bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secukinumab leads to shifts from stage-based towards response-based disease clusters- Comparative data from very early and established psoriatic arthritis
Authors: Kampylafka Eleni , Tascilar Koray , Lerchen Veronika , Linz Christina , Sokolova Maria , Zekovic Ana , Kleyer Arnd , Simon David , Rech Juergen , Sticherling Michael , Schett Georg , Hueber Axel 
Published: July 2020

Abstract
Background. Limited information exists about the very early forms of psoriatic arthritis. In particular, differences and responsiveness of patient-reported outcomes (PROs) in very early as compared to established PsA have not been investigated to date.Methods. Cross-sectional and prospective longitudinal evaluation of PROs related to pain (VAS), physical function (HAQ-DI, SF-36 physical), mental function (SF-36 mental), impact of psoriatic skin (DLQI), joint (PsAID) and global disease (VAS) in two small prospective observational studies on secukinumab 300mg over 6 months in very early disease patients (IVEPSA study; N=20) and established PsA (PSARTROS study; N=20). Cluster analysis was performed at baseline and 24-weeks follow-up.Results. While responses in pain and physical activity-related PROs to secukinumab were more pronounced in established PsA than very early disease, effects on PROs related to general health perception, as well as those related to emotional and mental well-being, were modified in a similar way in very early disease and established PsA. Cluster analysis based on global disease activity and PROs showed that baseline clusters reflected very early disease and established PsA, while after secukinumab treatment these clusters were abolished and new clusters based on differential responses to physically and mentally-oriented PROs formed.Conclusions. Inhibition of IL-17A by secukinumab leads to comprehensive improvement of general health perception and mental well-being in very early and established PsA, while overall responses in pain and physical activity are more pronounced in established disease. Most importantly, treatment restructures the original patients clusters based on disease stage and leads to the formation of new clusters that reflect their response in physical and mental-orientated PROs.Trial Registration: NCT02483234, Registered 26 June 2015, retrospectively registered
Response to treatment with Intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligo articular Juvenile Idiopathic arthritis
Authors: Masoud Rana , Jeelani Wajiha , Agbor Barbine Tchamba Agbor , Hennon Teresa , Wrotniak Brian H , Abdul-Aziz Rabheh 
Published: July 2020

Abstract
Background:Oligo-articular juvenile idiopathic arthritis (Oligo JIA) is the most common subtype of juvenile idiopathic arthritis. Intra-articular corticosteroid (IAC) injection is a mainstay treatment of oligo JIA providing pain relief, improving mobility and preventing further joint destruction in the majority of patients. In 2015, production of triamcinolone hexacetonide (TH) an intra-articular corticosteroid was discontinued in the United States leading to use of triamcinolone acetonide (TA) as an alternative. In this study, we compared response to treatment in children with oligo JIA who underwent therapy with intra-articular TA and TH injection.Methods:Our study is a retrospective chart review of children with oligo JIA who were treated with IAC injections with TH between January 2012 and June 2015 and TA between J uly 2015 and December 2018. The two groups were followed at John R. Oishei Children’s Hospital of Buffalo and were evaluated for response to treatment, side effects and predictors of response including duration of disease before treatment, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). Response to treatment was defined as at least 6 months follow up without evidence of active arthritis in injected joints. Patients were considered to be non-responders if they continued to show active arthritis during their first follow up after joint injection. The primary objective was to evaluate whether there was a significant difference in rate of response between TH and TA.Results:Forty-nine patients, 38 female and 11 male with oligo JIA were included in the study. The average age was 6.7 years. A total of 111 joints were injected includin g 78 knees, 13 ankles, 9 wrists, 4 hips, 4 elbows, 2 TMJ and one subtalar joint. In the TA group, 49% (29/59) did not show response to injection compared to 27% (14/52) in the TH group. After 6 months, response rates were better for individuals injected with TH compared to TA (73% vs. 51%). In general, response to intra-articular TH was superior to TA with P = .016 using chi-square test of independence. This difference in outcome was not influenced by other variables such as duration of illness before treatment (P value 0.784) or elevated ESR and CRP. No difference in side effects between the two groups were noted.Conclusion:Our results in conjunction with prior published data suggests that TH intra-articular joint injection in oligo JIA is superior to TA, although future controlled trials are necessary for confirmation. An effective, long lasting treatment can have a great impact on the outcome of these children.
Effects of Sequential and Simultaneous Double Elicitation on Aloe-Emodin Production in Cassia Tora Root Cultures
Authors: Teptat Palin , Tansakul Pimpimon , Sakunphueak Athip 
Published: July 2020

Abstract
Cassia tora root cultures were established to study anthraquinone production and as an alternative source of anthraquinone. In this study, several plant defence-based techniques were used to enhance aloe-emodin production in Cassia tora root cultures. Elicitation and the initial optimisation of exposure time and culture age suggested that 100 mg/L yeast extract was the most efficient elicitor, with the highest efficiency during early to mid-stationary growth phase. The elicited root produced approximately 2.7-2.9 folds-improvement in aloe-emodin content when compared with the control. The efficiency of the elicitor tended to increase along with the exposure time. Extending the elicitation period to the end of culture cycle (9-10 days) increased the production up to 6.21 times (5.740 ± 0.584 mg/gDW). Simultaneous double elicitation and sequential double elicitation also showed their effectiveness on aloe-emodin production. Aloe-emodin production was improved up to 9.09 times higher than the control by a simultaneous add-on of 50 mg/L chitosan with 100 mg/L yeast extract. Meanwhile, sequential elicitation of 50 mg/L chitosan for 24 hours prior to elicitation by yeast extract improved the production up to 11.27 times higher than the control. Both treatment styles exhibited a particular advantage toward the extracellular accumulation, which might facilitate the use of two-phase culture or in conjunction with other enhancing techniques.
Rapid Adaptation and Continuous Performance Evaluation of SARS-CoV-2 Envelope Gene (E-gene) Real-Time RT-PCR Assays to Support the Hospital Surge in Test Demand
Authors: Ho Yolanda Iok Ieng , Wong Ann Han , Leung Eddie Chi Man , Wong River Chun Wai , Lai Raymond Wai Man 
Published: July 2020

Abstract
We describe timely adaption of both published WHO E-gene protocol and commercially available LightMix Modular E-gene assay to the test platform (ABI 7900 Fast real-time analyzer and TaqMan Fast One-step Virus Master Mix) available in an accredited tertiary hospital laboratory with on-going evaluation to ensure provision of quality service within time constraint. The LightMix Modular E-gene was slightly more sensitive when compared to the WHO E-gene, both analytically and diagnostically. The assay was recommended for screening of SARS-CoV-2 infection. With the availability of technically competent staff through continuous training, provision of round the clock service is feasible despite the test is of high complexity. The shorten turn-around-time of about 4 hours per batch could support surges in testing demand, which is essential to control the current SARS-CoV-2 pandemic, to prevent potential overwhelming of the healthcare system and to optimize utilization of the isolation beds.
Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review
Authors: Fiedler Janis , Eckert Tobias , Wunsch Kathrin , Woll Alexander 
Published: July 2020

Abstract
BackgroundElectronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.MethodsPubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.ResultsThe systematic search reveled eleven systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.ConclusionFindings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registrationThe protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.
A Systematic Review Assessing the Under-Representation of Elderly Adults in COVID-19 Trials
Authors: Prendki Virginie , Tau Noam , Avni Tomer , Falcone Marco , Huttner Angela , Kaiser Laurent , Paul Mical , Leibovici-Weissmann Yaara , Yahav Dafna 
Published: July 2020

Abstract
BackgroundCoronavirus disease (COVID-19) has caused a pandemic threatening millions of people worldwide. Yet studies specifically assessing the geriatric population are scarce. We aimed to examine the participation of elderly patients in therapeutic or prophylactic trials on COVID-19.MethodsIn this review, randomized controlled trials (RCTs; n=12) comparing therapeutic or prophylactic interventions registered on preprint repositories and/or published since December 2019 were analyzed. We aimed to describe the age of included patients, the presence of an upper age limit and of adjusted analyses on age, any exclusion criteria that could limit participation of elderly adults such as comorbidities, cognitive impairment, limitation of life expectancy; and the assessment of long-term outcomes such as the need of rehabilitation of institutionalization. Mean participant ages were reported and compared with observational studies.ResultsTwelve RCTs assessing drug therapy for COVID-19 were included. Mean age of patients included in RCTs was 56.3 years. An upper age limit was applied in three published trials (25%) and in 200/650 (31%) trials registered at clinicaltrials.gov. One trial reported a subgroup analysis in patients ≥65. Patients were excluded for liver-function abnormalities in eight trials, renal disease in six, cardiac disease or risk of torsade de pointes in five, and four for cognitive or mental criteria, which are frequent comorbidities in the oldest patients. Only three trials allowed a family member to provide consent. Patients enrolled in RCTs were on average 20 years younger than those included in large (n≥1000) observational studies. Seven studies had as their primary outcome a clinical endpoint, but none reported cognitive, functional or quality of life outcomes or need for rehabilitation or long-term care facility placement.ConclusionsElderly patients are clearly underrepresented in RCTs, although they comprise the population hardest hit by the COVID-19 pandemic. Long-term outcomes such as the need of rehabilitation or institutionalization were not reported. Future investigations should target specifically this vulnerable population.
“It’s worse with fellow patients… they judge you as evil”: Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.
Authors: Ssekamatte Tonny , Isunju John Bosco , Muyanga Naomi , Buregyeya Esther , Mugambe Richard K , Wanyenze Rhoda K. , Bukenya Justine Nnakate 
Published: July 2020

Abstract
Background

Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with challenges in access to and utilisation of HIV/STI prevention services. Our study explored the barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms.

Methodology

This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. Twenty-two in-depth interviews, six key informant interviews and nine focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis under a hybrid of inductive and deductive approaches.

Results

Barriers to access and utilisation of HIV/STI prevention and care services were classified as individual, community and health system barriers. Individual barriers included internalised stigma and low socio-economic status. Health system barriers included discrimination by some healthcare providers, stigmatisation by fellow patients, stockout of lubricants drugs and other medical supplies, inadequate access to trans-specific STI drugs, and high cost of drugs. Community barriers comprised social exclusion and lack of recognition by other key population groups, and transphobia. The coping strategies included the use of substitutes such as lotions, avocado, egg white or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to mimic gender identity.

Conclusion

Trans-women sex workers grapple with access to HIV/STI prevention and care services. Individual, community and healthcare facility level barriers hindered trans-women sex workers from access and utilisation of HIV/STI prevention and care services. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community on the transgender identity.
Association Between Serum Lactate Level During Cardiopulmonary Resuscitation and Survival in Adult Out-of-Hospital Cardiac Arrest: A Multicenter Cohort Study (The Critical Study in Osaka, Japan)
Authors: Nishioka Norihiro , Kobayashi Daisuke , Izawa Junichi , Irisawa Taro , Yamada Tomoki , Yoshiya Kazuhisa , Park Changhwi , Nishimura Tetsuro , Ishibe Takuya , Yagi Yoshiki , Kiguchi Takeyuki , Kishimoto Masafumi , Inoue Toshiya , Hayashi Yasuyuki , Sogabe Taku , Morooka Takaya , Sakamoto Haruko , Suzuki Keitaro , Nakamura Fumiko , Matsuyama Tasuku , Okada Yohei , Matsui Satoshi , Hirayama Atsushi , Yoshimura Satoshi , Kimata Shunsuke , Shimazu Takeshi , Kitamura Tetsuhisa , Kawamura Takashi , Iwami Taku 
Published: July 2020

Abstract
Background: Serum lactate reflects hypoxic insult in many conditions, but its role as prognostic markers after cardiac arrest is still controversial. This study aimed to investigate the association between serum lactate levels during cardiopulmonary resuscitation (CPR) and survival in patients with out-of-hospital cardiac arrest (OHCA).Methods:We analyzed the data of the Osaka Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study, a prospective multicenter observational study of 14 participating institutions in Osaka Prefecture, Japan that enrolled consecutive OHCA patients. We included adult nontraumatic OHCA patients transported to the hospital with ongoing CPR from 2013 to 2017. Based on the serum lactate levels during CPR, the patients were divided into four quartiles: Q1 (lactate ≤ 10.6 mEq/L), Q2 (10.6 < lactate ≤ 14.1 mEq/L), Q3 (14.1 < lactate ≤ 18.0 mEq/L), and Q4 (lactate > 18.0 mEq/L). The primary outcome of this study was 1-month survival. Results:A total of 11,960 patients were registered and 4,978 of them were eligible for our analyses. The Q1 group had the highest 1-month survival (4.3% [53/1,245]), followed by Q2 (2.5% [31/1,245]), Q3 (1.1% [14/1,328]), and Q4 (0.5% [6/1,160]) groups. In the multivariable logistic regression analysis, the proportion of 1-month survival in the Q4 group was significantly lower than that in the Q1 group (adjusted odds ratio 0.21; 95% confidence interval 0.086 to 0.50). One-month survival decreased in a stepwise manner as the quartiles increased (p for trend <0.001). In subgroup analysis, there was a significant interaction between initial rhythm and survival (p for interaction <0.001); 1-month survival of patients with a non-shockable rhythm decreased when the lactate levels increased (p for trend <0.001), but not in patients with a shockable rhythm (p for trend =0.76).CONCLUSION:High serum lactate level during CPR was associated with poor 1-month survival in OHCA patients. Serum lactate may be one of the effective prognostic indications for OHCA during CPR, especially in patients with non-shockable rhythm.
FMT for chronic intestinal obstruction caused by constrictive pericarditis: a case report
Authors: Chen Huan , Wang ZiJie , Hu Qing , Deng Mingming , Lü MuHan , LUO GANG 
Published: July 2020

Abstract
A 62-year-old man presented to our department with repeated vomiting, abdominal pain, bloating, and constipation. Echocardiography and computed tomography revealed his thickened pericardium with multiple eggshell-like calcifications, and incomplete intestinal obstruction. Colonoscopy showed extensive focal erosions in the colonic mucosa. After fecal microbiota transplantation, the patient's nutritional status was improved, intestinal obstruction was relieved, and his cardiac function his was restored. This case may provide a new option for the treatment of refractory incomplete intestinal obstruction.
Circulating Plasma Epstein–Barr virus DNA Load During the Follow-up Periods Predicts Recurrence and Metastasis in Nasopharyngeal Carcinoma
Authors: He Sha-sha , Yang Yun-ying , Wang Yan , Ren Yu-feng , Wang Cheng-tao , Zhu Mei-yan , Lu Li-xia , chen yong 
Published: July 2020

Abstract
PURPOSE

Epstein Barr virus DNA (EBV DNA) load has been identified as a prognostic factor in nasopharyngeal carcinoma, while the dynamic changes in the long period have not been explored. In this study, we evaluated EBV DNA kinetics and its role in the survival.

METHODS

We conducted a retrospective review of 900 NPC patients. Plasma EBV DNA levels were measured at various time points after treatment. The correlations of EBV kinetics with recurrence and metastasis were analyzed. After stratifying patients according to the EBV results, survival was compared using Kaplan–Meier estimates. 12 and 24-month landmark analyses for OS data were performed according to the EBV groups.

RESULTS

Patients with post-EBV < 2,500 copies/mL achieved better survival than the higher ones. Furthermore, patients with continuously elevated EBV DNA had significantly poorer OS (HR: 2.542, 95%CI: 2.077–3.111, P < 0.001), DMFS (HR: 2.970, 95%CI: 2.392–3.687, P < 0.001), LRFS (HR: 1.699, 95%CI: 1.072–2.692, P = 0.013), and PFS (HR:2.535, 95%CI: 1.987–3.233, P < 0.001) than patients with continuously normal EBV or those with elevated levels at any time-point. The 5-year OS with elevated EBV was lower than the remission group by the 12 and 24-month landmark analysis.

CONCLUSIONS

Elevated EBV DNA after treatment was a better predictive indicator of survival than the baseline concentrations. Furthermore, continuously elevated EBV DNA after treatment indicated recurrence, metastasis and unfavorable prognosis for NPC. In addition, EBV DNA was predictable no matter how long the follow-up time.
IDO1/COX2 Expression Is Associated With Poor Prognosis In Colorectal Cancer Liver Oligo-metastases
Authors: Ma Wenjuan , Wang Xing , Wang Lulu , Chen Tinglan , Hu Shanshan , Xu Haineng , Pan Zhizhong , Chen Gong , Zhou Zhongguo , Zhang Rong-xin 
Published: July 2020

Abstract
Background: IDO1 and COX2 have emerged as promising immunotherapy targets, and their inhibitors could enhance T cell responses to tumor cells. Whether IDO1 and COX2 expression in colorectal cancer (CRC) patients with liver oligometastases could be an independent predictor for overall survival (OS) and progression-free survival (PFS) is unclear. The purpose of this study was to investigate the correlation of IDO1 and COX2 expression with OS and PFS in CRC patients with liver oligometastases.Methods: The expression levels of IDO1 and COX2 were assessed by immunohistochemistry in 107 specimens from patients with liver oligometastases. The correlation between the expression of IDO1 and COX2 and the clinicopathological parameters and OS/PFS in patients was examined.Results: The expression level of IDO1/COX2 was significantly correlated with age and was not associated with gender, BMI, T stage, N stage, primary tumor size, liver metastasis size, CEA, CA19-9, CD3 TILs or CD8 TILs. In univariate analysis, we found that IDO1/COX2 expression, CEA and N stage all yielded significantly poor OS and PFS outcomes. In our multivariate Cox model, IDO1/COX2 coexpression, CEA and N stage were found to be significantly correlated with OS; IDO1/COX2 coexpression and CEA were significantly correlated with PFS.Conclusions: IDO1/COX2 coexpression has a pivotal role and may act as a potential prognostic biomarker for survival in CRC patients with liver oligometastases.