bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiphospholipid antibody positivity in early systemic lupus erythematosus is associated with subsequent vascular events
Authors: Farina Nicola , Abdulsalam Ruya , McDonnell Thomas , Pericleous Charis , D’Souza Amrita , Ripoll Vera M , Webster Jemma , Isenberg David A , Giles Ian , Rahman Anisur 
Published: October 2022

Abstract

Objective
aPL are found in the blood of 20–30% of patients with SLE. Although aPL cause vascular thrombosis in the antiphospholipid syndrome, it is not clear whether positive aPL levels in early SLE increase risk of subsequent vascular events (VE). In a previous analysis of 276 patients with SLE, we found that early positivity for ≥2 of IgG anti-cardiolipin (anti-CL), IgG anti-β2-glycoprotein I (anti-β2GPI) and anti-domain I of β2-glycoprotein I (anti-DI) showed a possible association with VE. Here we have extended that analysis.

Methods
Serum samples taken from 501 patients with SLE early in their disease had been tested for IgG anti-CL, anti-β2GPI and anti-DI by ELISA. Complete VE history was available for 423 patients of whom 23 were excluded because VE occurred before the diagnosis of SLE. For the remaining 400 patients we carried out Kaplan–Meier survival analysis to define groups at higher risk of VE.

Results
Of 400 patients, 154 (38.5%) were positive for one or more aPL, 27 (6.8%) were double/triple-positive and 127 (31.8%) were single-positive. There were 91 VE in 77 patients, of whom 42 were aPL-positive in early disease. VE were significantly increased in aPL-positive vs aPL-negative patients (P = 0.041) and in double/triple-positive vs single-positive vs aPL-negative patients (P = 0.0057). Omission of the IgG anti-DI assay would have missed 14 double/triple-positive patients of whom six had VE.

Conclusion
Double/triple-positivity for IgG anti-CL, anti-β2GPI and anti-DI in early SLE identifies a population at higher risk of subsequent VE.
Sickle cell disease treatment and management in India: a systematic review of interventional studies
Authors: Sridevi Parikipandla , Sharma Yogita , Balakrishna Sunnam L , Babu Bontha V 
Published: October 2022

AbstractSickle cell disease (SCD) affects approximately 5% of the world’s population, and India has been the second highest country in the numbers of predicted SCD births. Despite the high burden in India, there is no state-led public health programme, and very few interventions dealing with the treatment and management of SCD are available. This review highlights the dearth of SCD-related interventions, and demonstrates that these interventions effectively improve patients' conditions and are feasible to implement in India. We systematically searched three databases—PubMed/Medline, Google Scholar and Web of Science—for articles from India on SCD-related interventions. The PRISMA guidelines were followed during this review. We included 22 studies, of which 19 dealt with specific therapeutic interventions, and 3 with comprehensive SCD care. Hydroxyurea therapy was the main therapy in 15 studies and is efficacious. Three studies demonstrated the feasibility of comprehensive care in resource-limited settings. The low number of SCD-related intervention studies does not match the huge burden of SCD in India. Governments of endemic countries should consider the findings of available interventions and include them in their countries’ programmes. Comprehensive care is feasible in India and other low-resource settings, from screening to treatment and psychosocial support.
Global trends and regional differences in non-transport unintentional injuries mortality among children and adolescents, 1990 to 2019: results from the Global Burden of Disease 2019 study
Authors: Liu Yunfei , Dong Yanhui , Yan Xiaojin , Ma Ning , Dang Jiajia , Zhang Jingshu , Zhong Panliang , Li Luo , Zou Zhiyong , Song Yi , Ma Jun 
Published: October 2022

Abstract

Background:
Non-transport unintentional injuries (NTUIs) are major public concerns, especially among children and adolescents in low- and middle-income countries. With environmental and cognitive changes, a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.

Methods:
We used mortality, population, and socio-demographic-index (SDI) data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality. We applied the slope index of inequality (SII) and relative index of inequality (RII) to measure the absolute and relative inequality between countries and territories. The concentration curve and concentration index (CI) were also used to measure the inequality. We conducted a sensitivity analysis to make our findings credible.

Results:
In 2019, there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years, which decreased from 375,000 in 1990. In 2019, the age-standardized mortality rate (ASMR) was 8.13 per 100,000, ranging from the lowest in the Netherlands (0.90 per 100,000) to the highest in the Solomon Islands (29.34 per 100,000). The low-middle SDI group had the highest ASMR of NTUIs, while the low SDI group had the slowest decrease. After excluding the death caused by “exposure to forces of nature” and “other unintentional injuries,” drowning accounted for the most deaths in almost every SDI group, gender, and age group, but the major causes of death varied in different subgroups. For example, animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups, while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings. The SII showed a declining trend, but the RII and CI did not, which might indicate that inequality was persistent. Similar results were found in the sensitivity analysis.

Conclusions:
Despite the declining trend of the mortality rate and the narrowing gap between countries, there were still a large number of children and adolescents dying from NTUIs, and those experiencing social-economic disadvantages remained at high mortality. Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities, which ensures that no one is left behind.
Pigmented Multinucleate Cell Angiohistiocytoma: First Case
Authors: Fernandez-Flores Angel , Cassarino David 
Published: October 2022

Abstract:
Multinucleate cell angiohistiocytoma (MCAH) is a benign vascular and fibrohistiocytic (probably reactive) proliferation with peculiar multinucleate cells which most authors interpret as degenerated macrophages. Several clinical variants of MCAH have been described, some of them with brownish-appearing lesions clinically. However, no histologically identified pigment has been described in the cytoplasm of the multinucleate cells so far. We present a pigmented MCAH with cytoplasmic brownish pigment, which was positive with a Masson–Fontana stain and negative with an iron stain, consistent with melanin, in a 33-year-old woman with multiple papules and plaques on the right elbow, right jawline, and left flank.
Isolated Vitreous Metastasis in a Patient with an ALK Positive Lung Cancer Treated with Lorlatinib
Authors: Suzani Martina , Benatti Eleonora , Ceola Stefano , Coppola Michele 
Published: October 2022

Abstract

Purpose:
To describe the ocular clinical and imaging findings of a patient with isolated vitreous metastasis, confirmed by vitreous biopsy, from an anaplastic lymphoma kinase (ALK) positive metastatic lung cancer

Methods:
case report

Results:
A 47-year-old female with a history of metastatic ALK positive lung cancer was referred by her oncologist due to unilateral blurred vision over 4 weeks. The fundus examination showed vitreous opacities with clumps of non-pigmented cells, without vasculitis or retinitis while optical coherence tomography (OCT) showed hyper-reflective deposits on the inner retinal surface with no retinal involvement. Diagnostic vitrectomy revealed neoplastic cells with ALK mutation.

Conclusion:
This is the first report that documents a case of isolated vitreous metastasis from ALK positive lung carcer in a patient under targeted therapy to treat metastatic lung cancer. We emphasize the importance of multimodal imaging, diagnostic vitrectomy, and a pathologist’s cooperation to provide essential information about diagnosis and effective treatment.
COVID-19: dealing with ventilator shortage
Authors: Santini Alessandro , Messina Antonio , Costantini Elena , Protti Alessandro , Cecconi Maurizio 
Published: October 2022

Purpose of review
To describe different strategies adopted during coronavirus disease 2019 pandemic to cope with the shortage of mechanical ventilators.

Recent findings
Short-term interventions aimed to increase ventilator supply and decrease demand. They included: redistributing and centralizing patients, repurposing operating rooms into intensive care units (ICUs) and boosting ventilator production and using stocks and back-ups; support by the critical care outreach team to optimize treatment of patients in the ward and permit early discharge from the ICU, ethical allocation of mechanical ventilators to patients who could benefit more from intensive treatment and short term ICU trials for selected patients with uncertain prognosis, respectively. Long-term strategies included education and training of non-ICU physicians and nurses to the care of critically-ill patients and measures to decrease viral spread among the population and the progression from mild to severe disease.

Summary
The experience and evidence gained during the current pandemic is of paramount importance for physicians and law-makers to plan in advance an appropriate response to any future similar crisis. Intensive care unit, hospital, national and international policies can all be improved to build systems capable of treating an unexpectedly large number of patients, while keeping a high standard of safety.
Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety
Authors: Franco Lissa , Jones-Pauley Michelle , Tamimi Omar , Neshatian Leila , Nguyen Duc , Graviss Edward , Quigley Eamonn MM , Victor David 
Published: October 2022

Goals:
Determine factors associated with Irritable bowel syndrome (IBS) in nonalcoholic fatty liver disease (NAFLD) patients.

Background:
IBS affects 10% to 15% of the adult population worldwide and is linked to anxiety and depression. The impact of IBS-type symptoms in NAFLD patients is not well described.

Study:
A cross-sectional study of patients in the hepatology clinic at Houston Methodist Hospital was performed based on a respondent postal survey. IBS was defined by the Rome IV questionnaire, anxiety and depression were assessed with the Hospital Anxiety Depression scale. Patients with inflammatory bowel disease, colorectal carcinoma, or small bowel tumors were excluded. Patients were divided based on Rome IV diagnostic criteria for IBS and Hospital Anxiety Depression scale.

Results:
130 patients were included in the analysis, 38 satisfied Rome IV criteria for IBS (IBS group) versus 92 who did not (non-IBS group). Depression was more prevalent in the IBS group (18.4% vs 5.4%, P=0.01). Anxiety was also greater in the IBS group (31.6% vs 9.8%, P=0.002). Female sex, depression, and body mass index (BMI)>30 were independent predictors of IBS in NAFLD in 4 multiple logistic regression models. In newly diagnosed IBS patients, gamma-glutamyl transferase levels were lower (67.5 vs 28, P=0.04). Current abdominal pain was higher than 100% versus 81.3% (P=0.045), as was pain associated with the change in stool frequency (96.3% vs 50%; P<0.001).

Conclusion:
Our study highlights the increased rate of IBS symptoms, depression, and anxiety in patients with NAFLD. Clinicians should be alert when IBS symptoms are reported by a NAFLD patient and be aware of the impact of these comorbidities on quality of life and response to therapy.
The efficacy of irinotecan supplementation for colorectal cancer: A meta-analysis of randomized controlled studies
Authors: Jiang Wei , Liu Qiying , Yang Donglin , Yang Shi-bin 
Published: October 2022

Background:
The efficacy of irinotecan as the adjunctive therapy to fluorouracil and leucovorin remains controversial in patients with colorectal cancer. We conduct this meta-analysis to explore the efficacy of irinotecan supplementation for colorectal cancer.

Methods:
We have searched PubMed, EMBASE, Web of science, EBSCO, and Cochrane library databases through March 19, 2020, and included randomized controlled trials assessing the efficacy of irinotecan plus fluorouracil and leucovorin for colorectal cancer.

Results:
Five randomized controlled trials were included in the meta-analysis. Compared with fluorouracil and leucovorin for colorectal cancer, irinotecan supplementation could significantly improve progression-free survival rate (hazard ratio = 0.72; 95% confidence interval [CI] = 0.58–0.90; P = .003), median progression-free survival (standard mean difference = –0.30; 95% CI = –0.44 to –0.15; P < .0001), overall survival rate (hazard ratio = 0.77; 95% CI = 0.66–0.90; P = .001), and objective response (risk ratio [RR] = 0.57; 95% CI = 0.49–0.66; P < .00001) and decrease progressive disease (RR = 2.10; 95% CI = 1.40–3.14; P = .0003), but revealed no obvious effect on complete response (RR = 0.88; 95% CI = 0.33–2.29; P = .79). The incidence of grade ≥3 adverse events in irinotecan supplementation group was increased compared to control group (RR = 0.67; 95% CI = 0.57–0.79; P < .00001).

Conclusions:
Irinotecan as the adjunctive therapy to fluorouracil and leucovorin can increase the survival and objective response of patients with colorectal cancer, but the incidence of grade ≥3 adverse events is found to be increased after irinotecan supplementation.
Effectiveness and safety of Tai Chi for anxiety disorder of COVID-19: A protocol of systematic review and meta-analysis
Authors: Zhang Shiqiang , Zhu Luwen , Liang Runyu , Yin Xia , Wang Ruoyu , Ma Xiyuan , Li Hongyu , Tang Qiang 
Published: October 2022

Background:
Anxiety disorders pose a significant threat to the clinical rehabilitation of patients with coronavirus disease 2019 (COVID-19). Tai Chi is a therapeutic exercise that can be used to treat anxiety disorders. We aim to conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of Tai Chi for treating patients with anxiety disorders caused by COVID-19.

Methods:
The PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature, Wan Fang, and Chinese Clinical Trial Registry databases will be searched for reports of randomized controlled trials on Tai Chi for the treatment of anxiety disorders caused by COVID-19, published from December 1, 2019, to August 22, 2022. Two researchers will screen the articles and extract the relevant information.

Results:
The results will provide a systematic overview of the current evidence on the use of Tai Chi to treat anxiety disorders caused by COVID-19 among patients.

Conclusion:
The conclusions of this study will help clarify whether Tai Chi is effective and safe for treating anxiety disorders caused by COVID-19.
Analysis of differentially expressed genes in individuals with noninfectious uveitis based on data in the gene expression omnibus database
Authors: Zhang Dandan , Zhang Ning , Wang Yan , Zhang Qian , Wang Jiadi , Yao Jing 
Published: October 2022

Noninfectious uveitis (NIU), an intraocular inflammation caused by immune-mediated reactions to eye antigens, is associated with systemic rheumatism and several autoimmune diseases. However, the mechanisms underlying the pathogenesis of uveitis are poorly understood. Therefore, we aimed to identify differentially expressed genes (DEGs) in individuals with NIU and to explore its etiologies using bioinformatics tools.
GSE66936 and GSE18781 datasets from the gene expression omnibus (GEO) database were merged and analyzed. Functional enrichment analysis was performed, and protein-protein interaction (PPI) networks were constructed.
A total of 89 DEGs were identified. Gene ontology (GO) enrichment analysis identified 21 enriched gene sets. Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis identified four core enriched pathways: antigen processing and expression signaling, natural killer (NK) cell-mediated cytotoxicity signaling, glutathione metabolic signal transduction, and arachidonic acid metabolism pathways. PPI network analysis revealed an active component-target network with 40 nodes and 132 edges, as well as several hub genes, including CD27, LTF, NCR3, SLC4A1, CD69, KLRB1, KIR2DL3, KIR3DL1, and GZMK.
The eight potential hub genes may be associated with the risk of developing NIU. NK cell-mediated cytotoxicity signaling might be the key molecular mechanism in the occurrence and development of NIU. Our study provided new insights on NIU, its genetics, molecular pathogenesis and new therapeutic targets.
Pharynx volume derived from three-dimensional computed tomography is associated with difficult intubation in spinal deformity surgery: A retrospective cohort study
Authors: Li Xiaoyan , An Bei , Jiang Bailin , Xu Shuai , Liu Haiying , Zhao Hong 
Published: October 2022

Spinal abnormality surgery, including surgery for ankylosing spondylitis and idiopathic scoliosis, can present significant challenges to anesthesiologists because of the potential difficult airway. The bedside screening tests routinely used to detect difficult airways are highly variable. Pharynx volume calculated using three-dimensional (3D) computed tomography (CT) may play a role in predicting difficult airways.
We conducted a retrospective cohort study on patients (aged ≥14 years) who received orthopedic surgery for ankylosing spondylitis/idiopathic scoliosis under general anesthesia. Volume of the pharynx air space was calculated through volume rendering technique by 3D reconstruction of patients’ cervical spine CT. Patients were divided into 2 groups according to their pharynx volume, pharyngeal volume lower than 16 mL (n = 11) and equal or higher than 16 mL (n = 13).
Pharynx volume in low volume group was 10.4 ± 3.6 mL (n = 11), and the counterpart in high volume group was 20.8 ± 5.5 mL (n = 13). The incidence of difficult intubation was significantly higher in low pharynx volume group than in high pharynx volume group (54.5% (6/11) vs 7.6% (1/13), P = .023). Bedside screening tests including modified Mallampati test, inter-incisor gap and thyromental distance, or radiological variables such as anterior neck soft tissue thickness to vocal cords were not different between the 2 groups.
Smaller pharynx volume played an important role in difficult airways for patients undergoing orthopedic surgery for ankylosing spondylitis/idiopathic scoliosis.
Additive effects of ezetimibe, evolocumab, and alirocumab on plaque burden and lipid content as assessed by intravascular ultrasound: A PRISMA-compliant meta-analysis
Authors: Liang Di , Li Chang , Tu Yanming , Li Zhiyong , Zhang Ming 
Published: October 2022

Background:
The additive effects of ezetimibe, evolocumab or alirocumab on lipid level, plaque volume, and plaque composition using intravascular ultrasound (IVUS) remain unclear.

Methods:
According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement, we performed a systematic review and meta-analysis of trials assessing the effects of ezetimibe, evolocumab, and alirocumab on coronary atherosclerosis using IVUS. The primary outcome was change in total atheroma volume (TAV), and the secondary outcomes were changes and differences in plaque composition and lipid content.

Results:
Data were collected from 9 trials, involving 917 patients who received ezetimibe, evolocumab or alirocumab in addition to a statin and 919 patients who received statins alone. The pooled estimate demonstrated a significant reduction in TAV with the addition of ezetimibe and favorable effects of evolocumab and alirocumab on TAV. Subgroup analysis also supported favorable effects of evolocumab and alirocumab on TAV, according to baseline TAV, gender, type 2 diabetes mellitus, and prior stain use. Addition of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor to statin therapy resulted in significant reductions in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), but not in high-density lipoprotein cholesterol (HDL-C). The pooled estimate also showed significant favorable effects of ezetimibe on LDL-C, TC, and TG, but an insignificant effect on HDL-C. Patients who received ezetimibe showed similar changes in the necrotic core, fibro-fatty plaque, fibrous plaque, and dense calcification compared with patients not treated with ezetimibe.

Conclusions:
The addition of ezetimibe to statin therapy may further reduce plaque and lipid burdens but may not modify plaque composition. Although current evidence supports a similar impact from the addition of PCSK9 inhibitors to statin therapy, more evidence is needed to confirm such an effect.
An Evaluation of an Enhanced Model of Integrating Family Planning Into HIV Treatment Services in Zambia, April 2018–June 2019
Authors: Medley Amy , Tsiouris Fatima , Pals Sherri , Senyana Brenda , Hanene Susan , Kayeye Shadrick , Casquete Rocio Rodriguez , Lasry Arielle , Braaten Mollie , Aholou Tiffiany , Kasonde Prisca , Chisenga Tina , Mweebo Keith , Harris Tiffany G. 
Published: October 2022

Background:
We designed and implemented an enhanced model of integrating family planning (FP) into existing HIV treatment services at 6 health facilities in Lusaka, Zambia.

Methods:
The enhanced model included improving FP documentation within HIV monitoring systems, training HIV providers in FP services, offering contraceptives within the HIV clinic, and facilitated referral to community-based distributors. Independent samples of women living with HIV (WLHIV) aged ≥16 years were interviewed before and after intervention and their clinical data abstracted from medical charts. Logistic regression models were used to assess differences in key outcomes between the 2 periods.

Results:
A total of 629 WLHIV were interviewed preintervention and 684 postintervention. Current FP use increased from 35% to 49% comparing the pre- and postintervention periods (P = 0.0025). Increased use was seen for injectables (15% vs. 25%, P < 0.0001) and implants (5% vs. 8%, P > 0.05) but not for pills (10% vs. 8%, P < 0.05) or intrauterine devices (1% vs. 1%, P > 0.05). Dual method use (contraceptive + barrier method) increased from 8% to 18% (P = 0.0003), whereas unmet need for FP decreased from 59% to 46% (P = 0.0003). Receipt of safer conception counseling increased from 27% to 39% (P < 0.0001). The estimated total intervention cost was $83,293 (2018 USD).

Conclusions:
Our model of FP/HIV integration significantly increased the number of WLHIV reporting current FP and dual method use, a met need for FP, and safer conception counseling. These results support continued efforts to integrate FP and HIV services to improve women's access to sexual and reproductive health services.