bluuebunny/crossref_metadata_2025_split huggingface dataset:
81 Juvenile RHUPUS syndrome: a case reports
Authors: Gacem Ourida , Abba Kahina , Tenkout Khaoula , Abbas Salima , Guers Saliha , Chouli Mohamed , Achir Moussa , Ladj Mohamed Samir 
Published: October 2022

Abstract

Background
RHUPUS syndrome is a rare association with rheumatoid arthritis and systemic lupus erythematosus (SLE) in adult patients. Its pediatric presentation is very rare and underdiagnosed. The mechanism is not well understood yet, but most theories accepted a real overlap between SLE and juvenile idiopathic arthritis. In children. Patients with Rhupus have clinical symptoms of SLE with positive ANA, anti-DNA or anti Sm associated with clinical symptoms of JIA.

Objective
Illustrate an unusual presentation of lupus in children

Methods
we present a case of juvenile rhupus syndrome; we describe the clinical presentation, the serological results, the diagnostic criteria for SLE (ACR 1997) and JIA (ILLA 2001) and the treatment installed.

Case reports
We recently diagnosed Rhupus syndrome in an 11-year-old girl who presented with polyarthritis deformans of the bilateral joints of the wrists, hands and feet for 24 months. she also had an onset of profound asthenia, recurrent oral aphtosis and massive hair loss over the past few months. Initial investigation showed anaemia, increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Radiographic examinations showed juxtra-articular osteopenia and chronic synovitis of the wrists. The autoimmune assessment was contributory with a positive rheumatoid factor (RF), antinuclear antibodies (ANA) (1/1000) and positive anti-Sm antibodies. Anticardiolipin and anti-RNP antibodies were negative. Our patient met &gt;4 ACR criteria for SLE classification. She was treated with methotrexate and hydroxychloroquine, under close medical supervision in order to watch for the appearance of other organic damage to lupus disease, in particular renal and neurological. This type of joint damage is considered to be either lupus joint damage, lupus with chronic arthritis, or overlapping lupus with JIA. Children with Rhupus initially present with JIA and later develop lupus. Previous reports have shown female predominance, polyarticular involvement, non-erosive arthritis, and years of diagnostic wandering. Our patient had polyarthritis deformans with a two-year delay in diagnosis of SLE.

Conclusion
Although rare, the infantile Rhupus syndrome must be evoked in front of a deforming arthropathy.
The role of B cells in the pathogenesis of systemic sclerosis: an update
Authors: Sakkas Lazaros I , Katsiari Christina G , Daoussis Dimitrios , Bogdanos Dimitrios P 
Published: October 2022

Abstract
The pathogenesis of SSc is incompletely understood, but several lines of evidence suggest that B cells are involved. Effector B (Beff) cells are hyperactivated and produce autoantibodies (autoAbs), and regulatory B cells (Bregs) are decreased, although a recent study reported a defect in central B cell tolerance. AutoAbs appear before fibrosis, and some have direct profibrotic effects, while others also induce microvasculopathy. Recently, a study found that B cells reactive to topo I with high affinity produce IL-6 and cause fibrosis in mice, whereas B cells with low affinity for topo I produce IL-10 and inhibit fibrosis. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, promoted B cells with low affinity for topo I and decreased fibrosis. These findings provide a rationale for innovative B cell–directed strategies for managing SSc, such as ibrutinib or chimeric antigen receptor T cells, particularly in the early inflammatory stage of the disease.
Similar effect of co-administration of methotrexate and folic acid for the treatment of arthritis compared to separate administration
Authors: Dalix Elisa , Maalouf Mathieu , Peyroche Sylvie , Vanden-Bossche Arnaud , Arthaud Charles-Antoine , Hodin Sophie , Müller Rüdiger B , Marotte Hubert 
Published: October 2022

AbstractObjectivesMTX is the recommended first-line treatment for RA associated with folic acid (FA) to reduce side effects related to MTX. Here, we proposed to test a co-administration of MTX with FA in the rat adjuvant-induced arthritis (AIA) on efficacy.Material and methodsAIA was induced in female Lewis rats and treated with MTX in three groups. The first group of rats received only MTX (n = 13), whereas the second received MTX and FA on the same day (n = 14). The third group received FA one day after MTX (n = 14). Arthritic index (AI), ankle circumference (AC), ankle microcomputed tomography, and blood tests assessed arthritis severity and MTX tolerance.ResultsAI and AC were similar in MTX groups at various time points. Bone erosion and bone loss parameters were similar in all groups. MTX-PG1 was found at similar levels in various MTX groups and correlated negatively with arthritis severity. Finally, haematology and metabolic parameters were found at a similar level in MTX groups.ConclusionCo-administration of MTX with FA on the same day did not reduce efficacy compared with FA application one day after MTX. Thus, co-administration of MTX and FA could be more convenient and improve compliance in patients.
Development of a scoring model for the Sharp/van der Heijde score using convolutional neural networks and its clinical application
Authors: Honda Suguru , Yano Koichiro , Tanaka Eiichi , Ikari Katsunori , Harigai Masayoshi 
Published: October 2022

Abstract

Objectives
To construct a predictive model for the Sharp/van der Heijde score (SHS) and assess its applicability in clinical research settings.

Material and methods
A prediction model for SHS was constructed in three steps using convolutional neural networks (CNN) and an in-house RA image database: orientation, detection and damage prediction. A predictive model for radiographic progression (ΔSHS &gt;3/year) was developed using a graph convolutional network (GCN). A multiple regression model was used to assess the association between predicted SHS using the CNN model and clinical features.

Results
In the orientation and detection phases, 100% accuracy was achieved in the image orientation correction, and all predicted joint coordinates were within 10 pixels of the correct coordinates. In the damage prediction phase, the κ values between the model and expert 1 were 0.879 and 0.865 for erosion and joint space narrowing, respectively. Using a dataset scored by experts 1 and 2, a minimal overfitting was determined to the scoring by expert 1. High-titre RF was an independent risk factor of ΔSHS per year, as predicted by the CNN model in biologics users. The AUCs of the GCN model for predicting ΔSHS &gt;3/year in patients with and without biologics at baseline were 0.753 and 0.734, respectively, superior to those of the other models. The RF titre was the most important feature in predicting ΔSHS &gt;3/year in biologics users in the GCN model.

Conclusion
A high-performance scoring model for SHS that is applicable to clinical research was constructed.
Rapid cycle adaptation of a classroom-based intervention to promote equity in access to youth physical activity
Authors: Hasson Rebecca E , Eisman Andria B , Wassmann Amy , Martin Scott , Pugh Pamela , Winkelseth Kerry , Zernicke Ronald , Rabaut Lisa 
Published: October 2022

AbstractOur objective was to systematically adapt Interrupting Prolonged sitting with ACTivity (InPACT), a classroom-based physical activity intervention, for home delivery to equitably increase access to structured youth physical activity opportunities during the COVID-19 pandemic. Key steps in the rapid-cycle research adaptation process included: (Step 1) identifying partner organizations; (Steps 2 and 3) engaging in problem and knowledge exploration to examine the problem from different perspectives; (Steps 4 and 5) initiating solution development and testing by selecting an intervention and adapting the format and content for home delivery. Using Rapid RE-AIM to guide online assessment and refinement of InPACT at Home; and (Step 6) utilizing dissemination strategies to extend the reach of the program. Core elements of the InPACT program that were retained included: the use of exercise videos, maintenance of the intervention dose, and teacher-led physical activities. Key adaptations included: utilization of physical education specialists to develop the exercise videos, incorporation of health messaging in videos, and utilization of dissemination strategies (intervention website) to reach K-12 students across the state. Intervention website reach included all 83 counties in Michigan, but goals were not met for website pageviews (5,147; 85% of goal) and video view duration (7 min 19 sec; 37% of goal). Accordingly, dissemination was expanded to include public television broadcasting (monthly viewers: 500,000) and videos were shortened to 8 minutes. Dissemination and implementation science frameworks guided the rapid adaptation of an existing intervention, InPACT, to equitably increase access to structured youth physical activity opportunities at home during the pandemic.
Opioid Use Patterns in a Statewide Adult Medicaid Population Undergoing Elective Lumbar Spine Surgery
Authors: Reitman Charles A. , Ward Ralph , Taber David J. , Moran William P. , McCauley Jenna , Basco William T. , Gebregziabher Mulugeta , Lockett Mark , Ball Sarah J. 
Published: October 2022

Study Design.
Retrospective administrative database review

Objective.
Analyze patterns of opioid use in patients undergoing lumbar surgery and determine associated risk factors in a Medicaid population.

Summary of Background Data.
Opioid use in patients undergoing surgery for degenerative lumbar spine conditions is prevalent and impacts outcomes. There is limited information defining the scope of this problem in Medicaid patients.

Methods.
Longitudinal cohort study of adult South Carolina (SC) Medicaid patients undergoing lumbar surgery from 2014-2017. All patients had continuous SC Medicaid coverage for 15 consecutive months, including 6 months prior to and 9 months following surgery. The primary outcome was a longitudinal assessment of post-operative opioid use to determine trajectories and group-based membership using latent modeling. Univariate and multivariable modeling was conducted to assess risk factors for group-based trajectory modeling (GBTM) and chronic opioid use (COU).

Results.
A total of 1,455 surgeries met inclusion criteria. GBTM demonstrated patients fit into 5 groups; very low use (23.4%), rapid wean following surgery (18.8%), increasing use following surgery (12.9%), slow wean following surgery (12.6%) and sustained high use (32.2%). Variables predicting membership in high opioid use included pre-operative opioid use, younger age, longer length of stay, concomitant medications, and readmissions. More than three-quarters of patients were deemed COUs (76.4%). On bivariate analysis, patients with degenerative disc disease (DDD) were more likely to be COUs (24.8% vs. 18.6%; P=0.0168), more likely to take opioids prior to surgery (88.5% vs. 61.9%; P<0.001) and received higher amounts of opioids during the 30-days following surgery (mean MME 59.6 vs. 25.1; P<0.001).

Conclusions.
Most SC Medicaid patients undergoing lumbar elective lumbar spine surgery were using opioids pre-operatively and continued long-term use post-operatively at a higher rate than previously reported databases. Pre-operative and perioperative intake, DDD, multiple prescribers, depression and concomitant medications were significant risk factors.
Genotyping and Cytology Triage of High-Risk HPV DNA Positive Women for Detection of Cervical High-Grade Lesions
Authors: El-Zein Mariam , Bouten Sheila , Abdrabo Lina Sobhi , Siblini Aya , Louvanto Karolina , Franco Eduardo , Ferenczy Alex 
Published: October 2022

Objective
A demonstration project of primary human papillomavirus (HPV) testing was initiated in 2011 among more than 23,000 women attending routine cervical cancer screening. We examined the additional diagnostic performance of HPV genotyping for detecting disease in women with abnormal cytology.

Methods
Women aged 30 to 65 years were originally screened for HPV using Hybrid Capture II test. Women with positive results were triaged using conventional cytology, and those with atypical squamous cells of undetermined significance or worse (≥ASC-US) were referred to colposcopy. We retrospectively genotyped (Roche cobas 4800 HPV system [Roche Molecular Systems Inc, Pleasanton, CA]) cervical specimens that were HPV+ with Hybrid Capture II test and extracted women's medical history postbaseline screening. We calculated positive predictive values (PPVs) and 95% confidence intervals (CIs) of triage tests to detect histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) within the first year of follow-up among women positive for HPV16, HPV18, and HPV16 and/or HPV18 as well as among those negative for HPVs 16 and 18.

Results
Of 1,396 HPV-positive women, 1,092 (78%) were classified as normal, 136 (10%) had CIN1, 80 (6%) had CIN2, 81 (6%) had CIN3, and 7 women had cancer throughout the entire follow-up period. Seventy CIN2+ cases were detected within the first year of follow-up. The PPV for detecting CIN2+ was 20.9% (63/239; 95% CI = 16.4–25.9) for ASC-US+ cytology. In women with ASC-US+, PPVs were 31.2% (24/77; 95% CI = 21.1–42.7) for HPV16+, 27.8% (5/18; 95% CI = 9.7–53.5) for HPV18+, 30.8% (28/91; 95% CI = 21.5–41.3) for HPV16+ and/or HPV18+ women, and 16.6% (35/211; 95% CI = 11.8–22.3) in women testing negative for HPVs 16 and 18.

Conclusion
Partial genotyping as an additional triage strategy to cytology can markedly improve clinical diagnostic performance.
Recurrence in Cervical High-Grade Squamous Intraepithelial Lesion: The Role of the Excised Endocervical Canal Length—Analysis of 2,427 Patients
Authors: Foggiatto Andresa Ines , de Carvalho Newton Sergio , Fonseca Fernanda Villar , Maestri Carlos Afonso 
Published: October 2022

Objective
This study aimed to evaluate the influence of the excised canal length on relapse rates of cervical high-grade squamous intraepithelial lesion (HSIL) treated by loop electrosurgical excision procedure and to find a cut-off point, above which lower recurrence rates could be observed, with low probability of compromising future obstetric outcome, and the relationship with other individual factors related to HSIL recurrence.

Method
This was a retrospective cohort study of 2,427 women diagnosed with cervical intraepithelial neoplasia CIN2+ who underwent cervical conization using the high-frequency loop electrosurgical excision procedure surgery technique, to analyze the role of endocervical canal length associated with individual factors in the recurrent disease after CIN2+ treatment and determine a cut-off point for the excised canal length needed to decrease the risk of disease relapse.

Results
In 2,427 cases, the relapse rate of HSIL treated was 12%. Compromised margins of conization, HIV+, and endocervical canal length were related directly to relapses (p < .001). The cut-off point, by receiver operating characteristic curve, to calculate the endocervical canal length related to relapses was 1.25 cm of canal excised. Canal length of less than 1.25 cm increased the recurrence rate 2.5 times. Compromised margins and HIV+ increased recurrence rates by more than 5 times.

Conclusion
Cervical HSIL recurrence was directly related to the endocervical canal length: excised canal length of 1.25 cm or more decreases recurrence rate; HIV and compromised margins increase the chance of recurrence by more than 5 times.
Vascular stiffening and endothelial dysfunction in atherosclerosis
Authors: Hooglugt Aukie , Klatt Olivia , Huveneers Stephan 
Published: October 2022

Purpose of review
Aging is an important risk factor for cardiovascular disease and is associated with increased vessel wall stiffness. Pathophysiological stiffening, notably in arteries, disturbs the integrity of the vascular endothelium and promotes permeability and transmigration of immune cells, thereby driving the development of atherosclerosis and related vascular diseases. Effective therapeutic strategies for arterial stiffening are still lacking.

Recent findings
Here, we overview the literature on age-related arterial stiffening, from patient-derived data to preclinical in-vivo and in-vitro findings. First, we overview the common techniques that are used to measure stiffness and discuss the observed stiffness values in atherosclerosis and aging. Next, the endothelial response to stiffening and possibilities to attenuate this response are discussed.

Summary
Future research that will define the endothelial contribution to stiffness-related cardiovascular disease may provide new targets for intervention to restore endothelial function in atherosclerosis and complement the use of currently applied lipid-lowering, antihypertensive, and anti-inflammatory drugs.
The Change in the Fibrosis-4 Index for the Assessment of Liver Fibrosis After Pancreaticoduodenectomy
Authors: Tani Masaji , Maehira Hiromitsu , Iida Hiroya , Mori Haruki , Miyake Toru , Nitta Nobuhito 
Published: October 2022

Objectives
Nonalcoholic fatty liver is a complication of pancreaticoduodenectomy (PD); however, liver fibrosis after PD is not well documented. Therefore, we estimated the hepatic fibrotic index of nonalcoholic fatty liver after PD.

Methods
We retrospectively examined the electronic medical records of patients who had underwent PD and had computed tomography (CT) records preoperatively and 6 months postoperatively between 2011 and 2019 at the Shiga University of Medical Science Hospital.

Results
Overall, 115 patients were enrolled. After 6 months from PD, body mass index significantly decreased from 21.90 to 19.57 kg/m2 (−10.6%). The Fibrosis-4 (FIB-4) index significantly increased from 1.756 to 2.384 (P < 0.001). The FIB-4 grade significantly worsened. Contrarily, neither the albumin-bilirubin (ALBI) score nor the ALBI grade demonstrated significant differences. The CT attenuation value significantly decreased (P < 0.001) from 57.6 to 49.5. Multivariate analysis predicted a high preoperative FIB-4 index, high ALBI index, and hypo-CT attenuation value (<30 HU) as risk factors for a high postoperative FIB-4 index.

Conclusions
The FIB-4 index worsened when the follow-up period was only 6 months, regardless of the eternalness in the ALBI score. Liver fibrosis should be assessed using the FIB-4 index for a long-term survivorship after PD.
Recruitment and Retention Strategies for the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study
Authors: Yazici Cemal , Dyer Anne-Marie , Conwell Darwin L. , Afghani Elham , Andersen Dana K. , Basina Marina , Bellin Melena D. , Boone Leslie R. , Casu Anna , Easler Jeffrey J. , Greenbaum Carla J. , Hart Phil A. , Jeon Christie Y. , Lee Peter J. , Meier Shelby , Papachristou Georgios I. , Raja-Khan Nazia T. , Saeed Zeb I. , Serrano Jose , Yadav Dhiraj , Fogel Evan L. ,   on behalf of the Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC)
Published: October 2022

Abstract
Recruitment and retention of patients with acute pancreatitis (AP) in clinical studies can be challenging. While some obstacles are similar to other clinical conditions, some are unique to AP. Identifying potential barriers early and developing targeted solutions can help optimize recruitment and retention in AP studies. Such pre-emptive and detailed planning can help prospective, longitudinal studies focus on exocrine and endocrine complications of AP in accurately measuring outcomes. This article highlights the challenges in recruitment and retention strategies in AP studies and reviews available resources to create opportunities to address them. We describe the multifaceted approach used by the Recruitment and Retention Committee of the Type 1 Diabetes in Acute Pancreatitis Consortium, which builds upon earlier experiences to develop a recruitment and retention plan for the DREAM (Diabetes RElated to Acute pancreatitis and its Mechanisms) study.
Standard Operating Procedures for Biospecimen Collection, Processing, and Storage
Authors: Wasserfall Clive , Dyer Anne-Marie , Speake Cate , Andersen Dana K. , Baab Kendall Thomas , Bellin Melena D. , Broach James R. , Campbell-Thompson Martha , Chinchilli Vernon M. , Lee Peter J. , Park Walter G. , Pratley Richard E. , Saloman Jami L. , Sims Emily K. , Tang Gong , Yadav Dhiraj , Yazici Cemal , Conwell Darwin L. ,   on behalf of the Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC)
Published: October 2022

Abstract
Differences in methods for biospecimen collection, processing, and storage can yield considerable variability and error. Therefore, best practices for standard operating procedures are critical for successful discovery, development, and validation of disease biomarkers. Here, we describe standard operating procedures developed for biospecimen collection during the DREAM (Diabetes RElated to Acute pancreatitis and its Mechanisms) Study within the Type 1 Diabetes in Acute Pancreatitis Consortium. Notably, these protocols were developed using an integrative process based on prior consortium experience and with input from working groups with expertise in immunology, pancreatitis, and diabetes. Publication and adoption consistent biospecimen protocols will inform future studies and allow for better comparisons across different metabolic research efforts.
Rationale and Design for the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study
Authors: Hart Phil A. , Papachristou Georgios I. , Park Walter G. , Dyer Anne-Marie , Chinchilli Vernon M. , Afghani Elham , Akshintala Venkata S. , Andersen Dana K. , Buxbaum James L. , Conwell Darwin L. , Dungan Kathleen M. , Easler Jeffrey J. , Fogel Evan L. , Greenbaum Carla J. , Kalyani Rita R. , Korc Murray , Kozarek Richard , Laughlin Maren R. , Lee Peter J. , Maranki Jennifer L. , Pandol Stephen J. , Phillips Anna Evans , Serrano Jose , Singh Vikesh K. , Speake Cate , Tirkes Temel , Toledo Frederico G.S. , Trikudanathan Guru , Vege Santhi Swaroop , Wang Ming , Yazici Cemal , Zaheer Atif , Forsmark Christopher E. , Bellin Melena D. , Yadav Dhiraj ,   on behalf of the Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC)
Published: October 2022

Abstract
Acute pancreatitis (AP) is a disease characterized by an acute inflammatory phase followed by a convalescent phase. Diabetes mellitus (DM) was historically felt to be a transient phenomenon related to acute inflammation; however, it is increasingly recognized as an important late and chronic complication. There are several challenges that have prevented precisely determining the incidence rate of DM after AP and understanding the underlying mechanisms. The DREAM (Diabetes RElated to Acute Pancreatitis and its Mechanisms) Study is a prospective cohort study designed to address these and other knowledge gaps to provide the evidence needed to screen for, prevent, and treat DM after AP. In the following article, we summarize literature regarding the epidemiology of DM after AP and provide the rationale and an overview of the DREAM study.