change upon human respiratory health approaches 20/20. The data represent a mandate for change. Change needs to include international, national, and individual efforts.
Peritoneal irrigation vs suction alone during pediatric appendectomy for perforated appendicitis
Authors: Bi Le-Wee , Yan Bei-Lei , Yang Qian-Yu , Cui Hua-Lei
Published: December 2019

Background:

There currently exists no substantial evidence reporting the efficacy of peritoneal irrigation in reducing the incidence of postoperative intra-abdominal abscess in pediatric patients. The purpose of our study was to perform a meta-analysis to compare rates of intra-abdominal abscess after appendectomy between irrigation and suction alone groups.

Methods:

We identified studies by a systematic search in EMBASE, PubMed, Web of Science, and the Cochrane Library to recognize randomized controlled trials and case control studies from the 1950 to May 2019. We limited the English language studies. We checked the reference list of studies to recognize other potentially qualified trials. We analyzed the merged data with use of the Review Manager 5.3.

Results:

We identified 6 eligible papers enrolling a total of 1633 participants. We found no significant difference in the incidence of postoperative intraabdominal abscess, wound infection, and the length of hospitalization between 2 group, but duration of surgery is longer in irrigation group (MD = 6.76, 95% CI = 4.64 to 8.87, P < .001; heterogeneity, I
2 = 25%, P = .26).

Conclusion:

Our meta-analysis did not provide strong evidence allowing definite conclusions to be drawn, but suggested that peritoneal irrigation during appendectomy did not decrease the incidence of postoperative IAA. This meta-analysis also indicated the need for more high-quality trials to identify methods to decrease the incidence of postoperative IAA in pediatric perforated appendicitis patients.

Trial registration number Standardization of endoscopic treatment of acute abdomen in children: 14RCGFSY00150
Nonalcoholic steatohepatitis
Authors: Trifan Anca , Stanciu Carol , Jurcău Monica , Zenovia Sebastian , Frunzuc Georgiana , Timofte Daniel
Published: December 2019

Background:

Nonalcoholic steatohepatitis (NASH) is a subtype of non-alcoholic fatty liver disease (NAFLD) with a potentially progressive course to liver fibrosis, cirrhosis with its complications, or even hepatocellular carcinoma. NAFLD is a rapidly growing chronic liver disease, with a global prevalence of about 25%, with a significant increase in the last 2 decades, changing the landscape of hepatology. This study aimed to undertake a bibliometric global analysis of research literature focusing on NASH.

Methods:

We searched the Scopus database to identify all articles pertaining to “non-alcoholic steatohepatitis” or “NASH” – the 2 keywords used to search in the title or abstract within the time period 1980 to 2018. The collected data included document type, author, journal, publication year, citation reports, country, and were analyzed using Microsoft Excel and Microsoft Word.

Results:

A total number of 6632 articles published in 1355 journals were retrieved. English was the predominant language of publication, USA being the most productive with 1937 articles published (29.2% of the total number of publications), followed by Japan with 909, representing 13.7% of publications. Hepatology, Journal of Hepatology and World Journal of Gastroenterology were the most active journals. Research articles were the most common type of publications (4524; 68.22%), followed by review articles (1359; 20.49%). The total number of citations received by all publications was 274,041, with an average of 41.32 per article (range: 0–4384). The average number of authors per article has increased in the last 2 decades, whereas the trend of single- (or few) authored publications has decreased.

Conclusion:

This study indicates that NASH is a significant topic in the hepatology research, as proved by the huge number of publications, recording an exponential growth in the last 2 decades. The USA stands out as by far the most productive country.
Impact of contrast-enhanced transcranial Doppler ultrasound diagnosis for young adult with cryptogenic stroke
Authors: Jiang Xiao-xue , Song You , Hu Chun-rong , Wang Li-hua , Liu Lu , Zhang Ya-juan
Published: December 2019

Background:

This study aims to assess the impact of contrast-enhanced transcranial Doppler ultrasound (cTCD) diagnosis for young adult with cryptogenic stroke (CS).

Methods:

This study will analyze data from case-controlled studies investigating the impact of cTCD diagnosis for young adult with CS. A comprehensive literature search will be performed from PUBMED, EMBASE, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data from their inceptions up to the August 1, 2019. All databases will be searched with no language limitations. Two researchers will independently carry out study selection, data collection, and study quality assessment. Any discrepancies between two researchers will be solved by a third researcher. We will apply RevMan 5.3 software and Stata 12.0 software for statistical analysis.

Results:

Outcomes consist of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for determination of cTCD diagnosis for young adult with CS.

Conclusion:

The results of this study may summarize up-to-date evidence of cTCD diagnosis for young adult with CS.

Systematic review registration:

PROSPERO CRD42019145641.
Case report: Novel GJB2 variant c.113T>C associated with autosomal recessive non-syndromic hearing loss (ARNSHL) in a Han family
Authors: Lan Xinqiang , Sun Shiyu , Lan Xin , Niu Linyuan , Zhang Chunxiao , Chen Xiaoli , Xia Ningning
Published: December 2019

Rationale:

Molecular mechanism underlying the autosomal recessive non-syndromic hearing loss (ARNSHL) is still plausible. Pathogenic mutations of the gap junction beta 2 protein (GJB2) are reported to be the primary causes of ARNSHL.

Patient concerns:

A propositus was diagnosed as ARNSHL with bilateral congenital profound hearing loss.

Diagnosis:

With microarray and target gene sequencing testing methods, a novel GJB2 mutant was found to be associated with ARNSHL in this Han Chinese family.

Interventions/Outcomes:

Based on the finding in this research, prenatal screening of GJB2 mutation and genetic counseling are recommended to this family for their next pregnancy. Our interventions allow the family to plan informatively.

Lessons:

In this family, we discovered 2 heterozygous carriers of c.113T>C variation in the GJB2 gene. The propositus, who had profound hearing loss, had inherited the c.113T>C variation from his normal mother and the c.235delC from his father.
Development of myelofibrosis and acute monocytic leukemia in a patient with hereditary spherocytosis
Authors: Qian Juan , Shen Qian , Yin Hong , Shi Wen-yu , Yang Li , Zhang Ya-ping , Liu Hong
Published: December 2019

Introduction:

Common symptoms of hereditary spherocytosis (HS) include intermittent jaundice and splenomegaly. Here, we present an unusual clinical course wherein a patient with HS treated with splenectomy developed secondary myelofibrosis and acute monocytic leukemia (M5).

Patient concerns:

After presenting with paleness, fatigue and jaundice, the patient was diagnosed with HS. After splenectomy, follow-up testing, including bone marrow biopsy, revealed myelofibrosis. Subsequently, the patient exhibited blood cell abnormalities consistent with M5.

Diagnosis:

M5 comorbid with myelofibrosis and a history of HS.

Interventions:

HS was treated with splenectomy. Myelofibrosis was treated with hydroxyurea. The patient refused chemotherapy for M5 and was discharged. He was maintained on hydroxyurea and received periodic blood product transfusions with regular routine blood test monitoring.

Outcomes:

Because of intracranial hemorrhage, the patient died on May 17, 2018, a little >10 months after being diagnosed with leukemia.

Conclusion:

The present patient developed M5 while undergoing treatment for myelofibrosis and after undergoing splenectomy for HS, raising the question of whether these conditions might be associated. Examination of this question will require the analysis of additional cases.
Effect of phosphodiesterase-5 inhibitors (PDE5is) on the treatment of male infertility
Authors: Dong Liang , Zhang Xiaojin , Yan Xuhong , Shen Yifeng , Yu Xujun , Li Yulin
Published: December 2019

Background:

Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction (ED), but more and more studies show that it has a certain effect on male infertility in recent years. The literatures of PDE5is related to male infertility have shown inconsistent results, and there is currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality in male infertility patients.

Methods:

The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org, China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry and Cochrane Library were retrieved. Grey literature will be searched in Open Grey. Related Randomized controlled trials (RCTs) were collected and selected before October 20, 2019. We will search English literature and Chinese literature with search terms “male infertility”, “phosphodiesterase-5 inhibitors”, “PDE5i”, “Tadalafil”, “Sildenafil”, “Vardenafil”, “Udenafil”, “Avanafil”, “semen” and “sperm”. Sperm concentration, motility and morphology, sperm DNA fragmentation index, number of per ejaculate, sperm viability and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement.

Conclusion and dissemination:

Efficacy and safety of PDE5is on male sperm quality in infertile men will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions.

Registration information:

PROSPERO CRD42019142980
Chlorpheniramine-induced anaphylaxis
Authors: Lee So-Hee , Lee Youngsoo , Woo Seong-Dae , Doo Ko-Eun , Ha Chae-Yeon , Lee Young-Hee , Ye Young-Min
Published: December 2019

Rationale:

Anaphylaxis is a serious allergic reaction which could be life-threatening. To date, it could be diagnosed by causality between clinical manifestations and triggers. But it is not always easy to find out the clue. Chlorpheniramine maleate (peniramin) is known to safe and it is an antihistamine commonly used to treat almost the whole allergic disease, including urticaria and allergic rhinitis. We recently experienced 2 cases of chlorpheniramine induced anaphylaxis. To document suspected cases of chlorpheniramine-induced adverse reactions, we analyzed a database spontaneously reported adverse drug reactions in the Ajou Regional Pharmacovigilance Center from 2011 to 2017.

Patient concerns:

Two female patients presented urticaria and abdominal pain right after chlorpheniramine injection.

Diagnoses:

Both patients were diagnosed with symptoms. One patient confirmed by assistance with tryptase level and another one confirmed cross-reactivity by skin tests.

Interventions:

One patient was instructed to avoid future administration of chlorpheniramine. The other patient was advised not to take chlorpheniramine, and piperazine derivatives including cetirizine/levocetirizine, but piperidine derivatives such as fexofenadine, loratadine, and ebastine can be available.

Outcomes:

The patients fully recovered after prompt treatment for anaphylaxis. After that, no recurrences were observed at the following. Among 54 patients with chlorpheniramine-induced adverse drug reactions from the Pharmacovigilance Center database, 17 (31.5%) were reported as anaphylaxis.

Lessons:

Physicians should be aware chlorpheniramine could be a cause for allergic reaction. In addition, we suggest that serum tryptase level, skin prick test, and intradermal test could be considered as a supplementary test for diagnosing chlorpheniramine anaphylaxis and cross-reactivity should also be considered.
Primary sclerosing cholangitis with increased immunoglobulin G4 levels
Authors: Chen Qing-Ling , Zhong Rui , Zhang Xiao-Xue , Feng Li-Na , Wen Xiao-Yu , Jin Qing-Long
Published: December 2019

Rationale:

Primary sclerosing cholangitis (PSC) is recognized as an autoimmune-mediated liver disease characterized by progressive biliary inflammation and fibrosis. Some PSC cases with elevated immunoglobulin G4 (IgG4) levels are likely to be misdiagnosed with immunoglobulin G4-related sclerosing cholangitis (IgG4-SC). Thus, distinguishing these 2 diseases is particularly important.

Patient concerns:

A 34-year-old male presented with right hypochondrium abdominal intermittent pain and jaundice lasting for 1 month. Here, we present a case of PSC with increased IgG4 levels with improvement of quality of life upon liver transplantation (LT).

Diagnosis:

The diagnosis of PSC was confirmed based on clinical symptoms, laboratory test results, imaging findings, pathologic results and a lack of response to steroid therapy.

Interventions:

LT surgery was performed successfully when his vital parameters were stabilized. Immunosuppressive agents were routinely used after LT.

Outcomes:

Three years after LT, liver function values show that alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were in the normal range. An abdominal ultrasonography showed no obvious abnormalities.

Lessons:

There are similar biochemical characteristics and cholangiographic findings between PSC and IgG4-SC. Therefore, distinguishing these 2 diseases is particularly important. LT remains the only option for end-stage PSC. Early diagnosis and effective treatment can achieve a good prognosis.
Evaluation of Ocular Complications by Using Optical Coherence Tomography in Children With Sickle Cell Disease Eye Findings in Children With Sickle Cell Disease
Authors: Vatansever Esra , Vatansever Mustafa , Dinç Erdem , Temel Gülhan Ö. , Ünal Selma
Published: December 2019

Objective:

The aim of this study was to compare optical coherence tomography (OCT) findings in pediatric patients with sickle cell disease (SCD) and healthy individuals and to investigate associations between these data and the patients’ systemic findings.

Materials and Methods:

The study included 108 eyes of 54 patients with SCD with no visual symptoms and a control group consisting of 110 eyes of 55 healthy subjects with no systemic or ocular pathology. After best-corrected visual acuity assessment, the study participants underwent a complete ophthalmologic examination including intraocular pressure. After examination and pupil dilation induced with 1% tropicamide, 9×9 mm macular sections were obtained with spectral-domain OCT. The macular sections were evaluated according to Early Treatment Diabetic Retinopathy Study (ETDRS) map and internal and external retinal thicknesses were measured using the software included in the OCT device.

Results:

The patient group showed significantly more foveal flattening, temporal thinning, and vascular tortuosity than the control group (P<0.0001 for all). Foveal width was significantly greater in the patient group (1592.39±175.56 µm) compared with the control group (1391.01±175.56 µm) (P<0.0001), whereas foveal depth was significantly lower in the patient group (121.15±26.83 µm) than in the control group (146.1±12.25 µm) (P<0.0001). The mean total retinal thickness was 253.53±22.31 µm in the patient group and 261.03±18.48 µm in the control group (P=0.007). Similarly, central retinal thickness was significantly lower in the patient group (219.35±10.53 µm) compared with the control group (235.32±12.51 µm) (P<0.0001).

Discussion:

Our study shows that pediatric patients with SCD may have subclinical retinal involvement and that temporal thinning, in particular, is an important OCT finding. This strongly suggests that OCT imaging would be a beneficial addition to routine ophthalmologic examination in the diagnosis and follow-up of this patient group.
L-type Voltage-gated Calcium Channel Modulators Inhibit Glutamate-induced Morphology in Astrocytoma Cells
Authors: Tabatabaee Mitra Sadat , Menard Frederic
Published: December 2019

The excitatory neurotransmitter glutamate evokes physiological responses within the astrocytic network that lead to fine morphological dynamics. However, the mechanism by which astrocytes couple glutamate sensing with cellular calcium rise remains unclear. Employing natural properties of U118-MG astrocytoma cells, we tested a possible connection between L-type voltage-gated calcium channels (Cav) and glutamate receptors. Using live confocal imaging and pharmacological inhibitors, the extension of U118-MG processes upon glutamate exposure are shown to depend mainly on extracellular calcium entry via L-type Cav’s. Inhibitors of the Cavα1 protein, decreased astrocytic filopodia extension; while, gabapentinoids, ligands of the Cav’s α2δ auxiliary subunit blocked all process growth. This study suggests that α2δ is the main contributor to Cav’s role in glutamate-dependent filopodiagenesis. It opens new avenues of research on the role of α2δ in neuron-astrocyte glutamate signaling and neurochemical signaling at tripartite synapses.
Diverse genetic origins of medieval steppe nomad conquerors
Authors: Mikheyev Alexander S. , Qiu Lijun , Zarubin Alexei , Moshkov Nikita , Orlov Yuri , Chartier Duane R. , Kornienko Igor V. , Faleeva Tatyana G. , Klyuchnikov Vladimir , Batieva Elena F. , Tatarinova Tatiana V.
Published: December 2019

Over millennia, steppe nomadic tribes raided and sometimes overran settled Eurasian civilizations. Most polities formed by steppe nomads were ephemeral, making it difficult to ascertain their genetic roots or what present-day populations, if any, have descended from them. Exceptionally, the Khazar Khaganate controlled the trade artery between the Black and Caspian Seas in VIII-IX centuries, acting as one of the major conduits between East and West. However, the genetic identity of the ruling elite within the polyglot and polyethnic Khaganate has been a much-debated mystery; a controversial hypothesis posits that post-conversion to Judaism the Khazars gave rise to modern Ashkenazim. We analyzed whole-genome sequences of eight men and one woman buried within the distinctive kurgans of the Khazar upper (warrior) class. After comparing them with reference panels of present-day Eurasian and Iron Age populations, we found that the Khazar political organization relied on a polyethnic elite. It was predominantly descended from Central Asian tribes but incorporated genetic admixture from populations conquered by Khazars. Thus, the Khazar ruling class was likely relatively small and able to maintain a genetic identity distinct from their subjugated populations over the course of centuries. Yet, men of mixed ancestry could also rise into the warrior class, possibly providing troop numbers necessary to maintain control of their large territory. However, when the Khaganate collapsed it left few persistent genetic traces in Europe. Our data confirm the Turkic roots of the Khazars, but also highlight their ethnic diversity and some integration of conquered populations.
Don’t Dismiss Logistic Regression: The Case for Sensible Extraction of Interactions in the Era of Machine Learning
Authors: Levy Joshua J. , O’Malley A. James
Published: December 2019

Background

Machine learning approaches have become increasingly popular modeling techniques, relying on data-driven heuristics to arrive at its solutions. Recent comparisons between these algorithms and traditional statistical modeling techniques have largely ignored the superiority gained by the former approaches due to involvement of model-building search algorithms. This has led to alignment of statistical and machine learning approaches with different types of problems and the under-development of procedures that combine their attributes. In this context, we hoped to understand the domains of applicability for each approach and to identify areas where a marriage between the two approaches is warranted. We then sought to develop a hybrid statistical-machine learning procedure with the best attributes of each.

Methods

We present three simple examples to illustrate when to use each modeling approach and posit a general framework for combining them into an enhanced logistic regression model building procedure that aids interpretation. We study 556 benchmark machine learning datasets to uncover when machine learning techniques outperformed rudimentary logistic regression models and so are potentially well-equipped to enhance them. We illustrate a software package,InteractionTransformer, which embeds logistic regression with advanced model building capacity by using machine learning algorithms to extract candidate interaction features from a random forest model for inclusion in the model. Finally, we apply our enhanced logistic regression analysis to two real-word biomedical examples, one where predictors vary linearly with the outcome and another with extensive second-order interactions.

Results

Preliminary statistical analysis demonstrated that across 556 benchmark datasets, the random forest approach significantly outperformed the logistic regression approach. We found a statistically significant increase in predictive performance when using hybrid procedures and greater clarity in the association with the outcome of terms acquired compared to directly interpreting the random forest output.

Conclusions

When a random forest model is closer to the true model, hybrid statistical-machine learning procedures can substantially enhance the performance of statistical procedures in an automated manner while preserving easy interpretation of the results. Such hybrid methods may help facilitate widespread adoption of machine learning techniques in the biomedical setting.