bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of 6-Month Versus Continuous Isoniazid Preventive Therapy for Mycobacterium tuberculosis in Adults Living With HIV/AIDS in Malawi
Authors: Hsieh Yuli L. , Jahn Andreas , Menzies Nicolas A. , Yaesoubi Reza , Salomon Joshua A. , Girma Belaineh , Gunde Laurence , Eaton Jeffrey W. , Auld Andrew , Odo Michael , Kiyiika Caroline N. , Kalua Thokozani , Chiwandira Brown , Mpunga James U. , Mbendra Kuzani , Corbett Liz , Hosseinipour Mina C. , Cohen Ted , Kunkel Amber 
Published: September 2020

Background:
To assist the Malawi Ministry of Health to evaluate 2 competing strategies for scale-up of isoniazid preventive therapy (IPT) among HIV-positive adults receiving antiretroviral therapy.

Setting:
Malawi.

Methods:
We used a multidistrict, compartmental model of the Malawi tuberculosis (TB)/HIV epidemic to compare the anticipated health impacts of 6-month versus continuous IPT programs over a 12-year horizon while respecting a US$10.8 million constraint on drug costs in the first 3 years.

Results:
The 6-month IPT program could be implemented nationwide, whereas the continuous IPT alternative could be introduced in 14 (of the 27) districts. By the end of year 12, the continuous IPT strategy was predicted to avert more TB cases than the 6-month alternative, although not statistically significant (2368 additional cases averted; 95% projection interval [PI], −1459 to 5023). The 6-month strategy required fewer person-years of IPT to avert a case of TB or death than the continuous strategy. For both programs, the mean reductions in TB incidence among people living with HIV by year 12 were expected to be <10%, and the cumulative numbers of IPT-related hepatotoxicity to exceed the number of all-cause deaths averted in the first 3 years.

Conclusions:
With the given budgetary constraint, the nationwide implementation of 6-month IPT would be more efficient and yield comparable health benefits than implementing a continuous IPT program in fewer districts. The anticipated health effects associated with both IPT strategies suggested that a combination of different TB intervention strategies would likely be required to yield a greater impact on TB control in settings such as Malawi, where antiretroviral therapycoverage is relatively high.
Incidence, Persistence, and Factors Associated With HPV Infection Among Male Adolescents With and Without Perinatally Acquired HIV Infection
Authors: Gatechompol Sivaporn , Teeratakulpisarn Nipat , Wittawatmongkol Orasri , Teeraananchai Sirinya , Kerr Stephen J. , Chalermchockcharoenkit Amphan , Thamkhantho Manopchai , Singtoroj Thida , Phanuphak Nittaya , Sohn Annette H. , Chokephaibulkit Kulkanya ,   on behalf of the HPV in Adolescents Study
Published: September 2020

Background:
Infection with high-risk human papillomavirus (HR-HPV) has been shown to be more prevalent and persistent in female adolescents with HIV. However, data among male adolescents with perinatally acquired HIV (PHIV) are limited.

Setting:
We investigated the incidence and persistence of HR-HPV in anogenital compartments and associated factors among PHIV in comparison to HIV-uninfected (HU) male adolescents in Thailand.

Methods:
PHIV and HU males aged 12–24 years were enrolled. At baseline and 3 subsequent annual visits, specimens from the scrotum, penis, and anal area were obtained for HPV and other testing.

Results:
From June 2013 to October 2017, 49 PHIV and 47 HU male adolescents with a median age of 18 (interquartile range 17–20) years were enrolled. PHIV had higher incidence of any HR-HPV infection than HU adolescents {33.05 [95% confidence interval (CI): 20.82 to 52.46] vs. 15.73 [95% CI: 8.18 to 30.22] per 100 person-years, P = 0.04}. The persistence of any HR-HPV genotypes (detected at ≥2 annual visits) was not different by group (PHIV 27% vs. HU 23%, P = 0.75). Having ≥3 sex partners in past 6 months (adjusted prevalence ratio 2.39, 95% CI: 1.14 to 5.05; P = 0.02) and co-infection with other sexually transmitted infections (syphilis, chlamydia, and/or gonorrhea) were associated with persistent HR-HPV infection (adjusted prevalence ratio 6.21, 95% CI: 2.87 to 13.41; P < 0.001).

Conclusions:
Thai PHIV male adolescents had a higher incidence of HR-HPV infection than those without HIV. Having multiple sex partners and co-infection with sexually transmitted infections was associated with persistent HR-HPV infection. These data demonstrate the need to prioritize PHIV male adolescents in routine and catch-up HPV vaccination programs.
Brief Report: Demographic and Genetic Associations With Markers of Small and Large Fiber Sensory Neuropathy in HIV Patients Treated Without Stavudine
Authors: Safri Ahmad Yanuar , Gaff Jessica , Octaviana Fitri , Setiawan Denise Dewanto , Imran Darma , Cherry Catherine L. , Laws Simon M. , Price Patricia 
Published: September 2020

Abstract:
Neurotoxic antiretroviral therapy (ART) such as stavudine has been now replaced with safer therapies, reducing the prevalence of neuropathy from 34% to 15% in HIV+ Indonesians. However, it is unclear whether the residual cases display damage to small or large nerve fibers and whether both are influenced by known risk factors, including alleles of CAMKK2 associated with neuropathy in HIV patients. The encoded protein influences the growth and repair of nerve fibers. HIV-positive adults on ART for >12 months without exposure to stavudine were screened for neuropathy using the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen (BPNS). Large fiber neuropathy was assessed by nerve conduction (NC) and small fiber neuropathy using stimulated skin wrinkling (SSW) applied to the fingers. CAMKK2 alleles were assessed by TaqMan OpenArray technology. Neuropathy diagnoses were more common with SSW than BPNS (49/173 vs 26/185, χ2; P = 0.0009), with poor alignment between these outcomes (P = 0.60). NC and BPNS diagnosed neuropathy at similar frequencies (29/151 vs 26/185; P = 0.12) and were aligned (P < 0.0001). In bivariate analyses, all diagnoses were associated with patients' age and persistent HIV replication, with minor effects from CD4 T-cell counts and time on ART. CAMKK2 alleles associated with neuropathy diagnosed with BPNS and SSW but not NC. Multivariable analyses confirmed the importance of age and HIV replication, with distinct CAMKK2 polymorphisms affecting BPNS and SSW. Paradoxically, height was protective against skin wrinkling. Overall the data link CAMKK2 genotypes with small rather than large fiber damage. SSW may reflect pathology distinct from that identified using BPNS.
Rheumatoid Arthritis Patients Have Better Outcomes Than Non-Rheumatoid Arthritis Patients When Hospitalized for Ischemic Stroke
Authors: Edigin Ehizogie , Ojemolon Pius Ehiremen , Eseaton Precious Obehi , Shaka Hafeez , Akuna Emmanuel , Asemota Iriagbonse Rotimi , Manadan Augustine 
Published: September 2020

Objectives
The aims of this study were to compare the outcomes of patients primarily admitted for ischemic stroke with and without a secondary diagnosis of RA.

Methods
Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS was searched for hospitalizations for adult patients with ischemic stroke as principal diagnosis with and without RA as secondary diagnosis using International Classification of Diseases, 10th Revision codes. The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, odds of receiving tissue plasminogen activator, and mechanical thrombectomy were secondary outcomes of interest. Multivariate logistic and linear regression analyses were used accordingly to adjust for confounders.

Results
There were more than 71 million discharges included in the combined 2016 and 2017 NIS database. Of 525,570 patients with ischemic stroke, 8670 (1.7%) had RA. Hospitalizations for ischemic stroke with RA had less inpatient mortality (4.7% vs. 5.5%; adjusted odds ratio, 0.66; 95% confidence interval, 0.52–0.85; p = 0.001), shorter LOS (5.1 vs 5.7 days, p < 0.0001), lower mean total hospital charges ($61,626 vs. $70,345, p < 0.0001), and less odds of undergoing mechanical thrombectomy (3.9% vs. 5.1%; adjusted odds ratio, 0.55; 95% confidence interval, 0.42–0.72; p < 0.0001) compared with those without RA.

Conclusions
Hospitalizations for ischemic stroke with RA had less inpatient mortality, shorter LOS, lower total hospital charges, and less likelihood of undergoing mechanical thrombectomy compared with those without RA. However, the odds of receiving tissue plasminogen activator were similar between both groups. Further studies to understand its mechanism would be helpful.
Patient Perception of Depressive Symptoms in Rheumatic Diseases
Authors: Ingegnoli Francesca , Schioppo Tommaso , Ubiali Tania , Ostuzzi Silvia , Bollati Valentina , Buoli Massimiliano , Caporali Roberto 
Published: September 2020

Objectives
The presented study aimed to explore the presence and the self-identification of depressive symptoms among patients with rheumatic musculoskeletal diseases (RMDs) through the use of the Patient Health Questionnaire (PHQ-9).

Methods
Between June and October 2019, patients from the regional association for people with RMDs in Lombardy, Italy (ALOMAR), were invited to participate in a cross-sectional online survey. Participants completed PHQ-9 along with a survey about their perception of depressive symptoms. Patients were stratified according to PHQ-9 score as follows: not depressed (<4), subclinical or mild depression (5–9), moderate depression (10–14), moderately severe depression (10–14), and severe depression (20–27). Descriptive statistics and analyses of variance were used to explore data.

Results
Of the 192 RMD patients who completed PHQ-9, 35 (18.2%) were not depressed, 68 (35.4%) had subclinical or mild depression, 42 (21.9%) had moderate depression, 30 (15.6%) had moderately severe depression, and 17 (8.9%) had severe depression. Contrary to the above findings, only 16 respondents (8.3%) reported that they experienced depressive symptoms, and only 7 of the 16 were being followed by a psychiatrist. Respondents with higher PHQ-9 scores tended to have concomitant fibromyalgia, to be younger, and to be overweight.

Conclusions
The current results indicate the overall burden of depressive symptoms in RMD patients. While clinical depression (PHQ-9 >10) was detected in 41.2% of respondents, only 8.3% reported that they experience depressive symptoms. Routine screening of RMD patients for depression is therefore critical.
The Relationship Between Primary Knee Osteoarthritis and Aortic Stiffness, Distensibility, and Valve Calcifications
Authors: Karaali Evren , Çiloğlu Osman , Yücel Ceyhun , Ekiz Timur 
Published: September 2020

Objective
The purpose of our study was to evaluate aortic stiffness and distensibility changes and the presence of aortic and mitral valve calcifications in patients with primary knee osteoarthritis (OA), using 2-dimensional and Doppler transthoracic echocardiography.

Methods
This case-control study included 115 participants with OA and a control group between May 2019 and November 2019. The Kellgren-Lawrence classification was used for the diagnosis and classification of knee OA, based on radiological images. We compared the demographic data, 2-dimensional and Doppler transthoracic echocardiography results, and laboratory findings between the OA patient group and the control group.

Results
There was a significant difference between aortic strain, aortic distensibility, aortic stiffness, and C-reactive protein values between the OA patient group and the control group (p < 0.001 for all). Post hoc analyses revealed that aortic strain and aortic distensibility values were significantly lower, and aortic stiffness values were significantly higher in the grade 4 OA group than those of other groups (p < 0.05 for all). In addition, the C-reactive protein values of the grades 3 and 4 patients were significantly higher than those of other groups (p < 0.05 for all). No significant difference was observed between the groups in terms of aortic and mitral valve calcifications (p > 0.05 for all).

Conclusion
Aortic strain and distensibility values were lower in the advanced grades of primary knee OA, whereas aortic stiffness values and the frequency of valve calcifications were higher.
Can Early Postoperative Complications Predict High Morbidity and Decrease Failure to Rescue Following Major Abdominal Surgery?
Authors: Staiger Roxane D. , Gerns Esther , Castrejón Subirà Mariona , Domenghino Anja , Puhan Milo A. , Clavien Pierre-Alain 
Published: September 2020

Objective:
To assess whether specific patterns of early postoperative complications may predict overall severe morbidity after major surgery, warranting early escalation of care and prevention of failure to rescue.

Summary of Background Data:
It is unclear whether early postoperative complications predict a poor outcome. Detailed knowledge of the chronology and type of early complications after major surgery may alert clinicians when to expect higher risk for subsequent major negative events.

Methods:
All 90-day postoperative events following complex pancreas, liver, and rectal surgeries, and liver transplantation were analyzed over a 3-year period in a single tertiary center. Each complication was recorded regarding severity, type (cardiac, infectious, etc), etiology (surgical/medical), and timing of occurrence. The Comprehensive Complication Index (CCI®), covering the first 7 postoperative days, was calculated as a measure for early cumulative postoperative morbidity.1–3 The statistical analysis (descriptive, sequence pattern analyses, and logistic regression analyses) aimed to detect any combinations of events predicting poor outcome as defined by a cumulative CCI® ≥37.1 at 90-days.

Results:
The occurrence of ≥2 complications, irrespective of severity, type or etiology, was strongly associated with a severe postoperative course (P < 0.001). Even 2 mild complications (≤ grade II) greatly increased the chance for high morbidity compared to patients with 0 or 1 complication within the first postoperative week (odds ratio 10.2, 95% confidence interval 5.82–17.98). The CCI® at postoperative day 7 strongly predicted high 90-day morbidity (odds ratio 3.96 per 10 CCI® points, P < 0.001).

Conclusion:
Multiple complications of any cause or severity within the first postoperative days represents a “warning-signal” for overall high morbidity by 90 days, which should be used to trigger an escalation of care to prevent failure to rescue and eventually poor outcome.
Stratification of Major Hepatectomies According to Their Outcome
Authors: Viganò Luca , Torzilli Guido , Aldrighetti Luca , Ferrero Alessandro , Troisi Roberto , Figueras Joan , Cherqui Daniel , Adam René , Kokudo Norihiro , Hasegawa Kiyoshi , Guglielmi Alfredo , Majno Pietro , Toso Christian , Krawczyk Marek , Abu Hilal Mohammad , Pinna Antonio Daniele , Cescon Matteo , Giuliante Felice , De Santibanes Eduardo , Costa-Maia José , Pawlik Timothy , Urbani Lucio , Zugna Daniela 
Published: September 2020

Objective:
To stratify major hepatectomies (MajHs) according to their outcomes.

Summary of Background Data:
MajHs are associated with non-negligible operative risks, but they include a wide range of procedures. Detailed depiction of the outcomes of different MajHs is the basis for a new classification of liver resections.

Methods:
We retrospectively considered patients that underwent hepatectomy in 17 high-volume centers. Patients with an associated digestive/biliary resection were excluded. We analyzed open MajHs in non-cirrhotic patients. MajHs were classified according to the Brisbane nomenclature. Right hepatectomies (RHs) were reference standards. Outcomes were adjusted for potential confounders, including indication, liver function, preoperative portal vein embolization, and enrolling center.

Results:
We analyzed a series of 2212 patients. In comparison with RH, left hepatectomy had lower mortality [0.6% vs 2.2%, odds ratio (OR) = 0.25], severe morbidity (11.7% vs 14.4%, OR = 0.62), and liver failure rates (2.1% vs 11.6%, OR = 0.16). Left hepatectomy+Sg1 and mesohepatectomy+/−Sg1 had outcomes similar to RH, except for higher bile leak rate (31.3% and 13.5% vs 6.7%, OR = 4.36 and OR = 2.29). RH + Sg1 had slightly worse outcomes than RH. Right and left trisectionectomies had higher mortality (5.0% and 7.3% vs 2.2%, OR = 2.07 and OR = 2.71) and liver failure rates than RH (19.0% and 22.0% vs 11.6%, OR = 2.03 and OR = 2.21). Left trisectionectomy had even higher severe morbidity (25.6% vs 14.4%, OR = 2.07) and bile leak rates (14.6% vs 6.7%, OR = 2.31).

Conclusions:
The term “major hepatectomy” includes resections having heterogeneous outcome. Different MajHs can be stratified according to their mortality, severe morbidity, liver failure, and bile leak rates.
Incidence and Grading of Complications After Gastrectomy for Cancer Using the GASTRODATA Registry
Authors: Baiocchi Gian Luca , Giacopuzzi Simone , Reim Daniel , Piessen Guillaume , Costa Paulo Matos da , Reynolds John V. , Meyer Hans-Joachim , Morgagni Paolo , Gockel Ines , Santos Lucio Lara , Jensen Lone Susanne , Murphy Thomas , D’Ugo Domenico , Rosati Riccardo , Fumagalli Romario Uberto , Degiuli Maurizio , Kielan Wojciech , Mönig Stefan , Kołodziejczyk Piotr , Polkowski Wojciech , Pera Manuel , Schneider Paul M. , Wijnhoven Bas , de Steur Wobbe O. , Gisbertz Suzanne S. , Hartgrink Henk , van Sandick Johanna W. , Botticini Maristella , Hölscher Arnulf H. , Allum William , De Manzoni Giovanni 
Published: September 2020

Objective:
Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe.

Summary Background Data:
The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries.

Methods:
Using a secure online platform (www.gastrodata.org), referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period.

Results:
A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications’ incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and Comprehensive Complications Index were IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively.

Conclusions:
The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications.
Endoscopic Lateral Neck Dissection (IIA, IIB, III, and IV) Using a Breast Approach: Outcomes From a Series of the First 24 Cases
Authors: Qu Rui , Hu Xiaochi , Guo Youming , Zhou Xuezhi , Huo Jinlong , Chen Yanqi , Chen Xin , Liu Wei , Chen Chen , Mao Guowen , Mu Shiyong , Ma Zhixue , Luo Yuanxin 
Published: September 2020

Introduction:
In order to avoid large neck scar caused by conventional lateral neck dissection. We have explored and introduced endoscopic lateral neck dissection (IIA, IIB, III, and IV) using a breast approach. Now, we summarized and shared the outcomes of the first 24 cases.

Materials and Methods:
All the patients were treated in our institute from January 2017 to May 2018, and followed-up for more than 1 year. The details of patients and this technique have been summarized and analyzed retrospectively.

Results:
A series of first 24 cases were successfully managed with this technique, and no cases were converted to an open approach. Among these 24 patients, levels III + IV dissection had been performed in 6 patients and levels II+III+IV dissection had been performed in 18 patients. The mean age, body mass index, and sex were 39.3±10.5 years old, 24.1±3.5, and 2 male/22 female, respectively. The average operative time of total operation and lateral neck dissection was 238.8±37.2 minutes and 128.8±21.1 minutes, respectively. The mean dissected lateral lymph nodes were 5.9±2.2 (level II) in 18 cases and 15.9±3.9 (levels III+IV) in 24 cases. In addition, with no severe complications to date, such as asphyxia, main nerves injury (cervical plexus, vagus nerve, etc.), and permanent hypoparathyroidism, nor permanent recurrent laryngeal nerve injury, and so on. However, unexpectedly, had some mild and common complications like transient hypocalcemia in 4 cases (16.67%), transient horse 1 case (4.2%), controllable lymphatic leakage in 2 cases (8.3%), and controllable jugular vein injury in 2 cases (8.3%). One year after the operation, 1 case found lung metastasis but no local recurrence. In other 23 patients, no recurrence/metastasis and the average of serum thyroglobulin is 3.2±3.8 ng/mL.

Conclusions:
This technique can yield adequate oncological dissection for selected patients. Endoscopic thyroidectomy along with lateral neck dissection using a breast approach may provide an option for selected patients who favor avoiding a visible neck incision.
Long-term Results of Endoscopic Submucosal Dissection (ESD) for the Treatment of Early Gastric Cancer (EGC) in a High-volume Latin American Center
Authors: Mejía Ricardo , Sáez Josefina , Norero Enrique , Briones Pamela , Ceroni Marco , Martínez Cristian , Díaz Alfonso , Calvo Alfonso , Sharp Allan 
Published: September 2020

Background:
Gastric cancer is the second leading cause of death by cancer worldwide. Endoscopic submucosal dissection (ESD) is a technique that allows en bloc resection of early lesions of the digestive tract. It has curative potential in selected patients and benefits over gastrectomy for the treatment of early gastric cancer (EGC). The aim of this study is to present the results of ESD for EGC in a high-volume center in Chile.

Materials and Methods:
Retrospective descriptive study of patients who underwent ESD for EGC at the Doctor Sótero del Río Hospital.

Results:
A total of 100 ESDs were performed in 96 patients between 2008 and 2020. Fifty-five percent were female patients, the average age was 68 years (range, 45 to 89 y). En bloc resection was achieved in 98% of cases and the rate of complications Clavien grade III or higher was 8.3%. There were no cases of perioperative mortality. Ninety-three percent of the dissections were classified as R0 and 83% met curative standards according to expanded criteria. The mean follow-up was 42 months (range, 1 to 144 mo). Overall survival was 97%. Cancer-specific survival was 100% and recurrence-free survival was 97%.

Conclusions:
The present study describes the largest series of ESD for the treatment of EGC reported in Latin America. Our results support the feasibility of implementing ESD in Chile and indicate good oncological outcomes comparable to those reported in the large Asian series published to date.