bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between depressive symptoms and neurocognitive impairment in people with well-treated HIV in Switzerland
Authors: Santos Galia , Locatelli Isabella , Métral Mélanie , Berney Alexandre , Nadin Isaure , Calmy Alexandra , Tarr Philip , Gutbrod Klemens , Hauser Christoph , Brugger Peter , Kovari Helen , Kunze Ursi , Stoeckle Marcel , Früh Severin , Schmid Patrick , Rossi Stefania , Di Benedetto Caroline , Du Pasquier Renaud , Darling Katharine , Cavassini Matthias ,   the NAMACO study group and Swiss HIV Cohort Study
Published: February 2021

Background: Depression may contribute to neurocognitive impairment (NCI) in people with HIV (PWH). Attributing NCI to depression rather than to HIV is complicated as depression may be both a causal factor and an effect of NCI. This study aimed to determine the association between depressive symptoms and NCI among PWH with well-controlled infection. Methods: The Neurocognitive Assessment in the Metabolic and Ageing Cohort study is an ongoing, prospective, longitudinal study of PWH aged ≥45 years old nested within the Swiss HIV Cohort Study. Neurocognitive Assessment in the Metabolic and Ageing Cohort study participants underwent neurocognitive assessment and grading of depressive symptoms using the Centre for Epidemiological Studies Depression Scale. Neurocognitive impairment categories were defined using Frascati criteria. Participants with NCI related to neurological or psychiatric confounders other than depression were excluded. The cross-sectional association between the Centre for Epidemiological Studies Depression score and neurocognitive impairment was examined taking Centre for Epidemiological Studies Depression score as a continuous variable and then as a binary variable using two score thresholds, 16 and 27. Results: Excluding 79 participants with confounding factors, 902 participants were studied: 81% were men; 96% had plasma viral loads <50 copies/ml; 35% had neurocognitive impairment; 28% had Centre for Epidemiological Studies Depression scores ≥16. Higher Centre for Epidemiological Studies Depression scores were associated with female sex ( p = 0.0003), non-Caucasian origin ( p = 0.011) and current/past intravenous drug use ( p = 0.002). Whilst neurocognitive impairment was associated with higher Centre for Epidemiological Studies Depression scores, the Centre for Epidemiological Studies Depression score was a poor predictor of having neurocognitive impairment (area under the ROC curve 0.604). Applying a Centre for Epidemiological Studies Depression score threshold of 16 predicted the presence of neurocognitive impairment with a sensitivity of 38.3% (specificity 77.2%), increasing the threshold to 27 lowered sensitivity to 15.4% (specificity 93.6%). Conclusion: In this large cohort of PWH in Switzerland, we did not observe a Centre for Epidemiological Studies Depression score threshold that was sensitive in predicting neurocognitive impairment. As neurocognitive impairment was however associated with higher Centre for Epidemiological Studies Depression scores, the data support the screening for and treatment of depression among PWH diagnosed with neurocognitive impairment.
Intersex adolescents seeking help for their depression: the case study of SPARX in New Zealand
Authors: Lucassen Mathijs F G , Perry Yael , Frampton Christopher , Fleming Theresa , Merry Sally N , Shepherd Matthew , Stasiak Karolina 
Published: February 2021

Objective: SPARX is a computerized cognitive behavioral therapy self-help program for adolescent depression that is freely available in New Zealand. At registration, users identify themselves as either male, female, intersex, or transgender. We aimed to describe the mental health of adolescent intersex users. Method: A secondary analysis of SPARX usage data over 5 years. Results: Of the 8922 adolescents users, 0.6% ( n = 50) identified as intersex. Based on Patient Health Questionnaire 9 – modified for Adolescents (PHQ-A) results, 78.3% of intersex users had high levels of depression and/or self-harm and suicidal ideation. The mean PHQ-A scores for intersex users were significantly higher than for males and females ( p < .001). As only three intersex users completed SPARX Level 4 or more (of the seven-level program), we were unable to meaningfully investigate any reductions in their depressive symptoms over time. Conclusions: There is a dearth of empirical data on the mental health of intersex adolescents. These results suggest that intersex adolescents seeking help from an online resource have high mental health needs compared with other young people, possibly because they defer seeking help.
A Review of Fam-Trastuzumab Deruxtecan-nxki in HER2-Positive Breast Cancer
Authors: Nguyen Xoan , Hooper Morgan , Borlagdan Jared Paul , Palumbo Alison 
Published: February 2021

Objective: To review the pharmacology, efficacy, and safety of antibody-drug conjugate fam-trastuzumab deruxtecan-nxki in the treatment of advanced, unresectable, or metastatic breast cancer. Data Sources: Relevant information was identified through a MEDLINE/PubMed (January 2015 to December 2020) literature search. The new drug application, prescribing information, clinical practice guideline, and abstracts from scientific meetings were also reviewed. Study Selection and Data Extraction: The literature search was limited to human studies published in the English language. All studies evaluating the pharmacology, efficacy, or safety of fam-trastuzumab deruxtecan-nxki for breast cancer were included. Data Synthesis: Fam-trastuzumab deruxtecan-nxki is composed of an anti–human epidermal growth factor receptor 2 (HER2) antibody and topoisomerase I inhibitor (DXd), which causes DNA damage and apoptotic cell death. Major phase I and phase II clinical trials established the efficacy and safety of fam-trastuzumab deruxtecan-nxki for treatment of HER2-positive advanced, unresectable, or metastatic breast cancers that are refractory or intolerant to standard treatment. In these trials, the response rate was 60.9% (95% CI = 53.4-68.0) Common adverse effects included fatigue, nausea, vomiting, decreased appetite, constipation, diarrhea, alopecia, neutropenia, anemia, and thrombocytopenia. Serious adverse effects included interstitial lung disease or pneumonia, febrile neutropenia, left ventricular dysfunction, and embryo-fetal toxicity. Relevance to Patient Care and Clinical Practice: Fam-trastuzumab deruxtecan-nxki is an option for HER2-positive breast cancer following 2 previous lines of HER2-targeted therapy. Conclusions: Fam-trastuzumab deruxtecan-nxki is an effective treatment for HER2-positive breast cancer in the metastatic setting, but randomized controlled trials are needed.
Investigating the Associations of Everyday Discrimination and Inflammation in Latina Women: A Pilot Study
Authors: Caceres Billy A. , Barcelona Veronica , Vo Danny , Suero-Tejeda Niurka , Jackman Kasey , Taylor Jacquelyn , Corwin Elizabeth 
Published: February 2021

Introduction: Discrimination is associated with negative health outcomes among Latinos. Research on the link between discrimination and inflammation in adults has focused on pro-inflammatory markers rather than characterizing the more informative balance of pro- and anti-inflammatory markers. The purpose of this cross-sectional study was to examine the associations of everyday discrimination with inflammation ratio (defined as the ratio of pro- to anti-inflammatory cytokines) in a sample of middle-aged and older Latinas. Methods: Latinas were recruited from an existing study in New York City. Participants reported frequency and count of everyday discrimination. Peripheral blood was used to analyze pro- (IL-1 B and IL-6) and anti-inflammatory (IL-4 and IL-10) cytokines. The inflammation ratio was calculated by dividing the sum of pro-inflammatory cytokines by the sum of anti-inflammatory cytokines. We used linear regression to assess the link between everyday discrimination and inflammation ratio. Results: The final sample included 40 Latinas (mean age = 63.2 years). Approximately 68% had household incomes less than $15,000. More than half (53%) reported experiencing some form of everyday discrimination. Regression models showed everyday discrimination was not associated with individual pro- and anti-inflammatory cytokines. In adjusted regression models, the frequency of everyday discrimination was not associated with inflammation ratios ( B[ SE] = 0.57[0.30], p = .07). However, a higher count of everyday discrimination was associated with inflammation ratios ( B[ SE] = 1.15[0.55], p = .04). Conclusions: The count of everyday discrimination was positively associated with inflammation in Latina women. Future studies should replicate these findings using longitudinal assessment of discrimination and inflammatory markers.
Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling
Authors: Blautain Benjamin , Glacet-Bernard Agnès , Blanco-Garavito Rocio , Toutée Adélaïde , Jung Camille , Ortoli Manon , Souied Eric H 
Published: February 2021

Purpose: To evaluate anatomical and functional changes in patients with vitreomacular interface disease after internal limiting membrane (ILM) peeling, using microperimetry along with usual clinical and multimodal retinal imaging. Methods: Patients with vitreomacular interface disease requiring vitrectomy underwent multimodal retinal evaluation, including visual acuity assessment, fundus color photograph, Spectral-Domain Optical Coherence Tomography, Optical Coherence Tomography-Angiography, and microperimetry. They were examined at baseline (M0), 6 months (M6) and 18 months (M18) after surgery. Retinal sensitivity was subdivided into three concentric polygons: Large, Medium, Small. Results: Eleven eyes of 11 patients were analyzed, including 10 epiretinal membranes (ERMs). Best-corrected visual acuity (BCVA) improved in all patients from 0.51 logarithm of the minimal angle of resolution (logMAR) to 0.067 ( p = 0.0074). Retinal sensitivity improved between M0 and M6 in all polygons and continued to improve between M6 and M18 for polygons Medium (M) and Small (S) with no statistical significance. At M18, BCVA and retinal sensitivity were similar in the operated eye compared with the fellow eye for all patients. Dissociated optic nerve fiber layer appearance was observed in 8 patients at M18. It was not correlated with either retinal sensitivity or BCVA or microscotomas. No recurrence of ERM or macular hole occurred during follow-up. Conclusion: After surgery, the retinal sensitivity assessed by microperimetry gradually improved until the 18th month and was not different from the values of the fellow eye. These results seemed to confirm that ILM peeling can be an effective and safe technique to treat patients with vitreomacular interface disease.
Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review
Authors: Hanning Nikita , Edwinson Adam L. , Ceuleers Hannah , Peters Stephanie A. , De Man Joris G. , Hassett Leslie C. , De Winter Benedicte Y. , Grover Madhusudan 
Published: February 2021

Background and Aim: Irritable bowel syndrome (IBS) is a complex and heterogeneous disorder. Sensory, motor and barrier dysfunctions are the key physiological endophenotypes of IBS. Our aim is to review studies evaluating barrier dysfunction in adults and children with IBS, as well as to link those changes with IBS symptomatology and quality of life. Methods: A comprehensive and systematic review of multiple databases was performed up to March 2020 to identify studies comparing intestinal permeability in IBS patients with healthy controls. Both in vivo and in vitro studies were considered. Results: We identified 66 studies, of which 27 used intestinal probes to quantify barrier function. The prevalence of barrier dysfunction differed between PI-IBS (17–50%), IBS-D (37–62%) and IBS-C (4–25%). At a group level, permeability was increased compared with healthy controls in IBS-D (9/13 studies) and PI-IBS (4/4 studies), but only a minority of IBS-C (2/7 studies) and not in the only IBS-M study. All four studies in children with IBS demonstrated loss of barrier function. A heterogeneous set of tight junction genes were found to be altered in small and large intestines of adults with IBS, but these have not been evaluated in children. Positive associations were identified between barrier dysfunction and bowel disturbances (6/9 studies), abdominal pain (9/13 studies), overall symptom severity (1/6 studies), depression and anxiety (1/1 study) and quality of life (1/4 studies). Fecal slurry or supernatants of IBS patients were found to induce barrier disruption in animal models (5/6 studies). Conclusions: Barrier dysfunction is present in a significant proportion of adult and all pediatric IBS studies, especially in the IBS-D and PI-IBS subtype. The majority of studies indicated a positive association between loss of barrier function and symptoms such as abdominal pain and changes in the bowel function.
Outcomes of pulmonary vasodilator use in Veterans with pulmonary hypertension associated with left heart disease and lung disease
Authors: Gillmeyer Kari R. , Miller Donald R. , Glickman Mark E. , Qian Shirley X. , Klings Elizabeth S. , Maron Bradley A. , Hanlon Joseph T. , Rinne Seppo T. , Wiener Renda S. 
Published: February 2021

Randomized trials of pulmonary vasodilators in pulmonary hypertension due to left heart disease (Group 2) and lung disease (Group 3) have demonstrated potential for harm. Yet these therapies are commonly used in practice. Little is known of the effects of treatment outside of clinical trials. We aimed to establish outcomes of vasodilator treatment for Groups 2/3 pulmonary hypertension in real‐world practice. We conducted a retrospective cohort study of 132,552 Medicare‐eligible Veterans with incident Groups 2/3 pulmonary hypertension between 2006 and 2016, and a secondary nested case–control study. Our primary outcome was a composite of death by any cause or selected acute organ failures. In our cohort analysis, we calculated adjusted risks of time to our outcome using Cox proportional hazards models with facility‐specific random effects. In our case–control analysis, we used logistic mixed‐effects models to estimate the effect of any past, recent, and cumulative exposure on our outcome. From our cohort study, 3249 (2.5%) Veterans were exposed to pulmonary vasodilators. Exposure to vasodilators was associated with increased risk of our primary outcome, in both Group 3 (HR: 1.58 (95% CI: 1.37–1.82)) and Group 2 (HR: 1.26 (95% CI: 1.12–1.41)) pulmonary hypertension patients. The case–control study determined odds of our outcome increased by 11% per year of exposure (OR: 1.11 (95% CI: 1.07–1.16)). Treating Groups 2/3 pulmonary hypertension with vasodilators in clinical practice is associated with increased risk of harm. This extension of trial findings to a real‐world setting offers further evidence to limit use of vasodilators in Groups 2/3 pulmonary hypertension outside of clinical trials.
Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study
Authors: Nakazato Layse , Mendes Felipe , Paschoal Ilma A. , Oliveira Daniela C. , Moreira Marcos M. , Pereira Mônica C. 
Published: February 2021

Pulmonary arterial hypertension impairs exercise tolerance and daily physical activity. Aside from the hemodynamic limitations, physical, cognitive, and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the physical activity level and psychological disorders, health‐related quality of life, and daily activities. We also searched for an association of the physical activity level with clinical factors and functional capacity. This was an analytical, cross‐sectional, observational study conducted in a Brazilian University Hospital. Twenty stable pulmonary arterial hypertension subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF‐36), as well as the Hospital Anxiety and Depression scale, and the Manchester Respiratory Activities of Daily Living questionnaire. Transthoracic echocardiography, the six‐minute walk test, the one‐minute sit‐to‐stand test, and spirometry were performed. For statistical analysis, we used Chi‐square tests or Fisher’s test as appropriate and the Mann–Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic pulmonary arterial hypertension, and 20% had connective tissue disease. The mean daily step count was 4280 ± 2351, and the mean activity time was 41.6 ± 19.3 min. The distance covered (six‐minute walk test) was 451.5 m, and the number of movements (one‐minute sit‐to‐stand test) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (Hospital Anxiety and Depression scale). There was a significant correlation between accelerometer data and walking distance (six‐minute walk test), number of movements (one‐minute sit‐to‐stand test), level of daily physical activity (Manchester Respiratory Activities of Daily Living questionnaire), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with pulmonary arterial hypertension.
A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial
Authors: Musiimenta Angella , Tumuhimbise Wilson , Pinkwart Niels , Katusiime Jane , Mugyenyi Godfrey , Atukunda Esther C 
Published: February 2021

Background Uganda’s maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited. Objective To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda. Methods 80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively. Results Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%). Conclusion The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.
Neurological Complications of Acute Rhinosinusitis: Meningitis
Authors: Bennett Stephen , Meghji Sheneen , Syeda Farahnaz , Bhat Nazir 
Published: February 2021

Meningitis remains a rare but potentially life-threatening intracranial complication of acute rhinosinusitis. We describe a case of a 62-year-old man with a background of chronic rhinosinusitis who presented to hospital with confusion, fever and bilateral green purulent rhinorrhoea. After immediate sepsis management, urgent contrast-enhanced computed tomography head revealed opacification of all paranasal sinuses and bony erosion of the lateral walls of both ethmoid sinuses. He was treated with intravenous antibiotics, topical nasal steroids, decongestants and irrigation. Following a turbid lumbar puncture and multidisciplinary discussion, he was admitted to the critical care unit and later intubated due to further neurological deterioration. After 13 days admission and rehabilitation in the community he made a good recovery. This case highlights the importance of timely diagnosis and appropriate management of acute rhinosinusitis and awareness of the possible complications. Joint care with physicians and intensivists is crucial in the management of these sick patients.
Comparison study of clinical outcomes and sagittal alignment improvement between anterior and posterior fusion techniques for multilevel cervical spondylotic myelopathy
Authors: Liu Hui , Li Xiang , Wang Jianru , Li Zemin , Li Zihao , Chen Siwen , Wang Hua , Zheng Zhaomin 
Published: February 2021

Purpose: To compare the sagittal alignment of different surgical approaches in patients with multiple levels cervical spondylotic myelopathy and explore the relationship between the cervical sagittal alignment and patient’s health relative quality of life. Method: A total of 97 multiple levels cervical spondylotic myelopathy patients who underwent surgery from January 2013 to January 2019 were collected in this study. Patients were divided into three groups: anterior cervical discectomy with fusion, anterior cervical corpectomy with fusion and laminectomy with fusion groups. Clinical outcomes and sagittal alignment parameters were compared preoperative and postoperative. Results: There were no significant differences in the average age and sex ratio among the groups. Sagittal parameters correlated to health relative quality of life were C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis. Both anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion groups exhibited better sagittal alignment and clinical outcomes improvement postoperatively. Anterior cervical discectomy with fusion provided better clinical outcomes and the better improvement of cervical lordosis, C7 slope, occipito-C2 angle and cervical sagittal vertical axis compared with patients with Laminectomy with fusion. Conclusion: C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis are the most important cervical sagittal parameters correlated to clinical outcomes in patients with multilevels cervical spondylotic myelopathy; anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion provides more efficient to restoration of cervical sagittal alignment.