bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relevant domains and outcome measurement instruments in neuropsychiatric systemic lupus erythematosus: a systematic literature review
Authors: Silvagni Ettore , Chessa Elisabetta , Bergossi Francesca , D’Amico Maria Ester , Furini Federica , Guerrini Giulio , Cauli Alberto , Scirè Carlo Alberto , Bertsias George , Govoni Marcello , Piga Matteo , Bortoluzzi Alessandra 
Published: March 2021

Abstract

Objectives
Although neuropsychiatric involvement in SLE (NPSLE) is one of the most complex and troubling manifestations of the disease, validated outcome instruments to be used as sensitive endpoints in controlled clinical trials are lacking. We performed a systematic literature review (SLR) to identify outcome measurement instruments and domains used to assess NPSLE.

Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used. Articles available in English (1967–2020), listed in PubMed, Embase, PsycINFO, Cochrane Library and the EULAR outcome measures library were screened. All domains and outcome measurement instruments were characterized according to the OMERACT Filter 2.1, considering core areas (manifestations/abnormalities, life impact, death/lifespan, societal/resource use) and contextual factors.

Results
Of 3392 abstracts evaluated, 83 studies were included in the SLR (15 974 patients, females 89.9%). Eligible studies included domains and instruments pertinent to all core areas defined by the OMERACT, except for ‘societal/resource use’. The most common core areas were ‘manifestations/abnormalities’, covering 10 domains pertinent to laboratory and instrumental markers, indexes and neuropsychiatric dimension (cognitive, neurologic and psychiatric field), and ‘life impact’, covering 7 domains related to physical function (from both the perspective of the patient and the physician), pain and quality of life.

Conclusion
Our study revealed great heterogeneity in the instruments derived from populations with NPSLE and none of these had high-quality evidence. This supports the need to develop and further validate a core domain set and outcome measurement instruments to promote clinical research in this field, enhancing comparability across studies.
Labor’s Capital and Worker Well-Being: Do US Pension Funds Benefit Labor Interests?
Authors: Liu Larry , Goldstein Adam 
Published: March 2021

Abstract
Since the 1980s, the shareholder value revolution has undermined the position of workers and organized labor within US firms. At the same time, workers have paradoxically become one of the largest classes of shareholders through labor pension funds (LPF), including state public employee funds and private sector union-affiliated funds. Does workers’ concentrated ownership of capital in LPF represent a mechanism to advance worker interests against the prevailing wage, benefit, and jobs squeeze in publicly traded firms? This article links data on US state pension funds’ investments and shareholder activism to firm-level data on work and employment outcomes from 2001–2016. LPF shareholder proposals targeting large firms have declined over time. However, panel regression models show that intra-firm mobilization by LPF in the form of shareholder proposals is associated with modestly improved worker outcomes. There is no evidence that greater ownership share by public pension funds (PPF) is associated with more labor-friendly outcomes. This null association obtains even when focusing only on ownership by the most socially activist funds, or those from Democrat-controlled states. Nor does PPF ownership buffer workers from the negative impact of extractive hedge funds. Together, the results help reconcile contending accounts of pension fund capitalism’s effects on worker well-being. The analysis contributes to the sociological study of financialization, corporate governance, work and employment, and labor movements.
HIV increases sleep-based brain age despite antiretroviral therapy
Authors: Leone Michael J , Sun Haoqi , Boutros Christine L , Liu Lin , Ye Elissa , Sullivan Lee , Thomas Robert J , Robbins Gregory K , Mukerji Shibani S , Westover M Brandon 
Published: March 2021

AbstractStudy ObjectivesAge-related comorbidities and immune activation raise concern for advanced brain aging in people living with HIV (PLWH). The brain age index (BAI) is a machine learning model that quantifies deviations in brain activity during sleep relative to healthy individuals of the same age. High BAI was previously found to be associated with neurological, psychiatric, cardiometabolic diseases, and reduced life expectancy among people without HIV. Here, we estimated the effect of HIV infection on BAI by comparing PLWH and HIV− controls.MethodsClinical data and sleep EEGs from 43 PLWH on antiretroviral therapy (HIV+) and 3,155 controls (HIV−) were collected from Massachusetts General Hospital. The effect of HIV infection on BAI, and on individual EEG features, was estimated using causal inference.ResultsThe average effect of HIV on BAI was estimated to be +3.35 years (p &lt; 0.01, 95% CI = [0.67, 5.92]) using doubly robust estimation. Compared to HIV− controls, HIV+ participants exhibited a reduction in delta band power during deep sleep and rapid eye movement sleep.ConclusionWe provide causal evidence that HIV contributes to advanced brain aging reflected in sleep EEG. A better understanding is greatly needed of potential therapeutic targets to mitigate the effect of HIV on brain health, potentially including sleep disorders and cardiovascular disease
Clinical Uncertainty and Equipoise in the Management of Recurrent Glioblastoma
Authors: Patel Mukt , Au Karolyn , Davis Faith G. , Easaw Jacob C. , Mehta Vivek , Broad Robert , Chow Michael M.C. , Hockley Aaron , Kaderali Zul , Magro Elsa , Nataraj Andrew , Scholtes Felix , Chagnon Miguel , Gevry Guylaine , Raymond Jean , Darsaut Tim E. 
Published: March 2021

Background:
A significant proportion of glioblastoma (GBM) patients are considered for repeat resection, but evidence regarding best management remains elusive. Our aim was to measure the degree of clinical uncertainty regarding reoperation for patients with recurrent GBM.

Methods:
We first performed a systematic review of agreement studies examining the question of repeat resection for recurrent GBM. An electronic portfolio of 37 pathologically confirmed recurrent GBM patients including pertinent magnetic resonance images and clinical information was assembled. To measure clinical uncertainty, 26 neurosurgeons from various countries, training backgrounds, and years’ experience were asked to select best management (repeat surgery, other nonsurgical management, or conservative), confidence in recommended management, and whether they would include the patient in a randomized trial comparing surgery with nonsurgical options. Agreement was evaluated using κ statistics.

Results:
The literature review did not reveal previous agreement studies examining the question. In our study, agreement regarding best management of recurrent GBM was slight, even when management options were dichotomized (repeat surgery vs. other options; κ=0.198 [95% confidence interval: 0.133-0.276]). Country of practice, years’ experience, and training background did not change results. Disagreement and clinical uncertainty were more pronounced within clinicians with (κ=0.167 [0.055-0.314]) than clinicians without neuro-oncology fellowship training (κ=0.601 [0.556-0.646]). A majority (51%) of responders were willing to include the patient in a randomized trial comparing repeat surgery with nonsurgical alternatives in 26/37 (69%) of cases.

Conclusion:
There is sufficient uncertainty and equipoise regarding the question of reoperation for patients with recurrent glioblastoma to support the need for a randomized controlled trial.
Modulation of Metacognitive Confidence Judgments Through Provision of Performance Feedback in Moderate to Severe Traumatic Brain Injury
Authors: Chiou Kathy S. , Klecha Holly , Jones Megan , Dobryakova Ekaterina 
Published: March 2021

Objective:
Traumatic brain injury (TBI) may result in metacognitive impairments. Enhancing memory in healthy adults can improve metacognitive accuracy, but it is unclear whether such interventions apply to individuals with TBI. This study examined the effects of manipulating target memory experiences on metacognitive accuracy in TBI.

Participants:
Fourteen community-dwelling adults with TBI and 17 healthy controls.

Main Measures:
Memory was manipulated through performance feedback (monetary, nonmonetary, or none) presented during a word-pair learning task. Recognition of the word pairs was assessed, and metacognition was evaluated by retrospective confidence judgments.

Results:
Both groups demonstrated greater recognition performance for items learned with nonmonetary feedback. Healthy individuals demonstrated improved metacognitive accuracy for items learned with nonmonetary feedback, but this effect was not seen in individuals with TBI. A notable (but statistically nonsignificant) effect was observed whereby adults with TBI overestimated performance for items learned with monetary feedback compared with other feedback conditions.

Conclusion:
Provision of feedback during learning enhances recognition performance. However, target memory experiences may be utilized differently after injury to facilitate confidence judgments. In addition, the type of feedback provided may have different effects on metacognitive accuracy. These results have implications for rehabilitative efforts in the area of memory and metacognition after injury.
Microsporidial Stromal Keratitis: Epidemiological Features, Slit-Lamp Biomicroscopic Characteristics, and Therapy
Authors: Matoba Alice , Goosey John , Chévez-Barrios Patricia 
Published: March 2021

Purpose:
Microsporidial stromal keratitis is a rare form of infectious keratitis, with only 7 cases reported in the United States to date. This study was performed to evaluate risk factors, clinical features, and response to therapy.

Methods:
A retrospective review of the medical records of all patients diagnosed with microsporidial stromal keratitis seen in the practices of the authors between 1999 and 2020 was performed. Diagnosis was determined by cytology or histopathology in corneal specimens. Risk factors, presence or absence of distinctive clinical features, and response to medical and surgical therapies were recorded.

Results:
Nine patients—7M:2F, aged 7 to 99 years—with microsporidial stromal keratitis were identified. Exposures to recreational water and hymenopteran insect bites, both epidemiologically linked risk factors for systemic microsporidial infection, were identified in our patients. Presence of stromal edema with features of disciform keratitis and a distinctive granular keratitis were observed in 6 of 9 and 5 of 9 patients, respectively. Poor response to medical therapy was noted. Penetrating keratoplasty was effective in curing the infection. Final visual acuity was 20/40 or better in 6 of 9 patients.

Conclusions:
In patients with slowly progressive keratitis, history of exposure to recreational water or hymenopteran insects should be sought. In patients with corneal edema consistent with disciform keratitis, with evolution to a granular keratitis, microsporidia should be considered in the differential diagnosis. In cases of established microsporidial stromal keratitis, penetrating keratoplasty should be considered if prompt response to medical therapy is not noted.
Ophthalmic Presentation and Outcomes for Malignant Sinonasal Tumors
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: March 2021

Purpose:
To evaluate the ophthalmic clinical features and functional outcomes for patients with malignant sinonasal tumors who initially presented with orbital symptoms.

Patients and Methods:
Retrospective chart review for patients seen at Moorfields Eye Hospital between 1997 and 2020. Patient demographics and clinical features, radiology, histology, and treatment outcomes were reviewed.

Results:
Forty patients (22 females; 55%) with sinonasal cancers first presented to an ophthalmologist at an average age of 53.9 years (median 56; range 8–92 years), with their having had first symptoms at 53.6 years (median 55.8; range 7.8–91.9 years). The commonest symptoms were persistent periorbital ache (19/40; 48%), periocular swelling (18; 45%), proptosis (16; 40%), and diplopia (15; 38%). All midface tumors affected only 1 orbit, and 13 of 40 (33%) eyes presented with an acuity of 20/60 or worse—5 having no perception of light—and 10 eyes (25%) had a relative afferent pupillary defect. An average of 4.5 mm relative exophthalmos was present (median 4 mm; range 0–9 mm), and a palpable mass in 19 of 40 (48%) orbits. Reduced eye movements and nonaxial displacement were recorded in 29 (73%) and 34 (85%) patients, respectively, and 9 (23%) had an abnormal optic disc or fundus. Bone erosion affected 95% of orbits, and almost a half had involvement of the neighboring extraocular muscles, orbital apex, or intracranially. The commonest tumor groups were sinonasal carcinomas (45%), sarcomas (28%), or lymphomas (11%). Of 37 globe-sparing treatments, 25 (68%) had persistence of previously impaired ophthalmic functions and 6 of 37 (16%) developed new impairment; only 6 of 37 (16%) of affected orbits retained normal function, and 6 patients lost all vision on the affected side.

Conclusions:
Sinonasal malignancies that present with orbital invasion are probably at the more aggressive end of the cancer spectrum, might be expected to carry a worse prognosis, and usually arise from the ethmoid or maxillary sinuses. In our series, carcinomas and sarcomas were the commonest malignancies, with similar 5-year overall survivals (of just over 50%), and over three-quarters of patients developed permanent impairment of orbital function and/or visual loss.
The Contribution of Material, Behavioral, Psychological, and Social-Relational Factors to Income-Related Disparities in Cardiovascular Risk Among Older Adults
Authors: Lee Chiyoung , Yang Qing , Im Eun-Ok , McConnell Eleanor Schildwachter , Jung Sin-Ho , Kim Hyeoneui 
Published: March 2021

Background
Understanding the factors underlying health disparities is vital to developing strategies to improve health equity in old age. Such efforts should be encouraged in Korea.

Objective
This study explored how material, behavioral, psychological, and social-relational factors contribute to income-related disparities in cardiovascular risk among Korean adults 65 years and older.

Methods
This was a secondary analysis of Korean National Health and Nutrition Examination Survey data (2013–2017), targeting 7347 older adults (≥65 years). Socioeconomic position, defined as income, was the primary indicator. The outcome was binary for predicted cardiovascular risk (<90 vs ≥90 percentile). Disparities were measured using relative index of inequality (RII). The contributions of material, behavioral, psychological, and social-relational factors were estimated by calculating percentage reduction in RII when adjusted for these factors.

Results
Among men aged 65 to 74 years and women 75 years or older, the largest reductions in RII were achieved after adjusting for social-relational factors. Among men 75 years or older and women aged 65 to 74 years, adjusting for material factors resulted in the largest reductions in RII. Adjustments for behavioral factors also reduced RII for both genders aged 65 to 74 years.

Conclusions
Improving the social, material, and behavioral circumstances of lower-income older adults may help address income-related disparities in cardiovascular risk in old age.
Carotid Web and Ischemic Stroke: A Primer for Nursing
Authors: Sutherly Loretta J. , Wasserman Jessica , Haussen Diogo C. 
Published: March 2021

ABSTRACT

BACKGROUND: Carotid artery web may cause ischemic stroke and affects a vulnerable population of mostly younger patients. Multiple treatment options and lack of diagnostic consensus can cause confusion and reduce the likelihood to follow the recommended follow-up care. METHODS: We reviewed relevant literature using the following keywords: carotid web, CW, risk factors, stroke, treatments, education, incidence, prevalence, diagnostics, and nursing care. RESULTS: CW is commonly missed or misdiagnosed, which has led to scarce prevalence data. It has been reported to potentially represent approximately 0.5% of all ischemic strokes; however, after appropriate workup of patients with no clear stroke etiology, as many as 9.4% to 37% were found to have CW. This fibrotic shelflike lesion in the internal carotid bifurcation leads to flow disruption and possible thrombus formation. Treatment options include dual antiplatelets and anticoagulation or more invasive options such as revascularization with surgical excision or stenting, but research remains limited on which could be most beneficial. CONCLUSION: With multiple options and the uncertainty of which are best, patients can be lost to follow-up because of confusion and stress. Involving neuroscience nurses in the education process of these patients may help facilitate understanding of this disease phenomenon and increase patient understanding and compliance.
Profound Sudden Sensorineural Hearing Loss in Hematologic Malignancy: A Case for Urgent Cochlear Implantation With Discussion and Systematic Review of the Literature
Authors: Dumberger Lukas D. , Hwa Tiffany P. , Panara Kush , Husain Solomon , Yver Christina , Bigelow Douglas C. 
Published: March 2021

Objective:
To perform a systematic review of sensorineural hearing loss (SNHL) in hematologic malignancy; to describe an illustrative case of urgent cochlear implantation for bilateral profound SNHL and vestibular hypofunction in hyperviscosity syndrome; to suggest an approach to management of hyperviscosity syndrome-associated deafness with cochlear implantation.

Data Sources:
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic search of PubMed and Embase databases was undertaken for articles detailing clinical information about SNHL caused directly by hematologic malignancies.

Results:
A total of 37 studies from 1989 to 2020 were qualitatively reviewed, the majority of which were case studies or case series. Causes of hearing loss in hematologic malignancy were found to include hyperviscosity syndrome, labyrinthine hemorrhage, infiltration, and infection. Patients with profound SNHL in hematologic malignancies from hyperviscosity syndrome may be candidates for cochlear implantation, and are also at increased risk for cochlear ossification. We review previous cases for their diagnostic approach, treatment paradigm, and outcomes data, and propose an approach to management.

Conclusion:
Bilateral sudden profound SNHL and vestibular hypofunction is a presenting symptom of hyperviscosity syndrome in hematologic malignancy. Although this entity is rare and previous reports have suggested improvement in hearing with oncologic treatment, cases with profound hearing loss are unlikely to recover serviceable hearing. We advocate for early magnetic resonance imaging with attention to fluid signal in the inner ear and serial audiometric follow-up to guide clinical decisions. We advise early consideration for cochlear implantation.
Congenital Syphilis: A Case Report Demonstrating Missed Opportunities for Screening and Inadequate Treatment Despite Multiple Health Care Encounters During Pregnancy
Authors: Fukuda Acasia , Katz Alan R. , Park Ina U. , Komeya Alan Y. , Chang Ann , Ching Natascha , Tomas Juval E. , Wasserman Glenn M. 
Published: March 2021

Abstract
A case of congenital syphilis due to multiple missed opportunities, highlights the challenges of treating syphilis during pregnancy. Although cases are increasing in the United States, congenital syphilis, a disease with devastating consequences, is preventable.
A Comparison of Treponema pallidum Subspecies pallidum Molecular Typing Systems: Multilocus Sequence Typing vs. Enhanced Centers for Disease Control and Prevention Typing
Authors: Sahi Sharon K. , Zahlan Jana M. , Tantalo Lauren C. , Marra Christina M. 
Published: March 2021

Background
At least 3 syphilis typing systems are proposed. Recent work suggests that multilocus sequence typing (MLST) may be superior to enhanced Centers for Disease Control and Prevention typing (ECDCT) by yielding a higher discriminatory power. The goal of this study was to compare the 2 systems and identify associations between neurosyphilis and strain types.

Methods
Multilocus sequence typing for tp0136, tp0548, and tp0705 was determined for DNA from 78 Treponema pallidum subspecies pallidum isolates propagated in rabbits, 10 oral and 10 genital or non-genital lesion swabs, and 10 blood samples from patients with syphilis. These samples were chosen because they were completely typeable by ECDCT. Using both systems, association between strain types and neurosyphilis, defined as a reactive cerebrospinal fluid Venereal Disease Research Laboratory test, was determined. Partial and complete ECDCT types were also determined for samples from different anatomical sites in 35 patients, and from blood and blood isolates (rabbit propagated) from 13 patients.

Results
The MLST type could be fully determined for 100 (92.6%) of 108 samples. Although MLST subdivided 3 common ECDCT types, it failed to distinguish among others. Neurosyphilis was more common in individuals infected with type 1.1.2 and tp0705 type 2 using MLST, and tp0548 type f using ECDCT. Enhanced Centers for Disease Control and Prevention typing was stable among anatomical sites and between patient-derived and rabbit propagated organisms.

Conclusions
Compared with ECDCT, MLST was not uniformly more discriminating. Both typing systems demonstrate that specific types may be more neurotropic than others.
Rectal Douching and Anal Human Papillomavirus Among Young Men Who Have Sex With Men in China
Authors: Li Peiyang , Fan Song , Yuan Tanwei , Ouyang Lin , Gong Hui , Ding Yi , Luo Zhenzhou , Yu Maohe , Wu Guohui , Zou Huachun 
Published: March 2021

Background
Young men who have sex with men (YMSM) are particularly at increased risk for human papillomavirus (HPV) infection and related malignancies. Rectal douching, commonly practiced among MSM, has been associated with HIV, chlamydia, gonorrhea, and viral hepatitis in cross-sectional studies. We conducted this study to understand the association between self-reported rectal douching and anal HPV among YMSM in China.

Methods
Between September 2018 and March 2019, MSM aged 15 to 24 years who ever engaged in receptive anal intercourse over the last 3 months were recruited via community-based organizations and centers for disease control located in 4 cities in China. Participants were asked to complete an online survey. We performed multivariate logistic regression adjusted for potential confounders to examine the association between self-reported rectal douching and anal HPV.

Results
Among 273 MSM with a median age of 20 years (interquartile range, 19–21 years) included in this study, 130 (47.6%) practiced rectal douching during the preceding 3 months and 96 (36.2%) were infected with anal HPV. Self-reported rectal douching was found to be associated with increased odds of anal HPV infection (odds ratio, 2.16; 95% confidence interval, 1.22–3.82) among YMSM, after adjusting for age, sexual debut, sex with alcohol or drugs, and HIV testing history.

Conclusions
Self-reported rectal douching is associated with higher odds of anal HPV infection independent of sexual behaviors among YMSM. More prospective studies to ascertain this association are needed. Health education materials should inform men of the potential risk of rectal douching. Research on safer rectal douching procedures is warranted.