bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vulvar vitiligo and lichen sclerosus in children: A clinical challenge
Authors: Veronesi Giulia , Virdi Annalucia , Leuzzi Miriam , Gurioli Carlotta , Chessa Marco Adriano , Guglielmo Alba , Neri Iria 
Published: September 2021

AbstractVulvar vitiligo (VV) and vulvar lichen sclerosus (VLS), both feature skin and mucosal hypo‐/depigmentation. The aim of this study was to describe the clinical and dermoscopic features of VV and VLS in the pediatric population, providing diagnostic clues, and to define their association. We performed a systematic literature review of the clinical and dermoscopic features of pediatric VV and VLS. An observational study was conducted on children affected by VLS associated with VV, referred to the Dermatology Unit of the Sant’Orsola Polyclinic in Bologna, Italy. Medical history, age at diagnosis, ethnicity, clinical and dermoscopic features, and symptoms were recorded for all patients. 124 cases of VLS and 10 cases of VV were reviewed. Clinical manifestations included hypo‐/depigmented patches in both conditions, while ecchymosis/purpura and fissures/erosion were observed in VLS. Symptoms including pruritus, pain, or burning were reported only by VLS patients. In our study five patients with VLS associated with VV were retrieved. Clinical features included well‐demarcated depigmented patches in VV and translucent areas, erythema, ecchymoses/purpura, and labial fusion in VLS. Dermoscopy showed white structureless areas with a whipped cream‐like appearance, linear or dotted vessels, white chrysalis‐like structures, erosion and red‐purpuric blotches in VLS and reduced pigment network or pigment absence, intralesional spots of residual pigmentation and telangiectasias in VV. Symptoms were present in all patients. Both VV and VLS show hypo‐/depigmented patches. In the presence of associated symptoms, possible VLS should be investigated with clinical and dermoscopic examination to achieve a prompt diagnosis.
Age‐ and sex‐mediated differences in T lymphocyte populations of kidney transplant recipients
Authors: Dziarmaga Robert , Ke Danbing , Sapir‐Pichhadze Ruth , Cardinal Héloïse , Phan Véronique , Piccirillo Ciriaco A. , Mazer Bruce , Foster Bethany J. 
Published: September 2021

AbstractBackgroundGraft failure rates increase through childhood and adolescence, decline in adulthood, and are higher in female than male kidney transplant recipients (KTR) until middle age. We aimed to describe age‐ and sex‐related differences in T‐cell subsets among KTR to determine which differences may help to explain the differences in kidney graft failure rates.MethodsEffector T (Teff)‐cell and regulatory T (Treg)‐cell phenotypes in PBMCs from healthy controls and KTR, who were at least 1 year post‐transplant with stable graft function under immunosuppression, were analyzed by flow cytometry. The effects of age, sex, and status (KTR or control) were analyzed using linear regressions.ResultsWe enrolled 20 male and 21 female KTR and 20 male and 20 female controls between 3 and 29 years of age. CD3+ T‐cell frequencies were not associated with age or sex but were higher in KTR than controls. There were no differences in CD4+ and CD8+ frequencies. Th1 (IFNγ+ IL‐4− IL‐17A−) and Th17 (IL‐17A+) frequencies within the CD4+ T‐cell population were higher at older ages. The frequencies of FOXP3 + Helios + Treg cells in CD4+ CD25+ CD127− T cells were lower in females than males and in KTR than controls.ConclusionsIncreasing frequencies of Th1 and Th17 cells with increasing age mirrors the increasing graft failure rates from childhood to young adulthood. Importantly, sex differences in frequencies of circulating Treg cells may suggest a role in the sex differences in graft failure rates.
A 250‐kDa glycoprotein of Naegleria fowleri induces protection and modifies the expression of α4β1 and LFA‐1 on T and B lymphocytes in mouse meningitis model
Authors: Castillo‐Ramírez Diego A. , Carrasco‐Yépez María Maricela , Rodríguez‐Mera Itzel Berenice , Reséndiz‐Albor Aldo Arturo , Rosales‐Cruz Érica , Rojas‐Hernández Saúl 
Published: September 2021

AbstractThe aims of this work were to evaluate the protective role of the 250‐kDa polypeptide band of Naegleria fowleri. We designed an immunization strategy in Balb/c mice which were inoculated by i.n. route with an electrocuted 250‐kDa polypeptide band of N. fowleri. We observed that the 250‐kDa band induced 80% of protection, whereas the coadministration with Cholera Toxin induced 100% of protection. Moreover, high levels of IgA‐ and IgG‐specific antibodies were detected by ELISA assay. We also analysed migration molecules (α4β1 and LFA‐1) on T and B lymphocytes in nose‐associated lymphoid tissue (NALT), cervical lymph nodes (CN) and nasal passages (NP) by flow cytometry. We observed that the percentage of B cells (B220/α4β1) and T cells (CD4/α4β1) in NP were higher in all immunized groups compared with the other compartments analysed. Finally, we detected by immunohistochemistry ICAM‐1 and V‐CAM‐1 in the nasal cavity. The immunization with the 250‐kDa polypeptide band, protect mice against N. fowleri challenge and modifies migration molecules and their ligands.
The effect of gender on intramuscular pressure in patients with chronic exertional compartment syndrome of the lower leg
Authors: Lindorsson Sophia , Rennerfelt Kajsa , Brisby Helena , Zhang Qiuxia 
Published: September 2021

This study aimed to compare intramuscular pressure (IMP) in all four compartments of the lower leg between men and women in patients with suspected chronic exertional compartment syndrome (CECS), and to assess possible effects of gender in relation to covariation factors. A consecutive series of patients with exertional leg pain (n = 962, median age 27 years, 56.2% women) underwent IMP measurements between 2009 and 2019. The CECS diagnosis was confirmed (n = 491, 48% women) or ruled out (n = 471, 65% women) based on the patient's history, clinical examination, and IMP measurements. IMP values of the compartments were compared between genders. A multiple linear regression analysis was performed for IMP in the anterior and lateral compartments, where the number of patients was large enough to investigate the possible impact of other factors such as height, age, and duration of pain. Among those with a confirmed CECS diagnosis, one‐minute post‐exercise IMP was significantly lower in women than in men for all four muscle compartments: anterior (median [range] mmHg 44 [24–120] vs. 50 [24–130]), lateral (35 [20–89] vs. 40 [26–106]), deep posterior (31 [25–36] vs. 34 [24–53]), and superficial posterior (32 [27–39] vs. 37 [22–54]). In the multiple regression analysis, gender differences remained significant in the anterior compartment but not the lateral compartment, where only height remained a significant predictor of IMP. Gender should be considered when using cut‐off values for IMP in diagnosing CECS, especially for the anterior compartment.
Through thick and thin?: Young adults’ implicit beliefs about friendship and their reported use of dissolution and maintenance strategies with same‐gender friends
Authors: Santucci Katya , Khullar Thomas H. , Dirks Melanie A. 
Published: September 2021

AbstractDespite the documented importance of friendship for the well‐being of young adults, there is a paucity of work mapping factors associated with friendship dissolution and maintenance during this developmental period. We examined whether implicit theories of friendships – specifically, growth beliefs (i.e., the belief that friendships can be developed) and destiny beliefs (i.e., the belief that friendships are either meant to work or not) — were associated with endorsement of dissolution and maintenance responses in two types of challenging situations occurring with same‐gender friends. One hundred forty‐five undergraduate students (80 females, Mage = 20.71, SD = 1.46) completed an online questionnaire. Participants read twelve hypothetical situations depicting transgressions by a friend (i.e., violations of friendship expectancies) or conflicts of interest (i.e., differences of needs, desires, or opinions) and reported how likely they would be to engage in strategies reflecting maintaining the friendship or dissolving it, either by ending it completely or diminishing its quality. They also completed a scale assessing implicit theories of friendships. Participants endorsed dissolving the friendship more strongly when the friend had transgressed than in conflicts of interest, whereas maintenance strategies were endorsed more strongly in conflicts than in transgressions. Moreover, higher destiny beliefs were associated with greater endorsement of ending the friendship and weaker endorsement of maintaining it; in contrast, higher growth beliefs were associated with greater endorsement of maintenance. Findings provide new insight into when and why young adults may dissolve or maintain a friendship.
ABO(H) and Lewis blood group substances and disease treatment
Authors: Liu Junting , Wang Deqing 
Published: September 2021

AbstractSince the early 20th century, scientists have determined that blood group antigens can be inherited. With more and more studies have been devoted to finding the relationship between blood groups and diseases, the relationship of ABO(H) and Lewis blood groups and the development of human diseases have been summarised. In addition, many studies have shown that blood group substances, such as blood group antigen or related antibody, play an important role in disease prevention and treatment. This review focuses on the advances of ABO(H), Lewis blood group substances in the treatment of diseases, which has important significance for the development of novel therapeutic methods.
Urbanisation and the shifting conditions of the state as a territorial‐political community: A study of the geographies of political efficacy
Authors: Luukkonen Juho , Weckroth Mikko , Kemppainen Teemu , Makkonen Teemu , Sirviö Heikki 
Published: September 2021

AbstractIn this paper, we contribute to recent debates on the geographies of discontent by examining the implications of urbanisation on the state as a territorial‐political community in the European context. Building on an Arendtian conception of politics, we argue that the emergence of the “urban” as a dominant spatio‐political imaginary has led to a narrowing of the conditions of politics and political agency within states. The urban imaginary has provoked selective spatio‐political discourses, geopolitical strategies, and policy practices that have resulted in the exclusion of certain social and spatial fractions of society from a shared sense of community and political agency within the state. To demonstrate this point, we empirically analysed the experience of political efficacy in Europe. The results of our analysis show that perceived external political efficacy is weakest in more rural settings and in regions with low GDP and a declining population. Accordingly, we suggest that policy measures ought to be directed against this sort of political alienation and should be used to create a stronger sense of political belonging and community.
Theorising liminal states of health: A spatio‐temporal analysis of undiagnosis and anticipatory diagnosis in the shadow of toxic pollution
Authors: Senanayake Nari 
Published: September 2021

AbstractThis paper demonstrates how greater engagement with liminality – as a concept and lived experience – can expand scholarly conceptualisations of health/disease in contaminated spaces. Drawing on ethnographic fieldwork conducted in Sri Lanka's dry zone between 2013 and 2017, I focus on residents' encounters with chronic kidney disease diagnosis in a region where the causes of illness are uncertain, the consequences of disease are often deadly, and the possibilities of developing sickness in the future are both unpredictable and ever‐present. Specifically, I examine how residents of kidney disease hotspots negotiate various attempts to categorise them as being, or not being, healthy in ways that give rise to experiences of liminality. Building on work in feminist disability studies, I conceptualise “undiagnosis” and “anticipatory diagnosis” as two such liminal states of health that reconfigure medical and social practices in the dry zone. As part of this analysis, I explain why residents are so reluctant to get screened for kidney disease and demonstrate how they strategically mobilise moments of “undiagnosis” to resist patient subjectivities and prolong existing lifeways. I then turn to a discussion of anticipatory diagnosis, which describes the practice of re‐classifying residents of disease hotspots who are not yet sick as embodying the potential to become ill at any time. Frequently deployed by the state, medical practitioners, and non‐dry zone communities, I demonstrate how this practice collapses categories of “at‐risk” and “diseased” in external categorisations of residents' future health status. In short, liminality comes to be embodied through the constant anticipation of disease despite uncertainty about who will actually become sick and why. Tying these experiences together, I elucidate how geography matters to the constitution of liminal states of health and crucially demonstrate how this liminality helps reproduce place attachments as well as forms of geographic differentiation in the shadow of toxic contamination.
Patterns of employment, skills, and tasks within MNEs associated with offshoring
Authors: Eliasson Kent , Hansson Pär , Lindvert Markus 
Published: September 2021

AbstractWe examine the relationship between relative demands for skills, non‐routine, and non‐offshorable tasks in Swedish MNE parents (onshore) and their employment shares in affiliates abroad (offshore). Our estimations suggest that increased employment shares in affiliates abroad (offshore) result in higher relative demand for skills and larger shares of non‐routine tasks performed by employed that are highly educated in the parents at home (onshore). However, we do not find any evidence for that the share of non‐offshorable tasks rises in the parents of Swedish MNEs when employment shares increase in their affiliates overseas. Furthermore, we estimate the relationships between absolute employment onshore (skilled and less‐skilled labour) and employment in affiliates offshore (high‐ and low‐income countries). Increased employment in affiliates in low‐income countries relates negatively to the employment of less‐skilled workers in manufacturing MNE parents (substitute), whereas increased employment in affiliates in high‐income countries correlates positively with the employment of skilled workers in service MNE parents (complement).
Dysbiosis of the gut microbiome impairs mouse skeletal muscle adaptation to exercise
Authors: Valentino Taylor R. , Vechetti Ivan J. , Mobley C. Brooks , Dungan Cory M. , Golden Lesley , Goh Jensen , McCarthy John J. 
Published: September 2021

AbstractThere is emerging evidence of a gut microbiome–skeletal muscle axis. The purpose of this study was to determine if an intact gut microbiome was necessary for skeletal muscle adaptation to exercise. Forty‐two 4‐month‐old female C57BL/6J mice were randomly assigned to untreated (U) or antibiotic‐treated (T) non‐running controls (CU or CT, respectively) or progressive weighted wheel running (PoWeR, P) untreated (PU) or antibiotic‐treated (PT) groups. Antibiotic treatment resulted in disruption of the gut microbiome as indicated by a significant depletion of gut microbiome bacterial species in both CT and PT groups. The training stimulus was the same between PU and PT groups as assessed by weekly (12.35 ± 2.06 vs. 11.09 ± 1.76 km/week, respectively) and total (778.9 ± 130.5 vs. 703.8 ± 112.9 km, respectively) running activity. In response to PoWeR, PT showed less hypertrophy of soleus type 1 and 2a fibres and plantaris type 2b/x fibres compared to PU. The higher satellite cell and myonuclei abundance of PU plantaris muscle after PoWeR was not observed in PT. The fibre‐type shift of PU plantaris muscle to a more oxidative type 2a fibre composition following PoWeR was blunted in PT. There was no difference in serum cytokine levels among all groups suggesting disruption of the gut microbiome did not induce systemic inflammation. The results of this study provide the first evidence that an intact gut microbiome is necessary for skeletal muscle adaptation to exercise.
imageKey points
Dysbiosis of the gut microbiome caused by continuous antibiotic treatment did not affect running activity.
Continuous treatment with antibiotics did not result in systemic inflammation as indicated by serum cytokine levels.
Gut microbiome dysbiosis was associated with blunted fibre type‐specific hypertrophy in the soleus and plantaris muscles in response to progressive weighted wheel running (PoWeR).
Gut microbiome dysbiosis was associated with impaired PoWeR‐induced fibre‐type shift in the plantaris muscle.
Gut microbiome dysbiosis was associated with a loss of PoWeR‐induced myonuclei accretion in the plantaris muscle.
Protocol for an observational cohort study investigating personalised medicine for intensification of treatment in people with type 2 diabetes mellitus: the PERMIT study
Authors: Bidulka Patrick , O’Neill Stephen , Basu Anirban , Wilkinson Samantha , Silverwood Richard J , Charlton Paul , Briggs Andrew , Adler Amanda I , Khunti Kamlesh , Tomlinson Laurie A , Smeeth Liam , Douglas Ian J , Grieve Richard 
Published: September 2021

IntroductionFor people with type 2 diabetes mellitus (T2DM) who require an antidiabetic drug as an add-on to metformin, there is controversy about whether newer drug classes such as dipeptidyl peptidase-4 inhibitors (DPP4i) or sodium-glucose co-transporter-2 inhibitors (SGLT2i) reduce the risk of long-term complications compared with sulfonylureas (SU). There is widespread variation across National Health Service Clinical Commissioning Groups (CCGs) in drug choice for second-line treatment in part because National Institute for Health and Care Excellence guidelines do not specify a single preferred drug class, either overall or within specific patient subgroups. This study will evaluate the relative effectiveness of the three most common second-line treatments in the UK (SU, DPP4i and SGLT2i as add-ons to metformin) and help target treatments according to individual risk profiles.Methods and analysisThe study includes people with T2DM prescribed one of the second-line treatments-of-interest between 2014 and 2020 within the UK Clinical Practice Research Datalink linked with Hospital Episode Statistics and Office of National Statistics. We will use an instrumental variable (IV) method to estimate short-term and long-term relative effectiveness of second-line treatments according to individuals’ risk profiles. This method minimises bias from unmeasured confounders by exploiting the natural variation in second-line prescribing across CCGs as an IV for the choice of prescribed treatment. The primary outcome to assess short-term effectiveness will be change in haemoglobin A1c (%) 12 months after treatment initiation. Outcome measures to assess longer-term effectiveness (maximum ~6 years) will include microvascular and macrovascular complications, all-cause mortality and hospital admissions during follow-up.Ethics and disseminationThis study was approved by the Independent Scientific Advisory Committee (20-064) and the London School of Hygiene & Tropical Medicine Research Ethics Committee (21395). Results, codelists and other analysis code will be made available to patients, clinicians, policy-makers and researchers.
Association of antenatal corticosteroids with morbidity and mortality among preterm multiple gestations: meta-analysis of observational studies
Authors: Lin Dongxin , Fan Dazhi , Chen Gengdong , Luo Caihong , Guo Xiaoling , Liu Zhengping 
Published: September 2021

ObjectiveThis meta-analysis aimed to assess the efficacy of antenatal corticosteroids (ACS) on morbidity and mortality among preterm multiple pregnancies.MethodsThe PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies investigating the outcomes among preterm multiple gestations following to ACS, from their inception to 1 November 2020. Two authors independently performed the study selection, risk of bias assessment and data extraction. The primary outcomes were respiratory distress syndrome (RDS) and mortality and secondary outcomes included intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), necrotising enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia. Pooled ORs were obtained using random effects models. Subgroup analyses were performed to explain heterogeneity by ACS completeness, administration-to-delivery intervals (≤7 days) and single or multicentre.ResultsA total of 16 observational studies with 36 973 newborns were included in the meta-analysis. ACS treatment was associated with a reduction in RDS (OR 0.66; 95% CI 0.54 to 0.82; I2=91.4%; p<0.001), mortality (OR 0.64; 95% CI 0.50 to 0.81; I2=85.9%; p<0.001), IVH (OR 0.67; 95% CI 0.54 to 0.83; I2=77.4%; p<0.001) and PVL (OR 0.65; 95% CI 0.47 to 0.92; I2=75.5%; p<0.001). Subgroup analyses showed ACS completeness, administration-to-delivery interval and multicentre study affected these associations.DiscussionACS may be beneficial for reducing the risks of RDS, mortality, IVH and PVL among preterm multiple gestations. The efficacy of ACS could be affected by ACS completeness and administration-to-delivery. More robust evidence on the efficacy of ACS treatment among multiple gestations is warranted.
Variation in preoperative stress testing by patient, physician and surgical type: a cohort study
Authors: Pappas Matthew A , Sessler Daniel I , Auerbach Andrew D , Kattan Michael W , Milinovich Alex , Blackstone Eugene H , Rothberg Michael B 
Published: September 2021

ObjectivesTo describe variation in and drivers of contemporary preoperative cardiac stress testing.SettingA dedicated preoperative risk assessment and optimisation clinic at a large integrated medical centre from 2008 through 2018.ParticipantsA cohort of 118 552 adult patients seen by 104 physicians across 159 795 visits to a preoperative risk assessment and optimisation clinic.Main outcomeReferral for stress testing before major surgery, including nuclear, echocardiographic or electrocardiographic-only stress testing, within 30 days after a clinic visit.ResultsA total of 8303 visits (5.2%) resulted in referral for preoperative stress testing. Key patient factors associated with preoperative stress testing included predicted surgical risk, patient functional status, a previous diagnosis of ischaemic heart disease, tobacco use and body mass index. Patients living in either the most-deprived or least-deprived census block groups were more likely to be tested. Patients were tested more frequently before aortic, peripheral vascular or urologic interventions than before other surgical subcategories. Even after fully adjusting for patient and surgical factors, provider effects remained important: marginal testing rates differed by a factor-of-three in relative terms and around 2.5% in absolute terms between the 5th and 95th percentile physicians. Stress testing frequency decreased over the time period; controlling for patient and physician predictors, a visit in 2008 would have resulted in stress testing approximately 3.5% of the time, while a visit in 2018 would have resulted in stress testing approximately 1.3% of the time.ConclusionsIn this large cohort of patients seen for preoperative risk assessment at a single health system, decisions to refer patients for preoperative stress testing are influenced by various factors other than estimated perioperative risk and functional status, the key considerations in current guidelines. The frequency of preoperative stress testing has decreased over time, but remains highly provider-dependent.