bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fibromyalgia and mental health in rheumatoid arthritis: a cross-sectional prevalence study from the COVID-19 pandemic
Authors: Upadhyaya Sundeep Kumar , Malgutte Deepak Ramchandra , Handa Rohini , Gupta Sirinder , Kumar Anil , Budumuru Srujana 
Published: June 2023

ObjectivesThis study evaluated the prevalence of fibromyalgia (FM), anxiety and depression in patients with rheumatoid arthritis (RA) and their effects on the clinical parameters of RA during the COVID-19 pandemic.DesignCross-sectional, outpatient clinic, observational, non-interventional.SettingSingle-centre, tertiary care, multispecialty, service and research hospital, north-central India.ParticipantsAdult patients with RA, controls.ResultsThis cross-sectional study included 200 patients with RA diagnosed with the American College of Rheumatology/European League Against Rheumatism 2010 (ACR) criteria and 200 controls. FM was diagnosed using the revised 2016 ACR FM Criteria. Disease activity, quality of life and functional disability in patients with RA were assessed using multiple Disease Activity Scores. The presence of depression and anxiety was determined using the Hospital Anxiety and Depression Scale. FM was present in 31% of patients with RA compared with 4% of controls in our study. Patients with RA with FM were older, predominantly females with longer disease duration, and more likely to be on steroids. Patients with RA with FM had a higher disease activity, and none of our RA with FM patients were in remission. The multivariable analysis found FM to be an independent predictor of the Simplified Disease Activity Index for RA. Patients with RA with FM had worse functional ability and poorer quality of life. The prevalence of anxiety and depression was 12.5% and 30%, significantly higher in RA with FM patients.ConclusionDuring the COVID-19 pandemic, around one-third of our study patients had FM and depression, significantly higher than pre-COVID-19 times. Thus, mental health assessment should be incorporated into the routine management of patients with RA.
Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys
Authors: Elnakib Shatha , Paina Ligia , Attal Bothaina , Akter Rumana , Khoury Ghada , Karim Loqman , Barkat Hemeda Houssein , Tamang Anand , Yenokyan Gayane , Metzler Janna , Robinson Courtland 
Published: June 2023

ObjectiveTo examine incidence of child marriage among displaced and host populations in humanitarian settings.DesignCross-sectional surveys.SettingData were collected in Djibouti, Yemen, Lebanon and Iraq in the Middle East and in Bangladesh and Nepal in South Asia.ParticipantsAdolescent girls aged 10–19 in the six settings and age cohort comparators.Outcome measuresCumulative incidence of marriage by age 18.ResultsIn Bangladesh and Iraq, the hazard of child marriage did not differ between internally displaced populations (IDPs) and hosts (p value=0.25 and 0.081, respectively). In Yemen, IDPs had a higher hazard of child marriage compared with hosts (p value<0.001). In Djibouti, refugees had a lower hazard of child marriage compared with hosts (p value<0.001). In pooled data, the average hazard of child marriage was significantly higher among displaced compared with host populations (adjusted HR (aHR) 1.3; 95% CI 1.04 to 1.61).In age cohort comparisons, there was no significant difference between child marriage hazard across age cohorts in Bangladesh (p value=0.446), while in Lebanon and Nepal, younger cohorts were less likely to transition to child marriage compared with older comparators (p value<0.001). Only in Yemen were younger cohorts more likely to transition to child marriage, indicating an increase in child marriage rates after conflict (p value=0.034). Pooled data showed a downward trend, where younger age cohorts had, on average, a lower hazard of child marriage compared with older cohorts (aHR 0.36; 95% CI 0.29 to 0.4).ConclusionsWe did not find conclusive evidence that humanitarian crises are associated with universal increases in child marriage rates. Our findings indicate that decision-making about investments in child marriage prevention and response must be attuned to the local context and grounded in data on past and current trends in child marriage among communities impacted by crisis.
Change in cardiorespiratory parameters following surgical correction of pectus excavatum: protocol for the historical-prospective HeartSoar cohort
Authors: Suehs Carey Meredith , Molinari Nicolas , Bourdin A , Solovei Laurence 
Published: June 2023

IntroductionHow cardiorespiratory function changes following the surgical correction of pectus excavatum (PE) often gives mixed results, with meta-analyses demonstrating no benefit in terms of pulmonary function but improvement in cardiac function. Functional responses may depend on type of surgery, follow-up time and/or the patient’s presurgical functional status, and debate persists on the purely aesthetic nature of such surgery. The aim of this protocol is to analyse data describing lung function and incremental exercise testing before vs after the surgical correction of PE.Methods and analysisA historical-prospective before–after surgical correction of PE cohort will be constituted. Historical inclusions are recruited during follow-up visits at approximately 12, 24, 36 or 48 months following a prior surgery (with presurgical data mined from patient records). Prospective inclusions are recruited during presurgical work-ups and followed for 1 year following surgery. The data collected include spirometry, incremental exercise testing, body mass index, body composition, questionnaires targeting general health status, self-esteem and body image. Any complications due to surgery are also described.The primary outcome is oxygen pulse during incremental exercise testing, and 44 data points are required to demonstrate a moderate postsurgical change (ie, a Cohen’s effect of d=0.5). Wilcoxon signed-rank tests or t-tests for paired data will be used for before–after comparisons (with false discovery rate corrections for secondary analyses).Ethics and disseminationThis study will be conducted according to the principles of the Declaration of Helsinki (as revised in 2013) and was approved by a randomly assigned, independent, ethics committee (Comité de Protection des Personnes Sud-Méditerranée II, reference number: 218 B21) as per French law on 6 July 2018. Informed, written consent for study participation is required of all study candidates prior to enrolment. Results will be published in an international peer-reviewed journal.Trial registration numberNCT03770390; Clinicaltrials.gov.
Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study
Authors: Mekinian Arsène , Biard Lucie , Lorenzo Dagna , Novikov Pavel I , Salvarani Carlo , Espitia Olivier , Sciascia Savino , Michaud Martin , Lambert Marc , Hernández-Rodríguez José , Schleinitz Nicolas , Awisat Abid , Puechal Xavier , Aouba Achille , Munoz Pons Helene , Smitienko Ilya , Gaultier Jean Baptiste , Edwige Le Mouel , Benhamou Ygal , Perlat Antoinette , Jego Patrick , Goulenok Tiphaine , Sacre Karim , Lioger Bertrand , Hassold Nolan , Broner Jonathan , Dufrost Virginie , Sené Thomas , Seguier Julie , Maurier Francois , Berthier Sabine , Belot Alexandre , Frikha Faten , Denis Guillaume , Audemard-Verger Alexandra , Koné-Paut Isabelle , Humbert Sebastien , Woaye-Hune Pascal , Tomelleri Alessandro , Baldissera Elena Marina , Kuwana Masataka , Lo Gullo Alberto , Mukuchyan Vahan , Dellal Azeddine , Gaches Francis , Zeminsky Pierre , Galli Elena , Alvarado Moya , Boiardi Luigi , Muratore Francesco , Vautier Mathieu , Campochiaro Corrado , Moiseev Sergey , Vieira Matheus , Cacoub Patrice , Fain Olivier , Saadoun David 
Published: June 2023

ObjectivesIn this large multicentre study, we compared the effectiveness and safety of tocilizumab intravenous versus subcutaneous (SC) in 109 Takayasu arteritis (TAK) patients.MethodsWe conducted a retrospective multicentre study in referral centres from France, Italy, Spain, Armenia, Israel, Japan, Tunisia and Russia regarding biological-targeted therapies in TAK, since January 2017 to September 2019.ResultsA total of 109 TAK patients received at least 3 months tocilizumab therapy and were included in this study. Among them, 91 and 18 patients received intravenous and SC tocilizumab, respectively. A complete response (NIH <2 with less than 7.5 mg/day of prednisone) at 6 months was evidenced in 69% of TAK patients, of whom 57 (70%) and 11 (69%) patients were on intravenous and SC tocilizumab, respectively (p=0.95). The factors associated with complete response to tocilizumab at 6 months in multivariate analysis, only age <30 years (OR 2.85, 95% CI 1.14 to 7.12; p=0.027) and time between TAK diagnosis and tocilizumab initiation (OR 1.18, 95% CI 1.02 to 1.36; p=0.034). During the median follow-up of 30.1 months (0.4; 105.8) and 10.8 (0.1; 46.4) (p<0.0001) in patients who received tocilizumab in intravenous and SC forms, respectively, the risk of relapse was significantly higher in TAK patients on SC tocilizumab (HR=2.55, 95% CI 1.08 to 6.02; p=0.033). The overall cumulative incidence of relapse at 12 months in TAK patients was at 13.7% (95% CI 7.6% to 21.5%), with 10.3% (95% CI 4.8% to 18.4%) for those on intravenous tocilizumab vs 30.9% (95% CI 10.5% to 54.2%) for patients receiving SC tocilizumab. Adverse events occurred in 14 (15%) patients on intravenous route and in 2 (11%) on SC tocilizumab.ConclusionIn this study, we confirm that tocilizumab is effective in TAK, with complete remission being achieving by 70% of disease-modifying antirheumatic drugs-refractory TAK patients at 6 months.
Mechanical model for the FCC-ee interaction region
Authors: Boscolo Manuela , Palla Fabrizio , Bosi Filippo , Fransesini Francesco , Lauciani Stefano 
Published: June 2023

AbstractThe Future Circular Collider FCC-ee aims at unprecedented luminosities to be obtained with the crab-waist collision scheme. In this paper we describe the mechanical model of the interaction region layout including its assembly procedure. After a discussion on the requirements and constraints, we present the engineered design of the vacuum chamber with the cooling system, the bellows, the vertex and outer tracker detectors and their integration in a carbon-fibre lightweight support structure that will support also the luminosity calorimeter.
Gum and Resin Production and Marketing: Implications for Pastoral Livelihood in Adadle District, Somali Region, Ethiopia
Authors: Yussuf Bishar Ahmed , Lelamo Latamo Lameso , Abdi Mahamud Mahamed 
Published: June 2023

Both locally and nationally, Ethiopia’s gum resin sector has a substantial economic impact. Even though collecting and selling gum and resin is one of the main livelihood activities in Ethiopia’s remote pastoral areas, there are few case studies that adequately reflect national realities. Therefore, the goal of this study is to pinpoint and evaluate gum and resin production and sale, as well as any implications for pastoral livelihood, in the Adadle district of the Somali Region. Both purposive and random sampling techniques were employed. The primary data gathering technique used were household surveys, key informant interviews, focus groups, market surveys, direct observation, and surveys of community-based organizations. Multiple response tests, one-way ANOVA, and descriptive statistics were used in SPSS Version 26 to statistically analyze the collected data. The study discovered many Acacia, Boswellia, and Commiphora tree species that are employed in the production of gum and resin. It was also found that natural oozing and artificial tapping were the methods used for collecting and harvesting gum and resin. The average amount of gum and resin/frankincense harvested annually by each family was 219.82 kg and 58.27 kg, respectively, with gum harvesting being substantially higher (

p

0.05

) than resin harvesting. The recurrent drought, season, and awareness level of harvesters on taping were the factors affecting the quantity and quality of production. The average annual household income from gum and resin/frankincense was 18,684 Ethiopian Birr and 43,704 Ethiopian Birr, respectively. The mean annual income from resin was substantially larger (

p

0.05

) than that of gum. The gum and resin market chain in the area comprises eight actors with five market channels. The research also demonstrates that the income made by selling gum and resin was used to pay for basic necessities for the family, save money for health care and medications, and pay for social concerns and educational expenses. Recurrent drought, lack of market access and market expertise, lack of institutional cooperatives, and lack of infrastructure and facilities were all determined to be obstacles to the production and sale of gum and resin. Generally, resources should be conserved and interventions should be done to ensure the sustainability of the resource base and improve production potential. Proper tapping techniques should be introduced to enhance production potential, and access to market information should be ensured to maximize primary producers’ income share insured for maximizing the income share of primary producers.
Abstract 113: Protection Of Cardiomyocytes Against Hypoxia/reoxygenation Injury: Interaction Of Poloxamer 188 And Endothelial Cells
Authors: Li Zhu , Barajas Matthew B , Oyama Takuro , Walter Miriam J , Riess Matthias L 
Published: June 2023

Administration of Poloxamer (P) 188, a copolymer-based cell membrane stabilizer, significantly improves myocardial ischemia/reperfusion (IR) injury through its ability to protect cell membranes. Cell-to-cell interactions between endothelial cells (ECs) and cardiomyocytes (CMs) further protect CM from IR injury. Thus, we established a co-culture model of ECs and CMs and could previously demonstrate that the mere presence of ECs potentiates cardioprotection as evidenced by dose-dependent attenuation of LDH release from CMs caused by hypoxia/reoxygenation (HR). Here, we sought to determine if P188 can further potentiate the attenuation of LDH release in the presence of different ECs densities.
Mouse CMs cultured in wells underwent 24 h hypoxia followed by 2 h reoxygenation. Mouse coronary artery ECs were plated in well-inserts at densities of 25,000, 50,000, or 100,000 per well which were placed into the CM wells. P188 at 0, 30, 100, 300, or 1,000 μM was administered upon reoxygenation. Statistics: ANOVA and SNK, alpha 0.05.
ECs did not have a protective effect by themselves when a low number of ECs (25,000 per well) were present, but P188 could reduce LDH release in CMs after HR injury in a dose-dependent manner (lower panel). When a high number of ECs (100,000 per well) were co-cultured with CMs, ECs themselves exerted a protective effect while P188 did not further decrease LDH release significantly (upper panel). An intermediate number of ECs (50,000 per well) did not produce significant results in either direction (center panel). Our data suggests that the EC-mediated protection of CMs depends on EC density; furthermore, while at low density the role of ECs was limited and allowed P188 to promote additional protection against HR injury, at high density ECs appeared to saturate cardioprotection and blunt additional P188’s CM protection.
These findings suggest an important, yet not additive interaction between the protection conferred by ECs and that by P188.
Abstract 12155: Trends in Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic and Nonischemic Cardiomyopathy: A National Inpatient Sample Trend in the Years 2016-2019
Authors: Ferraro Bruce , Thwe Ei Ei , Shah Kashyap , Modi Vivek , Stevens Steven , Shirani Jamshid 
Published: June 2023

Introduction:
Catheter ablation of ventricular tachycardia (CAVT) has emerged as a viable option in structural heart disease. Recent studies report differences in outcomes of CATV in ischemic (ICM) and non-ischemic (NICM) cardiomyopathy. We aimed to examine temporal trends and in-hospital outcomes of CATV in ICM and NICM.

Methods:
National Inpatient Sample 2016-2019 was queried using ICD-10 codes to identify adults with ICM or NICM who underwent CAVT. Temporal trends were assessed using logistic regression.

Results:
193895 CAVT were performed between 2016 and 2019. CAVT increased in numbers for both ICM [16415 in 2016 to 23030 in 2019 (P<0.001)] and NICM [22915 in 2016 to 31355 in 2019 (P<0.001)] during this period. Overall, rate of most common in-hospital complications increased during study period (7.4% in 2016 to 9.2% in 2019, p<0.0001) particularly of cardiogenic shock (3% in 2016 to 4.2% in 2019, p<0.001) and pericardial effusion (2.9% in 2016 and 3.7% in 2019, p<0.001). In concordance with higher rates of complications over time, there was also an increase in the rate of comorbid conditions as indicated by the Charlson’s Comorbidity Index Score >3 (35% in 2016 and 40% in 2019, p<.0001). Differences existed in the rate of most common in-hospital complications between ICM and NICM patients including cardiogenic shock (5%-vs-2.6%), pericarditis (1.3%-vs-2.1%), pericardial effusion 2.6%-vs-3.7%), and cardiac tamponade 1%-vs-1.5%) [all p<0.001). In-patient mortality and length of stay were higher in those with ICM (1.6%-vs-0.8%; and 6.3-vs-4.9 days; both p<0.001).

Conclusions:
The number of VT ablations for structural heart disease has increased in recent years. These promising procedures are performed with reasonable complication rates in progressively more complex settings. Differences exist in rates of complications between patients with ICM and NICM including in-hospital mortality.
Abstract 12887: Lightning Strikes Twice - A Case of Light Chain and Attr Amyloidosis
Authors: Prathivadhi-Bhayankaram Sruti , Mansour Shareef 
Published: June 2023

The most common subsets of amyloidosis that affect the heart include light chain (AL) and transthyretin (ATTR). While both types cause diffuse amyloid fibril deposition within the interstitial space of the myocardium, they arise from two different precursors. AL amyloidosis results from misfolded monoclonal light chains, whereas ATTR amyloidosis results from misfolded transthyretin monomers. This distinction is essential as it suggests that a diagnosis of one disease does not exclude the existence of the other. We present a unique case of a patient with evidence of both systemic ATTR and AL amyloidosis occurring concurrently.
An 80-year-old male with a past medical history of severe mitral regurgitation S/p mechanical mitral valve replacement, rotator cuff tear, bilateral carpal tunnel syndrome, and multiple hospitalizations for decompensated systolic heart failure was referred to cardiomyopathy clinic. He presented with class III New York Heart Association (NYHA) symptoms, including significant limitations in activity due to dyspnea. An echocardiogram demonstrated severe left ventricular hypertrophy with a low global longitudinal strain, an apical sparing pattern suspicious of amyloidosis. Monoclonal gammopathy workup showed an elevated lambda free light chain. Subsequent bone marrow biopsy demonstrated plasma cell dyscrasia and amyloid deposition in hypocellular bone marrow. Mass spectrometry showed both lambda light chain and transthyretin amyloid protein. He had elevated cardiac biomarkers, speaking for advanced cardiac involvement, together with nephrotic range proteinuria. He was started on chemotherapy/immunotherapy, with daratumumab, bortezomib and dexamethasone. He was in end stage heart failure requiring inotropic support. Few weeks after chemotherapy, he transitioned toward hospice care.
In conclusion, we present a rare case of ATTR and AL amyloidosis coinciding simultaneously that demonstrates the importance of having high index of suspicion for this disease, a stepwise and thorough diagnostic approach highlighting the importance of mass spectroscopy after amyloid protein detection.
Abstract 14503: Cardiac Arrest Secondary to Inferior ST-Segment Elevation Myocardial Infarction in Patient With Paroxysmal Nocturnal Hemoglobinuria and COVID 19 Infection
Authors: Mohamed Mohamed Salah , Salama Amr , Hashem Anas , Hussein Ahmed , Balmer-Swain Mallory 
Published: June 2023

Background:
Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) have attacks of complement-mediated hemolysis that can be spontaneous or secondary to precipitating factors such as infections. During these episodes, these patients have an increased risk of thrombosis, typically venous and rarely arterial. We present a rare case of cardiac arrest due to ventricular fibrillation (VF) and inferior STEMI in a patient with PNH and a recent COVID infection.

Case: 63 years old male patient with a medical history of PNH presented with typical chest pain, fever, cough, jaundice, and dark-colored urine. On examination, he was hemodynamically stable with jaundiced eyes. A few minutes later, he had cardiac arrest due to VF. He achieved return of spontaneous circulation (ROSC) after two defibrillation shocks. EKG showed inferior STEMI. Labs showed hemoglobin of 6.4 g/dl, elevated cardiac markers, serum LDH, and indirect bilirubin. Serum haptoglobin was < 1 mg/dl. His COVID 19 PCR test was positive.
Decision making: He received 2 units of packed RBCs and underwent a coronary angiogram (CA) which revealed total proximal occlusion of the right coronary artery (Figure A). He underwent successful PCI by two drug-eluting stents (figure B). His peripheral blood immunophenotyping and flow cytometry was positive for loss of glycosylphosphatidylinositol-linked antigens and decreased expression of CD 59/14/24. He was started on Ravulizumab, a humanized monoclonal antibody complement five inhibitor.

Conclusion:
PNH and COVID increase the risk of thrombosis. Thrombosis mechanism in PNH includes platelets and coagulation system activation via complement cascade and impairment of the fibrinolytic system. COVID infection increases the risk of thrombosis by endothelial cell dysfunction and release of cytokines. Due to the patient’s acute presentation, he needed to undergo immediate CA and lifesaving PCI regardless of his hematological disorder or active COVID-19 infection.