bluuebunny/crossref_metadata_2025_split huggingface dataset:
P054 Acute articular rheumatism at the Hassan II hospital center, Fez, Morocco (prospective study: about 152 cases)
Authors: Sara Himri , Bouchra Oumokhtar , Samira El Fakir , Samir Atmani 
Published: November 2021

Abstract

Background
Acute Articular Rheumatism (AAR) is a major public health problem in developing countries, due to the high prevalence of its main complication, which is rheumatic heart disease. The objective of this study is to determine the clinical and biological manifestations of rheumatic fever in children at CHU Hassan II in Fez, Morocco.

Methods
This is a prospective study carried out from January 2016 to July 2019 in the cardiopediatric unit of CHU Hassan II in Fez. Included were patients below 18 years of age. 152 children with RAA are diagnosed according to the modified Jones criteria. The patients are classified into 2 groups: group 1: RAA with carditis and group 2: RAA without carditis. Patient data is collected on operating sheets. Statistical analysis was performed using SPSS v 21 software.

Results
The average age of the patients was 12 years and 10 months. The male/female sex ratio was 0.7. The most represented age group was between 5 and 15 years (76.16%). Patients of urban origin presented 78.8%. The majority of children who are diagnosed with AAR with and without cardiac involvement are admitted in winter and fall respectively. A family history of RAA was found in 1 patient and recurrent tonsillitis were mentioned in 68.42%. Cardiac involvement is found in 78.3% of patients. Arthritis was the most common major end point in patients with and without carditis (24.4% and 12.1% respectively). Arthralgia was the most common minor outcome in these patients (67.2% and 78.8% respectively). Penicillin A was the most prescribed antibiotic in the two groups (80.83% and 79.31% respectively). The predominant valve disease in children with cardiac involvement is mitral leakage (69%). Serological proof of a streptococcal infection (ASLO&gt; 300U/ml) was found in 37.2% of cases. A high biological inflammatory syndrome (ESR&gt; 20) was noted in 29.4%. Corticosteroid therapy was used in 42.8% of patients with carditis and in 30.3% of patients without carditis. There was a recurrence in surveillance, this is an aggravation of the mitral leakage with in an 11-year-old boy. 6 patients (3.9%) underwent valve replacement: 4 valve replacements (mitral or aortic) and two double valve replacements (mitral and aortic). One death is noted, a form of acute carditis.

Conclusion
Cardiac involvement was very common in our series, which shows that AAR still remains a public health problem in our country.

Keywords
RAA, child, cardiac involvement
P055 Title: Standard rate of ASLO in healthy children with streptococcal (angina) or post-streptococcal (RAA) infection in Morocco
Authors: Sara Himri , Bouchra Oumokhtar , Fakir Samira El , Samir Atmani 
Published: November 2021

Abstract

Background
The antistreptolysins O “ASLO” are anti streptococcal antibodies directed against streptolysin O. The assay of ASLO can provide proof of infection of streptococcal origin. However, it cannot confirm the presence of RAA or the degree of severity of the disease. A level of ASLO less than or equal to a critical threshold of 200 IU/ml is considered normal in children. Several factors influence the ASLO title and therefore their standard rate such as age, geographic location and seasonal variation. The objective of this study is to determine the upper normal limit (ULN) of ASLO in healthy children with angina or RAA at the CHU Hassan II of Fez in Morocco.

Methods
This is a cross-sectional study carried out from January 2016 to July 2019 in the cardiopediatric unit of CHU Hassan II and the Anarjiss health center in Fez. Patients below 18 years of age were included in this study. The children are classified into 3 groups: group 1: 152 children with RAA and who are diagnosed according to the modified Jones criteria, group 2: 177 children with angina, group 3: 157 healthy children who did not have an RAA, a history of recurrent or recent pharyngitis. Patient data is collected on operating sheets. Statistical analysis was performed using SPSS v 21 software. To establish a normal upper limit for ASLOs, the 90 percentile was used as it is a value below which at least 90% of cases studied in each group.

Results
The most common age group in the 3 groups is the age group between 5 and 15 years old. The frequency of children of urban origin is greater than that of rural origin in all the groups studied. The ULN is 421.4U/ml in the group of normal children, 641.95 U/ml in the RAA group and 561.8 U/ml in the group of children with pharyngitis. The study of changes in ASLO rates over time shows that they increase significantly in angina and tend to decrease in RAA. The LSN of ASLOs by gender shows that it is higher for boys than for girls. The ULN according to the residence shows that it is higher in urban areas. As well as the LSN of ASLO according to the season shows that it is higher in the cold period, especially in winter and spring (P &lt; 0.001). With regard to age, the ULN of ASLOs is higher in the 5–15 age group.

Conclusion
In this study, it can be concluded that an ASLO level less than or equal to 400 U/ml is the critical threshold in a normal child, while an ASLO level &gt;400 U/ml is considered pathological in children. children in Morocco.
P057 Uveitis in enthesitis-related arthritis: what are the predictive factors?
Authors: Miri Sirine , Triki Wafa , Ferjani Hanene , Maatallah Kaouther , Nsib Dorra Ben , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood. Uveitis is its most common extra-articular manifestation [1]. It is a potentially sight-threatening condition with a considerable risk of morbidity. This study aimed to describe the prevalence and characteristics of JIA-related uveitis in enthesitis-related arthritis (ERA) patients.

Methods
We conducted a retrospective study including 40 patients with JIA according to the classification criteria of the International League of Associations for Rheumatology (ILAR). All selected patients presented with ERA. A screening of uveitis was conducted in all patients. Clinical, radiologic and, biologic features of JIA were collected. We evaluated the association between these features and the presence of uveitis.

Results
The mean age of our patients was 24 years, with a sex ratio of 3. The mean age at the onset of JIA was 11 years. Upon screening, fifteen percent of the patients had active uveitis. Nine percent of the patients presented with an acute onset of JIA. Forty-six percent had initial spinal symptoms, while 26% presented with peripheral onset. Upon examination, 4% of the patients presented with monoarthritis, 20.4% with oligoarthritis and 34.8% with polyarthritis. Thirteen percent had enthesitis. Fifty-seven percent of the patients had coxitis. Sixty-eight percent had sacroiliitis. The mean CRP and ESR levels were respectively 16 mg/l and 34. Human leucocyte antigen (HLA) B27 screening came back positive in 11% of the cases. The mean BASDAI and BASFI levels were both at 4.7. The mean MASES was 0.44.
Twenty percent of the patients received NSAIDs. Eleven percent received methotrexate, 18% salazopyrine and, 5.6% biologics.
A significant association was established between the presence of uveitis and a polyarticular onset of JIA (P = 0.036). However, no significant associations were established with the sex of patients (P = 0.457), age of onset (P = 0.828), activity of the disease as evaluated by BASDAI (P = 0.40) and MASES (P = 0.87), inflammatory markers (CRP P = 0.946, and ESR P = 0.662), the use of NSAIDS (P = 1), methotrexate (P = 0.318), salazopyrine (P = 0.170) and biologics (P = 1).

Conclusion
In conclusion, uveitis associated with JIA is a serious and sight-threatening disease.
Several factors associated with a more severe disease development have been identified [2–4]. Our study showed a significant association between the polyarticular onset of JIA and the occurrence of uveitis. Also, our study showed no significant association with male gender and HLA-B27 in children, unlike previous studies of spondyloarthritis conducted in adults [5–6].
We conclude that the screening of uveitis should be performed in all JIA patients, especially those presenting initially with polyarthritis.
P073 Joint manifestations of IBD: about 9 cases
Authors: Nassiri N , Rkain M , El Ouali A , Ghannam A , Babakhouya A , Benajiba N 
Published: November 2021

Abstract

Background
Joint manifestations during chronic inflammatory bowel diseases (IBD) represent the most frequent extra digestive manifestations, dominated by spondylarthropathy, isolated sacroillitis and peripheral rheumatism. We conducted a retrospective study of 9 cases of IBD collected in the pediatric services of the CHU MOHAMMED VI of Oujda over a 4 year period from July 2017 to March 2021.The objective of our study is to describe the joint manifestations in inflammatory bowel diseases in children.

Materials and methods
This is a retrospective study of 9 cases of IBD collected in the pediatric services of the CHU MOHAMMED VI of Oujda over a 4-year period from June 2017 to March 2021.
All these parameters were collected on operating sheets and reported on ExcelThe data were collected from the files registered in a pediatric hospitalization register

Results
Our study includes 9 patients with male predominance in 60% of cases, the prevalence of joint manifestations was 45% of which 3/4 of cases are in Crohn's disease and 1/4 of cases in UC.Axial joint involvement was 25% in Crohn's disease while joint involvement was peripheral in 75% of which 2/3 in Crohn's and 1/3 in UC.Peripheral involvement affects the large joints in all patients with a bilateral character. With a biological inflammatory syndrome in which the CRP was &gt;50 mg/l and the VS more than 30All patients received corticotherapy and analgesics in 25% of cases. The evolution was marked by a good clinical and biological improvement with an average delay of 10 days.

Discussion
Ulcerative colitis (UC) and Crohn's disease (CD) are chronic cryptogenetic inflammatory bowel diseases (IBD). In addition to intestinal involvement, these IBDs are associated in 20% to30% of cases with extra digestive manifestations, with joint manifestations being the most frequent. There are essentially two types: Peripheral attacks which are the most frequent (8–20% of patients) especially during Crohn's disease; All joints can be affected, but most often asymmetric oligoarthritisAxial involvement includes sacroiliitis (SI) and ankylosing spondylitis (SpA) SI is more prevalent than SpA in both UC and CD Treatment of joint manifestations involves rest and exercise% tocontrol spinal stiffening in axial involvement; and analgesics Close collaboration between gastro-pediatricians and pediatric rheumatologists is the key to optimal management of the extra-digestive manifestations of IBD.

Conclusion
Joint involvement plays an important role in the extra digestive manifestations of IBD. It should be systematically screened in IBD patients, especially if they present a biological inflammatory syndrome, thus enabling early diagnosis and better management.
Cardiovascular events in adult polymyositis and dermatomyositis: a meta-analysis of observational studies
Authors: Xiong Anji , Hu Ziyi , Zhou Shifeng , Qiang Yiying , Song Zhuoyao , Chen Huini , Xiang Qilang , Zhang Yan , Cao Yuzi , Cui Hongxu , Luo Jie , Wang Ye , Yang Yuan , Cui Beibei , Li Menglan , Shuai Shiquan 
Published: November 2021

Abstract

Objectives
We aimed to review whether PM and DM patients have an increased cardiovascular (CV) risk, including ischaemic heart disease (IHD), cerebrovascular accidents (CVA) and venous thromboembolism.

Methods
We searched PubMed, Embase and the Cochrane database for relevant studies from inception to February 2021.

Results
Twenty-two studies comprising 25 433 patients were included. With PM/DM vs general populations, the risk was significantly increased for CV events [relative risk (RR) = 2.37, 95% CI: 1.86, 3.02]. The RR of CV events for males with PM/DM was higher than for females (RR = 1.43; 95% CI: 1.17, 1.74). PM/DM patients followed for one to five years had a significantly higher CV risk than those followed for five to ten years (RR = 3.51, 95% CI: 1.95, 6.32). The risk was increased for North Americans (RR = 4.28, 95% CI: 2.57, 7.11), Europeans (RR = 2.29, 95% CI: 1.58, 3.31) and Asians (RR = 2.03, 95% CI: 1.41, 2.90). Our meta-analysis found that the elevated CV event risk was related to PM (RR = 2.35, 95% CI: 1.51, 3.66) and DM (RR = 2.55, 95% CI: 1.66, 3.93). Subgroup analyses showed that the risk was significantly increased for IHD (RR = 1.76, 95% CI: 1.40, 2.21), CVA morbidity (RR = 1.31, 95% CI: 1.03, 1.67) and ischaemic stroke (IS) (RR = 1.47, 95% CI: 1.26, 1.73), with no statistically significant increased risk of haemorrhagic stroke mortality (RR = 1.43, 95% CI: 0.92, 2.21). The CV event risk was increased for venous thromboembolism (RR = 4.60, 95% CI: 3.17, 6.66), deep venous thrombosis (RR = 5.53, 95% CI: 3.25, 9.39) and pulmonary embolism (RR = 5.26, 95% CI: 2.62, 10.55).

Conclusion
This meta-analysis found that PM/DM patients had a ∼2.37 times increased CV risk, particularly males diagnosed in the previous five years. PM/DM may be an independent risk factor for developing IHD, IS, deep venous thrombosis and pulmonary embolism.
A new pro-thrombotic mechanism of neutrophil extracellular traps in antiphospholipid syndrome: impact on activated protein C resistance
Authors: Foret Thomas , Dufrost Virginie , Salomon du Mont Lucie , Costa Patricia , Lakomy Cecile , Lagrange Jeremy , Lacolley Patrick , Regnault Veronique , Zuily Stephane , Wahl Denis 
Published: November 2021

Abstract

Objectives
In APS, precise evaluation of thrombotic risk is a major challenge. Different players, such as activated protein C (APC) resistance or neutrophil extracellular traps (NETs) contribute to the risk of thrombosis. Nevertheless, no study has investigated the interaction between these actors. The main objective of this study was to investigate the relation between NETs and APC resistance.

Methods
We designed a cross-sectional study including APS/antiphospholipid antibodies (aPL) patients and patients with autoimmune diseases (AID). We performed thrombin generation tests without and with APC to determine APC resistance. To evaluate circulating NETs, we measured plasma levels of MPO-DNA complexes and cell-free DNA with ELISA.

Results
We recruited 117 patients with definite APS/aPL or AID. We found a positive correlation between NETs and APC resistance, in APS patients and specifically in patients with high thrombotic risk, displaying LA or positivity of all three aPL tests (triple+), or anti-domain I IgG (aDI+). All these patient subgroups had increased NETs concentrations and APC resistance. As the risk profile for thrombosis increased, the relationship between NETs and APC resistance was stronger.

Conclusion
We have shown that NETs participate in the hypercoagulable state of APS patients by contributing to APC resistance, in particular in high-risk patients. In these most at-risk patients, a targeted action on NETs could reduce APC resistance and constitute a new therapeutic approach in the treatment of APS patients in addition to antithrombotic therapy.
Depression and Psychosis Risk Shared Vulnerability for Motor Signs Across Development, Symptom Dimensions, and Familial Risk
Authors: Damme Katherine S F , Park Jadyn S , Walther Sebastian , Vargas Teresa , Shankman Stewart A , Mittal Vijay A 
Published: November 2021

Abstract

Background
Motor abnormalities are strong transdiagnostic indicators of psychopathology risk that reflect emerging neural network abnormalities. Indeed, motor signs, such as motor slowing and agitation, are widely recognized as core features of both psychosis and depression. However, it is unclear whether these reflect shared or distinct etiology.

Methods
A sample of 11 878 adolescents completed self-reported clinical measures of rated psychotic-like experiences (PLEs) and depression. Familial risk for psychopathology and the presence of motor signs were drawn from parental reports, including developmental motor delays (eg, sitting, walking), and adolescent motor signs (eg, dyscoordination, psychomotor retardation, and psychomotor agitation). Finally, motor network connectivity in theoretically relevant networks (cortico-striatal, cortico-thalamic, and cortico-cerebellar) were related to symptoms and familial risk for psychopathology.

Results
Developmental motor delays related to increased PLEs, increased depression symptoms, and greater familial risk. Familial risk for both PLEs and depression showed higher rates of developmental motor delays than all other groups. Adolescent motor signs, however, showed unique patterns of relationships to symptoms and familial risk such that dyscoordination reflected risk for PLEs, both psychomotor agitation and retardation reflected depression risk, and psychomotor agitation reflected transdiagnostic risk. Cortico-striatal connectivity was related to depression and PLEs, but cortico-cerebellar connectivity was linked to PLEs only.

Conclusions
Motor signs may be a transdiagnostic marker of vulnerability for psychopathology. Early developmental motor delays could belie pluripotent, familial risk features. Unique items, eg, dyscoordination specifically related to PLEs, possibly reflecting processes inherent in distinct emerging forms of psychopathology.
Magnesium absorption, translocation, subcellular distribution and chemical forms in citrus seedlings
Authors: Xu Hao , Luo Ziwei , Hu Wenlang , Jia Yamin , Wang Yuwen , Ye Xin , Li Yan , Chen Li-Song , Guo Jiuxin 
Published: November 2021

Abstract Magnesium (Mg) is an essential macronutrient for plant growth and development; however, the adaptive mechanisms of Mg deficiency to underlying changes in Mg translocation, subcellular distribution and chemical forms in citrus plants are unknown. In this study, we conducted a sand culture experiment with 0 (Mg-deficiency) or 2 (Mg-sufficiency) mmol l−1 Mg2+ treatments to investigate the responses underlying Mg adaptability, as well as the resulting growth and Mg transport features in citrus seedlings [Citrus sinensis (L.) Osbeck cv. ‘Xuegan’]. We found that Mg-deficiency significantly depressed biomass by 39% in the whole plant and by 66% in branch organs compared with Mg-sufficient conditions, which further resulted in a subsequent decrease in Mg concentration and accumulation with changes in its distribution in different organs and a reduction in root growth. Under Mg-sufficiency, &gt;50% of Mg was sequestered in the soluble fraction and this was reduced by 30% under Mg-deficiency. Furthermore, &gt;70% of Mg existed as inorganic (42%) and water-soluble (31%) forms with high mobility across treatments and organs. Under Mg-deficiency, the proportion of water-soluble Mg was reduced in leaf and increased in root, whereas the proportion of inorganic Mg increased in main stem leaves and decreased in branch leaves and root. However, under Mg-deficiency, the proportion of Mg forms with low mobility, including pectates and proteins, phosphates, oxalates and residues, was increased in leaf and root organs, with the exception of pectate and protein Mg, which was decreased in root. The Mg transfer factor showed that Mg-deficiency improved Mg transport from parent to branch organs, which was related to Mg subcellular distribution and chemical forms. Taken together, our study establishes a defined process to clarify the mechanisms of Mg absorption and translocation and reveals a possible strategy to effectively improve Mg mobility and availability in citrus plants.
Male High School Students’ Perceptions of Nursing as a Professional Career Choice: Nursing Pathway Project
Authors: Palazzo Steven J. , Erickson Mark S. 
Published: November 2021

Abstract

AIM
The aim of this study was to understand male high school students’ perceptions of nursing as a professional career choice.

BACKGROUND
Nursing is predominantly female, with male nurses accounting for less than 10 percent of the nursing workforce.

METHOD
A 32-item descriptive survey that contained demography items and constructs of the theory of planned behavior was administered to 820 high school students from a large Pacific Northwest school district.

RESULTS
Male students scored higher (less positive) relative to female students on all scales. When gay and bisexual male students were compared to female students, there was no statistically significant difference. Gay and bisexual male students scored significantly lower (more positive) than straight male students.

CONCLUSION
Self-identified female individuals and self-identified gay and/or bisexual male individuals have a more positive perception of the nursing profession than other self-identified male individuals. Nurse educators should work with high schools, schools of nursing, and nursing professional organizations to implement strategies to recruit male high school students.
A Comprehensive Unit-based Safety Program to Improve Perioperative Efficiency in Adolescent Idiopathic Scoliosis
Authors: Raman Divya L. , Bixby Elise C. , Wang Kevin , Rossi Danielle , Ringler Jennifer , Wiggins Danielle A. , Arora Sushrut , Delfin Jema , Guida SarahJane , McLeod Lisa , Vitale Michael G. 
Published: November 2021

Background:
Addressing operational inefficiencies in operating rooms (ORs) enhances patient access to care, reduces delays, and improves employee and patient satisfaction. The Comprehensive Unit-based Safety Program (CUSP) promotes patient safety through increased teamwork, empowerment of frontline staff, and utilization of science of safety principles. CUSP has demonstrated success in outpatient and inpatient settings to decrease complication rates and establish a culture of safety but has been used minimally in the perioperative setting. In this study, the CUSP methodology was utilized to improve perioperative efficiency in pediatric spine surgery, and preimplementation and postimplementation efficiency were compared, using the rate of first case on-time starts (FCOTS) as the primary metric.

Methods:
A CUSP quality improvement workgroup including nurses, technicians, surgeons, anesthesiologists, and administrators sought feedback on opportunities for improvement and tracked key performance metrics in the OR from 2015 to 2020. Key interventions developed in response to feedback included standardizing and streamlining room setup and adjusting staffing models for greater efficiency. Univariate analysis was conducted to compare time periods pre-CUSP and post-CUSP implementation.

Results:
First case on-time starts increased from 38% to a high of 81% after implementation. For more complex cases, the average patient in the room to anesthesia ready time improved by 31% with decreased variance over time, and average closure to patient out of room time improved by 45%. Improvements were sustained through Year 3, while CUSP remained a primary focus for the team.

Conclusions:
CUSP is effective in enhancing perioperative efficiency, demonstrating strong improvement in on-time starts over 5 years. The results indicate that process improvement in ORs requires consistent attention to sustain gains over time. Engaging frontline staff in quality improvement fosters collaboration and provides employee buy-in to promoting a culture of safety and improving value in patient care.

Level of Evidence:
Level III—retrospective comparative study.