bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19-related anxiety trajectories in children, young people and adults with rheumatic diseases
Authors: Shoop-Worrall Stephanie J W , Verstappen Suzanne M M , Costello Wendy , Angevare Saskya P , Uziel Yosef , Wouters Carine , Wulffraat Nico , Beesley Richard 
Published: January 2023

Abstract

Objectives
Uncertainty regarding the risk of coronavirus disease 2019 (COVID-19), its complications and the safety of immunosuppressive therapies may drive anxiety among adults and parents of children and young people (CYP) with rheumatic diseases. This study explored trajectories of COVID-related anxiety in adults and parents of CYP with rheumatic diseases.

Methods
Adults and parents of CYP participating in the international COVID-19 European Patient Registry were included in the current study if they had enrolled in the 4 weeks following 24 March 2020. COVID-related anxiety scores (0–10) were collected weekly for up to 28 weeks.
Group-based trajectory models explored COVID-related anxiety clusters in adult and parent populations, with optimal models chosen based on model fit, parsimony and clinical plausibility. Demographic, clinical and COVID-19 mitigation behaviours were compared between identified clusters using univariable statistics.

Results
In 498 parents of CYP and 2640 adults, four common trajectory groups of COVID-related anxiety were identified in each cohort: persistent extreme anxiety (32% and 17%), persistent high anxiety (43% and 41%), improving high anxiety (25% and 32%) and improving moderate anxiety (11% and 10%), respectively. Few characteristics distinguished the clusters in the parent cohort. Higher and more persistent anxiety clusters in the adult cohort were associated with higher levels of respiratory comorbidities, use of immunosuppressive therapies, older age and greater self-isolation.

Conclusions
COVID-19-related anxiety in the rheumatic disease community was high and persistent during the COVID-19 pandemic, with four common patterns identified. In the adult cohort, higher COVID-related anxiety was related to perceived risk factors for COVID-19 morbidity and mortality.
Assessment of the mode of action underlying development of liver lesions in mice following oral exposure to HFPO-DA and relevance to humans
Authors: Heintz Melissa M , Haws Laurie C , Klaunig James E , Cullen John M , Thompson Chad M 
Published: January 2023

AbstractHFPO-DA (ammonium, 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)propanoate) is a short-chain polyfluorinated alkyl substance (PFAS) used in the manufacture of some types of fluorinated polymers. Like many PFAS, toxicity studies with HFPO-DA indicate the liver is the primary target of toxicity in rodents following oral exposure. Due to the structural diversity of PFAS, the mode of action (MOA) can differ between PFAS for the same target tissue. There is significant evidence for involvement of peroxisome proliferator-activated receptor alpha (PPARα) activation based on molecular and histopathological responses in the liver following HFPO-DA exposure, but other MOAs have also been hypothesized based on limited evidence. The MOA underlying the liver effects in mice exposed to HFPO-DA was assessed in the context of the Key Events (KEs) outlined in the MOA framework for PPARα activator-induced rodent hepatocarcinogenesis. The first 3 KEs (ie, PPARα activation, alteration of cell growth pathways, and perturbation of cell growth/survival) are supported by several lines of evidence from both in vitro and in vivo data available for HFPO-DA. In contrast, alternate MOAs, including cytotoxicity, PPARγ and mitochondrial dysfunction are generally not supported by the scientific literature. HFPO-DA-mediated liver effects in mice are not expected in humans as only KE 1, PPARα activation, is shared across species. PPARα-mediated gene expression in humans produces only a subset (ie, lipid modulating effects) of the responses observed in rodents. As such, the adverse effects observed in rodent livers should not be used as the basis of toxicity values for HFPO-DA for purposes of human health risk assessment.
Immediate Hypersensitivity to Chlorhexidine: Experience from an Allergy Center in China
Authors: Xiao Hao , Zhang Hongting , Jia Qiaoru , Xu Feng , Meng Juan 
Published: January 2023

Background
Chlorhexidine generally has a good safety profile. However, allergic reactions are reported with increasing frequency. In China, it is rarely reported, and its characteristics are unknown. The purpose of this study was to summarize the experience of a Chinese allergy center with chlorhexidine allergy.

Methods
The authors retrospectively reviewed all patients who underwent chlorhexidine allergy testing in the Allergy Center of West China Hospital, Sichuan University (Chengdu, China), in the period February 2018 to May 2022 (n = 43 patients) and included the patients diagnosed with chlorhexidine allergy for analysis.

Results
Ten patients who were diagnosed by skin prick and serum-specific immunoglobulin E tests were included. They experienced a total of 30 allergic reactions to chlorhexidine (mean ± SD, 3.0 ± 1.3). Five patients experienced six allergic reactions (6 of 30, 20%) during general or local anesthesia, and they may have been exposed to chlorhexidine via different routes. Only one allergic reaction (1 of 30, 3%) was recorded with exposure via a mouthwash. The other 23 allergic reactions (23 of 30, 77%) were caused via a skin disinfectant; the route of exposure was IV cannulation in 22 allergic reactions (22 of 23, 96%) and broken skin in one allergic reaction (1 of 23, 4%). The symptoms included a quick onset and great severity. Two patients (2 of 10, 20%) had been accidentally re-exposed to chlorhexidine after diagnosis.

Conclusions
This study conducted in China showed that the majority of reactions to chlorhexidine were attributed to skin disinfectants, and IV cannulation was the most common exposure route; in general, however, chlorhexidine allergy was easily overlooked. The potential allergenicity of chlorhexidine used for skin preparation before IV cannulation or should be considered in patients who develop allergic reactions perioperatively.

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What We Already Know about This Topic

What This Article Tells Us That Is New
Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children With Hearing Aids
Authors: Wiseman Kathryn B. , McCreery Ryan W. , Walker Elizabeth A. 
Published: January 2023

Objectives:
The purpose of this study was to determine if traditional audiologic measures (e.g., pure-tone average, speech recognition) and audibility-based measures predict risk for spoken language delay in children who are hard of hearing (CHH) who use hearing aids (HAs). Audibility-based measures included the Speech Intelligibility Index (SII), HA use, and auditory dosage, a measure of auditory access that weighs each child’s unaided and aided audibility by the average hours of HA use per day. The authors also sought to estimate values of these measures at which CHH would be at greater risk for delayed outcomes compared with a group of children with typical hearing (CTH) matched for age and socioeconomic status, potentially signaling a need to make changes to a child’s hearing technology or intervention plan.

Design:
The authors compared spoken language outcomes of 182 CHH and 78 CTH and evaluated relationships between language and audiologic measures (e.g., aided SII) in CHH using generalized additive models. They used these models to identify values associated with falling below CTH (by > 1.5 SDs from the mean) on language assessments, putting CHH at risk for language delay.

Results:
Risk for language delay was associated with aided speech recognition in noise performance (<59% phonemes correct, 95% confidence interval [55%, 62%]), aided Speech Intelligibility Index (SII < 0.61, 95% confidence internal [.53,.68]), and auditory dosage (dosage < 6.0, 95% confidence internal [5.3, 6.7]) in CHH. The level of speech recognition in quiet, unaided pure-tone average, and unaided SII that placed children at risk for language delay could not be determined due to imprecise estimates with broad confidence intervals.

Conclusions:
Results support using aided SII, aided speech recognition in noise measures, and auditory dosage as tools to facilitate clinical decision-making, such as deciding whether changes to a child’s hearing technology are warranted. Values identified in this article can complement other metrics (e.g., unaided hearing thresholds, aided speech recognition testing, language assessment) when considering changes to intervention, such as adding language supports, making HA adjustments, or referring for cochlear implant candidacy evaluation.
Perspective of SGLT2i in the Treatment of Abdominal Aortic Aneurysms
Authors: Jin Zhongtiao , Deng Hongping , Xiong Sizheng , Gao Ling 
Published: January 2023

Abstract:
The incidence of abdominal aortic aneurysm (AAA) in the elderly is increasing year by year with high mortality. Current treatment is mainly through surgery or endovascular intervention, which is not sufficient to reduce future risk. Therefore, we still need to find an effective conservative measure as an adjunct therapy or early intervention to prevent AAA progression. Traditional therapeutic agents, such as β-receptor blockers, calcium channel blockers, and statins, have been shown to have limited effects on the growth of AAA. Recently, sodium–glucose cotransport proteins inhibitors (SGLT2is), a new class hypoglycemic drug, have shown outstanding beneficiary effects on cardiovascular diseases by plasma volume reduction, vascular tone regulation, and various unidentified mechanisms. It has been demonstrated that SGLT2i is abundantly expressed in the aorta, and some studies also showed promising results of SGLT2i in treating animal AAA models. This article aims to summarize the recent progress of AAA studies and look forward to the application of SGLT2i in AAA treatment for early intervention or adjunct therapy after surgical repair or stent graft.
Unreasonable Expectations: A Call for Training and Educational Transparency in Gender-affirming Surgery
Authors: Boskey Elizabeth R. , Kant Jessica D. 
Published: January 2023

Summary:
Although in most areas of practice, there is a reasonable expectation that doctors are sufficiently trained to offer care, this is not true in the case of gender-affirming procedures, which are not required learning in any surgical residency. At the current time, the field of gender surgery is too rapidly evolving, with available resources too scarce for fellowship or residency training to be a realistic requirement for offering these procedures, as the demand already outstrips the available workforce. However, patients are currently given too little information about surgeons’ history with these procedures to provide truly informed consent. There is, as such, an ethical mandate to mold the culture of gender-affirming surgery such that surgeons are expected to routinely disclose relevant information about their training, experience, and outcomes to facilitate patient decision-making about care.
Investment in Prevention Health Care Delivery Research by the National Institutes of Health
Authors: Ganoza Luis F. , Villani Jennifer , Klabunde Carrie N. 
Published: January 2023

Background:
Research assessing the delivery of preventive health care has considerable potential for improving health outcomes and reducing health care costs for the United States population.

Objective:
To characterize the prevention health care delivery research grant portfolio supported by the National Institutes of Health (NIH).

Materials and Methods:
A random sample of 14,523 NIH research projects funded during 2012–2019 was selected and coded for various study topics using a structured taxonomy. We analyzed the subset of prevention research projects, for which health care delivery was identified as an independent or dependent variable, including study characteristics and funding trends.

Results:
Overall, 11.2% of NIH-funded prevention research projects were relevant to health care delivery. Of these projects, 68.6% assessed access to care, 53.4% examined quality, and 27.1% assessed costs. Over the study period, the percentage of funded prevention research projects involving health care delivery increased from 10.9%–15.1%. Over half of the projects assessed research related to the prevention of a new health condition, identification of risk factors, or health promotion (55.5%), whereas < half addressed prevention of disease progression/recurrence (40.4%), screening for early disease (20.2%), or screening for risk factors (1.4%). human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use were the most prevalent health topics studied, whereas other topics—such as lung diseases and Alzheimer disease—were less frequently studied.

Conclusions:
Health care delivery research comprises a modest portion of the NIH prevention research portfolio and is mostly focused on access and quality of care; cost-related analyses are less prevalent.
human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use are frequently studied health topics in this portfolio.
Point-of-Care Sexually Transmitted Infection Testing Improves HIV Preexposure Prophylaxis Initiation in Pregnant Women in Antenatal Care in Cape Town, South Africa, 2019 to 2021
Authors: de Voux Alex , Mvududu Rufaro , Happel Anna , Jaspan Heather B. , Nyemba Dorothy Chiwoniso , Mashele Nyiko , Myer Landon , Davey Dvora Leah Joseph 
Published: January 2023

A study of HIV-uninfected pregnant women in South Africa found that women offered point-of-care sexually transmitted infection testing had higher odds of initiating HIV preexposure prophylaxis than women offered laboratory-based testing.

Background
Preexposure prophylaxis (PrEP) programs present a platform for diagnostic sexually transmitted infection (STI) testing in low- and middle-income countries, and availability of targeted STI testing has been hypothesized to influence PrEP use. We evaluated the association of STI testing modality and PrEP uptake among pregnant women in antenatal care.

Methods
We enrolled pregnant, HIV-uninfected women (16 years or older) at their first antenatal visit with follow-up through 12 months postpartum. Women were offered oral PrEP and tested for Chlamydia trachomatis and Neisseria gonorrhoeae using a point-of-care (POC; Cepheid, August 2019–November 2020) or laboratory-based (Thermofisher, December 2020–October 2021) test. We compared the proportion of women initiating and continuing PrEP by STI test adjusting for confounders.

Results
We evaluated 1194 women (median age, 26 years [interquartile range, 22–31 years]) with an STI result (46% POC and 54% laboratory-based). The prevalence of any STI was the same in POC-tested (28%) and laboratory-tested (28%) women—25% versus 23% for C. trachomatis (P = 0.35) and 7% versus 9% for N. gonorrhoeae (P = 0.11). Mean time from testing to result was 0 day for POC and 26 days for laboratory testing, and mean time from testing to treatment was 3 days for POC and 38 days for laboratory testing. Receiving a POC STI test was associated with higher PrEP initiation compared with women receiving a laboratory-based test (90% vs. 78%; adjusted odds ratio, 2.1; 95% confidence interval, 1.5–2.9), controlling for age, gravidity, STI diagnosis, intimate partner violence, gestational age, employment, HIV risk perception, and cohabiting status.

Conclusions
Point-of-care STI testing, offering same-day results and treatment initiation, may increase PrEP initiation among pregnant women in antenatal care.
HIV Diagnoses Through Partner Services in the United States in 2019 and Opportunities for Improvement
Authors: Williams Weston O. , Song Wei , Huang Taoying , Mulatu Mesfin S. , Uhl Gary , Rorie Michele 
Published: January 2023

HIV partner services in 2019 resulted in 1214 diagnoses (3.5% of diagnoses in the United States) with 22.7% new positivity among partners without prior diagnosis. Areas for improvement are identified.

Background
HIV partner services (HIV PS) is an effective strategy for diagnosing HIV infection. Sex/needle-sharing partners of individuals diagnosed with HIV are notified about potential exposure and offered HIV testing and other services. We assessed the HIV PS contribution to HIV diagnoses in the United States and assessed priority areas for improvements.

Methods
National HIV Monitoring and Evaluation Partner Services and case surveillance data reported to the Centers for Disease Control and Prevention for 2019 were used for this analysis. The percentage of all new diagnoses that HIV PS programs reported is described nationally and by state. Linkage to HIV medical care among newly diagnosed partners is described. Potential increases in diagnosing HIV infection are assessed by HIV PS step to identify priority areas for improvement.

Results
HIV PS contributed 1214 of 35,164 (3.5%) of all diagnoses nationally in 2019, and contributions ranged from 0% to 31.8% by state. Of partners tested with nonmissing data, 22.7% were newly diagnosed. An estimated 1692 new partner diagnoses were lost during HIV PS steps. Steps resulting in the highest losses included index patients not being interviewed, partners not being tested for HIV, and index patients not being located. Seventy-two percent of partners newly diagnosed with HIV were linked to HIV medical care.

Conclusions
HIV PS is an effective strategy for diagnosing HIV, and a high percent of sex/needle-sharing partners was newly diagnosed with HIV. Expanded HIV PS in some states and targeted improvements in HIV PS steps can enhance the contribution of HIV PS toward achieving national goals.
Extragenital Sexually Transmitted Infection Testing Among Louisiana Parish Health Units, 2016–2019
Authors: Rahman Mohammad M. , Johnson Chaquetta , Taylor Stephanie N. , Peterman Thomas A. , Bennett Tammy S. , Haydel Danielle , Newman Daniel R. , Furness Bruce W. 
Published: January 2023

Background
The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) get tested annually for urethral and rectal chlamydia (CT) and gonorrhea (NG), and pharyngeal NG. There are no national recommendations to screen women and heterosexual men at extragenital sites. We assessed extragenital CT/NG screening among men and women at Louisiana's Parish Health Units (PHU).

Methods
The Louisiana STD/HIV/Hepatitis Program piloted extragenital screening at 4 PHUs in February 2016 and expanded to 11 PHUs in 2017. Sexual histories were used to identify gender of sex partners and exposed sites. Because of billing restrictions, up to 2 anatomical sites were tested for CT/NG.

Results
From February 2016 to June 2019, 70,895 urogenital and extragenital specimens (56,086 urogenital, 13,797 pharyngeal, and 1,012 rectal) were collected from 56,086 patients. Pharyngeal CT positivity was 160 of 7,868 (2.0%) among women, 54 of 4,838 (1.1%) among men who have sex with women (MSW) and 33 of 1,091 (3.0%) among MSM. Rectal CT positivity was 51 of 439 (11.6%) among women and 95 of 573 (16.6%) among MSM. Pharyngeal NG positivity was 299 of 7,868 (3.8%) among women, 222 of 4,838 (4.6%) among MSW, and 97 of 1,091 (8.9%) among MSM. Rectal NG positivity was 20 of 439 (4.6%) among women and 134 of 573 (23.4%) among MSM.
Urogenital-only screening would have missed: among women, 173 of 3,923 (4.4%) CT and 227 of 1,480 (15.3%) NG infections; among MSW, 26 of 2,667 (1%) CT and 149 of 1,709 (8.7%) NG infections; and among MSM, 116 of 336 (34.5%) CT and 127 of 413 (42.1%) NG infections.

Conclusions
Many CT/NG infections would have been missed with urogenital-only screening. Men who have sex with men had much higher extragenital infection rates than women and MSW.
Effect of Electrical Stimulation on Disuse Muscular Atrophy Induced by Immobilization: Correlation with Upregulation of PERK Signal and Parkin-Mediated Mitophagy
Authors: Zhang Quan-Bing , Liu A-Ying , Fang Qiao-Zhou , Wang Feng , Wang Hua , Zhou Yun 
Published: January 2023

ABSTRACT

Objective
To investigate the effect of electrical stimulation on disuse muscular atrophy induced by immobilization, and to explore the role of PERK signal and Parkin-dependent mitophagy in this process.

Design
In the first sub-experiment, 24 rabbits were divided into four groups which underwent different periods of immobilization. In the second sub-experiment, 24 rabbits were divided into four groups on average in accordance with different kinds of interventions. To test the time-dependent changes of rectus femoris after immobilization, and to evaluate the effect of electrical stimulation, the wet weights, CSA and fat deposition of rectus femoris were assessed in this study, along with the protein levels of atrogin-1, p-PERK, Parkin and COXIV.

Results
The wet weights and CSA decreased, and the fat deposition increased in rectus femoris following immobilization, along with the elevated protein levels of atrogin-1, p-PERK, Parkin and decreased protein levels of COXIV. The above histomorphological and molecular changes can be partially ameliorated by electrical stimulation.

Conclusions
Immobilization of unilateral lower limb could induce rectus femoris atrophy which can be partially rectified by electrical stimulation. PERK signal and Parkin-mediated mitophagy may be the mechanisms by which electrical stimulation can play a significant role.
High Lymphocyte Count as a Significant Risk Factor for Incisional Hernia After Laparoscopic Colorectal Surgery
Authors: Tamai Koki , Okamura Shu , Kamakura Yu , Koh Masahiro , Hayashi Koji , Hara Akio , Katsura Yoshiteru , Hirose Hajime , Tanaka Natsumi , Ebisui Chikara , Yokouchi Hideoki , Yano Masahiko 
Published: January 2023

Background:
In the era of laparoscopic surgery, incisional hernia (IH) remains a common complication of colorectal surgery. Various risk factors for IH have been evaluated to reduce the incidence, but the impact of nutrition on IH has not been well discussed. The aim of this study is to evaluate the relationship between nutritional status and the development of IH after laparoscopic colorectal surgery.

Materials and Methods:
We retrospectively evaluated 342 colorectal cancer patients undergoing laparoscopic colectomy or proctectomy between January 2012 and December 2018. Postoperative computed tomography was used to diagnose the IH. Patient characteristics, including preoperative albumin and lymphocyte counts, were evaluated for the risk of development of IH. Further investigations were conducted regarding the impact of nutritional status on the development of IH in each patient of body mass index (BMI) under and over 25.0 kg/m2.

Results:
IH was observed in 37 patients (10.8%), with a median follow-up period of 48.5 months. Female [odds ratio (OR)=3.43, P<0.01], BMI ≥25 kg/m2 (OR=2.9, P<0.01), lymphocyte count ≥1798/µL (OR=3.37, P<0.01), and operative time ≥254 minutes (OR=3.90, P<0.01) had statistically significant relationships to IH in multivariate analysis. Low albumin was related to IH in BMI ≥25 kg/m2 (P=0.02), but was not in BMI<25 kg/m2 (P=0.21). On the other hand, a high lymphocyte count was related to IH regardless of BMI (BMI ≥25 kg/m2: P=0.01, BMI<25 kg/m2: P=0.04).

Conclusions:
A high preoperative lymphocyte count is an independent risk factor for IH, whereas a low albumin count is limited regarding predicting IH.