bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deficiency in the frequency and function of Tr1 cells in IgAV and the possible role of IL-27
Authors: Pan Lu , Wang Jinghua , Liu Jinxiang , Guo Lishuang , Yang Sirui 
Published: October 2020

AbstractObjectiveType 1 regulatory T (Tr1) cells are involved in the pathogenesis of numerous immune-mediated diseases. However, little is known about whether and how Tr1 cells affect the development of IgA vasculitis (IgAV). We aimed to investigate this question in IgAV patients.Methods. Tr1 cells in peripheral blood and kidney tissue of IgAV patients were analysed by multi-parametric flow cytometry and immunofluorescence techniques. An in vitro assay of suppression of T cell proliferation and cytokine release was performed to evaluate the function of Tr1 cells. Real-time PCR and cell stimulation in vitro were used to explore the roles of IL-27 and early growth response gene 2 (EGR2).ResultsThe frequency of Tr1 cells was decreased in peripheral blood but increased in kidney tissue from IgAV patients. A defective suppressive function of Tr1 cells in IgAV was observed. The frequency of Tr1 cells and the cytokines secreted by them were up-regulated in the presence of recombinant IL-27 in vitro. Moreover, IL-27 also increased the expression of EGR2. Furthermore, lower frequency of Tr1 cells during remission had a higher recurrence rate.ConclusionTr1 cells are involved in the pathogenesis of IgAV. The low IL-27 in IgAV is responsible for impaired frequency and function of Tr1 cells, and EGR2 may be the specific transcription factor involved in the progression. Tr1 may be a risk factor for IgAV recurrence.
Socioeconomic status and occurrence of chronic pain: a meta-analysis
Authors: Prego-Domínguez Jesús , Khazaeipour Zahra , Mallah Narmeen , Takkouche Bahi 
Published: October 2020

Abstract

Objective
To examine the association between socioeconomic status (SES) and the occurrence of chronic pain, defined as pain that persists or recurs for &gt;3 months.

Methods
We performed a structured search in Medline, Embase, WHO Global Index Medicus and Conference Proceedings Citation Index-Science databases to identify cohort and case–control studies on chronic pain and SES and its subgroups (SES combined index, educational level, income and occupational status). We extracted study characteristics, outcome measures and measures of association and their 95% CIs. Literature search, data extraction and risk of bias assessment were conducted by two independent researchers. We performed main and subgroup meta-analyses using random-effects model, and formally assessed heterogeneity and publication bias.

Results
A total of 45 studies, covering a population of ∼175 000 individuals, were meta-analysed, yielding a pooled Odds Ratio (OR) of 1.32 (95% CI: 1.21, 1.44) and 1.16 (95% CI: 1.09, 1.23) for low and medium SES levels, respectively, compared with high level. We obtained similar results in all the subgroup analyses. Heterogeneity was generally moderate to high across strata, and some evidence of publication bias for low socioeconomic status was found.

Conclusion
Our results support a moderate increase in the risk of chronic pain for low and medium SES when compared with high SES, a feature that remained constant in all measures of exposure or outcome used. Further prospective research on populations from developing countries are needed to confirm our findings as the studies available for this meta-analysis were carried out exclusively in developed countries.
Political Epistemology in Gender Policy-Making: The German Democratization of Expertise
Authors: Kulawik Teresa 
Published: October 2020

AbstractThis article proposes the concept of feminist political epistemology to examine the changing modalities of knowledge production in Germany. The article examines how German gender equality policies have been embedded in and shaped by the shifting modalities of knowledge production and the remaking of the science expertise–politics nexus. The two formative time periods investigated—the 1960s–1970s and 1998 to the present—account for major shifts in the gender and political knowledge regime in Germany. The findings provide insights into the contradictory dynamics involved in transformations of political and epistemic authority.
The U.S. Safety Net since the Great Recession: Trends and Reforms, 2007–2017
Authors: Chang Yu-Ling , Romich Jennifer L 
Published: October 2020

Abstract
The negative impacts of the Great Recession (GR) (2007 to 2009) on the lives of families with low incomes warrant social work concerns about how well antipoverty policy responded to meet economic needs over this period and since. Given America’s long-standing tension between welfare state adequacy and market-oriented policies, how well did the safety net respond to the economic downturn? Did GR-era changes reverse or accelerate trends in public assistance? This article examines key policy changes and indicators of caseloads, inclusion, and generosity for three antipoverty policies: the Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamp Program), and the Earned Income Tax Credit from 2007 to 2017. Authors’ analysis shows a continuation of market-oriented U.S. antipoverty policy. Authors argue that the reemphasis of conditioning benefits on employment undermines the countercyclical feature of the social safety net and perpetuates the inequitable redistribution of public resources between those inside and outside of the labor market. Authors discuss social workers’ role in strengthening antipoverty policies to improve the economic well-being of people with low incomes and the economic justice of the social safety net.
Pension funds, quasi-trustees and statutory guidance
Authors: Akhtar Zia 
Published: October 2020

Abstract
In an important decision for public law, the Supreme Court has ruled that ministerial guidance, given to administering authorities to oversee investment of Local Government Pension Scheme (LGPS) funds on how to discharge their powers, is unlawful. All five judges accepted that administering authorities owe “quasi-trustee” duties to LGPS members (in the area of investment) and that, as the law stands, the Secretary of State’s powers are limited by these overriding duties. However, only three judges accepted that the Public Service Pensions Act 2013 did not allow central government policy to be “imposed” on LGPS funds. The two dissenting judges stated that the public interest component of the 2013 Act was significant, and, under certain circumstances, central government could legitimately seek to align LGPS fund investment with government policy. The consequence of the ruling is that the Government will not be able to interfere in the ethical investment decisions of LGPS and their members, and the principle from the Padfield case that a discretionary power granted in legislation can never be completely unfettered and must be exercised in accordance with the purpose of the legislation has been upheld.
Dexmedetomidine versus midazolam for sedation during endobronchial ultrasound-guided transbronchial needle aspiration
Authors: Kim Junghyun , Choi Sun Mi , Park Young Sik , Lee Chang-Hoon , Lee Sang-Min , Yoo Chul-Gyu , Kim Young Whan , Lee Jinwoo 
Published: October 2020

BACKGROUND
Desaturation is a common complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine (DEX), a commonly used sedative in intensive care, is associated with less respiratory depression compared with other sedatives.

OBJECTIVE
We compared DEX with midazolam (MDZ) when used as a sedative during EBUS-TBNA.

DESIGN
A randomised, parallel, double-blinded trial.

SETTING
A university-affiliated teaching hospital between June 2014 and July 2015

PATIENTS
A total of 102 patients who underwent EBUS-TBNA were randomly allocated to two groups (48 DEX group, 54 MDZ group).

INTERVENTIONS
DEX group received 0.25 to 0.75 μg kg−1 h−1 (start with 0.5 μg kg−1 h−1, modulated in three steps from 0.25 to 0.75 μg kg−1 h−1) of DEX after a loading dose of 0.25 μg kg−1 h−1 for 10 min to maintain a Ramsay Sedation Scale (RSS) of 3 to 5. If the patient was agitated, 1 mg of MDZ bolus was used as a rescue drug. Patients in the MDZ group initially received 0.05 mg kg−1 of MDZ as a bolus. For maintenance and rescue, 1 mg of MDZ bolus was used.

MAIN OUTCOME MEASURES
The primary outcome was the presence of oxygen desaturation. Secondary outcomes were level of sedation (Ramsay Sedation Scale score), cough score, sedation and procedure satisfaction score.

RESULTS
The baseline characteristics of the patients, duration of EBUS-TBNA procedures and the use of rescue MDZ were not different between the groups. There was no significant difference in desaturation events between the DEX and MDZ groups (56.3 and 68.5%, respectively; P = 0.20). The level of sedation and the sedation satisfaction scores were similar between the two groups. However, cough score was significantly lower in the DEX group (41.9 vs. 53.4; P = 0.02).

CONCLUSION
The use of DEX during EBUS-TBNA was not superior to MDZ in terms of oxygen desaturation.

TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT02157818.
Cervical Length at 28–32 Weeks of Gestation Predicts Preterm Birth
Authors: Zhang Mengying , Zhang Xiaoxiao , Yang Huixia , Shi Chunyan 
Published: October 2020

Abstract

Objective:
To evaluate the ability of cervical length (CL) at 28–32 weeks of gestation to predict spontaneous preterm delivery and preterm premature rupture of membranes (PPROM).

Methods:
It was a retrospective cohort study that vaginal ultrasonography at approximately 28–32 weeks of gestation was performed in 14,953 women between 17–49 years old with singleton pregnancies who delivered after 28 weeks of gestation at the Peking University First Hospital from June 2008 to December 2012. The pregnancy outcomes were followed and the relationship between the CL and preterm delivery or PPROM was assessed. The relative risk was calculated to assess group differences in the likelihood of an event occurring.

Results:
The overall prevalence of preterm delivery was 5.7% (858/14,953); the incidence for therapeutic preterm delivery was 2.1% (318/14,953), for spontaneous preterm delivery was 0.9% (133/14,953), and for PPROM was 2.7% (407/14,953). Excluding the 318 women who had therapeutic preterm delivery, the relative risk of preterm delivery for women with a CL between 25 mm and <30 mm, between 15 mm and <25 mm, and <15 mm was 3.7, 9.3, and 30.2, respectively. The sensitivity, specificity, and positive and negative predictive values of CL ≤25 mm at 28–32 weeks of gestation as the cut-off value for predicting preterm delivery were 19.8%, 97.5%, 23.4%, and 96.9%, respectively. For preterm delivery before 35 weeks of gestation, the sensitivity, specificity, and positive and negative predictive values of a CL ≤ 25 mm at 28–32 weeks of gestation as the cut-off value were 30.0%, 97.2%, 11.8%, and 99.1%, respectively. In addition, women with PPROM (n = 407) had significantly shorter CL (31.9 ± 7.4) mm at 28–32 weeks of gestation compared that of women without PPROM (34.0 ± 8.3) mm. The incidence of PPROM in women with a CL≤25 mm at 28–32 weeks of gestation (19.4%, 79/407) was significantly lower than that for women with a CL >25 mm (80.6%, 328/407, P < 0.05).

Conclusion:
CL at 28–32 weeks of gestation can predict spontaneous preterm delivery, and is valuable for predicting PPROM.
The Effect of Hospital Safety-Net Burden and Patient Ethnicity on In-Hospital Mortality Among Hospitalized Patients With Cirrhosis
Authors: Wong Robert J. , Hirode Grishma 
Published: October 2020

Background:
Over 2.1 million individuals in the United Stats have cirrhosis, including 513,000 with decompensated cirrhosis. Hospitals with high safety-net burden disproportionately serve ethnic minorities and have reported worse outcomes in surgical literature. No studies to date have evaluated whether hospital safety-net burden negatively affects hospitalization outcomes in cirrhosis. We aim to evaluate the impact of hospitals’ safety-net burden and patients’ ethnicity on in-hospital mortality among cirrhosis patients.

Methods:
Using National Inpatient Sample data from 2012 to 2016, the largest United States all-payer inpatient health care claims database of hospital discharges, cirrhosis-related hospitalizations were stratified into tertiles of safety-net burden: high (HBH), medium (MBH), and low (LBH) burden hospitals. Safety-net burden was calculated as percentage of hospitalizations per hospital with Medicaid or uninsured payer status. Multivariable logistic regression evaluated factors associated with in-hospital mortality.

Results:
Among 322,944 cirrhosis-related hospitalizations (63.7% white, 9.9% black, 15.6% Hispanic), higher odds of hospitalization in HBHs versus MBH/LBHs was observed in blacks (OR, 1.26; 95%CI, 1.17-1.35; P<0.001) and Hispanics (OR, 1.63; 95% CI, 1.50-1.78; P<0.001) versus whites. Cirrhosis-related hospitalizations in MBHs or HBHs were associated with greater odds of in-hospital mortality versus LBHs (HBH vs. LBH: OR, 1.05; 95% CI, 1.00-1.10; P=0.044). Greater odds of in-hospital mortality was observed in blacks (OR, 1.27; 95% CI, 1.21-1.34; P<0.001) versus whites.

Conclusion:
Cirrhosis patients hospitalized in HBH experienced 5% higher mortality than those in LBH, resulting in significantly greater deaths in cirrhosis patients. Even after adjusting for safety-net burden, blacks with cirrhosis had 27% higher in-hospital mortality compared with whites.
Rescue Therapies for Helicobacter pylori Infection in Foreign Patients Treated in Italy
Authors: Saracino Ilaria M. , Pavoni Matteo , Zullo Angelo , Fiorini Giulia , Saccomanno Laura , Lazzarotto Tiziana , Antonelli Guido , Cavallo Rossana , Borghi Claudio , Vaira Dino 
Published: October 2020

Background and Aims:

Helicobacter pylori prevalence remains high worldwide, especially in developing areas where infection acquisition occurs in early childhood. H. pylori eradication fails in a definite number of patients, despite one or more therapeutic attempts. Curing these patients is progressively more difficult, due to development of antibiotic resistance. While the cure rate of first-line therapies in foreigners was found to be different from that of Italians, no data are available on rescue therapies.

Materials and Methods:
Consecutive foreigner patients with H. pylori infection following at least one therapy failure were enrolled. All patients underwent upper endoscopy with gastric biopsies used for both histologic examination and culture/susceptibility test. Rescue therapies administered accordingly to susceptibility testing were rifabutin-based therapy, levofloxacin-based therapy, sequential. Pylera was prescribed regardless the resistance pattern.

Results:
A total of 103 (M/F: 27/76, mean age: 41.9 y, range: 18 to 85) were enrolled. The overall resistance rates toward clarithromycin, metronidazole, and levofloxacin were 76.7%, 66%, and 42.7%, respectively, with triple resistance present in 33.9% of bacterial isolates. Eradication rates were 71.4% on 40 patients for rifabutin-based therapy, 82.8% on 42 cases for levofloxacin-based therapy, 75% on 11 patients treated with sequential therapy, and 100% on 10 cases who received Pylera regimen.

Conclusions:
To our knowledge, this is the first study assessing H. pylori eradication rates in foreigner patients, who failed at least one therapeutic attempt, managed in Italy. Even by using a culture-based approach, the infection was not cured in a definite number of patients.
Characteristics of different histological subtypes of thyroid nodules classified with 99mTc-methoxy-isobutyl-isonitrile imaging and Thyroid Imaging Reporting And Data System
Authors: Schenke Simone Agnes , Klett Rigobert , Wagner Peer-Roman , Mott Sebastian , Zimny Michael , Feek Ulrich , Kreissl Michael Christoph 
Published: October 2020

Introduction
Thyroid Imaging Reporting And Data System (TIRADS) is helpful for risk stratification of thyroid nodules. However, there is a lack of data for TIRADS classification of different histological subtypes [classical papillary thyroid cancer (PTC), follicular variant of papillary thyroid cancer (FVPTC), and follicular thyroid cancer (FTC)], and benign thyroid nodules (follicular adenoma, oncocytic adenoma, and multinodular goiter (MNG)]. Methoxy-isobutyl-isonitrile (MIBI) imaging has a high negative predictive value for the exclusion of thyroid malignancy in hypofunctioning thyroid nodules. The aim of this analysis was to compare malignant and benign subtypes of thyroid nodule using three TIRADS and MIBI imaging.

Methods
Retrospective analysis of MIBI imaging studies. Hypofunctioning thyroid nodules were classified with Kwak-TIRADS, EU-TIRADS, and K-TIRADS. MIBI imaging was visually categorized.

Results
We included 242 thyroid nodules (32 malignant, 19 PTC, 7 FVPTC, and 6 FTC). When using Kwak-TIRADS 4C and 5 as a marker for high-risk nodules, we found 85.5% of the follicular adenoma, 80.8% of the MNG, 100% of the oncocytic adenoma, 100% of the FTC, 57.1% of the FVPTC, and 42.2% of the PTC to be below this cutoff. All PTC and FVPTC were MIBI-positive, 83% of the FTC, 78% of the follicular adenoma, 75% of the oncocytic adenoma, and 60% of the MNG were MIBI-positive.

Conclusion
TIRADS is useful to detect PTC, but FVPTC and FTC may be missed. MIBI imaging seems to be more suitable to detect FVPTC and FTC. However, neither TIRADS nor MIBI imaging are able to differentiate between follicular adenoma and FTC or FVPTC.
Common Variable Immunodeficiency, Autoimmune Hemolytic Anemia, and Pancytopenia Associated With a Defect in IKAROS
Authors: Yilmaz Ebru , Kuehn Hye S. , Odakir Eda , Niemela Julie E. , Ozcan Alper , Eken Ahmet , Rohlfs Meino , Cansever Murat , Gok Veysel , Aydin Firdevs , Karakukcu Musa , Hauck Fabian , Klein Christoph , Unal Ekrem , Rosenzweig Sergio D. , Patiroglu Turkan 
Published: October 2020

Objective:
Mutations in IKZF1, which encodes Ikaros family zinc finger 1 (IKAROS) transcription factor, are associated with recurrent infections, cytopenia, autoimmune diseases, and hematologic malignancies. Diverse clinical phenotypes resulting from IKZF1 mutations include pulmonary fungal infections, cytopenia, autoimmune hemolytic anemia (AIHA), and malignancies. In this study, we aimed to assess the DNA-binding ability and pericentromeric (PC) localization of a variant of IKZF discovered in a patient.

Materials and Methods:
DNA-binding ability of a pathogenic IKZF variant was tested using electrophoretic mobility shift assay and PC localization of the variant was assessed by immunofluorescent microscopy in NIH3T3 cells.

Results:
Clinical features of a 3-month-old male infant who underwent hematopoietic stem cell transplantation because of an IKZF1 mutation-associated common variable immunodeficiency, AIHA, and pancytopenia are described. DNA studies revealed a heterozygous missense variant (IKZF1 NM_006060 c.427C>T; p.R143W). Cotransfection studies revealed that mutant R143W has a partial dominant-negative effect over PC targeting and DNA binding.

Conclusions:

IKZF1 mutation must be kept in mind if neonatal AIHA, common variable immunodeficiency, and pancytopenia are observed.
Pre-exposure Prophylaxis Use and Detected Sexually Transmitted Infections Among Men Who Have Sex With Men in the United States—National HIV Behavioral Surveillance, 5 US Cities, 2017
Authors: Chapin-Bardales Johanna , Johnson Jones Michelle L. , Kirkcaldy Robert D. , Bernstein Kyle T. , Paz-Bailey Gabriela , Phillips Christi , Papp John R. , Raymond Henry F. , Opoku Jenevieve , Braunstein Sarah L. , Spencer Emma C. , Khuwaja Salma , Wejnert Cyprian ,   for the NHBS STI Study Group
Published: October 2020

Background:
Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) may be at high risk for bacterial sexually transmitted infections (STIs). We examined the prevalence of extragenital gonorrhea and chlamydia by PrEP status among a multisite sample of US MSM.

Methods:
MSM aged ≥18 years were recruited through venue-based sampling to participate in the 2017 National HIV Behavioral Surveillance. In 5 cities (San Francisco, Washington DC, New York City, Miami, and Houston), participants completed a questionnaire, HIV testing, and pharyngeal and rectal STI specimen self-collection. We measured prevalence of pharyngeal and rectal gonorrhea and chlamydia among self-reported non–HIV-positive MSM who reported using or not using PrEP in the previous 12 months.

Results:
Overall, 29.6% (481/1627) of non–HIV-positive MSM reported PrEP use in the past year. MSM who reported PrEP use were more likely to have any STI (ie, extragenital gonorrhea and/or chlamydia) than MSM not on PrEP [14.6% vs. 12.0%, adjusted prevalence ratio (aPR) = 1.5, 95% confidence interval (CI) : 1.1 to 2.0], reflecting differences in rectal chlamydia prevalence (8.7% vs. 6.0%, aPR = 1.6, 95% CI: 1.1 to 2.4). PrEP use was not associated with pharyngeal chlamydia, pharyngeal gonorrhea, or rectal gonorrhea.

Conclusions:
The prevalence of extragenital STI was high for both MSM on PrEP and those not on PrEP in the past year. MSM on PrEP were more likely to have rectal chlamydia but not pharyngeal STIs or rectal gonorrhea. Our findings support regular STI testing at exposed anatomic sites as recommended for sexually active MSM, including those on PrEP.
Does Fixation of Gastric Sleeve Prevent Functional Stenosis in Sleeve Gastrectomy Patients?
Authors: Şen Ozan , Sekmen Ümit , Türkçapar Ahmet G. , Yerdel Mehmet A. 
Published: October 2020

Aim:
The aim of this study is to determine whether gastric sleeve fixation prevents functional stenosis (twist or kink) and to investigate its effects on symptoms such as nausea and vomiting after laparoscopic sleeve gastrectomy (LSG).

Methods:
A total of 717 patients who underwent primary LSG for morbid obesity and completed at least 1 year of follow-up between 2012 and 2019 were included in the study. All operations were performed by the same surgical team using the same technique. The patients were divided into 2 groups, that is, group 1: standard LSG and group 2: gastric sleeve fixation with LSG. These 2 groups were compared in terms of demographic characteristics, baseline body mass index, follow-up duration, bleeding, leaks, gastric stenosis, postoperative nausea, vomiting, and the need for antiemetics. In the follow-up period, patients with suspected gastric stenosis underwent endoscopy and upper gastrointestinal series.

Results:
LSG was performed in 717 patients (55.2% female) with a mean age of 37.8±11.5 years and a median body mass index of 42.2 (30.2 to 74.2) kg/m2. The 241 patients in the first group underwent LSG without fixation, and the 476 patients in the second group with fixation. Functional stenosis was detected in 8 patients, all of whom were in group 1. One patient in group 1 had a leak on the background of functional stenosis. There was bleeding that required transfusion in 2 patients (group 1) and reoperation in 2 patients (group 2). None of the study patients died. During the in-hospital period, 122 (50.6%) patients in group 1 and 159 (33.4%) patients in group 2 had nausea and vomiting that required antiemetic treatment (P<0.001).

Conclusion:
Gastric sleeve fixation in LSG prevents complications that may arise because of improper gastric mobilization. This method is effective in reducing nausea and vomiting in LSG patients.