bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of General and Local Anesthesia on Postoperative Pain After a Loop Electrosurgical Excision Procedure
Authors: Güngördük Kemal , Türkmen Hilal Ezgi , Gülseren Varol , Küçükler Berfin , Çelikkol Özgü , Özdemir İsa Aykut 
Published: May 2023

ObjectiveTo compare patient satisfaction, histopathologic results, and short-term morbidity in patients undergoing loop electrosurgical excision procedure (LEEP) under local anesthesia (LA) versus general anesthesia (GA).MethodsParticipants who met the inclusion criteria were randomly allocated in a 1:1 ratio to the LA group or GA group. Pain was determined by both objective (faces pain scale-revised) and subjective (visual analog scale score) methods.ResultsData from 244 patients (123 in the LA group and 121 in the GA group) were analyzed. The median cone volume was 2.0 (0.4–4.7) cm3in the LA group and 2.4 (0.3–4.8) cm3in the GA group. There was no difference in margin involvement or repeat conization between the groups. The procedure time, time to complete hemostasis, intraoperative blood loss, and early postoperative blood loss were similar between the groups. The visual analog scale scores were higher in the LA group at 1, 2, and 4 hours postoperatively, but the differences between the groups were not significant. In addition, the median faces pain scale-revised scores at 1, 2, and 4 hours postoperatively were not significantly different between the LA and GA groups.ConclusionsThe present study showed no difference in pain during the postoperative period, need for additional analgesia, volume of the extracted cone specimens, rate of positive surgical margin, bleeding volume, or operation time in women undergoing loop electrosurgical excision procedure under LA versus GA.
Impact of dynamic explosive resistance exercise with elastic bands on pulse pressure in hypertensive older adults: a randomized crossover study
Authors: Bavaresco Gambassi Bruno , Nobre Izadora , Prazeres Jozimar , de Melo Maycon Henrique , Bianco Roberto , Novais Tânia Maria , Oliveira Paula de Lourdes , Souza Thiago Antonio , Ribeiro Maria Jacqueline , Schwingel Paulo Adriano 
Published: May 2023

Objective
This study aimed to evaluate the acute responses of pulse pressure (PP), SBP, and DBP to dynamic explosive resistance exercise (DERE) with elastic resistance bands in hypertensive older adults.

Methods
Eighteen hypertensive older adults were randomly assigned to participate in DERE and control sessions. PP, SBP, and DBP were measured before (baseline) and after each session (immediately, 10, and 20 min after the session). The DERE protocol has five sets of two consecutive exercises.

Results
There was an important clinical decrease in PP (Δ = −7.8 mmHg; d

z
= 0.7) and in DBP (Δ = −6.3 mmHg; d
z = 0.6) favoring the exercise session post-20 min in the intersession comparison. DERE also promoted lowering levels in SBP (140.3 ± 16.0 vs. 126.2 ± 14.3 mmHg; Δ = −14.1 mmHg; P = 0.04) with a large effect size (d

z
= 0.9) post-20 min when compared to the control session.

Conclusion
Our findings indicate that DERE with elastic resistance bands improved SBP in hypertensive older adults. In addition, our results support the hypothesis that DERE can an important clinical decrease in PP and DBP. According to this, professionals may have additional exercise training possibilities with elastic resistance bands when prescribing resistance exercises for systemic arterial hypertension treatment in this population.
DEGS1-related leukodystrophy: a clinical report and review of literature
Authors: Wong Melissa Song Ting , Thomas Terrence , Lim Jiin Ying , Kam Sylvia , Teo Jing Xian , Ching Jianhong , Goh Chew Yin Jasmine , Jamuar Saumya Shekhar , Lim Weng Khong , Koh Ai Ling 
Published: May 2023

Background:
Leukodystrophies are a heterogeneous group of disorders affecting the white matter of the central nervous system, with or without affecting the peripheral nervous system. Biallelic variants in DEGS1, coding for desaturase 1 (Des1) protein, were recently reported to be associated with hypomyelinating leukodystrophy (HLD), a subclass of leukodystrophies where the formation of the myelin sheath is affected.

Methods
Genomic sequencing was performed on our index patient with severe developmental delay, severe failure to thrive, dystonia, seizures, and hypomyelination on brain imaging. Sphingolipid analysis was performed and dihydroceramide/ceramide (dhCer/Cer) ratios were obtained by the measurement of ceramide and dihydroceramide species.

Results
A homozygous missense variant was identified in DEGS1 (c.565A > G:p Asn189Asp). The identified DEGS1 variant has been annotated as “conflicting reports of pathogenicity” on ClinVar. Follow-up sphingolipid analysis on our patient showed significantly raised dhCer/Cer and this was consistent with dysfunction of the Des1 protein, providing additional evidence to support the pathogenicity of this variant.

Conclusion
While rare, pathogenic variants in DEGS1 should be considered in patients with HLD phenotype. To date, 25 patients have been reported across four studies on DEGS1-related HLD, and, in this report, we summarize the literature. More such reports will enable deeper phenotypic characterization of this disorder.
Mechanisms and clinical applications of incretin therapies for diabetes and chronic kidney disease
Authors: Alicic Radica Z. , Neumiller Joshua J. , Tuttle Katherine R. 
Published: May 2023

Purpose of review
Diabetic kidney disease (DKD) is the leading cause of kidney failure worldwide. Development of DKD increases risks for cardiovascular events and death. Glucagon-like peptide-1 (GLP-1) receptor agonist have demonstrated improved cardiovascular and kidney outcomes in large-scale clinical trials.

Recent finding
GLP-1 and dual GLP-1/glucose-depending insulinotropic polypeptide (GIP) receptor agonists have robust glucose-lowering efficacy with low risk of hypoglycemia even in advanced stages of DKD. Initially approved as antihyperglycemic therapies, these agents also reduce blood pressure and body weight. Cardiovascular outcome and glycemic lowering trials have reported decreased risks of development and progression of DKD and atherosclerotic cardiovascular events for GLP-1 receptor agonists. Kidney and cardiovascular protection is mediated partly, but not entirely, by lowering of glycemia, body weight, and blood pressure. Experimental data have identified modulation of the innate immune response as a biologically plausible mechanism underpinning kidney and cardiovascular effects.

Summary
An influx of incretin-based therapies has changed the landscape of DKD treatment. GLP-1 receptor agonist use is endorsed by all major guideline forming organizations. Ongoing clinical trials and mechanistic studies with GLP-1 and dual GLP-1/GIP receptor agonists will further define the roles and pathways for these agents in the treatment of DKD.
Fibroblast growth factor 23, klotho and heparin
Authors: Thomas S. Madison , Li Qing , Faul Christian 
Published: May 2023

Purpose of review
Fibroblast growth factor (FGF) 23 is a bone-derived hormone that regulates phosphate and vitamin D metabolism by targeting the kidney. When highly elevated, such as in chronic kidney disease (CKD), FGF23 can also target the heart and induce pathologic remodeling. Here we discuss the mechanisms that underlie the physiologic and pathologic actions of FGF23, with focus on its FGF receptors (FGFR) and co-receptors.

Recent findings
Klotho is a transmembrane protein that acts as an FGFR co-receptor for FGF23 on physiologic target cells. Klotho also exists as a circulating variant, and recent studies suggested that soluble klotho (sKL) can mediate FGF23 effects in cells that do not express klotho. Furthermore, it has been assumed that the actions of FGF23 do not require heparan sulfate (HS), a proteoglycan that acts as a co-receptor for other FGF isoforms. However, recent studies revealed that HS can be part of the FGF23:FGFR signaling complex and modulate FGF23-induced effects.

Summary
sKL and HS have appeared as circulating FGFR co-receptors that modulate the actions of FGF23. Experimental studies suggest that sKL protects from and HS accelerates CKD-associated heart injury. However, the in vivo relevance of these findings is still speculative.
Direct-to-consumer STI screening methods: Preferred communication sources and channels among young adult women
Authors: Griner Stacey B. , Johnson Kaeli C. , Neelamegam Malinee , Webb Nathaniel J. , Kinard Ashlyn , Kline Nolan 
Published: May 2023

Abstract

Background
Direct-to-consumer (DTC) sexually transmitted infection (STI) screening methods utilize self-collected samples in a non-clinical setting. DTC methods may reach a population of women who avoid screening due to stigma, privacy concerns, or who lack access to clinical care. Little is known about the salient dissemination approaches to promote these methods. The study’s purpose was to identify preferred sources and communication channels for information about DTC methods among young adult women.

Methods
Participants were sexually active 18–24-year-old college women at one university, recruited via purposive sampling using campus email, list-servs, and campus events to participate in an online survey (n = 92). Interested participants were invited to participate in in-depth interviews (n = 24). Both instruments were guided by the Diffusion of Innovation theory to identify relevant communication channels.

Results
Survey participants ranked healthcare providers as their preferred source of information, followed by the internet and college- and university-based resources. Race was significantly associated with the ranking of partners and family members as information sources. Interview themes focused on healthcare providers legitimizing DTC methods, using the internet and social media to increase awareness, and linking DTC method education to other services provided by the college.

Conclusion
This study revealed common information sources that college-age women may utilize when researching DTC method information and potential channels and strategies for DTC uptake and dissemination. Utilizing trusted sources including healthcare providers, trusted websites, and established college resources as dissemination channels may be beneficial to increase the awareness and use of DTC methods for STI screening.
Human papillomavirus positivity at three anatomical sites among transgender women in Central Brazil
Authors: de Oliveira Brunna Rodrigues , Diniz e Silva Bruno Vinícius , dos Santos Kamila Cardoso , Caetano Karlla Antonieta Amorim , Mota Giana , Saddi Vera Aparecida , dos Santos Silvia Helena Rabelo , Villa Luisa Lina , Vaddiparti Krishna , Cook Robert L. , Teles Sheila Araujo , Carneiro Megmar Aparecida dos Santos 
Published: May 2023

Abstract

Background
Transgender women (TGWs) are susceptible to the acquisition of sexually transmitted infections (STIs), including human papillomavirus (HPV). Nonetheless, the exact data for this population are scarce. We estimated HPV positivity at the anal, genital, and oral sites among TGWs and also identified the related characteristics and behaviors that could be risk factors for HPV infection in a sample of TGWs in Brazil. Furthermore, we characterized the site-specific HPV genotypes among those who were positive for HPV at these three sites.
Methods: A cross-sectional study was conducted on TGWs in Goiânia City (Central–Midwest region), Brazil, between April 2018 and August 2019. Respondent-driven sampling was applied for recruitment. Next, self-collected anal, genital, and oral samples were examined for HPV DNA using polymerase chain reaction (SPF-10 primer). HPV genotypes were identified in 12 TGWs.

Results
In the TGWs included in the study, the anal, genital, and oral HPV positivity was 77.2% (95% CI: 67.3–84.6), 33.5% (95% CI: 26.1–48.9), and 10.9% (95% CI: 5.8–17.0), respectively. Additionally, the majority of 12 participants who tested for HPV had multiple genotypes. HPV-52 was the most prevalent genotype identified at the anal (66.6%) and genital (40.0%) sites, whereas HPV-62 and HPV-66 were the most common at the oral site (25.0%).

Conclusions
A high HPV positivity was observed among TGWs. Therefore, additional epidemiological studies on HPV genotypes should generate health intervention information, including the prevention, diagnosis, and treatment of STIs.
Family Support, Open Communication, and Black Gay and Bisexual Young Men’s Attitudes and Stigma Around Pre-Exposure Prophylaxis
Authors: Boyd Donte , Abu-Ba’are Gamji Rabiu , Zigah Edem Yaw , Williams Antonio T. , Flores Dalmacio D. 
Published: May 2023

ABSTRACT

Purpose
This study addresses the gap in the literature on protective factors for Pre-exposure prophylaxis (PrEP) stigma and attitudes among Black men who have sex with men (BMSM) and young adults using the Developmental Assets Framework to examine how external assets (e.g., family support, open family communication, and communication with parents about sex and drugs) can help reduce stigma and increase positive attitudes toward PrEP use.

Methods
A cross-sectional survey was administered to participants (N = 400, mean age = 23.46, standard deviation =2.59) using Amazon Mechanical Turk, social media sites, and community-based organization. A path analysis was conducted to examine associations between stigma and positive attitudes toward PrEP among external assets (family support, communication with parents about sex and drugs, and open family communication).

Results
Communication with parents about sex and drugs was positive and directly associated with PrEP stigma (β = 0.42, p < .001). Family support was negative and indirectly associated with stigma associated with PrEP (β = −0.20, p < .001).

Conclusion
This is the first study to use a developmental asset framework to assess positive PrEP attitudes and stigma among young BMSM. Our results underscore that parents have an influence on HIV prevention behaviors for BMSM. In addition, their influence can be both positive by helping lowering PrEP stigma and negatively lowering PrEP attitudes. It’s critical that we develop culturally competent HIV and sexuality prevention and intervention programs for BMSM and their families.
Evaluating the impact of the COVID-19 related public health restrictions on access to digital sexually transmitted and blood borne infection testing in British Columbia, Canada: An interrupted time series analysis
Authors: Iyamu Ihoghosa , Pedersen Heather , Ablona Aidan , Chang Hsiu-Ju , Worthington Cathy , Grace Daniel , Grennan Troy , Wong Jason , Salmon Amy , Koehoorn Mieke , Gilbert Mark 
Published: May 2023

AbstractBackgroundEvidence of long-term impacts of COVID-19 related public health restrictions on digital sexually transmitted and blood borne infection (STBBI) testing utilization is limited. We assessed these impacts onGetCheckedOnline(a digital testing resource for STBBIs) relative to all STBBI tests in British Columbia (BC).MethodsInterrupted time series analyses were conducted usingGetCheckedOnlineprogram data comparing monthly test episodes (STBBI tests per requisition) among BC residents, stratified by BC region, testers’ sociodemographic and sexual risk profiles, for the pre-pandemic (March 2018-February 2020) and pandemic periods (March 2020-October 2021). Trends inGetCheckedOnlinetesting per 100 STBBI tests in BC regions withGetCheckedOnlinewere analysed. Each outcome was modelled using segmented generalized least squared regression.ResultsOverall, 17,215 and 22,646 test episodes were conducted in the pre-pandemic and pandemic periods. MonthlyGetCheckedOnlinetest episodes reduced immediately after restrictions. By October 2021(end of pandemic period), monthlyGetCheckedOnlinetesting increased 21.24 test episodes per million BC residents (95%CI: -11.88, 54.84) andGetCheckedOnlinetests per 100 tests in corresponding BC regions increased 1.10 (95%CI: 0.02, 2.17) above baseline trends. After initial increases among users at higher STBBI risk (symptomatic testers/testers reporting sexual contacts with STBBIs), testing decreased below baseline trends later in the pandemic, while monthlyGetCheckedOnlinetesting increased among people ≥40 years, men who have sex with men, racialized minorities, and first-time testers viaGetCheckedOnline.ConclusionsSustained increases in utilization of digital STBBI testing during the pandemic suggest fundamental changes in STBBI testing in BC, highlighting the need for accessible and appropriate digital testing, especially for those most affected by STBBIs.
Updates in Risk Stratification in Myelodysplastic Syndromes
Authors: Aguirre Luis E. , Sallman David A. , Stone Richard , Komrokji Rami S. 
Published: May 2023

Abstract
Risk stratification plays an essential role in treatment planning in myelodysplastic syndromes. For decades, the International Prognostic Scoring System and its revised version have provided unified consensus for clinical trial enrollment and design. These models relied on laboratory and cytogenetic data to estimate prognosis and dictate treatment paradigms. Critical developments in DNA sequencing techniques in recent years, as well as our growing understanding of the clonal dynamics of myelodysplastic syndromes and the role that specific mutations have in shaping disease-specific phenotypes and treatment susceptibilities, have made it possible to identify molecular markers that carry critical diagnostic and therapeutic relevance and remained unaccounted for in the older models. The Molecular International Prognostic Scoring System is a novel risk stratification model that integrates clinical, cytogenetic, and molecular data to devise a more refined prognostic tool that builds on the accuracy of the traditional models.
Germline Predisposition to Myelodysplastic Syndromes
Authors: Gener-Ricos Georgina , Gerstein Yoheved S. , Hammond Danielle , DiNardo Courtney D. 
Published: May 2023

AbstractWhile germline predisposition to myelodysplastic syndromes is well-established, knowledge has advanced rapidly resulting in more cases of inherited hematologic malignancies being identified. Understanding the biological features and main clinical manifestations of hereditary hematologic malignancies is essential to recognizing and referring patients with myelodysplastic syndrome, who may underlie inherited predisposition, for appropriate genetic evaluation. Importance lies in individualized genetic counseling along with informed treatment decisions, especially with regard to hematopoietic stem cell transplant–related donor selection. Future studies will improve comprehension of these disorders, enabling better management of affected patients and their families.
Evolution of Therapeutic Benefit Measurement Criteria in Myelodysplastic Syndromes/Neoplasms
Authors: Stempel Jessica M. , Xie Zhuoer , Bewersdorf Jan Philipp , Stahl Maximilian , Zeidan Amer M. 
Published: May 2023

Abstract
Myelodysplastic syndromes/neoplasms (MDS) are heterogeneous, clonal myeloid neoplasms characterized by ineffective hematopoiesis, progressive cytopenias, and an increased risk of progression to acute myeloid leukemia. The diversity in disease severity, morphology, and genetic landscape challenges not only novel drug development but also therapeutic response assessment. The MDS International Working Group (IWG) response criteria were first published in the year 2000 focusing on measures of blast burden reduction and hematologic recovery. Despite revision of the IWG criteria in 2006, correlation between IWG-defined responses and patient-focused outcomes, including long-term benefits, remains limited and has potentially contributed to failures of several phase III clinical trials. Several IWG 2006 criteria also lacked clear definitions leading to problems in practical applications and interobserver and intraobserver consistency of response reporting. Although the 2018 revision addressed lower-risk MDS, the most recent update in 2023 redefined responses for higher-risk MDS and has set out to provide clear definitions to enhance consistency while focusing on clinically meaningful outcomes and patient-centered responses. In this review, we analyze the evolution of the MDS response criteria, limitations, and areas of improvement.
Effectiveness of topical cidofovir for treatment of refractory anal high-grade squamous intraepithelial lesion (HSIL)
Authors: Burgos Joaquin , Campany David , Garcia Jorge , Landolfi Stefania , Falcó Vicenç , Curran Adrià 
Published: May 2023

Objectives:
Ablative electrocautery is effective treating anal high-grade squamous intraepithelial lesions (HSIL). However, persistence or recurrence of the HSIL despite ablative sessions is not uncommon. The aim of this study is to assess the feasibility of topical cidofovir as salvage therapy for the management of refractory HSIL

Design:
A prospective un-controlled unicenter study of men and transgender people who have sex with men with HIV who had a refractory intra-anal HSIL after ablative treatments and who received topical cidofovir (ointment at 1%, auto-applicated, three times a week, a total of 8 weeks) as salvage therapy. Effectiveness was evaluated on-treatment defining response as resolution or regression to low-grade lesion of HSIL in the biopsy post-treatment. Tolerance and recurrences were recorded.

Results:
From 2017 to 2022, 23 patients with refractory intra-anal HSIL (78.3% persistent lesions, 39% affecting > 50% of circumference and a median of 6 previous ablative sessions) were treated with topical cidofovir. A response was observed in 16 of 23 patients (69.5% [95% CI; 50.8–88.4]). Local tolerance was reported as regular or bad in 13 patients (52.2%), requiring modification of the treatment in 8 patients (3 early discontinuation and 5 dose reduction). Non serious side-effects were reported. After a median follow-up of 30.3 months, 2 of the 16 patients with a response developed recurrent HSIL (Recurrence rate, 25.4% at 12 months [95% CI, 0–35]).

Conclusions:
Topical cidofovir could be a good option in the management of anal HSIL due to its good effectiveness, low recurrence rate, and acceptable tolerance even in difficult-to-treat lesions.
Sex differences in incident atherosclerotic cardiovascular disease events among women and men living with HIV
Authors: Wise Jenni M. , Jackson Elizabeth A. , Kempf Mirjam-Colette , Oates Gabriela R. , Wang Zhixin , Overton Edgar T. , Siddiqui Mohammed , Woodward Mark , Rosenson Robert S. , Muntner Paul 
Published: May 2023

Background:
The protective advantage against atherosclerotic cardiovascular disease (ASCVD) experienced by women compared to men in the general population is diminished in some high- risk populations. People living with HIV have a higher risk for ASCVD compared to the general population.

Objective:
Compare the incidence of ASCVD among women versus men living with HIV.

Methods:
We analyzed data from women (n = 17,118) versus men (n = 88,840) with HIV, and women (n = 68,472) and men (n = 355,360) matched on age, sex, and calendar year of enrollment without HIV who had commercial health insurance in the MarketScan database between 2011 and 2019. ASCVD events during follow-up, including myocardial infarction, stroke, and lower- extremity artery disease, were identified using validated claims-based algorithms.

Results:
Among those with and without HIV, the majority of women (81.7%) and men (83.6%) were <55 years old. Over a mean follow-up of 2.25 to 2.36 years depending on sex-HIV sub- group, the ASCVD incidence rate per 1,000 person-years was 2.87 (95%CI 2.35, 3.40) and 3.61 (3.35, 3.88) among women and men living with HIV, respectively, and 1.24 (1.07, 1.42) and
2.57 (2.46, 2.67) among women and men without HIV, respectively. After multivariable adjustment, the hazard ratio for ASCVD comparing women to men was 0.70 (95%CI 0.58, 0.86) among those with HIV and 0.47 (0.40, 0.54) among those without HIV (p-interaction = 0.001).

Conclusion:
The protective advantage of female sex against ASCVD observed in the general population is diminished among women living with HIV. Earlier and more intensive treatment strategies are needed to reduce sex-based disparities.