bluuebunny/crossref_metadata_2025_split huggingface dataset:
OA03 Are there any differences in the outcomes of treatment of a 12-month course of rituximab BCD020 biosimilar in systemic lupus erythematosus in children with early and late administration of the drug
Authors: Kalashnikova Elvira , Rinat Raupov , Lubimova Natalia , Ekaterina Kuchinskaya , Isupova Eugeniya , Gaidar Ekaterina , Masalova Vera , Snegireva Lyudmila , Kornishina Tatyana , Sorokina Lyuobov , Kaneva Mariya , Kalashnikova Olga , Burtseva Tatiana , Argunova Vera , Sleptsova Polina , Chasnyk Vyacheslav , Kostik Mikhail 
Published: August 2023

Abstract

Background
Juvenile systemic lupus erythematosus (JSLE) is a severe life-threatening disease. The place of rituximab in JSLE management is still undefined. The early biologic intervention might improve disease’s outcomes.

Aim of study
To assess the advantages of early rituximab administration compared with late.

Material and methods
In the retrospective cohort study the information about 36 JSLE patients, whom rituximab biosimilar BCD020 was initiated were included. All patients were divided in two groups: early start of rituximab (less than six months from onset) and late start (more than one year). We compared initial disease characteristics at onset, on the baseline (BL)—start of rituximab and end of the study—(EOS) - 12 months, and treatment characteristics.

Results
The time gap between early and late rituximab administration was 19 months. There were no differences in disease profile at onset, except higher SLEDAI and MAS frequency in early rituximab group. Baseline differences were: lower C3, C4, higher SLEDAI and oral daily corticosteroids dosage. At the end of the study, patient whom rituximab was prescribed early had more impressive changes in SLEDAI, e.g. 100% of patients decreased SLEDAI, compared with 79% in late rituximab group. The detailed information about disease activity and treatment outcomes in both groups are in the table. There were no differences in adverse events between groups, except more impressive signs of corticosteroid toxicity in group of late rituximab administration.

Conclusion
Early administration of rituximab biosimilar made it possible to control the JSLE activity faster and reduce the dose of corticosteroids effectively. There were no differences in adverse events, except signs of corticosteroid toxicity in group of late rituximab initiation.
This work was financially supported by the Ministry of Science and Higher Education of the Russian Federation (Agreement No. 075–15-2022–301).

Ethics
The study was approved by the Ethical Committee of the Saint-Petersburg State Pediatric Medical University (Protocol No1/3 from 11/Jan/2021). There were no violations of patient's rights according to the Declaration of Helsinki.
E13 Cervical spine involvement in juvenile idiopathic arthritis: frequency and associated factors
Authors: Tbini Houssem , Rahmouni Safa , Rekik Sonia , Ben Ammou Ahlem , Zouaoui Khaoula , Boussaid Soumaya , Sahli Hela , Elleuch Mohammed 
Published: August 2023

Abstract

Background
Juvenile idiopathic arthritis (JIA) is a pediatric rheumatism including several subgroups. The cervical spine involvement is poorly studied in JIA compared with adult rheumatism.

Objectives
This study aimed to assess the frequency and associated factors with cervical spine involvement in JIA.

Methods
We conducted a retrospective study including adults with long-standing JIA according to International League of Associations of Rheumatology (ILAR) criteria over a 28-year period (1994 – 2022). We retrieved radiographs of the cervical spine in anteroposterior, lateral, and lateral flexion views in search of an atlantoaxial dislocation (AAD). Demographic, clinical, biological, and radiological data were compared according to the presence or absence of AAD.

Results
A total of 29 Patients were enrolled (12 men and 17 women), the mean age was 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years.
The mean body mass index (BMI) was 21.20 ± 4.88 [14.17–27.55] kg/m2.
Most patients had a polyarticular form (55.2%, n = 16). Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm/h. A biological inflammatory syndrome was present in 19 cases. Rheumatoid factor, ACPA and anti-nuclear antibodies were observed in 12, 7 and 5 cases respectively. At least one extra-articular involvement was noted in 16 cases.
Bone erosions and hip involvement were noted in 18 and 14 cases, respectively.
AAD was noted in 4 patients (13.8%). It was diagnosed on average 4.28 ± 10.07 [0–27] years after disease onset.
AAD was only associated with extra-articular involvement in our study (75% vs 13.6%; P = 0.047).
On the other hand, our study showed that age, gender, age at onset, diagnostic delay, duration of symptoms, BMI, JIA sub form, inflammation markers, rheumatoid factor, ACPA, antinuclear antibodies, bone erosions, and hip involvement were not associated with AAD.

Conclusion
The cervical spine involvement was not negligible in our study and was associated with extra-articular involvement.
This condition is serious and can be life threatening. Therefore, it is important to perform more studies to better evaluate its frequency, clinical presentation, and imaging.
E18 What is the relationship between body mass index and juvenile idiopathic arthritis characteristics?
Authors: Tbini Houssem , Rahmouni Safa , Rekik Sonia , Ben Ammou Ahlem , Zouaoui Khaoula , Boussaid Soumaya , Sahli Hela , Elleuch Mohammed 
Published: August 2023

Abstract

Introduction
Juvenile idiopathic arthritis (JIA) is a group of pediatric chronic inflammatory joint diseases. The various forms of JIA may be associated with delayed growth or local growth disturbances.

Objectives
We conducted this study to evaluate the relationship between the different clinical and biological characteristics of JIA and the anthropometric parameters of patients.

Methods
Retrospective study including adults with long-standing JIA according to International League of Associations of Rheumatology (ILAR) criteria over a period from 1994 to 2022. Clinical and biological parameters were collected. Body mass index (BMI) was interpreted according to World Health Organization cut-offs as follows: underweight &lt;18.5, normal [18.5–24.9], overweight [25–29.9], and obese ≥30 kg/m2.

Results
Seventeen women and 12 men were included. The mean age was 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years.
The polyarticular form was the most frequent (55.2%). Rheumatoid factor, ACPA and antinuclear antibodies were present in 41.4%, 24.1% and 17.2% of cases respectively.
At least one extra-articular manifestation was noted in 16 patients: ophthalmologic (n = 6), skin (n = 4), cardiac (n = 4), pulmonary (n = 3) and renal (n = 2) involvement. Osteoporosis was noted in 7 cases.
Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm. An elevation of inflammation markers was noted in 19 cases. The mean haemoglobin value was 11.31 ± 2.10 [6.5–15] g/dl Anaemia was noted in 20 cases.
The mean body mass index was 21.20 ± 4.88 [14.17–27.55] kg/m2, 36.4% of patients were underweight, 27.2% had a normal BMI, and 36.4 were overweight. No patient was obese. Growth delay was noted in 3 cases.
Our statistical study found a correlation of BMI with ESR (r = 0.998; P &lt; 0.001), rheumatoid factor positivity (r = -1.000; P &lt; 0.001), and osteoporosis (r = 0.803; P = 0.030). No other correlation of BMI with clinical and biological characteristics of the study population was identified.

Conclusion
BMI should be well considered in the JIA evaluation and treatment. BMI correlated with ESR, rheumatoid factor positivity, and osteoporosis in our study.
E47 Low prevalence and mortality associated with COVID-19 in sub-Saharan African Children and adolescents: hypotheses from a literature review
Authors: Kemta Lekpa Fernando , Simeni Njonnou Sylvain Raoul , Enyama Dominique , Noukeu Njinkui Diomede , Ateudjieu Jerome , Tonnang Henri E Z , Namme Luma Henry , Choukem Simeon Pierre 
Published: August 2023

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 continues to spread around the world, particularly in sub-Saharan Africa. However, outside South Africa, as in adults, the pandemic has had very little impact on African children and adolescents, despite very low vaccination coverage. In addition, cases of multisystemic inflammatory syndrome in children were anecdotal in sub-Saharan Africa.

Aims
To identify plausible hypotheses that may explain the low prevalence and mortality of Covid-19 in children in sub-Saharan Africa.

Methods
A narrative review of the literature

Results
We have identified five major hypotheses that may explain the low prevalence and mortality of COVID-19 in children and adolescents in sub-Saharan Africa: 1) the lack of a proper epidemiological study; 2) the youthfulness of the population in sub-Saharan Africa, for a disease that essentially concerns elderly subjects with comorbidities; 3) immunomodulation due to frequent contact with certain infectious agents and/or vaccines, 4) cross-reactive immunity between SARS-CoV-2 and different strains of human coronaviruses of different lineage, and 5) the widespread and off-label use of antimalarials and other drugs such as zinc, vitamin C and other complementary therapies.

Conclusion
All these hypotheses deserve to be confirmed in these populations by specific studies with a rigorous design.

Ethics
None declared.
E50 Central Nervous System manifestation of Systemic Lupus Erythematosus: A case presentation
Authors: Khalif Abdifatah , Wanjohi Meryl , Migowa Angela 
Published: August 2023

Abstract

Background
Systemic Lupus Erythematosus (SLE) is a complex, chronic, multisystem autoimmune disease with clinical manifestations in all organ systems. It is characterized by production of autoantibodies to components of the cell nucleus. Pediatric patients tend to have more severe disease and widespread organ involvement. If untreated, the 5-year mortality rate is almost 95%. Literature on SLE, more so pediatric SLE in Sub-Saharan Africa is scarce.

Aim
To describe the diagnostic journey of a child with CNS lupus in our setting.

Method
Retrospective chart review of a child with CNS Lupus at a tertiary referral teaching hospital in Nairobi, Kenya.

Results
We present a case of a 14-year-old boy who was diagnosed with CNS Lupus. He was known to have a convulsive disorder, with a recent history of mutism and was on Lamictal and rivotril for approximately one year. He presented to our facility in status epilepticus, having complained of a sudden onset of headache prior to the onset of the convulsions. He had had an uneventful birth and developmental history with no family history of chronic ailments. On examination, he was found to have bilateral ptosis with no other neurological deficits and otherwise normal systemic examination. Complete blood count initially showed a slight neutrophilia and thrombocytosis. Kidney function was normal and the CSF workup was negative for infection. Chest X ray showed features of aspiration pneumonia for which he received Augmentin, nebulization with hypertonic saline and chest physiotherapy. EEG showed generalized electrical seizures. CT/MRI brain showed acute infarcts in the superior frontal gyrus, post central gyrus and in the right insular cortex. He was managed in the Intensive Care Unit until cessation of the seizures.
Post extubation, he was noted to have reduced lower limb power and bulbar dysfunction. A rheumatology consult was requested and revealed speech regression, a prior episode of conjunctivitis, a vasculitic palmar rash, palatial petechiae and suspected right knee arthritis. Urinalysis was suggestive of glomerulonephritis. ANA Antibodies were positive (titers of 1:160), positive anti-Ro antibodies. Anti-Ds DNA, P and C ANCA were negative. Renal histopathology was unremarkable. He was pulsed with IV methylprednisolone for 3 days with improvement and thereafter on follow up as an outpatient in the Pediatric Rheumatology clinic.

Conclusion
Pediatric SLE has significant morbidity and mortality therefore early intervention is crucial to retard disease progression. Given the vast array of clinical manifestations, it requires a high index of suspicion to enable early, accurate diagnosis and prompt treatment.
Local market, central government support, and local governments’ homegrown development strategy in high-tech industries
Authors: Peng Huidong 
Published: August 2023

Abstract
The homegrown strategy (i.e. supporting domestic enterprises) in the high-tech manufacturing sector is very important for developing countries’ sustainable growth and economic security. In reality, only some local governments adopt the homegrown strategy in high-tech industries while others not. This paper attempts to explore factors affecting local governments’ adoption of the homegrown strategy in the high-tech sector. It argues that under the decentralized fiscal system and relative performance–based cadre evaluation system, local development strategy choices in a high-tech industry are significantly shaped by two factors: (1) the size of the local high-tech product market in the early stage of this industry’s development and (2) the support for domestic enterprises from the central government. Localities with a large local high-tech product market and support from the center are more likely to adopt the homegrown strategy. Case studies on eight Chinese sub-provincial localities’ chipmaking industries confirm these hypotheses.
β-Cyclocitric acid enhances drought tolerance in peach (Prunus persica) seedlings
Authors: Zhu Kaijie , Feng Yimei , Huang Yufeng , Zhang Dongmei , Ateeq Muhammad , Zheng Xiongjie , Al-Babili Salim , Li Guohuai , Liu Junwei 
Published: August 2023

Abstract
The β-cyclocitric acid (β-CCA) is a bioactive apocarotenoid previously shown to improve drought tolerance in annual plants. However, the underlying molecular mechanism of this process remains largely elusive. Moreover, the question about the activity of β-CCA in perennial fruit crops is still open. Here, we found that treatment of β-CCA enhances drought tolerance in peach seedlings. The application of β-CCA significantly increased the relative water content and root activity and reduced the electrolyte leakage of peach seedlings under drought stress. Moreover, treatment with β-CCA under drought stress increased chlorophyll fluorescence, indicating a positive effect on photosynthesis, while also enhancing superoxide dismutase and peroxidase activity and reducing reactive oxygen species (ROS) levels. Consistent with these alterations, transcriptome analysis revealed an up-regulation of photosynthesis and antioxidant-related genes upon the application of β-CCA under drought stress. We also detected an induction in genes related to detoxification, environmental adaptation, primary metabolism, phytohormone, phenylpropanoid and the biosynthesis of cutin, suberine and wax, which might contribute to the induction of drought resistance. Altogether, our study reveals that β-CCA positively modulates peach drought tolerance, which is mainly mediated by enhancing photosynthesis and reducing ROS, indicating the potential of utilizing β-CCA for drought control in peach and perhaps other fruit crops.
Hepatobiliary manganese homeostasis is dynamic in the setting of inflammation or infection in mice
Authors: Sunuwar Laxmi , Tomar Vartika , Wildeman Asia , Culotta Valeria , Melia Joanna 
Published: August 2023

AbstractManganese is a diet‐derived micronutrient that is essential for critical cellular processes like redox homeostasis, protein glycosylation, and lipid and carbohydrate metabolism. Control of Mn availability, especially at the local site of infection, is a key component of the innate immune response. Less has been elucidated about Mn homeostasis at the systemic level. In this work, we demonstrate that systemic Mn homeostasis is dynamic in response to inflammation and infection in mice. This phenomenon is evidenced in male and female mice, mice of two genetic backgrounds (C57BL/6 and BALB/c), in multiple models of acute (dextran sodium sulfate‐induced) and chronic (enterotoxigenic Bacteroides fragilis) colitis, and systemic infection with Candida albicans. When mice were fed a standard corn‐based chow with excess Mn (100 ppm), liver Mn decreased and biliary Mn increased threefold in response to infection or colitis. Liver iron, copper, and zinc were unchanged. When dietary Mn was restricted to minimally adequate amounts (10 ppm), baseline hepatic Mn levels decreased by approximately 60% in the liver, and upon induction of colitis, liver Mn did not decrease further, however, biliary Mn still increased 20‐fold. In response to acute colitis, hepatic Slc39a8 mRNA (gene encoding the Mn importer, Zip8) and Slc30a10 mRNA (gene encoding the Mn exporter, Znt10) are decreased. Zip8 protein is decreased. Inflammation/infection‐associated dynamic Mn homeostasis may represent a novel host immune/inflammatory response that reorganizes systemic Mn availability through differential expression of key Mn transporters with down‐regulation of Zip8.
Cognitive behavioral therapy for patients suffering with tinnitus distress
Authors: Miller Leila 
Published: August 2023

ABSTRACT
Of the 21% of the US population with tinnitus, between 3% and 6% develop tinnitus distress, a sudden, traumatic, and severe emotional response to tinnitus. Cognitive behavioral therapy (CBT) is the most effective therapy for reducing the initial and secondary emotional stresses caused by tinnitus distress. The skills taught in CBT lead to habituation and desensitization, providing relief for the patient. This article describes tinnitus distress, CBT, and resources that clinicians can use immediately in their practices.
A practical guide to managing genitourinary syndrome of menopause in primary care
Authors: Schmidt Elizabeth 
Published: August 2023

ABSTRACT
Females spend a third to half of their life in menopause, and the number of US females in menopause is growing. A high percentage of postmenopausal females experience bothersome, sometimes debilitating genitourinary symptoms, which can affect quality of life. The genitourinary syndrome of menopause (GSM) describes the condition previously referred to as vulvovaginal atrophy, atrophic vaginitis, or urogenital atrophy. Of concern, many patients with symptoms of GSM have never been asked about nor have they initiated conversations about these concerns with a healthcare provider. This article addresses the need to improve screening, identification, and patient-centered management in primary care of females with GSM.
Initiation of Extended-release Depot Buprenorphine in a Patient Subject to a Community Treatment Order for Both Antipsychotic and Opioid Agonist Treatments
Authors: Pidutti Joel , Cuperfain Ari B. , Solway Eric , Duff Virginia , Lurie Erin 
Published: August 2023

Abstract
Opioid use disorder (OUD) and schizophrenia are commonly comorbid, and patient outcomes are improved when these conditions are managed concurrently. Medication for OUD such as methadone and buprenorphine are treatments for OUD, yet psychosis introduces additional challenges in retaining patients in care. Extended-release depot buprenorphine is an emerging option for the treatment of moderate-to-severe OUD, and it may provide certain benefits in patients with concurrent OUD and psychosis. We present the case of a 32-year-old man with schizophrenia, traumatic brain injury, and OUD with a history of multiple opioid-related overdoses, followed by an assertive community treatment team, and subject to a community treatment order for both his primary psychotic disorder and OUD treatments. We discuss the role of extended-release depot buprenorphine in this unique patient population and the ethical considerations of involuntary treatment of OUD in patients lacking capacity to consent to treatment.
Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians
Authors: Foti Tara R. , Green Andrea , Altschuler Andrea , Iturralde Esti , Does Monique B. , Jackson-Morris Melanie , Adams Sara R. , Goler Nancy , Ansley Deborah , Conway Amy , Young-Wolff Kelly C. 
Published: August 2023

OBJECTIVE:
To understand pregnant patients' reasons for prenatal cannabis use and perceptions of safety, desired and undesirable health care experiences, and desired information about prenatal cannabis use and secondarily to understand racial differences in these perceptions and preferences.

METHODS:
We conducted a qualitative study including 18 semi-structured, race-concordant virtual focus groups with pregnant individuals who self-reported cannabis use at prenatal care entry in a large integrated health care system in Northern California from November 2021 to December 2021. The focus groups included semi-structured questions that were recorded, transcribed, and coded by the research team. Thematic analysis was used to analyze the data.

RESULTS:
Overall, 53 participants were included; 30 self-identified, as White and 23 self-identified as Black. Participants averaged 30.3 years of age (SD 5.2 years) and were on average at 20.9 weeks of gestation at study enrollment; 69.8% reported daily cannabis use, 24.5% reported weekly cannabis use, and 5.7% reported monthly or less cannabis use at entrance to prenatal care. Although some participants quit cannabis use in early pregnancy because of concerns about potential health risks, many perceived a lack of scientific evidence or believed that prenatal cannabis use was safe. Many preferred cannabis to over-the-counter or prescription medications for treating mood, morning sickness, pain, and sleep. Participants valued open interactions with obstetricians that acknowledged their motivations for use, and they desired information about potential risks through conversations and educational materials. White and Black participants' perspectives were generally similar, but a few Black participants uniquely described concerns about racial bias related to their prenatal cannabis use.

CONCLUSION:
Pregnant patients used cannabis to manage mood and medical symptoms, and many believed that prenatal cannabis use was safer than the use of prescription medications. Obstetrician-initiated, patient-centered conversations around prenatal cannabis use, advice to discontinue cannabis use during pregnancy, and exploration of willingness to switch to medically recommended interventions for pregnancy-related symptoms may benefit patients.