bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic reviews of pharmacological and nonpharmacological treatments for patients with chronic urticaria
Authors: Shi Yunzhou , Zhou Siyuan , Zheng Qianhua , Huang Ying , Hao Pingsheng , Xu Mingmin , Zhang Leixiao , Xiao Xianjun , Zheng Hui , Li Ying 
Published: May 2019

Abstract
A wide range of pharmacological and nonpharmacological interventions for chronic urticaria (CU) have been evaluated in systematic reviews (SRs). We conducted an umbrella review of SRs of the effectiveness and safety of pharmacological and nonpharmacological interventions for CU, which allow the findings of separate reviews to be compared and contrasted and thereby provide decision makers in healthcare with the evidence they need.
We included SRs evaluating pharmacological and nonpharmacological interventions for CU. Comprehensive searches were conducted in 7 bibliographic databases, relevant journals up to July 2018. Two reviewers independently assessed the studies’ relevance and quality. The assessment of multiple systematic reviews tool and grading of recommendations assessment, development and evaluation method was used to assess the methodological quality of the SRs and classify the quality of the outcomes.
In total, 41 SRs were included. Thirty-seven reviews performed quantitative research syntheses, and 4 reviews performed qualitative research syntheses. The majority of SRs evaluated interventions based on combination therapies, antihistamines, traditional Chinese medicines, autohemotherapy, omalizumab, acupuncture, cyclosporine, and leukotriene receptor antagonist. Positive intervention outcomes were reported in the majority (75.32%) of the reviews. However, the methodological quality and evidence quality of the reviews were generally poor.
There is some evidence to support a variety of interventions for CU. However, there was much heterogeneity in evidence quality among SRs. Many of the SRs had methodological weaknesses that make them vulnerable to bias. Moreover, there remained little information on the relative effectiveness of one intervention compared with another. Therefore, further SRs that adherence to strict scientific methods are necessary, and primary studies make comparisons between the different treatment options directly.
Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy
Authors: Chen Lingyuan , Liang Xueyan , Tan Xinmei , Wen Haibin , Jiang Junsong , Li Yan 
Published: May 2019

Abstract

Background:
Sedation with etomidate or propofol alone during gastroscopy has many side effects. A systematic review and meta-analysis were conducted to evaluate the safety and efficacy of the combined use of propofol and etomidate for sedation during gastroscopy.

Methods:
PubMed, Embase, Medline (via Ovid SP), Cochrane library databases, CINAHL (via EBSCO), China Biology Medicine disc (CBMdisc), Wanfang, VIP, and China National Knowledge Infrastructure (CNKI) databases were systematically searched. We included randomized controlled trials (RCTs) comparing the combined use of propofol and etomidate vs etomidate or propofol alone for sedation during gastroscopy. Data were pooled using the random-effects models or fixed-effect model based on heterogeneity.

Results:
Fifteen studies with 2973 participants were included in the analysis. Compared to propofol alone, the combined use of propofol and etomidate possibly increased recovery time (SMD = 0.14, 95% CI = 0.04–0.24; P = .005), and the risk for myoclonus (OR = 3.07, 95% CI = 1.73–5.44; P < .001), injection pain, and nausea and vomiting. Furthermore, compared to propofol alone, the combination of propofol and etomidate produced an apparent beneficial effect for mean arterial pressure (MAP) after anesthesia (SMD = 1.32, 95% CI = 0.38–2.26; P = .006), SPO2 after anesthesia (SMD = 0.99, 95% CI = 0.43–1.55; P < .001), apnea or hypoxemia (OR = 0.16, 95% CI = 0.08–0.33; P < .001), injection pain, and body movement. Further, compared to etomidate alone, the combination of propofol and etomidate reduced the risk for myoclonus (OR = 0.15, 95% CI = 0.11–0.22; P < .001), body movement, and nausea and vomiting.

Conclusion:
The combination of propofol and etomidate might increase recovery time vs that associated with propofol, but it had fewer side effects on circulation and respiration in patients undergoing gastroscopy. The combined use of propofol and etomidate can improve and produce an apparent beneficial effect on the adverse effects of propofol or etomidate alone, and it was safer and more effective than propofol or etomidate alone.
Top-100 highest-cited original articles in inflammatory bowel disease
Authors: Chen Xinrong , Yang Kun , Xu Yujie , Li Ka 
Published: May 2019

Abstract

Objectives:
The use of citation analysis to identify the first 100 papers in inflammatory bowel disease (IBD) provides unique insights into advances in disease understanding and subsequent follow-up treatment innovations over time.

Methods:
The Thomson Reuters Web of Science database with the search terms “inflammatory bowel disease” or “Crohn disease” or “ulcerative colitis” or “colitis” was used to identify all English language full manuscripts for the study. Title, first and senior authors, institution and department of first author, journal, country of origin, year, and topic of each manuscript were analyzed.

Results:
The top 100 manuscripts were published between 1955 and 2013. 224,809 eligible papers were returned and the median (range) citation number was 1028.5 (719–3957). The country and year with the greatest number of publications were the USA (n = 47), and 2007 (n = 11). Gastroenterology published the highest number of papers (n = 18, 21,083 citations) and The New England Journal of Medicine had the most citations (n = 13, 25,035 citations).

Conclusions:
This highly cited list of papers identifies the subjects and authors who have had the greatest impact on IBD research in the last decades, which serves as a reference for researchers and clinicians “highly citable” manuscripts.
Diagnostic accuracy of intestinal ultrasound and magnetic resonance enterography for the detection of endoscopy-based disease activity in ileocolonic Crohn’s disease
Authors: Yuksel Ilhami , Kilincalp Serta , Coskun Yusuf , Akinci Hakan , Hamamci Mevlut , Alkan Afra 
Published: May 2019

Background
Crohn’s disease (CD) is characterised by chronic gastrointestinal inflammation with relapsing–remitting behaviour and often requires endoscopic and/or radiologic assessment.

Objective
The objective of this study was to compare the diagnostic accuracy of intestinal ultrasound (IUS) and magnetic resonance enterography (MRE) for the assessment of disease activity in CD using a simple endoscopic score for CD as a reference standard.

Patients and methods
A prospective observational study was carried out in 71 consecutive adult patients with known CD, attending our tertiary inflammatory bowel disease clinic, between November 2014 and July 2016. Ileocolonoscopy, IUS and MRE were performed within 1 month prospectively. The simple endoscopic score-CD 0–2 was accepted as remission.

Results
The sensitivity of IUS and MRE for detecting endoscopic activity was found similar with regard to bowel wall thickening and mesenteric fibrofatty proliferation (P>0.05). The overall accuracy for detecting mural lesions was similar between IUS and MRE. When mural lesions were analysed, the sensitivity of MRE in detecting the loss of wall stratification and stenosis was significantly higher than IUS (P<0.001 for both). IUS showed higher specificity for bowel wall thickening, loss of wall stratification and stenosis (P=0.009, P<0.001 and P<0.001, respectively). Sensitivity and accuracy of IUS were higher in detecting ascites in active disease (P=0.002).

Discussion
Our results showed that IUS and MRE were equally accurate in detecting endoscopic activity. IUS may be the preferred technique for the evaluation of disease activity and for the follow-up of CD.
Combining Natural Language Processing of Electronic Medical Notes With Administrative Data to Determine Racial/Ethnic Differences in the Disclosure and Documentation of Military Sexual Trauma in Veterans
Authors: Gundlapalli Adi V. , Jones Audrey L. , Redd Andrew , Divita Guy , Brignone Emily , Pettey Warren B.P. , Carter Marjorie E. , Samore Matthew H. , Blais Rebecca K. , Fargo Jamison D. 
Published: May 2019

Background:
Despite national screening efforts, military sexual trauma (MST) is underreported. Little is known of racial/ethnic differences in MST reporting in the Veterans Health Administration (VHA).

Objective:
This study aimed to compare patterns of MST disclosure in VHA by race/ethnicity.

Research Design:
Retrospective cohort study of MST disclosures in a national, random sample of Veterans who served in Afghanistan and Iraq and completed MST screens from October 2009 to 2014. We used natural language processing (NLP) to extract MST concepts from electronic medical notes in the year following Veterans’ first MST screen.

Measure(s):
Any evidence of MST (positive MST screen or NLP concepts) and late MST disclosure (NLP concepts following a negative MST screen). Multivariable logistic regressions, stratified by sex, tested racial/ethnic differences in any MST evidence, and late disclosure.

Results:
Of 6618 male and 6716 female Veterans with MST screen results, 1473 had a positive screen (68 male, 1%; 1405 female, 21%). Of those with a negative screen, 257 evidenced late MST disclosure by NLP (44 male, 39%; 213 female, 13%). Late MST disclosure was usually documented during mental health visits. There were no significant racial/ethnic differences in MST disclosure among men. Among women, blacks were less likely than whites to have any MST evidence (adjusted odds ratio=0.75). In the subsample with any MST evidence, black and Hispanic women were more likely than whites to disclose MST late (adjusted odds ratio=1.89 and 1.59, respectively).

Conclusions:
Combining NLP results with MST screen data facilitated the identification of under-reported sexual trauma experiences among men and racial/ethnic minority women.
Privacy in Health Disparity Research
Authors: Xu Heng , Zhang Nan 
Published: May 2019

Background:
Most research on identifying and understanding health disparities focused on measurement strategies and analytics design over administrative and survey data. What has received less attention, however, is the complex interplay between privacy concerns and the needs of health disparity research.

Objectives:
The main objective of the paper is to illustrate the fundamental challenges facing the reconciliation of privacy needs and health disparity research.

Research Design:
We investigated whether privacy disparity exists over raw, unprocessed, public health data, and then examined the effect of a state-of-the-practice data anonymization process and a state-of-the-art privacy-preserving data sharing technique on both privacy disparity and the efficacy of health disparity research.

Results:
We demonstrate that the essential elements for health disparity research, for example, the integration of demographics attributes such as race in public health datasets, could indeed lead to privacy disparity if not carefully treated.

Discussions and Policy Implications:
The findings in this paper indicate that regulators must carefully study the privacy implications before mandating the inclusion of certain attributes like race and geolocation in a released dataset. For example, the Affordable Care Act requires all federally supported public health programs to collect data on race, ethnicity, sex, geographic location, etc., to the extent feasible. Although doing so could help identify health disparities, if the collected data are directly released without proper sanitization, the released data may introduce privacy disparities, causing further harm to underserved populations.
Severe Sepsis in Pediatric Liver Transplant Patients: The Emergence of Multidrug-Resistant Organisms
Authors: Alcamo Alicia M. , Alessi Lauren J. , Vehovic S. Noona , Bansal Neha , Bond Geoffrey J. , Carcillo Joseph A. , Green Michael , Michaels Marian G. , Aneja Rajesh K. 
Published: May 2019

Objectives:
To describe characteristics of liver transplant patients with severe sepsis in the PICU.

Design:
Retrospective descriptive analysis.

Setting:
Tertiary children’s hospital PICU.

Patients:
Liver transplant recipients admitted January 2010 to July 2016 for pediatric severe sepsis.

Interventions:
None.

Measurements and Main Results:
Between January 2010 and July 2016, 173 liver transplants were performed, and 36 of these patients (21%) were admitted with severe sepsis (54 episodes total). Median age at admission was 2 years (1–6.5 yr), 47.2% were male. Bacterial infections were the most common (77.8%), followed by culture negative (12.9%) and viral infections (7.4%). Fungal infections accounted for only 1.9%. Median time from transplant for viral and culture negative infections was 18 days (8.25–39.75 d) and 25 days (9–41 d), whereas 54.5 days (17–131.25 d) for bacterial infections. Bloodstream and intra-abdominal were the most common bacterial sites (45% and 22.5%, respectively). Multidrug-resistant organisms accounted for 47.6% of bacterial sepsis. Vancomycin-resistant Enterococcus and extended-spectrum beta-lactamase producers were the most frequently identified multidrug-resistant organisms. Patients with multidrug-resistant organism sepsis demonstrated higher admission Pediatric Logistic Organ Dysfunction scores (p = 0.043) and were noted to have an odds ratio of 3.8 and 3.6 for mechanical ventilation and multiple organ dysfunction syndrome, respectively (p = 0.047 and p = 0.044). Overall mortality was 5.5% (n = 2 patients), with both deaths occurring in multidrug-resistant organism episodes.

Conclusions:
We report that multidrug-resistant organisms are increasingly being identified as causative pathogens for sepsis in pediatric liver transplant recipients and are associated with significantly higher odds for mechanical ventilation and higher organ failure. The emergence of multidrug-resistant organism infections in pediatric liver transplant patients has implications for patient outcomes, antibiotic stewardship, and infection prevention strategies.
Brief Report: HIV Shedding in the Female Genital Tract of Women on ART and Progestin Contraception: Extended Follow-up Results of a Randomized Clinical Trial
Authors: Kourtis Athena P. , Wiener Jeffrey , Hurst Stacey , Nelson Julie A.E. , Cottrell Mackenzie L. , Corbett Amanda , Chinula Lameck , Msika Albans , Haddad Lisa B. , Tang Jennifer H. 
Published: May 2019

Background:
Progestin contraception has been linked to higher risk of female to male sexual HIV transmission.

Setting:
A clinical trial among HIV-infected women in Lilongwe, Malawi, randomized to initiation of depomedroxyprogesterone acetate injectable or levonorgestrel implant, and followed for up to 33 months, with the outcome of HIV shedding in the genital tract.

Methods:
We compared the frequency and magnitude of HIV genital shedding before and after initiation of contraception and between study arms among women receiving antiretroviral therapy (ART). Genital HIV RNA was measured in TearFlo Strips using the Abbott RealTime HIV-1 assay.

Results:
Among 68 HIV-infected Malawian women on ART, randomization to depot medroxyprogesterone acetate compared with the levonorgestrel implant was not associated with genital shedding and neither progestin contraceptive was associated with increased HIV genital shedding, for up to 33 months after contraceptive initiation. Having detectable plasma HIV [adjusted risk ratio (RR) 10.5; 95% confidence interval (CI): 3.18 to 34.7] and detectable genital shedding before contraceptive initiation (adjusted RR 3.53; 95% CI: 1.31 to 9.47) were associated with a higher risk of detectable genital shedding after contraceptive initiation. Higher plasma efavirenz concentrations were associated with a lower risk of detectable genital shedding (adjusted RR 0.85; 95% CI: 0.73 to 0.99, per increase of 1000 ng/mL).

Conclusion:
Among HIV-infected women receiving ART, our results provide evidence that progestin contraception does not impact women's risk of transmission of HIV to partners. Our finding that detectable genital shedding before contraceptive initiation independently predicts shedding suggests that there may be other individual-level biological or behavioral factors that increase the risk for shedding.
Daily Vaginal Swabs and Mobile Phone Sex Report for Assessing HIV Virion Exposure Prospectively Among a Cohort of Young Sexually Active Women in South Africa (HVTN 915)
Authors: Lemos Maria P. , Lazarus Erica , Isaacs Abby , Dietrich Janan , Morgan Cecilia , Huang Yunda , Grove Doug , Andrasik Michele , Laher Fatima , Hural John , Chung Eva , Dragavon Joan , Puren Adrian , Gulati Reena K. , Coombs Robert , McElrath Margaret Juliana , Gray Glenda , Kublin James G. 
Published: May 2019

Background:
Measurements of HIV exposure could help identify subpopulations at highest risk of acquisition and improve the design of HIV prevention efficacy trials and public health interventions. The HVTN 915 study evaluated the feasibility of self-administered vaginal swabs for detection of HIV virions to assess exposure.

Methods:
Fifty 18- to 25-year-old sexually active HIV-seronegative women using contraception were enrolled in Soweto, South Africa. Participants self-administered daily vaginal swabs and answered sexual behavior questions through mobile phone for 90 days. Clinician-administered vaginal swabs, behavioral questionnaires, HIV diagnostic testing, and counseling were performed at 8 clinic visits. Glycogen concentrations assessed adherence to swabbing. Y-chromosome DNA (Yc-DNA) assessed the accuracy of reported condom use. HIV exposure was measured by virion polymerase chain reaction in swabs from 41 women who reported unprotected vaginal sex during follow-up.

Results:
Glycogen was detected in 315/336 (93.8%) participant-collected and in all clinician-collected swabs. Approximately 20/39 daily swabs (51.3%) linked to mobile reports of unprotected sex tested positive for Yc-DNA, whereas 10/187 swabs collected after 3 days of abstinence or protected sex (5.3%) had detectable Yc-DNA. No participant became HIV infected during the study; yet, exposure to HIV was detected by nucleic acids in 2 vaginal swabs from 1 participant, collected less than 1 hour after coitus.

Conclusion:
There was high adherence to daily vaginal swabbing. Daily mobile surveys had accurate reporting of unprotected sex. Detection of HIV in self-collected vaginal swabs from an uninfected participant demonstrated it was possible to measure HIV exposure, but the detection rate was lower than expected.
Neuronal Intranuclear Inclusion Disease
Authors: Yadav Nishtha , Raja Pritam , Shetty Safal S. , Jitender Saini , Prasad Chandrajit , Kamble Nitish L. , Mahadevan Anita , M. Netravathi 
Published: May 2019

Introduction:
Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder pathologically characterized by localized neuronal loss, and presence of eosinophilic intranuclear inclusions in neurons and glial cells.

Case Report:
A 50-year-old man presented with rapidly progressive dementia, behavioral changes, gait disturbances, and incontinence of 3 months duration. His brain magnetic resonance imaging showed diffuse T2/FLAIR hyperintensity of basal ganglia, thalami, cerebral peduncles, ventral pons, and supratentorial white matter with a frontal predominance. Hyperintensity was noted along the corticosubcortical junction on diffusion-weighted images. NIID was suspected and the patient underwent triple biopsy of the sural nerve with adjacent skin and biceps biopsy. Biopsy revealed ubiquitin-positive intranuclear inclusions surrounding the myofibers, and vascular smooth muscles suggestive of NIID.

Conclusions:
NIID is a rare neurodegenerative disorder usually diagnosed postmortem. The rectal and skin biopsy had proved helpful in antemortem diagnosis. We have increased the diagnostic armamentarium by showing the presence of intranuclear inclusions in smooth muscle cells of the muscle. Hence, a high degree of suspicion, magnetic resonance imaging features, with nerve/muscle/skin biopsy can help in diagnosis of NIID.
Analysis of Finnish blue mussel (Mytilus edulisL.) shell: Biomineral ultrastructure, organic-rich interfacial matrix and mechanical behavior
Authors: Mohammadi Pezhman , Wagermaier Wolfgang , Penttila Merja , Linder Markus B. 
Published: May 2019

AbstractStudying various marine biomineralized ultrastructures reveals the appearance of common architectural designs and building blocks in materials with fascinating mechanical properties that match perfectly to their biological tasks. Advanced mechanical properties of biological materials are attributed to evolutionary optimized molecular architectures and structural hierarchy. One example which has not yet been structurally investigated in great detail is the shell ofMytilus edulisL. (Finnish blue mussel) found in the archipelago of SW-Finland. Through a combination of various state-of-the-art techniques such as high-resolution electron microscopy imaging, Fourier-transformed infrared spectroscopy, powder X-ray diffraction, synchrotron wide-angle X-ray diffraction, nanoindentation and protein analysis, both the inorganic mineralized components as well as the organic-rich matrix were extensively characterized. We found very similar ultra-architecture across the shell ofM. edulisL. as compared to the widely studied and closely relatedM. edulis. However, we also found interesting differences, for instance in the thickness and degree of orientation of the mineralized layers indicating dissimilar properties and related alterations in the biomineralization processes. Our results show that the shell ofM. edulisL. has a gradient of mechanical properties, with the increase in the stiffness and the hardness from anterior to the posterior region of the shell. The shell is made from distinct and recognizable mineralized layers each varying in thickness and microstructural features. At posterior regions of the shell, moving from dorsal to ventral side, these layers are an oblique prismatic layer, a prismatic layer and a nacreous layer, in which the oblique prismatic layer is found to be the main and thickest mineralized layer of the shell. Probing the calcified rods in the oblique prismatic layer using high resolution SEM imaging revealed opening of channels with a diameters of 40-50 nm and lengths up to a micrometer extending through the rods. The chitin and protein have been found to be the main component of the organic-rich interfacial matrix as expected. Protein analysis showed two abundant proteins with sizes around 100 kD and 45 kD which likely not only regulates biomineralization and adhesion of the crystals but also governing the intrinsic-extrinsic toughening in the shell. Overall, this detailed analysis provides new structural insights into biomineralization of marine shells in general.