bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Fibrosis-4 index and non-alcoholic fatty liver disease fibrosis scores in metabolic (dysfunction) associated fatty liver disease according to body mass index: failure in the prediction of advanced fibrosis in lean and morbidly obese individuals
Authors: Eren Fatih , Kaya Eda , Yilmaz Yusuf 
Published: September 2020

Background and aim
While non-invasive scores are increasingly being used to screen for advanced fibrosis in metabolic (dysfunction) associated fatty liver disease (MAFLD), the effect of BMI on their clinical utility remains uncertain. This study assessed the usefulness of the Fibrosis-4 index (FIB-4) and the non-alcoholic fatty liver disease fibrosis score (NFS) in lean, overweight, obese, severely obese, and morbidly obese patients with biopsy-proven MAFLD.

Methods
A total of 560 patients (28 lean, 174 overweight, 229 obese, 89 severely obese, 40 morbidly obese) were included. Diagnostic performances and optimal cut-off values for FIB-4 and NFS were calculated using receiver operating characteristic (ROC) curve analysis.

Results
In both lean and morbidly obese patients with MAFLD, both FIB-4 and NFS failed to discriminate advanced fibrosis. Conversely, both scores showed acceptable diagnostic performances in exclusion of advanced fibrosis in overweight, obese, and severely obese patients. FIB-4 was able to exclude advanced fibrosis with the highest diagnostic accuracy in the subgroup of overweight patients (area under the ROC curve: 0.829, 95% confidence interval: 0.738−0.919).

Conclusion
FIB-4 and NFS can confidently be used to exclude advanced fibrosis in overweight, obese, and severely obese patients. However, they do not appear clinically useful in lean and morbidly obese patients.
Safety and efficacy of outpatient continuous terlipressin infusion for the treatment of portal hypertensive complications in cirrhosis
Authors: Gow Paul J. , Sinclair Marie , Thwaites Phoebe A. , Angus Peter W. , Chapman Brooke , Terbah Ryma , Testro Adam G. 
Published: September 2020

Background/Aim
Therapeutic options are limited for patients with hepatorenal syndrome (HRS), diuretic refractory ascites and hepatic hydrothorax who are awaiting liver transplant. We assessed the safety and efficacy of continuous terlipressin infusion (CTI) for treating these conditions in an outpatient setting.

Method
All patients treated with CTI from May 2013 through March 2018 at our institution were initiated in-hospital on bolus dose terlipressin therapy for 24−72 h prior to commencing CTI for home therapy. Daily home visits for clinical assessment and medication administration were provided. Adverse events, effects of treatment on renal function, model for end-stage liver disease (MELD) score, and paracentesis/thoracentesis requirements were assessed.

Results
Twenty-three patients were included (HRS = 17; refractory ascites = 4; refractory hepatic hydrothorax = 2). Median (range) duration of outpatient CTI was 50 (1–437) days with a total of 2482 patient days of treatment. Fourteen patients (60.9%) received a liver transplant; of whom 13 (92.9%) were alive at the end of the study period. There were no cardiac or ischemic complications and no serious adverse events reported. In patients with HRS, median serum creatinine significantly decreased from 202.0 μmol/L at baseline to 125.5 μmol/L at day 14 of CTI (P = 0.0003) and remained stable thereafter. Median MELD score decreased from 22.5 to 19.0 at end of CTI (P = 0.008). Median frequency of paracentesis/thoracentesis was 4 per month prior to CTI versus 1.52 during treatment.

Conclusion
Transplant-eligible and otherwise stable patients can be managed with CTI at home for an extended duration under supervision without adverse consequences.
Improving Cervical Screening in Trans and Gender-Diverse People
Authors: Kerr Lucille , Fisher Christopher M. , Jones Tiffany 
Published: September 2020

Background
Trans and gender-diverse people with a cervix experience difficulties accessing cervical cancer screening because of structural, interpersonal, and individual barriers.

Objective
The aim of this study was to explore issues with cervical cancer screening participation, awareness, and healthcare provider recommendation for trans and gender-diverse people.

Methods
A national Australian survey was conducted in 2018 to 2019. Participants included 196 trans and gender-diverse people with a cervix. Data were analyzed using descriptive and multiple regression analyses. Two awareness items related to cervical cancer screening, healthcare provider recommendation, and cervical cancer screening participation were assessed. Four variables associated with cervical cancer screening were included in the regression: age, healthcare provider recommendation, like for body, and gender.

Results
The sample was young; half (52.6%) were aged 20 to 24 years. Almost half (44.6%) had never had a healthcare provider recommend cervical cancer screening to them. Around half (48.0%) had never participated, with 21.9% reporting that they are regular screeners. More than a quarter (27.5%) of people who had screening had an abnormal result. The most common reasons for not participating in screening were that it is emotionally traumatic for them (55.3%) and inability to find a healthcare provider with whom they are comfortable (38.3%).

Conclusions
Trans and gender-diverse Australians with a cervix are unlikely to be regular participants in cervical cancer screening. To continue reducing cervical cancer rates, healthcare providers must address underscreening in this community.

Implications for Practice
Gender diversity training needs to be provided to healthcare providers. In addition, healthcare providers need to promote participation in cervical screening in this trans and gender-diverse community.
Caregiver Burden Among Primary Family Caregivers of Patients Undergoing Hematopoietic Stem Cell Transplantation
Authors: Xie Lili , Shen Chen , Shi Yaqin , Li Huiling 
Published: September 2020

Background
Patients undergoing hematopoietic stem cell transplantation (HSCT) require extensive care, and their caregivers were previously found to experience high levels of caregiver’s burden. However, the current status of HSCT patient caregiver burden in Suzhou, China, is still unknown.

Objective
To investigate the current status of caregiver burden among family caregivers of HSCT patients from Suzhou, China, and explore the related factors of caregiver burden.

Methods
This cross-sectional study enrolled 116 HSCT patient-caregiver dyads. The following measurement tools were used: a demographic questionnaire, Zarit Burden Interview, and World Health Organization Quality of Life questionnaire (brief version). Multiple regression model was used to analyze the factors associated with caregiver burden, and the relationship between caregiver burden and quality of life was analyzed.

Results
Caregivers’ marital status, family monthly income, duration of caregiving, daily caregiving time, other cocaregivers, transplant-related complications, and relapse were closely related to caregiver burden, and 75.4% of the variance in caregivers’ burden was explained by these factors. A negative correlation between caregiver burden and quality of life was noted.

Conclusion
The HSCT patient caregivers’ burden noted in this study was higher than that found in previous studies. The quality of life of HSCT patient caregivers is lower than that of the average Chinese population and decreases with a greater sense of burden.

Implications for Practice
Hematopoietic stem cell transplantation patient caregivers should be given appropriate social support to reduce their burden of care. Factors identified in this study may help center future intervention programs on caregivers who need help the most.
Acute Aortic Regurgitation Due to Endocarditis Caused by Disseminated Gonococcal Infection: A Case Report
Authors: Neto Ana , Sevilha Joana , Seabra Daniel , Oliveira Inês , Santos Rui Pontes , Andrade Aurora , Pinho Paulo , Costa Paula Martins , Viana Mariana , Pinto Paula 
Published: September 2020

Abstract
A 23-year-old man presented with cough and progressive shortness of breath. Echocardiogram showed a biscupid aortic valve with a large vegetation causing severe regurgitation. Blood cultures were positive for Neisseria gonorrhoeae sensitive to cefotaxime and penicillin. Despite direct antibiotherapy, the patient required cardiac surgery with aortic valve replacement.
Chlamydia Screening Among Women Aged 15 to 44 Years Who Reported Anal Sex During the Past 12 Months in the United States, 2013 to 2017
Authors: Kumar Sagar , Patel Chirag G. , Tao Guoyu 
Published: September 2020

Abstract
Using the 2013–2017 National Survey of Family Growth, 37.6% of women with ≥1 anal sex partner in the last 12 months reported chlamydia testing at unspecified anatomic sites in the past 12 months. Women whose medical provider asked about type of sex (i.e., vaginal, oral, anal), compared with those whose provider did not, reported higher chlamydia testing.
Risk-stratified and stepped models of care for back pain and osteoarthritis: are we heading towards a common model?
Authors: Kongsted Alice , Kent Peter , Quicke Jonathan G. , Skou Søren T. , Hill Jonathan C. 
Published: September 2020

Abstract
The overall quality of care for musculoskeletal pain conditions is suboptimal, partly due to a considerable evidence-practice gap. In osteoarthritis and low back pain, structured models of care exist to help overcome that challenge. In osteoarthritis, focus is on stepped care models, where treatment decisions are guided by response to treatment, and increasingly comprehensive interventions are only offered to people with inadequate response to more simple care. In low back pain, the most widely known approach is based on risk stratification, where patients with higher predicted risk of poor outcome are offered more comprehensive care. For both conditions, the recommended interventions and models of care share many commonalities and there is no evidence that one model of care is more effective than the other. Limitations of existing models of care include a lack of integrated information on social factors, comorbid conditions, and previous treatment experience, and they do not support an interplay between health care, self-management, and community-based activities. Moving forwards, a common model across musculoskeletal conditions seems realistic, which points to an opportunity for reducing the complexity of implementation. We foresee this development will use big data sources and machine-learning methods to combine stepped and risk-stratified care and to integrate self-management support and patient-centred care to a greater extent in future models of care.
Brief Report: Bacterial Vaginosis and Risk of HIV Infection in the Context of CD101 Gene Variation
Authors: Wanga Valentine , Mackelprang Romel D. , Thomas Katherine K. , Donnell Deborah , Cohen Craig R. , Mugo Nelly R. , Bukusi Elizabeth A. , de Bruyn Guy , Irungu Elizabeth , Celum Connie , Baeten Jared M. , Lingappa Jairam R. ,   for the Partners in Prevention HSV/HIV Transmission Study and the Partners PrEP Study
Published: September 2020

Background:
Whether bacterial vaginosis (BV) and CD101 immunoglobulin-like (Ig-like) variants independently increase HIV risk through mucosal inflammation is not well understood. We evaluated whether the impact of BV on HIV acquisition in women differs by the presence or absence of candidate CD101 Ig-like variants.

Methods:
We used data from 2 studies of HIV serodiscordant couples in east (Kenya, Tanzania, and Uganda) and southern (Botswana, South Africa, and Zambia) Africa, which longitudinally assessed HIV acquisition (by ELISA) and BV (by Nugent score ≥7). We used previously generated CD101 sequence data for each case and control participant to create a binary variable indicating the presence/absence of any of 5 CD101 Ig-like variants.

Results:
Confirming previously shown results in this cohort, Ig-like variants increased HIV-infection risk (adjusted hazard ratio [aHR], = 2.63; 95% confidence interval [CI], 1.41 to 4.89). BV was associated with 2.5-fold higher HIV-infection risk only in the absence of Ig-like variants (aHR = 2.47; 95% CI, 0.99 to 6.15; P = 0.052), whereas in the presence of Ig-like variants, BV was not associated with higher HIV-infection risk (aHR = 0.87; 95% CI, 0.35 to 2.15; P = 0.765); however, a test for interaction was nonsignificant (P = 0.116).

Conclusions:
We hypothesized that both BV and CD101 Ig-like variants facilitate HIV acquisition by augmenting similar genital inflammation pathways. Our findings indicate that inflammatory mucosal effects of Ig-like variants may influence the impact of BV on HIV risk. Host-defined inflammatory pathways may be useful targets for HIV prevention.
Cardiac Magnetic Resonance–Derived Indexed Volumes and Volume Ratios of the Cardiac Chambers Discriminating Group 2 Pulmonary Hypertension From Other World Health Organization Groups
Authors: Sakrana Amal Abdelsattar , Abdel Razek Ahmed Abdel khalek , Yousef Aida M. , El Tahlawi Mohammad abdalla , Gadelhak Basma Nabil 
Published: September 2020

Objective
The aims of the study were to assess the performance of cardiac magnetic resonance (CMR)-derived cardiac chamber volumes and volume ratios to identify group 2 pulmonary hypertension (PH) patients and to determine their cutoff values with the highest sensitivity and specificity.

Methods
One hundred six patients underwent CMR, 2 months after the diagnosis of PH by right heart catheterization. We classified patients with pulmonary capillary wedge pressure of greater than 15 mm Hg as group 2 PH. Cardiac chamber volumes indexed to the body surface area and volume ratios were correlated to the type of PH. Their sensitivity and specificity to detect group 2 PH were examined at various cutoff points.

Results
The most appropriate cutoff values to designate group 2 PH patients with high sensitivity and specificity were as follows: left atrium volume index of 54.72 mL/m2 or greater, right ventricle volume/left atrium volume of 2.07 or less, and right atrium volume/left atrium volume of 1.61 or less.

Conclusions
Cardiac magnetic resonance–derived cardiac chamber volume indices and volume ratios can determine group 2 PH diagnosis with high sensitivity and specificity.
Hyperdense Thymic Atrophy After Chemotherapy in Pediatric Patients With Extrathoracic Malignancies
Authors: Kawaguchi Masaya , Kato Hiroki , Kaneko Yo , Matsuo Masayuki 
Published: September 2020

Objective
The aim of the study was to evaluate computed tomography (CT) imaging findings of hyperdense thymic atrophy after chemotherapy in pediatric patients with extrathoracic malignancies.

Methods
Seventy-eight pediatric patients with extrathoracic malignancies, who developed thymic atrophy after chemotherapy, were included in this study. All patients underwent CT imaging before and after chemotherapy. We retrospectively reviewed the CT images. Hyperdense thymic atrophy was defined as thymic atrophy with high CT attenuation (≥80 HU).

Results
Hyperdense thymic atrophy after chemotherapy was observed in 7 (9%) of 78 patients. Age (4.3 ± 2.4 vs 8.4 ± 5.4 years, P < 0.01), thymic CT attenuation before chemotherapy (70.4 ± 18.8 vs 55.2 ± 11.9 HU, P < 0.01), reduction rate in thymic area (0.76 ± 0.06 vs 0.60 ± 0.22, P < 0.01), and thymic CT attenuation change (30.3 ± 15.2 vs −16.8 ± 24.0 HU, P < 0.01) were significantly different between patients with and without hyperdense thymic atrophy after chemotherapy. Thymic CT attenuation after chemotherapy (61.2 ± 23.8 vs 33.8 ± 30.1 HU, P < 0.01) and thymic CT attenuation change (−1.3 ± 21.2 vs −19.3 ± 27.9 HU, P < 0.01) were significantly different between patients 5 years or younger (n = 29) and 6 years or older (n = 49).

Conclusions
Hyperdense thymic atrophy after chemotherapy was observed in 9% of pediatric patients with extrathoracic malignancies. It was associated with younger age, greater thymic CT attenuation before chemotherapy, larger reduction rate in thymic area, and greater thymic CT attenuation change.
A Multicenter International Randomized Controlled Manikin Study on Different Protocols of Cardiopulmonary Resuscitation for Laypeople
Authors: Baldi Enrico , Contri Enrico , Burkart Roman , Borrelli Paola , Ferraro Ottavia Eleonora , Paglino Martina , Pugliesi Marinella , Barbati Chiara , Bertaia Daniele , Tami Christian , Lopez Daniel , Boldarin Susi , Dénéréaz Sandrine , Terrapon Michael , Cortegiani Andrea ,   and the MANI-CPR investigators
Published: September 2020

Background
Compression-only cardiopulmonary resuscitation (CPR) is a suggested technique for laypeople facing out-of-hospital cardiac arrest (OHCA). However, it is difficult performing high-quality CPR until emergency medical services arrival with this technique. We aimed to verify whether incorporating intentional interruptions of different frequency and duration increases laypeople's CPR quality during an 8-minute scenario compared with compression-only CPR.

Methods
We performed a multicenter randomized manikin study selecting participants from 2154 consecutive laypeople who followed a basic life support/automatic external defibrillation course. People who achieved high-quality CPR in 1-minute test on a computerized manikin were asked to participate. Five hundred seventy-six were enrolled, and 59 were later excluded for technical reasons or incorrect test recording. Participants were randomized in an 8-minute OHCA scenario using 3 CPR protocols (30 compressions and 2-second pause, 30c2s; 50 compressions and 5-second pause, 50c5s; 100 compressions and 10-second pause, 100c10s) or compression-only technique. The main outcome was the percentage of chest compressions with adequate depth.

Results
Five hundred seventeen participants were evaluated. There was a statistically significant difference regarding the percentage of compressions with correct depth among the groups (30c2s, 96%; 50c5s, 96%; 100c10s, 92%; compression only, 79%; P = 0.006). Post hoc comparison showed a significant difference for 30c2s (P = 0.023) and for 50c5s (P = 0.003) versus compression only. Regarding secondary outcome, there were a higher chest compression fraction in the compression-only group and a higher rate of pauses longer than 10 seconds in the 100c10s.

Conclusions
In a simulated OHCA, 30c2s and 50c5s protocols were characterized by a higher rate of chest compressions with correct depth than compression only. This could have practical consequences in laypeople CPR training and recommendations.

Clinical Trial Registration: NCT02632500
Complex dynamics arising from the interplay between prey harvest saturation and predator-prey dynamics
Authors: Costa Michel Iskin da S. , dos Anjos Lucas 
Published: September 2020

AbstractA study of the influence of prey harvest saturation on the dynamics of a predator-prey system is undertaken. It is shown that the augmentation of the constant intensity harvest part of this functional response can significantly change prey-predator dynamics by means of slight variations of the constant harvest intensity, rendering thus species management difficult due to, for instance, multiple attractors. Given that some management policies rely on the harvest saturation structure studied in this work, these results may have significant implications regarding renewable resource management.
Spatial proteomic characterization of HER2-positive breast tumors through neoadjuvant therapy predicts response
Authors: McNamara Katherine L. , Caswell-Jin Jennifer L. , Joshi Rohan , Ma Zhicheng , Kotler Eran , Bean Gregory R. , Kriner Michelle , Zhou Zoey , Hoang Margaret , Beechem Joseph , Zoeller Jason , Press Michael F. , Slamon Dennis J. , Hurvitz Sara A. , Curtis Christina 
Published: September 2020

AbstractAddition of HER2-targeted agents to neoadjuvant chemotherapy has dramatically improved pathological complete response (pCR) rates in early-stage HER2-positive breast cancer. Still, up to 50% of patients have residual disease following treatment, while others are likely overtreated. Here, we performed multiplex spatial proteomic characterization of 122 samples from 57 HER2-positive breast tumors from the neoadjuvant TRIO-US B07 clinical trial sampled pre-treatment, after 14-21 days of HER2-targeted therapy, and at surgery. We demonstrate that proteomic changes following a single cycle of HER2-targeted therapy aids the identification of tumors that ultimately undergo pCR, outperforming pre-treatment measures or transcriptomic changes. We further developed and validated a classifier that robustly predicts pCR using a single marker, CD45, measured on-treatment, and show that CD45-positive cell counts measured via conventional immunohistochemistry perform comparably. These results demonstrate novel biomarkers to enable the stratification of sensitive tumors early during neoadjuvant HER2-targeted therapy with implications for tailoring subsequent therapy.
Impact of Personal Care Habits on Post-Lockdown COVID-19 Contagion: Insights from Agent-based Simulations
Authors: Álvarez-Pomar Lindsay , Rojas-Galeano Sergio 
Published: September 2020

AbstractAfter the first wave of spread of the COVID-19 pandemic, countries around the world are struggling to recover their economies by slowly lifting the mobility restrictions and social distance measures enforced during the crisis. Therefore, the post-lockdown containment of the disease will depend strongly not any more on government-imposed interventions but on personal care measures, taken voluntarily by their citizens. In this respect, recent studies have shed some light regarding the effectiveness individual protection habits may have in preventing SARS-Cov-2 transmission, particularly physical contact distancing, facial mask wearing and hand-washing habits. In this paper we describe experiments performed on a simulated COVID-19 epidemic in an artificial population using an agent based model, so as to illustrate to what extent the interplay between such personal care habits contributes to mitigate the spread of the disease, assuming the lack of other population-wide non-pharmaceutical interventions or vaccines. We discuss scenarios where wide adherence to these voluntary care habits alone, can be enough to contain the unfold of the contagion. Our model purpose is illustrative and contributes to ratify the importance of disseminating the message regarding the collective benefits of mass adoption of personal protection and hygiene habits, as an exit strategy for COVID-19 in the new normal state.