bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase 1 trial to model primary, secondary, and tertiary dengue using a monovalent vaccine
Authors: Odio Camila D. , Lowman Kelsey E. , Law Melissa , Aogo Rosemary A. , Hunsberger Sally , Wood Brad J. , Kassin Michael , Levy Elliot , Callier Viviane , Firdous Saba , Hasund Chloe M. , Voirin Charlie , Kattappuram Robbie , Yek Christina , Manning Jessica , Durbin Anna , Whitehead Stephen S. , Katzelnick Leah C. 
Published: May 2023

AbstractBackgroundThe four co-circulating and immunologically interactive dengue virus serotypes (DENV1-4) pose a unique challenge to vaccine design because sub-protective immunity can increase the risk of severe dengue disease. Existing dengue vaccines have lower efficacy in DENV seronegative individuals but higher efficacy in DENV exposed individuals. There is an urgent need to identify immunological measures that are strongly associated with protection against viral replication and disease following sequential exposure to distinct serotypes.Methods/DesignThis is a phase 1 trial wherein healthy adults with neutralizing antibodies to zero (seronegative), one non-DENV3 (heterotypic), or more than one (polytypic) DENV serotype will be vaccinated with the live attenuated DENV3 monovalent vaccine rDEN3Δ30/31-7164. We will examine how pre-vaccine host immunity influences the safety and immunogenicity of DENV3 vaccination in a non-endemic population. We hypothesize that the vaccine will be safe and well tolerated, and all groups will have a significant increase in the DENV1-4 neutralizing antibody geometric mean titer between days 0 and 28. Compared to the seronegative group, the polytypic group will have lower mean peak vaccine viremia, due to protection conferred by prior DENV exposure, while the heterotypic group will have higher mean peak viremia, due to mild enhancement. Secondary and exploratory endpoints include characterizing serological, innate, and adaptive cell responses; evaluating proviral or antiviral contributions of DENV-infected cells; and immunologically profiling the transcriptome, surface proteins, and B and T cell receptor sequences and affinities of single cells in both peripheral blood and draining lymph nodes sampled via serial image-guided fine needle aspiration.DiscussionThis trial will compare the immune responses after primary, secondary, and tertiary DENV exposure in naturally infected humans living in non-endemic areas. By evaluating dengue vaccines in a new population and modeling the induction of cross-serotypic immunity, this work may inform vaccine evaluation and broaden potential target populations.Trial RegistrationNCT05691530 registered on January 20, 2023.
Thrombotic thrombocytopenic purpura in a patient on long-term alpha-interferon therapy for essential thrombocythemia: a case report
Authors: Qin Chunmei , Yin Dan , Liu Fang , Qiu Hongyu 
Published: May 2023

Abstract
Background
Thrombotic thrombocytopenic purpura (TTP) is rare and severe thrombotic microangiopathy characterized by thrombocytopenia, hemolytic anemia, and renal dysfunction. In contrast, essential thrombocythemia (ET) is a myeloproliferative disease associated with an abnormal increase in platelet numbers. Previous studies reported several cases of the development of ET in patients with TTP. However, the case of an ET patient complicated with TTP has not been previously reported. In this case study, we present a patient with TTP who was previously diagnosed with ET. Therefore, to the best of our knowledge, this is the first report of TTP in ET.

Case presentation
A 31-year-old Chinese female who was previously diagnosed with ET presented with anemia and renal dysfunction. The patient had been on long-term treatment with hydroxyurea, aspirin, and alpha interferon (INF-α) for ten years. The diagnosis of TTP was confirmed by clinical features, schistocytes noted on the peripheral blood smear, and lower ADAMTS13 activity (8.5%), together with the renal biopsy results. INF-α was discontinued, and the patient was then treated with plasma exchange and corticosteroids. After one year of follow-up, the patient had a normal hemoglobin level and platelet numbers, and her ADAMTS13 activity had improved. However, the patient’s renal function remains impaired.

Conclusions
We report a case of an ET patient complicated with TTP that was possibly due to INF-α, highlighting the potential complications associated with long-term ET therapy. The case also highlights the importance of considering TTP in patients with pre-existing ET who present with anemia and renal dysfunction, extending the spectrum of known studies.
Elevated NT-proBNP predicts unfavorable outcomes in patients with acute ischemic stroke after thrombolytic therapy
Authors: Zhu Zhuang , Muhammad Bilal , Du Bo , Gu Ning , Meng Tian-Yue , Kan Shu , Mu Ying-Feng , Cheng Yan-Bo , Zhu Shi-Guang , Geng De-Qin 
Published: May 2023

AbstractObjectiveFew studies correlated n-terminal pro-brain natriuretic peptide (NT-proBNP) with early neurological deterioration (END) and prognosis of acute ischaemic stroke (AIS) patients with rt-PA intravenous thrombolysis. Therefore this study aimed to investigate the relationship between NT-proBNP and END, and prognosis after intravenous thrombolysis in patients with AIS.MethodsA total of 325 patients with AIS were enrolled. We performed the natural logarithm transformation on the NT-proBNP [ln(NT-proBNP)]. Univariate and multivariate logistic regression analyses were performed to assess the relationship between ln(NT-proBNP) and END, and prognosis and receiver operating characteristic (ROC) curves were used to show the sensitivity and specificity of NT-proBNP.ResultsAfter thrombolysis, among 325 patients with AIS, 43 patients (13.2%) developed END. In addition, three months follow-up showed a poor prognosis in 98 cases (30.2%) and a good prognosis in 227 cases (69.8%). Multivariate logistic regression analysis showed that ln(NT-proBNP) was an independent risk factor for END (OR = 1.450,95%CI:1.072 ~ 1.963,P = 0.016) and poor prognosis at three months follow-up (OR = 1.767, 95%CI: 1.347 ~ 2.317,P < 0.001) respectively. According to ROC curve analysis, ln(NT-proBNP) (AUC 0.735, 95%CI: 0.674 ~0.796,P < 0.001) had a good predictive value for poor prognosis, with a predictive value of 5.12 and sensitivity and specificity of 79.59% and 60.35% respectively. When combined with NIHSS to predict END(AUC 0.718, 95%CI: 0.631 ~ 0.805,P < 0.001) and poor prognosis(AUC 0.780, 95%CI: 0.724 ~ 0.836,P < 0.001), the predictive value of the model is further improved.ConclusionNT-proBNP is independently associated with END and poor prognosis in patients with AIS following intravenous thrombolysis and has a particular predictive value for END and poor prognosis.
Predictive effect of TCED-HFV grading and imaging biomarkers on anti-VEGF therapy in diabetic macular edema
Authors: Yu Lu , Hao Xiaolin , Cheng Jie , Ling Yu , Ren Hong , Mo Bin , Liu Wu 
Published: May 2023

Abstract
Background
To evaluate the predictive effect of TCED-HFV grading and imaging biomarkers on anti-vascular endothelial growth factor (anti-VEGF) treatment in diabetic macular edema (DME).

Methods
81 eyes of 81 DME patients who were treated with anti-VEGF were included in this retrospective cohort study. All patients underwent a comprehensive ophthalmic examination at baseline and follow-up, including best-corrected visual acuity (BCVA), fundus photography, and spectral domain–optical coherence tomography (SD-OCT). Baseline imaging biomarkers were qualitatively and quantitatively graded according to the TCED-HFV classification protocol, and DME was divided into early stage, advanced stage, severe stage, and atrophy stage.

Results
Six months post treatment, central subfield thickness (CST) in 49 eyes (60.5%) had decreased by 10% from baseline, 30 eyes (37.0%) had achieved CST < 300 μm, and 45 eyes (55.6%) had BCVA improved by more than five letters. Multivariate regression analysis revealed that eyes with baseline CST ≥ 390 μm had a higher probability of ≥ 10% reduction in CST from baseline, and eyes with abundant hyperreflective dots (HRD) had a lower probability of 10% reduction in CST (all P < 0.05). Eyes with vitreomacular traction (VMT) or epiretinal membrane (ERM) at baseline were less likely to reach the end point of CST < 300 μm (P < 0.05). BCVA increases of more than five letters were less likely in eyes with baseline BCVA ≥ 69 letters, complete or partial destruction of ellipsoid zone (EZ) at baseline (all P < 0.05). TCED-HFV staging was negatively correlated with BCVA at both baseline and 6 months (Kendall’s tau-b=-0.39 and − 0.55, all P < 0.01). TCED-HFV staging was positively correlated with CST at 6 months (Kendall’s tau-b = 0.19, P = 0.049) and negatively correlated with the reduction of CST (Kendall’s tau-b=-0.32, P < 0.01).

Conclusion
The TCED-HFV grading protocol facilitates a comprehensive assessment of DME severity, standardizes the grading of multiple imaging biomarkers, and predicts the anatomical and functional outcomes of anti-VEGF treatment.
Efficacy analysis of oral dexamethasone in the treatment of infantile spasms and infantile spasms related Lennox–Gastaut syndrome
Authors: Li Jieling , Gao Yujing , Cao Jie , Cai Fangcheng , Zhai Xiuquan 
Published: May 2023

AbstractObjectiveTreatment with adrenocorticotropic hormone (ACTH) or a corticosteroid is the first choice for infantile spasms (IS), and vigabatrin is the first choice for children with tuberous sclerosis. Although corticosteroids may be also effective against IS and IS-related Lennox–Gastaut syndrome (LGS), the use of dexamethasone (DEX), a kind of corticosteroid, for these diseases has been rarely reported. This retrospective study aimed to evaluate the efficacy and tolerability of DEX for the treatment of IS and IS-related LGS.MethodsPatients diagnosed as having IS (including patients whose condition evolved to LGS after the failure of early treatment) in our hospital between May 2009 and June 2019 were treated with dexamethasone after failure of prednisone treatment. The oral dose of DEX was 0.15–0.3 mg/kg/d. Thereafter, the clinical efficacy, electroencephalogram (EEG) findings, and adverse effects were observed every 4–12 weeks depending on the individual patient’s response. Then, the efficacy and safety of DEX in the treatment of IS and IS-related LGS were retrospectively evaluated.ResultsAmong 51 patients (35 cases of IS; 16 cases of IS-related LGS), 35 cases (68.63%) were identified as responders to DEX treatment, comprising 20 cases (39.22%) and 15 cases (29.41%) with complete control and obvious control, respectively. To discuss the syndromes individually, complete control and obvious control were achieved in 14/35 and 9/35 IS cases and in 6/16 and 6/16 IS-related LGS cases, respectively. During DEX withdrawal, 11 of the 20 patients with complete control relapsed (9/14 IS; 2/6 LGS). The duration of dexamethasone treatment (including weaning) in most of the 35 responders was less than 1 year. However, 5 patients were treated with prolonged, low-dose maintenance therapy, which continued for more than 1.5 years. These 5 patients showed complete control, and 3 patients had no recurrence. Except for one child who died of recurrent asthma and epileptic status 3 months after stopping DEX, there were no serious or life-threatening adverse effects during DEX treatment.ConclusionOral DEX is effective and tolerable for IS and IS-related LGS. all LGS patients were evolved from IS in this study. The conclusion may not apply to patients with other etiology and courses of LGS. Even when prednisone or ACTH is failed, DEX may still be considered as a treatment option. For children who respond to DEX but do not show complete control after 6 months of treatment, prolonged treatment with low-dose DEX administered in the morning might be considered.
Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort
Authors: Ogilvie James M. , Tzoumakis Stacy , Thompson Carleen , Allard Troy , Dennison Susan , Kisely Steve , Stewart Anna 
Published: May 2023

Abstract
Background
Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time.

Methods
Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29–31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending.

Results
The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending.

Conclusions
Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.
Barriers and facilitators to HPV and meningococcal vaccination among men who have sex with men: a qualitative study
Authors: Naidu Justin , Polonijo Andrea N. 
Published: May 2023

Abstract
Background
Men who have sex with men (MSM) have suboptimal uptake of human papillomavirus (HPV) and meningococcal vaccines. This study examines barriers and facilitators to HPV and meningococcal vaccination among MSM in a large, racially/ethnically diverse, and medically underserved U.S. region.

Methods
In 2020, we conducted five focus groups with MSM living in the Inland Empire, California. Participants discussed (1) their knowledge about and attitudes toward HPV, meningococcal disease, and related vaccines; and (2) factors that would encourage or discourage vaccine uptake. Data were systematically analyzed to identify salient barriers and facilitators to vaccination.

Results
Participants (N = 25) had a median age of 29. Most were Hispanic (68%), self-identified as gay (84%), and had college degrees (64%). Key barriers to vaccination included: (1) limited awareness and knowledge about HPV and meningococcal disease, (2) reliance on mainstream healthcare providers for vaccine information, (3) stigma and reluctance to disclose sexual orientation, (4) uncertainty about health insurance coverage and vaccine costs, and (5) distance and time required to access vaccines. Key facilitators to vaccination were: (1) vaccine confidence, (2) perceived severity of HPV and meningococcal disease, (3) bundling vaccination into routine healthcare, and (4) pharmacies as vaccination sites.

Conclusions
Findings highlight opportunities for HPV and meningococcal vaccine promotion, including targeted education and awareness campaigns for MSM, LGBT inclusivity training for healthcare providers, and structural interventions to improve vaccine accessibility.
Observational evidence for detrimental impact of inhaled ozone on human respiratory system
Authors: Lu Jiaying , Yao Ling 
Published: May 2023

AbstractThe detrimental influence of inhaled ozone on human respiratory system is ambiguous due to the complexity of dose response relationship between ozone and human respiratory system. This study collects inhaled ozone concentration and respiratory disease data from Shenzhen City to reveal the impact of ozone on respiratory diseases using the Generalized Additive Models (GAM) and Convergent Cross Mapping (CCM) method at the 95% confidence level. The result of GAM exhibits a partially significant lag effect on acute respiratory diseases in cumulative mode. Since the traditional correlation analysis is incapable of capturing causality, the CCM method is applied to examine whether the inhaled ozone affects human respiratory system. The results demonstrate that the inhaled ozone has a significant causative impact on hospitalization rates of both upper and lower respiratory diseases. Furthermore, the harmful causative effects of ozone to the human health are varied with gender and age. Females are more susceptible to inhaled ozone than males, probably because of the estrogen levels and the differential regulation of lung immune response. Adults are more sensitive to ozone exposure than children, potentially due to the fact that children need longer time to react to ozone stress than adults, and the elderly are more tolerant than adults and children, which may be related to pulmonary hypofunction of the elderly while has little correlation with ozone exposure.
Non-invasive diagnostic potential of salivary miR-25-3p for periodontal disease and osteoporosis among a cohort of elderly patients with type 2 diabetes mellitus
Authors: Ni Jing , Zhang Qiong , Lei Fei 
Published: May 2023

Abstract
Objective
Osteoporosis (OP) and periodontal disease (PD) are two common health issues that threaten the older population and potentially connected each other in the context of type 2 diabetes mellitus (T2DM). Dysregulated expression of microRNAs (miRNAs) may contribute to the development and progression of both OP and PD among elderly T2DM patients. The present study aimed to evaluate the accuracy of miR-25-3p expression for the detection of OP and PD when compared to a mixed group of patients with T2DM.

Methods
The study recruited 45 T2DM patients with normal bone mineral density (BMD) and healthy periodontium, 40 type 2 diabetic osteoporosis patients coexistent with PD, 50 type 2 diabetic osteoporosis patients with healthy periodontium, and 52 periodontally healthy individuals. miRNA expression measurements in the saliva were determined by real-time PCR.

Results
The salivary expression of miR-25-3p was higher in type 2 diabetic osteoporosis patients than patients with T2DM only and healthy individuals (P < 0.05). Among type 2 diabetic osteoporosis patients, those with PD exhibited a higher salivary expression of miR-25-3p than those with healthy periodontium (P < 0.05). Among type 2 diabetic patients with healthy periodontium, a higher salivary expression of miR-25-3p was noted in those with OP than those without (P < 0.05). We also found a higher salivary expression of miR-25-3p in T2DM patients than healthy individuals (P < 0.05). It was revealed that the salivary expression of miR-25-3p was increased as the T scores of BMD of patients were lowered, the PPD and CAL values of patients were enhanced. The salivary expression of miR-25-3p used as a test to predict a diagnosis of PD among type 2 diabetic osteoporosis patients, a diagnosis of OP among type 2 diabetic patients, and a diagnosis of T2DM among healthy individuals produced AUC of 0.859. 0.824, and 0.886, respectively.

Conclusion
The findings obtained from the study support salivary miR-25-3p confers non-invasive diagnostic potential for PD and OP among a cohort of elderly T2DM patients.
Influence of Er:YAG laser irradiation on the outcomes of alveolar ridge preservation at the infected molar sites: a randomized controlled trial
Authors: Zhou Yong , Sun Fengying , Zhang Zhoujing , Duan Xinxiu , Long Xianyan , Liu Xiang , Zou Duohong , He Jiacai 
Published: May 2023

Abstract
Background
The purpose of this study was to investigate the socket healing outcome after alveolar ridge preservation at infected molar sites using an erbium-doped yttrium aluminium garnet (Er:YAG) laser.

Methods
Eighteen patients who needed molar extraction and exhibited signs of infection were included and allocated into either the laser group or the control group. Er:YAG laser irradiation for degranulation and disinfection was performed with alveolar ridge preservation (ARP) in the laser group. Traditional debridement with a curette was performed in the control group. Two months after ARP, bone tissue samples were harvested at the time of implant placement for histological analysis. Assessment of dimension changes in alveolar bone was conducted by superimposing two cone-beam computed tomography (CBCT) scans taken at baseline and two months after extraction.

Results
Histologically, after two months of healing, Er:YAG laser treatment resulted in more newly formed bone (laser: 17.75 ± 8.75, control: 12.52 ± 4.99, p = 0.232). Moreover, greater osteocalcin (OCN) positive expression and lower runt-related transcription factor 2 (RUNX-2) positive expression were detected in the laser group. However, no statistically significant difference was observed between the two groups. The difference in the vertical resorption of the buccal bone plate was statistically significant between groups (laser: -0.31 ± 0.26 mm, control: -0.97 ± 0.32 mm, p < 0.05). Major changes in ridge width were observed at 1 mm below the bone crest. However, the differences between groups were not significant (laser: -0.36 ± 0.31 mm, control: -1.14 ± 1.24 mm, p = 0.171).

Conclusions
ARP with Er:YAG laser irradiation seemed to improve bone healing by regulating osteogenesis-related factor expression in the early stage at infected sites.

Trial registration
The trial was registered on the Chinese Clinical Trial Registry Platform (https://www.chictr.org.cn/) (registration number: ChiCTR2300068671; registration date: 27/02/2023).