bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidity burden in the first three years after diagnosis in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis: a general practice registry-based study
Authors: Stouten Veerle , Pazmino Sofia , Verschueren P , Mamouris Pavlos , Westhovens René , de Vlam Kurt , Bertrand Delphine , Van der Elst Kristien , Vaes Bert , De Cock Diederik 
Published: June 2021

ObjectivesRheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA) are chronic inflammatory rheumatic conditions with high levels of comorbidity requiring additional therapeutic attention. We aimed to compare the 3-year comorbidity incidence and pain medication prescription in patients diagnosed with RA, PsA or SpA versus controls.MethodsData between 1999 and 2012 were obtained from Intego, a general practitioner (GP) morbidity registry in Flanders, Belgium. Cases were identified by International Classification of Primary Care (ICPC-2) codes representing ‘rheumatoid/seropositive arthritis (L88)’ or ‘musculoskeletal disease other (L99)’. The registered keywords mapped to these ICPC-2 codes were further verified and mapped to a RA/SpA/PsA diagnosis. Controls were matched on age, gender, GP practice and diagnosis date. We analysed the 3-year comorbidity burden in cases and controls, measured by the Rheumatic Diseases Comorbidity Index (RDCI). All electronically GP-prescribed drugs were registered.ResultsIn total, 738, 229 and 167 patients were included with a diagnosis of RA, SpA or PsA, respectively. Patients with RA or PsA had comparable median RDCI scores at baseline, but higher scores at year 3 compared with controls (RA: p=0.010; PsA: p=0.008). At baseline, depression was more prevalent in PsA patients vs controls (p<0.003). RA patients had a higher 3-year incidence of cardiovascular disease including myocardial infarction than controls (p<0.035). All disease population were given more prescriptions than controls for any pain medication type, even opioids excluding tramadol.ConclusionsThis study highlights the increasing comorbidity burden of patients with chronic inflammatory rheumatic conditions, especially for individuals with RA or PsA. The high opioid use in all populations was remarkable.
Antenatal Exposure to UV‐B Radiation and Preeclampsia: A Retrospective Cohort Study
Authors: Hastie Claire E. , Mackay Daniel F. , Clemens Tom L. , Cherrie Mark P. C. , Megaw Lauren J. , Smith Gordon C. S. , Stock Sarah J. , Dibben Chris , Pell Jill P. 
Published: June 2021

Background
Risk of preeclampsia varies by month of delivery. We tested whether this seasonal patterning may be mediated through maternal vitamin D concentration using antenatal exposure to UV‐B radiation as an instrumental variable.

Methods and Results

Scottish maternity records were linked to antenatal UV‐B exposure derived from satellites between 2000 and 2010. Logistic regression analyses were used to explore the association between UV‐B and preeclampsia, adjusting for the potential confounding effects of month of conception, child's sex, gestation, parity, and mean monthly temperature. Of the 522 896 eligible singleton deliveries, 8689 (1.66%) mothers developed preeclampsia. Total antenatal UV‐B exposure ranged from 43.18 to 101.11 kJ/m
2
and was associated with reduced risk of preeclampsia with evidence of a dose‐response relationship (highest quintile of exposure: adjusted odds ratio, 0.57; 95% CI, 0.44–0.72;
P
<0.001). Associations were demonstrated for UV‐B exposure in all 3 trimesters.

Conclusions
The seasonal patterning of preeclampsia may be mediated through low maternal vitamin D concentration in winter resulting from low UV‐B radiation. Interventional studies are required to determine whether vitamin D supplements or UV‐B–emitting light boxes can reduce the seasonal patterning of preeclampsia.
Central Triage of Acute Stroke Patients Across a Distributive Stroke Network Is Safe and Reduces Transfer Denials
Authors: Holder Derek , Leeseberg Kevin , Giles James A. , Lee Jin-Moo , Namazie Sheyda , Ford Andria L. 
Published: June 2021

Background and Purpose:
Mechanical thrombectomy has dramatically increased patient volumes transferred to comprehensive stroke centers (CSCs), resulting in transfer denials for patients who need higher level of care only available at a CSC. We hypothesized that a distributive stroke network (DSN), triaging low severity acute stroke patients to a primary stroke center (PSC) upon initial telestroke consultation, would safely reduce transfer denials, thereby providing additional volume to treat severe strokes at a CSC.

Methods:
In 2017, a DSN was implemented, in which mild stroke patients were centrally triaged, via telestroke consultation, to a PSC based upon a simple clinical severity algorithm, while higher acuity/severity strokes were triaged to the CSC. In an observational cohort study, data on acute ischemic stroke patients presenting to regional community hospitals were collected pre- versus post-DSN implementation. Safety outcomes and rate of CSC transfer denials were compared pre-DSN versus post-DSN.

Results:

The pre-DSN cohort (n=150), triaged to the CSC, had a similar rate of symptomatic intracerebral hemorrhage and discharge location compared with the post-DSN cohort (n=150), triaged to the PSC. Time to stroke unit admission was faster post-DSN (2 hours 40 minutes) versus pre-DSN (3 hours 29 minutes;
P
<0.001). Transfer denials were reduced post-DSN (3.8%) versus pre-DSN (1.8%;
P
=0.02), despite an increase in telestroke consultation volume over the same period (median, 3 calls per day pre-DSN versus 5 calls per day post-DSN;
P
=0.001). No patients who were triaged to the PSC required subsequent transfer to the CSC.

Conclusions:
A DSN, triaging mild ischemic stroke patients from community hospitals to a PSC, safely reduced transfer denials to the CSC, allowing greater capacity at the CSC to treat higher acuity stroke patients.
Comparative Theology in the Contemporary Australian Context
Authors: Ray Anita C. 
Published: June 2021

Abstract
This essay examines the practice of comparative theology within the culturally and religiously plural landscape of contemporary Australia. Tracing the early stages of the discipline in Australia to the Faculty of Theology and Philosophy at Australian Catholic University (acu) in 2012, the paper tracks its subsequent progress in the vibrant Asia-Pacific region. For the sake of clarity, I investigate a specific example of comparative theology, testing the feasibility of an engagement between Anglo-Celtic Christians and Indigenous Australian peoples. Seeking greater theological depth, I isolate a precise theme—the creation of the universe—and position the Indigenous viewpoint within the oral ‘Dreaming’ myths of the central Australian desert. The Christian perspective derives from written Biblical sources.
Theorising a Decolonising Asian Hermeneutic for Comparative Theology
Authors: Hedges Paul 
Published: June 2021

Abstract
This paper advances some ways in which Asian perspectives challenge the regnant discourse of comparative theology. It sets out some key aspects of the postcolonial critique of comparative theology, and shows how conceptions of “religion” in the discipline are often based in problematic Western paradigms. However, it also challenges any reified distinction of “Orient” and “Occident”. It is argued that if Asian comparative theology is to fulfil its potential it must not operate within existing dominant Western frames. The author suggests that a hermeneutical basis for comparative theology may be rethought through Asian lenses, and draws on the philosophy of Nāgārjuna to provide an example of this.
The spatiotemporal characteristics of near-surface water vapor in a coastal region revealed from radar-derived refractivity
Authors: Feng Ya-Chien , Hsu Hsiu-Wei , Weckwerth Tammy M. , Lin Pay-Liam , Liou Yu-Chieng , Wang Tai-Chi Chen 
Published: June 2021

AbstractThe radar-retrieved refractivity fields provide detailed depictions of the near-surface moisture distribution at the meso-gamma scale. This study represents a novel application of the refractivity fields by examining the spatiotemporal characteristics of moisture variability in a summertime coastal region in Taiwan over four weeks. The physiography in Taiwan lends itself to a variety of flow features and corresponding moisture behavior, which has not been well-studied. High-resolution of refractivity analyses demonstrate how a highly variable moisture field is related to the complex interaction between the synoptic-scale winds, diurnal local circulations, terrain, storms, and heterogeneous land-use. On average, higher refractivity (water vapor) is observed along the coastline and refractivity decreases inland toward the foothills. Under weak synoptic forcing conditions, the daytime refractivity field develops differently under local surface wind directions determined by the synoptic-scale prevailing wind and the sea breeze fronts. High moisture penetrates inland toward the foothills with southwesterly winds, but it stalls along the coastline with southerly and the northwesterly winds. The moisture distribution may further affect the occurrence of the inland afternoon storms. During the nighttime, the dry downslope wind decreases the moisture from the foothills toward the coast and forms a refractivity gradient perpendicular to the meridionally-oriented mountains. Furthermore, the refractivity fields illustrate higher resolution moisture distribution over surface station point measurements by showing the lagged daytime sea-breeze front between the urban and rural areas and the detailed nighttime heterogeneous moisture distribution related to land-use and rivers.
Discordance Between Subjective and Objective Measures of Smell and Taste in US Adults
Authors: Jang Sophie S. , Choi Janet S. , Kim James H. , Kim Natalie , Ference Elisabeth H. 
Published: June 2021

ObjectiveExamine the rates and factors associated with under‐ and overreporting of subjective changes in smell or taste as compared with objective measures.Study DesignCross‐sectional analysis.SettingNational Health and Nutrition Examination Survey (2013‐2014).MethodsWe examined participants ≥40 years old who completed subjective questionnaires (smell, n = 3510; taste, n = 3089), validated objective 8‐odor pocket smell tests, and NaCl/quinine taste tests. Over‐ and underreporting was determined by the difference in subjective and objective results. Univariate and multivariate logistic regression analyses incorporated sampling weights.ResultsA majority of participants correctly classified impairment: smell (73.7%; 95% CI, 71.2%‐76.1%) and taste (78.3%; 95% CI, 75.6%‐80.7%). Age ≥65 years (odds ratio, 2.23; P =. 001) was associated with underreporting impairment, and persistent cold symptoms (odds ratio, 2.15; P =. 001) were associated with overreporting smell impairment. Smoke, onion, and natural gas scents were incorrectly identified more frequently by individuals aged ≥65 years after Bonferroni correction. No factors were associated with under‐ and overreporting taste impairment.ConclusionAlthough the concordance rate between subjective and objective assessment of smell and taste impairment remains high, we found that older age was associated with incorrect report of impairment. This suggests that the subjective perception of smell varies across demographical and clinical factors, and it is important to not overlook such factors in clinical practice. Potentially using a simplified odor assessment regularly in the clinical setting may aid in early detection and intervention.
Nutrition knowledge, food choices and diet quality of genotyped and non-genotyped individuals during the COVID-19 pandemic
Authors: Kapellou Angeliki , Silva Gabriela , Pilic Leta , Mavrommatis Yiannis 
Published: June 2021

Background: Severe obesity (body mass index ≥ 40 kg/m2) and non-communicable diseases, both influenced by diet, have been associated with COVID-19. Genotype-based personalised nutrition advice may improve nutrition knowledge and enhance behaviour change towards better diet quality compared with conventional recommendations. Aim: To investigate the nutrition knowledge, food choices and diet quality in genotyped and non-genotyped individuals during the COVID-19 pandemic. Methods: One hundred and twenty-three healthy UK adults were recruited using convenience sampling through social networks. The online questionnaire consisted of the General Nutrition Knowledge Questionnaire, the Food Choices Questionnaire, and the EPIC-Norfolk Food Frequency Questionnaire (FFQ). FFQ was used to calculate participant diet quality with the Diet Quality Index-International and socio-demographic and anthropometric data. Results: Median general nutrition knowledge, diet variety and diet balance scores were higher in genotyped compared with non-genotyped individuals (71.0 ± 11.0 vs. 61.0 ± 15.0, p = <.001, 18.00 ± 5.00 vs. 15.00 ± 5.00, p = .007 and 2.00 ± 4.00 vs. 0.00 ± 2.00, p = .025, respectively). Pooled sample multiple regression showed that health motive positively influenced while familiarity motive negatively influenced diet quality index scores ( β = .428, t = 4.822, p = <.001 and β = –.356, t = –4.021, p = .001, respectively). Conclusions: Nutrition knowledge and diet quality indices of balance and variety were higher among genotyped compared with non-genotyped individuals; overall diet quality was similar between groups. This may be due to pandemic-specific factors, such as altered motives of food choice and availability.
Multiomic analysis of the function of SPOCK1 across cancers: an integrated bioinformatics approach
Authors: Han Jie , Rong Yihui , Gao Xudong 
Published: June 2021

Objective To investigate SPARC (osteonectin), cwcv and kazal like domains proteoglycan 1 ( SPOCK1) gene expression across The Cancer Genome Atlas (TCGA) cancers, both in cancer versus normal tissues and in different stages across the cancer types. Methods This integrated bioinformatics study used data from several bioinformatics databases (Cancer Cell Line Encyclopedia, Genotype-Tissue Expression, TCGA, Tumor Immune Estimation Resource [TIMER]) to define the expression pattern of the SPOCK1 gene. A survival analysis was undertaken across the cancers. The search tool for retrieval of interacting genes (STRING) database was used to identify proteins that interacted with SPOCK1. Gene Set Enrichment Analysis was conducted to determine pathway enrichment. The TIMER database was used to explore the correlation between SPOCK1 and immune cell infiltration. Results This multiomic analysis showed that the SPOCK1 gene was expressed differently between normal tissues and tumours in several cancers and that it was involved in cancer progression. The overexpression of the SPOCK1 gene was associated with poor clinical outcomes. Analysis of gene expression and tumour-infiltrating immune cells showed that SPOCK1 correlated with several immune cells across cancers. Conclusions This research showed that SPOCK1 might serve as a new target for several cancer therapies in the future.
Factors associated with microvascular occlusion in patients with ST elevation myocardial infarction after primary percutaneous coronary intervention
Authors: Huang Yinhao , Lei Dazhou , Chen Ziwei , Xu Biao 
Published: June 2021

Objective This study aimed to determine predictors of microvascular occlusion (MVO) in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI). Methods This retrospective, observational study consecutively included 113 patients with STEMI undergoing pPCI. Cardiac magnetic resonance imaging was used to determine the presence of MVO in these patients. Biomarkers in serum were routinely tested 1 day after pPCI. Multivariable logistic regression analysis was used to evaluate significant predictors of occurrence of MVO. Results There were 62 patients in the MVO group and 51 patients in the non-MVO group. C-reactive protein (CRP), thrombomodulin, lymphatic vessel endothelial hyaluronan receptor-1, syndecan-1, and troponin T (TnT) levels after the procedure were significantly higher in the MVO group than in the non-MVO group. CRP (hazard ratio [HR]=1.036), TnT (HR=1.316), and syndecan-1 (HR=1.986) levels were independently associated with MVO in patients with acute myocardial infarction after pPCI. Conclusions Levels of CRP, TnT, and syndecan-1 can be used as serum biomarkers for MVO in patients with STEMI receiving pPCI.
Improving outcomes of surgery in advanced infiltrative thymic tumours: the benefits of multidisciplinary approach
Authors: Billè Andrea , Bilkhu Rajdeep , Benedetti Giulia , Lucchese Gianluca 
Published: June 2021

Background: For stage III or IVa thymic tumours, a multimodality approach is recommended. The role of surgery is to achieve complete resection. Aim: To present the outcomes of patients undergoing surgery for stage III or IVa thymoma. Methods: Retrospective review of patients undergoing open surgery for stage III or IVa thymoma between 2016 and 2020 at a single centre was performed. Preoperative imaging, treatment plan, surgical approach, and postoperative outcomes were analyzed. Results: Forty-seven patients underwent surgery for thymoma. Patients with clinical stage I/II thymoma or minimally invasive thymectomy were excluded. Thirteen patients with clinical stage III or IVa were included. Median sternotomy approach was used in four patients, of which one was redo sternotomy; a hemi-clamshell in four; and a combination of approaches in the remaining five patients. There was no postoperative mortality. Four patients had postoperative complications. Complete resection was achieved in all but two patients. At a median follow-up of 17.9 months, all patients were alive with no evidence of recurrence except one who died 4 months after surgery from coronavirus disease 2019 (COVID-19) pneumonia. Conclusions: Surgery for stage III and IVa thymoma is safe and can be achieved with complete macroscopic resection. To obtain adequate exposure of all structures involved in the tumour, combined surgical approaches can be used with no increased morbidity. The majority of patients, even after extrapleural pneumonectomy, did not receive adjuvant radiotherapy and had no evidence of local relapse.
Heliox for Pediatric Critical Asthma: A Multicenter, Retrospective, Registry-Based Descriptive Study
Authors: Lew Alicia , Morrison John M. , Amankwah Ernest , Sochet Anthony A. 
Published: June 2021

Background: In cases of critical asthma (CA), heliox may be applied as an adjunctive rescue therapy to avoid invasive mechanical ventilation (MV), improve deposition of aerosolized medications, and enhance laminar airflow through obstructed airways. Using the Pediatric Health Information System (PHIS) registry, we evaluate heliox prescribing and explored for differences in MV rates and hospital length of stay (LOS) among children with and without heliox exposure. Methods: We performed a retrospective cohort study using PHIS data from 42 pediatric intensive care units among children 5-17 years of age admitted for CA from 2010 through 2019. Primary outcomes were heliox prescribing rates and trends. Secondary outcomes were invasive MV rates and LOS assessed in a subgroup of children receiving ≥ 1 adjunctive intervention(s). Results: Of the 19,780 studied, heliox was prescribed in 12.5% and linearly declined from 16.1% in 2010 to 5.6% in 2019. The overall MV rate was 12.8% and was lower in subjects receiving heliox alone (4.9%) compared to heliox plus alternative adjunctive therapies [31.2%] or children receiving non-heliox adjunctive therapies [22.1%], P < .01). Accounting for MV, no difference in LOS was observed. In exploratory adjusted models, MV free hospitalization was associated with heliox-only exposure (OR: 0.33, 95% CI: 0.17-0.63, P < .01) and exposure to multiple adjunctive therapies was associated with MV (OR: 2.48, 95% CI: 1.56-3.94, P < .01). Conclusions: In this multicenter retrospective study from 42 children’s hospitals, heliox prescribing for CA declined over the last decade. Subjects receiving multiple adjunctive therapies more commonly required invasive MV perhaps indicating a greater severity of illness. At this time, prospective trials needed to identify the role of heliox for pediatric CA.
Patient-Specific Risk Factors Associated With the Development of Hyperchloremia in a Neurocritical Care Intensive Care Unit
Authors: Hamilton Leslie A. , Behal Michael L. , Carter Ashley R. , Rowe A. Shaun 
Published: June 2021

Background: Hypertonic sodium chloride (HTS) is used in intensive care unit (ICU) settings to manage cerebral edema, intracranial hypertension, and for the treatment of severe hyponatremia. It has been associated with an increased incidence of hyperchloremia; however, there is limited literature focusing on hyperchloremic risk in neurologically injured patients. Objective: The primary objective of this study was to determine risk factors associated with development of hyperchloremia in a neurocritical care (NCC) ICU population. Methods: This was a retrospective case-control study performed in an adult NCC ICU and included patients receiving HTS. The primary outcome was to evaluate patient characteristics and treatments associated with hyperchloremia. Secondary outcomes included acute kidney injury and mortality. Results: Overall, 133 patients were identified; patients who were hyperchloremic were considered cases (n = 100) and patients without hyperchloremia were considered controls (n = 33). Characteristics and treatments were evaluated with univariate analysis and a logistic regression model. In the multivariate model, APACHE II Score, initial serum osmolality, total 3% saline volume, and total 23.4% saline volume were significant predictors for hyperchloremia. In addition, patients with a serum chloride greater than 113.5 mEq/L were found to have a higher risk of acute kidney injury (AKI) (adjusted OR 3.15; 95% CI 1.10-9.04). Conclusions: This study demonstrated APACHE II Score, initial serum osmolality, and total 3% and 23.4% saline volumes were associated with developing hyperchloremia in the NCC ICU. In addition, hyperchloremia is associated with an increased risk of AKI.
Using Climate-HIV to describe real-world clinical outcomes for people living with HIV taking dolutegravir-based regimens
Authors: Okoli Chinyere , Schwenk Achim , Radford Matthew , Myland Melissa , Taylor Stephen , Barnes Justine , Fox Ashini , Darley Alison , Grimson Fiona , Reeves Iain , Munshi Sajid , Croucher Adam , Boxall Naomi , Paice Alistair , van Wyk Jean , Benn Paul 
Published: June 2021

Objectives: The objective of this study was to describe the real-world use and effectiveness of dolutegravir-based regimens (DBRs) in routine clinical practice in the United Kingdom. Methods: Retrospective analysis was conducted using data from four National Health Service trusts using Climate-HIV, an electronic case record system. Eligible patients were aged ≥18 years with HIV-1 infection who were prescribed a DBR from December 2012 to March 2018. Outcome measurements were accessed at DBR initiation and at weeks 24, 48 and 96 and the last recorded visit up to the extraction date (last measurement). The primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL at Week 48. Results: The study cohort included 934 patients; 337 (36%) were female, 414 (47%) were white and 717 (77%) were treatment experienced (TE). The Kaplan–Meier estimated probability of achieving HIV-1 RNA <50 copies/mL at 48 weeks was 96% for treatment-naive (TN) patients and 86% for TE patients. Median times to viral suppression (<50 copies/mL) were 49 and 57 days for TN and TE patients with detectable baseline viral load, respectively, according to Kaplan–Meier analysis. Median follow-up time was 377 days (interquartile range: 131–683). At last measurement, 87% (809/934) of patients remained on a DBR; among those patients, 681 (84%) had HIV-1 RNA <50 copies/mL. Conclusions: High levels of virologic suppression and low rates of discontinuation of DBRs were seen in a large, diverse, UK-based population with HIV-1 infection. These findings are broadly consistent with efficacy data from phase III studies.