bluuebunny/crossref_metadata_2025_split huggingface dataset:
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada
Authors: Chahal Daljeet , Marquez Vladimir , Hussaini Trana , Kim Peter , Chung Stephen W. , Segedi Maja , Chartier-Plante Stephanie , Scudamore Charles H. , Erb Siegfried R. , Salh Baljinder , Yoshida Eric M. 
Published: October 2021

Abstract
Liver disease etiology and transplantation outcomes may vary by ethnicity. We aimed to determine if disparities exist in our province.
We reviewed the provincial database for liver transplant referrals. We stratified cohorts by ethnicity and analyzed disease etiology and outcomes.
Four thousand nine hundred sixteen referrals included 220 South Asians, 413 Asians, 235 First Nations (Indigenous), and 2725 Caucasians. Predominant etiologies by ethnicity included alcohol (27.4%) and primary sclerosing cholangitis (PSC) (8.8%) in South Asians, hepatitis B (45.5%) and malignancy (13.9%) in Asians, primary biliary cholangitis (PBC) (33.2%) and autoimmune hepatitis (AIH) (10.8%) in First Nations, and hepatitis C (35.9%) in Caucasians. First Nations had lowest rate of transplantation (30.6%, P = .01) and highest rate of waitlist death (10.6%, P = .03). Median time from referral to transplantation (268 days) did not differ between ethnicities (P = .47). Likelihood of transplantation increased with lower body mass index (BMI) (hazard ratio [HR] 0.99, P = .03), higher model for end stage liver disease (MELD) (HR 1.02, P < .01), or fulminant liver failure (HR 9.47, P < .01). Median time from referral to ineligibility status was 170 days, and shorter time was associated with increased MELD (HR 1.01, P < .01), increased age (HR 1.01, P < .01), fulminant liver failure (HR 2.56, P < .01) or South Asian ethnicity (HR 2.54, P < .01). Competing risks analysis revealed no differences in time to transplant (P = .66) or time to ineligibility (P = .91) but confirmed increased waitlist death for First Nations (P = .04).
We have noted emerging trends such as alcohol related liver disease and PSC in South Asians. First Nations have increased autoimmune liver disease, lower transplantation rates and higher waitlist deaths. These data have significance for designing ethnicity specific interventions.
The incidence of psoriasis among smokers and/or former smokers inflammatory bowel diseases patients treated with tumor necrosis factor antagonist
Authors: Yang Meiqi , Liu Weixin , Deng Qiuping , Liang Zeng , Wang Qin 
Published: October 2021

Abstract

Background:
Infliximab (IFX) and adalimumab (ADA) refer to the classic drugs to treat moderate-severe inflammatory bowel disease (IBD), which have been proven to be effective to control IBD. However, the side effects exerted by IFX and ADA should be monitored in therapies, especially the paradoxical reaction of the skin system (e.g., psoriasis). Psoriasis is recognized as the most common skin lesion, capable of significantly affecting the quality of patients’ life.

Methods:
This study searched literatures published in English language with the qualifications on PubMed, Embase, Web of Science, Google, and Geenmedical databases. Over 2 co-authors assessed the quality of the articles and extracted the data independently. The data acquired were statistically analyzed with the statistical software of Revman and Stata.

Results:
The ADA Group achieved a higher incidence of psoriasis (odds ratio [OR] = 0.658, 95% confidence interval [CI] [0.471–0.919]); Females achieved a higher incidence of psoriasis than males (OR = 1.941, 95%CI [1.326–2.843], P < .05); Smoking up-regulated the incidence of psoriasis (OR = 1.679, 95%CI [1.237–2.279], P < .05); The interval of medication was over 1 year, and the interval of medication applying IFX was longer than that of the ADA Group; most cases could be relieved by using local hormone, phototherapy, or systemic hormone therapy under the strategy of biological agents.

Conclusions:
The frequency of reported in IBD exceeds those of other autoimmune diseases, and the ADA treatment for IBD is safer than IFX. Psoriasis is more common in females than in males. Smoking refers to one of risk factors of psoriasis.
Familial chylomicronemia syndrome due to a heterozygous deletion of the chromosome 8 treated with the apoCIII inhibitor volanesorsen
Authors: Tünnemann-Tarr Adrienn , Scharnagl Hubert , Katzmann Julius L. , Stürzebecher Paulina , Laufs Ulrich 
Published: October 2021

Abstract

Rationale:
Familial chylomicronemia syndrome is a congenital, severe form of hypertriglyceridemia associated with increased risk of acute pancreatitis. Treatment options are limited.

Patient concerns:
A 52-year-old woman was referred with recurrent pancreatitis and severe hypertriglyceridemia to our lipid clinic.

Diagnosis:
Laboratory examination showed elevated serum triglyceride concentrations of 8090 mg/dL (90 mmol/L). Lipid electrophoresis showed a type V phenotype with positive chylomicrons. Genetic investigation revealed a novel heterozygous large deletion of the lipoprotein lipase gene on chromosome 8. A familial chylomicronemia syndrome was diagnosed. Other causes of hypertriglyceridemia were excluded.

Interventions:
Fibrates and diet did not lower triglyceride levels. Therefore, treatment with the apolipoprotein CIII (apoCIII) inhibitor volanesorsen was initiated.

Outcomes:
After 3 months of treatment, a 90% reduction of triglycerides was observed. ApoCIII concentrations were reduced by 90% in the total and by 61% in the chylomicron-free serum. Treatment was well tolerated with only minor local reaction after the first application. The platelet count was monitored weekly and did not decrease <150 cells/μL.

Lessons:
This case report shows that inhibition of apoCIII potently reduces serum triglycerides in patients with heterozygous monogenetic deletion of the lipoprotein lipase gene. Follow-up will show the effect on recurrent episodes of pancreatitis.
Efficacy of combined anti-VEGF and photodynamic therapy for bilateral diffuse uveal melanocytic proliferation
Authors: Miyata Manabu , Ooto Sotaro , Hata Masayuki , Takahashi Ayako , Tsujikawa Akitaka 
Published: October 2021

Abstract

Rationale:
Bilateral diffuse uveal melanocytic proliferation (BDUMP) is an extremely rare retinal exudative disease with physical disorders and no established treatment standard. We describe treatment courses in 3 cases of BDUMP.

Patients concerns:
Three male patients complained active vision loss. One male patient in his 70s (patient 1) was treated with prednisolone, mesalazine, and ciclosporin for hypoplastic anemia and ulcerous colitis. One male patient in his 60s (patient 2) was on prednisolone therapy for adult Still disease. Another male patient in his 70s (patient 3) was on prednisolone therapy for polymyalgia rheumatica, giant cell arteritis, and pancreatic body tumor.

Diagnoses:
Retinal specialists diagnosed these patients with BDUMP based on characteristic fundus findings of multiple red patches and retinal exudate.

Interventions:
Two patients (patients 1 and 2) with poor response to anti-vascular endothelial growth factor (VEGF) monotherapy and/or triamcinolone acetonide sub-Tenon injection were treated with combined anti-VEGF therapy and photodynamic therapy. One patient (patient 3) was treated with 3 rounds of monthly anti-VEGF monotherapy.

Outcomes:
Retinal exudates were resolved in all patients. No recurrence of retinal exudates was observed for at least 10 months, 2 years, or 4 months after the therapy in patients 1, 2, and 3, respectively. However, best-corrected visual acuity of the right eye was low (20/200) compared with that of the left eye (20/22) in patient 2 despite exudate resolution, due to permanent outer retinal damage secondary to long-term retinal exudate.

Lessons subsections:
Combined anti-VEGF therapy and photodynamic therapy may be a feasible therapeutic option for treatment-resistant exudate in patients with BDUMP. Early diagnosis of BDUMP and prompt administration of combination therapy are crucial.
Serum matrix metalloproteinase-9 concentration as a marker of disease activity in patients with inflammatory bowel disease
Authors: Shamseya Ayman M. , Hussein Wafaa M. , Elnely Dalia A. , Adel Fadwa , Header Doaa A. 
Published: October 2021

Background and aim
Diagnosing inflammatory bowel disease (IBD), determining the appropriate treatment and follow-up of patients rely mainly on endoscopy and biopsy. Finding a sensitive, specific, cost-effective and less-invasive biomarker is the focus of much of the current research in this field. The aim was to investigate the relation between serum matrix metalloproteinase-9 (MMP-9) levels and disease activity in patients with IBD, correlating with clinical and endoscopic indices of disease activity and with treatment received.

Patients and methods
Sixty patients (30 with ulcerative colitis, 30 with Crohn’s disease) and 20 controls were included. Serum MMP-9 levels were measured for all patients and controls by ELISA. Clinical activity was determined by partial Mayo score for patients with ulcerative colitis and Crohn’s Disease Activity Index for patients with Crohn’s disease, and endoscopic activity was assessed using Ulcerative Colitis Endoscopic Index of Severity for patients with ulcerative colitis and Simple Endoscopic Score of Crohn’s disease for patients with Crohn’s disease.

Results
Serum MMP-9 was higher in patients with active ulcerative colitis than in patients with inactive disease and the control group. Serum MMP-9 was also higher in patients with active Crohn’s disease than in patients with inactive disease and the control group. In both ulcerative colitis and Crohn’s disease groups, there was a significant difference between serum MMP-9 levels in patients receiving conventional treatment and those on biological treatment, with lower levels of the marker detected in the sera of patients subgroups receiving biologics.

Conclusion
Serum MMP-9 can be used to differentiate between active and inactive IBD (including both ulcerative colitis and Crohn’s disease).
Can 18F-FDG PET/CT alone or combined with radiology be used to reliably grade cartilage bone neoplasms for surgical decision making?
Authors: Gundavda Manit K. , Agarwal Manish G. , Singh Natasha , Gupta Rajat , Reddy Rajeev , Bary Ashik 
Published: October 2021

Objective
Treatment of chondrosarcomas is grade based; intralesional curettage for grade 1 and resection for grade 2 or more. Currently used methods to determine grades before surgery are not highly accurate and create a dilemma for the surgeon. We have used a PET-CT combined with imaging to answer the following study questions: (1) Does SUVmax value from an 18F-FDG PET/CT correlate with the grade of chondrosarcoma? (2) Can a cutoff SUVmax value be used to differentiate between various grades of chondroid neoplasms with sufficient sensitivity and specificity? (3) Does SUVmax guide the clinician and add value to radiology in offering histologic grade-dependent management?

Methods
SUVmax values of patients with suspected chondrosarcoma were retrospectively correlated with the final histology grade for the operated patients. Radiologic parameters and radiology aggressiveness scores (RAS) were reevaluated and tabulated.

Results
Totally 104 patients with chondroid tumors underwent 18F-FDG PET/CT assessment. In total 73 had tissue diagnosis available as a pretreatment investigation. Spearman correlation indicated that there was a significant positive association between SUVmax and the final histology grading of chondroid tumors (correlation coefficient = 0.743; P < 0.01). SUVmax cutoff of 13.3 was 88.9% sensitive and 100% specific for diagnosing dedifferentiated chondrosarcomas. An RAS cutoff value of 3 or more could diagnose IHGCS with a sensitivity of 80.7% and specificity of 93.75%. Adding an SUVmax cutoff of 3.6 improves the sensitivity to 89.5%.

Conclusion
SUVmax value can reliably help diagnose dedifferentiated chondrosarcoma and when added to the radiology score can improve the accuracy of grading chondrosarcoma.
Discharge Rehabilitation Measures Predict Activity Limitations in Patients With Stroke 6 Months After Inpatient Rehabilitation
Authors: Minor Maria , Jaywant Abhishek , Toglia Joan , Campo Marc , O’Dell Michael W. 
Published: October 2021

Objective
The aim of this study was to identify rehabilitation measures at discharge from acute inpatient stroke rehabilitation that predict activity limitations at 6 mos postdischarge.

Design
This is a retrospective analysis of a prospective, longitudinal, observational cohort study. It was conducted in an acute inpatient rehabilitation unit at an urban, academic medical center. Activity limitations in patients (N = 141) with stroke of mild-moderate severity were assessed with the activity measure for post-acute care at inpatient stroke rehabilitation discharge and 6-mo follow-up. Rehabilitation measures at discharge were investigated as predictors for activity limitations at 6 mos.

Results
Measures of balance (Berg Balance Scale), functional limitations in motor-based activities (functional independence measure–motor subscore), and motor impairment (motricity index), in addition to discharge activities measure for post-acute care scores, strongly predicted activity limitations in basic mobility and daily activities at 6 mos (51% and 41% variance explained, respectively). Functional limitations in cognition (functional independence measure–cognitive subscore) and executive function impairment (Trail Making Test–part B), in addition to the discharge activities measure for post-acute care score, modestly predicted limitations in cognitively based daily activities at 6 mos (12% of variance).

Conclusions
Standardized rehabilitation measures at inpatient stroke rehabilitation discharge can predict future activity limitations, which may improve prediction of outcome post-stroke and aid in postdischarge treatment planning.
Cardiovascular risk score associations with frailty in men and women with or at risk for HIV
Authors: Kuniholm Mark H. , Vásquez Elizabeth , Appleton Allison A. , Kingsley Lawrence , Palella Frank J. , Budoff Matthew , Michos Erin D. , Fox Ervin , Jones Deborah , Adimora Adaora A. , Ofotokun Igho , D'souza Gypsyamber , Weber Kathleen M. , Tien Phyllis C. , Plankey Michael , Sharma Anjali , Gustafson Deborah R. 
Published: October 2021

Objective:
To understand the relationship between cardiovascular disease (CVD) risk and frailty among men (MWH) and women living with HIV (WWH), or at risk for HIV.

Design:
We considered 10-year coronary heart disease and atherosclerotic CVD risk by Framingham risk score (FRS, 2001 National Cholesterol Education Program Adult Treatment Program III) and Pooled Cohort Equations (PCE, 2013 American College of Cardiology/American Heart Association) in relation to the Fried Frailty Phenotype (FFP) in the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS).

Methods:
FFP was ascertained in MACS from 2004 to 2019 and in WIHS from 2005 to 2006 and 2011–2019. FFP score at least three of five components defined frailty. Repeated measures logistic regression (both cohorts) and Cox proportional hazards regression (MACS) were performed, controlled for education, income, cholesterol medication and hepatitis C virus serostatus, and among MWH and WWH, CD4+ cell count/μl, antiretroviral therapy, and HIV viral load.

Results:
There were 5554 participants (1265 HIV seronegative/1396 MWH; 768 seronegative/1924 WWH) included. Among men, high-risk FRS was associated with increased risk of incident frailty among seronegative [adjusted hazard ratio (aHR)) = 2.12, 95% confidence interval (CI):1.22–3.69] and MWH (aHR = 2.19, 95% CI: 1.33–3.61). Similar associations were seen with high-risk PCE and incident frailty among SN (aHR = 1.88, 95% CI: 1.48–2.39) and MWH (aHR = 1.59, 95% CI: 1.26–2.00). Among women, high-risk PCE was associated with frailty in SN [adjusted odds ratio (aOR) = 1.43, 95% CI: 1.02–2.00] and WWH (aOR = 1.36, 95% CI: 1.08–1.71); however, high-risk FRS was not (seronegative: aOR = 1.03, 95% CI: 0.30–3.49; WWH: aOR = 0.86, 95% CI: 0.23–3.20).

Conclusion:
Higher CVD risk was associated with increased frailty regardless of HIV serostatus among men and women. These findings may inform clinical practices of screening for frailty.
HIV care outcomes among transgender persons with HIV infection in the United States, 2006–2021
Authors: Becasen Jeffrey S. , Morris Joseph D. , Denard Christa L. , Mullins Mary M. , Kota Krishna Kiran , Higa Darrel H. 
Published: October 2021

Objectives:
HIV prevalence is an estimated 14% among transgender women (TW) and 3% among transgender men (TM). HIV care is vital for viral suppression but is hindered by transphobia and HIV stigma. We assessed HIV care outcomes among transgender persons (TG) with HIV in the United States.

Design:
Systematic review and meta-analysis of peer-reviewed journal articles.

Methods:
We searched multiple electronic databases and Centers for Disease Control and Prevention's HIV Prevention Research Synthesis database for 2006–September 2020. Eligible reports were US-based studies that included TG and reported HIV care outcomes. Random-effects models were used to calculate HIV care outcome rates. The protocol is registered with PROSPERO (CRD42018079564).

Results:
Few studies reported outcomes for TM; therefore, only TW meta-analysis results are reported. Fifty studies were identified having low-to-medium risk-of-bias scores. Among TW with HIV, 82% had ever received HIV care; 72% were receiving care, and 83% of those were retained in HIV care. Sixty-two percent were currently virally suppressed. Among those receiving HIV care or antiretroviral therapy (ART), 67% were virally suppressed at last test. Sixty-five percent were linked to HIV care 3 months or less after diagnosis. Seventy-one percent had ever been prescribed ART. Approximately 66% were taking ART, and 66% were ART-adherent. Only 56% were currently adherent the previous year.

Conclusions:
HIV care outcomes for TW were not ideal, and research gaps exists for TM. High heterogeneity was observed; therefore, caution should be taken interpreting the findings. Integrating transgender-specific health needs are needed to improve outcomes of transgender persons across the HIV care continuum.
Diagnosis delays in the UK according to pre or postmigration acquisition of HIV
Authors: Stirrup Oliver , Tostevin Anna , Ragonnet-Cronin Manon , Volz Erik , Burns Fiona , Delpech Valerie , Dunn David 
Published: October 2021

Objectives:
The aim of this study was to evaluate whether infection occurred pre or postmigration and the associated diagnosis delay in migrants diagnosed with HIV in the UK.

Design:
We analyzed a cohort of individuals diagnosed with HIV in the UK in 2014–2016 born in Africa or elsewhere in Europe. Inclusion criteria were arrival within 15 years before diagnosis, availability of HIV pol sequence, and viral subtype shared by at least 10 individuals.

Methods:
We examined phylogenies for evidence of infection after entry into the UK and incorporated this information into a Bayesian analysis of timing of infection using biomarkers of CD4+ cell count, avidity assays, proportion of ambiguous nucleotides in viral sequences, and last negative test dates where available.

Results:
One thousand, two hundred and fifty-six individuals were included. The final model indicated that HIV was acquired postmigration for most MSM born in Europe (posterior expectation 65%, 95% credibility interval 64–67%) or Africa (65%, 62–69%), whereas a minority (20–30%) of men and women with heterosexual transmission acquired HIV postmigration. Estimated diagnosis delays were lower for MSM than for those with heterosexual transmission, and were lower for those with postmigration infection across all subgroups. For MSM acquiring HIV postmigration, the estimated mean time to diagnosis was less than one year, but for those who acquired HIV premigration, the mean time from infection to diagnosis was more than five years for all subgroups.

Conclusion:
Acquisition of HIV postmigration is common, particularly among MSM, calling for prevention efforts aimed at migrant communities. Delays in diagnosis reinforce the need for targeted testing initiatives.
Peripheral artery disease and physical function in women with and without HIV
Authors: Cedarbaum Emily R. , Ma Yifei , Adimora Adaora A. , Bamman Marcas , Cohen Mardge H. , Fischl Margaret A. , Gustafson Deborah , Matsushita Kunihiro , Ofotokun Igho , Plankey Michael , Seaberg Eric C. , Sharma Anjali , Tien Phyllis C. 
Published: October 2021

Objectives:
Peripheral artery disease (PAD) is associated with decreased physical function and increased mortality in the general population. We previously found that PAD is common in middle-aged women with and without HIV infection, but its association with functional decline is unclear. We examine the contribution of PAD to functional decline in the Women's Interagency HIV Study, controlling for traditional cardiovascular risk factors and HIV-related factors.

Methods:
Analysis included 1839 participants (72% with HIV) with measured ankle–brachial index (ABI) and 4 m gait speed. ABI values categorized PAD severity. Linear models with repeated measures estimated the association of PAD severity with log-transformed gait speed after controlling for demographic, behavioral, and metabolic risk factors, and HIV/hepatitis C virus status.

Results:
Median age was 50 years and more than 70% were Black. Compared with normal ABI, there was a dose–response relationship between increasing PAD severity and slower gait speed in univariable analyses: 6% slower gait speed for low-normal ABI [95% confidence interval (CI): 4–9%], 10% for borderline PAD (95% CI: 6–13%), 14% for mild PAD (95% CI: 9–18%), and 16% for moderate–severe PAD (95% CI: 5–25%). PAD severity remained associated with slower gait speed in multivariable analyses. HIV/hepatitis C virus co-infection was independently associated with 9% (95% CI: 4–14%) slower gait speed compared with those with neither infection. Among women with HIV, neither CD4+ cell count nor HIV-RNA level was associated with gait speed.

Conclusion:
In middle-aged women with and without HIV infection, greater PAD severity is associated with progressively slower gait speed. Early detection of subclinical PAD may decrease the risk of lower extremity functional impairment and its long-term health consequences.