bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality prediction in systemic lupus erythematosus patients with pulmonary infection
Authors: Lu Zhimin , Li Jing , Ji Juan , Gu Zhifeng , Da Zhanyun 
Published: April 2019

AbstractObjectiveThe impact of pulmonary infection (PI) on mortality of patients with systemic lupus erythematosus (SLE) has been established. Nevertheless, the effect of risk factors in mortality remains controversial. The objective of this study is to determine the risk factors of short‐term mortality among SLE patients with PI.MethodThe clinical data of 54 SLE patients with 59 episodes of PI who were hospitalized from January 2013 to May 2018 was retrospectively analyzed. Demographic data, clinical features, and outcomes were collected. Logistic regression analysis was carried out to determine the independent predictors of 60‐day mortality during hospitalization. We used receiver operating characteristics (ROC) curves to verify the indices as mortality predictors in the study patients.ResultsThere were a total of 54 patients with 59 episodes of PI. There were 12 deaths during hospitalization. In multivariate analysis, 24‐hour urinary protein (24h‐PRO) (odds ratio [OR]: 2.713, 95% CI: 1.234‐5.965, P = 0.013), peripheral lymphocyte count (OR: 0.066, 95% CI: 0.005‐0.887, P = 0.040), and serum complement 3 level (C3) (OR: 0.097, 95% CI: 0.010‐0.954, P = 0.045) were associated with mortality among our cohort of SLE patients with PI. ROC curve values were 0.818 for lymphocyte count (95% CI: 0.696‐0.907, P = 0.001), 0.894 for 24h‐PRO (95% CI: 0.786‐0.959, P < 0.001) and 0.825 for C3 (95% CI: 0.704‐0.912, P = 0.001). The cut‐off value of lymphocytes, 24h‐PRO and C3 were 0.53 × 109/L, 0.92 g and 0.52 g/L, respectively.ConclusionThe presence of albuminuria, lymphopenia and low complement C3 levels were independent prognostic predictors of short‐term mortality in SLE patients with PI.
Overlap myositis, a distinct entity beyond primary inflammatory myositis: A retrospective analysis of a large cohort from the REMICAM registry
Authors: Nuño‐Nuño Laura , Joven Beatriz Esther , Carreira Patricia E. , Maldonado‐Romero Valentina , Larena‐Grijalba Carmen , Llorente Cubas Irene , Tomero Eva , Barbadillo‐Mateos María Carmen , García de la Peña Lefebvre Paloma , Ruiz‐Gutiérrez Lucía , López‐Robledillo Juan Carlos , Moruno‐Cruz Henry , Pérez Ana , Cobo‐Ibáñez Tatiana , Almodóvar Raquel , Lojo Leticia , García de Yébenes María Jesús , López‐Longo Francisco Javier 
Published: April 2019

AbstractBackgroundInflammatory idiopathic myositis (IIM) comprises a heterogeneous group of systemic muscular diseases that can occur together with other connective tissue diseases (CTD), named overlap myositis (OM). The question of whether OM is a distinct entity still remains controversial.AimThe present study was conducted to assess the clinical and prognostic differences between patients diagnosed with OM, primary polymyositis (PM) and primary dermatomyositis (DM).MethodThe study consists of a retrospective longitudinal and multicenter series of IIM patients. Patients were classified as OM, PM and DM. Overlap myositis was defined as patients fulfilling criteria for IIM plus criteria for other CTD (namely systemic sclerosis, systemic lupus erythematosus, mixed connective tissue disease, rheumatoid arthritis and primary Sjögren's syndrome).ResultA total of 342 patients were included (98 OM, 137 PM and 107 DM). Overlap myositis patients, in comparison with PM and DM, showed significant differences, with more extramuscular involvement, particularly more arthritis (66%, 34.6% and 48.1%, respectively), puffy fingers (49.5%, 11.1% and 24.3%), sclerodactyly (45.4%, 2.2% and 2%), dysphagia (41.8%, 18.2% and 26.4%), Raynaud phenomenon (65.3%, 16.9% and 19.8%), leucopenia (28.9%, 2.2% and 8.4%), thrombocytopenia (8.2%, 2.2% and 1.9%), interstitial lung disease (ILD) (48%, 35% and 30.8%), renal manifestations (13.4%, 3.7% and 1.9%), and more severe infections (41.3%, 26.7% and 21%). No significant differences were found in survival between groups in log rank test (P = 0.106). Multivariate adjusted survival analyses revealed a worse prognosis for severe infections, ILD and baseline elevation of acute phase reactants.ConclusionOverlap myositis stands out as a distinct entity as compared to PM and DM, featuring more extramuscular involvement and more severe infections. Close monitoring is recommended in this subset for early detection and treatment of possible complications.
Efficacy of PD‐1/PD‐L1 inhibitors in patients with advanced non‐small cell lung cancer: A meta‐analysis of randomized clinical trials
Authors: Peng Tzu‐Rong , Wu Ta‐Wei 
Published: April 2019

BackgroundThis meta‐analysis systematically evaluated the efficacy of PD‐1 and PD‐L1 inhibitors for the treatment of advanced non‐small cell lung cancer (NSCLC) and investigated the efficacy of first‐line therapy and PD‐1 versus PD‐L1 inhibitors.MethodsPubMed, The Cochrane Library, and Embase were searched up to November 2018 for randomized controlled trials (RCTs) for eligible studies. The outcome of interest was overall survival (OS). The methodology was based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses and Cochrane Collaboration guidelines. Data were pooled by using the random effects model and expressed as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed and quantified (I
2).ResultsSeven RCTs were included in this study. PD‐1/PD‐L1 inhibitors achieved superior OS compared to chemotherapy (HR 0.72, 95% CI 0.63–0.82; P < 0.0001). OS was superior in previously treated patients compared to untreated patients (HR 0.69, 95% CI 0.63–0.76; HR 0.82, 95% CI 0.47–1.44, respectively). No significant differences in OS were observed between PD‐1 and PD‐L1 inhibitors (HR 0.71, 95% CI 0.59–0.86; HR 0.73, 95% CI 0.63–0.84, respectively).ConclusionsPD‐1/PD‐L1 inhibitors significantly prolonged the OS of previously treated patients. No significant differences in OS were observed between PD‐1 and PD‐L1 inhibitors.
Chronic post‐surgical pain after colon surgery in patients included in an enhanced recovery program
Authors: Lois Fernande , Lavand'homme Patricia , Leonard Daniel , Remue Christophe , Bellemans Vanessa , Kartheuser Alex 
Published: April 2019

BackgroundEnhanced recovery after surgery (ERAS) program improves immediate recovery. Beyond immediate benefits, long‐term impact of ERAS implementation is not yet evident. This retrospective single‐center cohort study investigates prevalence and characteristics of chronic post‐surgical pain (CPSP) in patients who underwent colon surgery.MethodsTwo hundred and ninety‐seven patients enrolled prospectively in our ERAS database were contacted by mail to question the presence of CPSP. In case of CPSP, intensity, location, and type of pain, impact of pain on quality of life and treatment taken were assessed. Post‐operative pain experience during hospital stay, recall of pain, and discomfort duration when back home were assessed in all patients. Comparison between patients with and without CPSP was made to approach the risk factors of CPSP in this population.ResultsAt 27 months after colon surgery, 25/198 patients reported CPSP (12.6%) and pain was severe in 5 patients (2.5%). CPSP had a deep abdominal component in 56% of patients and a parietal component in 20% of patients. Patients with CPSP+ differed from patients CPSP− for pre‐operative pain presence (56% vs 24.8%, P = 0.004), recalled post‐operative pain intensity (4 vs 3, P = 0.045), duration of discomfort after discharge (2 vs 1 weeks, P = 0.035). Pre‐operative pain was found as a significant CPSP risk factor (odds ratio 1.34; 95% CI: 1.05‐1.70).ConclusionCPSP prevalence after laparoscopic colon surgery seems not much affected by ERAS context. Pre‐operative presence of pain emerged as an important risk factor. These findings should be confirmed in a prospective multicenter study.
Chronic pain among the hospitalized patients after the 22 July 2011 terror attacks in Oslo and at Utøya Island
Authors: Wisløff‐Aase Kristin , Ræder Johan , Månum Grethe , Løvstad Marianne , Schanke Anne‐Kristine , Dyb Grete , Ekeberg Øivind , Stanghelle Johan Kvalvik 
Published: April 2019

BackgroundOn 22 July 2011, 48 people were hospitalized due to physical injuries from gun shots or explosion, following 2 terror attacks in the Oslo area, Norway. In this study, we have investigated the occurrence of chronic pain, the severity and consequences of chronic pain in these patients, 3 to 4 years after the incidents.MethodsTotally 43 eligible terror trauma patients were invited to participate in the study, 30 patients were included. They underwent a consultation with a psychologist and a physician; containing psychological assessment, neuropsychological screening, a standardized clinical interview, medical examination, and a pain protocol.ResultsIn 18 (60%) the injury was severe, as defined by New Injury Severity Score > 15. Twenty‐four patients (80%) reported injury‐related chronic pain after the trauma, in 22 with consequences on daily life. Analgesics were used by 20 patients, including 5 in need of opioids. Ten patients had unmet needs of further specialist pain care.In 12 patients, the average pain score last week was above three on a 0‐10 Numeric Rating Scale. In these patients, clinical signs of neuropathic pain were evident in 10, as tested by the Douleur Neuropathique score. There were significant correlations (P < 0.05) between severity of chronic pain and presence of post‐traumatic stress symptoms, reduced quality of life, reduced psychosocial and physical function; but no correlation with pre‐injury patient characteristics or the degree of physical injury.ConclusionChronic pain was frequent and significant, irrespective of injury severity, in these patients who obtained their physical injuries under extreme psychological conditions.
Cell‐type‐specific role of lamin‐B1 in thymus development and its inflammation‐driven reduction in thymus aging
Authors: Yue Sibiao , Zheng Xiaobin , Zheng Yixian 
Published: April 2019

AbstractCellular architectural proteins often participate in organ development and maintenance. Although functional decay of some of these proteins during aging is known, the cell‐type‐specific developmental role and the cause and consequence of their subsequent decay remain to be established especially in mammals. By studying lamins, the nuclear structural proteins, we demonstrate that lamin‐B1 functions specifically in the thymic epithelial cells (TECs) for proper thymus organogenesis. An up‐regulation of proinflammatory cytokines in the intra‐thymic myeloid immune cells during aging accompanies a gradual reduction of lamin‐B1 in adult TECs. We show that these cytokines can cause senescence and lamin‐B1 reduction of the young adult TECs. Lamin‐B1 supports the expression of TEC genes that can help maintain the adult TEC subtypes we identified by single‐cell RNA‐sequencing, thymic architecture, and function. Thus, structural proteins involved in organ building and maintenance can undergo inflammation‐driven decay which can in turn contribute to age‐associated organ degeneration.
Acute Ethanol Produces Ataxia and Induces Fmr1 Expression via Histone Modifications in the Rat Cerebellum
Authors: Dulman Russell S. , Auta James , Teppen Tara , Pandey Subhash C. 
Published: April 2019

BackgroundThe cerebellum is fundamental for motor coordination and therefore crucial in ethanol (EtOH)‐induced ataxia. EtOH contributes to cerebellar pathophysiology. Fragile‐X mental retardation protein (FMRP) is a complex regulator of RNA and synaptic plasticity implicated in fragile‐X tremor and ataxia syndrome, a phenotype featuring increased Fmr1 mRNA expression. Recent studies have implicated glutamatergic targets of FMRP in hereditary cerebellar ataxias including the main cerebellar excitatory amino acid (Eaa1) transporter and a subtype of metabotropic glutamate receptor (Grm5). However, EtOH‐induced changes in cerebellar Fmr1 expression and its epigenetic regulation have not been investigated. Here, we examined the effects of acute EtOH exposure on ataxic behavior, gene expression, and epigenetic regulation of the Fmr1 gene and its glutamatergic targets in the rat cerebellum.MethodsMale adult Sprague Dawley rats received acute EtOH (2 g/kg) intraperitoneally 1 hour prior to ataxic behavioral testing on the accelerating rotarod and were sacrificed immediately thereafter. Cerebellar tissues were analyzed for gene expression and epigenetic regulation of the Fmr1 gene and its glutamatergic targets in the rat cerebellum using real‐time quantitative polymerase chain reaction (PCR) and chromatin immunoprecipitation.ResultsAcute EtOH exposure caused marked ataxia on the accelerating rotarod test compared with saline‐treated controls. This ataxic response was associated with increases in mRNA levels of Fmr1, postsynaptic density 95 (Psd95), Eaa1, and Grm5 in the cerebellum. In addition, we found increased H3K27 acetylation both at the promoter region of Fmr1 and at a proposed cyclic adenosine monophosphate (cAMP) response‐element binding (CREB) site downstream of the Fmr1 transcription start site. Furthermore, acute EtOH exposure significantly increased Creb1 and the histone acetyltransferases (HAT) CREB binding protein (Cbp), and p300 mRNA transcripts.ConclusionsOverall, EtOH regulates cerebellar Fmr1 expression most likely via HAT‐mediated increase in histone acetylation. We propose that FMRP regulation of glutamatergic transcripts plays an important role in disrupting the excitatory–inhibitory balance in the cerebellum underlying EtOH‐induced ataxia.
Uterus duplex bicollis, Vagina simplex in laboratory Guinea pigs (Cavia porcellus), rats (Rattus norvegicus forma domestica) and mice (Mus musculus forma domestica)
Authors: Bertram Christof A. , Klopfleisch Robert , Erickson Nancy A. , Müller Kerstin 
Published: April 2019

AbstractThe female genital tract originates from the Müllerian ducts during embryological development. Fusion of the ducts occurs in different segments depending on the animal species, resulting in a variational number of the respective organ. Current literature on genital tract morphology of laboratory rodents is controversial. Therefore, the present study aimed at determining an anatomically correct definition of the uterus in laboratory guinea pigs, mice and rats. In all three rodent species, we found two separate cervical canals that communicate with an individual uterus via discrete ostia uteri interna. The correct anatomical definition should therefore be uterus duplex bicollis, vagina simplex.
Prognostic factors in metastatic germ‐cell cancer
Authors: Beyer J. 
Published: April 2019

AbstractDetermining stage and anticipating prognosis are the two crucial steps after the diagnosis of a germ‐cell cancer that both guide subsequent treatment decisions. This review focuses on metastatic disease, which means germ‐cell cancers beyond stage I limited to the testis. In the past, major centers developed separate staging and prognostic classifications for metastatic germ‐cell cancer, which heavily impaired communication and comparisons across clinical trials. More recently, the classification system of the International Germ‐Cell Cancer Collaborative Group (IGCCCG) has found acceptance worldwide and is currently being updated.
What is the functional result of a delayed coloanal anastomosis in redo rectal surgery?
Authors: Boullenois Hortense , Lefevre Jérémie H. , Creavin Ben , Calmels Mélanie , Voron Thibault , Debove Clotilde , Chafai Najim , Parc Yann 
Published: April 2019

BackgroundDelayed coloanal anastomosis (DCAA) may be used in patients with complex rectal conditions, such as chronic pelvic sepsis, low recto‐vaginal and recto‐vesical fistula; however, limited data are available. The aim is to report the morbidity and functional results of DCAA in redo rectal surgery.MethodsAll patients undergoing DCAA between January 2014 and August 2017 were retrospectively included. Success was defined as a functional anastomosis without stoma, evaluated using the Low Anterior Resection Syndrome (LARS) score and the Gastrointestinal Quality of Life Index (GIQLI) functional assessment tools.ResultsOf the 72 redo pelvic surgeries, 29 (40.3%) DCAA were performed over a 4‐year period. Indications for redo resection were chronic pelvic sepsis (n = 13, 44.8%), recto‐vaginal fistula (n = 11, 37.9%) and recto‐vesical fistula (n = 5, 17.2%). Mean interval period between the two procedures was 14 ± 3 days (8–21). Global major morbidity (Clavien‐Dindo III or IV) was seen in six patients (20.7%). Stoma closure was feasible for 22 (75.9%) patients after a median period of 78 days (interquartile range 61–98). The 6‐month success rate was 79.3%. Mean LARS was 28.8 ± 10.2 (3–41) (minor LARS) for 18 patients with no stoma at the end of follow‐up. LARS score was significantly better with a follow‐up >2 years (23.3 ± 12.2 versus 32.3 ± 7.9), P = 0.074. Mean GIQLI score was 79.2 ± 14.3 (48–98).ConclusionsTransanal colonic pull through with delayed anastomosis for redo‐surgery in complex pelvic situations had low morbidity and avoided a permanent stoma in three out of four patients with an acceptable quality of life.
The cnidome and ultrastructural morphology of late planulae in Lophelia pertusa (Linnaeus, 1758)—With implications for settling competency
Authors: Strömberg Susanna M. , Östman Carina , Larsson Ann I. 
Published: April 2019

AbstractThe larval pre‐competency period and competency window are important in delimiting the potential dispersal distance for pelagic larvae of sessile marine fauna. Here, we provide evidence for morphological changes in the late planulae of Lophelia pertusa that have implications for their dispersal potential. Three weeks after spawning, the planulae gain functional cnidocysts, indicating that they are competent to settle at this time. Cnidae have been shown to be used for primary anchoring during settling, and before this time point, the larvae most probably do not have the ability to attach to a substrate in high flow conditions. The appearance of functional cnidae coincides with larvae gaining a flexible mouth that can be opened to the full width of the larva. The larval isorhizas differ the most from the adult polyps isorhizas, while the p‐ and b‐mastigophores bear more resemblance to the adult homologues of similar size. The external and internal morphology of late planulae is further described with demonstration of long apical cilia and its effect on swimming agility, morphological changes of the ciliated cells in the larval mouth region and an internal nerve plexus. This study also indicates that L. pertusa planulae seek out cryptic spaces for settling.
The Beliefs in Trichotillomania Scale (BiTS): Factor analyses and preliminary validation
Authors: Rehm Imogen C. , Nedeljkovic Maja , Moulding Richard , Thomas Anna 
Published: April 2019

ObjectivesThe role of cognitions and beliefs in trichotillomania (TTM; hair pulling disorder) has been the subject of only limited investigation. This study aimed to develop and validate the Beliefs in TTM Scale (BiTS).MethodsA pool of 50 items based upon themes identified in previous research was administered online to 841 participants with and without self‐reported problematic, non‐cosmetic hair pulling behaviours.ResultsExploratory and confirmatory factor analyses conducted in randomly split‐halves of the sample supported retention of 14 items comprising three factors: negative self‐beliefs, low coping efficacy, and perfectionism.ConclusionsThe BiTS demonstrated satisfactory psychometric properties and all three subscales significantly correlated with greater hair pulling severity. Negative self‐beliefs predicted hair pulling severity over and above mood symptoms, suggesting the importance of addressing self‐construals in psychological treatments for TTM. Validation in a clinician diagnosed sample is required.Practitioner points

Research supports cognitive therapies for treating trichotillomania (hair pulling disorder), although studies investigating the nature and role of cognitions and beliefs in this disorder have been lacking.

This study developed and validated a self‐report measure of three styles of beliefs most relevant to trichotillomania: negative self‐beliefs, low coping efficacy, and perfectionism.

Negative self‐beliefs predicted the severity of trichotillomania symptoms over and above depression and anxiety, suggesting such cognitions may not necessarily be due to comorbidities.

Future research should validate the new measure in a clinician diagnosed sample, and therapies for trichotillomania may be enhanced by targeting shame specifically.
Muted voices: The unexplored sexuality of young persons with learning disability in Malta
Authors: Azzopardi Lane Claire L. , Cambridge Paul , Murphy Glynis 
Published: April 2019

Accessible summary

Persons with learning disability who live in Malta, especially women, feel they do not have as many opportunities to make friends and form relationships as other persons who do not have a learning disability.

Persons with learning disability feel lonely but wish they had the opportunity to do the things non‐disabled people do, such as have relationships, get married, live on their own and have children.

At times, their parents and people who work with them do not help them with this.

It is important that persons with learning disability from a young age are supported and empowered so that they can exercise their sexual rights.

AbstractBackgroundThis paper explores the sexuality of young persons with learning disability in Malta with respect to their opportunities and the constraints they experience.Materials and MethodsInterpretative phenomenological analysis was used to decode qualitative data collected from persons with learning disability.ResultsFindings reveal a context of disabling social attitudes, stereotypical gender imagery and exclusionary social practices. In addition, youth with learning disability experience a lack of community support and social networking, thus calling for platforms and spheres where they can form and maintain friendships and relationships.ConclusionsIt is concluded that Malta lacks the fundamental social acceptance that persons with learning disability are sexual beings, with the right to express their sexuality and to form relationships. Overcoming such cultural hurdles will empower persons with learning disability to establish and express their sexual identities.