bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complement promotes endothelial von Willebrand factor and angiopoietin-2 release in obstructive sleep apnea
Authors: Gao Su , Emin Memet , Thoma Theodosia , Pastellas Kalliopi , Castagna Francesco , Shah Riddhi , Jimenez Alondra , Patel Neha , Wei Ying , Jelic Sanja 
Published: December 2020

Abstract

Study Objective
Obstructive sleep apnea (OSA) is highly prevalent and triples vascular thromboembolic risk. Intermittent hypoxia (IH) during transient cessation of breathing in OSA impairs endothelial protection against complement. Complement activation stimulates the endothelial release of a pro-thrombotic von Willebrand factor (vWF). We investigated whether increased complement activity in OSA promotes the endothelial release of vWF and pro-inflammatory angiopoietin-2. We further investigated whether improving complement protection with statins reverses these changes.

Methods
Using endothelial cells (ECs) and blood collected from OSA patients (n = 109) and controls (n = 67), we assessed whether altered cellular localization of complement inhibitor CD59 in OSA modulates exocytosis of Weibel-Palade bodies (WPB), secretory granules that store vWF and angiopoietin-2. These interactions were also assessed in vitro in ECs exposed to normoxia or IH with or without recombinant complement C9 and with or without atorvastatin.

Results
Circulating levels of angiopoietin-2 were greater in OSA than controls and levels of vWF cleavage products correlated with OSA severity. In cultured ECs, IH enhanced complement-stimulated angiopoietin-2 and vWF release by reducing EC surface and increasing intracellular expression of complement inhibitor CD59. Intracellular CD59 co-localized with WPB in OSA. IH increased binding of intracellular CD59 to syntaxin-3, which dissociated syntaxin-3 from voltage-sensitive calcium channel Cav1.2, and activated WPB exocytosis in a calcium-dependent manner. Atorvastatin reversed IH-enhanced endothelial release of vWF and angiopoietin-2.

Conclusions
IH promotes the complement-mediated release of vWF and angiopoietin-2, which may contribute to pro-thrombotic and pro-inflammatory conditions in OSA. Statin reversed these effects, suggesting a potential approach to reduce cardiovascular risk in OSA.
Hypochlorous acid decreases antioxidant power, inhibits plasma membrane redox system and pathways of glucose metabolism in human red blood cells
Authors: Qadir Tantry Irfan , Ali Asif , Mahmood Riaz 
Published: December 2020

Abstract
Hypochlorous acid (HOCl) is generated at a high concentration by activated neutrophils at sites of inflammation in a myeloperoxidase catalyzed reaction. The increased and sustained production of HOCl at inflammatory sites may lead to tissue injury and this process is believed to play an important role in the progression of several diseases like chronic inflammation, atherosclerosis and some types of cancers. We have examined the effect of HOCl on human red blood cells (RBCs) under in vitro conditions. Treatment of RBC with different concentrations of HOCl (0.05–2.5 mM) at 37°C resulted in decreased activities of major antioxidant enzymes while the antioxidant power of RBC was weakened, as shown by lowered metal-reducing and free radical quenching ability of HOCl treated cells. RBC plasma membrane redox system was also inhibited suggesting membrane damage. The enzymes of glucose metabolism were inhibited indicating deranged energy metabolism. Electron microscopic images showed gross morphological changes in HOCl treated RBC. These results show that HOCl causes major alterations in the cellular antioxidant defense system and inhibition of glycolytic pathways, which increase the susceptibility of RBC to oxidative damage.
Value of C-reactive protein in differentiating viral from bacterial aetiologies in patients with non-malaria acute undifferentiated fever in tropical areas: a meta-analysis and individual patient data study
Authors: Otten Twan , de Mast Quirijn , Koeneman Bouke , Althaus Thomas , Lubell Yoel , van der Ven André 
Published: December 2020

Abstract
C-reactive protein (CRP) is used to discriminate common bacterial and viral infections, but its utility in tropical settings remains unknown. We performed a meta-analysis of studies performed in Asia and Africa. First, mean CRP levels for specific tropical infections were calculated. Thereafter, individual patient data (IPD) from patients with non-malarial undifferentiated fever (NMUF) who were tested for viral and bacterial pathogens were analysed, calculating separate cut-off values and their performance in classifying viral or bacterial disease. Mean CRP levels of 7307 patients from 13 countries were dengue 12.0 mg/l (standard error [SE] 2.7), chikungunya 41.0 mg/l (SE 19.5), influenza 15.9 mg/l (SE 6.3), Crimean–Congo haemorrhagic fever 9.7 mg/l (SE 4.7), Salmonella 61.9 mg/l (SE 5.4), Rickettsia 61.3 mg/l (SE 8.8), Coxiella burnetii 98.7 mg/l (SE 44.0) and Leptospira infections 113.8 mg/l (SE 23.1). IPD analysis of 1059 NMUF patients ≥5 y of age showed CRP &lt;10 mg/l had 52% sensitivity (95% confidence interval [CI] 48 to 56) and 95% specificity (95% CI 93 to 97) to detect viral infections. CRP &gt;40 mg/l had 74% sensitivity (95% CI 70 to 77) and 84% specificity (95% CI 81 to 87) to identify bacterial infections. Compared with routine care, the relative risk for incorrect classification was 0.64 (95% CI 0.55 to 0.75) and the number needed to test for one extra correctly classified case was 8 (95% CI 6 to 12). A two cut-off value CRP test may help clinicians to discriminate viral and bacterial aetiologies of NMUF in tropical areas.
Basic sanitation: a new indicator for the spread of COVID-19?
Authors: Silva Renata R , Ribeiro Caique J N , Moura Tatiana R , Santos Márcio B , Santos Allan D , Tavares Débora S , Santos Priscila L 
Published: December 2020

Abstract

Background
Basic sanitation could be a potential indicator of the spread of coronavirus disease-2019 (COVID-19) and, in this context, space-time patterns are important tools with which to elucidate the spread of disease and identify risk factors. The aim of this study was to assess a possible association between basic sanitation indices and COVID-19 rates in all the 5570 municipalities of Brazil and its spatial distribution.

Methods
Data of COVID-19 cases registered in Brazil from 28 February until 31 May 2020 and independent variables associated with basic sanitation were included.

Results
High incidence rates were significantly associated with precarious water service index (0–25% coverage) and offstandard faecal coliforms index for tap water (5–50% and 75–100% of samples tested). A significant association between high mortality rates and sewage collection (0–25% coverage)/treatment (25–50% coverage) indices was also verified. In addition, clusters with significant spatial autocorrelation were identified mainly in the North and Northeast regions for mortality and incidence rates (high-high risk areas) and for offstandard faecal coliforms index. Those regions are considered the poorest in Brazil, presenting with low incomes, human agglomerations, as well as a poor basic sanitation system, which also hinder the implementation of COVID-19-preventative measures.

Conclusions
A precarious basic sanitation infrastructure could potentially be associated with the high transmission of severe acute respiratory syndrome coronavirus-2 in Brazil.
Direct Oral Anticoagulants Versus Vitamin-K Antagonist After PCIs in Patients With AF: A Meta-analysis of Cardiac Ischemic Events
Authors: Cordero Alberto , Ferreiro José L. , Bertomeu-González Vicente , Rodríguez-Mañero Moisés , Fácila Lorenzo , Escribano David , Sanchez-Recalde Angel , Zuazola Pilar , Ruiz-Nodar Juan M. , González-Juanatey Jose R. 
Published: December 2020

Background:
Clinical trials have assessed the effect of direct oral antagonists (DOACs) in patients with atrial fibrillation (AF) after percutaneous coronary interventions (PCI). Studies were designed to test the effect on bleeding incidence, but concerns related to safety on ischemic events remain.

Methods:
We performed a meta-analysis with currently available studies involving DOACs versus Vitamin-K antagonist (VKA) in patients with AF after PCI. The primary endpoint was the incidence of cardiac ischemic events, including myocardial infarction and stent thrombosis. Secondary endpoints were the incidence of stroke, all-cause mortality, and major bleeding.

Results:
Eleven thousand twenty-three patients were included in the analysis: 5510 receiving DOACs and 5513 VKA. A total of 190 cases of myocardial infarction were registered in patients treated with DOACs and 177 in patients on VKA, and no statistical difference was noted [relative risk (RR): 1.07 95% confidence interval (CI) 0.88–1.31]. The incidence of stent thrombosis was very low with no differences between both treatment strategies (RR: 1.14 95% CI 0.76–1.71). The incidence of cardiac ischemic events was the same in patients receiving DOACs or VKA (HR 1.09 95% CI 0.91–1.30). No differences were observed in the incidence of stroke (RR: 0.86 95% CI 0.61–1.23) or mortality (RR: 1.09, 95% CI 0.90–1.31). Treatment with DOACs was associated with 34% reduction in major bleeding (RR: 0.66, 95% CI 0.54–0.81).

Conclusions:
Treatment with DOACs in patients with AF after a PCI do not increase the risk of cardiac ischemic events, stroke, or death and reduce the incidence of major bleeding by 34% as compared with VKA.
Sexual behaviors and function during menopausal transition—does menopausal hormonal therapy play a role?
Authors: Nowosielski Krzysztof , Sidorowicz Marcin 
Published: December 2020

Abstract

Objectives:
The menopausal transition is a biological adaptation to the variety of life changes (body, comorbidities, relationship), but that biology is not an “end all” in the context of sexual function and overall sexual health. The aim of this study is to evaluate determinants altering the risk of female sexual dysfunction (FSD) and other sexual problems and to establish whether menopausal hormonal therapy (MHT) decreases that risk and modifies sexual behaviors.

Methods:
A cross-sectional observational study was conducted in 210 women between the ages of 45 and 55. Two groups were identified: MHT users (n = 107) and controls—MHT non-users (n = 103). Diagnostic and Statistical Manual of Mental Disorders -five criteria were used to assess sexual dysfunction. Sexual problems were evaluated by the Changes in Sexual Function Questionnaire (CSFQ), body image by Body Exposure during Sexual Activity Questionnaire, and quality of relationship by the Well-Match Relationship Questionnaire. Logistic regression was used to determine the risk factors for FSD and sexual problems.

Results:
Women using MHT had higher body esteem during sexual activities, better sexual function (CSFQ) in all domains except desire/interest, better quality of relationship, and lower prevalence of FSD and sexual complaints (CSFQ) except arousal/excitement problems. However, self-rated effects of MHT on sexual behaviors showed that MHT did not play a major role. Women with secondary and higher education (OR = 0.09, CI: 0.02-0.4; P < 0.01 and OR = 0.2, CI: 0.05-1.0; P < 0.05, respectively) and with a higher number of lifetime sexual partners (OR = 0.6, CI: 0.4-0.9; P < 0.01) were less likely to have FSD. In contrast, individuals with more anxious behaviors during sexual activity (OR = 3.2, CI: 1.3-7.3; P < 0.01) and with more severe menopausal symptoms (OR = 1.1, CI: 1.0-1.2; P < 0.001) were more likely to have FSD. Using MHT was not associated with that risk nor with sexual function.

Conclusion:
In women during menopausal transition, sexual behaviors were different in MHT users compared with non-users. However, in this cross-sectional observational study conducted in 210 women between the ages of 45 to 55 years, using MHT was not associated with modification of sexual function, decreasing the risk of sexual dysfunction, nor sexual problems.

Video Summary:

http://links.lww.com/MENO/A688.
Inverse association between dietary fiber intake and depression in premenopausal women: a nationwide population-based survey
Authors: Kim Yunsun , Hong Minseok , Kim Seonah , Shin Woo-young , Kim Jung-ha 
Published: December 2020

Abstract

Objective:
Depression is among the most common neuropsychiatric disorders, and its prevalence is twofold higher in women than in men. This study aimed to investigate the relationship between dietary fiber intake and depression in women by menopause status using data from a nationwide population-based survey conducted in Korea.

Methods:
We utilized the Korea National Health and Nutritional Examination Survey data for 2014, 2016, and 2018 with a complex sampling design. Dietary fiber intake was calculated according to the 24-hour recall method, and we used Patient Health Questionnaire-9 scores to assess depression. A t test based on the general linear model was used to compare mean dietary fiber intake according to the presence of depression by menopause status. A logistic regression analysis was conducted to compute the odds ratio for depression according to the gradually adjusted model.

Results:
This study included 5,807 women. Among the premenopausal women, dietary fiber intake was higher in the nondepression group than in the depression group (P < 0.001), while there was no significant difference among postmenopausal women. Accordingly, among the premenopausal women, a significantly inverse relationship was observed between a change in daily dietary fiber intake as 1 g/1,000 kcal and the prevalence of depression in the fully adjusted model with an odds ratio of 0.949 (95% confidence interval, 0.906-0.993; P = 0.03). However, among the postmenopausal women, this significant association was not observed.

Conclusions:
Dietary fiber intake was inversely associated with depression in premenopausal but not postmenopausal women.
Trabecular Microbypass Stent and Phacoemulsification in African American Patients With Open-angle Glaucoma: Outcomes and Effect of Prior Laser Trabeculoplasty
Authors: Bargoud Albert R. , Lira Jennifer , An Selena , Walsman Scott M. , Herndon Leon W. , Khouri Albert S. 
Published: December 2020

Precis:
In African American patients with glaucoma, iStent/phacoemulsification lowered intraocular pressure and reduced glaucoma medication usage for up to 1 year, even in patients with prior selective laser trabeculoplasty (SLT).

Purpose:
Currently, no studies have examined the outcomes of a trabecular microbypass stent and phacoemulsification in African American patients. Here, the authors investigate whether iStent/phacoemulsification decreases intraocular pressure (IOP) and/or medication usage in African American patients with glaucoma. They are also interested in whether prior SLT would affect outcomes of iStent/phacoemulsification.

Patients and Methods:
A multicenter, retrospective case series of eyes that underwent iStent/phacoemulsification between 2013 and 2017 with up to 1-year follow-up. Eyes with a confirmed diagnosis of glaucoma in African American patients were included. Eyes with neovascular glaucoma or closed angle glaucoma and eyes that underwent previous incisional glaucoma surgery were excluded.

Results:
Eighty-nine eyes were included in the study and data for 66 eyes were available at postoperative year 1 (POY1). IOP decreased from 18.3±5.7 mm Hg to 15.9±4.6 (P<0.001) and glaucoma medication usage decreased from 1.9±1.1 to 1.1±1.1 (P<0.001) at POY1. Eyes that underwent prior SLT experienced less of a decrease in IOP when compared with eyes without prior SLT, but IOP at POY1 was not significantly different between these groups. Both groups had a similar reduction in medication usage. The most common complications were IOP spikes on postoperative day 1 and microhyphemas.

Conclusions:
In this cohort, there was a significant decrease in IOP and medication usage 1 year after iStent/phacoemulsification. iStent/phacoemulsification is an effective and safe treatment option in African American patients with glaucoma.
Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses of Treatments for Glaucoma
Authors: Okonya Ochije , Lai Elaine , Ottwell Ryan , Khattab Mostafa , Arthur Wade , Khaimi Mahmoud A. , Wright Drew N. , Hartwell Micah , Vassar Matt 
Published: December 2020

Purpose:
Spin—the misrepresentation of the study’s actual findings—carries the ability to distort a reader’s perception of a treatments’ full benefits and risks. Recent studies have suggested that spin is common in abstracts of randomized controlled trials and systematic reviews focused on treatments for a variety of medical disorders. Therefore, our primary objective was to evaluate the prevalence of spin in the abstracts of systematic reviews and meta-analyses related to glaucoma treatments. We further assessed whether specific study characteristics were associated with spin, including the methodological quality of a study.

Patients and Methods:
We used a cross-sectional study design searching MEDLINE and Embase databases all for systematic reviews and meta-analyses focused on glaucoma treatments. Each abstract was assessed for the 9 most severe—severity determined by the likelihood of distorting a reader’s perception—types of spin that occur in systematic review abstracts. The screening and data extraction was performed in a duplicate, masked fashion. The methodological quality of each review was assessed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) instrument. To evaluate relationships between spin, AMSTAR-2 appraisals, and other study characteristics, we used unadjusted odds ratios and the Fisher exact test.

Results:
Only 3 of the 102 abstracts contained spin, with spin type 5 being the most prevalent. No abstracts contained spin types 1, 2, 3, 4, 6, or 8, and no association was found between the presence of spin in an abstract and any particular study characteristic. Using the AMSTAR-2 quality appraisal instrument, 35 (34.3%) of the studies received a methodological quality rating as high, 42 (41.2%) as moderate, 11 (10.8%) as low, and 14 (13.7%) as critically low.

Conclusions:
We found that spin is present in only a small proportion of systematic reviews and meta-analyses covering the treatment of glaucoma. In comparison to studies in other fields of medicine, ophthalmology appears to be a leader in publishing systematic reviews and meta-analyses with low rates of spin occurring in the abstract.
Metabolic effects of cross-sex hormone therapy in transgender individuals in Taiwan
Authors: Liu Yu-Hsien , Wu Tsung-Hui , Chu Chia-Huei , Lin Yi-Chun , Lin Liang-Yu 
Published: December 2020

Background:
Transgender individuals often require gender-affirming interventions, such as endogenous sex hormone inhibition or gender-affirming hormone therapy (HT), while there is discordance between their body and gender identity. However, a recent study found that the incidence of cardiovascular events is higher in transgender patients receiving cross-sex HT. The aim of this study was to investigate the metabolic effects of an altered sex hormone profile.

Methods:
This retrospective study, conducted in a referral center in Northern Taiwan, analyzed metabolic changes over time in 65 trans masculine and 45 trans feminine persons. The transgender individuals were examined at 4 time points: before the gender affirming HT, as well as 3, 6, and 12 months following treatment.

Results:
Compared with baseline measurements, the trans masculine patients showed significant increases in body mass index (BMI) (22.6 ± 0.3 vs 23.3 ± 0.4 kg/m2; p < 0.001; t = 3M), low-density lipoprotein cholesterol (124.3 ± 3.7 vs 131.3 ± 3.9 mg/dL; p = 0.03; t = 12M), creatinine (0.75 ± 0.01 vs 0.83 ± 0.14 mg/dL; p < 0.001; t = 12M), and hemoglobin (13.5 ± 0.7 vs 15.2 ± 0.2 g/dL; p < 0.001; t = 12M), as well as decreased high-density lipoprotein cholesterol (57 ± 2.1 vs 51 ± 2.0 mg/dL; p < 0.001; t = 12M). The trans feminine patients had reduced low-density lipoprotein cholesterol (104.2 ± 3.2 vs 100.8 ± 3.5 mg/dL; p = 0.05; t = 3M), hemoglobin (14.0 ± 0.1 vs 13.5 ± 0.1 g/dL; p = 0.008; t = 12M), and creatinine (0.82 ± 0.01 vs 0.79 ± 0.14 mg/dL; p < 0.001; t = 3M) compared with baseline data. In addition, most of these metabolic effects persisted during the follow-up period.

Conclusion:
This observational, retrospective study revealed that gender-affirming HT increased the relative cardiovascular risk in trans masculine individuals.
The application of a 70° endoscope in performing transcanal middle ear surgery
Authors: Ting Kuan-Chung , Tu Tzong-Yang 
Published: December 2020

Background:
Endoscopes increase the expediency of transcanal middle ear surgery. However, the application of a 70° endoscope is limited and seldom discussed, mainly because of its large angle. We introduce our experiences with the 70° endoscope in transcanal middle ear surgery.

Methods:
This is a retrospective chart review of 127 patients with chronic otitis media who underwent middle ear surgery performed by the senior author in 2016 at a tertiary referral center. The types of eardrum perforation were classified as central, inferior, posterior, or anterior according to the main location of the hole. The demographics, surgical pictures, and operative records were reviewed.

Results:
In 15 ears of the 127 patients, the ossicles were recognized directly by a microscope. In another 112 ears, the ossicles could not be identified under a microscope. Without elevating the tympanomeatal flap, the ossicles could be recognized in 72 of these 112 ears with endoscopes, especially the 70° endoscope. In 35 of these 112 ears, an incision to extend the drum perforation or creation of a small tympanomeatal flap in the posterior-superior canal was made to observe the ossicles. However, 5 of these 112 ears were still noted to have a narrow and/or curved ear canal and preoperatively needed to undergo endaural incisions. Among the other 122 patients who first underwent attempted transcanal surgery, 15 ears changed to endaural incisions. The drum perforations were repaired directly through the perforation in 107 ears via the transcanal route. One year after surgery, the air-bone gap closure was 16.0 ± 11.8 dB, and the graft take rate was 91.3%.

Conclusion:
With the help of a 70° endoscope, we can use the transcanal transperforation route to evaluate and reconstruct drum perforations and ossicular chains in appropriate patients. Hence, normal tissue injuries to the ear canal can be minimized.
A Physician's Guide for Workers’ Return to Work During COVID-19 Pandemic
Authors: Baptista Marcos C. , Burton Wayne N. , Pawlecki Brent , Pransky Glenn 
Published: December 2020

Objective:Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures.Methods:A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk.Results:The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars.Conclusions:A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.