bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of comorbidities in spondyloarthritis with regard to the phenotype and psoriasis: data from the ASAS-COMOSPA study
Authors: Puche-Larrubia M. Ángeles , Ladehesa-Pineda Lourdes , Font-Ugalde Pilar , Escudero-Contreras Alejandro , Moltó Anna , López-Medina Clementina , Collantes-Estévez Eduardo 
Published: September 2021

Introduction: The aim of the study was to compare the prevalence of comorbidities between patients with axial and peripheral phenotypes and to evaluate the role of psoriasis in such comorbidities. Methods: Patients from the cross-sectional Assessment in SpondyloArthritis Inter-national Society (ASAS)-COMOSPA study were classified as having either the axial (presence of sacroiliitis on X-ray or MRI) or peripheral phenotype (absence of sacroiliitis AND presence of peripheral involvement). Patients with each phenotype were divided into two groups depending on the presence or history of psoriasis. Pair-wise comparisons among the four groups (axial/peripheral phenotype with/without psoriasis) were conducted through univariate logistic regressions and generalized linear mixed models using disease duration and sex as fixed effects and country as random effect. Results: A total of 3291 patients were included in this analysis. The peripheral involvement with psoriasis phenotype showed the highest prevalence of hypertension (44.9%), dyslipidaemia (34%) and diabetes (8.8%), while the axial involvement without psoriasis phenotype exhibited the lowest prevalence of dyslipidaemia (14.2%), diabetes (4.1%) and stroke (0.9%). Among patients with psoriasis, the axial phenotype showed a significantly lower prevalence of hypertension (OR: 0.51, 95% CI: 0.35–0.75) and lower prevalence of Framingham score ⩾15 (OR: 0.57, 95% CI: 0.38–0.85) than patients with peripheral involvement after adjusting for disease duration, sex and country. Among patients with the axial phenotype, patients with psoriasis showed a higher prevalence of hypertension (OR 1.76, 1.40–2.20), dyslipidaemia (OR: 1.99, 95% CI: 1.56–2.53), diabetes (OR: 2.05, 95% CI: 1.39–3.02) and Framingham score ⩾15 (OR: 2.00, 95% CI: 1.57–2.55) than non-psoriatic patients. No differences were found across groups concerning bone metabolism disorders. Conclusion: Both the peripheral phenotype and psoriasis are independently associated with an increased prevalence of cardiovascular risk factors. No differences were found for bone metabolism disorders.
A retrospective study on the prevalence of anti-phospholipid antibodies, thrombotic events and cutaneous signs of vasculopathy in 173 hospitalized COVID-19 patients
Authors: Gasparini Giulia , Canepa Paola , Verdiani Simonetta , Carmisciano Luca , Cozzani Emanuele , De Grazia Denise , Andrea Orsi , Icardi Giancarlo , Parodi Aurora 
Published: September 2021

Background Hypercoagulability is a risk factor of thromboembolic events in COVID-19. Anti-phospholipid (aPL) antibodies have been hypothesized to be involved. Typical COVID-19 dermatological manifestations of livedo reticularis and digital ischemia may resemble cutaneous manifestations of anti-phospholipid syndrome (APS). Objectives To investigate the association between aPL antibodies and thromboembolic events, COVID-19 severity, mortality, and cutaneous manifestations in patients with COVID-19. Methods aPL antibodies [anti-beta2-glycoprotein-1 (B2GP1) and anti-cardiolipin (aCL) antibodies] were titered in frozen serum samples from hospitalized COVID-19 patients and the patients’ clinical records were retrospectively analyzed. Results 173 patients were enrolled. aPL antibodies were detected in 34.7% of patients, anti-B2GP1 antibodies in 30.1%, and aCL antibodies in 10.4%. Double positivity was observed in 5.2% of patients. Thromboembolic events occurred in 9.8% of patients, including 11 pulmonary embolisms, 1 case of celiac tripod thrombosis, and six arterial ischemic events affecting the cerebral, celiac, splenic, or femoral-popliteal arteries or the aorta. aPL antibodies were found in 52.9% of patients with vascular events, but thromboembolic events were not correlated to aPL antibodies (adjusted OR = 1.69, p = 0.502). Ten patients (5.8%) had cutaneous signs of vasculopathy: nine livedo reticularis and one acrocyanosis. No significant association was observed between the presence of cutaneous vasculopathy and aPL antibodies ( p = 0.692). Conclusions Anti-phospholipid antibodies cannot be considered responsible for hypercoagulability and thrombotic events in COVID-19 patients. In COVID-19 patients, livedo reticularis and acrocyanosis do not appear to be cutaneous manifestations of APS.
When no news is bad news: Improving diagnostic testing communication through patient engagement
Authors: Zomerlei Terri , Carraher Amanda , Chao Albert , Vink Shonda , Chandawarkar Rajiv 
Published: September 2021

Importance Up to 17% of diagnostic test results are missed, lost or ignored despite conventional fixes such as electronic physician reminders – naïvely, patients assume: ‘No-News-is-Good-News’. These lapses can result in poor outcomes, complications, and even death. In response, Centers for Medicare and Medicaid Services (CMS)-led physician quality reporting system measure#265 emphasizes prevention. This study aims to improve the timely review of results through increasing patient engagement. Design and Participants Ninety patients undergoing diagnostic testing were included in this Internal Review Board (IRB)-approved study. Two groups, group-A (patients with medical chart access through our EHR, n = 40); and group-B (controls, n = 50) were included. Group-A was reminded via written AVS and EHR portal messages to ask about their test results at their next appointment. Controls were sent no reminders, mimicking the status- quo. Main Outcomes At subsequent visits whether patients ‘asked’ or ‘did not ask’ about their results was recorded and analyzed. Study group participants were also surveyed on their preferences for reminder communication. Results Patients that were sent reminders were up to twenty times more likely to ask their provider regarding their test results than the control group ( p < 0.0001). Eighty-one percent indicated that the reminders were helpful with 90% indicating they were ‘necessary’. Neither gender nor age seemed predictive factors of patient engagement. Conclusions and Relevance This pilot study demonstrates that engaging patients in their own care through already-existing tools (AVS, EHR portal messages) improves patient-physician communication, and could lead to lower rates of missed diagnostic tests.
Hapln1b, a central organizer of the ECM, modulates kit signaling to control developmental hematopoiesis in zebrafish
Authors: Mahony Christopher B. , Cacialli Pietro , Pasche Corentin , Monteiro Rui , Savvides Savvas N. , Bertrand Julien Y. 
Published: September 2021

Abstract
During early vertebrate development, hematopoietic stem and progenitor cells (HSPCs) are produced in hemogenic endothelium located in the dorsal aorta, before they migrate to a transient niche where they expand to the fetal liver and the caudal hematopoietic tissue, in mammals and zebrafish, respectively. In zebrafish, previous studies have shown that the extracellular matrix (ECM) around the aorta must be degraded to enable HSPCs to leave the aortic floor and reach blood circulation. However, the role of the ECM components in HSPC specification has never been addressed. In this study, hapln1b, a key component of the ECM, was specifically expressed in hematopoietic sites in the zebrafish embryo. Gain- and loss-of-function experiments all resulted in the absence of HSPCs in the early embryo, showing that hapln1b is necessary, at the correct level, to specify HSPCs in the hemogenic endothelium. Furthermore, the expression of hapln1b was necessary to maintain the integrity of the ECM through its link domain. By combining functional analyses and computer modeling, we showed that kitlgb interacts with the ECM to specify HSPCs. The findings show that the ECM is an integral component of the microenvironment and mediates the cytokine signaling that is necessary for HSPC specification.
Heparin-induced thrombocytopenia in patients with COVID-19: a systematic review and meta-analysis
Authors: Uaprasert Noppacharn , Tangcheewinsirikul Nuanrat , Rojnuckarin Ponlapat , Patell Rushad , Zwicker Jeffrey I. , Chiasakul Thita 
Published: September 2021

Abstract
Heparin thromboprophylaxis is routinely administered during hospitalization for COVID-19. Because of the immune stimulation related to COVID-19, there is ongoing concern regarding a heightened incidence of heparin-induced thrombocytopenia (HIT). We performed a literature search using PubMed, EMBASE, Cochrane, and medRxiv database to identify studies that reported clinical and laboratory characteristics and/or the incidence of HIT in patients with COVID-19. The primary aim was to systematically review the clinical features and outcomes of patients with COVID-19 with confirmed HIT. The secondary objective was to perform a meta-analysis to estimate the incidence of HIT in hospitalized patients with COVID-19. A meta-analysis of 7 studies including 5849 patients revealed the pooled incidence of HIT in COVID-19 of 0.8% (95% confidence interval [CI], 0.2%-3.2%; I2 = 89%). The estimated incidences were 1.2% (95% CI, 0.3%-3.9%; I2 = 65%) vs 0.1% (95% CI, 0.0%-0.4%; I2 = 0%) in therapeutic vs prophylactic heparin subgroups, respectively. The pooled incidences of HIT were higher in critically ill patients with COVID-19 (2.2%; 95% CI, 0.6%-8.3%; I2 = 72.5%) compared with noncritically ill patients (0.1%; 95% CI, 0.0%-0.4%: I2 = 0%). There were 19 cases of confirmed HIT and 1 with autoimmune HIT for clinical and laboratory characterization. The median time from heparin initiation to HIT diagnosis was 13.5 days (interquartile range, 10.75-16.25 days). Twelve (63%) developed thromboembolism after heparin therapy. In conclusion, the incidence of HIT in patients with COVID-19 was comparable to patients without COVID-19, with higher incidences with therapeutic anticoagulation and in critically ill patients.
The mechanism of nicotinamide on reducing acute lung injury by inhibiting MAPK and NF-κB signal pathway
Authors: Zhang Qun , Li Junyao , Zhong Haixia , Xu Yanling 
Published: September 2021

Abstract
Background
Acute lung injury is an important factor that leads to the death of patients with pneumonia. Previous studies have shown that nicotinamide (NAM) plays a role in reducing cell damage, so this study explored the mechanism by which NAM functions in acute lung injury.

Methods
We explored the mechanism by which NAM affects acute lung injury in vivo and in vitro by qRT-PCR, western blotting and ELISA.

Results
The results showed that NAM could significantly reduce lung injury and proinflammatory mediator accumulation. Further mechanistic studies showed that NAM could significantly inhibit the MAPK and AKT/NF-κB signaling pathways.

Conclusion
These results suggested that NAM may reduce the release of proinflammatory mediators by inhibiting the MAPK and AKT/NF-κB signaling pathways and ultimately alleviate lung injury.
Osteoblast Response to Copper-Doped Microporous Coatings on Titanium for Improved Bone Integration
Authors: Wang Lai-jie , Ni Xiao-hui , Zhang Fei , Peng Zhi , Yu Fu-xun , Zhang Lei-bing , Li Bo , Jiao Yang , Li Yan-kun , Yang Bing , Zhu Xing-yuan , Zhao Quan-ming 
Published: September 2021

AbstractDue to their excellent mechanical properties and good biocompatibility, titanium alloys have become a popular research topic in the field of medical metal implants. However, the surface of the titanium alloy does not exhibit biological activity, which may cause poor integration between the interface of the titanium implant and the interface of the bone tissue and subsequently may cause the implant to fall off. Therefore, surface biological inertness is one of the problems that titanium alloys must overcome to become an ideal orthopedic implant material. Surface modification can improve the biological properties of titanium, thereby enhancing its osseointegration effect. Copper is an essential trace element for the human body, can promote bone formation and plays an important role in maintaining the physiological structure and function of bone and bone growth and development. In this study, a microporous copper-titanium dioxide coating was prepared on the surface of titanium by microarc oxidation. Based on the evaluation of its surface characteristics, the adhesion, proliferation and differentiation of MC3T3-E1 cells were observed. A titanium rod was implanted into the rabbit femoral condyle, and the integration of the coating and bone tissue was evaluated. Our research results show that the microporous copper-titanium dioxide coating has a nearly three-dimensional porous structure, and copper is incorporated into the coating without changing the structure of the coating. In vitro experiments found that the coating can promote the adhesion, proliferation and differentiation of MC3T3-E1 cells. In vivo experiments further confirmed that the titanium copper-titanium dioxide microporous coating can promote the osseointegration of titanium implants. In conclusion, copper-titanium dioxide microporous coatings can be prepared by microarc oxidation, which can improve the biological activity and biocompatibility of titanium, promote new bone formation and demonstrate good osteoinductive properties. Therefore, the use of this coating in orthopedics has potential clinical application.
Successful treatment of severe electrolyte imbalance-induced cardiac arrest caused by adrenal tuberculosis with ECMO in the ED
Authors: Yang Ning , Zhou Liping , Mo Xiaoye , Huang Guoqing , Wu Ping 
Published: September 2021

Abstract
Background
Tuberculosis (TB) is a chronic infectious disease, common in China. TB bacteria can invade multiple organs throughout the body, but they rarely cause critical illness. We present a complex critically ill case in this report.

Case presentation
A 40-year-old man suffered sudden cardiac arrest during an emergency room visit. Spontaneous circulation resumed after emergency cardiopulmonary resuscitation (CPR), but recurrent ventricular fibrillation and refractory cardiac shock emerged. Thereafter, extracorporeal membrane oxygenation (ECMO) was implemented to maintain hemodynamic stability. Blood test results revealed that the patient had severe electrolyte imbalance and adrenal insufficiency. Further imaging examination showed multiple tuberculosis lesions throughout the body, including the lungs, adrenal glands, and lumbar spine. In the end, the patient was successfully moved from the ICU after weaning from ECMO and the ventilator, and then transferred to an infectious disease specialist hospital for standard anti-tuberculosis therapy.

Conclusions
ECMO has won the opportunity for the diagnosis and treatment of this young patient who suffered from a rare cause of cardiac arrest and finally achieved a good prognosis.
The transcription factor reservoir and chromatin landscape in activated plasmacytoid dendritic cells
Authors: Mann-Nüttel Ritu , Ali Shafaqat , Petzsch Patrick , Köhrer Karl , Alferink Judith , Scheu Stefanie 
Published: September 2021

AbstractBackgroundTranscription factors (TFs) control gene expression by direct binding to regulatory regions of target genes but also by impacting chromatin landscapes and modulating DNA accessibility for other TFs. In recent years several TFs have been defined that control cell fate decisions and effector functions in the immune system. Plasmacytoid dendritic cells (pDCs) are an immune cell type with the unique capacity to produce high amounts of type I interferons quickly in response to contact with viral components. Hereby, this cell type is involved in anti-infectious immune responses but also in the development of inflammatory and autoimmune diseases. To date, the global TF reservoir in pDCs early after activation remains to be fully characterized.ResultsTo fill this gap, we have performed a comprehensive analysis in naïve versus TLR9-activated murine pDCs in a time course study covering early timepoints after stimulation (2 h, 6 h, 12 h) integrating gene expression (RNA-Seq) and chromatin landscape (ATAC-Seq) studies. To unravel the biological processes underlying the changes in TF expression on a global scale gene ontology (GO) analyses were performed. We found that 70% of all genes annotated as TFs in the mouse genome (1014 out of 1636) are expressed in pDCs for at least one stimulation time point and are covering a wide range of TF classes defined by their specific DNA binding mechanisms. GO analysis revealed involvement of TLR9-induced TFs in epigenetic modulation, NFκB and JAK-STAT signaling, and protein production in the endoplasmic reticulum. pDC activation predominantly “turned on” the chromatin regions associated with TF genes. Our in silico analyses pointed at the AP-1 family of TFs as less noticed but possibly important players in these cells after activation. AP-1 family members exhibit (1) increased gene expression, (2) enhanced chromatin accessibility in their promoter region, and (3) a TF DNA binding motif that is globally enriched in genomic regions that were found more accessible in pDCs after TLR9 activation.ConclusionsIn this study we define the complete set of TLR9-regulated TFs in pDCs. Further, this study identifies the AP-1 family of TFs as potentially important but so far less well characterized regulators of pDC function.
Patient-centered infertility questionnaire for female clients (PCIQ-F): part I: questionnaire development
Authors: Webair Hana Hasan , Ismail Tengku Alina Tengku , Ismail Shaiful Bahari , Khaffaji Azza Jameel , Hussain Nik Hazlina Nik , Kadir Azidah Abdul , Muhamad Rosediani , Bakar Fatin Aina Abu , Ismail Nur Raihan , Badri Nagwa 
Published: September 2021

Abstract
Background
Patient-centered care is an essential component of health care quality. To achieve patient-centered care, health care authorities should have a clear definition and an applicable tool to measure the extent of its application. The real concept of patient centeredness should be developed by the patients themselves. We aimed to demonstrate a way to develop a draft Arabic patient-centered infertility care (PCIC) questionnaire for females clients following practical steps that address women with infertility.

Methods
An iterative process of questionnaire development was undertaken by combining two approaches: the steps proposed by Robert F. DeVellis for scale development and the recommended practices for questionnaire development and testing in the European statistical system. We attempted to develop the draft questionnaire that involved conceptualization and operationalization, generation of an item pool, development of the questionnaire format, review of the initial item pool by experts, and consideration of validation items for inclusion.

Results
We generated an item pool from in-depth interviews with 14 women who sought infertility care within 6 months before the interview time. We then added more items from a literature review. The item pool contained 123 items distributed through 10 domains. Ten women with infertility were included for face validation. Then, experts with backgrounds in Obstetrics and Gynecology, Family Medicine, and Public Health reviewed the item pool using content validation (n = 10 professors and/or specialists). The item pool was finally reduced to 57 items. We developed the draft Arabic patient-centered infertility care questionnaire for female clients (PCIQ-F) with three sections, including 66 items: background variables, PCIC experience variables, and a general question about the quality of infertility care in the health facility. The draft questionnaire was further reviewed and edited last by experts in preparation for part 2, which will test the questionnaire and prepare the final version.

Conclusion
The PCIQ-F questionnaire development is a multi-step iterative process started and ended by the target users as experts. Experts’ participation in infertility care and in questionnaire format development had a great impact on questionnaire development and conflict resolution. We recommend this transparent and replicable approach for new instrument developers; it is likely to generate a questionnaire that is valid and acceptable to target users. The draft PCIQ-F questionnaire is ready for testing of its psychometric properties before the final version to measure the PCIC level in health facilities.
Conducting proportional meta-analysis in different types of systematic reviews: a guide for synthesisers of evidence
Authors: Barker Timothy Hugh , Migliavaca Celina Borges , Stein Cinara , Colpani Verônica , Falavigna Maicon , Aromataris Edoardo , Munn Zachary 
Published: September 2021

Abstract
Background
Single group data present unique challenges for synthesises of evidence. Proportional meta-analysis is becoming an increasingly common technique employed for the synthesis of single group data. Proportional meta-analysis shares many similarities with the conduct and reporting of comparative, or pairwise, meta-analysis. While robust and comprehensive methods exist detailing how researchers can conduct a meta-analysis that compares two (or more) groups against a common intervention, there is a scarcity of methodological guidance available to assist synthesisers of evidence in the conduct, interpretation, and importance of proportional meta-analysis in systematic reviews.

Main body
This paper presents an overview targeted to synthesisers of evidence and systematic review authors that details the methods, importance, and interpretation of a proportional meta-analysis. We provide worked examples of how proportional meta-analyses have been conducted in research syntheses previously and consider the methods, statistical considerations, and presentation of this technique.

Conclusion
This overview is designed to serve as practical guidance for synthesisers of evidence in the conduct of proportional meta-analyses.