bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual dysfunction in Egyptian females with systemic lupus erythematosus: a cross sectional study
Authors: Dorgham Dalia , Haggag Hisham M , Attia Doaa HS 
Published: July 2020

Objectives Sexual dysfunction in systemic lupus erythematous (SLE) patients is an important issue to be tackled. We aimed to study the prevalence of sexual dysfunction in SLE women and detect its association with depression, functional disability and quality of life. Methods This study included 94 SLE females. Ninety-eight control females agreed to participate. Patients and controls answered a written form of the Arabic version of the Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Health Assessment Questionnaire–Disability Index (HAQ-DI) and Short Form 36 (SF-36). Disease activity and damage were assessed using the SLE Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Results The frequency of sexual dysfunction was similar in the patients and control groups (77.7% versus 82.7%) while the BDI, HAQ-DI and SF-36 scores were significantly worse in SLE patients. SLE patients with and without sexual dysfunction differed in neither disease characteristics nor disease activity and damage indices. The FSFI showed a strong positive correlation with SF-36, and strong inverse correlations with BDI and HAQ-DI in the patients group while it had a weaker positive correlation with SF-36 and no correlations with the other two indices in the control group. Conclusion No significant difference was found in the prevalence of sexual dysfunction between SLE patients and controls. Sexual dysfunction in SLE patients is mostly related to depression, poor functional status, increased pain, poor health perception and bad quality of life. Neither disease activity nor damage contributes significantly to sexual dysfunction in lupus females.
Electroacupuncture ameliorates corticotrophin-releasing factor-induced jejunal dysmotility in a rat model of stress
Authors: Zhao Yu-Xue , Cui Chang-Xiang , Gao Jun-Hong , Liu Jun , Liu Qun , Lu Feng-Yan , Xin Juan-Juan , Yu Xiao-Chun , Zhu Bing 
Published: July 2020

Background Central injection of corticotrophin-releasing factor (CRF) mimics the effect of stress on gastrointestinal (GI) responses, including inhibition of GI motility. This study was designed to explore the effects of electroacupuncture (EA) on disordered jejunal motility in a rat model of stress induced by intracisternal (IC) injection of CRF. Methods A stress model was established by IC injection of CRF in Sprague–Dawley rats. GI motility was evaluated by assessing gastric emptying (GE), gastrointestinal transit (GIT) and jejunal motility in vivo. EA was performed at ST36. The functional roles of CRF receptor subtype 1 and subtype 2 (CRFr1 and CRFr2) were examined by IC administration of the corresponding selective CRF antagonists. Protein expression of CRFr1 and CRFr2 in the hypothalamus and jejunum was detected by Western blotting. Results IC injection of CRF significantly inhibited GE, GIT and jejunal motility. EA treatment remarkably improved the disturbed GI motility. Intriguingly, the disordered jejunal motility induced by central CRF was abolished by IC injection of a selective CRFr2 antagonist, indicating the essential role of central CRFr2 in mediating the stress-induced jejunal motor disorder. EA at ST36 decreased central and peripheral expression of CRFr2, which might be one of the potential mechanisms underlying the beneficial effect of EA on jejunal dysmotility in this rat model of stress. Conclusion This study suggested that EA at ST36 could ameliorate disordered jejunal motility induced by stress, and that this might be associated with the down-regulation of CRFr2.
Longitudinal Medication Adherence in Older Adults With Multimorbidity and Association With Health Care Utilization: Results From the Irish Longitudinal Study on Ageing
Authors: Walsh Caroline A. , Cahir Caitriona , Bennett Kathleen E. 
Published: July 2020

Background: The association between objectively measured nonadherence and health care utilization in multimorbid older people is unclear. Objective: To measure medication adherence across multiple chronic conditions, identify adherence patterns, and estimate the association between adherence and self-reported health care utilization. Methods: This is a retrospective cohort study of multimorbid participants aged ≥70 years in the Irish LongituDinal Study on Ageing (TILDA). Eligible participants had linked pharmacy claims data and completed TILDA wave 2 (2 years after wave 1). The RxRisk-V tool was used to identify multimorbidity. Average adherence (AA) across RxRisk-V conditions was estimated using the CMA7 function (AdhereR). Group-based trajectory models (GBTMs) identified adherence patterns in the 12 months following wave 1. Negative binomial regression was used to estimate the association between adherence and the rate of subsequent self-reported general practitioner [GP] visits, emergency department (ED) visits, outpatient visits, and hospitalizations in the 12 months following adherence measurement (reported at wave 2). Adjusted Incident Rate Ratios (aIRR) and 95% CIs are presented. Results: Higher AA (CMA7) was associated with a small significant decrease in GP visit rate (aIRR = 0.70; CI = 0.53-0.94) and outpatient visit rate (aIRR = 0.44; CI = 0.23-0.81). GBTM identified 6 adherence groups (n = 1050). Compared with high adherers, group 1 (rapid decline, modest increase) membership (aIRR = 1.72; CI = 1.09-2.73) and group 4 (high adherence, delayed decline) membership (aIRR = 1.92; CI = 1.19-3.05) significantly increased ED visit rate. Conclusion and Relevance: Suboptimal medication adherence in multimorbid older adults is associated with increased health care utilization. Identification of suboptimal adherence groups for medication management interventions may help decrease the health system burden and health care costs.
Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis
Authors: Zhang Wei , Li Xinyi , Li Xiaojing 
Published: July 2020

Background Scars with poor cosmesis that develop after wound healing may affect normal life. Objective To assess the efficacy and safety of botulinum toxin type A (BTXA) in preventing postoperative hypertrophic scars or keloids. Methods A systematic review was performed by searching the PubMed, Cochrane Library, and EMBASE databases from their inception date up to February 2020 for randomized controlled trials (RCTs) evaluating the efficacy of BTXA in preventing hypertrophic scars or keloids. The primary outcome measures included the Vancouver Scar Scale (VSS) score, Visual Analog Scale (VAS) score, scar width, patient satisfaction, and adverse events. Results Twelve RCTs involving 497 cases (372 patients) were included. The meta-analysis showed significant differences in the VAS score (weighted mean difference [WMD] = 1.31, 95% CI = 1.06 to 1.55, P < .00001), VSS score (WMD = −1.02, 95% CI = −1.72 to −0.32, P = .004), scar width (WMD = −0.18, 95% CI = −0.29 to −0.08, P = .0008), and patient satisfaction (relative risk = 1.25, 95% CI = 1.06-1.49, P = .01). Four studies reported trivial adverse events. Conclusions This meta-analysis showed that BTXA was more effective than the control treatment in preventing postoperative scars and improving the cosmetic appearance of facial scars for East Asians, and no serious adverse events were found during the follow-up period. However, there was insufficient evidence to support the use of BTXA for the prevention of scars in patients from other ethnic groups and regions or scars in non-facial areas.
Carers Create: Carer perspectives of a creative programme for people with dementia and their carers on the relationship within the (carer and cared-for) dyad
Authors: Skingley Ann , Billam Diane , Clarke David , Hodges Rona , Jobson Isabella , Jobson Roger , Moore Jacky , Vella-Burrows Trish , Vickers Pamela , Walker Jo , West Helen 
Published: July 2020

Introduction Relationships between people with dementia and their carers can prove challenging over the trajectory of the disease. Interventions with a potential to address this include arts and music-based activities. This research project aimed to evaluate a community engagement programme (Carers Create) where both people with dementia and their carers participate together in singing and other activities. A specific focus was on the impact of the sessions on the dyadic relationship. Methods A grounded theory approach involved conducting three focus group interviews with carers of people with dementia ( n = 16) facilitated by members of a local U3A (University of the Third Age) who were trained and supported by university researchers. Recorded conversations were transcribed and analysed using a three-stage coding and thematic development technique. Results Four overarching themes were identified from the discourse: remembering the positive qualities of the cared-for, the physical and emotional demands of caring, Carers Create as a shared, beneficial activity and the enduring value of Carers Create. Conclusion Carers found the sessions to positively influence the relationship with the person they cared for through offering some relief from the day-to-day pressures of caring and, in some cases, restoring elements of a previously strong relationship. Crucial to the experience was the fact that the sessions included both carer and cared-for, offering activities to do together, and that they took place within a group, thereby offering a degree of mutual support. In addition, some carers were able to build on learning which had taken place and use certain techniques, such as singing, to help manage care, thus extending the improved relationship.
Poor Prognosis Biomolecular Factors Are Highly Frequent in Childhood Acute Leukemias From Oaxaca, Mexico
Authors: Juárez-Avendaño Gerardo , Luna-Silva Nuria Citlalli , Chargoy-Vivaldo Euler , Juárez-Martínez Laura Alicia , Martínez-Rangel Mayra Noemí , Zárate-Ortiz Noemí , Martínez-Valencia Edith , López-Martínez Briceida , Pelayo Rosana , Balandrán Juan Carlos 
Published: July 2020

Objective: To investigate the cellular and molecular epidemiology of acute leukemias in vulnerable populations of children and adolescents in Oaxaca de Juarez, Mexico. Material and Methods: Descriptive, cross-sectional and retrospective study, conducted from 2014 to 2018 in which profiles of molecular and immunophenotypic aberrations were investigated in children and adolescents diagnosed with acute leukemia, by evaluating 28 molecular abnormalities by HemaVision-Q28 multiplex RT-PCR kit and standardized EuroFlow Immunophenotyping of bone marrow cells. Results: We included 218 patients, with 82.5% younger than 14 years and 17.5% adolescents. The median age was 9 years and a main peak of incidence was recorded at age of 4 to 5 years. B-cell acute lymphoblastic leukemia was diagnosed in 70.64% of all cases, acute myeloid leukemia was in 22.48%, T-cell acute lymphoblastic leukemia in 6.42%, and mixed lineage acute leukemia in 0.46% of cases. Overall, chromosomal translocations were positive in 29.82% of cases. While 65.31% of patients with acute myeloid leukemia reported aberrancies, only in 18.83% of B-cell acute lymphoblastic leukemia cases genetic abnormalities were obvious. Surprisingly, most prevalent translocations in B-cell acute lymphoblastic leukemia were t(9;22) in 20.7%, followed by t(4;11) in 17.2% and t(6;11) in 13.8%, whereas patients with acute myeloid leukemia showed t(15;17) in 40.6% and t(8;21) in 21.9%. In contrast, an homogeneous expression of t(3;21) and t(6;11) was recorded for T-cell acute lymphoblastic leukemia and mixed lineage acute leukemia cases, respectively. Except for t(1;19), expressed only by pre-B cells, there was no association of any of the studied translocations with differentiation stages of the B-leukemic developmental pathway. Conclusion: Our findings identify near 50% of patients with acute lymphoblastic leukemia at debut with high-risk translocations and poor prognosis in B-cell acute lymphoblastic leukemia as well as an unexpected increase of acute myeloid leukemia cases in young children, suggesting a molecular shift that support a higher incidence of poor prognosis cases in Oaxaca.
Real-Time Fluorescence Imaging Using Indocyanine Green to Assess Therapeutic Effects of Near-Infrared Photoimmunotherapy in Tumor Model Mice
Authors: Rosenberg Adrian , Fujimura Daiki , Okada Ryuhei , Furusawa Aki , Inagaki Fuyuki , Wakiyama Hiroaki , Kato Takuya , Choyke Peter L. , Kobayashi Hisataka 
Published: July 2020

Background: Near-infrared photoimmunotherapy (NIR-PIT) is a cancer therapy that causes an increase in tumor perfusion, a phenomenon termed the super-enhanced permeability and retention effect. Currently, in vivo treatment efficacy of NIR-PIT is observable days after treatment, but monitoring would be improved by more acute detection of intratumor change. Fluorescence imaging may detect increased tumor perfusion immediately after treatment. Methods: In the first experiment, athymic nude mouse models bearing unilateral subcutaneous flank tumors were treated with either NIR-PIT or laser therapy only. In the second experiment, mice bearing bilateral flank tumors were treated with NIR-PIT only on the left-sided tumor. In both groups, immediately after treatment, indocyanine green was injected at different doses intravenously, and mice were monitored with the Shimadzu LIGHTVISION fluorescence imaging system for 1 hour. Results: Tumor-to-background ratio of fluorescence intensity increased over the 60 minutes of monitoring in treated mice but did not vary significantly in control mice. Tumor-to-background ratio was highest in the 1 mg kg−1 and 0.3 mg kg−1 doses. In mice with bilateral tumors, tumor-to-untreated tumor ratio increased similarly. Conclusions: Acute changes in tumor perfusion after NIR-PIT can be detected by real-time fluorescence imaging.
Functional status as a marker of need for hospital admission following outpatient hernia repair
Authors: Reeves J Jeffery , Mannix Emily , Burton Brittany N , Gabriel Rodney A , Waterman Ruth S 
Published: July 2020

Introduction The careful selection of patients for hernia repair in ambulatory surgery centres is critical to prevent unanticipated inpatient admissions. The aim of this study was to evaluate risk factors associated with inpatient admission. Methods A multivariable logistic regression was performed utilising the ACS NSQIP database from 2007 to 2016. The primary outcome was same-day hospital discharge. The primary exposure variable was preoperative functional status. Additional covariates included sex, obesity, age, smoking status, steroid use, dyspnoea, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, hypertension, bleeding disorder, dialysis-dependence and American Society of Anesthesiologists classification score. Results A total of 194,822 patients underwent hernia repair in the outpatient setting; 8705 (4.5%) required hospital admission. The variables with the most significantly increased odds for hospital admission were partially dependent and totally dependent preoperative functional status. Conclusion A non-independent baseline functional status is the strongest predictor of need for admission following outpatient hernia repair.
Outbreak investigation of Candida auris at a tertiary care hospital in Karachi, Pakistan
Authors: Farooqi Joveria Q , Soomro Asad S , Baig Mirza A , Sajjad Shamoona F , Hamid Kamran , Jabeen Kauser , Naqvi Mohammed F , Nasir Nosheen , Roshan Rozina , Mahmood Syed F , Zafar Afia , Asghar Rana J 
Published: July 2020

Background: From September 2014, a tertiary care hospital in Karachi, Pakistan, started diagnosing 3–5 cases/month of a yeast locally identified as Saccharomyces spp. resistant to fluconazole. US Centers for Disease Control and Prevention identified the isolates as Candida auris. The Pakistan Field Epidemiology and Laboratory Training Program (FELTP) and the hospital investigated the outbreak from April 2015 to January 2016. Objective: The aim of the outbreak investigation was to determine the risk factors and to inform measures to limit the spread of the organism in the hospital. Methods: Medical records, nursing schedules and infection control practices were reviewed. Sixty-two age- and sex-matched hospital controls from the same wards were identified. Results: Thirty cases (17 males) were identified (mean age = 51.6 years, age range = 2–91 years), case fatality was 53%. Multivariate logistic regression showed that a history of surgery within 90 days of diagnosis, admission to the emergency department and history of chronic kidney disease were significantly associated with C. auris infection. Discussion: This is the report of the outbreak investigation that triggered a global exploration of C. auris as a newly identified multidrug-resistant nosocomial organism, spreading within the hospital, especially among patients with invasive procedures. Unfortunately, we could not identify any specific source of the outbreak nor stop the transmission of the organism.
The Nonoperative Instability Severity Index Score (NISIS): A Simple Tool to Guide Operative Versus Nonoperative Treatment of the Unstable Shoulder
Authors: Tokish John M. , Thigpen Charles A. , Kissenberth Michael J. , Tolan Stefan J. , Lonergan Keith T. , Tokish John M. , Dickens Jonathan F. , Hawkins Richard J. , Shanley Ellen 
Published: July 2020

Background: The management of the adolescent athlete after initial shoulder instability remains controversial. Hypothesis: Individual risk factors in athletes with shoulder instability who are managed nonoperatively can be integrated into a scoring system that can predict successful return to sport. Study Design: Retrospective cohort study. Level of Evidence: Level 4. Methods: A total of 57 scholastic athletes with primary anterior shoulder instability who were managed nonoperatively were reviewed. Success was defined as a return to index sport at the same level and playing at least 1 subsequent season without missed time as a result of the shoulder. Patient-specific risk factors were individually evaluated, and odds ratios were calculated. A 10-point Nonoperative Injury Severity Index Score (NISIS) incorporated the risk factors for failure. This score was then retrospectively applied with regression analysis and a chi-square analysis to determine the overall optimal score that predicted failure of nonoperative management. Results: In total, 6 risk factors for failure were included in the NISIS: age (>15 years), bone loss, type of instability, type of sport (contact vs noncontact), male sex, and arm dominance. Overall, 79% of patients treated nonoperatively were able to successfully return to sport. Nearly all (97%) low-risk patients (NISIS <7) successfully returned to sport, while only 59% of high-risk patients returned to sport, a relative risk of 12.2 ( P = 0.001). High-risk patients with unipolar bone loss successfully returned (100%), but 67% of high-risk patients with bipolar bone loss failed. Conclusion: The NISIS is a simple and effective clinical tool to determine successful nonoperative management following anterior shoulder instability and may be helpful in guiding decision making when presented with the unstable shoulder in the scholastic athlete.
Predictors of Biologic Use and Satisfaction Among Patients With Psoriasis: An Analysis and Geographic Visualization of the 2016 and 2017 National Psoriasis Foundation Annual Surveys
Authors: Enos Clinton W. , Galadima Hadiza , Saini Arjun D. , Bell Stacie , Siegel Michael , Van Voorhees Abby S. 
Published: July 2020

Background: There are an increasing number of biologic therapies approved for the treatment of psoriasis. Previous reports have identified undertreatment as a concern in the United States. Undertreatment has been associated with decreased patient satisfaction and increased morbidity. Objectives: Assess biologic use and satisfaction among respondents to the 2016 and 2017 National Psoriasis Foundation (NPF) Annual Surveys. Methods: Retrospective data analysis of the 2016 and 2017 NPF Annual Survey responses from individuals with psoriasis. ArcGIS Pro software was utilized to generate maps and perform an optimized hot spot analysis of moderate-to-severe psoriasis and biologic use. Results: There were 427 patients with psoriasis involving the skin alone. Biologics were used in <23% of respondents, while nearly 69% reported body surface area (BSA) >3%. Respondents with BSA <3% and 3% to 4% were less likely to be on biologic therapy (odds ratio [OR]: 0.29, 0.11-0.78 and OR: 0.22, 0.09-0.56, respectively). Nonbiologic users were more likely to be very unsatisfied with their treatment compared to those receiving biologic therapy (OR: 5.23, 2.80-9.75). With geographic information systems (GIS), counties with increased moderate-to-severe disease were identified in the southeastern United States. Conclusion: Despite the increasing number of Food and Drug Administration–approved biologic medications, the proportion of respondents on biologic therapy remained small. Treatment with biologics correlated with less residual disease and increased satisfaction. Geographic variation in state legislation as well as state and federal health insurance did not impact biologic use. However, using GIS, we identify a greater burden of moderate-to-severe disease among respondents in the Southeastern United States and a lack of commensurate use of biologics in those areas.
Dasatinib induces a dramatic response in a child with refractory juvenile xanthogranuloma with a novel MRC1-PDGFRB fusion
Authors: Eissa Shaimaa S. , Clay Michael R. , Santiago Teresa , Wu Gang , Wang Lu , Shulkin Barry L. , Picarsic Jennifer , Nichols Kim E. , Campbell Patrick K. 
Published: July 2020

Key Points
Juvenile xanthogranuloma (JXG) usually presents with lesions isolated to the skin; however, aggressive, disseminated forms also occur. Identification of a novel MRC1-PDGFRB fusion in a child with JXG guided targeted therapy with dasatinib, leading to a dramatic response.
Doxorubicin-loaded hollow gold nanospheres for dual photothermal ablation and chemoembolization therapy
Authors: Sheth Rahul A. , Wen Xiaoxia , Li Junjie , Melancon Marites P. , Ji Xin , Andrew Wang Y. , Hsiao Cheng-Hui , Chow Diana S.-L. , Whitley Elizabeth M. , Li Chun , Gupta Sanjay 
Published: July 2020

Abstract
Background
Doxorubicin-loaded hollow gold nanospheres (Dox@HAuNS) are a promising technology for simultaneous trans-arterial tumor-targeted chemotherapy delivery and thermal ablation. We evaluated the efficacy of intra-arterial delivery of Dox@HAuNS followed by photothermal ablation (PTA) in a rabbit model of liver cancer. Adult New Zealand white rabbits (N = 25) were inoculated with VX2 tumors into the left lobe of the liver. The animals were then randomized to sham surgery (N = 5), PTA only (N = 3), Dox@HAuNS only (N = 5), HAuNS + PTA (N = 5), and Dox@HAuNS + PTA (N = 7). Nanoparticles were delivered as an emulsion with Lipiodol (Guerbet, France) via a trans-arterial approach. Following nanoparticle delivery, PTA was performed using an 808-nm fibered laser at 1.5 W for 3 min. Thermography during PTA demonstrated a sustained elevation in tumoral temperature in both HAuNS + laser and Dox@HAuNS + laser treatment groups relative to animals that underwent laser treatment without prior nanoparticle delivery.

Results
There was a significant decrease in tumor volumes in all three treatment arms relative to control arms (P = 0.004). Concentrations of intratumoral doxorubicin were significantly greater in animals treated with laser compared to those that were not treated with laser (P < 0.01).

Conclusions
Doxorubicin-loaded HAuNS is a promising therapeutic agent for dual ablation/chemoembolization treatment of liver cancer.