bluuebunny/crossref_metadata_2025_split huggingface dataset:
Origin of modern syphilis and emergence of a contemporary pandemic cluster
Authors: Arora Natasha , Schuenemann Verena J. , Jäger Günter , Peltzer Alexander , Seitz Alexander , Herbig Alexander , Strouhal Michal , Grillová Linda , Sánchez-Busó Leonor , Kühnert Denise , Bos Kirsten I. , Rivero Davis Leyla , Mikalová Lenka , Bruisten Sylvia , Komericki Peter , French Patrick , Grant Paul R. , Pando María A. , Gallo Vaulet Lucía , Rodríguez Fermepin Marcelo , Martinez Antonio , Centurion Lara Arturo , Giacani Lorenzo , Norris Steven J. , Šmajs David , Bosshard Philipp P. , González-Candelas Fernando , Nieselt Kay , Krause Johannes , Bagheri Homayoun C. 
Published: April 2016

AbstractSyphilis swept across the world in the 16th century as one of most prominent documented pandemics and is re-emerging worldwide despite the availability of effective antibiotics. Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the non-cultivable and clonal nature of the causative bacteriumTreponema pallidumsubsp.pallidum. In this study, we used DNA capture and next generation sequencing to obtain whole genome data from syphilis patient specimens and from treponemes propagated in laboratory settings. Phylogenetic analyses indicate that the syphilis strains examined here share a common ancestor after the 15th century. Moreover, most contemporary strains are azithromycin resistant and members of a globally dominant cluster named here as SS14-Ω. This cluster diversified from a common ancestor in the mid-20thcentury and has the population genetic and epidemiological features indicative of the emergence of a pandemic strain cluster.
Holocene variability of an Amazonian hyperdominant
Authors: Bush Mark B. , McMichael Crystal N. H. 
Published: April 2016

Summary

Little is known regarding the long‐term stability or instability of Amazonian plant communities.

We assessed whether the most abundant species, hyperdominants, may have risen to prominence at the Pleistocene–Holocene transition, following subsequent changes in moisture regimes, or as a result of human activity later in the Holocene.

The fossil pollen history of the commonest western Amazonian tree, Iriartea deltoidea (hereafter Iriartea), is investigated using fossil pollen data from 13 lakes. Iriartea is a monospecific genus with diagnostic pollen. It is also considered a ‘useful’ plant, and its abundance could have been enriched by human action.

Iriartea pollen was found to have increased in abundance in the last 3000 years, but did not show a consistent relationship with human activity.

The suggestion that the hyperdominants in modern Amazonian forests are a legacy of pre‐Columbian people is unsupported.

The abundance of Iriartea pollen is related to increasing precipitation, not human activity over the last 3000 years. This member of the hyperdominant category of Amazonian trees has only recently acquired this status.

Synthesis. Our findings are consistent with the observation that communities in complex systems are ephemeral. The populations of even the most abundant species can change over a few tens of generations. The relative abundance of tree species, even in relatively stable systems such as those of Amazonian floodplains, changes on ecological not evolutionary timescales.
Symphysiotomy for obstructed labour: a systematic review and meta‐analysis
Authors: Wilson A , Truchanowicz EG , Elmoghazy D , MacArthur C , Coomarasamy A 
Published: April 2016

BackgroundObstructed labour is a major cause of maternal mortality. Caesarean section can be associated with risks, particularly in low‐ and middle‐income countries, where it is not always readily available. Symphysiotomy can be an alternative treatment for obstructed labour and requires fewer resources. However, there is uncertainty about the safety and effectiveness of this procedure.ObjectivesTo compare symphysiotomy and caesarean section for obstructed labour.Search strategyMEDLINE, EMBASE, Cochrane library, CINAHL, African Index Medicus, Reproductive Health Library and Science Citation Index (from inception to November 2015) without language restriction.Selection criteriaStudies comparing symphysiotomy and caesarean section in all settings, with maternal and perinatal mortality as key outcomes.Data collection and analysisQuality of the included studies was assessed using the STROBE checklist and the Newcastle Ottawa scale. Relative risks (RR) were pooled using the random effects model. Heterogeneity was assessed using I2 tests.Main resultsSeven studies (n = 1266 women), all of which were set in low‐ and middle‐income countries (as per the World Bank definition) and compared symphysiotomy and caesarean section were identified. Meta‐analyses showed no significant difference in maternal (RR 0.48, 95% CI 0.13–1.76; P = 0.27) or perinatal (RR 1.12, 95% CI 0.64–1.96; P = 0.69) mortality with symphysiotomy when compared with caesarean section. There was a reduction in infection (RR 0.30, 95% CI 0.14–0.62) but an increase in fistulae (RR 4.19, 95% CI 1.07–16.39) and stress incontinence with symphysiotomy (RR 10.04, 95% CI 3.23–31.21).ConclusionThere was no difference in key outcomes of maternal and perinatal mortality with symphysiotomy when compared with caesarean section.Tweetable abstractSymphysiotomy could be an alternative to caesarean section when resources are limited.
Breaking Narrative Ground: Innovative Methods for Rigorously Eliciting and Assessing Patient Narratives
Authors: Grob Rachel , Schlesinger Mark , Parker Andrew M. , Shaller Dale , Barre Lacey Rose , Martino Steven C. , Finucane Melissa L. , Rybowski Lise , Cerully Jennifer L. 
Published: April 2016

ObjectiveTo design a methodology for rigorously eliciting narratives about patients' experiences with clinical care that is potentially useful for public reporting and quality improvement.Data Sources/Study SettingTwo rounds of experimental data (N = 48 each) collected in 2013–2014, using a nationally representative Internet panel.Study DesignOur study (1) articulates and operationalizes criteria for assessing narrative elicitation protocols; (2) establishes a “gold standard” for assessment of such protocols; and (3) creates and tests a protocol for narratives about outpatient treatment experiences.Data Collection/Extraction MethodsWe randomized participants between telephone and web‐based modalities and between protocols placed before and after a closed‐ended survey.Principal FindingsElicited narratives can be assessed relative to a gold standard using four criteria: (1) meaningfulness, (2) completeness, (3) whether the narrative accurately reflects the balance of positive and negative events, and (4) representativeness, which reflects the protocol's performance across respondent subgroups. We demonstrate that a five‐question protocol that has been tested and refined yields three‐ to sixfold increases in completeness and four‐ to tenfold increases in meaningfulness, compared to a single open‐ended question. It performs equally well for healthy and sick patients.ConclusionsNarrative elicitation protocols suitable for inclusion in extant patient experience surveys can be designed and tested against objective performance criteria, thus advancing the science of public reporting.
Does Bt maize expressing Cry1Ac protein have adverse effects on the parasitoid Macrocentrus cingulum (Hymenoptera: Braconidae)?
Authors: Wang Zeng‐Xia , Li Yun‐He , He Kang‐Lai , Bai Shu‐Xiong , Zhang Tian‐Tao , Cai Wan‐Zhi , Wang Zhen‐Ying 
Published: April 2016

AbstractThe potential effects of insect‐resistant, genetically engineered (GE) crops on non‐target organisms, especially on predators and parasitoids, must be evaluated before their commercial cultivation. The effects of GE maize that produces Cry1Ac toxin on the parasitoid Macrocentrus cingulum were assessed by direct bioassay and indirect bioassay. In the indirect bioassay, parasitism rate, cocoon weight and the number of M. cingulum progeny produced per host were significantly reduced when M. cingulum‐parasitized Cry1Ac‐susceptible Ostrinia furnacalis were fed a diet containing purified Cry1Ac; however, life‐table parameters of M. cingulum were not adversely affected when the same assay was performed with Cry1Ac‐resistant O. furnacalis. These results indicated that the detrimental effects detected with a Cry1Ac‐susceptible host were mediated by poor host quality. In a direct bioassay, no difference in life‐table parameters were detected when M. cingulum adults were directly fed a 20% honey solution with or without Cry1Ac; however, survival and longevity were significantly reduced when M. cingulum adults were fed a honey solution containing potassium arsenate, which was used as a positive control. The stability and bioactivity of Cry1Ac toxin in the food sources and Cry1Ac toxin uptake by the host insect and parasitoid were confirmed by enzyme‐linked immunosorbent assay and sensitive‐insect bioassays. Our results demonstrate that M. cingulum is not sensitive to Cry1Ac toxin at concentrations exceeding those encountered in Bacillus thuringiensis maize fields. This study also demonstrates the power of using resistant hosts when assessing the risk of genetically modified plants on non‐target organisms and will be useful for assessing other non‐target impacts.
Meta‐analysis of confocal laser endomicroscopy for the diagnosis of gastric neoplasia and adenocarcinoma
Authors: Qian Wei , Bai Tao , Wang Huan , Zhang Lei , Song Jun , Hou Xiao Hua 
Published: April 2016

ObjectiveConfocal laser endomicroscopy (CLE) is a recently developed technique used to diagnose gastrointestinal diseases. The current meta‐analysis aimed to systematically assess the ability of CLE to diagnose neoplasia and gastric adenocarcinoma.MethodsA comprehensive literature search was performed using PubMed, Embase and the Cochrane Library for endomicroscopy, gastric neoplasia and gastric adenocarcinoma. Sensitivity and specificity data on the diagnosis of neoplasia and gastric adenocarcinoma were pooled. A summary receiver operating characteristic (sROC) curve was performed and the area under the curve was calculated.ResultsIn all, 13 studies were included in the current study. The pooled sensitivity and specificity assessing CLE as a method to diagnose gastric neoplasia were 0.81 and 0.98, respectively. For the diagnosis of gastric adenocarcinoma, the pooled sensitivity and specificity were 0.89 and 0.99, respectively. The pooled sensitivity and specificity were 0.82 and 0.95 when differentiating high‐grade intraepithelial neoplasia from low‐grade intraepithelial neoplasia. Additionally, the pooled sensitivity and specificity were 0.87 and 0.96, respectively, when distinguishing undifferentiated gastric adenocarcinoma from differentiated gastric adenocarcinoma.ConclusionCLE has a high sensitivity and specificity for diagnosing gastric intraepithelial neoplasia and gastric adenocarcinoma; therefore, it could be considered an alternative to the endoscopic method used to diagnose gastric intraepithelial neoplasia and gastric adenocarcinoma.
The IRIS (Insulin Resistance Intervention after Stroke) trial: A new perspective on pioglitazone
Authors: Inzucchi Silvio E. , Furie Karen L. 
Published: April 2016

Highlights

The TZD, pioglitazone, reduced stroke and MI by 24% in 3876 insulin resistant patients with a history of recent stroke or TIA.
The progression to diabetes was also reduced by 52% in this group of patients ‐ many of whom had pre‐diabetes.
Pioglitazone is the sole glucose-lowering drug demonstrated to reduce atherosclerotic events.
亮点

TZD,在3876名最近有中风或者TIA病史的胰岛素抵抗患者中,吡咯列酮可使中风或者MI减少24%。
在这组患者中进展为糖尿病的风险也减少了52%——他们中的许多人先前都处于糖尿病前期。
吡咯列酮是唯一得到证实可以减少动脉粥样硬化事件的降糖药物。
Comparison of heart rate variability and classic autonomic testing for detection of cardiac autonomic dysfunction in patients with fibromyalgia
Authors: Lee Kyung‐Eun , Choi Sung‐Eun , Kang Ji‐Hyoun , Yim Yi‐Rang , Kim Ji‐Eun , Lee Jeong‐Won , Wen Lihui , Park Dong‐Jin , Kim Tae‐Jong , Park Yong‐Wook , Lee Shin‐Seok 
Published: April 2016

AbstractAimCardiac autonomic dysfunction (CAD) is frequently found in patients with fibromyalgia (FM). Thus, we evaluated whether heart rate variability (HRV) is superior to the Ewing tests in detecting CAD in FM patients.MethodsWe studied 35 females with FM and 25 age‐matched healthy females. In Ewing tests, results were added to yield an overall score. An abnormal result on deep breathing, the Valsalva maneuver, or orthostatic standing was counted as 1 point. A change in systolic blood pressure (SBP) of > 10 mmHg while standing counted as 1 point, and a change of > 20 mmHg as 2 points. A score of 0 was regarded as no CAD, a score of ≥ 2 as severe CAD and a score of 1 as mild CAD. HRV was measured in two ways: by R‐R intervals (time‐domain analysis) and by spectral analysis of a series of successive R‐R intervals (frequency‐domain analysis).ResultsFM patients had significantly lower expiratory/inspiratory (E/I) ratios, lower Valsalva ratios and higher SBP values than healthy controls (P < 0.05, P < 0.05, P < 0.01, respectively). In the frequency domain, very low‐frequency and low‐frequency bands were also lower in FM patients than controls (both P < 0.05). Based on the discriminant analysis of the Ewing tests, 54.4% of cases were correctly classified. The addition of HRV parameters did not improve the reclassification.ConclusionHRV does not improve detection of CAD in FM patients over classic autonomic testing.
Safety of anti‐rheumatic drugs for rheumatoid arthritis in pregnancy and lactation
Authors: Ngian Gene‐Siew , Briggs Andrew M. , Ackerman Ilana N. , Van Doornum Sharon 
Published: April 2016

AbstractWomen with rheumatoid arthritis (RA) are often of childbearing age and therefore questions regarding reproductive health and the use of medications, including disease‐modifying anti‐rheumatic drugs (DMARDs) may arise during the clinical consultation. Each patient requires individual assessment in order to effectively manage the disease while minimizing any treatment‐associated risks to the fetus. Although good‐quality controlled trials are lacking, there is an increasing volume of evidence surrounding the use of immunosuppressive therapies in pregnancy and lactation. This review summarizes the currently available information which can be of benefit to clinicians guiding patients and their families through the risks and benefits of continuing RA therapy during pregnancy and lactation. Further studies and ongoing surveillance of drug safety in pregnancy are required to resolve the uncertainties that remain regarding synthetic and biologic DMARDs.
IgG4‐related retroperitoneal fibrosis: a newly characterized disease
Authors: Lian Linjuan , Wang Cong , Tian Jian‐li 
Published: April 2016

AbstractRetroperitoneal fibrosis (RPF) is a rare disease characterized by chronic, nonspecific inflammatory and sclerotic or fibrotic tissue in the periaortic or periiliac retroperitoneum that encases adjacent structures. There will be a series of clinical manifestations once the proliferated fibrous tissues encase the abdominal aorta, iliac arteries and urinary duct. RPF is generally divided into two types: idiopathic retroperitoneal fibrosis (IRPF) without identified pathogenesis, making up about two‐thirds of cases, and secondary retroperitoneal fibrosis. Recent studies on Immunoglobulin G4‐related disease (IgG4‐RD) reveal that abundant infiltration of IgG4 positive plasma cells is found in biopsies on the mass of RPF of some IRPF patients, which is identified as one spectrum of IgG4‐RD and is named IgG4‐related RPF. IgG4‐related RPF is often misdiagnosed as retroperitoneal visceral malignancy and is treated with surgery. In addition, because of its good response to glucocorticoid, early detection and treatment is important. We review the definition, epidemiology, clinical features, diagnostic criteria, treatment and prognosis of IgG4‐related RPF in this article to raise awareness of this newly characterized disease.
The experience of patients admitted to hospital with acute low back pain: a qualitative study
Authors: El‐Haddad Carlos , Damodaran Arvin , Patrick McNeil H. , Hu Wendy 
Published: April 2016

AbstractAimTo understand the patient experience of being admitted to hospital with acute low back pain (LBP), with a view to developing suggestions for care and LBP management guidelines.MethodInterpretive phenomenological analysis (IPA) was adopted to examine semi‐structured interviews from patients admitted to hospital with acute LBP. Sampling continued until thematic saturation was reached (n = 14). Data were analyzed using the Framework Method, so that data from multiple participants could be systematically summarized, compared, and analyzed.ResultsFour themes were identified: pain and helplessness, desire for validation, interactions with healthcare teams, and a return to pre‐morbid identity and roles. Patients' initial presentation to hospital was characterized by severe pain, disability and difficulty in communicating their illness experience. Patients expected doctors to investigate for an underlying cause of the back pain. To recover, they were required to navigate a system they did not understand, interacting with healthcare workers who seemed to operate independently rather than as a team. Patients viewed medical treatment as a means of returning to pre‐morbid activities of daily living, roles and relationships. Using these themes, a model of the inpatient journey was developed.ConclusionWe have described new patient insights which highlight how the hospital environment adds unique challenges to managing acute LBP. Several suggestions for acute LBP management guidelines are made: developing lay summaries for patients, including methods for communicating the team structure and roles to patients, and ensuring all members of treating teams are educated to ensure guidelines are consistently implemented.
Dual energy computed tomography: a novel technique for diagnosis of gout
Authors: Ahmad Zohra , Gupta Arun Kumar , Sharma Raju , Bhalla Ashu Seith , Kumar Uma , Sreenivas V. 
Published: April 2016

AbstractAimTo evaluate the sensitivity and specificity of dual energy computed tomography (DECT) for diagnosing gout compared with a composite gold standard (CGS) comprising joint aspiration and/or American College of Rheumatology clinico‐radiographic criteria.MethodsNinety patients of suspected gout underwent radiography and DECT of bilateral feet and knees. Radiographs and non‐contrast CT (NCCT) were assessed for morphological characteristics, following which DECT was used to identify urate deposits.ResultsWith CGS as a reference (n = 90), sensitivity of radiographs was 15% (95% confidence interval [CI]: 6–27%) while specificity was 100% (95% CI: 90–100%). Sensitivity of NCCT was 26% (95% CI: 15–40%) while specificity was 97% (95% CI: 85–99%). Sensitivity of DECT was 82% (95% CI: 68–90%) while specificity was 89% (95% CI: 73–96%). Fifty‐five patients underwent joint aspiration. Sensitivity and specificity of radiographs and NCCT with aspiration as a reference (n = 55) were not much different from that of CGS. However, DECT showed a higher sensitivity of 100% (95% CI: 86–100%) and a lower specificity of 48% (95%CI: 28–68%) with aspiration alone.ConclusionsDual energy computed tomography had higher sensitivity compared to conventional imaging with CGS as a reference; however, its specificity dropped with aspiration as a reference. It may be a useful adjunct for the diagnosis of gout, especially in the acute and inter‐critical stage.
Effect of early treatment on physical function in daily management of rheumatoid arthritis: a 5‐year longitudinal study of rheumatoid arthritis patients in the National Database of Rheumatic Diseases in Japan
Authors: Hirata Akie , Suenaga Yasuo , Miyamura Tomoya , Matsui Toshihiro , Tohma Shigeto , Suematsu Eiichi , Ohnaka Keizo , Takayanagi Ryoichi 
Published: April 2016

AbstractAimThe purpose of this study was to assess 5‐year changes in physical function and factors associated with improvement among patients with rheumatoid arthritis (RA) in daily clinical practice, focusing on the effect of treatments, including biologic agents, in the early stage of disease course.MethodsThe National Database of Rheumatic Diseases by iR‐net in Japan (NinJa) was searched for patients with disease duration ≤ 2 years and modified health assessment questionnaire (mHAQ) > 0 between 2004 and 2007, so that 510 patients were included in the final analysis. Multivariate‐logistic regression analyses were used to identify predictors of 5‐year mHAQ disability score improvement.ResultsMedian mHAQ score was 0.40 at baseline and decreased to a median 0.17 after 5 years. Seventy‐four percent of the patients were treated with methotrexate (MTX) and 25% with biologic agents, with early use of biologic agents (within 2 years of RA onset) increasing over time. Multivariate analyses identified higher baseline Disease Activity Score of 28 joints – C‐reactive protein and early use of MTX (within 1 year of RA onset) and of biologic agents (within 2 years) as significantly associated with improved mHAQ; odds ratios of the early treatment were 1.83 (P = 0.01) for MTX and 2.23 (P = 0.04) for biologic agents, respectively.ConclusionFive‐year mHAQ improved in early RA patients in the NinJa database. In daily clinical management of RA, likewise in clinical trials, early administration of MTX or biologic agents is able to improve physical function outcome.
Anti‐Sm is associated with the early poor outcome of lupus nephritis
Authors: Ahn Sung Soo , Yoo Byung‐Woo , Song Jason Jungsik , Park Yong‐Beom , Lee Soo‐Kon , Lee Sang‐Won 
Published: April 2016

AbstractAimWe investigated whether anti‐Smith (Sm) is associated with the outcome of kidney biopsy‐proven lupus nephritis.MethodsWe retrospectively analyzed clinical, laboratory and histological results in 90 patients with kidney biopsy‐proven lupus nephritis. We defined persistent administration of immunosuppressants for more than 3 months after the kidney biopsy as early poor outcome of lupus nephritis. We compared baseline variables and delta values of lupus nephritis‐related variables between patients with and without anti‐Sm. The independent predictive values for early poor outcome were analyzed using logistic regression analysis.ResultsThe median age was 32.0 years old, and 77 patients (85.5%) were women. Anti‐Sm was found in 44 of 90 patients (48.8%). When we analyzed the differences in delta values of variables reflecting the kidney function or the early poor outcome between patients with and without anti‐Sm, we found significant difference in the early poor outcome between the two groups (80.0% of patients having anti‐Sm vs. 56.5% of those not having anti‐Sm, P = 0.022). In multivariate logistic regression analysis, along with age and Systemic Lupus Erythematosus Disease Activity Index, the presence of anti‐Sm increased the potential of the early poor outcome of lupus nephritis (odds ratio 2.870, 95% confidence interval, 1.033, 7.976, P = 0.043).ConclusionOur data suggest that anti‐Sm identified at kidney biopsy might have a predictive value for the early poor outcome of biopsy‐proven lupus nephritis during the follow‐up period.