bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarkers of neurodegeneration and glial activation validated in Alzheimer’s disease assessed in longitudinal cerebrospinal fluid samples of Parkinson’s disease
Authors: Bartl Michael , Dakna Mohammed , Galasko Douglas , Hutten Samantha J. , Foroud Tatiana , Quan Marian , Marek Kenneth , Siderowf Andrew , Franz Jonas , Trenkwalder Claudia , Mollenhauer Brit ,   on behalf of the Parkinson’s Progression Markers Initiative
Published: October 2021

Aim
Several pathophysiological processes are involved in Parkinson’s disease (PD) and could inform in vivo biomarkers. We assessed an established biomarker panel, validated in Alzheimer’s Disease, in a PD cohort.

Methods
Longitudinal cerebrospinal fluid (CSF) samples from PPMI (252 PD, 115 healthy controls, HC) were analyzed at six timepoints (baseline, 6, 12, 24, 36, and 48 months follow-up) using Elecsys® electrochemiluminescence immunoassays to quantify neurofilament light chain (NfL), soluble TREM2 receptor (sTREM2), chitinase-3-like protein 1 (YKL40), glial fibrillary acidic protein (GFAP), interleukin-6 (IL-6), S100, and total α-synuclein (αSyn).

Results
αSyn was significantly lower in PD (mean 103 pg/ml vs. HC: 127 pg/ml, p<0.01; area under the curve [AUC]: 0.64), while all other biomarkers were not significantly different (AUC NfL: 0.49, sTREM2: 0.54, YKL40: 0.57, GFAP: 0.55, IL-6: 0.53, S100: 0.54, p>0.05) and none showed a significant difference longitudinally. We found significantly higher levels of all these markers between PD patients who developed cognitive decline during follow-up, except for αSyn and IL-6.

Conclusion
Except for αSyn, the additional biomarkers did not differentiate PD and HC, and none showed longitudinal differences, but most markers predict cognitive decline in PD during follow-up.
Do automatic push notifications improve patient flow in the emergency department? analysis of an ED in a large medical center in Israel
Authors: Trotzky Daniel , Posner Liron , Mosery Jonathan , Cohen Aya , Avisar Shiran , Pachys Gal 
Published: October 2021

Introduction
Congestion in emergency departments [ED] is a significant challenge worldwide. Any delay in the timely and immediate medical care provided in the ED can affect patient morbidity and mortality. Our research analyzed the use of an innovative platform to improve patient navigation in the ED, as well as provide updated information about their care. Our hope is that this can improve ED efficiency and improve overall patient care.

Objective
The primary objective of our study was to determine whether the use of an automatic push notification system can shorten ‘length of stay’ (LOS) in the ED, improve patient flow, and decrease ED patient load.

Methods
This was a prospective cohort study utilizing data extrapolated from the electronic medical records of 2972 patients who visited the walk-in ED of a large-scale central hospital in Israel from January 17, 2021 to March 15, 2021. During this period, the automatic push text notification system was activated on a week-on week-off basis. We compared data from our experimental group with the control group.

Results
The results of this study indicate that the use of an automatic push notification system had a minimal impact on specific parameters of ED patient flow. Apart from a few significant reductions of specific timed-intervals during patients’ ED visit, the majority of results were not statistically significant.

Conclusion
This study concluded that the anticipated benefits of a push text notification system in the ED do not, at this stage, justify the system’s additional cost. We recommend a follow-up study to further investigate other possible benefits.
A physician-led medical emergency team increases the rate of medical interventions: A multicenter study in Korea
Authors: Lee Su Yeon , Ahn Jee Hwan , Kang Byung Ju , Jeon Kyeongman , Lee Sang-Min , Lee Dong Hyun , Lee Yeon Joo , Kim Jung Soo , Park Jisoo , Moon Jae Young , Hong Sang-Bum 
Published: October 2021

Background
According to the rapid response system’s team composition, responding teams were named as rapid response team (RRT), medical emergency team (MET), and critical care outreach. A RRT is often a nurse-led team, whereas a MET is a physician-led team that mainly plays the role of an efferent limb. As few multicenter studies have focused on physician-led METs, we comprehensively analyzed cases for which physician-led METs were activated.

Methods
We retrospectively analyzed cases for which METs were activated. The study population consisted of subjects over 18 years of age who were admitted in the general ward from January 2016 to December 2017 in 9 tertiary teaching hospitals in Korea. The data on subjects’ characteristics, activation causes, activation methods, performed interventions, in-hospital mortality, and intensive care unit (ICU) transfer after MET activation were collected and analyzed.

Results
In this study, 12,767 cases were analyzed, excluding those without in-hospital mortality data. The subjects’ median age was 67 years, and 70.4% of them were admitted to the medical department. The most common cause of MET activation was respiratory distress (35.1%), followed by shock (11.8%), and the most common underlying disease was solid cancer (39%). In 7,561 subjects (59.2%), the MET was activated using the screening system. The commonly performed procedures were arterial line insertion (17.9%), intubation (13.3%), and portable ultrasonography (13.0%). Subsequently, 29.4% of the subjects were transferred to the ICU, and 27.2% died during hospitalization.

Conclusions
This physician-led MET cohort showed relatively high rates of intervention, including arterial line insertion and portable ultrasonography, and low ICU transfer rates. We presume that MET detects deteriorating patients earlier using a screening system and begins ICU-level management at the patient’s bedside without delay, eventually preventing the patient’s condition from worsening and transfer to the ICU.
The use of local therapy in preventing urethral strictures: A systematic review
Authors: Jacobs Marleen E. , de Kemp Vincent F. , Albersen Maarten , de Kort Laetitia M. O. , de Graaf Petra 
Published: October 2021

Background
Urethral stricture disease is a common problem amongst men in Western countries often leading to a decreased quality of life. Current endoscopic treatment procedure shows an unsatisfying stricture recurrence rate which could be improved by addition of local therapies.

Objectives
To provide an overview of both preclinical and clinical studies in order to investigate current level of evidence on the addition of local therapy to improve urethral stricture recurrence rates after endoscopic procedures.

Methods
We performed a literature search in December 2020 and August 2021 using Cochrane, Embase, PubMed, Scopus and Web of Science and identified articles through combinations of search terms for ‘urethral stricture disease’, ‘stricture formation’ and ‘local interventions’. We used the SYRCLE, RoB-2 and ROBINS-I tools to assess risk of bias across included studies. We did not perform a meta-analysis due to methodological differences between studies.

Results
We included 32 articles in the qualitative analysis, 20 of which were preclinical studies and 12 clinical studies. Regarding preclinical articles using an animal model, nearly all interventions showed to have a positive effect on either urethral fibrosis, urethral stricture formation and/or fibrotic protein expression levels. Here, immunosuppressants and chemotherapeutics seemed most promising for possible clinical purposes. Regarding clinical studies, mitomycin-C and hyaluronic acid and carboxymethylcellulose showed positive effects on urethral stricture recurrence rates with low to intermediate risk of bias across studies. However, the positive clinical effects of mitomycin-C and steroids seemed to decrease in studies with a longer follow-up time.

Conclusion
Although local adjuvant use of mitomycin-C or hyaluronic acid and carboxymethylcellulose may carry clinical potential to improve urethral structure recurrence rates after endoscopic procedures, we believe that a large, well-designed RCT with a yearlong follow-up time is necessary to identify the true clinical value.
Characteristics of new HIV diagnoses over 1995–2019: A clinic-based study in Montréal, Canada
Authors: Giguère Katia , Vaziri Maliheh , Olivier Clément , Charest Louise , Szabo Jason , Thomas Réjean , Maheu-Giroux Mathieu 
Published: October 2021

Background
Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montréal (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s.

Methods
Using diagnosis data from participants of the Clinique médicale l’Actuel cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 <350 cells/μL) or advanced stage (CD4 <200 cells/μL) of HIV infection at diagnosis were assessed through meta-regressions.

Results
A total of 2,612 patients diagnosed with HIV between January 1st, 1995 and December 31st, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%).

Conclusions
In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.
Eosinophilic Gastroenteritis: Using Presenting Findings to Predict Disease Course
Authors: Havlichek Daniel , Choung Rok Seon , Murray Joseph A. 
Published: October 2021

INTRODUCTION:
Studies on eosinophilic gastroenteritis have identified broad spectrums of disease. We aimed to characterize subtypes of disease and ascertain outcomes of each group.

METHODS:
This is a retrospective cohort study from a large tertiary medical center including 35 patients diagnosed with eosinophilic gastroenteritis from 2007 to 2018. We defined 2 groups of patients based on clinical and laboratory findings at presentation. Severe disease was defined as having weight loss at time of presentation, hypoalbuminemia at presentation, serosal disease involvement, or anemia at diagnosis. The remaining patients were labeled as mild disease group. We collected and compared demographic data, clinical features, laboratory findings, an allergy history, and disease course of both cohorts.

RESULTS:
Among 35 patients with eosinophilic gastroenteritis, 18 patients met the criteria for severe disease and 17 patients for mild disease. Of the patients with severe eosinophilic gastroenteritis, 6 (38%) had remission without chronic symptoms, whereas 10 (63%) had chronic symptoms requiring chronic medical therapy. Of the mild group, 12 patients (80%) had disease remission without chronic medications. An allergy history was more common in the severe disease group (83%) compared with the mild disease group (45%). Prednisone and open capsule budesonide were the most commonly used treatment medications in both groups.

DISCUSSION:
Patients with eosinophilic gastroenteritis may be characterized into 2 forms. Patients with weight loss at time of presentation, hypoalbuminemia at presentation, serosal disease involvement, or anemia at diagnosis were associated with a chronic disease course requiring chronic medications.
Clinical Impact of Pathogenic Germline Variants in Pancreatic Cancer: Results From a Multicenter, Prospective, Universal Genetic Testing Study
Authors: Uson Pedro L. S. , Samadder N. Jewel , Riegert-Johnson Douglas , Boardman Lisa , Borad Mitesh J. , Ahn Daniel , Sonbol Mohamad B. , Faigel Douglas O. , Fukami Norio , Pannala Rahul , Kunze Katie , Golafshar Michael , Klint Margaret , Esplin Edward D. , Nussbaum Robert L. , Stewart A. Keith , Bekaii-Saab Tanios 
Published: October 2021

INTRODUCTION:
To report the prevalence and outcomes of unselected pancreatic cancer (PC) patients with pathogenic/likely pathogenic germline variants (PGVs) detected using a universal testing approach.

METHODS:
We undertook a prospective, multisite study of germline sequencing using a >80 gene next-generation sequencing platform among 250 patients with PC (not selected for age or family history of cancer) between April 1, 2018, and March 31, 2020. Demographic, tumor characteristics, and clinical outcomes were compared between PGV carriers and noncarriers.

RESULTS:
Of 250 patients, the mean age was 65 years (SD 8.7), 56% was male, 83.6% was White, and 65.6% had advanced disease (stages III and IV). PGVs were found in 15.2% (N = 38) of patients, and 2 patients had more than 1 PGV. Variants of uncertain significance were found in 44.4% (N = 111). Family history of cancer (odds ratio: 2.36, 95% confidence interval: 1.14–5.19, P = 0.025) was associated with a higher risk of PGV. In a median follow-up of 16.5 months, the median overall survival was 16.8 months in PGV carriers compared with 16.5 months in noncarriers (hazard ratio: 0.51, 95% confidence interval: 0.25–1.01, P = 0.05). Higher levels of carbohydrate antigen 19-9 and advanced disease stages (III and IV) were associated with worse outcomes in both groups. Overall, 68% of PGV carriers had mutations in homologous recombination repair genes, including BRCA1, BRCA2, PALB2, ATM, CHEK2, NBN, and RAD51C.

DISCUSSION:
Universal multigene panel testing in PC reveals that 1 in 6 patients are carriers of PGV. Multigene germline testing should be used to aid in treatment selection, prognostication, and familial cancer counseling.
The effect of cytomegalovirus on clinical and paraclinical as well as immune parameters of children with rotavirus infection
Authors: Sliepchenko M. Yu. , Kuznetsov S. V. 
Published: October 2021

The aim is to evaluate the effect of cytomegalovirus on clinical and paraclinical as well as immunological parameters in children with rotavirus infection (RVI).
Materials and methods. 50 children aged one to three years, patients with moderate and severe intestinal infections of rotavirus etiology were examined. All children were examined for herpes virus infections types 1, 2, 4, 5, 6. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of specific Ig G and Ig M for herpes viruses types 1, 2, 4, 5, 6, and in the case of a positive test, polymerase chain reaction (PCR) determined the presence of DNA (qualitatively) of these herpesviruses. Group 1 (mono-RVI), which was taken as a reference, included 33 children in whom no infection with any of these viruses of the herpes group was detected. Group 2 included 17 patients who underwent RVI on the background of CMV infection, the presence of infection with other viruses of the herpes group was excluded. Immune response parameters (CD 3+, CD 4+, CD 8+, CD 16+, CD 22+, Ig A, Ig M, Ig G, IL 1β, 4, TNF-α) in the acute period of the disease and in the period of convalescence were analyzed.
Qualitative indicators were given in the form of absolute and relative (%) value. Significance of differences was determined using Pearson’s χ2 test (Pearson’s Chi-squared test). Quantitative indicators were given in the form of median (Me) and values of lower (LQ) and upper (UQ) quartiles. The significance of differences in quantitative indicators in two unrelated groups was determined using the Mann–Whitney U-test. The threshold value of the confidence level was taken as 0.05.
Results. The analysis of the obtained data allows to establish that in the acute period of RVI infection in children with CMV leads to lower figures of temperature reaction, lower vomiting rate, prolongation of hospitalization, along with decrease in leukocytes, CD 16+ (%) cells and immunoregulatory index (CD 4+/CD 8+) against the background of increased levels of monocytes, CD 8+ (%) T-lymphocytes, concentrations of IL-4 and TNF-α. During convalescence, the presence of CMV is associated with an increase in the duration of fever and diarrhea, an increase in monocytes, CD 8+ (%) T cells, concentrations of IL-4, TNF-α and lower figures of immunoregulatory index, CD 16+ (%), CD 22+ (%) T cells and Ig M.
Conclusions. Latent cytomegalovirus infection in children with rotavirus gastroenteritis significantly affects a number of clinical and paraclinical as well as immune parameters, which leads to a decrease in the intensity of clinical manifestations in the acute period of the disease and the prolongation of some symptoms during convalescence.
Pathomorphological changes of the placenta in coronavirus disease (COVID 19)
Authors: Savchuk T. V. , Gychka S. H. , Leshchenko I. V. 
Published: October 2021

The aim of this research was to study the pathomorphological changes in the placenta in case of coronavirus disease (COVID-19) in the anamnesis during different periods of gestation.
Materials and methods. 53 placentas of women with the coronavirus disease (COVID-19) (RNA determination of the SARS-CoV-2) during the pregnancy were studied. The material was divided into the following groups: 1 and 2 – placentas in cases with a negative PCR test in full-term newborns who were born in satisfactory condition and high Apgar score. Group 1 (n = 29) – mother’s history of COVID-19 at 34–39 weeks of gestation; group 2 (n = 17) – mother’s history of COVID-19 at 23-33 weeks of gestation; 3 (n = 7) – placenta in case of antenatal fetal death.
Results. Statistically significant differences were revealed between study groups: chorioamnionitis prevailed in group 1 (in 28 cases (96.6 %); confidence interval (CI): 86.4–100.0 %; P1-2 = 0.004); in groups 2 and 3 – arteriosclerosis (in 13 cases (76.5 %); CI: 52.2– 93.9 %; P1-2 = 0.0003 and in 7 cases (100 %); CI: 75.7–100.0 %; P1-3 = 0.001; respectively). COVID-19 was diagnosed in group 1 from 34 to 39 weeks of gestation (median 36.5), group 2 from 23 to 33 weeks (median 28.0), in group 3 from 13 to 32 weeks with a median of 24.5. Antenatal fetal death was observed between 14 and 41 weeks (median 31.4).
Conclusions. Pathomorphological changes in the placenta in the coronavirus disease COVID-19 depended on the duration of the post-COVID interval (the time interval from the diagnosis of COVID-19 and the moment of delivery), due to the sequential change in the phases of the inflammatory process: alteration, exudation and proliferation, followed by fibrosis. The formation of acute placental insufficiency in coronavirus disease COVID-19, diagnosed up to 1–6 weeks to delivery, is associated with the development of severe disorders of circulation and acute exudative inflammatory reactions of varying severity. The formation of chronic placental insufficiency is associated with the proliferative stage of inflammation. These changes lead to the development of fibrosis in the wall of arterioles and intervillous space. The most significant structural changes in the placenta, leading to placental insufficiency, were observed in group 2 – at the time of infection in the period from 23–33 weeks of pregnancy. Coronavirus disease COVID-19 in the mother in the second trimester of pregnancy is a risk factor for perinatal losses, which are caused by the changes in the placenta described above with an increase in the duration of the post-COVID interval.
Study of the antimicrobial and fungicidal activity of the essential oil Thymus x citriodorus (Pers.) Schreb. var. “Silver Queen”
Authors: Steshenko Ya. M. , Mazulin O. V. , Polishchuk N. M. 
Published: October 2021

The main problem of modern phytotherapy is the medicinal plants that have a sufficient raw material base and contain a large number of biologically active substances. Treatment of diseases with synthetic drugs leads to the development of resistance to pathogenic microflora and the appearance of allergic reactions. Therefore, to solve this problem, it is necessary to find new plant-based antimicrobials that are safe for long-term use and have a wide spectrum of action.
The aim of the work was to study the antibacterial and fungicidal activity of the essential oil of Thymus x citriodorus (Pers.) Schreb. var. “Silver Queen”.
Materials and methods. The essential oil of Thymus x citriodorus (Pers.) Schreb. var. “Silver Queen” was used for the experimental part. To test the antimicrobial and antifungal action of the essential oil, reference test strains, gram-positive and gram-negative bacteria, as well as yeast-like fungi of the genus Candida were selected. The studies were performed in vitro using the disco-diffusion method.
Results. Studies have shown that the essential oil of Thymus x citriodorus (Pers.) Schreb. var. “Silver Queen” has a significant antibacterial effect against S. aureus ATCC 25923 (diameters of growth inhibition were 14.60 ± 1.52 mm) and fungicidal effect Candida albicans ATCC 885-6530 (29.30 ± 2.82 mm). Antibacterial activity of the essential oil was detected in relation to E. coli (19.60 ± 1.85 mm). It was experimentally proven that the essential oil had no bactericidal effect on the test strain of P. aeruginosa.
Conclusions. It was found that the essential oil of the studied hybrid species Thymus x citriodorus (Pers.) Schreb. var. “Silver Queen” shows a significant antibacterial activity and is promising for further research.