bluuebunny/crossref_metadata_2025_split huggingface dataset:
Matrix Metalloproteinase 9 Blood Alterations in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis
Authors: Schoretsanitis Georgios , de Filippis Renato , Ntogka Maria , Leucht Stefan , Correll Christoph U , Kane John M 
Published: January 2021

Abstract

Background
Matrix metalloproteinase 9 (MMP-9), an extracellular network protease implicated in glutamatergic signaling, may be part of the pathophysiology of schizophrenia spectrum disorders (SSD).

Methods
We performed a systematic review in PubMed/Embase until July 15, 2020, conducting a random-effects meta-analysis of studies comparing MMP-9 blood levels in SSD vs healthy controls (HCs) and psychiatric controls (PCs), calculating between-group differences in standardized mean differences (SMDs) ± 95% confidence intervals (CIs). Meta-regression analyses included sex, age, illness duration, antipsychotic dose, and Positive and Negative Syndrome Scale (PANSS) total/subscales. Subgroup analyses included first-episode patients (FEP) vs non-FEP, each vs HCs and vs PCs, and blood sample type. Study quality was assessed using the Newcastle-Ottawa scale.

Results
Four, five, and two trials were rated as high, fair, and low quality. In 11 studies (n = 1443), 643 patients (age = 36.7 ± 14.1 years, females = 42.9%) were compared with HCs (n = 631), with 4 studies including also 169 PCs. MMP-9 levels were higher in SSD vs HCs (SMD = 0.52, 95%CI = 0.20–0.85, P = .002), but not in PCs vs HCs (n = 132, after removing one implausible outlier [SMD = 0.33, 95%CI = −0.16 to 0.85, P = .082]). MMP-9 differences between SSD and HCs were associated with higher PANSS total (coefficient = 0.02, 95%CI = 0.01–0.02, P &lt; .001), PANSS positive (coefficient = 0.08, 95%CI = 0.02–0.13, P = .006), and PANSS general scores (coefficient = 0.02, 95%CI = 0.01–0.03, P &lt; .001). MMP-9 level differences vs HCs did not vary significantly between FEP (n = 103, SMD = 0.44, 95%CI = 0.15–0.72, P = .71) and non-FEP patients (n = 466, SMD = 0.59, 95%CI = 0.38–0.80; P = .34) (FEP vs non-FEP: P = .39). In four high-quality studies, MMP-9 levels remained significantly higher in SSD vs HCs (SMD = 0.82, 95%CI = 0.03–1.61).

Conclusions
Findings suggest MMP-9 upregulation in SSD, requiring further validation and understanding of related pathways.
Mucosal and Histologic Healing in Children With Inflammatory Bowel Disease Treated With Antitumor Necrosis Factor-Alpha
Authors: Scarallo Luca , Alvisi Patrizia , Bolasco Giulia , Di Toma Michele , Lanari Marcello , Cangiari Alice , Paci Monica , Naldini Sara , Renzo Sara , Barp Jacopo , De Masi Salvatore , Lionetti Paolo 
Published: January 2021

ABSTRACT

Objectives:
Mucosal healing (MH) and histological healing (HH) have been recently proposed as a novel treatment target for inflammatory bowel disease (IBD). The aim of the present study was to evaluate real-life achievement of such outcomes in a cohort of pediatric patients with IBD treated with anti-TNF-alpha (ATA) agents.

Methods:
A retrospective analysis was performed on patients affected by IBD who received ATA and were followed up at two referral centers. Incidence and cumulative rates for MH and HH for each group were calculated.

Results:
Of 170 (105 Crohn's disease [CD] and 65 ulcerative colitis [UC]) patients, 78 with CD and 56 with UC underwent endoscopic re-assessment during the study period. MH was achieved by 32 CD (41%) and 30 UC (53.6%) patients; 26 CD (33.3%) and 22 UC (39.3%) patients achieved HH. MH incidence rate was 19.1/1000 and 47/1000 person-months, whereas HH incidence rate was 15.5/1000 and 34.7/1000 person-months for CD and UC, respectively. Remission at the end of induction was associated with higher MH and HH rates (HR: 2.43, P = 0.049 and HR: 2.94, P = 0.046, respectively) in CD. In UC, adalimumab was associated with lower MH and HH rates (HR: 0.16, P = 0.004 and HR: 0.07, P = 0.003).

Conclusions:
We reported a real-life experience arising from a large cohort of pediatric IBD who received ATA scheduled treatment. Less than half of patients with CD and only a little >50% of UC patients achieved MH. Microscopical inflammation was observed in 18.8% CD and 26.7% UC patients who achieved MH. Overall, MH and HH rates appear lower compared to previously published data.
Syncope and COVID-19 disease – a systematic review
Authors: de Freitas Raquel Falcão , Torres Sofia Cardoso , L. Nunes José Pedro 
Published: January 2021

ABSTRACTBackgroundSyncope is not a common manifestation of COVID-19, but it may occur in this context and it can be the presenting symptom in some cases. Although several mechanisms may explain the pathophysiology behind COVID-19 related syncope, a valid relationship has not been established yet. In this systematic review, we aimed to examine the current incidence of syncope in COVID-19 patients and to explore different patterns observed in this setting.MethodsA systematic review across PubMed, ISI Web of Knowledge and SCOPUS was performed, according to PRISMA guidelines, in order to identify all relevant articles regarding both COVID-19 and syncope.ResultsWe identified 81 publications, of which 62 were excluded. The cumulative incidence of syncope and pre-syncope across the selected studies was 7.1% (256/3584 patients). Unspecified syncope was the most common type (76.2% of the reported episodes), followed by reflex syncope (18.1% of the cases). Orthostatic hypotension was responsible for 3.6% of the cases and syncope of presumable cardiac cause accounted for 2.0%. Arterial hypertension was present in 64.7% of the patients and either angiotensin receptor blockers or angiotensin converting enzyme inhibitors were used by 39.5% of hypertensive patients with syncope.ConclusionSyncope, although not considered a typical symptom of the COVID-19 disease, can be associated with it, particularly in early stages. Different types of syncope were seen in this context, each with different implications requiring distinct approaches. A careful reevaluation of blood pressure whenever a patient develops COVID-19 is suggested, including reassessment of antihypertensive therapy.
Outbreak or pseudo-outbreak? Integrating SARS-CoV-2 sequencing to validate infection control practices in an end stage renal disease facility
Authors: Pfaff Bridget L. , Richmond Craig S. , Sabin Arick P. , Athas Deena M. , Adams Jessica C. , Meller Megan E. , Usha Kumari , Schmitz Sarah A. , Simmons Brian J. , Borgert Andrew J. , Kenny Paraic A. 
Published: January 2021

ABSTRACTBackgroundThe COVID-19 pandemic of 2020 poses a particularly high risk for End Stage Renal Disease (ESRD) patients and led to a need for facility-wide control plans to prevent introduction and spread of infection within ESRD facilities. Rapid identification of clusters of contemporaneous cases is essential, as these may be indicative of within-facility spread. Nevertheless, in a setting of high community COVID-19 prevalence, a series of ESRD patients may test positive at around the same time without their shared ESRD facility being the nexus for disease spread. Here we describe a series of five cases occurring within an eleven-day period in November 2020 in a hospital-based 32-station ESRD facility in southwest Wisconsin, the subsequent facility-wide testing, and the use of genetic sequence analysis of positive specimens to evaluate whether these cases were linked.MethodsFour patient cases and one staff case were identified in symptomatic individuals by RT-PCR. Facility-wide screening was initiated at the request of local public health and conducted using Abbot BinaxNOW antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic test specimens using an amplicon-based approach on an Ion Torrent S5 sequencer.ResultsResidual specimens from 4 of 5 cases were available for sequence analysis. Each sequence was very clearly genetically distinct from the others, indicating that these contemporaneous cases were not linked. Facility-wide screening of 47 staff and 107 patients did not identify any additional cases.ConclusionsThese data indicate that despite the outward appearance of a case cluster, the facility did not experience within-facility spread nor serve as the epicenter of a new outbreak, suggesting that the enacted rigorous infection control procedures (screening, masking, distancing) practiced stringently by patients and staff were sufficient to permit dialysis to proceed safely in a very high-risk population under pressure from increasing community spread. These data also demonstrate the utility of rapid turnaround SARS-CoV-2 sequencing in outbreak investigations in settings like ESRD facilities.
Hair loss in females and thromboembolism in males are significantly enriched in post-acute sequelae of COVID (PASC) relative to recent medical history
Authors: Akama-Garren Elliot , Anand Praveen , Cristea-Platon Tudor , Lenehan Patrick , Lindemer Emily , Bade Sairam , Liukasemsarn Saran , O’Horo John C. , Hurt Ryan T. , Williams Amy W. , Gores Gregory J. , Badley Andrew D. , Awasthi Samir , Soundararajan Venky 
Published: January 2021

AbstractAfter one year of the COVID-19 pandemic, over 130 million individuals worldwide have been infected with the novel coronavirus, yet the post-acute sequelae of COVID-19 (PASC), also referred to as the ‘long COVID’ syndrome, remains mostly uncharacterized. We leveraged machine-augmented curation of the physician notes from electronic health records (EHRs) across the multi-state Mayo Clinic health system to retrospectively contrast the occurrence of symptoms and diseases in COVID-19 patients in the post-COVID period relative to the pre-COVID period (n=6,413). Through comparison of the frequency of 10,039 signs and symptoms before and after diagnosis, we identified an increase in hypertensive chronic kidney disease (OR 47.3, 95% CI 23.9-93.6, p=3.50×10−9), thromboembolism (OR 3.84, 95% CI 3.22-4.57, p=1.18×10−4), and hair loss (OR 2.44, 95% CI 2.15-2.76, p=8.46×10−3) in COVID-19 patients three to six months after diagnosis. The sequelae associated with long COVID were notably different among male vs female patients and patients above vs under 55 years old, with the hair loss enrichment found primarily in females and the thromboembolism enrichment in males. These findings compel targeted investigations into what may be persistent dermatologic, cardiovascular, and coagulopathic phenotypes following SARS-CoV-2 infection.
Modelling COVID -19 transmission in a hemodialysis centre using simulation generated contacts matrices
Authors: Tofighi Mohammadali , Asgary Ali , Merchant Asad A. , Shafiee Mohammad Ali , Najafabadi Mahdi M. , Nadri Nazanin , Aarabi Mehdi , Heffernan Jane , Wu Jianhong 
Published: January 2021

AbstractThe COVID-19 pandemic has been particularly threatening to the patients with end-stage kidney disease (ESKD) on intermittent hemodialysis and their care providers. Hemodialysis patients who receive life-sustaining medical therapy in healthcare settings, face unique challenges as they need to be at a dialysis unit three or more times a week, where they are confined to specific settings and tended to by dialysis nurses and staff with physical interaction and in close proximity. Despite the importance and critical situation of the dialysis units, modelling studies of the SARS-CoV-2 spread in these settings are very limited. In this paper, we have used a combination of discrete event and agent-based simulation models, to study the operations of a typical large dialysis unit and generate contact matrices to examine outbreak scenarios. We present the details of the contact matrix generation process and demonstrate how the simulation calculates a micro-scale contact matrix comprising the number and duration of contacts at a micro-scale time step. We have used the contacts matrix in an agent-based model to predict disease transmission under different scenarios. The results show that micro-simulation can be used to estimate contact matrices, which can be used effectively for disease modelling in dialysis and similar settings.
Morphological changes after cranial fractionated photon radiotherapy: localized loss of white matter and grey matter volume with increasing dose
Authors: Nagtegaal SHJ , David S , van Grinsven EE , van Zandvoort MJE , Seravalli E , Snijders TJ , Philippens MEP , Verhoeff JJC 
Published: January 2021

AbstractPurposeNumerous brain MR imaging studies have been performed to understand radiation-induced cognitive decline. However, many of them focus on a single region of interest, e.g. cerebral cortex or hippocampus. In this study, we use deformation-based morphometry (DBM) and voxel-based morphometry (VBM) to measure the morphological changes in patients receiving fractionated photon RT, and relate these to the dose. Additionally, we study tissue specific volume changes in white matter (WM), grey matter (GM), cerebrospinal fluid and total intracranial volume (TIV).Methods and MaterialsFrom our database, we selected 28 patients with MRI of high quality available at baseline and 1 year after RT. Scans were rigidly registered to each other, and to the planning CT and dose file. We used DBM to study non-tissue-specific volumetric changes, and VBM to study volume loss in grey matter. Observed changes were then related to the applied radiation dose (EQD2). Additionally, brain tissue was segmented into WM, GM and cerebrospinal fluid, and changes in these volumes and TIV were tested.ResultsPerforming DBM resulted in clusters of dose-dependent volume loss 1 year after RT seen throughout the brain. Both WM and GM were affected; within the latter both cerebral cortex and subcortical nuclei show volume loss. Volume loss rates ranging from 5.3 to 15.3%/30 Gy were seen in the cerebral cortical regions in which more than 40% of voxels were affected. In VBM, similar loss rates were seen in the cortex and nuclei. The total volume of WM and GM significantly decreased with rates of 5.8% and 2.1%, while TIV remained unchanged as expected.ConclusionsRadiotherapy is associated with dose-dependent intracranial morphological changes throughout the entire brain. Therefore, we will consider to revise sparing of organs at risk based on future cognitive and neurofunctional data.
OPTIMIZING COVID-19 VACCINE USAGE
Authors: Jara Carlos Poblete , Velloso Lício A. , de Araújo Eliana Pereira 
Published: January 2021

ABSTRACTAs the worldwide vaccination, it is imperative to minimize vaccine wastage by effectively using all doses available. Vaccine wastage can occur at multiple points during the vaccination process, but it is mainly because the device dead space and the filling process technique. However, there are no studies discussing the waste volume effect of COVID-19 vaccines in clinical practice. There is an increasing COVID-19 vaccine demand that we estimate up to several billion dual doses. The objective of this study was to assess the number of 0.3mL doses obtained from a multiple-dose vial using 1ml and 3ml syringes with different type of needles replicating the first COVID-19 vaccination protocol.Our results suggest that it is possible to obtain six or seven doses from each vial instead five. We provide evidence to optimize between 20% and 40% additional vaccine doses per vial if the current 5-dose vials are used, making scarce supplies go further.It is our duty, as researchers, to ensure the efficacy and efficiency of the worldwide COVID-19 vaccination process. However, if standard syringes-needles and technique are used, there may not be sufficient volume to draw extra doses from a single vial.
Brain activity is contingent on neuropsychological function in an fMRI study of Verbal Working Memory in Amyotrophic Lateral Sclerosis
Authors: Kobeleva Xenia , Machts Judith , Veit Maria , Vielhaber Stefan , Petri Susanne , Schoenfeld Mircea Ariel 
Published: January 2021

AbstractAmyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that causes progressive degeneration of neurons in motor and non-motor regions, affecting multiple cognitive domains. To contribute to the growing research field that employs structural and functional neuroimaging to investigate the effect of ALS on different working memory components, we conducted a functional magnetic resonance imaging (fMRI) study exploring the localization and intensity of alterations in neural activity. Being the first study to specifically address verbal working memory via fMRI in the context of ALS, we employed the verbal n-back task with 0-back and 2-back conditions. Despite ALS patients showing unimpaired accuracies (p = 0.724) and reaction times (p = 0.0785), there was significantly increased brain activity of frontotemporal and parietal regions in the 2-back minus 0-back contrast in patients compared to controls using nonparametric statistics with 5000 permutations and a T-threshold of 2.5. This increased brain activity during working memory performance was largely associated with better neuropsychological function within the ALS group, suggesting a compensatory effect. This study therefore adds to the current knowledge on neural correlates of working memory in ALS and contributes to a more nuanced understanding of hyperactivity during cognitive processes in fMRI studies of ALS.
Edoxaban versus warfarin on stroke risk in patients with atrial fibrillation: a territory-wide cohort study
Authors: Kong Dicken , Zhou Jiandong , Lee Sharen , Kit Leung Keith Sai , Liu Tong , Sawant Abhishek C , Corbelli John , Wai Abraham KC , Chang Carlin , Zhang Qingpeng , Tse Gary 
Published: January 2021

AbstractBackgroundIn this territory-wide, observational, propensity score-matched cohort study, we evaluate the development of transient ischaemic attack and ischaemic stroke (TIA/Ischaemic stroke) in patients with AF treated with edoxaban or warfarin.MethodsThis was an observational, territory-wide cohort study of patients between January 1st, 2016 and December 31st, 2019, in Hong Kong. The inclusion were patients with i) atrial fibrillation, and ii) edoxaban or warfarin prescription. 1:2 propensity score matching was performed between edoxaban and warfarin users. Univariate Cox regression identifies significant risk predictors of the primary, secondary and safety outcomes. Hazard ratios (HRs) with corresponding 95% confidence interval [CI] and p values were reported.ResultsThis cohort included 3464 patients (54.18% males, median baseline age: 72 years old, IQR: 63-80, max: 100 years old), 664 (19.17%) with edoxaban use and 2800 (80.83%) with warfarin use. After a median follow-up of 606 days (IQR: 306-1044, max: 1520 days), 91(incidence rate: 2.62%) developed TIA/ischaemic stroke: 1.51% (10/664) in the edoxaban group and 2.89% (81/2800) in the warfarin group. Edoxaban was associated with a lower risk of TIA or ischemic stroke when compared to warfarin.ConclusionsEdoxaban use was associated with a lower risk of TIA or ischemic stroke after propensity score matching for demographics, comorbidities and medication use.
Comparative effects of sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors on new-onset atrial fibrillation and stroke outcomes
Authors: Lee Sharen , Zhou Jiandong , Chang Carlin , Liu Tong , Chang Dong , Wong Wing Tak , Leung Keith SK , Wai Abraham KC , Yung Cheung Bernard Man , Tse Gary , Zhang Qingpeng 
Published: January 2021

AbstractBackgroundSGLT2I and DPP4I are medications prescribed for type 2 diabetes mellitus patients. However, there are few population-based studies comparing their effects on incident atrial fibrillation or ischemic stroke.MethodsThis was a territory-wide cohort study of type 2 diabetes mellitus patients prescribed SGLT2I or DPP4I between January 1st, 2015 to December 31st, 2019 in Hong Kong. Patients with both DPP4I and SGLT2I use and patients with drug discontinuation were excluded. Patients with prior AF or stroke were excluded for the respective analysis. 1:2 propensity-score matching was conducted for demographics, past comorbidities and medications using nearest-neighbor matching method. Cox models were used to identify significant predictors for new onset heart failure (HF) or myocardial infarction (MI), cardiovascular and all-cause mortality.ResultsThe AF-free cohort included 49108 patients (mean age: 66.48 years old [SD: 12.89], 55.32% males) and the stroke-free cohort included 49563 patients (27244 males [54.96%], mean baseline age: 66.7 years old [SD: 12.97, max: 104.6 years old]). After propensity score matching, SGLT2i use was associated with a lower risk of new onset AF (HR: 0.43[0.28, 0.66]), cardiovascular mortality (HR: 0.79[0.58, 1.09]) and all-cause mortality (HR: 0.69[0.60, 0.79]) in the AF-free cohort. It was also associated with a lower risk of new onset stroke (0.46[0.33, 0.64]), cardiovascular mortality (HR: 0.74[0.55, 1.00]) and all-cause mortality (HR: 0.64[0.56, 0.74]) in the stroke-free cohort.ConclusionsThe novelty of our work si that SGLT2 inhibitors are protective against atrial fibrillation and stroke development for the first time. These findings should be validated in other cohorts.
Angiotensin converting enzyme inhibitors and risk of lung cancer: a population-based cohort study
Authors: Hung Joshua Kai Fung , Zhou Jiandong , Lee Sharen , Xia Yunlong , Liu Ying , Zhang Yuhui , Wong Wing Tak , Li Guangling , Liu Tong , Yung Cheung Bernard Man , Kei Wong Ian Chi , Zhang Qingpeng , Tse Gary 
Published: January 2021

AbstractObjectivesTo determine whether the use of angiotensin converting enzyme inhibitors (ACEIs) was associated with a higher risk of lung cancer when compared to use of angiotensin receptor blockers (ARBs).Study DesignPopulation-based cohort study.SettingPublic hospitals under the Hospital Authority in Hong Kong, P.R. China.MethodsPatients admitted to public hospitals and first prescribed with ACEI and/or ARB between 1 January 2001 and 31 December 2018 were analyzed. The last follow-up date was 31 August 2020, or death, whichever was earlier.OutcomesThe primary outcome was the incidence of lung cancer. Logistic regression was used to calculate odds ratio [ORs] with 95% confidence intervals associated with the use of ACEIs compared to ARBs. Incidence and odds ratios were estimated for temporal analysis of incident cancer risk associated with time since the first prescription of ACEI or ARB.ResultsIn the unmatched cohort, 56,697 patients and 357,011 patients were included the ARB and ACEI cohorts, with lung cancer incidence of 2.16% and 1.29%, respectively. Using 1:3 matching for ARB to ACEI users, the incidences were 2.32% and 1.29%. ACEI use was associated with increased risks of lung cancer both before (hazard ratio: 1.30 [1.21-1.40], P<0.0001) and after (1.40 [1.29-1.51], P<0.0001) matching. There was a dose-dependent relationship between ACEI exposure and lung cancer risk.ConclusionsACEI use was associated with increased risk of lung cancer compared with ARB use at all time points. Additionally, incidence risk increases with the duration of exposure.