bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subcutaneous immunoglobulin for patients with idiopathic inflammatory myopathies: a real-world, single-centre experience
Authors: Ma Zechen , Johnson Dylan , Gniadecki Robert , Ritchie Bruce , Keeling Stephanie , Cohen Tervaert Jan Willem , Osman Mohammed 
Published: October 2023

Abstract

Objectives
Idiopathic inflammatory myopathies (IIMs) are heterogeneous diseases characterized by skeletal muscle inflammation associated with cutaneous, pulmonary and/or other visceral organ involvement. IVIG has been recommended as an adjunct therapy for IIM patients refractory to conventional therapy. However, IVIG has high resource needs and increased risk of adverse reactions. Subcutaneous immunoglobulin (SCIG) therapy has been used as an alternative to IVIG in primary immunodeficiencies and neuroinflammatory disorders. We assessed the satisfaction, patient preference and effectiveness in IIM patients who transitioned from IVIG to SCIG.

Methods
We retrospectively reviewed consecutive 20 patients with IIM who were transitioned from IVIG to SCIG therapy for &gt;12 months. Patient preference between IVIG and SCIG was surveyed using a questionnaire previously used in studies of neuroinflammatory conditions. In addition, disease flares, changes in immunosuppression, cumulative prednisone doses and global disease activity were evaluated using the Myositis Intention to Treat Index (MITAX) 12 months pre- and post-SCIG initiation.

Results
Most patients (78.9%) preferred SCIG over IVIG and preferred home-based therapies to hospital-based therapies. There was no significant difference in global disease activity (MITAX 3.31 vs 3.02) or in cumulative steroid doses 12 months pre- or post-SCIG initiation. Three patients experienced disease flares, five escalated in immunosuppression, while four patients deescalated in immunosuppressive medications.

Conclusions
SCIG is preferred by most patients over IVIG without a substantial increased disease activity or need for additional CS. Future cost-effectiveness studies may provide an additional rationale for utilizing SCIG over IVIG for maintenance therapy for IIM.
Looking up and down and round and round: a theoretical–empirical, individual-level analysis of income comparisons
Authors: Lehr Alex 
Published: October 2023

Abstract
Income comparisons imply that individuals care not only about the absolute value of their income but also about its relative value. Such comparisons likely have significant societal consequences while also challenging standard neoclassical economic theory. I argue that a better understanding of income comparisons requires a more systematic, theoretical engagement with three problems: (1) the problem of reference group selection, (2) the problem of orientation, and (3) the problem of functional form. Income comparisons are commonly attributed to interdependent preferences, in particular to envy. I propose an alternative theoretical approach in which comparisons are a rational means for individuals to improve upon imperfect information about their current earning potential. I test the empirical implications of both approaches for reference group selection, orientation, and functional form using individual-level data from the Netherlands. The evidence suggests that imperfect information drives comparisons, but interdependent preferences also play a role.
Biological effects of air pollution on the function of human skin equivalents
Authors: Reynolds Wil J. , Eje Ndubuisi , Christensen Paul , Li Wen‐Hwa , Daly Susan M. , Parsa Ramine , Chavan Bhaven , Birch‐Machin Mark A. 
Published: October 2023

AbstractThe World Health Organization reports that 99% of the global population are exposed to pollution levels higher than the recommended air quality guidelines. Pollution‐induced changes in the skin have begun to surface; however, the effects require further investigation so that effective protective strategies can be developed. This study aimed to investigate some of the aging‐associated effects caused by ozone and particulate matter (PM) on human skin equivalents. Full‐thickness skin equivalents were exposed to 0.01 μg/μL PM, 0.05 μg/μL PM, 0.3 ppm ozone, or a combination of 0.01 μg/μL PM and 0.3 ppm ozone, before skin equivalents and culture medium were harvested for histological/immunohistochemical staining, gene and protein expression analysis using qPCR, Western blotting, and ELISA. Markers include MMP‐1, MMP‐3, COL1A1, collagen‐I, 4‐HNE, HMGCR, and PGE2. PM was observed to induce a decrease in epidermal thickness and an enhanced matrix building phenotype, with increases in COL1A1 and an increase in collagen‐I protein expression. By contrast, ozone induced an increase in epidermal thickness and was found to induce a matrix‐degrading phenotype, with decreases in collagen‐I gene/protein expression and increases in MMP‐1 and MMP‐3 gene/protein expression. Ozone was also found to induce changes in lipid homeostasis and inflammation induction. Some synergistic damage was also observed when combining ozone and 0.01 μg/μL PM. The results presented in this study identify distinct pollutant‐induced effects and show how pollutants may act synergistically to augment damage; given individuals are rarely only exposed to one pollutant type, exposure to multiple pollutant types should be considered to develop effective protective interventions.
Risk Factors for Rectal Stump Leakage following Discontinuity Resection: Stump Length Matters Most
Authors: Ritter Alina S. , Dumm Noemi , Deisenhofer Julian M. , Franz Clemens , Al-Saeedi Mohammed , Büchler Markus W. , Schneider Martin 
Published: October 2023

BACKGROUND:
Discontinuity resection is commonly conducted to avoid anastomotic leakage in high-risk patients, but potentially results in rectal stump leakage. While risk factors for anastomotic leakage have been widely studied, data on rectal stump leakage rates and underlying risk factors are scarce.

OBJECTIVE:
To determine rectal stump leakage rates following Hartmann’s procedure and to identify patient- and surgery-associated risk factors.

DESIGN:
A retrospective study with univariate and multivariate analysis to identify risk factors of rectal stump leakage was performed. A subgroup analysis of scheduled operations was carried out.

SETTINGS:
The study was conducted a Heidelberg University Hospital, Germany.

PATIENTS:
Patients who underwent discontinuity resection with rectal stump formation between 2010 and 2020 were included.

MAIN OUTCOME MEASURES:
The main outcome measures included rectal stump leakage rates, 30-day mortality, length of hospitalization and necessity for further invasive treatment.

RESULTS:
Rectal stump leakage occurred in 11.78% of patients. Rectal stump leakage rates varied considerably depending on the surgical procedure performed and were highest following subtotal pelvic exenteration (34%). Diagnosis of rectal stump leakage peaked on postoperative day 7. A short rectal stump (p = 0.001), previous pelvic radiotherapy (p = 0.04), chemotherapy (p = 0.004) and previous laparotomy (p = 0.03) were independent risk factors for rectal stump leakage in the entire patient collective. In patients undergoing scheduled surgery, a short rectal stump was the only independent risk factor (p = 0.003). Rectal stump leakage was not associated with increased 30-day mortality, but prolonged length of hospitalization and frequently necessitated further invasive treatment.

LIMITATIONS:
Study results are limited by the retrospective design, a high number of emergency operations and the mere inclusion of symptomatic leakages.

CONCLUSIONS:
Rectal stump leakage is a relevant complication after discontinuity resection. Risk factors should be considered during surgical decision making when both discontinuity resection and abdominoperineal resection are feasible..
Tonsil tissue control is ideal for monitoring estrogen receptor immunohistochemical staining
Authors: Chang Chia-Ping , Hang Jen-Fan , Chen Chih-Jung , Tung Chun-Liang , Lien Huang-Chun , Lai Chiung-Ru , Hsu Chih-Yi 
Published: October 2023

Background:
Estrogen receptor (ER) testing performed using immunohistochemistry (IHC) is a critical predictive tool for breast cancer treatment. This study aimed to investigate the use of tonsil control for monitoring ER staining and hypothesize that optimal staining would reduce interlaboratory variations.

Methods:
A proficiency test for ER IHC was conducted using 21 tissue cores. The staining quality was centrally reviewed based on tonsil ER staining.

Results:
We found that 64.9% of participant samples demonstrated optimal or good staining quality. Poor staining quality was significantly associated with the use of Ventana autostainers and concentrated antibodies. Although the concordance rate did not show significant differences across staining quality levels, interparticipant agreement declined as staining quality deteriorated. Among the 19 discordant responses, 63.2% could be attributed to staining problems, whereas 36.8% could be due to misinterpretation. Poor staining quality due to inadequate staining was the primary reason for undercalls, which can lead to false-negative results. Misinterpretations of nonspecific faint staining that was weaker than the staining of the tonsil control were the cause of most overcalls.

Conclusion:
Tonsil tissue is an ideal control for monitoring ER staining and can serve as a reference for determining the lower bound for ER positivity. Optimal ER staining and appropriate references for ER positivity can further improve ER IHC quality.
The modern landscape of fertility, pregnancy, and parenthood in people with cystic fibrosis
Authors: Jain Raksha , Kazmerski Traci M. , Taylor-Cousar Jennifer L. 
Published: October 2023

Purpose of reviewWith improved long-term survival and the expanding availability of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies that treat the underlying genetic defect in cystic fibrosis, more people are interested in parenthood. Cystic fibrosis care centers and people with cystic fibrosis need more information to guide decisions related to parenting.Recent findingsHere we present currently available data on fertility, pregnancy, and parenthood in the modern era of cystic fibrosis care. Fertility may be improving in female individuals with cystic fibrosis with the use of CFTR modulator therapies, and there is an associated increase in annual pregnancies. Infertility in male individuals with cystic fibrosis remains approximately 97–98% and is unchanged with CFTR modulators in those already born with cystic fibrosis. As more female individuals with cystic fibrosis experience pregnancy, questions remain about the impact of pregnancy on their health and that of their child. Fortunately, there are multiple routes to becoming a parent; however, more work is needed to understand the impact of pregnancy and parenthood in the context of CF as some previous data suggests potential challenges to the health of parents with cystic fibrosis.SummaryWe encourage cystic fibrosis care teams to have knowledge and resources available to support the reproductive goals of all individuals with cystic fibrosis.
Count regression models analysis of factors affecting antenatal care utilization in Ethiopia: original article
Authors: Woldeyohannes Birhanu , Yohannes Zemene , Likassa Habte T. , Mekebo Gizachew G. , Wake Senahara K. , Sisay Assefa L. , Gondol Ketema B. , Argaw Abebe , Diriba Gezahagn , Irana Tariku 
Published: October 2023

Background:Antenatal care (ANC) reduces maternal and newborn mortalities and makes it easier to find infections early and prevent them from progressing. This study aimed to identify factors affecting ANC utilization in Ethiopia via the count regression model.Methods:The data for the study was drawn from the 2019 Ethiopian Mini Demographic and Health Survey dataset. Count regression models, such as Poisson, Negative Binomial (NB), Zero-Inflated Poisson (ZIP), and Zero-Inflated Negative Binomial (ZINB) models, were used to determine the factors influencing ANC utilization.Results:A total of 3962 women were included in the study. Only about 42% of women used the WHO-recommended number of ANC of a minimum of four visits. The ZIP model was outperforming to fit the data as compared to other count regression models. Rural residence (IRR=0.8832, 95% CI: 0.8264–0.9440), being resident of the Somalia region (IRR=0.4762, 95% CI: 0.3919–0.5785), SNNPR (IRR=0.8716, 95% CI: 0.7913–0.9600), and Gambela Region (IRR=0.7830, 95% CI: 0.7063–0.8680), being Muslim (IRR=0.9384, 95% CI: 0.8876–0.9921) decrease the ANC utilization. Contrarily, Addis Ababa residence (IRR=1.1171, 95% CI: 1.0181–1.2259), primary education (IRR=1.1278, 95% CI: 1.0728–1.1855), secondary and higher education (IRR=1.2357, 95% CI: 1.1550–1.3220), middle wealth index (IRR=1.0855, 95% CI: 1.0095–1.1671) and rich wealth index (IRR=1.0941, 95% CI: 1.0152–1.1790) increase the ANC utilization.Conclusion:The ZIP model best fitted the data compared to others. The study revealed that being poor, rural resident, uneducated, Somalia region resident, SNNPR resident, Gambela region resident, and Muslim were factors associated with lower ANC utilization. Thus, health education is needed to be given for mothers with no education. In addition, building a strong awareness-creation program regarding ANC is required for rural residents so as to improve the level of ANC utilization in Ethiopia.
Rare occurrence of hemoglobin Lepore variant in a Palestinian patient: a case report and brief literature review
Authors: Asees Mohammad Y. , Shrateh Oadi N. , Jobran Afnan W.M. , Assi Ayuob S. 
Published: October 2023

Introduction:
In hemoglobinopathies, a basic lesion alters the rate of globin synthesis or the structure of the globin in healthy hemoglobin (Hb). Genetic instructions are used to synthesize the polypeptide chains that make up globin chains. The kind and extent of the structural aberration of the Hb molecule are closely related to the clinical features. Hematologically, the heterozygous form of the Lepore syndrome has a pattern resembling minor thalassemia, and electrophoretically, it is characterized by aberrant Hb Lepore fractions at a rate of 5–15% and a decreased percentage of HbA and mildly increased HbF. Clinically speaking, Hb Lepore heterozygotes patients are asymptomatic and resemble the clinical picture of patients with mild thalassemia.

Case Presentation:
A 28-year-old female came to our attention for assessment of generalized weakness and fatigue for a 4-month duration. Laboratory evaluation, including complete blood count, showed mild microcytic hypochromic anemia with parameters resembling the thalassemia trait. Iron profile studies were normal. Abdominal ultrasound showed mild splenomegaly. Hb electrophoresis was performed and showed an abnormal high-performance liquid chromatography pattern with an abnormal Hb band, mild elevated HbF, and mild reduction in HbA. The interpretation of the Hb electrophoresis curve suggested heterozygosity for beta chain variant Hb Lepore.

Discussion and Conclusion:
Hb Lepore is one of the structural Hb variants with a characteristic fusion gene between the delta and beta chains. Hematologically, the heterozygous form of the Lepore syndrome has a pattern resembling the thalassemia trait. In Palestine, the prevalence of Hb Lepore, either homozygous or homozygous state, is unknown.
Comparison of abdominal depth with subcutaneous fat thickness in predicting surgical site infection among patients undergoing hepatopancreatobiliary surgery: a prospective observational study
Authors: Dahal Suman , Gyawali Sushil , Neupane Prashansha , Neupane Priyanka , Hamal Aliza , Verma Rupesh , Pachhai Prarthana , Khadka Rabi , Karki Badal , Khatiwada Raj D. , Kansakar Prasan B. S. 
Published: October 2023

Introduction:Surgical site infection (SSI) is a significant cause of postoperative morbidity resulting in an increased hospital stay and cost. Various measures have been used to predict SSI such as subcutaneous fat thickness (SCFT) and abdominal depth (AD) in case of abdominal surgeries. The objective of the study was to compare SCFT with AD to predict SSI in HPB surgeries.Methods:A prospective observational study was conducted from February 2020 to February 2021, which included 76 patients who underwent elective open hepatopancreatobiliary surgeries. SCFT and AD at the level of the umbilicus were measured preoperatively using the computed tomography abdomen. The occurrence of SSI was evaluated in correlation with SCFT and AD. SCFT and AD were compared using the receiver operating characteristic curve for prediction of SSI.Results:Twenty-five (32.3%) patients who underwent elective HPB surgeries developed SSI. 72% of the SSI were superficial. In multivariate analysis, only SCFT was associated with SSI, which was statistically significant. It was compared with AD using the receiver operating characteristic curve where SCFT proved to be better at predicting SSI (AUC=0.884) with cut-off =2.13 cm, sensitivity 84%, and specificity 86%), compared to AD with an AUC of 0.449.Conclusion:SSI is the common cause of increased morbidity following hepato-pancreato-biliary surgeries with risk factors including SCFT and AD. Approximately one-third of patient developed SSI, with most the common being superficial SSI. SCFT at the incision site was associated with an increased rate of SSI and the better predictor for SSI as compared with the AD.
Effects of combined use of intermittent theta burst stimulation and cognitive training on post-stroke cognitive impairment : a single-blind randomized controlled trial
Authors: Zhang Youmei , Chu Minmin , Zheng Yanjun , Zhang Feilan , Yu Hong , Ye Xiancong , Xie Hangkai , Chen Jing , Qian Zhiyong , Zeng Chao , Chen Weihai , Pei Zhongcai , Zhang Yue , Chen Jianer 
Published: October 2023

Abstract

Objective
Post-stroke cognitive impairment (PSCI) substantially affects patients’ quality of life. This study explored the therapeutic efficacy of intermittent theta burst stimulation (iTBS) combined with cognitive training for PSCI.

Design
The experimental group received iTBS and cognitive training, whereas the control group only received cognitive training, both for six weeks. The outcome measures were the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Modified Barthel Index (MBI), Transcranial Doppler Ultrasonography (TCD), and Functional Near-infrared Spectroscopy (fNIRS).

Results
After therapy, between-group comparisons revealed a substantial difference in the LOTCA scores (P = 0.024). Improvements in visuomotor organization and thinking operations were more noticeable in the experimental group than in the other groups (P = 0.017 and P = 0.044, respectively). After treatment, the resistance index of the experimental group differed from that of the control group; channels 29, 37, and 41 were activated(P < 0.05). The active locations were the left dorsolateral prefrontal cortex (DLPFC), prefrontal polar cortex, and left Broca’s region.

Conclusion
iTBS combined with cognitive training had a superior effect on improving cognitive function and everyday activities compared with cognitive training alone, notably in visuomotor organization and thinking operations. iTBS may enhance cognitive performance by improving network connectivity.
Clinician perspectives on postamputation pain assessment and rehabilitation interventions
Authors: Rich Tonya L. , Falbo Kierra J. , Phelan Hannah , Gravely Amy , Krebs Erin E. , Finn Jacob A. , Matsumoto Mary , Muschler Katherine , Olney Christine M. , Kiecker Jessica , Hansen Andrew H. 
Published: October 2023

Objective:
The purpose of this study was to explore self-reported Veterans Affairs (VA) amputation clinician perspectives and clinical practices regarding the measurement and treatment for amputation-related pain.

Study Design:
Cross-sectional survey with 73 VA rehabilitation clinicians within the VA Health Care System.

Results:
The most frequent clinical backgrounds of respondents included physical therapists (36%), prosthetists (32%), and physical medicine and rehabilitation specialist (21%). Forty-one clinicians (56%) reported using pain outcome measures with a preference for average pain intensity numeric rating scale (generic) (97%), average phantom limb pain intensity numeric rating scale (80%), or Patient-Reported Outcomes Measurement Information System pain interference (12%) measures. Clinicians' most frequently recommended interventions were compression garments, desensitization, and physical therapy. Clinicians identified mindset, cognition, and motivation as factors that facilitate a patient's response to treatments. Conversely, clinicians identified poor adherence, lack of belief in interventions, and preference for traditional pain interventions (e.g., medications) as common barriers to improvement. We asked about the frequently used treatment of graded motor imagery. Although graded motor imagery was originally developed with 3 phases (limb laterality, explicit motor imagery, mirror therapy), clinicians reported primarily using explicit motor imagery and mirror therapy.

Results:
Most clinicians who use standardized pain measures prefer intensity ratings. Clinicians select pain interventions based on the patient's presentation. This work contributes to the understanding of factors influencing clinicians' treatment selection for nondrug interventions. Future work that includes qualitative components could further discern implementation barriers to amputation pain rehabilitation interventions for greater consistency in practice.
Predictive model for diagnostic yield of bone marrow examination in patients with HIV infection having fever of unknown origin
Authors: Noiperm Panarat , Saelue Pirun 
Published: October 2023

Objective:
Bone marrow examination is valuable for identifying the cause of fever of unknown origin (FUO) in HIV-infected patients. Based on the outcomes of bone marrow examination of patients with FUO, we aimed to develop a predictive model for identifying the factors that can increase the diagnostic yield of bone marrow examination.

Design:
For this retrospective cohort study, we enrolled HIV-infected patients, aged more than 15 years and diagnosed with FUO, at Songklanakarind Hospital in Southern Thailand, between January 2009 and December 2019.

Methods:
Evaluations were based on bone marrow aspiration, biopsy, and culture; any missing data were imputed with regression imputation.

Results:
Among the final 108 included patients, 44 (40.74%) showed positive bone marrow results. The diagnoses mainly comprised histoplasmosis, penicilliosis, and tuberculosis. Bone marrow examination led to treatment modifications in approximately 33% patients. Platelet count less than 150 000 cells/μl, alkaline phosphatase (ALP) level at least 200 U/l, and no previous antibiotic treatment were significantly associated with higher diagnostic yields. The HIV bone marrow (HIVBM) model, comprising of spleen size, hematocrit (Hct), platelet count before bone marrow examination, ALP level at admission, and previous antibiotic treatment, was generated as a nomogram to predict the diagnostic yield of bone marrow examination in HIV-infected patients with FUO.

Conclusion:
The results of this study indicate that the HIVBM model can be used to predict the diagnostic yield of bone marrow examination, and therefore assist in clinical decision-making regarding bone marrow procedures, to be performed for identifying the origin of fever in HIV-infected patients.
18F-FDG PET/CT Findings in Waldenström Macroglobulinemia With Mesentery Involvement
Authors: Chen Xueqi , Chen Guoqian , Li Qian , Fu Zhanli 
Published: October 2023

Abstract
A 74-year-old man presented to the hospital complaining of weight loss, increasing fatigue, and blurred vision. The abdominal ultrasonography initially revealed a massive lesion in the mesentery, which was later confirmed by a contrast-enhanced CT scan. The 18F-FDG PET/CT scan showed a single, solitary hypermetabolic mass. The patient was finally diagnosed with Waldenström macroglobulinemia with mesentery involvement by the histopathological examination.