bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemic injury of the upper gastrointestinal tract after out-of-hospital cardiac arrest: a prospective, multicenter study
Authors: Grimaldi D. , Legriel S. , Pichon N. , Colardelle P. , Leblanc S. , Canouï-Poitrine F. , Ben Hadj Salem O. , Muller G. , de Prost N. , Herrmann S. , Marque S. , Baron A. , Sauneuf B. , Messika J. , Dior M. , Creteur J. , Bedos J. P. , Boutin E. , Cariou A. 
Published: March 2022

Abstract
Background
The consequences of cardiac arrest (CA) on the gastro-intestinal tract are poorly understood. We measured the incidence of ischemic injury in the upper gastro-intestinal tract after Out-of-hospital CA (OHCA) and determined the risk factors for and consequences of gastrointestinal ischemic injury according to its severity.

Methods
Prospective, non-controlled, multicenter study in nine ICUs in France and Belgium conducted from November 1, 2014 to November 30, 2018. Included patients underwent an esophago-gastro-duodenoscopy 2 to 4 d after OHCA if still intubated and the presence of ischemic lesions of the upper gastro-intestinal tract was determined by a gastroenterologist. Lesions were a priori defined as severe if there was ulceration or necrosis and moderate if there was mucosal edema or erythema. We compared clinical and cardiac arrest characteristics of three groups of patients (no, moderate, and severe lesions) and identified variables associated with gastrointestinal ischemic injury using multivariate regression analysis. We also compared the outcomes (organ failure during ICU stay and neurological status at hospital discharge) of the three groups of patients.

Results
Among the 214 patients included in the analysis, 121 (57%, 95% CI 50–63%) had an upper gastrointestinal ischemic lesion, most frequently on the fundus. Ischemic lesions were severe in 55/121 (45%) patients. In multivariate regression, higher adrenaline dose during cardiopulmonary resuscitation (OR 1.25 per mg (1.08–1.46)) was independently associated with increased odds of severe upper gastrointestinal ischemic lesions; previous proton pump inhibitor use (OR 0.40 (0.14–1.00)) and serum bicarbonate on day 1 (OR 0.89 (0.81–0.97)) were associated with lower odds of ischemic lesions. Patients with severe lesions had a higher SOFA score during the ICU stay and worse neurological outcome at hospital discharge.

Conclusions
More than half of the patients successfully resuscitated from OHCA had upper gastrointestinal tract ischemic injury. Presence of ischemic lesions was independently associated with the amount of adrenaline used during resuscitation. Patients with severe lesions had higher organ failure scores during the ICU stay and a worse prognosis.
Clinical Trial RegistrationNCT02349074.
OPAL: a randomised, placebo-controlled trial of opioid analgesia for the reduction of pain severity in people with acute spinal pain—a statistical analysis plan
Authors: Jones Caitlin MP , Lin Chung-Wei Christine , Day Richard O. , Koes Bart W. , Latimer Jane , Maher Chris G. , McLachlan Andrew , Billot Laurent 
Published: March 2022

Abstract
Background
Low back and neck pain are a leading cause of disease burden globally. Opioids are recommended in guidelines for acute low back and neck pain; however, there is a lack of compelling efficacy data to support this.

Methods
The OPAL trial is a prospectively registered, triple-blinded, randomised, placebo-controlled trial. Patients with acute (≤12 weeks duration) back and/or neck pain receive guideline care plus either an opioid (oxycodone + naloxone, up to 20 mg per day) or a placebo for up to 6 weeks or earlier, if pain is resolved. The primary outcome is pain measured using the Pain Severity Score of the Brief Pain Inventory with the primary time point being 6 weeks. Secondary outcomes include physical function, time to recovery, quality of life, adverse events and risk of opioid misuse. Outcomes are collected at weeks 2, 4, 6, 12, 26 and 52. Analysis will be done on an intention-to-treat principle. p values of < 0.05 will be considered significant and 95% confidence intervals will be reported. Repeated-measures linear mixed models will be used to assess the effect of the treatment group on the primary outcome and continuous secondary outcomes. Adverse events will be compared between groups using Fisher’s exact test. Cost-effectiveness analyses will be conducted if a treatment effect on pain is seen at week 6. Subgroup analyses will be performed to assess whether pain duration and pain location are treatment effect modifiers.

Discussion
The OPAL trial will provide important evidence about whether a short course of opioids is effective in the treatment of acute non-specific low back and/or neck pain. This pre-specified statistical analysis plan details the methodology for the analysis of the OPAL trial results.

Trial registration
ACTRN12615000775516. The trial has completed recruitment. Follow-up on the last patient will be completed in March 2022.
Differentiated prevention and care to reduce the risk of HIV acquisition and transmission among female sex workers in Zimbabwe: study protocol for the ‘AMETHIST’ cluster randomised trial
Authors: Cowan Frances M. , Machingura Fortunate , Chabata Sungai T. , Ali M. Sanni , Busza Joanna , Steen Richard , Desmond Nicola , Shahmanesh Maryam , Revill Paul , Mpofu Amon , Yekeye Raymond , Mugurungi Owen , Phillips Andrew N. , Hargreaves James R. 
Published: March 2022

AbstractBackgroundFemale sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and are critical to engage in HIV prevention, testing and care services. We describe the design of our evaluation of the ‘AMETHIST’ intervention, nested within a nationally-scaled programme for FSW in Zimbabwe. We hypothesise that the implementation of this intervention will result in a reduction in the risk of HIV transmission within sex work.MethodsThe AMETHIST intervention (Adapted Microplanning to Eliminate Transmission of HIV in Sex Transactions) is a risk-differentiated intervention for FSW, centred around the implementation of microplanning and self-help groups. It is designed to support uptake of, and adherence to, HIV prevention, testing and treatment behaviours among FSW. Twenty-two towns in Zimbabwe were randomised to receive either the Sisters programme (usual care) or the Sisters programme plus AMETHIST. The composite primary outcome is defined as the proportion of all FSW who are at risk of either HIV acquisition (HIV-negative and not fully protected by prevention interventions) or of HIV transmission (HIV-positive, not virally suppressed and not practicing consistent condom use). The outcome will be assessed after 2 years of intervention delivery in a respondent-driven sampling survey (totaln= 4400;n= 200 FSW recruited at each site). Primary analysis will use the ‘RDS-II’ method to estimate cluster summaries and will adapt Hayes and Moulton’s ‘2-step’ method produce adjusted effect estimates. An in-depth process evaluation guided by our project trajectory will be undertaken.DiscussionInnovative pragmatic trials are needed to generate evidence on effectiveness of combination interventions in HIV prevention and treatment in different contexts. We describe the design and analysis of such a study.Trial registrationPan African Clinical Trials RegistryPACTR202007818077777. Registered on 2 July 2020.
SOX combined with intraperitoneal perfusion of docetaxel compared with DOS regimen in the first-line therapy for advanced gastric cancer with malignant ascites: a prospective observation
Authors: Bin Yehong , Lan Dong , Bao Wenguang , Yang Haiyan , Zhou Shengsheng , Huang Fengxiang , Wang Man , Peng Zhigang 
Published: March 2022

Abstract
Objective
This study aimed to verify the survival superiority of the combination of intraperitoneal perfusion and systemic chemotherapy over standard systemic chemotherapy.

Methods
A total of 78 advanced gastric cancer patients with malignant ascites were randomly divided into D-SOX group (intraperitoneal infusion of docetaxel 30 mg/m2 on d1 and d8, intravenous oxaliplatin 100 mg/m2 on d1, and oral administration of S-1 on d1-d14) and DOS group (intravenous docetaxel 60 mg/m2 on d1, intravenous oxaliplatin 100 mg/m2 on d1, and oral administration of S-1 on d1-d14). Efficacy of both groups was evaluated every 2 cycles with 21 days as a cycle. The primary endpoint was overall survival, and the secondary endpoints were objective response rate, ascites control rate, negative conversion rate of ascites cytology, and side effects.

Results
The median overall survival in D-SOX group was significantly higher than that in the DOS group (11.7 vs 10.3 months, HR 0.52, 95%CI 0.31–0.86, P = 0.005). The ascites control rate in the D-SOX group was 58.9% and 30.8% in DOS group (95%CI 42.8–75.1% vs 95%CI 15.6–45.9%, P = 0.012). Besides, the adverse reactions were tolerable in both groups, and patients in the D-SOX group had lower grade 3/4 blood toxicity than that in the DOS group (26% vs 54%, P = 0.01).

Conclusion
Compared with traditional systemic chemotherapy, docetaxel intraperitoneal infusion combined with chemotherapy has better therapeutic effect on gastric cancer ascites, with better survival benefit and tolerance and less hematological toxicity, which is worthy of further research and clinical application.
Ticks and prevalence of tick-borne pathogens from domestic animals in Ghana
Authors: Nimo-Paintsil Shirley C. , Mosore Mba , Addo Seth Offei , Lura Taylor , Tagoe Janice , Ladzekpo Danielle , Addae Charlotte , Bentil Ronald E. , Behene Eric , Dafeamekpor Courage , Asoala Victor , Fox Anne , Watters Chaselynn M. , Koehler Jeffrey W. , Schoepp Randy J. , Arimoto Hanayo , Dadzie Samuel , Letizia Andrew , Diclaro Joseph W. 
Published: March 2022

Abstract
Background
Ticks are important vectors of various pathogenic protozoa, bacteria and viruses that cause serious and life-threatening illnesses in humans and animals worldwide. Estimating tick-borne pathogen prevalence in tick populations is necessary to delineate how geographical differences, environmental variability and host factors influence pathogen prevalence and transmission. This study identified ticks and tick-borne pathogens in samples collected from June 2016 to December 2017 at seven sites within the Coastal, Sudan and Guinea savanna ecological zones of Ghana.

Methods
A total of 2016 ticks were collected from domestic animals including cattle, goats and dogs. Ticks were morphologically identified and analysed for pathogens such as Crimean-Congo haemorrhagic fever virus (CCHFV), Alkhurma haemorrhagic fever virus (AHFV), Rickettsia spp. and Coxiella burnetii using polymerase chain reaction assays (PCR) and sequence analysis.

Results
Seven species were identified, with Amblyomma variegatum (60%) most frequently found, followed by Rhipicephalus sanguineus sensu lato (21%), Rhipicephalus spp. (9%), Hyalomma truncatum (6%), Hyalomma rufipes (3%), Rhipicephalus evertsi (1%) and Rhipicephalus (Boophilus) sp. (0.1%). Out of 912 pools of ticks tested, Rickettsia spp. and Coxiella burnetii DNA was found in 45.6% and 16.7% of pools, respectively, whereas no CCHFV or AHFV RNA were detected. Co-infection of bacterial DNA was identified in 9.6% of tick pools, with no statistical difference among the ecozones studied.

Conclusions
Based on these data, humans and animals in these ecological zones are likely at the highest risk of exposure to rickettsiosis, since ticks infected with Rickettsia spp. displayed the highest rates of infection and co-infection with C. burnetii, compared to other tick-borne pathogens in Ghana.

Graphical Abstract
Taenia multiceps coenurosis: a review
Authors: Varcasia Antonio , Tamponi Claudia , Ahmed Fahad , Cappai Maria Grazia , Porcu Francesca , Mehmood Naunain , Dessì Giorgia , Scala Antonio 
Published: March 2022

AbstractTaenia multicepsis a taeniid cestode that inhabits the small intestines of both wild and domestic carnivores. The larval stage,Coenurus cerebralis, is typically found in the central nervous system (CNS) of a wide range of livestock and, to a lesser extent, in the extra-cerebral tissues of sheep and goats. This review covers all aspects of the life cycle ofT. multicepsand its epidemiology, molecular characterization, pathogenesis, diagnosis, therapy, control and zoonotic potential. Coenurosis caused by the larval stage ofT. multicepshas a worldwide distribution and is often fatal in intermediate hosts, which can result in substantial economic losses in livestock farming. Molecular characterization using the mitochondrial genes cytochrome c oxidase subunit 1 and nicotinamide adenine dinucleotide dehydrogenase subunit 1 of differentT. multicepspopulations has revealed significant genetic variation and the presence of three major haplotypes. The disease mostly affects young sheep and is referred to as either acute or chronic coenurosis. Acute coenurosis occurs as a result of oncospheres migrating through the CNS, while chronic coenurosis occurs as a consequence of the coenurus maturing, which causes displacement and pressure atrophy of brain tissue. Non-cerebral coenurosis has been most commonly reported in goats. The best diagnostic method for cerebral coenurosis involves the interpretation of clinical signs with accurate localization of the cyst using diagnostic imaging techniques. A vaccine based on recombinant oncosphere antigens has proved to be an effective tool againstT. multicepsinfection in sheep. Additionally, use of anthelmintics during the parasite’s migration stages reduces the development of cysts in the sheep brain. Surgery is considered the most effective method for the treatment of cerebral coenurosis in small ruminants, but is often not carried out because of the limited finances of many sheep and goat breeders. However, coenurosis can also be controlled effectively through preventative measures, such as anthelmintic treatment of dogs and the proper disposal of intermediate host carcasses. The parasite is also zoonotic, and cases of coenurosis have been reported in humans with coenuri located in the brain, spinal cord and eyes.Graphical abstract
High zoonotic potential of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in wild nonhuman primates from Yunnan Province, China
Authors: Shu Fanfan , Song Shujiao , Wei Yanting , Li Falei , Guo Yaqiong , Feng Yaoyu , Xiao Lihua , Li Na 
Published: March 2022

Abstract
Background
Cryptosporidium spp., Giardia duodenalis and Enterocytozoon bieneusi are important zoonotic protists in humans and animals around the world, including nonhuman primates (NHPs). However, the prevalence, genetic identity and zoonotic potential of these pathogens in wild NHPs remain largely unclear.

Methods
A total of 348 fecal samples were collected from wild NHPs at four locations in Yunnan, southwestern China, and analyzed for these pathogens using nested PCR targeting various genetic loci and DNA sequence analysis of the PCR products. The zoonotic potential of the pathogens was assessed by comparing the genetic identity of the pathogens in these animals with that previously reported in humans.

Results
Altogether, two (0.6%), 25 (7.2%) and 30 (8.6%) samples were positive for Cryptosporidium sp., G. duodenalis and E. bieneusi, respectively. The Cryptosporidium sp. identified belonged to C. parvum subtype IIdA20G1. Both assemblages A (n = 3) and B (n = 22) were identified among G. duodenalis-positive animals. Five genotypes in zoonotic Group 1 were identified within E. bieneusi, including Type IV (n = 13), D (n = 7), Peru8 (n = 6), MMR86 (n = 2) and HNFS01 (n = 2). All genotypes and subtypes identified are known human pathogens or phylogenetically related to them.

Conclusions
Data from this study suggest a common occurrence of zoonotic genotypes of G. duodenalis and E. bieneusi in wild NHPs in southwestern China.

Graphical Abstract
‘Not at target’: prevalence and consequences of inadequate disease control in systemic lupus erythematosus—a multinational observational cohort study
Authors: Kandane-Rathnayake Rangi , Louthrenoo Worawit , Hoi Alberta , Luo Shue-Fen , Wu Yeong-Jian J. , Chen Yi-Hsing , Cho Jiacai , Lateef Aisha , Hamijoyo Laniyati , Navarra Sandra V. , Zamora Leonid , Sockalingam Sargunan , An Yuan , Li Zhanguo , Katsumata Yasuhiro , Harigai Masayoshi , Hao Yanjie , Zhang Zhuoli , Kikuchi Jun , Takeuchi Tsutomu , Basnayake B. M. D. B. , Chan Madelynn , Ng Kristine Pek Ling , Tugnet Nicola , Kumar Sunil , Oon Shereen , Goldblatt Fiona , O’Neill Sean , Gibson Kathryn A. , Ohkubo Naoaki , Tanaka Yoshiya , Bae Sang-Cheol , Lau Chak Sing , Nikpour Mandana , Golder Vera , Morand Eric F. ,   For the Asia-Pacific Lupus Collaboration
Published: March 2022

Abstract
Background
The unmet need in systemic lupus erythematosus (SLE) with the current standard of care is widely recognised, but few studies have quantified this. The recent definition of treat-to-target endpoints and other thresholds of uncontrolled disease activity provide an opportunity to formally define unmet need in SLE. In this study, we enumerated the prevalence of these states and examined their association with adverse outcomes.

Methods
Data were collected prospectively in a 13-country longitudinal SLE cohort between 2013 and 2019. Unmet need was defined as never attaining lupus low disease activity state (LLDAS), a time-adjusted mean SLEDAI-2K (AMS) > 4, or ever experiencing high disease activity status (HDAS; SLEDAI-2K ≥10). Health-related quality of life (HRQoL) was assessed using SF36 (v2) and damage accrual using the SLICC-ACR SLE Damage Index (SDI).

Results
A total of 3384 SLE patients were followed over 30,313 visits (median [IQR] follow-up 2.4 [0.4, 4.3] years). Eight hundred thirteen patients (24%) never achieved LLDAS. Median AMS was 3.0 [1.4, 4.9]; 34% of patients had AMS > 4. Twenty-five per cent of patients had episodes of HDAS. Each of LLDAS-never, AMS>4, and HDAS-ever was strongly associated with damage accrual, higher glucocorticoid use, and worse HRQoL. Mortality was significantly increased in LLDAS-never (adjusted HR [95% CI] = 4.98 [2.07, 12.0], p<0.001) and HDAS-ever (adjusted hazard ratio (HR) [95% CI] = 5.45 [2.75, 10.8], p<0.001) patients.

Conclusion
Failure to achieve LLDAS, high average disease activity, and episodes of HDAS were prevalent in SLE and were significantly associated with poor outcomes including organ damage, glucocorticoid exposure, poor quality of life, and mortality.
Transcriptional, epigenetic and metabolic signatures in cardiometabolic syndrome defined by extreme phenotypes
Authors: Seyres Denis , Cabassi Alessandra , Lambourne John J. , Burden Frances , Farrow Samantha , McKinney Harriet , Batista Joana , Kempster Carly , Pietzner Maik , Slingsby Oliver , Cao Thong Huy , Quinn Paulene A. , Stefanucci Luca , Sims Matthew C. , Rehnstrom Karola , Adams Claire L. , Frary Amy , Ergüener Bekir , Kreuzhuber Roman , Mocciaro Gabriele , D’Amore Simona , Koulman Albert , Grassi Luigi , Griffin Julian L. , Ng Leong Loke , Park Adrian , Savage David B. , Langenberg Claudia , Bock Christoph , Downes Kate , Wareham Nicholas J. , Allison Michael , Vacca Michele , Kirk Paul D. W. , Frontini Mattia 
Published: March 2022

Abstract
Background
This work is aimed at improving the understanding of cardiometabolic syndrome pathophysiology and its relationship with thrombosis by generating a multi-omic disease signature.

Methods/results
We combined classic plasma biochemistry and plasma biomarkers with the transcriptional and epigenetic characterisation of cell types involved in thrombosis, obtained from two extreme phenotype groups (morbidly obese and lipodystrophy) and lean individuals to identify the molecular mechanisms at play, highlighting patterns of abnormal activation in innate immune phagocytic cells. Our analyses showed that extreme phenotype groups could be distinguished from lean individuals, and from each other, across all data layers. The characterisation of the same obese group, 6 months after bariatric surgery, revealed the loss of the abnormal activation of innate immune cells previously observed. However, rather than reverting to the gene expression landscape of lean individuals, this occurred via the establishment of novel gene expression landscapes. NETosis and its control mechanisms emerge amongst the pathways that show an improvement after surgical intervention.

Conclusions
We showed that the morbidly obese and lipodystrophy groups, despite some differences, shared a common cardiometabolic syndrome signature. We also showed that this could be used to discriminate, amongst the normal population, those individuals with a higher likelihood of presenting with the disease, even when not displaying the classic features.
Liver infarctions as the first manifestation of antiphospholipid antibody syndrome in pregnancy: a case report
Authors: Meloni Claudia , Schreiber Cornelia , Studt Jan-Dirk , Kamm Simone , Di Chiara Manuela , Herren Thomas 
Published: March 2022

Abstract
Background
The differential diagnosis of abdominal pain in pregnant women is broad. Liver diseases as the origin of abdominal pain in pregnancy are rare, and severe forms occur in less than 0.1% of pregnancies. Some disorders, such as hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and preeclampsia, are unique to pregnancy, while others, such as antiphospholipid antibody syndrome, may manifest in pregnancy but have consequences beyond the current pregnancy. All of them require prompt identification and treatment.

Case presentation
A 27-year-old Caucasian woman who was 15+1 weeks pregnant reported to the emergency department twice due to stabbing right-upper-quadrant abdominal pain. Initial laboratory testing revealed mild leukocytosis and slightly elevated liver enzymes. On second presentation, the patient was febrile and had an increased C-reactive protein concentration. Over the course of the next days, nonhemolytic anemia and thrombocytopenia emerged with elevated liver enzymes. Coagulation studies also revealed a prolongation of activated partial thromboplastin time. Magnetic resonance imaging showed nonspecific alterations in the right liver lobe, possibly corresponding to infection or infarction. A hepatic viral infection was ruled out. At that time, the most likely diagnosis was cholangitis with liver abscess formation, and antibiotic therapy was started. Further worsening of the anemia and thrombocytopenia, development of proteinuria, together with a miscarriage on the fourth day of hospitalization resulted in the tentative diagnosis of (triple-positive) antiphospholipid antibody syndrome, which was confirmed 12 weeks after the initial investigation. Treatment consisted of prompt anticoagulation with heparin and later on with a vitamin K antagonist as well as high-dose glucocorticoid therapy. There was no need for intravenous immunoglobulin therapy or plasma exchange, although we suspected a catastrophic form of antiphospholipid antibody syndrome due to infarctions of the liver, placenta, and possibly kidneys (proteinuria). The outcome was favorable.

Conclusion
We report a 27-year-old pregnant woman whose abdominal pain was caused by liver infarctions as the first manifestation of catastrophic antiphospholipid antibody syndrome. The antiphospholipid antibody syndrome was possibly secondary to hitherto clinically silent systemic lupus erythematosus since the antinuclear antibodies were increased later on. Hydroxychloroquine therapy was initiated to prevent antiphospholipid antibody syndrome recurrence in a future pregnancy.