bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrointestinal involvement in adult IgA vasculitis (Henoch-Schönlein purpura): updated picture from a French multicentre and retrospective series of 260 cases
Authors: Audemard-Verger Alexandra , Pillebout Evangéline , Amoura Zahir , Cacoub Patrice , Jourde-Chiche Noémie , Lioger Bertrand , Martis Nihal , Moulis Guillaume , Rivière Etienne , Baldolli Aurélie , Girard Charlotte , Goutte Julie , Gouellec Noémie Le , Raffray Loïc , Urbanski Geoffrey , Sanges Sébastien , Maurier Francois , Thervet Eric , Aouba Achille , Guillevin Loïc , Maillot Francois , Terrier Benjamin ,   French Vasculitis Study Group (FVSG)
Published: February 2020

Abstract

Objectives
To describe the clinical presentation, treatments and prognosis of gastrointestinal (GI) involvement in adult IgA vasculitis (IgAV).

Methods
Data from 260 adults with IgAV included in a French multicentre retrospective survey were analysed. Presentation and outcomes of patients with (GI+) and without (GI-) GI involvement were compared.

Results
One hundred and thirty-seven (53%) patients had GI involvement. Initial manifestations were abdominal pain in 99%, intestinal bleeding in 31%, diarrhoea in 26% and acute surgical abdomen in only 4%. Abdominal imaging revealed thickening of intestinal wall in 61%, and endoscopies revealed abnormalities in 87%, mostly mucosal ulcerations. GI+ vs GI- patients were younger (46 ± 18 vs 54 ± 18 years; P = 0.0004), had more constitutional symptoms (43% vs 23%; P = 0.0005) and joint involvement (72 vs 50%; P = 0.0002), and higher CRP levels (3.7 vs 1.9 mg/dl; P = 0.001). Clinical response and relapse rates were comparable between groups, and all causes mortality (2 vs 4%) and IgAV-related mortality (1% vs 2%) as well. GI-related deaths were due to intestinal perforation and mesenteric ischaemia.

Conclusion
GI involvement is frequent in adult IgAV. GI involvement is frequent in adult IgAV. Mortality is not uncommon but does not seem to be specifically related to GI. Immunosuppressants should not be preferred as first-line therapy for GI+ patients but may be required in case of acute surgical abdomen.
Original Research: Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors
Authors: Park So-Hyun , Strauss Shiela M. 
Published: February 2020

ABSTRACT

Background:
The American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention recommend an adequate level of physical activity for cancer prevention and survivorship. Many adults have been diagnosed with arthritis, with a significantly higher rate in women. People with arthritis tend to be less physically active than those without arthritis, and are less likely to engage in moderate or vigorous activity. The proportion of adults meeting ACS physical activity guidelines is especially low among those with arthritis.

Objective:
We wanted to explore the extent to which arthritis-related functional limitations are predictive of inadequate physical activity in female adult cancer survivors after accounting for other known predictors.

Methods:
Data included in the analyses were from a sample of 729 adult women diagnosed with cancer who participated in the U.S. National Health and Nutrition Examination Survey between 2011 and 2016. Inadequate physical activity was defined as not meeting ACS physical activity guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify correlates of inadequate physical activity.

Results:
Being age 65 years or older, having no more than a high school education, being overweight or obese, being clinically depressed, and having arthritis-related functional limitations were found to be significant correlates of inadequate physical activity in the study population.

Conclusions:
Our results indicate that, in addition to previously identified predictors of inadequate physical activity in cancer survivors, having arthritis-related functional limitations is a significant predictor of inadequate physical activity in female adult cancer survivors. Assessment and management of arthritis-related functional limitations by health care providers are needed to facilitate successful adherence to physical activity guidelines.
Relationship Between Emotional Intelligence and Clinical Performance in Student Registered Nurse Anesthetists
Authors: Christianson Krista L. , Fogg Louis , Kremer Michael J. 
Published: February 2020

Abstract
Emotional intelligence (EI) includes skills such as recognizing, understanding, and managing emotions. This pilot study investigated the utility of the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 as a screening instrument in student registered nurse anesthetists by determining if EI predicted clinical performance. Scores from 11 participants enrolled in a single nurse anesthesia program were correlated with formative clinical evaluations. Relationships between EI and clinical performance were examined. Participants consistently met clinical performance objectives but were unable to use emotion to solve problems or to recognize others’ emotions, suggesting that EI abilities could impact future student registered nurse anesthetist clinical performance.
Group-based Trajectory Modeling: A Novel Approach to Classifying Discriminative Functional Status Following Adult Spinal Deformity Surgery
Authors: Yang Jingyan , Lafage Renaud , Gum Jeffrey L. , Shaffrey Christopher I. , Burton Douglas , Kim Han Jo , Ames Christopher P. , Mundis Gregory , Hostin Richard , Bess Shay , Klineberg Eric O. , Smith Justin S. , Schwab Frank , Lafage Virginie 
Published: February 2020

Study Design.
Retrospective review of prospectively collected database.

Objective.
To delineate and visualize trajectories of the functional status in surgically-treated adult spinal deformity (ASD) patients.

Summary of Background Data.
Classifying long-term recovery following ASD surgery is not well defined.

Methods.
One thousand one hundred seventy-one surgically-treated patients with a minimum of 3-year follow-up were included. The group-based trajectory modeling (GBTM) was used to identify distinct trajectories of functional status over time, measured by Oswestry Disability Index (ODI). Patient profiles were then compared according to the observed functional patterns.

Results.
The GBTM identified four distinct functional patterns. The first group (10.0%) started with minimal disability (ODI: 15 ± 10) and ended up almost disability-free (low-low). The fourth group (21.5%) began with high ODI (66 ± 11) and improvement was minimal (high-high). Groups two (40.1%) and three (28.4%) had moderate disability (ODI: 39 ± 11 vs. 49 ± 11, P < 0.001) before surgery. Following surgery, marked improvement was seen in group two (median-low), but deterioration/no change was observed in group three (median-high). The low-low group primarily included adult idiopathic scoliosis, while the high-high group had the oldest and the most severe patients as compared with the rest of the groups. A subgroup analysis was performed between groups two and three with propensity score matching on age, body mass index, baseline physical component score (PCS), and severity of deformity. Notably, the baseline mental status of the median-high group was significantly worse than that of the median-low group, though the differences in demographics, surgery, and deformity no longer existed.

Conclusions.
Patients with moderate-to-low disability are more likely to obtain better functional postoperative outcomes. Earlier surgical interventions should be considered to prevent progression of deformity, and to optimize favorable outcomes. Greatest improvement appears to occur in moderately disabled patients with good mental health. GBTM permits classification into distinct groups, which can help in surgical decision making and setting expectations regarding recovery.

Level of Evidence: 3
Machine learning in nephrology: scratching the surface
Authors: Li Qi , Fan Qiu-Ling , Han Qiu-Xia , Geng Wen-Jia , Zhao Huan-Huan , Ding Xiao-Nan , Yan Jing-Yao , Zhu Han-Yu 
Published: February 2020

Abstract
Machine learning shows enormous potential in facilitating decision-making regarding kidney diseases. With the development of data preservation and processing, as well as the advancement of machine learning algorithms, machine learning is expected to make remarkable breakthroughs in nephrology. Machine learning models have yielded many preliminaries to moderate and several excellent achievements in the fields, including analysis of renal pathological images, diagnosis and prognosis of chronic kidney diseases and acute kidney injury, as well as management of dialysis treatments. However, it is just scratching the surface of the field; at the same time, machine learning and its applications in renal diseases are facing a number of challenges. In this review, we discuss the application status, challenges and future prospects of machine learning in nephrology to help people further understand and improve the capacity for prediction, detection, and care quality in kidney diseases.
The role of physical activity in the link between menopausal status and mental well-being
Authors: Bondarev Dmitriy , Sipilä Sarianna , Finni Taija , Kujala Urho M. , Aukee Pauliina , Laakkonen Eija K. , Kovanen Vuokko , Kokko Katja 
Published: February 2020

Abstract

Objective:
To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA).

Methods:
Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjusted for age, marital and employment status, parity, self-reported mental disorder, use of psycholeptics and psychoanaleptics, and menopausal symptoms.

Results:
Depressive symptoms were lower amongst the pre than postmenopausal women (B = 0.07, confidence interval 0.01-0.13). Menopausal symptoms attenuated these associations. Menopausal status showed no associations with life satisfaction, or with positive or negative affectivity.
Women with high PA scored higher on positive affectivity, and the pre, early peri, and postmenopausal women scored higher on life satisfaction (B = 0.79, P < 0.001; B = 0.63, P = 0.009; B = 0.42, P = 0.009, respectively) and scored lower on depressive symptoms (B = −0.13, P = 0.039; B = −0.18, P = 0.034; and B = −0.20, P < 0.001, respectively) than their low PA counterparts. The pre and postmenopausal women with medium PA scored higher on life satisfaction (B = 0.54, P = 0.001; B = 0.038, P = 0.004, respectively) than those with low PA.

Conclusions:
Postmenopausal women reported marginally higher depressive symptoms scores compared with premenopausal women, but menopause was not associated with positive mental well-being. However, this association varies with the level of PA.

Video Summary:

http://links.lww.com/MENO/A520.
Gabapentin for the treatment of hot flushes in menopause: a meta-analysis
Authors: Yoon Sang-Hee , Lee Ji Young , Lee Chulmin , Lee Hyojin , Kim Soo-Nyung 
Published: February 2020

Abstract

Objective:
Gabapentin is used to treat vasomotor symptoms (VMS) in postmenopausal women with contraindications to hormonal therapy or who prefer alternatives. We investigated the efficacy and tolerability of gabapentin for treating menopausal hot flushes via a meta-analysis.

Methods:
We searched the PubMed, MEDLINE, EMBASE, and CENTRAL databases for English-language articles published until June, 2018. The following search terms were used: “menopause,” “hot flushes,” “vasomotor symptoms,” “gabapentin,” and “non-hormonal therapy.” Primary outcomes were frequency, duration, and composite score of hot flushes. Secondary outcomes were adverse effects and dropout rate. We estimated the standardized mean difference (SMD) and combined odds ratio (OR) using fixed or random-effects models, depending on study heterogeneity. Subgroup and meta-regression analyses of gabapentin dosage were performed.

Results:
We included seven randomized controlled trials that compared single-agent gabapentin with placebo for treating hot flushes in the meta-analysis. Women who received gabapentin reported a significantly greater reduction in the frequency (SMD 2.99 [95% confidence interval 2.01-3.98], P < 0.001), duration (0.89 [0.49-1.30], P < 0.001), and composite score (2.31 [1.50-3.11], P < 0.001) of hot flushes. Adverse events were significantly more frequent among those taking gabapentin than among those taking the placebo (OR 1.58 [0.98-2.18], P < 0.001; and 1.19 [0.43-1.95], P = 0.002 for dizziness and unsteadiness, respectively).

Conclusions:
Gabapentin could be used to treat VMS in postmenopausal women with contraindications to hormonal therapy. Future studies should investigate the lowest effective dose of gabapentin to minimize adverse effects.

Video Summary:

http://links.lww.com/MENO/A521.
Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers
Authors: Arigo Danielle , Mogle Jacqueline A. , Brown Megan M. , Roberts Savannah R. , Pasko Kristen , Butryn Meghan L. , Downs Danielle Symons 
Published: February 2020

AbstractObjective:Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory).Methods:Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano).Results:Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day.Conclusions:Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method.Video Summary:http://links.lww.com/MENO/A545.
The association between hormone therapy and sarcopenia in postmenopausal women: the Korea National Health and Nutrition Examination Survey, 2008-2011
Authors: Kim Sung-Woo , Kim Rebecca 
Published: February 2020

Abstract

Objective:
Menopausal transition contributes to sarcopenia, but the effects of hormone therapy (HT) on sarcopenia in postmenopausal women have not been determined. This study assessed the effect of HT on sarcopenia in postmenopausal women.

Methods:
The present study included 4,254 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys from 2008 to 2011. Appendicular skeletal muscle mass divided by weight (ASM/Wt) and the prevalence of sarcopenia were analyzed in groups of women stratified by duration of HT use.

Results:
ASM/Wt was higher and the prevalence of sarcopenia was lower in participants with a history of prolonged (≥13 mo) HT use than in participants with a shorter duration of HT use or no HT use. After adjusting for multiple confounding factors, prolonged use of HT remained significantly associated with estimated mean ASM/Wt and the prevalence of sarcopenia (odds ratio: 0.60; 95% confidence interval: 0.41-0.88; P = 0.01). In addition, the prevalence of sarcopenia was linearly associated with history of hypertension, duration of hypertension, physical activity, and duration of HT use. Subgroup analysis showed that the association between duration of HT use and the prevalence of sarcopenia was maintained in younger (<65 y old) and leaner (body mass index <25 kg/m2) postmenopausal women.

Conclusions:
The present study showed that the prolonged use of HT was associated with high muscle mass and a low prevalence of sarcopenia in postmenopausal women.
Factors Influencing Corneal Biomechanics in Diabetes Mellitus
Authors: Ramm Lisa , Herber Robert , Spoerl Eberhard , Pillunat Lutz E. , Terai Naim 
Published: February 2020

Purpose:
Diabetes mellitus (DM) induces changes in corneal biomechanical properties. The influence of disease-specific factors was evaluated, and a novel DM index was created.

Methods:
Eighty-one patients with DM and 75 healthy subjects were matched according to age, intraocular pressure, and central corneal thickness. Information on the disease was collected, and measurements with the Ocular Response Analyzer and the Corvis ST were taken. Results were compared between the groups, and the influence of disease-specific factors was evaluated. From dynamic corneal response parameters, a DM index was calculated.

Results:
In DM, corneal hysteresis was higher than in healthy subjects (10.5 ± 1.9 vs. 9.7 ± 1.9 mm Hg, P = 0.008). In addition, dynamic corneal response parameters showed significant differences. Among others, highest concavity (HC) (17.212 ± 0.444 vs. 16.632 ± 0.794 ms, P < 0.001) and A2 time (21.85 ± 0.459 vs. 21.674 ± 0.447 ms, P = 0.017) as well as A1 (0.108 ± 0.008 vs. 0.104 ± 0.011 mm, P = 0.019) and A2 deflection amplitudes (0.127 ± 0.014 vs. 0.119 ± 0.014 mm, P < 0.001) were increased in DM. In DM type 1, HC deformation amplitude (1.14 ± 0.19 vs. 1.095 ± 0.114 mm, P = 0.035) was higher than in type 2. The time of deflection amplitude max correlated with the severity of retinopathy (R = 0.254, P= 0.023). In case of diabetic maculopathy, A1 velocity (0.155 ± 0.018 vs. 0.144 ± 0.019 ms, P = 0.043) and A2 time (22.052 ± 0.395 vs. 21.79 ± 0.46 ms, P = 0.04) were increased. Deformation amplitude max (R = 0.297, P = 0.024), HC time (R = 0.26, P = 0.049), HC deformation amplitude (R = 0.297, P = 0.024), and A2 deformation amplitude (R = 0.276, P = 0.036) were associated to disease duration. The DM index revealed a sensitivity of 0.773 and a specificity of 0.808 (area under the curve of receiver operating characteristic = 0.833).

Conclusions:
In DM, changes in corneal biomechanics were correlated with disease-specific factors. The DM index achieved reliable sensitivity and specificity values.
Corneal Endothelial Cell Toxicity Determines Long-Term Outcome After Ocular Exposure to Sulfur Mustard Vapor
Authors: McNutt Patrick M. , Nguyen Dominique L. , Nelson Marian R. , Lyman Megan E. , Eisen Margaret M. , Ondeck Celinia A. , Wolfe Sarah E. , Pagarigan Kathleen T. , Mangkhalakhili Mark C. , Kniffin Denise M. , Hamilton Tracey A. 
Published: February 2020

Purpose:
Ocular exposure to sulfur mustard (SM) vapor causes acute loss of corneal endothelial cells (CECs). Persistent corneal endothelial pathologies are observed in eyes that do not recover from SM exposure, suggesting that endothelial toxicity contributes to mustard gas keratopathy (MGK). Here, we evaluated the contributions of endothelial loss to acute and chronic corneal injuries in SM-exposed eyes.

Methods:
Rabbit eyes were exposed in vivo to equivalent doses of SM using 9-, 11-, or 14-mm vapor caps. The effects of exposure area on corneal injury progression were longitudinally evaluated over 12 weeks using clinical evaluations. The effects of exposure area on CEC morphology, endothelial and epithelial ultrastructure, and endothelial barrier function were determined from 1 day to 12 weeks.

Results:
SM exposure caused loss of CECs and failure of endothelial barrier integrity at 1 day, independent of exposure cap size. By 3 weeks, eyes exposed with the 14-mm vapor cap exhibited increased corneal permeability, repopulation of the endothelium by cells with fibroblastic morphology, and abnormal deposition of extracellular matrix. Eyes exposed with 9- or 11-mm vapor caps exhibited transient symptoms of injury that fully resolved, with the rate of recovery correlated with cap size.

Conclusions:
The nonlinear correlation between endothelial lesion size and probability of developing MGK suggests that the CEC loss is a determinative factor for emergence of MGK. These studies illustrate the importance of endothelial repair in preventing MGK. Furthermore, they exclude chemical modification of basement membrane as a mechanistic cause of recurrent epithelial erosions in MGK eyes.
Anemia in preschool children from Angola: a review of the evidence
Authors: Fançony Cláudia , Lavinha João , Brito Miguel , Barros Henrique 
Published: February 2020

AbstractAngola is one of the southern African countries with the highest prevalence of anemia, and despite the high geographic heterogeneity of its distribution across the country, it was reported to be indicative of a severe public health problem in some areas, mainly in children. Despite the relevance of this condition in the country there is still an important gap regarding scientific evidences and knowledge systematization in the indexed literature, that could be used to inform and optimize national public health policies willing to address it. Furthermore, the changes in anemia epidemiology among African preschool children and the late updates in nutrition-specific and nutrition-sensitive preventive strategies in the continent are of imperative relevance, as they could contribute to design context-specific national approaches to reduce anemia's morbidity and mortality. In this study we intent to perform a systematic review regarding the sparse evidence available on the country regarding the prevalence of anemia, its associated factors, the prevention, and/or control strategies with potential to reduce anemia that were implemented, and to discuss interventions targeting infections and/or nutrition conducted in other African countries.
Nursing Interventions of Intraoperative Malignant Hyperthermia in Patients With Scoliosis: A Report of 3 Cases
Authors: An Xiaoyan , Wang Qiaogui , Qiu Yong , Zhu Zezhang , Ma Zhengliang , Hua Wei , Li Xueyun 
Published: February 2020

ABSTRACT

INTRODUCTION: The report summarizes the intraoperative rescue and nursing intervention of malignant hyperthermia (MH) in the correction surgery for 3 patients with spinal deformity. Although rare, MH may occur in up to 1 of 5000 cases. INTERVENTION: The key points of nursing care include preoperative MH risk assessment, MH early warning, cessation of anesthetic, use of a validated scoring system, and initiation of cooling measures. CONCLUSION: Prompt nursing recognition and team-fcoused interventions provided successful rescue of 3 patients with MH.