bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Socio-educational Interventions on the Quality of Life of People with a Digestive Ostomy
Authors: Duque Paula A. , Valencia Rico Claudia L. , Campiño Valderrama Sandra M. , López González Luz A. 
Published: May 2023

Introduction The creation of digestive stomata is associated with a change in people's lives. Causing a strong impact that influences all dimensions of life. This paper reports on the effects of socio-educational interventions on the quality of life (QOL) of people with a digestive ostomy. Objective To describe the effect of a nursing intervention on the QOL of people with a digestive ostomy. Methods A quasiexperimental study was conducted whose sample consisted of 12 people who were ostomized in a public hospital in Colombia. Participants were selected through convenience sampling and randomly assigned to the intervention group and the control group. For the control group, an educational process was carried out through a theoretical session with virtual mediation (educational video). The QOL was evaluated before and after the interventions through the Montreux questionnaire. Results The average age was 57(+7) years. No statistical differences were found between the groups in the QOL index or for any of the dimensions that make up QOL. Pretest and post-test analysis for each intervention separately showed improvement in two dimensions of QOL for each group; in the intervention group body image dimension ( p  =  .017) and the positive coping dimension ( p  =  .027). In the control group, the physical well-being dimension ( p  =  .037) and social concerns dimension ( p  =  .034). Conclusions The personalized educational intervention or carried out through virtual pedagogical mediation, generated a clinically significant increase in the dimensions of QOL, without statistical differences. The study adds knowledge about the impact that digestive stomata have on the QOL, which is why it is necessary to establish specialized interdisciplinary teams to care for the person's new condition at home during the following months.
Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial
Authors: Mankikian Julie , Caille Agnès , Reynaud-Gaubert Martine , Agier Marie-Sara , Bermudez Julien , Bonniaud Philippe , Borie Raphael , Brillet Pierre-Yves , Cadranel Jacques , Court-Fortune Isabelle , Crestani Bruno , Debray Marie-Pierre , Gomez Emmanuel , Gondouin Anne , Hirschi-Santelmo Sandrine , Israel-Biet Dominique , Jouneau Stéphane , Juvin Karine , Leger Julie , Kerjouan Mallorie , Marquette Charles-Hugo , Naccache Jean-Marc , Nunes Hilario , Plantier Laurent , Prevot Grégoire , Quetant Sébastien , Traclet Julie , Valentin Victor , Uzunhan Yurdagul , Wémeau-Stervinou Lidwine , Bejan-Angoulvant Theodora , Cottin Vincent , Marchand-Adam Sylvain 
Published: May 2023

BackgroundStandard of care for interstitial lung disease (ILD) with a nonspecific interstitial pneumonia (NSIP) pattern proposes mycophenolate mofetil (MMF) as one of the first-step therapies while rituximab is used as rescue therapy.MethodsIn a randomised, double-blind, two-parallel group, placebo-controlled trial (NCT02990286), patients with connective tissue disease-associated ILD or idiopathic interstitial pneumonia (with or without autoimmune features) and a NSIP pattern (defined on NSIP pathological pattern or on integration of clinicobiological data and a NSIP-like high-resolution computed tomography pattern) were randomly assigned in a 1:1 ratio to receive rituximab (1000 mg) or placebo on day 1 and day 15 in addition to MMF (2 g daily) for 6 months. The primary end-point was the change in percent predicted forced vital capacity (FVC) from baseline to 6 months analysed by a linear mixed model for repeated measures analysis. Secondary end-points included progression-free survival (PFS) up to 6 months and safety.FindingsBetween January 2017 and January 2019, 122 randomised patients received at least one dose of rituximab (n=63) or placebo (n=59). The least-squares mean change from baseline to 6 months in FVC (% predicted) was +1.60 (se1.13) in the rituximab+MMF group and −2.01 (se1.17) in the placebo+MMF group (between-group difference 3.60, 95% CI 0.41–6.80; p=0.0273). PFS was better in the rituximab+MMF group (crude hazard ratio 0.47, 95% CI 0.23–0.96; p=0.03). Serious adverse events occurred in 26 (41%) patients of the rituximab+MMF group and in 23 (39%) of the placebo+MMF group. Nine infections were reported in the rituximab+MMF group (five bacterial infections, three viral infections, one other) and four bacterial infections in the placebo+MMF group.InterpretationCombination of rituximab and MMF was superior to MMF alone in patients with ILD and a NSIP pattern. The use of this combination must take into consideration the risk of viral infection.
Drivers determining tuberculosis disease screening yield in four European screening programmes: a comparative analysis
Authors: Zenner Dominik , Brals Daniella , Nederby-Öhd Joanna , Menezes Dee , Aldridge Robert , Anderson Sarah R. , de Vries Gerard , Erkens Connie , Marchese Valentina , Matteelli Alberto , Muzyamba Morris , van Rest Job , Spruijt Ineke , Were John , Migliori Giovanni Battista , Lönnroth Knut , Cobelens Frank , Abubakar Ibrahim 
Published: May 2023

BackgroundThe World Health Organization End TB Strategy emphasises screening for early diagnosis of tuberculosis (TB) in high-risk groups, including migrants. We analysed key drivers of TB yield differences in four large migrant TB screening programmes to inform TB control planning and feasibility of a European approach.MethodsWe pooled individual TB screening episode data from Italy, the Netherlands, Sweden and the UK, and analysed predictors and interactions for TB case yield using multivariable logistic regression models.ResultsBetween 2005 and 2018 in 2 302 260 screening episodes among 2 107 016 migrants to four countries, the programmes identified 1658 TB cases (yield 72.0 (95% CI 68.6–75.6) per 100 000). In logistic regression analysis, we found associations between TB screening yield and age (≥55 years: OR 2.91 (95% CI 2.24–3.78)), being an asylum seeker (OR 3.19 (95% CI 1.03–9.83)) or on a settlement visa (OR 1.78 (95% CI 1.57–2.01)), close TB contact (OR 12.25 (95% CI 11.73–12.79)) and higher TB incidence in the country of origin. We demonstrated interactions between migrant typology and age, as well as country of origin. For asylum seekers, the elevated TB risk remained similar above country of origin incidence thresholds of 100 per 100 000.ConclusionsKey determinants of TB yield included close contact, increasing age, incidence in country of origin and specific migrant groups, including asylum seekers and refugees. For most migrants such as UK students and workers, TB yield significantly increased with levels of incidence in the country of origin. The high, country of origin-independent TB risk in asylum seekers above a 100 per 100 000 threshold could reflect higher transmission and re-activation risk of migration routes, with implications for selecting populations for TB screening.
Serial lung ultrasound in monitoring viral pneumonia: the lesson learned from COVID-19
Authors: Clofent David , Culebras Mario , Felipe-Montiel Almudena , Arjona-Peris Marta , Granados Galo , Sáez María , Pilia Florencia , Ferreiro Antía , Álvarez Antonio , Loor Karina , Bosch-Nicolau Pau , Polverino Eva 
Published: May 2023

BackgroundLung ultrasound (LUS) has proven to be useful in the evaluation of lung involvement in COVID-19. However, its effectiveness for predicting the risk of severe disease is still up for debate. The aim of the study was to establish the prognostic accuracy of serial LUS examinations in the prediction of clinical deterioration in hospitalised patients with COVID-19.MethodsProspective single-centre cohort study of patients hospitalised for COVID-19. The study protocol consisted of a LUS examination within 24 h from admission and a follow-up examination on day 3 of hospitalisation. Lung involvement was evaluated by a 14-area LUS score. The primary end-point was the ability of LUS to predict clinical deterioration defined as need for intensive respiratory support with high-flow oxygen or invasive mechanical ventilation.Results200 patients were included and 35 (17.5%) of them reached the primary end-point and were transferred to the intensive care unit (ICU). The LUS score at admission had been significantly higher in the ICU group than in the non-ICU group (22 (interquartile range (IQR) 20–26)versus12 (IQR 8–15)). A LUS score at admission ≥17 was shown to be the best cut-off point to discriminate patients at risk of deterioration (area under the curve (AUC) 0.95). The absence of progression in LUS score on day 3 significantly increased the prediction accuracy by ruling out deterioration with a negative predictive value of 99.29%.ConclusionSerial LUS is a reliable tool in predicting the risk of respiratory deterioration in patients hospitalised due to COVID-19 pneumonia. LUS could be further implemented in the future for risk stratification of viral pneumonia.
Asthma innovations from the first International Collaborative Asthma Network forum
Authors: Gaston Benjamin , Gardner Donna D. , Mahan Kenzie , Akuthota Praveen , Mendonca Eneida A. , Durrington Hannah , Marozkina Nadzeya , Martinez-Nunez Rocio T. , Newcomb Dawn , Ainsworth Benjamin , Owora Arthur H. , Chung Kian Fan , Walker Samantha , Fowler Stephen J. , Siddiqui Salman , Winders Tonya , Zein Joe , Jarjour Nizar , Huang Yvonne J. , Cahill Katherine N. , Djukanovic Ratko 
Published: May 2023

BackgroundMany patients have uncontrolled asthma despite available treatments. Most of the new asthma therapies have focused on type 2 (T2) inflammation, leaving an unmet need for innovative research into mechanisms of asthma beyond T2 and immunity. An international group of investigators developed the International Collaborative Asthma Network (ICAN) with the goal of sharing innovative research on disease mechanisms, developing new technologies and therapies, organising pilot studies and engaging early-stage career investigators from across the world. This report describes the purpose, development and outcomes of the first ICAN forum.MethodsAbstracts were solicited from interdisciplinary early-stage career investigators with innovative ideas beyond T2 inflammation for asthma and were selected for presentation at the forum. Breakout sessions were conducted to discuss innovation, collaboration and research translation.ResultsThe abstracts were categorised into: 1) general omics and big data analysis; 2) lung–brain axis and airway neurology; 3) sex differences; 4) paediatric asthma; 5) new therapeutic targets inspired by airway epithelial biology; 6) new therapeutics targeting airway and circulating immune mediators; and 7) lung anatomy, physiology and imaging. Discussions revealed that research groups are looking for opportunities to further their findings using larger scale collaboration and the ability to translate theirin vitrofindings into clinical treatment.ConclusionsThrough ICAN, teams that included interdisciplinary early-stage career investigators discussed innovation, collaboration and translation in asthma and severe asthma research. With a combination of fresh ideas and energetic, collaborative, global participation, ICAN has laid a firm foundation and model for future collaborative global asthma research.
Response to endobronchial valve treatment: it's all about the target lobe
Authors: Hartman Jorine E. , Roodenburg Sharyn A. , van Dijk Marlies , Koster T. David , Klooster Karin , Slebos Dirk-Jan 
Published: May 2023

BackgroundBronchoscopic lung volume reduction using endobronchial valves (EBV) has been shown to be beneficial for severe emphysema patients. The most important predictor of treatment response is absence of collateral ventilation between the treatment target and ipsilateral lobe. However, there are still a substantial number of nonresponders and it would be useful to improve the pre-treatment identification of responders. Presumably, predictors of response will be multifactorial, and therefore our aim was to explore whether we can identify response groups using a cluster analysis.MethodsAt baseline and 1 year follow-up, pulmonary function, exercise capacity and quality of life were measured. A quantitative chest computed tomography scan analysis was performed at baseline and 2–6 months follow-up. The cluster analysis was performed using a hierarchical agglomerative method.ResultsIn total, 428 patients (69% female, mean±sdage 61±8 years, forced expiratory volume in 1 s 27±8% predicted, residual volume 254±50% pred) were included in our analysis. Three clusters were generated: one nonresponder cluster and two responder clusters. Despite solid technical procedures, the nonresponder cluster had significantly less clinical response after treatment compared to the other clusters. The nonresponder cluster was characterised by significantly less emphysematous destruction, less air trapping and a higher perfusion of the target lobe, and a more homogeneous distribution of emphysema and perfusion between the target and ipsilateral lobe.ConclusionsWe found that target lobe characteristics are the discriminators between responders and nonresponders, which underlines the importance of visual and quantitative assessment of the potential treatment target lobe when selecting patients for EBV treatment.
Factor H preserves alternative complement function during ARDS, linked to improved survival
Authors: Bain William , Tabary Mohammadreza , Moore Sara R. , An Xiaojing , Kitsios Georgios D. , McVerry Bryan J. , Ray Prabir , Ray Anuradha , Mallampalli Rama K. , Ferreira Viviana P. , Lee Janet S. , Nouraie S. Mehdi 
Published: May 2023

BackgroundEffective regulation of complement activation may be crucial to preserving complement function during acute respiratory distress syndrome (ARDS). Factor H is the primary negative regulator of the alternative pathway of complement. We hypothesised that preserved factor H levels are associated with decreased complement activation and reduced mortality during ARDS.MethodsTotal alternative pathway function was measured by serum haemolytic assay (AH50) using available samples from the ARDSnet Lisofylline and Respiratory Management of Acute Lung Injury (LARMA) trial (n=218). Factor B and factor H levels were quantified using ELISA using samples from the ARDSnet LARMA and Statins for Acutely Injured Lungs from Sepsis (SAILS) (n=224) trials. Meta-analyses included previously quantified AH50, factor B and factor H values from an observational registry (Acute Lung Injury Registry and Biospecimen Repository (ALIR)). Complement C3, and complement activation products C3a and Ba plasma levels were measured in SAILS.ResultsAH50 greater than the median was associated with reduced mortality in meta-analysis of LARMA and ALIR (hazard ratio (HR) 0.66, 95% CI 0.45–0.96). In contrast, patients in the lowest AH50 quartile demonstrated relative deficiency of both factor B and factor H. Relative deficiency of factor B (HR 1.99, 95% CI 1.44–2.75) or factor H (HR 1.52, 95% CI 1.09–2.11) was associated with increased mortality in meta-analysis of LARMA, SAILS and ALIR. Relative factor H deficiency was associated with increased factor consumption, as evidenced by lower factor B and C3 levels and Ba:B and C3a:C3 ratios. Higher factor H levels associated with lower inflammatory markers.ConclusionsRelative factor H deficiency, higher Ba:B and C3a:C3 ratios and lower factor B and C3 levels suggest a subset of ARDS with complement factor exhaustion, impaired alternative pathway function, and increased mortality, that may be amenable to therapeutic targeting.
Diagnosis and treatment of primary urethral melanoma with regional lymphatic metastasis in an elderly woman: a case report and review of available therapies
Authors: Alvarez Restrepo Juan Camilo , Alvarez Restrepo Juan Felipe , Maya Giraldo Daniel S , Santafé Galvis Jhonatan S , Riveros Carlos Andres , Puentes Bernal Andres Felipe , Manrique Otto 
Published: May 2023

Abstract
Background
Mucosal melanomas account for 17% of melanomas, and less than 1% affect the urogenital tract. Primary urethral melanoma is extremely rare; less than 200 cases have been reported so far since it was first described. The clinical presentation is usually delayed, and the prognosis is generally poor.
Case presentation.
An 86-year-old female was referred to urology due to the presence of a three-month-old violaceous mass in the urethral meatus protruding through the vagina. On physical examination, a pedunculated, hyperpigmented, friable, and tender lesion was seen in the urethral meatus bulging between the labia minora. After initial diagnostic studies, the patient was taken to surgical resection of the lesion. The pathology report identified the lesion as a malignant melanoma of the urethra, and staging studies revealed regional lymph node metastases. After discussing the treatment options with the patient, palliative therapy with nivolumab was started. In follow-up at 26 months, the patient had evidence of extensive lymph node involvement, but a conserved performance status and no visceral metastases.

Conclusion
Primary melanoma of the female urethra is an uncommon disease with a poor prognosis. Despite the deficiency in literature regarding its management, it is important to consider patient expectations and preferences when treating this rare disease.
Combined central retinal vein occlusion and cilioretinal artery occlusion as the initial presentation of frosted branch angiitis: a case report and literature review
Authors: Albahlal Abdullah , Khayyat Waleed , Alsulaiman Sulaiman M. 
Published: May 2023

Abstract
Purpose
To report a case of combined central retinal vein occlusion (CRVO) with cilioretinal artery occlusion (CLRAO) that heralded the development of frosted branch angiitis (FBA).

Case report
A 25-year-old healthy male presented with sudden painless visual loss in his left eye with a visual acuity (VA) of 20/300. Fundus exam and fluorescein angiography showed signs of combined CRVO and CLRAO. Without treatment, his vision gradually improved until it reached 20/30 within four months. Five months after initial presentation, he returned with severe visual loss (20/400) in the same eye and a clinical picture of severe occlusive periphlebitis resembling a frosted branch angiitis pattern associated with severe macular edema. This was promptly and successfully treated with systemic steroids and immunosuppressive medications.

Conclusion
CRVO in young population can have an unusual course and one should carefully rule out underlying uveitic etiologies in each visit. Clinical suspicion and close follow‑up are required for early detection and timely management of FBA.
Balancing selection on the complement system of a wild rodent
Authors: Nandakumar Mridula , Lundberg Max , Carlsson Fredric , Råberg Lars 
Published: May 2023

Abstract
Background
Selection pressure exerted by pathogens can influence patterns of genetic diversity in the host. In the immune system especially, numerous genes encode proteins involved in antagonistic interactions with pathogens, paving the way for coevolution that results in increased genetic diversity as a consequence of balancing selection. The complement system is a key component of innate immunity. Many complement proteins interact directly with pathogens, either by recognising pathogen molecules for complement activation, or by serving as targets of pathogen immune evasion mechanisms. Complement genes can therefore be expected to be important targets of pathogen-mediated balancing selection, but analyses of such selection on this part of the immune system have been limited.

Results
Using a population sample of whole-genome resequencing data from wild bank voles (n = 31), we estimated the extent of genetic diversity and tested for signatures of balancing selection in multiple complement genes (n = 44). Complement genes showed higher values of standardised β (a statistic expected to be high under balancing selection) than the genome-wide average of protein coding genes. One complement gene, FCNA, a pattern recognition molecule that interacts directly with pathogens, was found to have a signature of balancing selection, as indicated by the Hudson-Kreitman-Aguadé test (HKA) test. Scans for localised signatures of balancing selection in this gene indicated that the target of balancing selection was found in exonic regions involved in ligand binding.

Conclusion
The present study adds to the growing evidence that balancing selection may be an important evolutionary force on components of the innate immune system. The identified target in the complement system typifies the expectation that balancing selection acts on genes encoding proteins involved in direct interactions with pathogens.
ETGPDA: identification of piRNA-disease associations based on embedding transformation graph convolutional network
Authors: Meng Xianghan , Shang Junliang , Ge Daohui , Yang Yi , Zhang Tongdui , Liu Jin-Xing 
Published: May 2023

Abstract
Background
Piwi-interacting RNAs (piRNAs) have been proven to be closely associated with human diseases. The identification of the potential associations between piRNA and disease is of great significance for complex diseases. Traditional “wet experiment” is time-consuming and high-priced, predicting the piRNA-disease associations by computational methods is of great significance.

Methods
In this paper, a method based on the embedding transformation graph convolution network is proposed to predict the piRNA-disease associations, named ETGPDA. Specifically, a heterogeneous network is constructed based on the similarity information of piRNA and disease, as well as the known piRNA-disease associations, which is applied to extract low-dimensional embeddings of piRNA and disease based on graph convolutional network with an attention mechanism. Furthermore, the embedding transformation module is developed for the problem of embedding space inconsistency, which is lightweighter, stronger learning ability and higher accuracy. Finally, the piRNA-disease association score is calculated by the similarity of the piRNA and disease embedding.

Results
Evaluated by fivefold cross-validation, the AUC of ETGPDA achieves 0.9603, which is better than the other five selected computational models. The case studies based on Head and neck squamous cell carcinoma and Alzheimer’s disease further prove the superior performance of ETGPDA.

Conclusions
Hence, the ETGPDA is an effective method for predicting the hidden piRNA-disease associations.