bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Bolus Transit Time on Barium Esophagram With Esophageal Peristalsis on High-resolution Manometry and Nonobstructive Dysphagia
Authors: Razia Deepika , Trahan Amy , Hu Chengcheng , Giulini Luca , Bremner Ross M. , Mittal Sumeet K. 
Published: January 2022

Goal:
The goal of this study was to correlate upright and prone bolus transit time (BTT) on barium esophagography (BE) with esophageal peristalsis on high-resolution manometry (HRM) and self-reported dysphagia in patients with normal lower esophageal sphincter parameters on HRM.

Background:
BTT on BE could be the gold standard for assessing the effectiveness of esophageal peristalsis if it can be quantified.

Materials and Methods:
Patients with normal lower esophageal sphincter parameters and standard-protocol BE from 2017 to 2020 were included. Patients were divided, based on the number of normal swallows (distal contractile integral >450 mm Hg-s-cm), into 11 groups (10 normal swallows to 0 normal swallows). Liquid barium swallows in prone position were objectively evaluated for prone BTT. Patients reported difficulty in swallowing on a scale from 0 (none) to 4 (very severe). Fractional polynomial and logistic regression analysis were used to study the association (along with the rate of change) between BTT, peristalsis, and dysphagia.

Results:
A total of 146 patients were included. Prone BTT increased as the number of normal swallows decreased (P<0.001). Two deflection points were noted on the association between peristalsis and prone BTT at 50% normal swallows, 40 seconds and 30% normal swallows, 80 seconds, after which peristaltic function declined independently of prone BTT. Patients with prone BTT>40 seconds had nearly 6-fold higher odds of 0% normal swallows on HRM than patients with prone BTT<40 seconds (P=0.002). Increasing prone BTT was associated with increasing dysphagia grades 1 and 2 (P≤0.036).

Conclusions:
Esophageal motility can be quantified by BE. Prone BTT correlates with the proportion of normal esophageal swallows and dysphagia.
Derivation and Validation of a Model to Predict Clinically Significant Portal Hypertension Using Transient Elastography and FIB-4
Authors: Banini Bubu A. , Patel Samarth , Yu Jonathan W. , Kang Le , Bailey Christopher , Strife Brian J. , Siddiqui Mohammad S. , Patel Vaishali , Matherly Scott C. , Lee Hannah , Lewis Shawn , Cherian Reena , Stravitz Richard T. , Luketic Velimir , Sanyal Arun J. , Sterling Richard K. 
Published: January 2022

Background:
Liver biopsy and hepatic venous pressure gradient (HVPG), the gold standard for assessing advanced fibrosis (AF) and clinically significant portal hypertension (CSPH), are invasive, costly, and time-consuming.

Goal:
We investigated if the combination of fibrosis index based on 4 factors (FIB-4) and liver stiffness measure (LSM) can identify AF and more importantly, CSPH.

Patients and Methods:
Patients with chronic liver disease referred for transjugular liver biopsy were analyzed retrospectively. FIB-4 and LSM were compared with liver histology for diagnosing AF. FIB-4, LSM, and platelet count were compared with HVPG for diagnosing CSPH. Optimal cutoffs for predicting CSPH were determined by grid search. A composite log-odds to predict CSPH was derived from logistic regression using LSM, FIB-4, and gender. Internal bootstrap validation and external validation were performed.

Results:
A total of 142 patients were included in the derivation; 42.3% had AF, and 11.3% had CSPH using the current gold standards. The area under the receiver operating characteristic curve (AUROC) for LSM, FIB-4, and their combination to predict AF were 0.7550, 0.7049, and 0.7768, respectively. LSM, FIB-4, and platelet count predicted CSPH with AUROC 0.6818, 0.7532, and 0.7240, respectively. LSM plus FIB-4 showed the best performance in predicting CSPH with AUROC 0.8155. Based on LSM, FIB-4, and gender, a novel model—the Portal Hypertension Assessment Tool (PHAT)—was developed to predict CSPH. PHAT score ≥−2.76 predicted CSPH with sensitivity 94%, specificity 67%, positive predictive value 27%, negative predictive value 99%, and accuracy 70%. In internal and external validation, AUROCs for the model were 0.8293 and 0.7899, respectively.

Conclusion:
A model consisting of FIB-4, LSM, and gender can identify CSPH among patients with chronic liver disease.
Increasing Prevalence and Racial Disparity of Alcohol-Related Gastrointestinal and Liver Disease During the COVID-19 Pandemic
Authors: Damjanovska Sofi , Karb Daniel B. , Cohen Stanley M. 
Published: January 2022

Objectives:
One consequence of social distancing during the coronavirus disease 2019 (COVID-19) pandemic was an increase in alcohol use disorders. We postulated that this would be associated with a rise in alcohol-related gastrointestinal and liver disease.

Methods:
Using Explorys Inc., an aggregate of electronic health records from US health care systems from 1999 to June 2021, we identified patients with “alcoholic hepatitis,” “inflammation of pancreas caused by alcohol,” and “alcoholic gastritis,” based on Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT). We compared patients utilizing health care during the pandemic to those before it.

Results:
We identified 8,445,720 patients treated from June 21, 2020 to June 20, 2021 (“COVID cohort”) and 65,587,860 patients treated before this (“pre-COVID cohort”). African American patients were more likely to be treated for all causes during COVID-19 [odds ratio (OR): 1.65; P<0.0001]. Alcoholic hepatitis (OR: 2.77), alcoholic pancreatitis (OR: 3.67), and alcoholic gastritis (OR: 1.70) (for each, P<0.0001) were more likely in all patients in the COVID cohort. African Americans in the COVID cohort were more likely to be diagnosed with alcoholic hepatitis (OR: 2.63), alcoholic pancreatitis (OR: 2.17), and alcoholic gastritis (OR: 3.09) [for each, P<0.0001].

Conclusions:
The prevalence of alcohol-related liver and gastrointestinal disease increased during COVID-19. We suspect these increases are associated with increased alcohol use disorder resulting from the stress of social isolation. These data suggest COVID-19 disproportionately affected African Americans in overall health care utilization and increased burden of alcoholic gastrointestinal and liver disease.
A Radio-Odontometric Analysis of Sexual Dimorphism in First Molars Using Cone-Beam Computed Tomography
Authors: Paknahad Maryam , Dokohaki Sonia , Khojastepour Leila , Shahidi Shoaleh , Haghnegahdar Abdolaziz 
Published: January 2022

Objective
Different techniques for sex prediction are developed and used in the forensic medicine field. One of these methods is based on the teeth morphometry. The aim of the present study was to evaluate the degree of sex determination of the maxillary and mandibular first molar teeth in cone beam computed tomography images.

Method and Materials
This study was carried out on cone beam computed tomography images of 100 men and 100 women with a mean age of 21.28 ± 2.47 years. The roof, floor and height of pulp chamber, as well as marginal enamel thickness and dentin thickness at the height of contour, tooth width, and crown length were measured. Student t test and discriminant analysis were applied to assess the differences in the measured parameters between men and women.

Results
According to the present study, the maxillary first molar was more dimorphic than the mandibular teeth. The accuracy of sex identification of mandibular and maxillary first molar tooth was 84% and 77%, respectively. The mesiodistal measured variables were more accurate in sexual differentiation than the buccolingual ones. For sex differentiation, the most dominant variables for maxillary and mandibular first molar teeth were crown height and dentin thickness, respectively.

Conclusions
The first molar tooth showed an acceptable level of sex determination accuracy based on the odontometric measurements.
Fatigue is associated with worse cognitive and everyday functioning in older persons with HIV
Authors: Campbell Laura M. , Sun-Suslow Ni , Heaton Anne , Heaton Robert K. , Ellis Ronald J. , Moore David J. , Moore Raeanne C. 
Published: January 2022

Objective:
The aim of this study was to determine whether there are relationships between fatigue, cognition, and everyday functioning in older persons with and without HIV and to examine if associations remain after accounting for depression, anxiety, and sleep quality.

Methods:
Sixty-nine persons with HIV (PWH) and 36 persons without HIV, aged 50–74 years, were recruited from ongoing studies at UC San Diego's HIV Neurobehavioral Research Program and from the community. Participants completed neuropsychological testing, a performance-based measure of everyday functioning, and self-report questionnaires of fatigue, depression, anxiety, sleep quality, and everyday functioning. Multivariable linear regressions and logistic regressions stratified by HIV serostatus were used to examine relationships between fatigue, cognition, and everyday functioning. Psychiatric symptoms and sleep quality were examined as covariates.

Results:
In this cross-sectional study, PWH had significantly greater fatigue than the HIV-negative group (g
= 0.83; P < 0.01). When stratifying by HIV serostatus, greater fatigue was significantly associated with worse global cognition (β = −0.56;P < 0.01) in PWH even when controlling for covariates;however, fatigue was not significantly associated with global cognition in persons without HIV. In PWH and when accounting for covariates, fatigue was also associated with greater risk of self-reported everyday functioning impairment [odds ratio (OR) = 1.66 for 10-point increase in fatigue, P
= 0.04] but not performance-based everyday functioning (P = 0.95).

Conclusion:
Fatigue is associated with cognition, particularly measures with a speeded component, and self-reported everyday functioning in older PWH. Findings suggest that fatigue is important to assess and consider in the context of aging with HIV.
Curable sexually transmitted infections among women with HIV in sub-Saharan Africa
Authors: Jarolimova Jana , Platt Laura R. , Curtis Megan R. , Philpotts Lisa L. , Bekker Linda-Gail , Morroni Chelsea , Shahmanesh Maryam , Mussa Aamirah , Barracks Khallela , Ciaranello Andrea L. , Parker Robert A. , Bassett Ingrid V. , Dugdale Caitlin M. 
Published: January 2022

Objectives:
Sexually transmitted infections (STIs) cause significant morbidity among women with HIV and increase HIV transmission. We estimated the prevalence of four STIs among women with HIV in sub-Saharan Africa (SSA) and compared prevalence among women with and without HIV.

Design:
Systematic review and meta-analysis.

Methods:
We searched for studies published 1 January 1999 to 19 December 2019 reporting prevalence of gonorrhea, chlamydia, trichomoniasis, or Mycoplasma genitalium among women with HIV in SSA. We excluded studies conducted in high-risk groups (e.g. female sex workers). We extracted data on laboratory-confirmed STIs among women with HIV, and when included, among women without HIV. We estimated pooled prevalence for each STI among women with HIV using inverse variance heterogeneity meta-analysis, compared prevalence to women without HIV, and examined the influences of region, clinical setting, and pregnancy status in subgroup analyses.

Results:
We identified 3756 unique records; 67 studies were included in the meta-analysis. Prevalence of gonorrhea, chlamydia, trichomoniasis, and M. genitalium was 3.5, 4, 15.6, and 10.2%, respectively. Chlamydia prevalence was lower in Eastern (2.8%) than in Southern (12.5%) and West/Central (19.1%) Africa combined. Prevalence of chlamydia and trichomoniasis was higher among pregnant (8.1%, 17.6%) than nonpregnant (1.7%, 12.3%) women. All STIs were more prevalent among women with than without HIV (relative risks ranging 1.54–1.89).

Conclusion:
STIs are common among women with HIV in SSA, and more common among women with than without HIV. Integrated STI and HIV care could substantially impact STI burden among women with HIV, with potential downstream impacts on HIV transmission.
Comparison of T2 Quantification Strategies in the Abdominal-Pelvic Region for Clinical Use
Authors: Draveny Robin , Ambarki Khalid , Han Fei , Hilbert Tom , Laurent Valérie , Morel Olivier , Bertholdt Charline , Beaumont Marine 
Published: January 2022

Objectives
The aim of the study was to compare different magnetic resonance imaging (MRI) acquisition strategies appropriate for T2 quantification in the abdominal-pelvic area. The different techniques targeted in the study were chosen according to 2 main considerations: performing T2 measurement in an acceptable time for clinical use and preventing/correcting respiratory motion.

Materials and Methods
Acquisitions were performed at 3 T. To select sequences for in vivo measurements, a phantom experiment was conducted, for which the T2 values obtained with the different techniques of interest were compared with the criterion standard (single-echo SE sequence, multiple acquisitions with varying echo time). Repeatability and temporal reproducibility studies for the different techniques were also conducted on the phantom. Finally, an in vivo study was conducted on 12 volunteers to compare the techniques that offer acceptable acquisition time for clinical use and either address or correct respiratory motion.

Results
For the phantom study, the DESS and T2-preparation techniques presented the lowest precision (ρ
2 = 0.9504 and ρ
2 = 0.9849 respectively), and showed a poor repeatability/reproducibility compared with the other techniques. The strategy relying on SE-EPI showed the best precision and accuracy (ρ
2 = 0.9994 and Cb
= 0.9995). GRAPPATINI exhibited a very good precision (ρ
2 = 0.9984). For the technique relying on radial TSE, the precision was not as good as GRAPPATINI (ρ
2 = 0.9872). The in vivo study demonstrated good respiratory motion management for all of the selected techniques. It also showed that T2 estimate ranges were different from one method to another. For GRAPPATINI and radial TSE techniques, there were significant differences between all the different types of organs of interest.

Conclusions
To perform T2 measurement in the abdominal-pelvic region, one should favor a technique with acceptable acquisition time for clinical use, with proper respiratory motion management, with good repeatability, reproducibility, and precision. In this study, the techniques relying respectively on SE-EPI, radial TSE, and GRAPPATINI appeared as good candidates.
Customized and Navigated Primary Orbital Fracture Reconstruction: Computerized Operation Neuronavigated Surgery Orbital Recent Trauma (CONSORT) Protocol
Authors: Consorti Giuseppe , Betti Enrico , Catarzi Lisa 
Published: January 2022

Abstract
Combined orbital medial wall and floor fractures and large isolated orbital floor fractures commonly require surgical treatment due to the high probability of diplopia and enophthal-mos. Primary reconstruction of these orbital fractures requires a high-level surgeon with a great amount of technical surgical skill. The use of novel technology can greatly improve the accuracy of reconstruction and achieve satisfactory clinical outcomes. Hence, the authors aimed to present our findings and overall experience with respect to extensive floor and medial wall orbital fracture reconstruction according to the Computerized Operation Neuronavigated Surgery Orbital Recent Trauma (CONSORT) protocol, a workflow designed for the primary reconstruction of orbital fractures with customized mesh and intraoperative navigation. A total of 25 consecutively presenting patients presenting with unilateral extensive orbital floor fractures and orbital floor and medial wall fractures were treated following the CONSORT workflow from January 2017 to March 2020. Fractures were surgically treated with a customized implant and intraoperative navigation. Patients underwent surgery within 14 days of the trauma injury. Preopera-tive and postoperative functional and aesthetic outcomes are described herein. All fractures were successfully reconstructed. Postoperatively, all 19 patients with preoperative diplopia reported the resolution of diplopia. Enophthalmos resolved in 18/20 cases. No patients had major complications during follow-up. Thus, the authors conclude that the CONSORT protocol introduced by the authors is an adaptable and reliable workflow for the early treatment of orbital fractures and can clearly optimize functional and aesthetic outcomes, reduce costs and intensive time commitments, and make customized and navigated surgery more available for institutions.
Determinants of Immune Response to Anti–SARS-CoV-2 mRNA Vaccines in Kidney Transplant Recipients: A Prospective Cohort Study
Authors: Magicova Maria , Zahradka Ivan , Fialova Martina , Neskudla Tomas , Gurka Jiri , Modos Istvan , Hojny Michal , Raska Petr , Smejkal Petr , Striz Ilja , Viklicky Ondrej 
Published: January 2022

Background.
Immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has been recently shown to be impaired in kidney transplant recipients (KTRs), but the underlying factors affecting vaccine effectiveness need to be further elucidated.

Methods.
In this prospective cohort study, antibodies against S1 and S2 subunits of SARS-CoV-2 were evaluated using an immunochemiluminescent assay (cutoff 9.5 AU/mL, sensitivity 91.2%, and specificity 90.2%) in 736 KTRs, who were previously either naive or infected with SARS-CoV-2 and vaccinated before or after transplantation. Cellular response was analyzed in a subset of patients using an interferon gamma release assay (cutoff 0.15 IU/mL, sensitivity 92%, and specificity 100%).

Results.
Seroconversion was significantly more impaired in SARS-CoV-2–naive KTRs than in those previously infected (40.1% versus 97.1%; P < 0.001). Mycophenolate use (odds ratio, 0.15; 95% confidence interval, 0.09-0.24; P < 0.001) and depleting therapy in the past year (odds ratio, 0.19; 95% confidence interval, 0.05-0.8; P = 0.023) were found to be among independent factors associated with impaired humoral response. Similarly, the interferon gamma release assay tested in 50 KTRs (cutoff 0.15 IU/mL, sensitivity 92%, specificity 100%) showed that specific T-cell responses against spike protein epitopes are impaired in SARS-CoV-2–naive KTRs, as compared to previously infected KTRs (9.4% versus 90%, P < 0.001). All 35 KTRs vaccinated on the waiting list before transplantation exhibited sustained seroconversion persisting after transplantation.

Conclusions.
Survivors of coronavirus disease 2019 and those vaccinated while on the waiting list exhibited a marked immune response to mRNA vaccines, contrary to poor response in naive KTRs vaccinated after transplantation (NCT04832841).
Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India
Authors: Hema V. K. , Kumar Karthik , Shah Virna M. 
Published: January 2022

Background:
Coronavirus disease 2019 (COVID-19) has a vast array of presentations and associations with neuro-ophthalmic diseases. There has been a recent surge in ophthalmic manifestations secondary to fungal sinus infections in India especially in diabetic patients who were given systemic steroids. We present our COVID-19–related cranial neuropathies presenting in our clinic.

Methods:
This is a retrospective case series of 10 patients affected with COVID-19 disease and who presented with cranial nerve palsies at the neuro-ophthalmic department of a tertiary eye care hospital in South India. An analysis of electronic medical records data was performed, including their comorbidities, symptoms, cranial nerves involved, ocular and neuroimaging findings, site of lesion, etiology, and prognosis.

Results:
Most of the patients (7 of 10) presented with multiple cranial nerve palsies (MCNP) with poor visual acuity. 2 of the 10 cases succumbed to death due to the intracranial involvement. All MCNP cases had uncontrolled diabetes with a history of systemic steroids, and neuroimaging of these cases showed sinusitis of varying severity most of which were suggestive of fungal invasive type.

Conclusion:
Our study emphasizes the need to screen for fungal involvement in COVID-19 cases presenting with MCNP especially on diabetic patients on systemic steroids so that an early diagnosis may reduce visual loss and mortality. Physicians treating COVID-19 cases need to be aware of this dreadful complication.
Clinical Neurophysiology of Zika Virus–Related Disorders of the Peripheral Nervous System in Adults
Authors: González-Salazar Carelis , Tartaglia Jordana Sartori , Teixeira Dourado Mario Emilio , França Marcondes C. 
Published: January 2022

Summary:
During the 2013 to 2016 outbreak in the Pacific and Americas, Zika virus infection resulted not only in febrile and cutaneous manifestations but also in (severe) neurologic complications. These included both central and peripheral nervous system disorders. The most frequent was Guillain–Barré syndrome that typically developed 1 to 2 weeks after the acute infection. Later, other peripheral nervous system syndromes were recognized in association with the viral infection, broadening the spectrum of Zika virus–related peripheral nervous system syndromes. In the current article, the authors review all available clinical neurophysiology data on Guillain–Barré syndrome and other peripheral nervous system syndromes in an attempt to characterize the major patterns of involvement related to Zika virus. The authors also highlight the clinical usefulness of nerve conduction studies and needle EMG in the investigation of suspected Zika virus–related Guillain–Barré syndrome.
Epilepsy and EEG Abnormalities in Congenital Zika Syndrome
Authors: van der Linden Hélio , Pessoa André , van der Linden Ana , Florêncio Rodrigo Neves , Carvalho Maria Durce C. G. , van der Linden Vanessa 
Published: January 2022

Summary:
The congenital Zika syndrome is a new entity of a group of etiologies that can lead to microcephaly and other brain damages during pregnancy, such as toxoplasmosis, rubeola, cytomegalovirus, and herpes simplex. The Zika virus crosses the placental barrier and, predominantly, affects neuronal progenitor cells. This disruptive process results in severe cortical developmental disorder, calcifications, cortical and subcortical atrophies, and malformations of the cerebellum, brain stem, and spinal cord. Children with congenital Zika syndrome have a set of clinical findings, such as cerebral palsy, dysphagia, orthopedic deformities, visual and auditory impairment, and, rarely, hydrocephalus. Because of the severity of brain lesions, epilepsy is a common finding and a frequent cause of increased morbidity. The prevalence of epilepsy in different series of patients ranges from 37.7% to 71.4%. The aim of this study is to review the studies published so far regarding epilepsy and the EEG pattern in series of patients with congenital Zika syndrome.