bluuebunny/crossref_metadata_2025_split huggingface dataset:
A patient-centred assessment of the 2016 ACR-EULAR Myositis Response Criteria: evaluating the meaningfulness of responses
Authors: Saygin Didem , Chandrasekhara Pillai Anjana , Moghadam-Kia Siamak , Oddis Chester V , Ren Dianxu , Najem Catherine , Dhatt Harman , Aggarwal Rohit 
Published: March 2024

Abstract

Objectives
The ACR-EULAR Myositis Response Criteria [Total Improvement Score (TIS)] is a composite measure calculated using changes in myositis core set measures. It is unclear if achieving improvement per TIS reflects improvement in any symptoms of patients with myositis. In this study, we examined the association between achieving TIS improvement and patient-centred outcome measures (PCOMs).

Methods
Adults with myositis were enrolled in a prospective study with baseline and 6-month visits. Six core set measures were collected at each visit along with the following PCOMs: fatigue [visual analogue scale (VAS) and short form 36 (SF36)], pain (VAS, SF36), health-related quality of life (SF-36), physical function (PROMIS-physical function, SF36, sit-to-stand, timed up-and-go and six-min walk) and physical activity (actigraphy). Mann–Whitney U was used to compare PCOMs between improvement groups. Spearman correlation and regression models were used for correlation and association between TIS and PCOMs, respectively.

Results
Of 50 patients (six polymyositis, 24 dermatomyositis, nine necrotizing myopathy, 11 anti-synthetase syndrome) enrolled (mean age: 52, 60% female), 21 patients satisfied the TIS improvement criteria at 6 months. PCOMs including fatigue, pain, quality of life, physical activity and physical function demonstrated significantly greater improvement in patients who had minimal TIS improvement compared with those with no improvement. Greater PCOM improvements were seen with moderate-major TIS improvement. TIS had moderate-strong correlations with most PCOMs.

Conclusion
Achieving improvement criteria was accompanied by significant clinical improvements in fatigue, pain, health-related quality of life, physical function, and physical activity. These results support the use of TIS as a clinically meaningful metric of improvement.
Characteristics associated with patient-reported treatment success in psoriatic arthritis
Authors: Samuel Christeen , Finney Amanda , Grader-Beck Thomas , Haque Uzma , Miller John , Grieb Suzanne M , Prichett Laura , Orbai Ana-Maria 
Published: March 2024

Abstract

Objectives
To determine characteristics associated with patient-reported treatment success in psoriatic arthritis (PsA).

Methods
Rheumatologist-diagnosed PsA patients fulfilling the CASPAR classification were recruited from a single center. PsA outcome measures included: 66/68 swollen/tender joint counts, Leeds/SPARCC dactylitis/enthesitis indices, psoriasis body surface area (BSA), and patient-reported outcomes (PROs) including PROMIS. The primary outcome was a patient-reported item: ‘Today, considering the level of control of your psoriatic arthritis and psoriasis, do you consider your treatment has been successful?’. Descriptive and multivariate logistic regression analyses identified clinical predictors of patient-reported treatment success. Patient-reported reasons for lack of treatment success were explored.

Results
A total of 178 participants had a baseline visit. Mean (SD) CASPAR score was 3.7 (0.9), age 51.7 (13.5) years, and BMI 31.3 (7.2) kg/m2. Fifty-two percent were women, and 86.0% white. Treatment success was reported by 116/178 (65%) patients in the analytic cohort. Among 76 patients who reported treatment failure, the most frequently selected reasons for lack of success were pain (n = 55, 72.4%), fatigue (n = 46, 60.5%), inflamed joints (n = 40, 52.6%) and stiffness (n = 40, 52.6%). Overall, 105 participants had complete data across variables in the logistic regression models. Patient-reported treatment success was independently associated with the 66-swollen/68-tender joint counts, psoriasis BSA, PROs (pain interference, physical function, fatigue) and TNF-inhibitor therapy, after controlling for BMI and demographics.

Conclusion
Patient-reported treatment success in PsA may be achieved through improvement of inflammatory arthritis, psoriasis, pain, physical function, fatigue and the use of TNF-inhibitors. Patients reported treatment failure was most commonly due to symptoms of pain, fatigue and stiffness.
Infrastructure and Structural Change in Africa
Authors: Dappe Matías Herrera , Lebrand Mathilde 
Published: March 2024

Abstract
Past investments in electricity, Internet, and road infrastructure, in isolation and bundled, have contributed to structural transformation and economic development in Africa. Using new data on the expansion of the road, electricity, and Internet networks over the past two decades, the paper shows that having access to both paved roads and electricity has led to a significant reallocation of labor from agricultural to both manufacturing and services. Adding access to fast Internet has had a major impact on structural change, with an even larger impact on reallocating labor away from agriculture. The paper then uses a spatial general-equilibrium model to quantify the impacts of future regional transport investments, bundled with electricity and Internet investments, on economic development in countries in the Horn of Africa and Lake Chad region.
Strangers and Foreigners: Trust and Attitudes toward Citizenship in Sub-Saharan Africa
Authors: Bertocchi Graziella , Dimico Arcangelo , Tedeschi Gian Luca 
Published: March 2024

Abstract
This study explores the factors that shape natives’ attitudes toward citizenship acquisition for foreigners. The hypothesis is that, in Sub-Saharan Africa, the slave trade represents a deep determinant of contemporary attitudes toward citizenship, through a proximate determinant which is the level of trust. Accordingly, individuals belonging to ethnic groups with higher exposure to historical slave exports are more likely to exhibit a sense of distrust toward strangers, and are consequently more likely to oppose citizenship laws that favor the inclusion of foreigners. The findings indicate that individuals with higher levels of trust toward other people do exhibit more favorable attitudes regarding the acquisition of citizenship at birth for children of foreigners, that these attitudes are also negatively related to the intensity of the slave trade, and that the underlying inverse relationship between trust and the slave trade is confirmed. Other factors such as conflict, kinship tightness, and witchcraft beliefs, which could also influence attitudes toward citizenship through the channel of trust, do not yield the same distinct pattern of associations as observed with the slave trade.
A New Look at Vertebral Body Tethering (VBT): Through the Modified Clavien-Dindo-Sink (mCDS) Classification
Authors: Vorhies John S. , Hauth Lucas , Garcia Samantha , Roye Benjamin D. , Poon Selina , Sturm Peter F. , Glotzbecker Michael , Fletcher Nicholas D. , Stone Joseph D. , Cahill Patrick J. ,   The Pediatric Spine Study Group, Anari Jason B. 
Published: March 2024

Introduction:
Anterior vertebral body tethering (AVBT) is increasingly popular as an option for surgical treatment of idiopathic scoliosis (IS). While the technology remains new, it is important for families and patients to be able to compare it to the current standard of care, posterior spinal fusion (PSF). The purpose of this study is to describe the complication rate of AVBT in IS using the mCDS and to compare it to the recently reported complication rate of PSF in IS.

Methods:
A multicenter pediatric spine deformity database was queried for all idiopathic scoliosis patients who underwent vertebral body tethering. There were 171 patients with a minimum 9-month follow-up included in this study. Complications were retrospectively graded by 2 attending pediatric spine surgeons using the mCDS classification system.

Results:
Data from 171 patients with idiopathic scoliosis was available for analysis, with 156/171 (91%) of patients being female and an average age of 12.2 years old at surgery. There were 156 thoracic tethers (1 with an LIV below L2), 5 lumbar tethers, 9 staged double tethers, and only 1 patient with same-day double tether. Fifty-five (55) (32%) patients experienced a total of 69 complications. The most common complication type for VBT by mCDS was Grade IIIb, encompassing 29/69 (42%) of complications. The second most frequent complication grade was Grade I at 23/69 (33%). Thirty-four (34) out of 69 (49%) of the VBT complications reported required either procedural/surgical intervention or admission to the ICU.

Conclusions:
This is the first study to directly compare the complication profile of VBT to PSF using the mCDS. Forty-nine percent (49%) of the VBT complications reported were at least Grade III, while only 7% of complications in the control PSF cohort from the literature were Grade III or higher. The mCDS complication classification brings light to the early learning experience of a new technique compared to the widely accepted standard of PSF for IS.

Level of Evidence:
III – Retrospective comparative study.
Acetabular “Fleck” Sign: Outcomes of Surgical Repair
Authors: Chen Stephanie , Tulchin-Francis Kirsten , Gaines Dan , Kadado Allen , Smith Craig , Klingele Kevin 
Published: March 2024

Background:
Traumatic, posterior hip dislocations in the pediatric population are typically managed by closed reduction to achieve a concentric hip joint. The presence of an acetabular “fleck” sign, despite concentric reduction, has been shown to signify significant hip pathology. The purpose of this study was to evaluate the outcomes of open labral repair through a surgical hip dislocation (SHD) in a consecutive series of patients with an acetabular “fleck” sign associated with a traumatic hip dislocation/subluxation.

Methods:
A retrospective review of patients between 2008 and 2022 who presented to a single, level 1 pediatric trauma center with a traumatic posterior hip dislocation/subluxation was performed. Patients were included if they had an acetabular “fleck” sign on advanced imaging and underwent open labral repair through SHD. Medical records were reviewed for sex, age, laterality, mechanism of injury (MOI), and associated orthopaedic injuries. The modified Harris hip score (mHHS) was utilized as the primary clinical outcomes measure. Patients were assessed for the presence of heterotopic ossification (HO) and complications, including implant issues, infection, avascular necrosis (AVN), and post-traumatic dysplasia.

Results:
Twenty-nine patients (23 male, average age: 13.0±2.7 y; range: 5.2 to 17.3) were identified. Eighteen injuries were sports related, 9 caused by motor vehicle accidents, and 1 pedestrian struck. All patients were found to have an acetabular “fleck” sign on CT (26 patients) or MRI (5 patients). Associated injuries included: femoral head fracture (n=6), pelvic ring injury (n=3), ipsilateral femur fracture (n=2), and ipsilateral PCL avulsion (n=1). At the latest follow-up (2.2±1.4 y), all patients had returned to preinjury activity/sport. Three patients developed asymptomatic, grade 1 HO in the greater trochanter region. There was no incidence of AVN. One patient developed post-traumatic acetabular dysplasia due to early triradiate closure. mHHS scores showed excellent outcomes (n=21, 94.9±7.4, range: 81 to 100.1).

Conclusions:
The acetabular “fleck” sign indicates a consistent pattern of osteochondral avulsion of the posterior/superior labrum. Restoring native hip anatomy and stability is likely to improve outcomes. SHD with open labral repair in these patients produces excellent clinical outcomes, with no reported cases of AVN.

Level of Evidence:
Level IV—therapeutic.
New latency-promoting agents for a block-and-lock functional cure strategy
Authors: Pellaers Eline , Denis Alexe , Debyser Zeger 
Published: March 2024

Purpose of review
Currently, HIV-infected patients are treated with antiretroviral therapy. However, when the treatment is interrupted, viral rebound occurs from latently infected cells. Therefore, scientists aim to develop an HIV-1 cure which eradicates or permanently silences the latent reservoir.

Recent findings
Previously, scientists focused on the shock-and-kill cure strategy, which aims to eradicate the latent reservoir using latency-reactivating agents. Limited success shifts the interest towards the block-and-lock cure approach, which aims to achieve a functional cure by “blocking” HIV-1 transcription and “locking” the provirus in a deep latent state, resistant to treatment-interruption. In this strategy, latency promoting agents are used to induce transcriptional silencing and alter the epigenetics environment at the HIV promotor.

Summary
For the block-and-lock cure strategy to succeed more investigation into the transcriptional and epigenetic regulation of HIV-1 gene expression is necessary to design optimal latency-promoting agents. In this review, we will discuss the latency promoting agents that have been described in literature during the past 2 years (2022–2023).
Cutaneous Hydrophilic Polymer Embolism: An Important and Overlooked Clinical Entity
Authors: Chan Kimberly Pei Rui , Lee Joyce Siong See , Lim Joel Hua Liang 
Published: March 2024

Abstract:
Hydrophilic polymer embolism from vascular medical devices is an underrecognized clinical entity that can cause deleterious end-organ ischemia and culminate in mortality. This is concerning as we are in the era where minimally invasive procedures are commonplace. Diagnosis is often made retrospectively after obtaining histopathological tissue samples showing endoluminal, cerebriform, amorphous, anucleate, basophilic, nonrefractile, nonpolarizable foreign body material. We detail 2 more cases of cutaneous hydrophilic polymer embolism to underscore its salient clinicopathological features and increase awareness of this important iatrogenic entity.
Perineural Infiltration: A Comprehensive Review of Diagnostic, Prognostic, and Therapeutic Implications
Authors: Torre-Castro Juan , Ríos-Viñuela Elisa , Balaguer-Franch Inmaculada , Díaz de Lezcano Ignacio , Aguado-García Ángel , Nájera Laura , Suárez Dolores , Requena Luis 
Published: March 2024

Abstract:
Perineural infiltration refers to a neoplastic cell involvement in, around, and through the nerves. It is considered as one of the neoplastic dissemination pathways. Thus, its identification is crucial to establish the prognosis of some malignant skin neoplasms, such as squamous cell carcinoma, and explains the locally aggressive behavior of cutaneous neoplasms, such as microcystic adnexal carcinoma. We have conducted a review of malignant and benign skin tumors in which perineural infiltration has been described, and we also discuss some histopathological findings that may simulate perineural infiltration.
Identification of At-Risk Patients That Need More Intensive Treatment Following mTBI: Post-Hoc Insights From the UPFRONT-Study
Authors: Scheenen Myrthe E. , van der Horn Harm J. , de Koning Myrthe E. , van der Naalt Joukje , Spikman Jacoba M. 
Published: March 2024

Objective:
To investigate which factors within an at-risk group make patients less likely to benefit from preventive treatment following mild traumatic brain injury (mTBI).

Setting:
Inclusion in 3 level I trauma centers in the Netherlands. Data collection through surveys as outpatients.

Participants:
mTBI patients (18-66 years), reporting 3 or more complaints 2 weeks postinjury (at-risk status). Eighty-four patients included and randomized (39 patients cognitive behavioral therapy, 45 patients telephonic counseling). Eighty patients filled out the questionnaires 12 months postinjury. Post hoc analysis investigating 80 patients as 1 at-risk group receiving psychological treatment.

Design:
Post hoc study of a randomized controlled trial (RCT). Binomial logistic regression performed determining which variables 2 weeks postinjury contributed strongly to unsuccessful return to work/study (RTW) and unfavorable outcome at 12 months.

Main measures:
RTW and functional outcome as measured with the Glasgow Outcome Scale-Extended (GOSE) at 12 months postinjury.

Results:
Out of 80 patients, 43 (53.8%) showed a favorable functional outcome at 12 months, and 56 (70%) patients had a full RTW. Patients with unfavorable outcome had a higher age and higher reports of anxiety, depression at 2 weeks and 12 months postinjury. Patients with an unsuccessful RTW had a higher age and higher reports of depression, and posttraumatic stress disorder at 2 weeks and 12 months postinjury. A logistic regression model for functional outcome (GOSE) was statistically significant (χ²7 = 40.30, P < .0001). Of 6 predictor variables, 3 were significant: anxiety, depression, and treatment condition. For RTW, logistic regression was also statistically significant (χ²7 = 19.15, P = .008), with only 1 out of 6 predictor variables (ie, age) being significant.

Conclusion:
Main findings comprise differences in demographic and psychological measures between patients with favorable and unfavorable outcomes and patients with RTW versus no RTW. Prediction models of outcome and RTW showed several psychological measures at 2 weeks greatly determining patients' likelihood benefitting from the preventive treatment. Results suggest that from the beginning there are some patients for whom a short preventive treatment is not sufficient. Selection and treatment of at-risk patients might be better based on psychological symptoms instead of posttraumatic complaints.
Neurobehavioral Symptoms in Spanish-Speaking Individuals With Subconcussive Injuries
Authors: Krch Denise , Lequerica Anthony H. , Arango-Lasprilla Juan Carlos , Corrigan John D. 
Published: March 2024

Objective:
To examine whether exposure to high-risk events causing injury to the head or neck has an effect on neurobehavioral symptoms in the absence of an alteration of consciousness in Spanish-speakers.

Setting:
Web-based survey.

Participants:
Seven hundred forty-eight individuals from Spain and Latin America, aged 18 to 65 years, with 10 years or more of education. Thirty-nine participants failed quality checks and were excluded. Seven hundred nine participants were included in the analyses.

Design:
Cross-sectional study. Subconcussive exposure was defined as endorsing exposure to one or more high-risk scenarios in the absence of any alteration of consciousness. Three injury groups were derived: No Head Injury, Subconcussive Exposure, and traumatic brain injury (TBI). The Subconcussive Exposure group was further divided into Single and Multiple Exposures. Two analyses were conducted: the effect of lifetime exposure to injury (No Head Injury, Subconcussive Exposure, TBI) on neurobehavioral symptoms; the effect of Subconcussive Exposure Frequency (No Head Injury, Single Exposure, Multiple Exposures) on neurobehavioral symptoms.

Main Measures:
Spanish Ohio State University Traumatic Brain Injury Identification Method Self-Administered-Brief (OSU TBI-ID SAB); Neurobehavioral Symptom Inventory (NSI).

Results:
There was a significant effect for Injury group on the NSI partial eta-squared (ηp
2 = 0.053) and a significant effect of Exposure Frequency group on the NSI (ηp
2 = 0.40). Individuals with subconcussive exposures reported significantly more neurobehavioral symptoms than those with no history of head injury and significantly less symptoms than those with TBI. Individuals with multiple subconcussive exposures reported significantly more neurobehavioral symptoms than those with single and no exposure.

Conclusion:
This research expands the utility of the OSU-TBI-ID SAB as a lifetime TBI history assessment tool to one capable of evaluating subconcussive exposure dosing effects in Spanish-speakers. Such an index may facilitate establishment of subconcussive exposure prevalence rates worldwide, leading to improved understanding of the chronic effects of high-risk exposures.
Prognostic impact of thrombocytosis in gastric cancer—A retrospective study
Authors: Castro Bárbara Neto , Costa Catarina , Martins Daniel , Amado Andreia , Santos Mariana , Graça Susana , Tavares Amélia , Ferreira António , Viveiros Fernando , Vale Sílvio , Oliveira Manuel 
Published: March 2024

Abstract

BACKGROUND:
Solid tumors are a common cause of secondary thrombocytosis, which has been identified as a prognostic factor in various cancers. However, the impact of thrombocytosis on the prognosis of gastric cancer is not yet well defined. The aim of this study was to assess the prevalence and prognostic value of thrombocytosis in patients with gastric cancer.

METHODS:
This was a retrospective study of patients with gastric carcinoma treated surgically, with curative intent, in our hospital, Centro Hospitalar Vila Nova de Gaia/Espinho, between January 2009 and December 2019. Clinical files were consulted and clinicopathological characteristics were analyzed.

RESULTS:
In the present sample (n = 352), the prevalence of pretreatment thrombocytosis was 16.5%. Thrombocytosis was associated with more advanced T stage, greater number of metastatic nodes, and more frequent lymphatic and venous permeation. The presence of thrombocytosis had a negative impact on disease-free survival (hazard ratio [HR] 3.54, 95% confidence interval [CI] 2.35–5.33, P < .001) and overall survival (HR 4.45, 95% CI 2.95–6.71, P < .001).

CONCLUSIONS:
The presence of pretreatment thrombocytosis had a negative impact on overall survival and disease-free survival and thus could be used as an independent prognostic factor.
An update on dietary therapies in paediatric Crohn's disease
Authors: Gkikas Konstantinos , Svolos Vaios , White Bernadette , Gerasimidis Konstantinos 
Published: March 2024

Purpose of review
This article provides a literature update on original articles published in the past 18 months (May 2022–November 2023) in the dietary management of paediatric Crohn's disease.

Recent findings
There is more data to support the use of exclusive enteral nutrition in the management of active Crohn's disease in children. Several food-based dietary therapies have been proposed for the management of Crohn's disease. There is an interest in precision nutritional therapy in Crohn's disease, but current data are scarce.

Summary
Exclusive enteral nutrition is an effective treatment for paediatric Crohn's disease. Predictors of response to exclusive enteral nutrition include mild disease phenotype and ileal disease involvement, although data remain inconclusive. Adherence to exclusive enteral nutrition is cornerstone to its efficacy. Treatment with exclusive enteral nutrition modifies the gut microbiome, modulates bile acid metabolism and has significant effects on host immune responses. More studies are expected in which drugs need to be combined with dietary therapies and microbial therapeutics. The efficacy of Crohn's disease exclusion diet coupled with partial enteral nutrition is supported by independent studies, but tolerance remains an issue, particularly for long-term disease management. More research is anticipated in precision nutritional therapy in paediatric Crohn's disease, but currently no recommendations can be made.