bluuebunny/crossref_metadata_2025_split huggingface dataset:
PBMC transcriptomics identifies immune-metabolism disorder during the development of HBV-ACLF
Authors: Li Jiang , Liang Xi , Jiang Jing , Yang Lingling , Xin Jiaojiao , Shi Dongyan , Lu Yingyan , Li Jun , Ren Keke , Hassan Hozeifa Mohamed , Zhang Jianing , Chen Pengcheng , Yao Heng , Li Jiaqi , Wu Tianzhou , Jin Linfeng , Ye Ping , Li Tan , Zhang Huafen , Sun Suwan , Guo Beibei , Zhou Xingping , Cai Qun , Chen Jiaxian , Xu Xiaowei , Huang Jianrong , Hao Shaorui , He Jinqiu , Xin Shaojie , Wang Di , Trebicka Jonel , Chen Xin , Li Jun 
Published: January 2021

ObjectiveHepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) pathophysiology remains unclear. This study aims to characterise the molecular basis of HBV-ACLF using transcriptomics.MethodsFour hundred subjects with HBV-ACLF, acute-on-chronic hepatic dysfunction (ACHD), liver cirrhosis (LC) or chronic hepatitis B (CHB) and normal controls (NC) from a prospective multicentre cohort were studied, and 65 subjects (ACLF, 20; ACHD, 10; LC, 10; CHB, 10; NC, 15) among them underwent mRNA sequencing using peripheral blood mononuclear cells (PBMCs).ResultsThe functional synergy analysis focusing on seven bioprocesses related to the PBMC response and the top 500 differentially expressed genes (DEGs) showed that viral processes were associated with all disease stages. Immune dysregulation, as the most prominent change and disorder triggered by HBV exacerbation, drove CHB or LC to ACHD and ACLF. Metabolic disruption was significant in ACHD and severe in ACLF. The analysis of 62 overlapping DEGs further linked the HBV-based immune-metabolism disorder to ACLF progression. The signatures of interferon-related, neutrophil-related and monocyte-related pathways related to the innate immune response were significantly upregulated. Signatures linked to the adaptive immune response were downregulated. Disruptions of lipid and fatty acid metabolism were observed during ACLF development. External validation of four DEGs underlying the aforementioned molecular mechanism in patients and experimental rats confirmed their specificity and potential as biomarkers for HBV-ACLF pathogenesis.ConclusionsThis study highlights immune-metabolism disorder triggered by HBV exacerbation as a potential mechanism of HBV-ACLF and may indicate a novel diagnostic and treatment target to reduce HBV-ACLF-related mortality.
Patterns of intimate partner violence against women in Europe: prevalence and associated risk factors
Authors: Podaná Zuzana 
Published: January 2021

BackgroundIntimate partner violence (IPV) is a complex phenomenon and some research suggests that there are qualitatively distinct IPV types. However, little is known about the risk factors associated with different IPV types.MethodsData from Violence against women: an European Union (EU)-wide survey, conducted by the EU Agency for Fundamental Rights was used. Latent class analysis (LCA) was employed to identify distinct IPV patterns based on the intensity of eight forms of violence by current partners (n=30 675). Multilevel multinomial logistic regression was used to examine individual and country-level risk factors associated with the outcome IPV patterns.ResultsA five-class solution was selected based on the LCA results. Two classes encompassed severe coercive IPV: the intimate terrorism class (1.5%) also comprised extensive physical violence whereas the high coercive control class (2.0%) did not. The partner’s alcohol abuse, violent behaviour outside the relationship and the woman’s abuse in childhood were the main individual factors positively associated with IPV. The country’s gender equality levels were negatively associated with the odds of experiencing intimate terrorism (adjusted OR, aOR 0.35, 95% CI 0.21 to 0.56) and high coercive control (aOR 0.63, 95% CI 0.47 to 0.85) versus no IPV. Although the effects of most individual risk factors were found universally for all IPV patterns, the strongest associations were typically revealed for the intimate terrorism pattern.ConclusionThe results support the importance of coercive control as a factor differentiating between IPV types and also highlight the need to consider IPV typologies in research. Policy implications of the findings are discussed.
‘The ethics approval took 20 months on a trial which was meant to help terminally ill cancer patients. In the end we had to send the funding back’: a survey of views on human research ethics reviews
Authors: Scott Anna Mae , Chalmers Iain , Barnett Adrian , Stephens Alexandre , Kolstoe Simon E , Clark Justin , Glasziou Paul 
Published: January 2021

BackgroundWe conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia.MethodsWe surveyed Australian health/medical researchers and Human Research Ethics Committee (HREC) members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide (optional) comments. Qualitative data were analysed thematically; quantitative data in R.ResultsWe received 514 responses. Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review (to prioritise systematic review topics 84%, on software strengths/weaknesses 85%); scenarios involving surplus samples (82%) and N-of-1 (single case) studies (76%) were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively.ConclusionsConsiderable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties—the same principle should apply to ethics reviews.
Clinical and laboratory features of 244 men with primary syphilis: a 5-year single-centre retrospective study
Authors: Ramoni Stefano , Genovese Giovanni , Pastena Andrea , Casazza Giovanni , Lunghi Giovanna , Marzano Angelo Valerio , Cusini Marco 
Published: January 2021

BackgroundSyphilis incidence has exponentially increased in recent decades, particularly among men who have sex with men (MSM). Primary syphilis is characterised by a chancre appearing at the site ofTreponema pallidum(TP) inoculation. Atypical morphological variants of syphilitic chancre are frequent. Clinical suspicion must be confirmed either by the demonstration of TP within the lesion through direct tests, such as dark field microscopy (DFM) orT. pallidumnucleic acid amplification technique (TP-NAAT), or by serological tests.ObjectivesTo analyse the clinical features, the sexual behaviour and the role of diagnostic tests in a cohort of men with primary syphilis in Milan.MethodsEpidemiological, clinical and laboratory data of male patients with primary syphilis seen at the STI Center of the University of Milan between 2015 and 2019 were retrospectively evaluated. Diagnosis was confirmed by at least one positive diagnostic test of either DFM, TP-NAAT or serology.ResultsAmong a total of 244 patients, 160 (65.6%) were MSM and 32 (13.1%) were living with HIV. One hundred twenty-four (50.8%) patients had a clinically atypical chancre. Chancres were exclusively extragenital in 30 (12.3%) patients, with MSM being more commonly affected (MSM vs heterosexuals: 16.3% vs 4.8%, respectively; p=0.012), and anal region the most frequently involved site. Chancres were multiple in 68/242 (28.1%) patients and morphologically atypical in 76/244 (31.1%). Diagnosis was obtained by (1) both serology and direct methods in 158/244 patients (64.7%), (2) serology solely in 47/244 (19.3%) and (3) direct methods solely in 39/244 (16%). DFM yielded positive results in 83/139 (59.7%) patients, while TP-NAAT gave positive results in 114/121 (94.2%) patients.ConclusionsPatients with primary syphilis frequently present with morphologically atypical chancres. Furthermore, MSM commonly exhibit extragenital involvement. A combined diagnostic approach including both direct and indirect tests is needed.
The Novelty of Icosapent Ethyl in the Management of Hypertriglyceridemia and Alleviating Cardiovascular Risk
Authors: Khan Muhammad Shoaib , Ishaq Muhammad , Ayub Muhammad Talha , Rehman Ateeq U. , Hayes John J. , Mortada Mohammad , Biederman Robert W. W. 
Published: January 2021

Hypertriglyceridemia is believed to be independently associated with an elevated risk of cardiovascular disease (CVD) events. Lifestyle changes and dietary modifications are recommended for individuals with high serum triglyceride (TG) levels (150-499 mg/dl), and pharmacological therapy in addition to lifestyle modification is recommended when serum

TG

levels
≥
500

mg
/
dl

. A residual cardiovascular risk remains even in statin appropriate treated patients with CVD risk factors, and in this patient population, hypertriglyceridemia poses an independent and increased risk of ischemic events. In December 2019, the US FDA approved icosapent ethyl (IPE) as an adjunct to a maximally tolerated statin to reduce the risk of CVD events in adults with serum

triglycerides
>
150

mg
/
dl

and have either established cardiovascular disease or diabetes and two or more additional CVD risk factors. Since IPE significantly decreases total ischemic events in the aforementioned patient population, it would be intriguing to know whether IPE alone added an advantage to lifestyle modification in the low-risk population, who has serum triglyceride between 150 mg/dl and 499 mg/dl.
Zanine, inovação social e móveis de madeira
Authors: Carvalho Amanda Beatriz Palma de , Bartholomeu Clara de Souza , Santos Maria Cecília Loschiavo dos 
Published: January 2021

José Zanine Caldas (1919-2001), designer e arquiteto autodidata brasileiro, foi responsável pelo desenvolvimento de produtos e casas icônicas em madeira e também de processos projetuais com artesãos com os quais trabalhava. Na área de design, seus dois momentos produtivos mais importantes apresentam significativas diferenças em relação à técnica utilizada, à inclusão do conhecimento técnico autóctone dos trabalhadores no processo produtivo, ao público-alvo dos produtos realizados e à preocupação com o meio-ambiente. Para demonstrar o desenvolvimento do pensamento de Zanine, compararemos seu trabalho nesses dois momentos diferentes: a época em que esteve à frente da Fábrica Móveis Artísticos Z, década de 1950, usando tecnologia importada e trabalho pouco especializado; e a produção de seus "Móveis-Denúncia", na década de 1970, em que fez móveis no sul da Bahia a partir do conhecimento dos construtores de canoas, de técnicas e ferramentas tradicionais. O artigo visa contribuir com a discussão sobre a função do designer e da produção material em um grupo de trabalhadores responsáveis pela confecção dos produtos a partir de diferentes metodologias projetuais adotadas pelo mesmo autor.
Higher Emergency Physician Chest Pain Hospitalization Rates Do Not Lead to Improved Patient Outcomes
Authors: Natsui Shaw , Sun Benjamin C. , Shen Ernest , Redberg Rita F. , Ferencik Maros , Lee Ming-Sum , Musigdilok Visanee , Wu Yi-Lin , Zheng Chengyi , Kawatkar Aniket A. , Sharp Adam L. 
Published: January 2021

Background:
Wide variation exists for hospital admission rates for the evaluation of possible acute coronary syndrome, but there are limited data on physician-level variation. Our aim is to describe physicians’ rates of admission for suspected acute coronary syndrome and associated 30-day major adverse events.

Methods:
We conducted a retrospective analysis of adult emergency department chest pain encounters from January 2016 to December 2017 across 15 community emergency departments within an integrated health system in Southern California. The unit of analysis was the Emergency physician. The primary outcome was the proportion of patients admitted/observed in the hospital. Secondary analysis described the 30-day incidence of death or acute myocardial infarction.

Results:
Thirty-eight thousand seven hundred seventy-eight patients encounters were included among 327 managing physicians. The median number of encounters per physician was 123 (interquartile range, 82–157) with an overall admission/observation rate of 14.0%. Wide variation in individual physician admission rates were observed (unadjusted, 1.5%–68.9%) and persisted after case-mix adjustments (adjusted, 5.5%–27.8%). More clinical experience was associated with a higher likelihood of hospital care. There was no difference in 30-day death or acute myocardial infarction between high- and low-admitting physician quartiles (unadjusted, 1.70% versus 0.82% and adjusted, 1.33% versus 1.29%).

Conclusions:
Wide variation persists in physician-level admission rates for emergency department chest pain evaluation, even in a well-integrated health system. There was no associated benefit in 30-day death or acute myocardial infarction for patients evaluated by high-admitting physicians. This suggests an additional opportunity to investigate the safe reduction of physician-level variation in the use of hospital care.
Health Service Utilization Patterns Among Adults With Congenital Heart Disease: A Population‐Based Study
Authors: Benderly Michal , Buber Jonathan , Kalter‐Leibovici Ofra , Blieden Leonard , Dadashev Alexander , Lorber Avraham , Nir Amiram , Yalonetsky Sergei , Chodick Gabriel , Weitzman Dahlia , Balicer Ran , Mazor Dray Efrat , Murad Havi , Razon Yaron , Hirsch Rafael ,   for the Israeli Adult Congenital Heart Disease Research Group
Published: January 2021

Background
Several studies have examined hospitalizations among patients with adult congenital heart disease (ACHD). Few investigated other services or utilization patterns. Our aim was to study service utilization patterns and predictors among patients with ACHD.

Methods and Results
We identified 11 653 patients with ACHD aged ≥18 years (median, 47 years), through electronic records of 2 large Israeli healthcare providers (2007–2011). The association between patient, disease, and sociogeographic characteristics and healthcare resource utilization were modeled as recurrent events accounting for the competing death risk. Patients with ACHD had high healthcare utilization rates compared with the general population. The highest standardized service utilization ratios (SSRs) were found among patients with complex congenital heart disease including primary care visits (SSR, 1.53; 95% CI, 1.47–1.58), cardiology outpatient visits (SSR, 5.17; 95% CI, 4.69–5.64), hospitalizations (SSR, 6.68; 95% CI, 5.82–7.54), and days in hospital (SSR, 15.37; 95% CI, 14.61–16.12). Adjusted resource utilization hazard increased with increasing lesion complexity. Hazard ratios (HRs) for complex versus simple disease were: primary care (HR, 1.14; 95% CI, 1.06–1.23); cardiology outpatient visits (HR, 1.40; 95% CI, 1.24–1.59); emergency department visits (HR, 1.19; 95% CI, 1.02–1.39); and hospitalizations (HR, 1.75; 95% CI, 1.49–2.05). Effects attenuated with age for cardiology outpatient visits and hospitalizations and increased for emergency department visits. Female sex, geographic periphery, and ethnic minority were associated with more primary care visits, and female sex (HR versus men, 0.89 [95% CI, 0.84–0.94]) and periphery (HR, 0.72 [95% CI, 0.58–0.90] for very peripheral versus very central) were associated with fewer cardiology visits. Arab minority patients also had high hospitalization rates compared with the majority group of Jewish or other patients.

Conclusions
Healthcare utilization rates were high among patients with ACHD. Female sex, geographic periphery, and ethnicity were associated with less optimal service utilization patterns. Further research should examine strategies to optimize service utilization in these groups.
Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder
Authors: von Känel Roland , Schmid Jean‐Paul , Meister‐Langraf Rebecca E. , Barth Jürgen , Znoj Hansjörg , Schnyder Ulrich , Princip Mary , Pazhenkottil Aju P. 
Published: January 2021

Background
Benzodiazepines and morphine are given during acute coronary syndromes (ACSs) to alleviate anxiety and pain, and β‐blockers may also reduce pain. ACS may induce posttraumatic stress disorder (PTSD) symptoms (PTSS). When taken during trauma other than ACS, benzodiazepines increase the risk of PTSS, but it is unknown if benzodiazepines increase the risk of PTSS in ACS. We examined the effects of drug exposure during ACS on the development of PTSS.

Methods and Results

Study participants were 154 patients with a verified ACS. Baseline demographics, clinical variables, and psychological measures were obtained through a medical history, through a psychometric assessment, and from patient records, and used as covariates in linear regression analysis. Three months after ACS, the severity of PTSS was assessed with the Clinician‐Administered PTSD Scale. During ACS, 37.7% of patients were exposed to benzodiazepines, whereas 72.1% were exposed to morphine and 88.3% were exposed to β‐blockers, but only 7.1% were exposed to antidepressants. Eighteen (11.7%) patients developed clinical PTSD. Adjusting for all covariates, benzodiazepine use was significantly associated with the Clinician‐Administered PTSD Scale total severity score (unstandardized coefficient B [SE], 0.589 [0.274]; partial
r
=0.18;
P
=0.032) and the reexperiencing subscore (B [SE], 0.433 [0.217]; partial
r
=0.17;
P
=0.047). Patients exposed to benzodiazepines had an almost 4‐fold increased relative risk of developing clinical PTSD, adjusting for acute stress disorder symptoms (odds ratio, 3.75; 95% CI, 1.31–10.77). Morphine, β‐blockers, and antidepressants showed no predictive value.

Conclusions
Notwithstanding short‐term antianxiety effects during ACS, benzodiazepine use might increase the risk of ACS‐induced PTSS with clinical significance, thereby compromising patients' quality of life and prognosis.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01781247.
Stroke Imaging Selection Modality and Endovascular Therapy Outcomes in the Early and Extended Time Windows
Authors: Nogueira Raul G. , Haussen Diogo C. , Liebeskind David , Jovin Tudor G. , Gupta Rishi , Jadhav Ashutov , Budzik Ron F. , Baxter Blaise , Krajina Antonin , Bonafe Alain , Malek Ali , Narata Ana Paula , Shields Ryan , Zhang Yanchang , Morgan Patricia , Bartolini Bruno , English Joey , Frankel Michael R. , Veznedaroglu Erol ,   for the Trevo Registry and DAWN Trial Investigators
Published: January 2021

Background and Purpose:
Advanced imaging has been increasingly used for patient selection in endovascular stroke therapy. The impact of imaging selection modality on endovascular stroke therapy clinical outcomes in extended time window remains to be defined. We aimed to study this relationship and compare it to that noted in early-treated patients.

Methods:
Patients from a prospective multicentric registry (n=2008) with occlusions involving the intracranial internal carotid or the M1- or M2-segments of the middle cerebral arteries, premorbid modified Rankin Scale score 0 to 2 and time to treatment 0 to 24 hours were categorized according to treatment times within the early (0–6 hour) or extended (6–24 hour) window as well as imaging modality with noncontrast computed tomography (NCCT)±CT angiography (CTA) or NCCT±CTA and CT perfusion (CTP). The association between imaging modality and 90-day modified Rankin Scale, analyzed in ordinal (modified Rankin Scale shift) and dichotomized (functional independence, modified Rankin Scale score 0–2) manner, was evaluated and compared within and across the extended and early windows.

Results:

In the early window, 332 patients were selected with NCCT±CTA alone while 373 also underwent CTP. After adjusting for identifiable confounders, there were no significant differences in terms of 90-day functional disability (ordinal shift: adjusted odd ratio [aOR], 0.936 [95% CI, 0.709–1.238],
P
=0.644) or independence (aOR, 1.178 [95% CI, 0.833–1.666],
P
=0.355) across the CTP and NCCT±CTA groups. In the extended window, 67 patients were selected with NCCT±CTA alone while 180 also underwent CTP. No significant differences in 90-day functional disability (aOR, 0.983 [95% CI, 0.81–1.662],
P
=0.949) or independence (aOR, 0.640 [95% CI, 0.318–1.289],
P
=0.212) were seen across the CTP and NCCT±CTA groups. There was no interaction between the treatment time window (0–6 versus 6–24 hours) and CT selection modality (CTP versus NCCT±CTA) in terms of functional disability at 90 days (
P
=0.45).

Conclusions:
CTP acquisition was not associated with better outcomes in patients treated in the early or extended time windows. While confirmatory data is needed, our data suggests that extended window endovascular stroke therapy may remain beneficial even in the absence of advanced imaging.
Minimalist Phenomenology and Van der Leeuw’s Phenomenology of Religion
Authors: Harding Brian 
Published: January 2021

Abstract
Beginning with a brief discussion of Dominique Janicaud’s proposal for a minimalist phenomenology, I turn to the work G. van der Leeuw and argue that his work in the phenomenology of religion can be profitably read as a minimalist phenomenology. I do this by focusing mainly on his methodological remarks, but do occasionally refer to his analyses of particular religious phenomena. Finally, the paper closes with some suggestions about how to think of the relationship between minimalist phenomenology and religious belief.
Antisemitism among Adolescents in Germany
Authors: Schröder Carl Philipp 
Published: January 2021

Abstract
Europe is facing a new wave of antisemitism, which has grown in recent years. In 2019, the number of reported antisemitic crimes has increased in Germany. On the one hand, Muslim immigrants are suspected of so-called “imported Antisemitism”. On the other hand, right-wing extremism still appears to be the main cause of most antisemitic crimes. Moreover, antisemitism may also be rooted in the left-wing spectrum hiding behind the criticism of Israel and its policies. To analyze the connections of antisemitic attitudes, data from a school survey of 6,715 ninth-graders are used. The results indicate a strong connection between right-wing attitudes and antisemitism as well as left-wing and Islamist attitudes and antisemitism. Higher values of antisemitism are also found among Muslims, but the main predictor of antisemitic attitudes is by far right-wing attitudes.