bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review
Authors: Sachdeva Muskaan , Kim Patrick , Mufti Asfandyar , Maliyar Khalad , Sibbald Cathryn , Alavi Afsaneh 
Published: September 2021

Background There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS. Methods MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020. Results The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% ( n = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab n = 17, infliximab n = 10, etanercept n = 1, unspecified n = 1), 5.9% with IL-12/23 inhibitors (ustekinumab n = 2), 5.9% with IL-1 inhibitors (i.e., anakinra n = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab n = 1) biologics. Of the 26 patients, 23.1% ( n = 6/26) experienced complete resolution (CR), 73.1% ( n = 19/26) experienced partial resolution (PR), and 3.8% ( n = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies. Conclusion Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.
Catastrophic Antiphospholipid Syndrome Following Lower Extremity Arterial Bypass Surgery: Case Report and Evidence Review
Authors: Sorour Ahmed A. , Kirksey Levester , Keller Sarah , O’Connor Michael S. , Lyden Sean P. 
Published: September 2021

Catastrophic antiphospholipid syndrome (CAPS) is a rare life threatening presentation of antiphospholipid syndrome. Surgery has been proposed as one of the triggering factors for this life threatening entity. There are no detailed published reports in the current literature describing CAPS as a complication after surgery. We report a case of a 21 year old that developed CAPS postoperatively and discuss the multidisciplinary approach for diagnosis and management.
The Development and Pilot of a Technology-Based Intervention in the United States for Father’s Mental Health in the Perinatal Period
Authors: Hamil Jaime , Gier Emma , Garfield Craig F. , Tandon Darius 
Published: September 2021

Paternal mental health is increasingly recognized as an important public health issue, with about 10% of men experiencing depression perinatally. Paternal depression is associated with less responsive parenting, greater parenting stress, and suboptimal child development. In response to a lack of existing interventions that directly focus on fathers’ mental health in the United States, we developed and pilot tested the Fathers and Babies (FAB) intervention for use with partners of women enrolled in home visiting (HV) programs. After a review of the extant literature, FAB was developed with input from HV stakeholders and infant mental health consultants. FAB was subsequently pilot tested with 30 father-mother dyads, with mixed-method data collected from a subset of intervention participants to assess intervention feasibility and acceptability and guide intervention refinement. Five themes related to FAB content and delivery considerations emerged from the initial focus groups that were used to guide FAB development. Mixed-method data collected during the pilot study established that fathers receiving FAB reported its content appropriate and thought it was feasible to receive the intervention. Several recommendations for FAB revisions were also provided. FAB is an innovative intervention developed for fathers from contemporary family structures that was well-received during its pilot testing. Feasibility and acceptability data suggest that fathers have favorable opinions about intervention content and delivery, while also highlighting areas for future revisions of FAB.
Benefit of second-line therapy for advanced esophageal squamous cell carcinoma: a tri-center propensity score analysis
Authors: Müller Moritz , Posch Florian , Kiem Dominik , Barth Dominik , Horvath Lena , Stotz Michael , Schaberl-Moser Renate , Pichler Martin , Greil Richard , Jost Philipp J. , Seeber Andreas , Amann Arno , Schlick Konstantin , Gerger Armin , Riedl Jakob M. 
Published: September 2021

Background: The level of evidence for palliative second-line therapy in advanced esophageal squamous cell carcinoma (aESCC) is limited. This is the first study that reports efficacy data comparing second-line therapy + active symptom control (ASC) versus ASC alone in aESCC. Methods: We conducted a tri-center retrospective cohort study ( n = 166) including patients with aESCC who had experienced disease progression on palliative first-line therapy. A propensity score model using inverse probability of treatment weighting (IPTW) was implemented for comparative efficacy analysis of overall survival (OS) in patients with second-line + ASC ( n = 92, 55%) versus ASC alone ( n = 74, 45%). Results: The most frequent second-line regimens used were docetaxel (36%) and paclitaxel (18%). In unadjusted primary endpoint analysis, second-line + ASC was associated with significantly longer OS compared with ASC alone [hazard ratio (HR) = 0.49, 95% confidence interval (CI): 0.35–0.69, p < 0.0001]. However, patients in the second-line + ASC group were characterized by more favorable baseline features including a better Eastern Cooperative Oncology Group (ECOG) performance status, a longer first-line treatment duration and lower C-reactive protein levels. After rigorous adjusting for baseline confounders by re-weighting the data with the IPTW the favorable association between second-line and longer OS weakened but prevailed. The median OS was 6.1 months in the second-line + ASC group and 3.2 months in the ASC group, respectively (IPTW-adjusted HR = 0.40, 95% CI: 0.24–0.69, p = 0.001). Importantly, the benefit of second-line was consistent across several clinical subgroups, including patients with ECOG performance status ⩾1 and age ⩾65 years. The most common grade 3 or 4 adverse events associated with palliative second-line therapy were hematological toxicities. Conclusion: This real-world study supports the concept that systemic second-line therapy prolongs survival in patients with aESCC.
Effects of Aerobic Exercise on Systemic Insulin Degludec Concentrations in People with Type 1 Diabetes
Authors: Herzig David , Groessl Michael , Álvarez-Martínez Mario , Reverter-Branchat Gemma , Nakas Christos T , Kosinski Christophe , Stettler Christoph , Bally Lia 
Published: September 2021

Background: There is conflicting evidence on the effect of exercise on systemic insulin concentrations in adults with type 1 diabetes. Methods: This prospective single-arm study examined the effect of exercise on systemic insulin degludec (IDeg) concentrations. The study involved 15 male adults with type 1 diabetes (age 30.7 ± 8.0 years, HbA1c 6.9 ± 0.7%) on stable IDeg regimen. Blood samples were collected every 15 minutes at rest, during 60 minutes of cycling (66% VO2max) and until 90 minutes after exercise termination. IDeg concentrations were quantified using high-resolution mass-spectrometry and analyzed applying generalized estimation equations. Results: Compared to baseline, systemic IDeg increased during exercise over time ( P < .001), with the highest concentrations observed toward the end of the 60-minute exercise (17.9% and 17.6% above baseline after 45 minutes and 60 minutes, respectively). IDeg levels remained elevated until the end of the experiment (14% above baseline at 90 minutes after exercise termination, P < .001). Conclusions: A single bout of aerobic exercise increases systemic IDeg exposure in adults on a stable basal IDeg regimen. This finding may have important implications for future hypoglycemia mitigation strategies around physical exercise in IDeg-treated patients.
Cone-beam CT angiography to assess the microvascular anatomy of intracranial arterial dissections
Authors: Diana Francesco , Raz Eytan , Biraschi Francesco , Romano Daniele G , Toccaceli Giada , Shapiro Maksim , Peschillo Simone 
Published: September 2021

Background Intracranial artery dissection is a rare and generally under-recognized cause of ischaemic stroke or subarachnoid haemorrhage. Objectives The aim of this study was to analyse the efficacy of cone-beam computed tomography angiography (CBCT-A) to detect arterial ultrastructural alterations in intracranial artery dissection. Method This is an observational and retrospective case series. Results Between January 2018 and November 2020, four patients were admitted with an acute ischaemic stroke due to intracranial dissection studied with CBCT-A. In all cases, the CBCT-A documented vascular ultrastructural alterations related with the intracranial dissection. Conclusions CBCT-A is an intraprocedural diagnostic technique that is useful for the diagnosis of intracranial dissections.
Efficacy of 0.4 mg tamsulosin monotherapy in patients with moderate-to-severe lower urinary tract symptoms
Authors: Kang Tae Wook , Jung Jae Hung , Kim Dong Wook , Lee Kwang Ho , Chung Hyun Chul 
Published: September 2021

Purpose: To evaluate efficacy of 0.4 mg tamsulosin monotherapy in patients with benign prostatic hyperplasia with moderate-to-severe International Prostate Symptom Score. Material and methods: From May 2015 to May 2017, 102 patients were analyzed, retrospectively. The patients were classified into three groups according to the combination of medication (tamsulosin 0.4 mg vs tamsulosin 0.4 mg + solifenacin 5 mg vs tamsulosin 0.4 mg + mirabegron 50 mg). Baseline characteristics (e.g. age, body weight, height, and underlying medical disease) were collected. International Prostate Symptom Score, prostate specific antigen, prostate volume, peak urinary flow rate (Qmax), voided volume, and post-voided volume before after treatment were evaluated. Results: We classified and analyzed the patients into three groups depending on the medication. And there were no significant differences between all parameters among the groups. Voided volume at 3 months after treatment in each group was 170.54 ± 125.83, 121.55 ± 46.19, and 274.63 ± 132.30 ( p = 0.019). Differences of voiding symptom score and difference of post-voided volume among the groups before after treatment was 5.00 ± 5.42, 1.92 ± 3.92, and 0.11 ± 5.11 and 8.37 ± 34.32, 0.78 ± 14.86, −33.63 ± 28.58 ( p = 0.037, p = 0.007). Conclusion: We think tamsulosin monotherapy will be feasible as a first-line therapy for the patients with benign prostatic hyperplasia who has struggled with moderate-to-severe lower urinary tract symptoms.
Successful management of a kitten with chlorpyrifos and cypermethrin toxicosis with pralidoxime and atropine
Authors: Roy Sawrab , Islam Saiful , Alam Shahrul , Ahmed Juned , Chowdhury Q M Monzur Kader 
Published: September 2021

Case summary Organophosphates and pyrethroids have been widely used as agricultural and domestic insecticides. This case report describes a 3-month-old free-roaming female kitten, weighing 930 g, that developed hypersalivation, hypothermia, dyspnoea due to increased bronchial secretion, bradycardia, miosis and neurological signs, including restlessness, ataxia, disorientation, apparent hallucination, muscle twitching and seizures within 6 h of accidental ingestion of an insecticide containing chlorpyrifos (500 g/l) and cypermethrin (50 g/l). The kitten was treated empirically with intramuscular atropine and dexamethasone, and rectal diazepam. The history of insecticide exposure was obtained after 6 h of treatment and intramuscular 2-pyridine aldoxime methochloride (pralidoxime [2-PAM]) and atropine therapy was started 2 h later. Recovery was complicated by suspected aspiration, but there were no sequelae from the insecticide exposure and by 7 days post-ingestion the kitten was normal and playful. Relevance and novel information To the best of our knowledge, this is the first report of successful management of chlorpyrifos and cypermethrin toxicosis in a cat in Bangladesh. This case report suggests that 2-PAM followed by atropine and other supportive therapy may be an effective strategy to manage a cat poisoned by chlorpyrifos and cypermethrin; however, expanded clinical trials are needed.
Nurses’ Knowledge in Relation to the Anorexia–Cachexia Syndrome in Cancer Patients: A Cross-National Comparison in Two European Countries
Authors: Socratous Georgia , Cloconi Constantina , Tsatsou Ioanna , Charalambous Andreas 
Published: September 2021

Introduction The Anorexia–Cachexia Syndrome (ACS) is a severe complication of cancer and is considered to be a significant cause of morbidity and mortality affecting up to two-thirds of cancer patients and one that needs specialized nursing care. Studies showed that the ACS has been relatively under-researched and under-resourced whist the nurses’ knowledge has not been systematically explored. Objective Τo explores nurses’ knowledge, understanding, and management of ACS in clinical practice in two European countries. Methods Descriptive-comparative study with 197 cancer nurses recruited during two National Conferences in Greece and Cyprus. Data were retrieved with the “Investigation of anorexia–cachexia syndrome in Practice” questionnaire. Results In terms of nurses’ perceptions on ACS, the prevailing characteristic reported in both countries was anorexia ( p = .65) followed by weight loss ( p = .04). 189 nurses (95.9%, p = .176) do not currently use a tool to assess patients’ nutritional status as part of their standard clinical practice. Statistically significant differences were found in relation to the routine assessment of nutritional-related symptoms including early satiety (Cyprus 64% vs. Greece 37%, p = .001), hiccough (66% vs. 36%, p < .001), alteration of the taste/odor sensation (77% vs. 45%, p < .001), problems in the oral cavity (84% vs. 68%, p = .032) and daily activities (85% vs. 69%, p = .032). The priority level for the ACS management differed significantly in the two countries ( p = .006), with higher priority being reported in Cyprus. Conclusion The study showed that more education is needed for cancer nurses to better understand the ACS which can facilitate the better management of the syndrome in clinical practice.
Acute effect of the COVID-19 pandemic on emergency transportation due to acute alcoholic intoxication: a retrospective observational study
Authors: Minami Marina , Kidokoro Kazumoto , Eitoku Masamitsu , Kawauchi Atsufumi , Miyauchi Masato , Suganuma Narufumi , Nishiyama Kingo 
Published: September 2021

Abstract
Background
The COVID-19 pandemic has caused changes in people’s drinking habits and the emergency management system for various diseases. However, no studies have investigated the pandemic’s impact on emergency transportation for acute alcoholic intoxication. This study examines the effect of the pandemic on emergency transportation due to acute alcoholic intoxication in Kochi Prefecture, Japan, a region with high alcohol consumption.

Methods
A retrospective observational study was conducted using data of 180,747 patients from the Kochi-Iryo-Net database, Kochi Prefecture’s emergency medical and wide-area disaster information system. Chi-squared tests and multiple logistic regression analyses were performed. The association between emergency transportation and alcoholic intoxication was examined. The differences between the number of transportations during the voluntary isolation period in Japan (March and April 2020) and the same period for 2016–2019 were measured.

Results
In 2020, emergency transportations due to acute alcoholic intoxication declined by 0.2%, compared with previous years. Emergency transportation due to acute alcoholic intoxication decreased significantly between March and April 2020, compared with the same period in 2016–2019, even after adjusting for confounding factors (adjusted odds ratio 0.67; 95% confidence interval 0.47–0.96).

Conclusions
This study showed that lifestyle changes due to the COVID-19 pandemic affected the number of emergency transportations; in particular, those due to acute alcoholic intoxication decreased significantly.
Analytical challenges in estimating the effect of exposures that are bounded by follow-up time: experiences from the Blood Stream Infection—Focus on Outcomes study
Authors: Evans Rebecca , Pike Katie , MacGowan Alasdair , Rogers Chris A. 
Published: September 2021

AbstractObjectiveTo illustrate the challenges of estimating the effect of an exposure that is bounded by duration of follow-up on all-cause 28-day mortality, whilst simultaneously addressing missing data and time-varying covariates.Study design and methodsBSI-FOO is a multicentre cohort study with the primary aim of quantifying the effect of modifiable risk factors, including time to initiation of therapy, on all-cause 28-day mortality in patients with bloodstream infection. The primary analysis involved two Cox proportional hazard models, first one for non-modifiable risk factors and second one for modifiable risk factors, with a risk score calculated from the first model included as a covariate in the second model. Modifiable risk factors considered in this study were recorded daily for a maximum of 28 days after infection. Follow-up was split at daily intervals from day 0 to 28 with values of daily collected data updated at each interval (i.e., one row per patient per day).Analytical challengesEstimating the effect of time to initiation of treatment on survival is analytically challenging since only those who survive to time t can wait until time t to start treatment, introducing immortal time bias. Time-varying covariates representing cumulative counts were used for variables bounded by survival time e.g. the cumulative count of days before first receipt of treatment. Multiple imputation using chained equations was used to impute missing data, using conditional imputation to avoid imputing non-applicable data e.g. ward data after discharge.ConclusionUsing time-varying covariates represented by cumulative counts within a one row per day per patient framework can reduce the risk of bias in effect estimates. The approach followed uses established methodology and is easily implemented in standard statistical packages.
Impact of immune checkpoint molecules on FoxP3+ Treg cells and related cytokines in patients with acute and chronic brucellosis
Authors: Sun Hua-Li , Du Xiu-Fang , Tang Yun-Xia , Li Guo-Qiang , Yang Si-Yuan , Wang Ling-Hang , Li Xing-Wang , Ma Cheng-Jie , Jiang Rong-Meng 
Published: September 2021

Abstract
Background
The immunoregulatory functions of regulatory T cells (Tregs) in the development and progression of some chronic infectious diseases are mediated by immune checkpoint molecules and immunosuppressive cytokines. However, little is known about the immunosuppressive functions of Tregs in human brucellosis, which is a major burden in low-income countries. In this study, expressions of immune checkpoint molecules and Treg-related cytokines in patients with acute and chronic Brucella infection were evaluated to explore their impact at different stages of infection.

Methods
Forty patients with acute brucellosis and 19 patients with chronic brucellosis admitted to the Third People’s Hospital of Linfen in Shanxi Province between August 2016 and November 2017 were enrolled. Serum and peripheral blood mononuclear cells were isolated from patients before antibiotic treatment and from 30 healthy subjects. The frequency of Tregs (CD4+ CD25+ FoxP3+ T cells) and expression of CTLA-4, GITR, and PD-1 on Treg cells were detected by flow cytometry. Levels of Treg-related cytokines, including IL-35, TGF-β1, and IL-10, were measured by customised multiplex cytokine assays using the Luminex platform.

Results
The frequency of Tregs was higher in chronic patients than in healthy controls (P = 0.026) and acute patients (P = 0.042); The frequency of CTLA-4+ Tregs in chronic patients was significantly higher than that in healthy controls (P = 0.011). The frequencies of GITR+ and PD-1+ Tregs were significantly higher in acute and chronic patients than in healthy controls (P < 0.05), with no significant difference between the acute and chronic groups (all P > 0.05). Serum TGF-β1 levels were higher in chronic patients (P = 0.029) and serum IL-10 levels were higher in acute patients (P = 0.033) than in healthy controls. We detected weak correlations between serum TGF-β1 levels and the frequencies of Tregs (R = 0.309, P = 0.031) and CTLA-4+ Tregs (R = 0.302, P = 0.035).

Conclusions
Treg cell immunity is involved in the chronicity of Brucella infection and indicates the implication of Tregs in the prognosis of brucellosis. CTLA-4 and TGF-β1 may contribute to Tregs-mediated immunosuppression in the chronic infection stage of a Brucella infection.
Establishing an appropriate Z score regression equation for Chinese pediatric coronary artery echocardiography: a multicenter prospective cohort study
Authors: Fan Shu-min , Xia Bei , Liu Wei-xiang , Yu Wei , Wu Zhi-xia , Chen Shu-Bao , Liu Qing-Hua , Chen Wen-juan , Zhu Shan-liang , Jin Mei , Min Jie-Qing , Xu Yang 
Published: September 2021

AbstractBackgroundZscore utility is emphasized in classifying coronary artery lesions in Kawasaki disease patients. The present study is the largest such multicenter Chinese pediatric study about coronary artery diameter reference values andZscore regression equation to date. It is useful in Chinese pediatric echocardiography.MethodsA multicenter cohort was assembled, which consisted of 852 healthy children between 1 month and 17 years of age, ten children were excluded because their ultrasound images were not clear, or lost in following up. Diameters of the right coronary artery, left coronary artery, and left anterior descending coronary artery were assessed using echocardiography. Data were body surface area (BSA)-corrected using BSA calculated via either the Stevenson BSA formula or the Haycock BSA formula. Coronary artery diameter reference values andZscore regression equations were established for use in the Chinese pediatric population.ResultsNo difference was observed between coronary artery diameter data corrected using BSAste or BSAhay. Of the five assessed regression models, the exponential model exhibited the best fit and was therefore selected as the basis for derivation of the SZ method. When comparingZscores, those produced by the SZ method conformed to the standard normal distribution, while those produced by the D method did not. In addition, there was a statistically significant difference betweenZscores produced by the SZ and D methods (P < 0.05).ConclusionsCoronary artery diameter reference values for echocardiography were successfully established for use in the Chinese pediatric population, and aZscore regression equation more suitable for clinical use in this population was successfully developed.