bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graft-versus-host disease following liver transplantation: A systematic review of literature
Authors: Kneifel Felicia , Vogel Thomas , Bormann Eike , Becker Felix , Houben Philipp , Flammang Isabelle , Slepecka Patrycja , Eichelmann Ann-Kathrin , Brockmann Jens G. , Pascher Andreas 
Published: September 2023

Background:Graft-versus-host disease following liver transplantation is a serious and usually fatal complication. Data identifying the risk factors and specifying the diagnosis and treatment options of the disease are scarce and contentious. Moreover, recommendations for therapeutic approaches are similarly sparse.Methods:A systematic review of the literature from 1988 to 2020 on graft-versus-host disease following liver transplantation was performed using the PubMed and MEDLINE databases. Medical subject headings, such as graft-versus-host disease and GvHD were used in combination with solid organ transplant, transplantation, or liver transplant. Following duplicate removal, 9298 articles were screened for suitability. A total of 238 full-text articles were analyzed for eligibility, resulting in 130 eligible articles for meta-analysis. Two hundred twenty-five patients developing graft-versus-host disease following liver transplantation reported herein were mainly published in case reports and case series.Results:Graft-versus-host disease occurred with an incidence of 1.2%. 85% developed following deceased donor liver transplant and 15% following living-related donor liver transplantation. The median follow-up period following liver transplantation was 84 days (interquartile range, 45–180). The median time from liver transplantation to graft-versus-host disease onset was 30 days (interquartile range, 21–42). The main clinical features included skin rash (59%), fever (43%), diarrhea (36%), and pancytopenia (30%). The overall mortality rate was 71%. Neither univariate (HR = 0.999; 95% CI, 0.493–2.023;p= 1.0) nor multivariate Cox regression analysis revealed a significant correlation between adaptation of immunosuppression and survival probability (HR = 1.475; 95% CI, 0.659–3.303;p= 0.3).Conclusions:This systematic review suggests that an increase in immunosuppressive regimen does not yield any survival benefit in patients suffering from graft-versus-host disease following liver transplantation.
Ashwagandha-induced liver injury—A case series from India and literature review
Authors: Philips Cyriac A. , Valsan Arun , Theruvath Arif H. , Ravindran Resmi , Oommen Tharun T. , Rajesh Sasidharan , Bishnu Saptarshi , Augustine Philip ,   on behalf of The Liver Research Club India
Published: September 2023

Background:
Ashwagandha herb is commonly used in Ayurveda and a “fad” dietary supplement for a host of indications based on low levels of evidence. Recently, ashwagandha was implicated in multiple reports of herb-induced liver injury (HILI), mainly from the United States. We present the first, and currently largest, series of ashwagandha-HILI from multiple centers in India.

Methods:
We retrospectively analyzed the respective institutional electronic medical records for ashwagandha-HILI. Patients consuming ashwagandha as part of multiherbal formulations or along with other known hepatotoxic supplements or medicines were excluded. All patients underwent a detailed diagnostic workup to exclude competing causes reasonably. Where possible, the implicated herbal formulation was retrieved and subjected to chemical analysis.

Results:
Out of 23 patients with liver injury from ashwagandha (January 2019 to December 2022), we report 8 patients with single-ingredient formulation-related HILI. Study cohort was male predominant, and cholestatic hepatitis was the commonest presentation. Five patients had underlying chronic liver disease; 3 presented with acute-on-chronic liver failure, and all 3 died on follow-up. In others, the liver injury was prolonged, nonetheless self-limiting. Liver biopsy revealed cholestatic features predominantly with hepatocellular necrosis and lymphocyte/eosinophil predominant portal-based inflammation. One patient progressed to chronic HILI. Chemical analysis revealed only natural phytochemicals without adulteration or contamination.

Conclusions:
Ashwagandha-HILI presents with cholestatic hepatitis and can lead to the syndrome of acute-on-chronic liver failure with high mortality in those with pre-existing liver disease. Educating the public on avoiding the use of potentially toxic and unrecommended herbal supplements can help mitigate the avoidable liver disease burden in the community.
Envelope antibody HBeIgG and HBV DNA in HBeAg-seronegative young adults in Nigeria
Authors: Olaniyan Mathew Folaranmi , Muhibi Musa Abidemi , Olaniyan Tolulope Busayo , Kanikwu Phoebe Nwamaka 
Published: September 2023

Study background:
Anti-HBe and hepatitis B virus (HBV) DNA are important markers in evaluating HBV infection. Anti-HBe indicates past or current infection that persists after hepatitis B e antigen (HBeAg) clearance. Detecting anti-HBe helps identify cleared or chronic infections. HBV DNA measures viral replication, indicating infection activity. Studying these markers in HBeAg-seronegative young adults provides insights into infection dynamics, immune responses, and transmission risk. It informs clinical management and public health interventions for preventing HBV transmission and reducing the burden of liver disease.

Aim and objectives:
This cross-sectional study aimed to determine the prevalence of HBeAg seronegativity and its association with HBV infection markers among young adults in Etsako, Edo State, Nigeria.

Materials and methods:
The study population consisted of HBeAg-seronegative individuals aged 18 to 30 years. A total of 400 participants (200 females and 200 males) were randomly selected from urban and rural communities using a multistage sampling technique. Anti-HBe and HBeAg were analyzed by ELISA, whereas HBV DNA was evaluated by polymerase chain reaction.

Results:

The prevalence of HBeAg seropositivity was 28%, whereas 72% of participants were seronegative. Among the HBeAg-seronegative participants, the frequencies of anti-HBe and HBV DNA were analyzed based on various categorical variables. The results showed no significant differences in the frequency of anti-HBe and HBV DNA based on occupation, training, or other categorical variables (
P
>0.05). However, there was a significantly higher proportion of males (60%) among the total number of anti-HBe-seropositive young adults compared to females (40%) (
P
<0.05). Additionally, a significantly higher proportion of single/unmarried individuals without children (63.3%) was observed among anti-HBe-seropositive young adults compared to those who were married (25%) and those who were single/unmarried with children (12.5%,
P
<0.05).

Conclusion:
The study findings contribute to the understanding of HBeAg seronegativity and its association with anti-HBe and HBV DNA in young adults in Etsako, Edo State, Nigeria. Further research and public health interventions are warranted to better comprehend the factors influencing HBeAg seronegativity and its association with anti-HBe and HBV DNA and its implications for HBV transmission and disease progression in this population.
Psychometric Analysis of the Health Self-Care Neglect Scale
Authors: Riegel Barbara , Barbaranelli Claudio , Quinn Ryan , Matus Austin , Stawnychy Michael A. , Hirschman Karen B. 
Published: September 2023

ObjectivesThe Health Self-Care Neglect (HSCN) scale is a measure of self-care neglect developed for use in informal caregivers, where self-care is defined as behaviors undertaken to maintain health. There was no formal psychometric analysis of the scale, so we tested a 9-item, dichotomous-response version of the HSCN scale in a sample of 250 informal caregivers of adults with chronic heart failure.MethodsAs the indicators of self-care neglect were considered formative (influencing the latent variable directly) rather than reflective (influenced by the latent variable), we used a procedure for the specification of formative measurement models. First, maximally correlated composites of indicators were identified for the latent variable, and optimal scoring weights were developed. Then, the reflective factor was tested with confirmatory factor analysis, and longitudinal invariance of the factorial structure was tested by introducing model constraints. Reliability was assessed with composite reliability model-based estimates. Concurrent validity was assessed by correlating the HSCN scale total score with the maintenance scale score of the Self-Care Inventory.ResultsStrict invariance, the highest level possible, was achieved. Reliability was 0.81 at baseline. Concurrent validity was demonstrated (r= −0.475,P< .0001).ConclusionThe results of this analysis indicate that the HSCN scale is reliable, stable, and valid as a measure of health self-care neglect when tested in a sample of caregivers. The HSCN scale measures the successful performance of self-care, whereas existing measures of self-care reflect intention. Understanding both intention and behavior is useful, so we recommend using the HSCN scale in addition to existing measures of self-care.
Impact of functional status on 30-day resource utilization and organ system complications following index bariatric surgery: a cohort study
Authors: Holley Z. Logan , Knio Ziyad O. , Pham Long-Quan , Shakoor Unique , Zuo Zhiyi 
Published: September 2023

Background:Bariatric surgical procedures carry an appreciable risk profile despite their elective nature. Identified risk factors for procedural complications are often limited to medical comorbidities. This study assesses the impact of functional status on resource utilization and organ system complications following bariatric surgery.Materials and methods:This retrospective cohort study analyzed patients undergoing elective, index bariatric surgery from American College of Surgeons National Surgical Quality Improvement Program participating hospitals from 2015 to 2019 (n=65627). The primary independent variable was functional status. The primary outcome was unplanned resource utilization. Secondary outcomes included composite organ system complications and mortality. The impact of functional status was first investigated with univariate analyses. Survival and multivariate analyses were then performed on select complications with clinically and statistically significant incidence in the dependent cohort.Results:On univariate analysis, dependent functional status was associated with unplanned resource utilization (12.1% [27/223] vs 4.1% [2661/65404]; relative risk [RR], 2.98 [95% CI, 2.09 to 4.25];P< 0.001) and hematologic/infectious complications (6.7% [15/223] vs 2.4% [1540/65404]; RR, 2.86 [95% CI, 1.75 to 4.67;P< 0.001). Survival analysis demonstrated a significantly shorter time to both events in patients with dependent functional status (P< 0.001). On multivariate analysis, dependent functional status was an independent predictor of unplanned resource utilization (adjusted odds ratio [AOR] 2.17 [95% CI, 1.27 to 3.50];P= 0.003; model c-statistic, 0.572) and hematologic/infectious complications (AOR, 2.20 [95% CI, 1.14 to 3.86];P= 0.011; model c-statistic, 0.579).Conclusion:Patients with dependent functional status are at an elevated risk of unplanned resource utilization and hematologic/infectious complications following index bariatric surgery. The increased risk cannot be explained by medical comorbidities alone.
Is dynamic change in mean platelet volume related with composite endpoint development after transcatheter aortic valve replacement?
Authors: Ince Orhan , Gulsen Kamil , Ozcan Sevgi , Donmez Esra , Ziyrek Murat , Sahin Irfan , Okuyan Ertugrul 
Published: September 2023

Aortic valve stenosis (AS) is the most common valvular disease, and surgical or transcatheter aortic valve replacement (TAVR) are the treatment options. Diminish in platelet production or dysfunction may occur due to shear stress, advanced age, and other coexisting diseases in AS patients. Bleeding is one of the complications of TAVR and associated with increased mortality. MPV (mean platelet volume) indicates platelet's thrombogenic activity. Overproduction or consumption of platelets in various cardiac conditions may affect MPV values. We aimed to investigate the pre and postprocedure MPV percentage change (MPV-PC) and its association with post-TAVR short-term complications.
A total of 204 patients who underwent TAVR with a diagnosis of severe symptomatic AS were included. The mean age was 78.66 ± 6.45 years, and 49.5% of patients were women. Two groups generated according to composite end point (CEP) development: CEP(+) and CEP(-).110 patients(53.9%) formed CEP(+) group.
Although baseline MPV and platelet levels were similar between groups, MPV was increased (P < 0.001) and platelet was decreased (P < 0.001) significantly following the procedure when compared to baseline. MPV-PC was significantly higher in the VARC type 2–4 bleeding (P
= 0.036) and major vascular, access-related, or cardiac structural complication groups (P
= 0.048) when CEP subgroups were analyzed individually. Regression analysis revealed that diabetes mellitus [P
= 0.044, β: 1.806 odds ratio (95% confidence interval): 1.016–3.21] and MPV-PC [P
= 0.007,β: 1.044 odds ratio (95% confidence interval): 1.012–1.077] as independent predictors of CEP development at 1 month after TAVR.
The MPV increase following TAVR may be an indicator of adverse outcomes following TAVR procedure within 1-month.
Brief Report: Changing Characteristics Among In-Hospital HIV Deaths: An 11-Year Retrospective Review of a Regional Hospital in South Africa
Authors: Lombardo Alexandra R. , Materi Joshua , Caturegli Giorgio , Milovanovic Minja , Martinson Neil , Calver Alistair , Nonyane Bareng A.S. , Golub Jonathan , Hoffmann Christopher J. , Variava Ebrahim 
Published: September 2023

Background:
Elevated HIV-associated mortality persists, despite a notable decline with the expansion of antiretroviral therapy (ART). In South Africa, the relative majority of deaths occur in health facilities, providing an opportunity to track decedent characteristics.

Setting:
We analyzed data from 14,870 adult patients who died between 2008 and 2018 at Klerksdorp/Tshepong Hospital Complex in South Africa.

Methods:
Recorded data included demographics, causes of death, HIV status, ART, and tuberculosis (TB) history. We present summary statistics and results from linear, log-binomial, and multinomial regressions to quantify changes over time.

Results:
Over the study period, the median age of decedents with HIV in the hospital increased from 39.3 to 43.4 years, and there was a switch to male predominance (46%–54%). Those who died at a younger age (<40 years) remained more likely to be HIV-positive than the older age group, despite the overall proportion of HIV-positivity decreasing over time. The proportion of decedents with HIV ever started on ART increased from 21% to 67%. The proportion of HIV patients dying from TB and AIDS-defining illnesses decreased from 31% to 22%.

Conclusions:
We noted a shift in deaths over time to more men and older individuals, whereas the burden of HIV was heaviest on the younger age groups. Advanced HIV disease remained an important cause of mortality. We also observed an increase in less-traditional opportunistic illnesses among those with HIV, including malignancy, cardiovascular disease, and kidney disease. The high proportion of patients on ART who died prematurely requires further research and interventions.
Time to Treatment Initiation and HIV Viral Suppression in People Diagnosed With HIV-1 During COVID-19 Pandemic in Ex-Aquitaine, France (ANRS CO3 AQUIVIH-NA Cohort-QuAliCOV Study)
Authors: Ben Farhat Jihane , Hessamfar Mojgan , Farbos Sophie , Desclaux Arnaud , Dumondin Gilles , Ferrand Hélène , Greib Carine , Castan Bernard , Rispal Patrick , Duffau Pierre , Leleux Olivier , Perrier Adélaïde , Wittkop Linda , Bonnet Fabrice , Barger Diana 
Published: September 2023

Objectives:
The COVID-19 pandemic's impact on initiation and effectiveness of antiretroviral therapy (ART) in people diagnosed with HIV remains unclear. We evaluated critical delays in HIV care in people diagnosed before and during the pandemic in ex-Aquitaine, France.

Methods:
We considered adults diagnosed with HIV-1 in 2018–2021 and enrolled in the ANRS CO3 AQUIVIH-NA and followed them until October 10, 2022 for those diagnosed during the pandemic (April 01, 2020–December 31, 2021) and until March 31, 2020 for historical controls. We compared their characteristics at inclusion and the median time between diagnosis and ART initiation, ART initiation and viral suppression, and diagnosis and virologic, suppression (effective management).

Results:
Eighty-three individuals were diagnosed during the pandemic versus 188 during the prepandemic period. Median follow-up was 549 (interquartile range: 329–713) days. Populations were similar in sex, age, HIV acquisition mode, hospital type, and clinical characteristics at diagnosis; however, fewer were foreign-born during the pandemic (15.7% versus 33.5%, P = 0.003). The probability of ART initiation, therapeutic success, and effective management was higher in people living with HIV (PLWH) diagnosed during the pandemic in adjusted analyses (hazard ratio [HR]: 2.0; 95% CI: 1.5 to 2.7; HR: 1.7; 95% CI: 1.2 to 2.3; HR: 1.8; 95% CI: 1.3 to 2.6, respectively). Those diagnosed during the pandemic were 2.3 (95% CI: 1.2 to 4.1) times more likely to be virologically suppressed within six months of diagnosis compared with historical controls.

Conclusions:
Pandemic-related reorganizations may have resulted in newly diagnosed PLWH being prioritized; however, the lower proportion of foreign-born PLWH diagnosed during the pandemic period, likely because of reduced migration and potential delays in diagnosis, may contribute to these preliminary findings.
A machine learning model derived from analysis of time-course gene-expression datasets reveal temporally stable gene markers predictive of sepsis mortality
Authors: Huang Min , Atreya Mihir R. , Holder Andre , Kamaleswaran Rishikesan 
Published: September 2023

AbstractSepsis is associated with significant mortality and morbidity among critically ill patients admitted to intensive care units (ICU) and represents a major health challenge globally. Given the significant clinical and biological heterogeneity among patients and the dynamic nature of the host immune response, identifying those at high risk of poor outcomes remains a critical challenge. Here, we performed secondary analysis of publicly available time-series gene-expression datasets from peripheral blood of patients admitted to the ICU to elucidate temporally stable gene expression markers between sepsis survivors and non-survivors. Using a limited set of genes that were determined to be temporally stable, we derived a dynamical model using a Support Vector Machine (SVM) classifier to accurately predict the mortality of sepsis patients. Our model had robust performance in a test dataset, where patients’ transcriptome was sampled at alternate time points, with an area under the curve (AUC) of 0.89 (95% CI: 0.82-0.96) upon 5-fold cross-validation. We also identified 7 potential biomarkers of sepsis mortality (STAT5A, CX3CR1, LCP1, SNRPG, RPS27L, LSM5, SHCBP1 that require future validation. Pending prospective testing, our model may be used to identify sepsis patients with high risk of mortality accounting for the dynamic nature of the disease and with potential therapeutic implications.
CEBPD REGULATES OXIDATIVE STRESS AND INFLAMMATORY RESPONSES IN HYPERTENSIVE CARDIAC REMODELING
Authors: Zhao Jinghong , Hu Jilin , Zhang Rongyi , Deng Jianping 
Published: September 2023

ABSTRACTHypertension seems to inevitably cause cardiac remodeling, increasing the mortality of patients. This study aimed to explore the molecular mechanism of CCAAT/enhancer-binding protein delta (CEBPD)–mediated oxidative stress and inflammation in hypertensive cardiac remodeling. The hypertensive murine model was established through angiotensin-II injection, and hypertensive mice underwent overexpressed CEBPD vector injection, cardiac function evaluation, and observation of histological changes. The cell model was established by angiotensin-II treatment and transfected with overexpressed CEBPD vector. Cell viability and surface area and oxidative stress (reactive oxygen species/superoxide dismutase/lactate dehydrogenase/malondialdehyde) were assessed, and inflammatory factors (TNF-α/IL-1β/IL-6/IL-10) were determined bothin vivoandin vitro. The levels of CEBPD, miR-96-5p, inositol 1,4,5-trisphosphate receptor 1 (IP3R), natriuretic peptide B, and natriuretic peptide A, collagen I, and collagen III in tissues and cells were determined. The binding relationships of CEBPD/miR-96-5p/IP3R 3′ untranslated region were validated. CEBPD was reduced in cardiac tissue of hypertensive mice, and CEBPD upregulation improved cardiac function and attenuated fibrosis and hypertrophy, along with reductions of reactive oxygen species/lactate dehydrogenase/malondialdehyde/TNF-α/IL-1β/IL-6 and increases in superoxide dismutase/IL-10. CEBPD enriched on the miR-96-5p promoter to promote miR-96-5p expression, whereas CEBPD and miR-96-5p negatively regulated IP3R. miR-96-5p silencing/IP3R overexpression reversed the alleviative role of CEBPD overexpression in hypertensive mice. In summary, CEBPD promoted miR-96-5p to negatively regulate IP3R expression to inhibit oxidative stress and inflammation, thereby alleviating hypertensive cardiac remodeling.
A Phase 2, randomized, double-blind, placebo-controlled multi-center trial sub-study for the clinical effects of paridiprubart treatment in hospitalized critically ill patients with COVID-19 ARDS
Authors: Gordon Blair , Allum Fiona , Brooks Michael , Rajakulendran Nishani , Rampakakis Emmanouil , Sampalis John ,   EB05 Study Investigators
Published: September 2023

ABSTRACTBackgroundCoronavirus disease 2019 (COVID-19) mortality is predominantly due to acute respiratory distress syndrome (ARDS). There are currently limited treatment options for ARDS, a life-threatening condition with different etiologies, secondary to inflammation-induced lung injury. Paridiprubart is a monoclonal antibody that inhibits Toll-like Receptor 4 (TLR4), a key player in ARDS pathophysiology.MethodsThis was a prespecified sub-study of a randomized, double-blind, placebo-controlled, Phase 2 trial evaluating the efficacy and safety of paridiprubart in COVID-19 patients with ARDS receiving invasive mechanical ventilation and additional organ support. Efficacy outcomes were 28- and 60-day all-cause mortality, and improvement in COVID-19 severity and ventilation-free days at 28-days post-treatment.ResultsThirteen (13) and twenty (20) patients received paridiprubart and placebo, respectively. The groups were comparable for demographics and baseline parameters, except for higher kidney failure incidence and use of immune modulators and antivirals, and lower corticosteroids use in the paridiprubart group. Mortality at 28-days post-treatment was 7.7% (1/13) in the paridiprubart group versus 40.0% (8/20) for placebo (OR=0.125; 95% CI, 0.013-1.160; P=0.067; P[bootstrap]=0.011). 60-day mortality was 23.1% (3/13) in paridiprubart-treated patients and 45.0% (9/20) in placebo patients (OR=0.367; 95% CI, 0.077-1.749; P=0.208; P[bootstrap]=0.162). Mean survival time was 55.78 days for paridiprubart recipients compared to 41.44 days for placebo patients (HR=0.386; 95% CI, 0.077-1.436; P=0.156; P[bootstrap]=0.083). Although not statistically significant, results for other efficacy measures favored paridiprubart. Incidence of adverse events was similar in both groups.ConclusionsIn COVID-19 patients with ARDS requiring invasive ventilation and organ support, paridiprubart was efficacious in preventing mortality and improving clinical outcomes, with no safety concerns.