bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of genomic profiling in identifying molecular phenotypes in obstructive lung diseases
Authors: Christenson Stephanie A. 
Published: November 2019

Purpose of review
The biology underlying asthma and chronic obstructive pulmonary disease (COPD) is heterogeneous. Targeting therapies to patient subgroups, or ‘molecular phenotypes’, based on their underlying biology is emerging as an efficacious treatment strategy. This review summarizes the role of airway sample gene expression profiling in understanding molecular phenotypes in obstructive lung disease.

Recent findings
Recent gene expression studies have reinforced the importance of Type two (T2) inflammation in asthma and COPD subgroups. Studies in asthma also suggest that the molecular phenotype with enhanced T2 inflammation is itself heterogeneous with a subgroup that has steroid-refractory inflammation. Other inflammatory pathways are also emerging as implicated in asthma and COPD molecular phenotypes, including Type one and Type 17 adaptive immune responses and proinflammatory cytokines, such as interleukin-6.

Summary
Genomic profiling studies are advancing our understanding of the complex biology contributing to asthma and COPD molecular phenotypes. Recent studies suggest that asthma and COPD subgroups may benefit from different treatment strategies than those currently in practice.
Neurological outcomes after an out-of-hospital cardiac arrest among people living in high-rise buildings in South Korea
Authors: Sohn Youdong , Cho Youngsuk , Cho Gyuchong 
Published: November 2019

Objective
Living in high-rise buildings may cause delays in reaching a hospital after an out-of-hospital cardiac arrest. This study aimed to compare neurological outcomes in people who had had an out-of-hospital cardiac arrest, according to their floor of residence.

Methods
We conducted a retrospective study of 1541 patients aged ≥20 years who had out-of-hospital cardiac arrest between 1 October 2015 and 30 June 2018, using data from a central registry. We compared the outcomes of patients living on the first (ground) or second floor and those living on the third floor or above, using multiple logistic regression.

Results
Those living on higher floors were more likely to have been at home (88.1% vs. 58.0%); to have had bystander cardiopulmonary resuscitation (57.9% vs. 45.2%); and experienced a significantly longer emergency medical service response time [median interquartile range (IQR): 7 min (6–10 min) vs. 7 min (5–9 min), P = 0.001] and on-scene time [median (IQR): 16 min (11–23 min) vs. 12 min (8–19 min), P < 0.001]. The strongest predictors of a good neurological outcome were younger age [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94–0.97], being on a lower floor at the time of the cardiac arrest (OR: 1.82, 95% CI: 1.09–3.12) and having a shockable rhythm (OR: 21.97, 95% CI: 12.81–39.47).

Conclusion
People living on higher floors have poorer outcomes after an out-of-hospital cardiac arrest. Further studies are required to assess factors causing a delay in the emergency medical service response time, and placement of automated external defibrillators in high-rise buildings.
Impact of an Animation Education Program on Promoting Compliance With Active Respiratory Rehabilitation in Postsurgical Lung Cancer Patients
Authors: Li Jina , Davies Marianne , Ye Man , Li Yingxia , Huang Lingzhi , Li Lezhi 
Published: November 2019

Background
Non–small cell lung cancer is the most common type of lung cancer. Lung resection is proven to be the most effective curative treatment for early-stage non–small cell lung cancer (stages I-IIIA). Studies show evidence-based pulmonary rehabilitation is critical for improving exercise capacity and pulmonary function, reducing burden of cancer-related symptoms, and facilitating quality of life following a lung resection.

Objective
To explore the effectiveness of an animation education program to promote respiratory rehabilitation outcomes for postsurgical lung cancer patients.

Interventions/Methods
Eighty lung cancer patients who had undergone lung resection were equally randomized to 2 groups with 40 participants in each group. The intervention group received animation education. The control group received traditional face-to-face education. The training-related knowledge and exercise compliance were evaluated at baseline, 3 days after education, and the day of discharge, along with related pulmonary functional indicators.

Results
Eighty of 99 eligible participants were enrolled (80.8%). Mean scores of training-related knowledge and exercise compliance in the intervention group were higher than those of the control group. Occurrences of postoperative pulmonary complications and the indwelling time of thoracic drainage tube were lower, and 6-minute walk distance was longer compared with the control group. No statistical differences in other pulmonary functional indicators were found.

Conclusions
Educational animation is effective for promoting training-related knowledge and exercise compliance with active respiratory rehabilitation in postsurgical lung cancer patients.

Implications for Practice
Oncology nurses can implement animation as an innovative educational method for improving cancer patients’ uptake and compliance on health education.
Challenges in the Diagnosis of a Posterior Lingual Abscess, a Potential Lethal Disorder
Authors: Schweigert Jessica , Christian Rylee , Kemp Walter L. 
Published: November 2019

Abstract
A lingual abscess is a rare but potentially life-threatening disorder. Since the introduction of antibiotics, the incidence of posterior lingual abscesses has significantly declined; however, this condition is often missed on physical examination or misdiagnosed as another condition. The consequence of this misdiagnosis can be severe because airway obstruction with subsequent difficult or unattainable intubation can develop and lead rapidly to death. Being relatively rare yet potentially lethal, consideration of a lingual abscess at the time of autopsy is important; otherwise, it may be missed. During most autopsies, the base of the tongue is often examined grossly in a cursory fashion, if at all, and microscopic sections of this region are not commonly used. As this case report will illustrate, such an approach would most likely miss this important condition.
Riga-Fede Disease
Authors: Lee Jonathan J. , Sarangam Maithri , Feldman Kenneth W. , Tieder Joel S. 
Published: November 2019

Objectives
The following case presents a pediatric patient with Riga-Fede disease (RFD), a rare disorder in children under 2 years of age characterized by sublingual ulceration of the tongue due to trauma from repeated rubbing against the primary teeth. Riga-Fede disease is well reported in dental literature but is relatively unknown to the general pediatric community. It can be confused with nonaccidental trauma (NAT) from forced feeding or other abusive trauma because it presents with injury of oral structures including the sublingual frenulum and often results in problems with growth. This case highlights the importance for physicians to recognize RFD as a source of isolated oral injury that is distinct from NAT. Although approximately 35 cases of RFD have been reported in the literature, this is the first case to describe the process of distinguishing this disease from child abuse.

Methods
We present a case of an 8-month-old female infant who presented with extensive injury of her ventral tongue from RFD who underwent a full workup for NAT. We review the literature for guidance on diagnosing RFD and discuss how to distinguish it from abuse.

Results
Infants with characteristic ulceration of the ventral tongue opposing new teeth and with no other medical, social, or developmental concerns do not need to undergo further workup. Clinical examination and thorough history are sufficient to make the diagnosis.

Conclusions
Traumatic intraoral injury in nonmobile children is highly concerning for child abuse. However, RFD is a well described cause of sublingual ulceration in infants that is not associated with abuse.
Impact of Wartime Stress Exposures and Mental Health on Later-Life Functioning and Disability in Vietnam-Era Women Veterans: Findings From the Health of Vietnam-Era Women’s Study
Authors: Smith Brian N. , Spiro Avron , Frayne Susan M. , Kimerling Rachel , Cypel Yasmin , Reinhard Matthew J. , Kilbourne Amy M. , Magruder Kathryn M. 
Published: November 2019

ABSTRACT

Objective
The effect of stress exposures and mental health sequelae on health-related outcomes is understudied among older women veterans. We examined a) the impact of wartime stress exposures on later-life functioning and disability in Vietnam-era women veterans and b) the extent to which mental health conditions known to be associated with stress—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)—are associated with additional later-life functioning and disability.

Methods
Data were collected in 2011 to 2012 using a mail survey and telephone interview of 4219 women veterans who were active duty during the Vietnam Era. Health functioning was assessed using the Veterans RAND 36-Item Health Survey, and disability was assessed using the World Health Organization Disability Assessment Schedule 2.0. Wartime exposures were assessed using the Women’s War-Zone Stressor Scale—Revised; the Composite International Diagnostic Interview, version 3.0 was used to assess PTSD, MDD, and GAD.

Results
Several wartime stress exposures—including job-related pressures, dealing with death, and sexual discrimination and harassment—were associated with worse later-life health (β ranges, −0.04 to −0.26 for functioning, 0.05 to 0.30 for disability). Current PTSD was linked with lower health functioning (physical, β = −0.06; mental, β = −0.15) and greater disability (β = 0.14). Current MDD and GAD were also associated with lower mental health functioning (MDD, β = −0.29; GAD, β = −0.10) and greater disability (MDD, β = 0.16; GAD, β = 0.06).

Conclusions
Results underscore the importance of detection and treatment of the potential long-term effects of wartime stressors and mental health conditions among women veterans.
Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort
Authors: Gray Diane M. , Wedderburn Catherine J. , MacGinty Rae P. , McMillan Lauren , Jacobs Carvern , Stadler Jacob A.M. , Hall Graham L. , Zar Heather J. 
Published: November 2019

Objective:
To assess the impact of HIV and antiretroviral exposure without infection on lung growth and function over the first 2 years of life.

Design:
Prospective observational study of an African birth cohort, Drakenstein Child Health Study.

Method:
Infants enrolled antenatally had lung function measured at 6 weeks, 1 and 2 years. HIV-infected women received antiretroviral therapy (ART) as per local guidelines. The association between HIV and antiretroviral exposure with lung function was assessed using mixed effects modelling.

Results:
Of 1143 infants born, two HIV-infected infants were excluded from analysis; 909 (80%) infants had lung function collected at 6 weeks [190 (21%) were HIV-exposed uninfected (HEU)]; 782 (69%) at 1 year and 741 (65%) at 2 years. At 6 weeks HEU infants had larger tidal volume compared with HIV-unexposed infants (1.13 ml, confidence interval: 0.02–2.23, P = 0.045). High maternal viral load was associated with a 17% lower expiratory flow over 2 years (0.17, confidence interval 0.00–0.34, P = 0.046). First-line ART initiated during pregnancy was associated with lower infant tidal volume at 6 weeks compared with those who initiated ART before pregnancy (−2.7 ml, −5.31 to −0.10, P = 0.042), and low maternal CD4+ cell counts associated with lower infant tidal over 2 years (−11.1 ml, −18.58–3.58, P = 0.004).

Conclusion:
HIV exposure is associated with altered lung function in early life, with a vulnerable HEU subgroup based on maternal disease severity, immunological compromise and ART exposure. These data highlight the importance of ongoing surveillance of respiratory health in HEU children.
Association of HIV Infection and Antiretroviral Therapy With Sudden Cardiac Death
Authors: Yen Yung-Feng , Lai Yun-Ju , Chen Yu-Yen , Lai Hsin-Hao , Chuang Pei-Hung , Chen Chu-Chieh , Deng Chung-Yeh 
Published: November 2019

Background:
HIV infection potentially increases coronary artery disease and heart failure risks. However, the association between HIV infection and sudden cardiac death (SCD) has not been extensively studied. This nationwide cohort study aimed to determine SCD risks in Taiwanese patients with and without HIV infection.

Methods:
Adult people living with HIV/AIDS (PLWHA) since January 1, 2003, were identified from the Taiwan Centers for Disease Control HIV surveillance system. HIV-infected individuals were defined as positive HIV-1 Western blot. A control cohort without HIV infection, matched for age and sex, was selected for comparison from the Taiwan National Health Insurance Research Database. All patients were followed up until SCD, mortality for another cause, or till December 31, 2014. A time-dependent Cox proportional hazards model was used to determine the association of HIV and antiretroviral therapy (ART) with SCD.

Results:
During a mean 5.86-year follow-up, 5342 (4.40%) of 121,530 patients (24,306 PLWHA and 97,224 matched controls) died; among them, 150 (0.12%) died of SCD. Among 150 SCD events, 97 (64.7%) and 53 (33.3%) occurred in PLWHA and controls, respectively, which corresponded to incidences of 68.31 in PLWHA and 9.31 per 100,000 person-years in controls (P < 0.001). After adjusting for age, sex, and comorbidities, HIV infection was an independent risk factor for SCD (adjusted hazard ratio, 8.15; 95% confidence interval: 5.58 to 11.90). SCD incidence was significantly lower in PLWHA receiving ART (adjusted hazard ratio 0.53; 95% confidence interval: 0.32 to 0.87).

Conclusions:
HIV infection is an independent risk factor for SCD. SCD rates are low in PLWHA receiving ART.
Brief Report: Low Sensitivity of the Fracture Risk Assessment Tool in Young HIV-Infected Patients: Time to Revise Our Screening Strategy
Authors: van Welzen Berend J. , Yesilay Sultan , Arends Joop E. , Hoepelman Andy I. M. , Mudrikova Tania 
Published: November 2019

Objectives:
The burden of reduced bone mineral density (BMD) is high among HIV-infected patients. As a screening strategy, current guidelines recommend calculating a Fracture Risk Assessment Tool (FRAX) score in patients aged 40–49 years. Patients with a 10-year risk of a major osteoporotic fracture ≥10% should undergo dual-energy x-ray absorptiometry (DXA) to assess BMD. The aim of this study was to establish the sensitivity of this threshold to identify patients with risk of osteoporosis in this age category—as a surrogate marker for high fracture risk.

Methods:
The study group consisted of patients aged 50–59 years and living with HIV for at least 10 years who recently underwent dual-energy x-ray absorptiometry (DXA). A clinical risk factor–based FRAX score was calculated using patient characteristics from 10 years earlier. In this way, we assessed which patients would have undergone DXA while they were 40–49 year old.

Results:
The cohort consisted of 126 patients; 23 patients (18.3%) had osteoporosis. Ten years before the DXA, none of them met the guideline threshold of a 10-year major osteoporotic fracture probability of ≥10%, resulting in a sensitivity of 0% in this cohort. There was no difference between the median FRAX score between patients who developed osteoporosis and those who did not (3.3% vs. 3.4%. P = 0.55).

Conclusions:
FRAX lacks sensitivity to determine which HIV-infected patients aged 40–49 years should undergo BMD testing to identify reduced BMD. Its role should be limited to treatment decisions.
Brief Report: Adipogenic Expression of Brown Fat Genes in HIV and HIV-Related Parameters
Authors: Srinivasa Suman , Torriani Martin , Fitch Kathleen V. , Maehler Patrick , Iyengar Sanjna , Feldpausch Meghan , Cypess Aaron M. , Grinspoon Steven K. 
Published: November 2019

Context:Persons with HIV are at increased risk for adipose dysfunction, which could mediate metabolic complications such as cardiovascular disease, fatty liver disease, and diabetes. We have previously reported reduced browning and beiging capacity of the subcutaneous adipose depot in HIV.Objective:We sought to evaluate how HIV-related parameters are related to the expression of brown and beige fat genes in the abdominal subcutaneous adipose tissue.Design:Eighteen persons with HIV underwent punch biopsy of abdominal subcutaneous fat to determine mRNA expression of adipose-related genes using quantitative reverse transcriptase-polymerase chain reaction.Results:Duration of antiretroviral therapy use, particularly related to protease inhibitor use, was significantly related to reduced expression of multiple brown and beige fat genes (including UCP1, PGC1α, PRDM16 and others, allP≤ 0.04) in the abdominal subcutaneous fat. In addition, duration of HIV and CD4 T-cell count were significantly correlated with reduced expression of multiple brown and beige fat genes in the abdominal subcutaneous fat (PGC1α, P2XR5, TMEM26, CD137, allP≤ 0.05 for duration of HIV; and PGC1α, ZIC1, PRDM16, PAT2, P2RX5, TMEM26, CD137, allP≤ 0.04). In contrast, HIV viral load did not correlate with any brown or beige fat genes.Conclusions:Key HIV-related parameters reflective of nonacute infection (increased duration of HIV and duration of antiretroviral therapy use) or relatively reduced immunologic function (lower CD4 count) were linked to reduced expression of brown and beige fat gene in the abdominal subcutaneous adipose depot.Clinical Trial Registration:NCT01098045.
Exosomal MicroRNAs Associate With Neuropsychological Performance in Individuals With HIV Infection on Antiretroviral Therapy
Authors: O'Meara Tess , Kong Yong , Chiarella Jennifer , Price Richard W. , Chaudhury Rabib , Liu Xinran , Spudich Serena , Robertson Kevin , Emu Brinda , Lu Lingeng 
Published: November 2019

Background:
Neurocognitive dysfunction remains prevalent among people living with HIV (PLWH), even after viral suppression on combination antiretroviral therapy (cART). We investigated associations between neuropsychological performance (NP) and patterns of circulating exosomal microRNA (exo-miRNA) expression in PLWH on cART.

Setting:
A cross-sectional examination of plasma exo-miRNA among PLWH on cART with systemic viral suppression and volunteers without HIV infection.

Methods:
Thirty-one PLWH who started cART during early infection (n = 19) or chronic infection (n = 12) participated in phlebotomy and an 11-test neuropsychological battery after >1 year on treatment. NP higher- or lower-performing participants were categorized based on normalized neuropsychological scores. Total RNA was extracted from purified exosomes of 31 PLWH and 5 volunteers without HIV and subject to small RNA sequencing. Differential expression of exo-miRNAs was examined and biological functions were predicted.

Results:
Eleven exo-miRNAs were up-regulated in NP lower-performing (n = 18) relative to higher-performing PLWH (n = 13). A high proportion of the differentiating exo-miRNA target the axon guidance KEGG pathway and neurotrophin tyrosine receptor kinase signaling Gene Ontology pathway. Differential expression analysis of exo-miRNAs between NP lower- (n = 7) and higher-performing (n = 12) PLWH within the early infection group alone confirmed largely consistent findings.

Conclusions:
Plasma exo-miRNA content differed between NP higher- and lower-performing PLWH. Several differentially expressed exo-miRNAs were predicted to be involved in inflammation and neurodegeneration pathways. Exo-miRNA in plasma may indicate cross-talk between the circulation and central nervous system and thus may be clinically relevant for neurocognitive dysfunction in PLWH.
Long-Term Outcomes of HIV-Infected Women Receiving Antiretroviral Therapy After Transferring Out of an Integrated Maternal and Child Health Service in South Africa
Authors: Phillips Tamsin K. , Mogoba Pheposadi , Brittain Kirsty , Gomba Yolanda , Zerbe Allison , Myer Landon , Abrams Elaine J. 
Published: November 2019

Background:
Integrated maternal and child health (MCH) services improve women's postpartum antiretroviral therapy (ART) outcomes during breastfeeding; however, long-term outcomes after transfer to general ART services remain unknown.

Methods:
The MCH-ART trial demonstrated that maternal retention and viral suppression at 12-months postpartum were improved significantly among women randomized to integrated MCH services continued in the antenatal clinic through cessation of breastfeeding (MCH-ART arm) compared with immediate transfer to general ART services postpartum (standard of care). We reviewed electronic health records for all women who participated in the MCH-ART trial to ascertain retention and gaps in care and invited all women for a study visit 36- to 60-months postpartum including viral load testing.

Results:
Of 471 women in MCH-ART, 450 (96%) contributed electronic health record data and 353 (75%) completed the study visit (median 44-month postpartum). At this time, outcomes were identical in both trial arms: 67% retained in care (P = 0.994) and 56% with viral loads <50 copies/mL (P = 0.751). Experiencing a gap in care after delivery was delayed in the MCH-ART arm with 17%, 36%, and 45% of women experienced a gap in care by 12-, 24-, and 36-months postpartum compared with 35%, 48%, and 57% in the standard of care arm, respectively.

Conclusions:
The benefits of integrated maternal HIV and child health care did not persist after transfer to general ART services. The transfer of women postpartum to routine adult care is a critical period requiring interventions to support continuity of HIV care.
Multifocal Urinary Bladder Paragangliomas With Negative 68Ga-DOTATATE Uptake and Positive 123I-MIBG Uptake
Authors: Parra Laura A. , Swanson Scott K. , Salomao Marcela A. , Yang Ming 
Published: November 2019

Abstract
We report a case of an adult male patient with multifocal urinary bladder paragangliomas, which were negative on 68Ga-DOTATATE PET/CT scan, but positive on 123I-MIBG SPECT/CT scan. While the 68Ga-DOTA analog PET/CT exhibits superior performance in diagnosis and staging of pheochromocytoma and paraganglioma, our case demonstrates negative somatostatin receptor expression in this rare entity and indicates that 123I-MIBG SPECT/CT still plays a vital role in characterization of bladder paraganglioma.
Albucasis
Authors: Asaad Malke , Rajesh Aashish , Zazo Aya , Banuelos Joseph , Kaadan Abdulnaser 
Published: November 2019

Abstract
The middle ages in the Arab world etched medical advancements that laid the foundations of modern medical practice. Among the several renowned physicians of historical importance, Abu Alkasem al-Zahrawi (Albucasis) left his mark in the fields of medicine and surgery. He is notably famous for his 30-volume compendium Kitab-al Tasreef, which served as his magnum opus. The last volume of this work was reserved for surgery. During his lifetime, Albucasis made contributions of unparalleled luminosity to the field of surgery. He described surgical techniques for a range of procedures encompassing several subspecialties that comprise modern plastic surgery. Beyond just a physician and surgeon, Albucasis was a remarkable teacher who taught medical students with fervor and emphasized the importance of affording treatment to patients of all social classes and the value of physician-patient relationships. The focus of this review is to explore the contributions of Albucasis to the field of plastic surgery.