bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice after Exit? Bulgarian Civic Activists between Protest and Emigration
Authors: Rone Julia , Junes Tom 
Published: May 2020

This article belongs to a forthcoming special cluster, “Contention Politics and International Statebuilding in Southeast Europe” guest-edited by Nemanja Džuverovic, Julia Rone and Tom Junes. Historically, civic activists who left their home countries in the wake of protests would either risk disappearing in anonymity or become engaged in political “exile networks.” However, since the outbreak of the “global wave” of protest, the ability of activists to take advantage of freedom of movement and technological advances in social media changed the framework and conditions of such “exile.” This article addresses the question of what happens when protest activists decide to go abroad to study, work, and build a life. We focus in particular on the case of Bulgaria, the fastest shrinking country in the world. On the basis of structured qualitative interviews with Bulgarian activists who have gone abroad in the aftermath of the 2013 Bulgarian protests, we trace how migration and intra-EU mobility affect the political participation of activists, the ways in which they participate, and their diagnoses of the present. In other words, we explore whether one can speak of “exit after voice,” leading in the long run to a decrease in activism. We argue instead that we are witnessing a transformation of the dichotomy “exit-voice” into a more complex scale of forms of protest organization and participation, facilitated by social media and the freedom of movement within the EU. Herein, the real risk might be not that migration leads to political passivity, but that the new “voice” found through the experience abroad remains rather marginal as activists’ networks are transformed and community building becomes a challenge in an increasingly precarious world.
Prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus patients: a retrospective analysis of 3140 cases in a Chinese population
Authors: Mao Yan-Mei , Shi Pei-Li , Wu Li , Hu Yu-Qian , He Yi-Sheng , Xiang Kun , Tao Jin-Hui , Pan Hai-Feng , Wu Guo-Cui 
Published: May 2020

Introduction The present study aimed to investigate the prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus (SLE) patients among the Chinese population in order to provide evidence for improving the treatment and nursing of SLE patients. Methods A retrospective analysis of 3140 SLE patients admitted to two large tertiary hospitals was conducted in Anhui, China, from 2011 to 2018. In addition, the influential factors related to SLE with thrombocytopaenia were analysed through univariate and multivariate analysis. Results A total of 804 SLE patients had thrombocytopaenia (25.6%). The top 5 clinical manifestations of SLE inpatients were proteinuria (51.0%), lupus nephritis (45.9%), new rash (38.4%), haematuria (36.7%) and pyuria (32.2%). The incidence of neurological manifestations, oral mucosal ulceration, pleurisy, pericarditis, hyperglycaemia, leucocytopaenia, urinary casts, haematuria, pyuria and high disease activity in the thrombocytopaenia group were higher than those in the non-thrombocytopaenia group ( p < 0.05). Multivariate analysis showed age (odds ratio (OR) = 1.009, p = 0.005), neurological manifestations (OR = 1.373, p = 0.048), pericarditis (OR = 1.394, p = 0.048), hyperglycaemia (OR = 1.717, p < 0.001), leucocytopaenia (OR = 2.551, p < 0.001), haematuria (OR = 1.582, p < 0.001), serum C3 level <0.85 g/L (OR = 1.525, p = 0.001), serum C4 concentration <0.10 g/L (OR = 1.287, p = 0.020), serum CRP concentration <8 ng/L (OR = 1.314, p = 0.005), prothrombin time >15.30 seconds (OR = 1.479, p = 0.032), activated partial thromboplatin time >45 seconds (OR = 1.924, p < 0.001) and thrombin time >21 seconds (OR = 1.629, p = 0.015) were associated with thrombocytopaenia. Conclusion Thrombocytopaenia has a high prevalence in SLE patients and is related to some baseline, clinical and laboratory characteristics, affecting multiple organs and systems.
Adherence to national guidelines for colorectal cancer screening in Israel: Comprehensive multi-year assessment based on electronic medical records
Authors: Paltiel Ora , Keidar Tirosh Aravah , Paz Stostky Orit , Calderon-Margalit Ronit , Cohen Arnon D , Elran Einat , Valinsky Liora , Matz Eran , Krieger Michal , Yehuda Arye Ben , Jaffe Dena H , Manor Orly 
Published: May 2020

Objectives To assess time trends in colorectal cancer screening uptake, time-to-colonoscopy completion following a positive fecal occult blood test and associated patient factors, and the extent and predictors of longitudinal screening adherence in Israel. Setting Nation-wide population-based study using data collected from four health maintenance organizations for the Quality Indicators in Community Healthcare Program. Methods Screening uptake for the eligible population (aged 50–74) was recorded 2003–2018 using aggregate data. For a subcohort (2008–2012, N = 1,342,617), time-to-colonoscopy following a positive fecal occult blood test and longitudinal adherence to screening guidelines were measured using individual-level data, and associated factors assessed in multivariate models. Results The annual proportion screened rose for both sexes from 11 to 65%, increasing five-fold for age group 60–74 and >six-fold for 50–59 year olds, respectively. From 2008 to 2012, 67,314 adults had a positive fecal occult blood test, of whom 71% eventually performed a colonoscopy after a median interval of 122 (95% confidence interval 110.2–113.7) days. Factors associated with time-to-colonoscopy included age, socioeconomic status, and comorbidities. Only 25.5% of the population demonstrated full longitudinal screening adherence, mainly attributable to colonoscopy in the past 10 years rather than annual fecal occult blood test performance (83% versus 17%, respectively). Smoking, diabetes, lower socioeconomic status, cardiovascular disease, and hypertension were associated with decreased adherence. Performance of other cancer screening tests and frequent primary care visits were strongly associated with adherence. Conclusions Despite substantial improvement in colorectal cancer screening uptake on a population level, individual-level data uncovered gaps in colonoscopy completion after a positive fecal occult blood test and in longitudinal adherence to screening, which should be addressed using focused interventions.
Effect of Microfracture on Functional Outcomes and Subchondral Sclerosis Following Distraction Arthroplasty of the Ankle Joint
Authors: Gianakos Arianna L. , Haring R. Sterling , Shimozono Yoshiharu , Fragomen Austin , Kennedy John G. 
Published: May 2020

Background: Treatment for post-traumatic osteoarthritis (PTOA) of the ankle remains challenging. Distraction arthroplasty (DA) is an alternative for patients who are averse to or poor candidates for arthrodesis or joint replacement. The purpose of this study was to examine the role of microfracture (MFX) and concentrated bone marrow aspirate (CBMA) on the outcome of patients undergoing DA for end-stage PTOA of the ankle joint. Methods: Ninety-five patients who underwent DA for the treatment of end stage PTOA from 2009 to 2014 were selected from the hospital ankle registry. Demographic data, functional activity levels, complications, and radiographs taken at 6, 12, 24, and 36 months postoperatively were reviewed. Foot and Ankle Outcome Scores (FAOS) were obtained at the same time intervals. A total of 78 patients were included in this study. Interventions were divided into 4 groups for comparison: DA+MFX (n = 8), DA+MFX+CBMA (n = 35), DA+CBMA (n = 22), and DA alone (n = 13). Results: Patients undergoing DA+MFX or DA+MFX+CBMA had significantly worse motion ( P = .003) when compared with DA alone. Patients undergoing MFX had significantly reduced postoperative joint space and a greater length of time to return to activity when compared to subgroups not using MFX ( P = .01). The use of MFX was associated with significantly lower FAOS scores. Conclusion: The current study showed no benefit from MFX when combined with DA in the treatment of PTOA. CBMA may have helped mitigate the adverse effect of MFX but conferred no benefit when used with DA alone. DA remains a useful alternative to ankle arthrodesis and arthroplasty in patients with PTOA. However, MFX and biologic augmentation using CBMA appeared to have no additional benefit. Level of Evidence: Level III, comparative study.
A MicroRNA Signature in Acute Coronary Syndrome Patients and Modulation by Colchicine
Authors: Barraclough Jennifer Y. , Joglekar Mugdha V. , Januszewski Andrzej S. , Martínez Gonzalo , Celermajer David S. , Keech Anthony C. , Hardikar Anandwardhan A. , Patel Sanjay 
Published: May 2020

Background: Circulating microRNAs (miRNAs) may play a pathogenic role in acute coronary syndromes (ACS). It is not yet known if miRNAs dysregulated in ACS are modulated by colchicine. We profiled miRNAs in plasma samples simultaneously collected from the aorta, coronary sinus, and right atrium in patients with ACS. Methods: A total of 396 of 754 miRNAs were detected by TaqMan real-time polymerase chain reaction from EDTA-plasma in a discovery cohort of 15 patients (n = 3 controls, n = 6 ACS standard therapy, n = 6 ACS standard therapy plus colchicine). Fifty-one significantly different miRNAs were then measured in a verification cohort of 92 patients (n = 13 controls, n = 40 ACS standard therapy, n = 39 ACS standard therapy plus colchicine). Samples were simultaneously obtained from the coronary sinus, aortic root, and right atrium. Results: Circulating levels of 30 of 51 measured miRNAs were higher in ACS standard therapy patients compared to controls. In patients with ACS, levels of 12 miRNAs (miR-17, -106b-3p, -191, -106a, -146a, -130a, -223, -484, -889, -425-3p, -629, -142-5p) were lower with colchicine treatment. Levels of 7 of these 12 miRNA were higher in ACS standard therapy patients compared to controls and returned to levels seen in control individuals after colchicine treatment. Three miRNAs suppressed by colchicine (miR-146a, miR-17, miR-130a) were identified as regulators of inflammatory pathways. MicroRNAs were comparable across sampling sites with select differences in the transcoronary gradient of 4 miRNA. Conclusion: The levels of specific miRNAs elevated in ACS returned to levels similar to control individuals following colchicine. These miRNAs may mediate ACS (via inflammatory pathways) or increase post-ACS risk, and could be potentially used as biomarkers of treatment efficacy.
Biosimilar infliximab administration for the management of acute graft-versus-host disease
Authors: Tollkuci Eris , Fitzpatrick Paul , N Seddon Amanda , Myers Rebecca , Nathan Sunita , Ustun Celalettin 
Published: May 2020

Introduction Acute graft-versus-host disease (aGVHD) is a significant immune-mediated complication of allogeneic hematopoietic stem cell transplant (HSCT). Despite prophylactic immunosuppression, the incidence of grades II–IV aGVHD post-HSCT varies from 20 to 80%. Tumor necrosis factor (TNF) is an important cytokine involved in the pathogenesis of GVHD, and medications such as infliximab (Remicade®) have been utilized as second-line treatment options in patients with steroid-refractory GHVD. Infliximab-dyyb (Inflectra®) and infliximab-qbtx (Ixifi®) are biosimilars approved by the FDA for a variety of autoimmune disorders. This is the first case report documenting the utility of infliximab-dyyb and -qbtx for the management of steroid-refractory aGVHD. Case report We report the post-transplant course of three patients treated with infliximab biosimilars as a part of therapy for management of steroid-refractory aGVHD. Management and outcome Steroid-refractory aGVHD is associated with poor prognosis and its management, as highlighted in our three patient cases, and can be very diverse often requiring different therapeutic modalities which overlap in administration. Discussion In these patients with steroid-refractory aGVHD, we were able to show that infliximab biosimilars could be used in lieu of the reference infliximab product. Although we had important limitations, this case report supports the use of anti-TNF agents in highly mortal steroid-refractory acute GI GVHD and that replacement of infliximab with its biosimilars is feasible.
Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review
Authors: Almalag Haya M , Alasmari Sarah S , Alrayes Mounerah H , Binhameed Munirah A , Alsudairi Reem A , Alosaimi Maha M , Alnasser Ghada A , Abuzaid Rawan A , Khalil Najma , Abouzaid Hanan H , Alarfaj Abdulrahman S 
Published: May 2020

Background Cyclophosphamide is an alkylating agent associated with significant toxicities, most importantly hemorrhagic cystitis. Many approaches including mesna use were established to reduce this toxicity. However, data on mesna efficacy are conflicting. Objective To investigate the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide therapy with or without mesna. Methods A retrospective chart review was done on all adult patients receiving cyclophosphamide therapy with or without mesna at the King Saud University Medical City. The incidence of hemorrhagic cystitis was recorded. Patients receiving mesna were compared with those not receiving mesna. Data were reported as numbers and percentages, and appropriate statistical tests of association were used. This step was followed by a comprehensive literature review using appropriate keywords in PubMed from the inception of the database until August 2019. All studies of interest were reported. Results A total of 718 patients’ medical records were reviewed. The majority of the patients received mesna (n = 433, 60%). The mesna group had a greater incidence of hemorrhagic cystitis (3.5% vs. 0.4%, p < 0.004) and received a significantly larger cumulative dose (3103 ± 1696 vs. 2465 ± 1528, p < 0.001) mg of cyclophosphamide therapy. Our literature review revealed large differences in the conclusions of published trials with highly diverse study designs and populations, emphasizing on the need of large prospective trials to address this topic. Conclusion and relevance: Our study results do not support the use of mesna in preventing hemorrhagic cystitis. We found that the only influential factor in the development of hemorrhagic cystitis was the dose of cyclophosphamide therapy.
Outcomes of Ahmed glaucoma valve in paediatric glaucoma following congenital cataract surgery in persistent foetal vasculature
Authors: Spiess Karina , Peralta Calvo Jesús 
Published: May 2020

Purpose To evaluate the outcomes of primary Ahmed glaucoma valve in refractory secondary glaucoma following congenital cataract surgery, particularly in persistent foetal vasculature. Method Retrospective review of paediatric patients after Ahmed glaucoma valve implantation for refractory post-lensectomy glaucoma in a tertiary referral centre in Spain. Surgical complications, additional and/or replacements of Ahmed glaucoma valve, intraocular pressure, cup-to-disc ratio, glaucoma medications and final visual acuity were studied. Results A total of 29 eyes, 41% with persistent foetal vasculature and 59% with non–persistent foetal vasculature were included with mean follow-up of 105 ± 67 and 74 ± 45 months, respectively, after first Ahmed glaucoma valve implant. Median survival time for the first Ahmed glaucoma valve was significantly lower in persistent foetal vasculature (7.0 ± 3.2 months) compared to non–persistent foetal vasculature (over 129 months), p = 0.001. The cumulative probability of success in persistent foetal vasculature and non–persistent foetal vasculature eyes with Ahmed glaucoma valve were, respectively, 37.5% and 88.2% at year 1 and 28.1% and 71.9% at year 5. Cox regression model suggested persistent foetal vasculature as predictive risk factor of time to Ahmed glaucoma valve failure (hazard ratio: 5.77, p = 0.004). Four eyes developed phthisis bulbi. Mean intraocular pressure prior glaucoma surgery was 32.66 ± 6.73 mmHg and decreased to 16.54 ± 2.75 mmHg (p < 0.001) at final visit. The most frequent early postoperative complication was severe hypotony (32.6%) which tended to be self-limiting. Vitreous haemorrhage was associated with persistent foetal vasculature (p = 0.024). Ahmed glaucoma valve replacements after complications and additional Ahmed glaucoma valve implantations due to unsatisfactory intraocular pressure were more common in the persistent foetal vasculature group. Conclusion Eyes with persistent foetal vasculature and secondary glaucoma after congenital cataract surgery followed by AGV implantation had a higher number of complications and a decreased probability of success compared to the non-persistent foetal vasculature group. Both groups achieved a significant decrease in intraocular pressure; thus, Ahmed glaucoma valve may be considered as first-line treatment in refractory glaucoma following congenital cataract surgery.
Pediatric posttraumatic orbital subperiosteal hematoma
Authors: Eshraghi Bahram , Razi-Khosroshahi Marjan , Hasani Hamidreza , Silbert David I 
Published: May 2020

Aim To report five children with posttraumatic orbital subperiosteal hematoma. Methods In this study, five cases with posttraumatic orbital subperiosteal hematoma were studied and reviewed along with similar cases in a systematic literature review. Results The mean age of our patients was 9.40 ± 3.51 years, ranging from 4 to 13 years, and all were male. Mechanisms of injuries were blunt trauma, falling from a building, car accident, and falling from a bicycle. All patients had unilateral involvement. Treatment options included needle aspiration, surgical drainage, and observation for spontaneous resolution. Except for one patient, positive outcomes were achieved. Conclusion The most common location for posttraumatic orbital subperiosteal hematoma is the superior orbital wall. Traumatic optic neuropathy and permanent visual loss are uncommon. Observation, surgical drainage, and aspiration are common treatment options.
Diagnostic Values of miR-21, miR-124, and M-CSF in Patients With Early Cervical Cancer
Authors: Ruan Fang , Wang Yun-fei , Chai Yun 
Published: May 2020

Objective: This study aimed to investigate the diagnostic values of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in patients with cervical cancer. Methods: A total of 68 patients with cervical cancer admitted in our hospital (cervical cancer group) and 57 healthy individuals undergoing physical examinations (healthy group, also control group) were enrolled in this study. The expression of serum microRNA-21 and microRNA-124 was detected by quantitative reverse transcription polymerase chain reaction. The expression of serum macrophage colony-stimulating factor was detected by enzyme-linked immunosorbent assay. The diagnostic values of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in cervical cancer were analyzed. The correlations between the expression of microRNA-21 and microRNA-124 with that of macrophage colony-stimulating factor were also analyzed. Results: Compared to those in the healthy group, patients in the cervical cancer group had a higher expression of microRNA-21 and macrophage colony-stimulating factor ( P < .05) but lower expression of microRNA-124 ( P < .05). The expression of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in the patients correlated with the tumor size, tumor node metastasis (TNM) staging, tumor differentiation, and the presence or absence of lymph node metastasis and human papillomavirus infection ( P < .05). According to the receiver operating characteristic curves, the area under the curve of microRNA-21 for diagnosing cervical cancer was 0.723, the specificity was 58.82%, and the sensitivity was 91.23%. The area under the curve of microRNA-124 was 0.766, the specificity was 94.12%, and the sensitivity was 57.89%. The area under the curve of macrophage colony-stimulating factor was 0.754, the specificity was 64.71%, and the sensitivity was 87.72%. Pearson correlation analysis showed that the expression of microRNA-21 positively correlated with that of macrophage colony-stimulating factor ( r = 0.6825, P < .001), and the expression of microRNA-124 negatively correlated with that of macrophage colony-stimulating factor ( r = −0.6476, P < .001). Conclusion: MicroRNA-21, microRNA-124, and macrophage colony-stimulating factor may be involved in the development and progression of cervical cancer. The detection of serum microRNA-21, microRNA-124, and macrophage colony-stimulating factor has good sensitivity and specificity in the diagnosis of cervical cancer.
The Diagnostic Value of Serum L1CAM in Patients With Colorectal Cancer
Authors: Chu Ling-Yu , Guo Dong-Ming , Chen Jun-Tian , Fang Wang-Kai , Xie Jian-Jun , Peng Yu-Hui , Xu Yi-Wei , Li Xin-Xin 
Published: May 2020

Objective: Colorectal cancer is one of the most important malignant cancer in the world with high incidence and mortality. Some studies have found that the expression of low serum L1 cell adhesion molecule is associated with poor prognosis in some malignancies. It is suggested that L1 cell adhesion molecule is a candidate serum marker for certain tumors. However, the relationship between serum L1 cell adhesion molecule and colorectal cancer, especially about the diagnostic value, is rarely reported. Therefore, this study aimed to evaluate the diagnostic potential of serum L1 cell adhesion molecule in patients with colorectal cancer. Methods: Enzyme-linked immunosorbent assay was carried out to detect L1 cell adhesion molecule level in sera of 229 patients with colorectal cancer and 145 normal controls. Receiver operating characteristic curves were employed to calculate the accuracy of diagnosis. Results: The levels of serum L1 cell adhesion molecule in the colorectal cancer group were significantly lower than that in normal controls ( P < .05). In the normal group, the area under the receiver operating characteristic curve (area under the curve) of all colorectal cancer was 0.781 (95% confidence interval: 0.734-0.828) and early-stage colorectal cancer was 0.764 (95% confidence interval: 0.705-0.823). With optimized cutoff of 17.760 ng/mL, L1 cell adhesion molecule showed certain diagnostic value with specificity of 90.3% and sensitivities of 43.2% and 36.2% in colorectal cancer and early-stage colorectal cancer, respectively. Clinical data analysis showed that the levels of L1 cell adhesion molecule were significantly correlated with gender ( P < .05) and early and late stages ( P < .05). Furthermore, when compared with carcinoembryonic antigen, serum L1 cell adhesion molecule had significantly improved diagnostic accuracy for both colorectal cancer and early-stage colorectal cancer. Conclusions: Our study demonstrated that serum L1 cell adhesion molecule might be served as a potential biomarker for the diagnosis of colorectal cancer.
Noninfectious aortitis: A case report
Authors: Jaikaran Omkaar , Nicoara Michael , Hingorani Anil 
Published: May 2020

Introduction Noninfectious aortitis has been increasingly reported worldwide with a growing prevalence in western medicine. Attributed to our increasingly diverse population, western surgeons must be vigilant to promptly differentiate these cases from its more common infectious counterpart in order to ensure subsequent appropriate management of these patients. Methods We present a case report of a 71-year-old Indo-Caribbean male who presented with nonspecific abdominal and back pain, found to have aortitis of a noninfectious etiology. Results and conclusion: While our patient’s process was ultimately managed without surgical intervention, the varied clinical presentation along with the lack of specific laboratory markers pose a challenge for surgeons to appropriately diagnose and manage aortitis. Appropriate diagnostic imaging, the utilization of a multidisciplinary team, and close patient monitoring are key components for effective management of this increasingly prevalent disease process.