bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial resistance in sexually transmitted Shigella in men who have sex with men: A systematic review
Authors: O’Flanagan Holly , Siddiq Mohammed , Llewellyn Carrie , Richardson Daniel 
Published: February 2023

Background Outbreaks of sexually transmitted Shigella flexneri and Shigella sonnei in men who have sex with men (MSM) are a major public health issue. While most cases can be managed conservatively, a minority require antimicrobial treatment. Recent reports have highlighted increasing antimicrobial resistant (AMR) strains of Shigella spp. in men who have sex with men. We aimed to systematically review antimicrobial resistance (and decreased antimicrobial sensitivity) in sexually transmitted shigella in men who have sex with men, focussing on macrolides, quinolones, and third generation cephalosporins. Methods We systematically searched 4 bibliographical databases (EMBASE, medline, EMCARE and CINAHL) from January 2011 to November 2021. We used a 2-stage process to assess eligibility: the primary author conducted an initial screen and then 3 authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts in English which included men who have sex with men with sexually transmitted shigella where data on antimicrobial resistance was available. Results Thirty-nine manuscripts met the inclusion criteria. A majority of the manuscripts ( N = 34) described reduced susceptibility or antimicrobial resistant to macrolides, quinolones and third generation cephalosporins in circulating strains of shigella within sexual networks of men who have sex with men. Extensively drug resistant outbreaks of shigella in men who have sex with men have been reported containing genetic markers of ceftriaxone resistance (e.g. BlaCTX-M27) where isolates also contained markers of reduced susceptibility, and antimicrobial resistant to macrolides and quinolones. Conclusion There is little role for macrolides, quinolones or third generation cephalosporins in the management of sexually transmitted shigella in men who have sex with men. More research is needed to develop novel strategies for shigella control in men who have sex with men, as antimicrobial options are diminishing.
Comorbidity and Operative Time are Stronger Predictors than Age for Palatoplasty Adverse Airway Events, A NSQIP-P Study of 6668 Cases
Authors: Yu Victor , Pham Jason , Lukomski Lydia , Joseph Jeremy , Guo Yifan 
Published: February 2023

Background Adverse airway events (AAEs) are rare but devastating complications following palatoplasty. The purpose of this study is to evaluate patient risk factors for their effect on these complications. We hypothesize that prolonged operative time and the presence of multiple medical comorbidities are risk factors for AAEs. Design Retrospective cohort study. Setting Participant hospitals in the Pediatric American College of Surgeons National Surgical Quality Improvement Program year 2016–2019. Patients Cases of palatoplasty in children under 3 years of age. Outcomes Adverse airway events including postoperative reintubation or any requirement of postoperative mechanical ventilation. Results A total of 6668 patients met inclusion criteria. The median operative time was 126 min (IQR 82). AAEs were identified in 107 (1.6%) patients. The incidence of risk factors was found to increase with age and AAEs were more prevalent in younger and older patients. Although patients in the older age groups had significantly higher burden of comorbidities, differences in age were not independently associated with AAEs. Following multivariable logistic regressions, operative times greater than 2 h, ASA class ≥3, >3 medical comorbidities, and black race were found to be significant independent risk factors. Conclusions In this large, retrospective database study in palatoplasty, increased operative time, ASA classification ≥3, multiple comorbidities, and black race were independently associated with AAEs.
B-mode ultrasound and colour Doppler findings in cats with gastric lymphoma
Authors: Quinci Manuela , Pey Pascaline , Diana Alessia , De Jesus Antonia , Penninck Dominique 
Published: February 2023

Objectives The purpose of this study was to describe B-mode and colour Doppler ultrasound (US) features of gastric lymphoma in cats. Methods Cats with histopathological or cytological confirmation of gastric lymphoma that underwent abdominal US were included in this retrospective study. Clinical signs were recorded and radiographs reviewed when available. Gastric lesions were ultrasonographically evaluated for location, distribution, wall layering, echogenicity and thickness. Colour Doppler assessment was based on vessels, location and direction. Results Forty-five cats were included. All presented with vomiting, 7/45 (15.5%) with haematemesis. Radiographs were available in 27/45 cases, and demonstrated a gastric mass in 19/27 (70.4%) cases. The most common US appearance was transmural wall thickening with absent layering 42/45 (93.3%) and hypoechogenicity 39/45 (86.7%). Median maximum thickness was 2.1 cm. Ulceration or erosion was suspected in 23/45 (51%) cases, two of which perforated. Colour Doppler images were available in 33/45 cases. The most common Doppler finding was transmural vessels coursing perpendicularly to the lumen in 14/33 (42.4%). Abdominal effusion was uncommon (n = 11/45; 24.4%). Regional lymphadenopathy was frequent, observed in 44/54 lymph nodes reviewed on US, and US suspicion of splenic, hepatic and intestinal lymphomatous infiltration was reported in 24/45 (53.3%) cases. Conclusions and relevance The most common US appearance of gastric lymphoma was transmural hypoechoic segmental wall thickening with layering loss. Location and distribution were variable. Colour Doppler displayed increased blood supply with a predominant pattern of perpendicular vessels, possibly representing aberrant arteries originating from subserosal and submucosal plexus. Lymphomatous infiltration of lymph nodes and other abdominal organs was frequent, confirming local and distant aggressiveness of gastric lymphoma in cats. Vomiting and haematemesis were frequently associated with the suspicion of ulcer on US. Perforation was a rare occurrence.
Validation and updating of the Older Person’s Emergency Risk Assessment (OPERA) score to predict outcomes for hip fracture patients
Authors: Arjan Khushal , Weetman Stefan , Hodgson Luke 
Published: February 2023

Introduction: Hip fractures are associated with significant morbidity and mortality in older people. Accurate risk stratification is important for planning of care, informed decision-making and communication with patients and relatives. The Older Persons’ Emergency Risk Assessment (OPERA) score is a risk stratification score for older people admitted to hospital. Our aims were to validate OPERA in hip fracture patients, update the score and compare performance with the Nottingham Hip Fracture Score (NHFS). Methods: This dual-centre 3-year observational study (2016–2018) included acutely admitted hip fracture patients managed surgically aged ⩾65 years. The primary outcome was 30-day mortality. Secondary outcomes included residence at 120 days and 1-year mortality. Model performance was assessed using area under the curve (AUC) analysis and Brier scores (discrimination) and calibration curves. The OPERA score was updated using regression analysis with additional independent predictors and validated using bootstrap analysis. Results: 2142 patients (median age 86 [80–91] years) were included with a 30-day mortality of 5.2% and a 1-year mortality of 31.4%. 30-day mortality AUC for OPERA was 0.75 (95% CI, 0.73–0.77) and for NHFS 0.68 (0.65–0.70). For 1-year mortality AUC for OPERA was 0.74 (0.73–0.75) and for NHFS 0.70 (0.69–0.71). The OPERA Score was updated to Hip-OPERA, including ASA grade. Hip-OPERA demonstrated an AUC for 30-day mortality of 0.77 (0.73–0.81) and an AUC for 1-year mortality of 0.76 (0.75–0.77). AUC for new residential care status at 120 days was 0.79 (0.78–0.80). Conclusions: Hip-OPERA demonstrated superior discrimination to the NHFS and OPERA for 30-day mortality, 1-year mortality and residence at 120 days following hip fracture. External validation is desirable.
Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F)
Authors: Eldeeb Sherief Y , Ludwig Natasha N , Wieckowski Andrea Trubanova , Dieckhaus Mary FS , Algur Yasemin , Ryan Victoria , Dufek Sarah , Stahmer Aubyn , Robins Diana L 
Published: February 2023

Males are more likely to be diagnosed with autism than females, and at earlier ages, yet few studies examine sex differences in screening. This study explored sex differences in psychometric properties, recommended cutoff scores, and overall scores of the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up. Participants were 28,088 toddlers enrolled in four early detection of autism studies. Children ( N = 731) at high likelihood for autism attended evaluations after screening and/or primary care clinician concern. Females were less likely to screen at high likelihood for autism at each stage of screening and therefore less likely to be invited for evaluations. Positive predictive value was significantly lower among females than males, but sensitivity was similar. False positive females were likely to have another developmental delay. Cutoff scores for males and females matched recommended guidelines. Final scores on the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up did not differ between males and females diagnosed with autism, but did for the overall sample identified at high likelihood for autism. Our findings suggest that females are less likely to be referred for evaluations, but the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identifies both males and females with autism at established cutoffs. Future research should examine methods to reduce false positive in females. Lay abstract This study examined a widely used autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up to identify differences in screening for autism between toddler males and females. Examining sex differences in screening for autism in toddlerhood is important as it determines who will be referred for evaluations and receive diagnoses, which is critical for access to autism-specific early intervention. This study found that females were less likely to screen positive and be invited for evaluations compared with males. Females at high likelihood for autism were less likely to be diagnosed with autism, which decreases confidence in the screener’s results. Importantly, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identified both males and females with autism. Future research should examine ways to improve accuracy in screening results for females.
Stroke Lesion Volume and Injury to Motor Cortex Output Determines Extent of Contralesional Motor Cortex Reorganization
Authors: Buetefisch Cathrin M. , Haut Marc W. , Revill Kate P. , Shaeffer Scott , Edwards Lauren , Barany Deborah A. , Belagaje Samir R. , Nahab Fadi , Shenvi Neeta , Easley Kirk 
Published: February 2023

Background After stroke, increases in contralesional primary motor cortex (M1CL) activity and excitability have been reported. In pre-clinical studies, M1CL reorganization is related to the extent of ipsilesional M1 (M1IL) injury, but this has yet to be tested clinically. Objectives We tested the hypothesis that the extent of damage to the ipsilesional M1 and/or its corticospinal tract (CST) determines the magnitude of M1CL reorganization and its relationship to affected hand function in humans recovering from stroke. Methods Thirty-five participants with a single subacute ischemic stroke affecting M1 or CST and hand paresis underwent MRI scans of the brain to measure lesion volume and CST lesion load. Transcranial magnetic stimulation (TMS) of M1IL was used to determine the presence of an electromyographic response (motor evoked potential (MEP+ and MEP−)). M1CL reorganization was determined by TMS applied to M1CL at increasing intensities. Hand function was quantified with the Jebsen Taylor Hand Function Test. Results The extent of M1CL reorganization was related to greater lesion volume in the MEP− group, but not in the MEP+ group. Greater M1CL reorganization was associated with more impaired hand function in MEP− but not MEP+ participants. Absence of an MEP (MEP−), larger lesion volumes and higher lesion loads in CST, particularly in CST fibers originating in M1 were associated with greater impairment of hand function. Conclusions In the subacute post-stroke period, stroke volume and M1IL output determine the extent of M1CL reorganization and its relationship to affected hand function, consistent with pre-clinical evidence. ClinicalTrials.gov Identifier: NCT02544503
Real-world outcomes of 54-week vedolizumab therapy and response durability after treatment discontinuation in ulcerative colitis: results from a multicenter prospective POLONEZ study
Authors: Eder Piotr , Kłopocka Maria , Cichoż-Lach Halina , Talar-Wojnarowska Renata , Kopertowska-Majchrzak Maria , Michalak Agata , Filip Rafał , Waszak Katarzyna , Stawczyk-Eder Kamila , Janiak Maria , Skrobot Krzysztof , Liebert Ariel , Zatorski Hubert , Solarska-Półchłopek Anna , Krogulecki Michał , Pękała Anna , Poniewierka Elżbieta , Smoła Izabela , Kaczka Aleksandra , Wojciechowski Krzysztof , Drygała Szymon , Zagórowicz Edyta 
Published: February 2023

Background: Vedolizumab is a gut-selective anti-lymphocyte trafficking agent used to treat ulcerative colitis (UC) and Crohn’s disease. Objectives: We aimed to evaluate the effectiveness, safety, and durability of the therapeutic effect of vedolizumab after treatment discontinuation in a real-world cohort of patients with UC treated in Poland. Design: This was a multicenter, prospective study involving patients with moderate to severely active UC from 12 centers in Poland who qualified for reimbursed treatment with vedolizumab between February and November 2019. Methods: The primary endpoints were clinical response (⩾2-point improvement from baseline on partial Mayo score) and clinical remission (partial Mayo score 0–1), including steroid-free remission, at week 54. Other outcomes included response durability at 26 weeks after treatment discontinuation, identification of predictors of response and remission, and safety assessment. Results: In all, 100 patients with UC were enrolled (55 biologic naïve and 45 biologic exposed). At baseline, 68% of patients were on corticosteroids and 45% on immunomodulators. Clinical response was observed in 62% of patients, clinical remission in 50%, and steroid-free remission in 42.6% at week 54. Within 26 weeks after treatment discontinuation, 37% of patients who maintained response by week 54 relapsed. The decreased number of liquid stools and rectal bleeding and endoscopic response at week 14 were predictive factors for response at week 54. Time from diagnosis ranging 2–5 years, decreased stool frequency, and non-concomitant use of corticosteroids at baseline and at week 14 were predictive factors for remission at week 54. Partial Mayo score < 3 with no subscale score > 1 at week 54 was a predictive factor for durable response after treatment discontinuation. The rate of serious adverse events related to treatment was 3.63 per 100 patient-years. Conclusion: Vedolizumab is effective and safe in UC treatment in Polish patients. However, the relapse rate after the treatment cessation was high. Registration: ENCePP (EUPAS34119).
Cinnamaldehyde Induces the Expression of MicroRNA-1285-5p and MicroRNA-140-5p in Chondrocytes to Ameliorate the Apoptosis and Inflammatory Response
Authors: Li Gang , Song Yun 
Published: February 2023

ObjectiveCinnamaldehyde (CA) is an active ingredient of Wenyang Tongluo capsule. This study was performed to investigate the function of CA on human chondrocytes.DesignDifferent doses of CA were used to treat C28/I2 cells, which were stimulated by interleukin-1β (IL-1β), and then the viability and apoptosis of the cells were examined by cell counting kit-8 and flow cytometry. Interleukin-6 (IL-6), interleukin-20 (IL-20), and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay. Quantitative real-time reverse transcriptase polymerase chain reaction was performed to measure miR-1285-5p, miR-140-5p, IL-20, and high-mobility group box 1 (HMGB1) messenger RNA (mRNA) expression. Western blot assay was performed to detect IL-20, HMGB1, IKBα, phospho-IKBα, IKKα/β, and phospho-IKKα/β expression. Moreover, the relationships between miR-1285-5p and IL-20, as well as miR-140-5p and HMGB1, were validated by dual-luciferase reporter assay.ResultsCA promoted the viability and inhibited the apoptosis of C28/I2 cells stimulated by IL-1β and repressed IL-6, IL-20, and TNF-α levels. CA increased miR-1285-5p and miR-140-5p expression levels. MiR-1285-5p and miR-140-5p promoted the viability and inhibited the apoptosis and inflammation of C28/I2 cells. IL-20 was a target gene of miR-1285-5p, and HMGB1 was a target gene of miR-140-5p. Overexpression of IL-20 or HMGB1 could reverse the effect of CA on C28/I2 cells treated with IL-1β. In addition, HMGB1 increased phospho-IKBα and phospho-IKKα/β expression in IL-1β- and CA-treated C28/I2 cells.ConclusionsCA protects chondrocytes via regulating miR-1285-5p/IL-20 axis and miR-140-5p/HMGB1/nuclear factor kappa B pathway.
Evaluating the effect of digital primary care on antibiotic prescription: Evidence using Swedish register data
Authors: Wilkens Jens , Thulesius Hans , Arvidsson Eva , Ekman Björn 
Published: February 2023

Background The growing use of digital primary care consultations has led to concerns about resource use, equity and quality. One of these is how it affects antibiotic prescription. Differences in ease of access for patients and available diagnostic information for the prescribing physicians are reasons to believe prescription rates may be affected. Objectives We estimated differences in antibiotic prescription between traditional office-based and digital contacts, if these differences varied between groups of diagnoses depending on the availability of information for the prescribing physician, and if differences were associated with socio-demographic patient characteristics. Methods Using individual level register data for a sample of patients diagnosed with an infection over a two-year period, we estimated differences in prescription between the two types of contacts and applied propensity score techniques to mitigate possible problems with treatment selection bias. Results The share of antibiotic prescription was 28 (95% CI 27–30, p < 0.001) to 33 (95% CI 29–36, p < 0.001) percentage points lower among digital contacts as compared to office-based contacts. For urinary tract infections, the differences in prescription rates between the two contact types were smaller (34 to 41 percentage points difference) than for throat and skin infections (50 to 60 percentage points difference). For women, rural, older, and people born outside Sweden, digital contacts were associated with higher prescription rates. Conclusions Antibiotic prescription rates were significantly lower for digital contacts compared with office-based contacts. The findings suggest that digital primary care may be an effective alternative to in-person visits without undue consequences for antibiotic prescription levels, although to varying degree depending on diagnosis.
The effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic and hybrid ceramic materials
Authors: Alshali Ruwaida Z , AlQahtani Mohammed A , Bukhary Dalea M , Alzahrani Mlak A , Alsoraihi Shatha S , Alqahtani Majed A 
Published: February 2023

Objective: To assess the effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic materials. Methods: The ceramic materials included IPS e.max CAD (lithium disilicate), VITA ENAMIC (polymer infiltrated ceramic), and Celtra Duo CAD (zirconia reinforced lithium silicate). Samples of each material were randomly divided into four groups ( n = 10); a control group immersed in distilled water, the second and third groups were treated with 20% carbamide peroxide (20% CP) and 35% carbamide peroxide (35% CP) bleaching agents for 4 h/day and 60 min/day respectively for 7 days. The fourth group was treated with 40% hydrogen peroxide (40% HP) applied twice, each turn for 20 min. After treatment, the surface roughness (using 3D non-contact profilometry) and surface gloss were assessed followed by imaging with a scanning electron microscope. The data were analyzed using multiple linear regression and Kruskal-Wallis one-way ANOVA tests (α = 0.05). Results: The surface roughness ( p = 0.157) and gloss ( p = 0.073) of IPS e.max CAD were not significantly affected by the different bleaching treatments. Similarly, no significant effect on surface roughness ( p = 0.162) and gloss ( p = 0.965) were shown for Celtra Duo CAD. On the other hand, VITA ENAMIC was significantly affected when treated with 20% CP and 35% CP showing increased roughness ( p = 0.001) and gloss ( p = 0.008). Conclusions: Home bleaching treatments (20% CP and 35% CP) significantly affected the surface roughness and gloss of VITA ENAMIC while IPS e.max CAD and Celtra Duo CAD were not affected by the different bleaching treatments.
Total Talar Replacement for Idiopathic Osteonecrosis of the Talus: Investigation of Clinical Outcomes, Pain, ADL, QOL
Authors: Ouchi Kazuo , Oi Naoyuki , Yabuki Shyoji , Konno Shin-ichi 
Published: February 2023

Background: Treatment of osteonecrosis of the talus is challenging. Nonoperative management includes nonweightbearing treatment. Various types of hindfoot fusion procedures have been performed, but delayed union and shortening of the operated leg have reportedly occurred. In contrast, talar body prosthesis is a surgical procedure with potential that relieves pain, restores ankle joint function, and is not associated with leg-length discrepancy. The aim of this study was to investigate postoperative pain, clinical outcomes, activities of daily living (ADL), and quality of life (QOL) after total talar replacement in patients with osteonecrosis of the talus. Methods: Ten ankles in 10 patients with idiopathic osteonecrosis of the talus who were treated with a total talar replacement between 2007 and 2015 were included in the investigation. Scores according to the visual analog scale (VAS), Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, Functional Independence Measure (FIM), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) were assessed. Results: The VAS score significantly improved from a mean of 80 ± 8 points before surgery to 18 ± 22 points after surgery ( P  < .01). The JSSF ankle-hindfoot scale score significantly improved from a mean of 53 ± 12 points before surgery to 89 ± 7 points after surgery ( P  < .01). The FIM score significantly improved from a mean of 122 ± 1 points before surgery to 125 ± 1 points after surgery ( P  < .01). The mean postoperative SAFE-Q scores were as follows: 81 ± 10.3 points for pain, 78 ± 14.7 points for physical function, 90 ± 12.4 points for social function, and 83 ± 15.4 points for shoe-related. Conclusion: Total talar replacement is a useful treatment for patients with osteonecrosis of the talus. This replacement surgery preserves the function of the ankle and subtalar joints, and improves pain, ADL, and QOL. Level of Evidence: Level IV, case series.