bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of Sjögren’s syndrome and anti-cN1A antibody in myositis patients
Authors: Levy Dan , Nespola Benoit , Giannini Margherita , Felten Renaud , Severac François , Varoquier Coralie , Rinagel Marina , Korganow Anne-Sophie , Martin Thierry , Poindron Vincent , Maurier Francois , Chereih Haitham , Bouldoires Bastien , Hervier Baptiste , Lenormand Cedric , Chatelus Emmanuel , Geny Bernard , Sibilia Jean , Arnaud Laurent , Gottenberg Jacques-Eric , Meyer Alain 
Published: May 2021

Abstract

Objective
We recently recorded a high prevalence of inclusion body myositis (IBM) in patients with Sjögren’s syndrome (SS). Whether myositis patients with SS differ from myositis patients without SS in terms of the characteristics of the myositis is currently unknown. Anti-cytosolic 5′-nucleotidase 1 A (cN1A) has recently been proposed as a biomarker for IBM but is also frequent in SS. Whether anti-cN1A is independently associated with IBM is still an open question. We aimed to assess the significance of SS and anti-cN1A in myositis patients.

Methods
Cumulative data on all myositis patients (EULAR/ACR 2017 criteria) screened for SS (ACR/EULAR 2016 criteria) in a single centre were analysed. Ninety-nine patients were included, covering the whole spectrum of EULAR/ACR 2017 myositis subgroups and with a median follow-up of 6 years (range 1.0–37.5). The 34 myositis patients with SS (myositis/SS+) were compared with the 65 myositis patients without SS (myositis/SS-).

Results
. IBM was present in 24% of the myositis/SS+ patients vs 6% of the myositis/SS- group (P = 0.020). None of the IBM patients responded to treatment, whether they had SS or not. Anti-cN1A was more frequent in myositis/SS+ patients (38% vs 6%, P = 0.0005), independently of the higher prevalence of IBM in this group (multivariate P value: 0.02). Anti-cN1A antibody specificity for IBM was 0.96 (95% CI: 0.87, 0.99) in the myositis/SS- group but dropped to 0.70 (95% CI: 0.48, 0.85) in the myositis/SS+ group.

Interpretation
In myositis patients, SS is associated with IBM and with anti-cN1A antibodies, independently of the IBM diagnosis. As a consequence, anti-cN1A has limited specificity for IBM in myositis patients with SS.
EFFECTIVE DOSES AND RADIATION RISKS FROM COMMON DENTAL RADIOGRAPHIC, PANORAMIC AND CBCT EXAMINATIONS
Authors: Shatskiy I 
Published: May 2021

AbstractThis study was aimed at the estimation of the effective doses and radiation risks from dental X-ray examinations based on the data collection in St. Petersburg and the Leningrad Region. The range of mean values of effective doses for intraoral examinations on the X-ray units with film detectors was from 3.5 to 8.2 μSv and for the units with digital detectors—from 1.2 to 2.5 μSv. The mean effective doses for panoramic examinations were 22.9 μSv and for cone-beam computed tomography (CBCT)—530.6 μSv, respectively. The highest detriment-adjusted lifetime risk values were estimated for the 20–24-year-old age group: 40.8 × 10−6 in females and 32.7 × 10−6 in males for CBCT. Effective doses in St. Petersburg and Leningrad region were comparable or higher compared with the published data.
Developing and Validating an Individualized Clinical Prediction Model to Forecast Psychotic Recurrence in Acute and Transient Psychotic Disorders: Electronic Health Record Cohort Study
Authors: Damiani Stefano , Rutigliano Grazia , Fazia Teresa , Merlino Sergio , Berzuini Carlo , Bernardinelli Luisa , Politi Pierluigi , Fusar-Poli Paolo 
Published: May 2021

AbstractAcute and transient psychotic disorders (ATPDs) include short-lived psychotic episodes with a high probability of developing psychotic recurrences. Clinical care for ATPD is currently limited by the inability to predict outcomes. Real-world electronic health record (EHR)-based retrospective cohort study STROBE/RECORD compliant included all individuals accessing the South London and Maudsley NHS Trust between 2006 and 2017 and receiving a first diagnosis of ATPD (F23, ICD-10). After imputing missing data, stepwise and LASSO Cox regression methods employing a priori predictors (n = 23) were compared to develop and internally validate an individualized risk prediction model to forecast the risk of psychotic recurrences following TRIPOD guidelines. The primary outcome was prognostic accuracy (area under the curve [AUC]). 3018 ATPD individuals were included (average age = 33.75 years, 52.7% females). Over follow-up (average 1042 ± 1011 days, up to 8 years) there were 1160 psychotic recurrences (events). Stepwise (n = 12 predictors) and LASSO (n = 17 predictors) regression methods yielded comparable prognostic accuracy, with an events per variable ratio &gt;100 for both models. Both models showed an internally validated adequate prognostic accuracy from 4 years follow-up (AUC 0.70 for both models) and good calibration. A refined model was adapted in view of the new ICD-11 criteria on 307 subjects with polymorphic ATPD, showing fair prognostic accuracy at 4 years (AUC: stepwise 0.68; LASSO 0.70). This study presents the first clinically based prediction model internally validated to adequately predict long-term psychotic recurrence in individuals with ATPD. The model can be automatable in EHRs, supporting further external validations and refinements to improve its prognostic accuracy.
Researching and Teaching with British Newsreels
Authors: Rutherford Emily 
Published: May 2021

Abstract
Following the free online publication of several digitized newsreel collections, this article seeks to articulate a place for newsreels as a primary source base in twentieth-century British history, and to provide some basic guidance for students, teachers, and researchers who might wish to integrate newsreels into their work. It briefly traces the history of the newsreel industry in Britain, the conditions of newsreel production and distribution, and newsreels’ audience. It discusses how a digital newsreel archive came to be constructed and how it has been used in the past for both academic and pedagogical purposes. It argues that researchers and teachers can overcome scepticism about newsreels’ unreliability as primary sources, engaging with the sources critically to a variety of ends. It demonstrates these claims with a case-study about films of inter-war university ‘rag’ festivities, and with a variety of practical suggestions about how to incorporate newsreels into undergraduate teaching.
Andexanet Alfa or Prothrombin Complex Concentrate for Factor Xa Inhibitor Reversal in Acute Major Bleeding: A Systematic Review and Meta-Analysis
Authors: Nederpelt Charlie J. , Naar Leon , Krijnen Pieta , le Cessie Saskia , Kaafarani Haytham M. A. , Huisman Menno V. , Velmahos George C. , Schipper Inger B. 
Published: May 2021

OBJECTIVES:
To combine evidence on andexanet alfa and prothrombin complex concentrates for factor Xa inhibitor-associated bleeding to guide clinicians on reversal strategies.

DATA SOURCES:
Embase, Pubmed, Web of Science, and the Cochrane Library.

STUDY SELECTION:
Observational studies and randomized clinical trials studying hemostatic effectiveness of andexanet alfa or prothrombin complex concentrate for acute reversal of factor Xa inhibitor-associated hemorrhage.

DATA EXTRACTION:
Two independent reviewers extracted the data from the studies. Visualization and comparison of hemostatic effectiveness using Sarode et al or International Society of Thrombosis and Hemostasis Scientific and Standardization Committee criteria at 12 and 24 hours, (venous) thrombotic event rates, and inhospital mortality were performed by constructing Forest plots. Exploratory analysis using a logistic mixed model analysis was performed to identify factors associated with effectiveness and venous thromboembolic event.

DATA SYNTHESIS:
A total of 21 studies were included (andexanet: 438 patients; prothrombin complex concentrate: 1,278 patients). The (weighted) mean effectiveness for andexanet alfa was 82% at 12 hours and 71% at 24 hours. The (weighted) mean effectiveness for prothrombin complex concentrate was 88% at 12 hours and 76% at 24 hours. The mean 30-day symptomatic venous thromboembolic event rates were 5.0% for andexanet alfa and 1.9% for prothrombin complex concentrate. The mean 30-day total thrombotic event rates for andexanet alfa and prothrombin complex concentrate were 10.7% and 3.1%, respectively. Mean inhospital mortality was 23.3% for andexanet versus 15.8% for prothrombin complex concentrate. Exploratory analysis controlling for potential confounders did not demonstrate significant differences between both reversal agents.

CONCLUSIONS:
Currently, available evidence does not unequivocally support the clinical effectiveness of andexanet alfa or prothrombin complex concentrate to reverse factor Xa inhibitor-associated acute major bleeding, nor does it permit conventional meta-analysis of potential superiority. Neither reversal agent was significantly associated with increased effectiveness or a higher rate of venous thromboembolic event. These results underscore the importance of randomized controlled trials comparing the two reversal agents and may provide guidance in designing institutional guidelines.
Enterococcus faecalis contributes to hypertension and renal injury in Sprague-Dawley rats by disturbing lipid metabolism
Authors: Zhu Yeyan , Liu Yuting , Wu Chunying , Li Haonan , Du Huiting , Yu Huijing , Huang Cailin , Chen Yating , Wang Weidong , Zhu Qing , Wang Lei 
Published: May 2021

Objective:
Increasing studies have demonstrated that gut microbiota play vital roles in the development of hypertension. However, the underlying mechanism is not fully understood.

Methods:
The relative abundance of Enterococcus faecalis was determined in the faecal samples of angiotensin II or deoxycorticosterone acetate/salt-induced hypertensive rats. Then, E. faecalis culture was administered orally to rats for 6 weeks. Blood pressure (BP) was measured, renal injury was estimated and a serum metabolomic analysis was performed.

Results:
Compared with control, E. faecalis was markedly enriched in the faecal samples of hypertensive rats. The rats receiving live E. faecalis but not dead bacteria exhibited higher BP and enhanced renal injury. The serum metabolomic data showed that the E. faecalis treatment resulted in 35 variable metabolites including 16 (46%) lipid/lipid-like molecules, suggesting significant disturbance of lipid metabolism. Furthermore, the mRNA levels of 18 lipid metabolic enzymes in the renal medulla and cortex presented distinct and dynamic changes in response to 3 or 6-week E. faecalis treatment. Consistently, the protein levels of lysophospholipases A1 (LYPLA1) and phospholipase A2 group 4 A (PLA2G4) were enhanced only by live E. faecalis, which thus may have decreased the nitric oxide production in the renal medulla and elevated BP.

Conclusion:
Our results suggest that E. faecalis in the gut contributes to hypertension and renal injury in rats by disturbing the lipid metabolism. The information provided here could shed new light on the pathologic mechanisms and potential intervention targets for the treatment of gut dysbiosis-induced hypertension.
Physician Assistant Students’ Perceptions and Competencies Concerning Lifestyle Medicine
Authors: Abreu Alyssa , Keyes Sarah-Ann K. , Faries Mark D. 
Published: May 2021

Purpose
With nearly two-thirds of chronic disease attributed to lifestyle, there is a need for physician assistants (PA) to develop competencies in Lifestyle Medicine (LM). The purpose of this study was to assess PA students' skill competencies in exercise and dietary prescription to guide curriculum implementation efforts.

Methods
An online survey was administered to PA students at a single institution.

Results
Overall, 74 (63%) students completed the survey, self-reporting moderate competence (range: 1–6) in conducting a physical exam to approve an exercise program (4.17 ± 1.22), designing a nutritional plan (3.76 ± 1.32), and designing an exercise prescription (3.50 ± 1.32). Only about half of the clinical students felt competent in conducting a physical examination to approve an exercise program (56%), determine maximal heart rate (54%), and design a nutritional plan (58%), and only 25% reported competence in designing an exercise prescription. Additionally, 84% of clinical students reported time spent on LM in their program as “poor” or inadequate, and 100% wanted to learn more.

Conclusions
PA students reported inadequate competence and knowledge in LM but expressed an unanimous interest in learning more about LM during their educational training.
How Exercise Protects Against Mild Cognitive Impairment in Nursing Home–Dwelling Older Adults
Authors: Wang Shuo , Yin Huiru , Liu Zengxia , Jia Yong , Shang Binghan , Meng Qiuyan , Yan Mingli , Wang Lisheng , Chen Li 
Published: May 2021

Abstract
To explore how exercise protects against mild cognitive impairment (MCI) from physical, psychological, and social perspectives, we conducted a cross-sectional study in four nursing homes in Changchun, China, selected by convenience sampling. A total of 338 older adults aged 60 years or more with normal cognition or MCI were included. Data including demographic characteristics, exercise habits, frailty status, depression, sleep quality, social support, and cognitive status were collected. Weighted least squares estimation with mean and variance adjusted chi-square and bootstrapping with 2000 resamples were used to conduct the analyses through Mplus 8.3. The results showed that both direct and indirect effects of exercise on MCI were significant. Frailty and depression were two independent mediating factors, and depression could also play a mediating role when combined with sleep quality or frailty. Social support played a partial mediating role between exercise and depression. Formulations of exercise programs for MCI prevention and improvement in nursing home-dwelling older adults should consider the mediating factors.
Development and Evaluation of a Procedure to Identify Possible Gonorrhea Treatment Failure Cases in Illinois
Authors: Smith Marguerite , Choat Lesli , McKinney-Colman Lynette , Brikshavana Danucha 
Published: May 2021

Background
Cephalosporins are the last effective class of antibiotics to treat gonorrhea infections. In Illinois, gonorrhea cases have increased by 70.9% from 2015 to 2019. Because of the concern of antimicrobial resistance and the increasing number of cases, the Illinois Department of Public Health Sexually Transmitted Diseases Section established a procedure to identify possible gonorrhea treatment failure cases.

Materials and Methods
A procedure was developed that identifies patients who have had 2 gonorrhea cases in the last 60 days, and the first case was treated with the Centers for Disease Control and Prevention–recommended treatment. Interview records were faxed to the local health department (LHD) where the patient resides. Descriptive statistics were used to analyze interview record data. A process evaluation was conducted using telephone interviews with LHDs to obtain qualitative feedback on the procedure.

Results
A total of 310 interview records were sent for investigation in 2018 and 2019 with 263 returned. Of those returned, 140 identified reexposure, 104 were unable to be located, 12 refused to be interviewed, 6 had treatment reported incorrectly, and 1 had a possible treatment failure. From telephone interviews with 6 LHDs, 1 question was removed and 2 questions were added to the interview record.

Conclusions
Antibiotic-resistant gonorrhea could occur in Illinois at any time. Monitoring for antibiotic-resistant gonorrhea cases is necessary as gonorrhea morbidity continues to increase. This procedure may prove to be a model for other states.
Timing and Clinical Significance of Fluid Overload in Pediatric Acute Respiratory Distress Syndrome*
Authors: Black Celeste G. , Thomas Neal J. , Yehya Nadir 
Published: May 2021

Objectives:
Fluid overload is associated with worse outcomes in adult and pediatric acute respiratory distress syndrome. However, the time-course of fluid overload and its relationship to outcome has not been described. We aimed to determine the relationship between the timing of fluid overload and outcomes over the first 7 days after acute respiratory distress syndrome onset in children.

Design:
Retrospective cohort study.

Setting:
Single tertiary care PICU.

Patients:
Intubated children with acute respiratory distress syndrome between 2011 and 2019.

Interventions:
None.

Measurements and Main Results:
Daily and cumulative total fluid intake, total output, urine output, and fluid balance were collected for each 24-hour period from days 1 to 7 after acute respiratory distress syndrome onset. We tested the association between daily cumulative fluid metrics with PICU mortality and probability of extubation by 28 days using multivariable logistic and competing risk regression, respectively. In a subset of children, plasma was collected on day 1 and day 3 of acute respiratory distress syndrome and angiopoietin-2 quantified. Of 723 children with acute respiratory distress syndrome, 132 died (18%). In unadjusted analysis, nonsurvivors had higher cumulative fluid balance starting on day 3. In multivariable analysis, a positive cumulative fluid balance on days 5 through 7 was associated with increased mortality. Higher cumulative fluid balance on days 4 to 7 was associated with lower probability of extubation. Elevated angiopoietin-2 on day 1 predicted early (within 3 d) fluid overload greater than or equal to 10%, and elevated angiopoietin-2 on day 3 predicted late (between days 4 and 7) fluid overload.

Conclusions:
Fluid overload after day 4 of acute respiratory distress syndrome, but not before, was associated with worse outcomes. Higher angiopoietin-2 predicted subsequent fluid overload. Our results suggest that future interventions aimed at managing fluid overload may have differential efficacy depending on when in the time-course of acute respiratory distress syndrome they are initiated.
Cumulative incidence of SARS-CoV-2 infections among adults in Georgia, USA, August-December 2020
Authors: Chamberlain Allison T. , Toomey Kathleen E. , Bradley Heather , Hall Eric W. , Fahimi Mansour , Lopman Benjamin A. , Luisi Nicole , Sanchez Travis , Drenzek Cherie , Shioda Kayoko , Siegler Aaron J , Sullivan Patrick Sean 
Published: May 2021

AbstractBackgroundReported COVID-19 cases underestimate the true number of SARS-CoV-2 infections. Data on all infections, including asymptomatic infection, are needed to guide state testing and prevention programs. To minimize biases in estimates from seroprevalence surveys and reported cases, we conducted a state-wide probability survey of Georgia households and estimated cumulative incidence of SARS-CoV-2 infections adjusted for antibody waning.MethodsFrom August to December 2020, we mailed kits to self-collect specimens (nasal swabs and blood spots) to a random sample of Georgia addresses. One randomly-selected adult household member completed a survey and returned specimens for virus and antibody testing. We estimated cumulative incidence of SARS-CoV-2 infections adjusted for waning antibodies, reported fraction, and infection fatality ratio (IFR). Differences in seropositivity among demographic, geographic and clinical subgroups were explored with weighted prevalence ratios (PR).ResultsAmong 1,370 Georgia adult participants, adjusted cumulative incidence of SARS-CoV-2 was 16.1% (95% credible interval (CrI): 13.5-19.2%) as of November 16, 2020. The reported fraction was 26.6% and IFR was 0.78%. Non-Hispanic Black (PR: 2.03, CI 1.0, 4.1) and Hispanic adults (PR: 1.98, CI 0.74, 5.31) were more likely than non-Hispanic White adults to be seropositive. Seropositivity in metropolitan Atlanta’s Fulton and DeKalb counties was similar to seropositivity elsewhere in Georgia (7.8% vs. 8.8%).ConclusionsAs of mid-November 2020, one in 6 adults in Georgia had been infected with SARS-CoV-2. The scope of the COVID-19 epidemic in Georgia is likely substantially underestimated by reported cases.Main pointUsing data from a probability survey of households in Georgia, USA, we estimated that 1.3 million adults aged ≥18 years experienced SARS-CoV-2 infections by November 16, 2020, of whom 1 in 4 were reported and of whom 0.78% died.
Multivariate Modeling of Direct and Proxy GWAS Indicates Substantial Common Variant Heritability of Alzheimer’s Disease
Authors: de la Fuente Javier , Grotzinger Andrew D. , Marioni Riccardo E. , Nivard Michel G. , Tucker-Drob Elliot M. 
Published: May 2021

AbstractGenome-wide association studies (GWAS) of proxy-phenotypes using family history of disease (GWAX) substantially boost power for genetic discovery when combined with direct case-control GWAS, most prominently in the context of Alzheimer’s Disease (AD). However, despite twin study heritability estimates of approximately 60%, recent SNP-based estimates of common variant heritability of AD from meta-analyzed GWAS-GWAX data have been particularly low (2.5%), calling into question the prospects of continued progress in AD genetics. We demonstrate that commonly used approaches for combining GWAX and GWAS data produce dramatic underestimates of heritability, and we introduce a multivariate method for estimating individual SNP effects and recovering unbiased estimates of SNP heritability when combining GWAS and GWAX summary data. We estimate the SNP heritability of Clinical AD diagnoses excluding the APOE region at ∼6-10%, with the corresponding estimate for biological AD (based on prevalence rate estimates from recently published molecular imaging data) as high as ∼20%. Common variant risk for AD appears to represent a very strong effect of APOE superimposed upon a relatively diffuse polygenic signal that is distributed across the genome.