bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pearls for the diagnosis and possible pathophysiological mechanisms of valproic acid-induced lupus erythematosus: A literature review
Authors: Papadopoulou Efthymia , Saroglou Maria , Ismailos Georgios , Fletsios Demosthenes , Tsavlis Drosos , Tryfon Stavros 
Published: March 2022

Background: Drug-induced lupus erythematosus (DILE) accounts for 10-15% of systemic lupus erythematosus (SLE) cases, with more than 100 pharmaceutical agents implicated in its development. Depending on the offending drug, clinical and serological manifestations present great variability and, thus, DILE may be overlooked in clinical practice. Valproic acid (VPA) – induced lupus erythematosus has not been analytically reported in the literature, rendering the recognition of such cases even more difficult. Objective: The aim of this study was to analyze VPA – induced lupus features and to discuss possible pathophysiological mechanisms. Materials and Methods: This literature review was conducted in PubMed and Embase databases in June 2021, in search of DILE cases induced by VPA. We found 164 manuscripts, out of which 140 articles regarding other adverse effects or drugs were discarded. Finally, 15 cases fulfilled the eligibility criteria to be included in this review. Results: Although SLE is more common in females, VPA-induced lupus presented a male predilection. Patients developed DILE within the first three months of treatment with VPA at a percentage of 50%, whereas four patients from one to five years after VPA initiation. DILE frequently presented with mild symptoms. In most patients, serositis manifested with polyarthritis, pleural effusion or pericarditis. Notably, one patient presented with Rowell's syndrome, a rare subtype of lupus erythematosus with erythema multiforme and speckled pattern of antinuclear antibodies (ANAs). Central nervous system, renal and skin involvement was scarcely observed. Cytopenia was noted in 7 patients. Immunological findings included positive ANAs in the vast majority of the patients (86.7%), positive anti-histone antibodies in five, positive anti-dsDNA antibodies in three and hypocomplementemia in two patients. Despite the prompt resolution of clinical symptoms after VPA discontinuation, serological abnormalities persisted up to 18 months. Apart from the discontinuation of VPA administration for the resolution of DILE, treatment included corticosteroids in 8 cases. Conclusion: Valproic acid has been implicated in several cases of DILE. Clinicians should be aware of this entity and recognize it promptly to ensure a favorable outcome. Possible pathophysiologic associations may be extrapolated, but a clearer understanding of this syndrome is to be gained by further studies.
Efficacy and safety of belimumab therapy in systemic lupus erythematosus: A systematic review and meta-analysis
Authors: Chiang Hsin-Yu , Guo Zi-An , Wu Ta-Wei , Peng Tzu-Rong 
Published: March 2022

Background Belimumab is the first biological agent approved for the treatment of systemic lupus erythematosus (SLE). The efficacy and safety of belimumab for SLE patients are not clear. Therefore, this meta-analysis is integrating the efficacy and safety of belimumab for patients with SLE. Methods PubMed, EMBASE, and Cochrane Library were searched for randomized clinical trials (RCTs) that studied the efficacy and safety of belimumab plus standard therapy before November 1, 2021. Data were pooled using the random-effects model and are expressed as risk ratios (RRs) or mean difference (MD) and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed and quantified using I2. Results Seven RCTs with 3,009 participants were included in this meta-analysis. Belimumab showed significantly decreased at least a 4-point improvement in Safety of Estrogen in Lupus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score than placebo (RR, 1.32; 95% CI, 1.21–1.44; p < 0.001). However, belimumab significantly reduced the prednisone dose by 50% or more than placebo (RR, 1.59; 95% CI, 1.17–2.15; p = 0.003) and belimumab significantly increased the 36 Physical Component Summary (PCS) score (MD, 1.60; 95% CI, 0.30–2.90; p = 0.02). Regarding adverse events, there was no significant difference between the belimumab group and the control group. Conclusion The results suggest that belimumab plus standard therapy is more effective than placebo plus standard therapy in SLE patients.
Exposure to Azathioprine Metabolites and Clinical Outcome in Indian Patients with Crohn’s Disease
Authors: Prabha Ratna , Mathew Sumith K. , Joseph A. J. , Mathew Binu Susan 
Published: March 2022

Aim: To determine the concentration of 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP), the interpatient variability, and the relationship with disease activity in patients with Chron’s disease on long-term stable doses of azathioprine (AZA). Methods: This is a prospective, tertiary care single-center hospital study in adult Chron’s disease patients treated with AZA. The quantification of phenotypic thiopurine methyltransferase enzyme activity in red blood cells and the estimation of the concentration of 6-TGN and 6-MMP in whole blood was performed using the HPLC-UV detector method. A clinical response was categorized as remission (Harvey-Bradshaw Index [HBI] < 5) or improvement (drop from baseline of at least three points of HBI) based on HBI. Exposure to metabolite concentrations and the clinical response to AZA treatment was observed. Results: Study analysis included 30 patients who were initiated on AZA, and they were followed up with an estimation of metabolite concentrations to determine their clinical outcome. At six months, 93% of ( n = 28) patients continued to be on AZA and had clinical improvement. All the patients achieved remission of Chron’s disease. Only two patients developed adverse effects such as joint pain and thrombocytopenia. Conclusion: AZA is a safe and effective therapy in managing Chron’s disease when administered after determining thiopurine methyltransferase phenotype and with dose optimization performed using therapeutic drug monitoring of 6-TGN and 6-MMP.
Parental Factors That Confer Risk and Resilience for Remote Learning Outcomes During the COVID-19 Pandemic Among Children With and Without Attention-Deficit/Hyperactivity Disorder
Authors: Silverman Melanie R. , Stadterman Jill , Lorenzi Danny , Feuerstahler Leah , Hirsch Emily , Roy Amy K. 
Published: March 2022

Objective: To test whether parental factors including internalizing symptoms, parenting style, and confidence in assisting with remote learning conferred risk/resilience for children with/without ADHD’s learning and emotional outcomes during the COVID-19 pandemic. Method: 291 parents of children (ages 6–13; n = 180 males) with ( n = 148) and without ADHD completed questionnaires online (April–July 2020). Results: Structural equation modeling identified parental risk/resilience factors. Across groups, risk predicted greater difficulties with learning, internalizing and externalizing symptoms, while parent confidence in educating their child predicted better outcomes. A positive association was observed between parental involvement and child difficulties, which was stronger in families of children with ADHD. Children with/without ADHD did not differ in remote learning difficulties. Conclusion: Parent factors impacted child emotional and learning outcomes during the pandemic. With increases in remote learning practices, there is a need for improved understanding of how parent factors impact outcomes of children with/without ADHD.
Live surgery outcomes in cataract surgery
Authors: Puzo Pasquale , D’Oria Francesco , Imburgia Aurelio , Incandela Cosimo , Sborgia Alessandra , Marchegiani Eleonora B , Rania Laura , Mularoni Alessandro , Alessio Giovanni 
Published: March 2022

Purpose To evaluate and compare the outcomes of live surgery (LS) and no-live surgery (NLS) on cataract surgery with implantation of different types of intraocular lenses (IOLs). Methods Retrospective, contralateral eye, case series of patients that underwent cataract surgery in live or non-live view during two consecutive editions of national meetings. Both eyes of the same patients were implanted with the same IOL, one in LS and the other in NLS. Results 108 eyes of 54 patients, aged between 50 and 82 (72 ± 8.2) and implanted with different types of IOLs, were reviewed. Both eyes in each patient were well matched at baseline in terms of intraocular biometric characteristics, corneal curvature and endothelial cell density (ECD) (p > 0.05). There are no statistically significant differences between the biometric and topographic parameters, aberrometric data and the loss of ECD in the post-operative outcomes (p > 0.05). However, comparing the different types of IOLs, there is a significant loss of ECD in eyes implanted with a toric IOL during LS (p = 0.0014 and p = 0.04, in 2017 and 2018 edition respectively). Conclusions In this series of live cataract surgery, eyes operated in LS or NLS have comparable outcomes, underlying the importance and the benefits of live view in terms of medical education and the low-risk of complications. Nevertheless, we have found a significant increase in ECD loss in patients implanted with toric IOLs during LS.
Factors Influencing Frequency of Pediatric Clinically Distinguishable Influenza: A 2 Season Case-Control Study
Authors: Salazar Ryan A. , Field Scott S. 
Published: March 2022

Background: Little is known about the individual differences in susceptibility to, or lifetime frequency of clinically distinguishable influenza in children. Methods: Rapid enzyme linked immunoassay-confirmed influenza pediatric cases (n = 96) in season 1 (2017-2018) were compared to age-matched (mean 7.7 years) controls (n = 171) with no evidence of influenza in season 1. The 2 cohorts were again studied in season 2 (2018-2019) for influenza outcomes and influences. Medical records, questionnaires, and interviews were used to determine past influenza disease and vaccine histories. Results: After season 2, known lifetime influenza illnesses per year of age averaged 22.6% in cases and 5.6% in controls, with 62% of controls still having never experienced known influenza. Having had prior influenza was marginally significant as a risk for season 1 influenza in cases versus controls ( P = .055), yet a significant risk factor in controls for season 2 ( P = .018). Influenza vaccine rates were significantly higher in controls than in cases for season 1, with a greater female vaccine benefit. Lack of previous influenza had greater calculated effectiveness (52%) than vaccination (17%-26%) in escaping season 2 influenza. Lifetime rates of vaccination did not correlate with lifetime rates of known influenza in either cohort. Conclusions: Lifetime clinically distinguishable influenza rates varied among children, with many escaping it for years even without being immunized against it. Findings of less than expected clinical influenza, no correlation between vaccination frequency and disease frequency, sex differences, and an association between past clinical influenza and current risk, point to innate differences in individual influenza experiences.
Real-World Moderate-to-Severe Hidradenitis Suppurativa: Decrease in Disease Burden With Adalimumab
Authors: Gulliver Wayne , Alavi Afsaneh , Wiseman Marni C. , Gooderham Melinda J. , Rao Jaggi , Shayesteh Alam Maryam , Papp Kim A. , Desjardins Olivier , Jean Christine 
Published: March 2022

Background Real-world knowledge of the burden of hidradenitis suppurativa (HS) on patients remains limited. Objectives To measure the impact of adalimumab on moderate-to-severe HS patients’ health-related quality of life (HRQoL) and work productivity. Methods In 23 Canadian centres, 138 adults with moderate-to-severe HS requiring a change in ongoing therapy were treated with adalimumab for up to 52 weeks as per the physician’s practice. Patient-reported outcome measures (PROMs) were obtained at baseline, weeks 24 and 52 to measure overall HRQoL, HS severity, levels of anxiety and depression, impact and symptoms of HS, work productivity and activity impairment. A post-hoc analysis further explored the PROMs by abscess and inflammatory nodule (AN) count at baseline (≤5, low; 6–10, medium; ≥11, high). Results From baseline to weeks 24 and 52, all PRO overall scores improved significantly ( P ≤ .0023). The number of patients reporting “good disease control” and “complete disease control” increased from 9.7% to 66.4% over 52 weeks. The score in Health Utility Index Mark 3 (HUI3) pain attribute meaningfully decreased over 52 weeks (mean difference ≥.05). The HS symptoms skin “tenderness” and “itchiness” improved the most. Work productivity loss and activity impairment improved by approximately 20% over 52 weeks. Disease burden improved more in 24 week responders with low and medium AN counts at baseline than in those with high AN count or in 24 week nonresponders. Conclusion At week 24 and maintained at week 52 in a real-world setting, adalimumab meaningfully improved HRQoL, work productivity, and activity impairment in moderate-to-severe HS patients.
Development of a checklist to assess COVID-19 information on orthodontic webpages
Authors: Keshtgar Safoora , Hodges Samantha , Owaise Sharif Mohammad 
Published: March 2022

Objective: To create a COVID-19 information checklist and critique all available webpages of hospitals with an orthodontic department in England. Design: Cross-sectional analysis. Setting: World Wide Web. Methods: A 16-item COVID-19 webpage checklist was developed using up-to-date COVID-19 government advice, and the General Dental Council Principles of Ethical Advertising. Presence of advice on managing orthodontic appliance breakages, information on outpatient appointment changes and video consultations was also assessed. The checklist was used to undertake a cross-sectional analysis of all available webpages of hospitals with an orthodontic department in England between September 2020 to October 2020. Results: A total of 61 webpages were assessed. Of them, 95% had a COVID-19 section on the homepage, including advice on the use of face coverings during hospital visits. Only 18% of websites provided information on orthodontic appliance care and breakages. Four orthodontic department websites stated the department was closed during this study. The mean update interval of the webpages was six weeks (range = 1–28 weeks). Only one webpage fully conformed with the COVID-19 checklist. Conclusion: Availability and completeness of COVID-19 information on webpages of hospitals with an orthodontic department varied, which may be due to the absence of a formal COVID-19 information webpage checklist. The checklist produced in this research may prove valuable to encourage uniform patient support and positive patient experience across orthodontic services. Principles behind the development of the checklist could be adopted during prolonged service disruptions to ensure optimal patient communications. The checklist is equally applicable to primary and secondary care settings.
Laypeople’s interpretation of, and preference for, orthodontic images
Authors: Berry Lauren , Jones Adam , Barber Sophy 
Published: March 2022

Background: Good communication is fundamental to provision of information and patient engagement in orthodontic treatment. Images can be used to support verbal and written information, but little is known about how laypeople interpret orthodontic images. Objective: To explore laypeople’s understanding and preferences for images (clinical photographs and medical illustrations) relating to orthodontic diagnoses and treatments. Design: Cross-sectional survey. Setting: UK. Population: Laypeople aged ⩾16 years. Methods: Participants were recruited through social media to complete an online questionnaire containing six pairs of images (clinical photograph and medical illustration) relating to orthodontic diagnoses and treatment. Photographs were selected from a bank with input from laypeople, then a matching medical illustration was created. Images were presented with questions relating to interpretation, preferences and reasons for preferences. Results: A total of 898 people completed the questionnaire. Interpretation of images by laypeople was variable and, in some cases, normal intra-oral features and image orientation caused confusion. A combination of photograph and illustration were preferred for images representing diagnosis (by 41%–50% participants), whereas the illustration alone or both photograph and illustration together was preferred for explaining treatment (43%–48% and 35%–44%, respectively). Photographs were liked for their realism and relatability, while illustrations were often found to be clearer. Arrows aided participants’ understanding of the images, but annotations were requested to further improve the value of images. Only 26% of participants reported having previously been shown dental images, but 96% felt they would be helpful to support verbal and written information. Conclusion: Laypeople may not interpret orthodontic images in the way that professionals expect, and unfamiliar intra-oral features may distract people from the intended focus of the image. A combination of photographs and illustrations together may improve the usefulness of images, alongside annotation or explanation.
A non-invasive system to manage impacted teeth associated with a large dentigerous cyst
Authors: Maltoni Manuela , Maltoni Ivano , Santucci Giorgia , Guiducci Daniela , Cremonini Francesca , Lombardo Luca 
Published: March 2022

A male patient aged 11 years presented a large dentigerous cyst in the lower left quadrant associated with retained deciduous lower lateral incisor and canine and impacted, unerupted corresponding permanent ones. The treatment consisted in marsupialisation and placement of a modified lingual arch that held a tube for decompression used for irrigation of the cystic cavity in a comfortable way for the patient and for the clinician. The same lingual arch was later used as an anchorage method for traction of the retained teeth. The final records showed complete resolution of the cyst and retained teeth were successfully Aligned into the oral cavity.
Individuals with Chronic Mild-to-Moderate Traumatic Brain Injury Exhibit Decreased Neuromuscular Complexity During Gait
Authors: Acuña Samuel A. , Tyler Mitchell E. , Thelen Darryl G. 
Published: March 2022

Background Synergy analysis provides a means of quantifying the complexity of neuromuscular control during gait. Prior studies have shown evidence of reduced neuromuscular complexity during gait in individuals with neurological disorders associated with stroke, cerebral palsy, and Parkinson’s disease. Objective The purpose of this study was to investigate neuromuscular complexity during gait in individuals who experienced a prior traumatic brain injury (TBI) that resulted in chronic balance deficits. Methods We measured and analyzed lower extremity electromyographic data during treadmill and overground walking for 44 individuals with residual balance deficits from a mild-to-moderate TBI at least 1 year prior. We also tested 20 unimpaired controls as a comparison. Muscle synergies were calculated for each limb using non-negative matrix factorization of the activation patterns for 6 leg muscles. We quantified neuromuscular complexity using Walk-DMC, a normalized metric of the total variance accounted for by a single synergy, in which a Walk-DMC score of 100 represents normal variance accounted for. We compared group average synergy structures and inter-limb similarity using cosine similarity. We also quantified each individual’s gait and balance using the Sensory Organization Test, the Dynamic Gait Index, and the Six-Minute Walk Test. Results Neuromuscular complexity was diminished for individuals with a prior TBI. Walk-DMC averaged 92.8 ± 12.3 for the TBI group during overground walking, which was significantly less than seen in controls (100.0 ± 10.0). Individuals with a prior TBI exhibited 13% slower overground walking speeds than controls and reduced performance on the Dynamic Gait Index (18.5 ± 4.7 out of 24). However, Walk-DMC measures were insufficient to stratify variations in assessments of gait and balance performance. Group average synergy structures were similar between groups, although there were considerable between-group differences in the inter-limb similarity of the synergy activation vectors. Conclusions Individuals with gait and balance deficits due to a prior TBI exhibit evidence of decreased neuromuscular complexity during gait. Our results suggest that individuals with TBI exhibit similar muscle synergy weightings as controls, but altered control of the temporal activation of these muscle weightings.
Comparing the Radiologic and Functional Outcome of Radial Shortening Versus Capitate Shortening in Management of Kienböck’s Disease
Authors: Mazhar Farid Najd , Motaghi Paniz , Kooshesh Mohammad Reza , Mahmoudinasab Omid 
Published: March 2022

Background: Kienböck’s disease is the avascular necrosis of the lunate bone. There is no consensus on the treatment strategy to avoid joint deterioration. This trial is conducted to compare the functional and radiological outcomes of radial shortening and capitate shortening techniques, in patients with avascular necrosis of lunate. Methods: Patients with a confirmed diagnosis of Kienböck’s disease who met the inclusion criteria were randomly divided into radial shortening and capitate shortening groups and treated by allocated technique. Physical examination and radiologic evaluations were performed before and 6 and 12 months after the operation. Results: A total of 52 patients (52 wrists) of stage II or III Kienböck’s disease were assessed for eligibility, 12 patients in the radial shortening group, and 17 patients remained until the end of the study. Patients in both groups achieved a satisfactory outcome, with no report of postoperative complications. None of the outcome measures, ranges of motion, grip, and pinch strengths were significantly different between the groups. The outcome was not considerably different in patients with positive or negative ulnar variances who were treated by capitate shortening technique. Conclusions: The capitate shortening technique which is performed through a smaller incision, and takes less time as compared with radial shortening can be advantageous for patients with stage II or III Kienböck’s disease regardless of the ulnar variance. This method can be as effective as classical methods such as radial shortening in improving clinical and functional symptoms after surgery while causing fewer complications.