bluuebunny/crossref_metadata_2025_split huggingface dataset:
A patient with eosinophilic granulomatosis with polyangiitis successfully weaned from corticosteroids through remission induction therapy with mepolizumab
Authors: Ueno Masanobu , Miyagawa Ippei , Kawabe Akio , Kusaka Katsuhide , Nakayamada Shingo , Tanaka Yoshiya 
Published: April 2022

ABSTRACT
The patient was a 74-year-old man who was admitted to our hospital for fever, purpura, abdominal pain, and bilateral numbness. Although the patient tested negative for anti-neutrophil cytoplasmic antibody (ANCA), he presented with an elevated peripheral eosinophil count, increased inflammatory responses, duodenitis, cholecystitis, lung lesions, renal disorder, and peripheral neuropathy. The skin biopsy findings revealed vasculitis. Thus, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA). Given the advanced age of the patient, in addition to the poor general condition and hepatic and renal dysfunction, administration of immunosuppressants was considered to pose a high risk. After obtaining informed consent, remission induction therapy was initiated with mepolizumab (MPZ; 300 mg/M) in combination with high-dose corticosteroid therapy (equivalent to 70 mg/day of prednisolone). After treatment initiation, eosinophil counts and inflammatory responses decreased. Moreover, the abdominal pain and purpura resolved, and renal/hepatic dysfunction and peripheral neuropathy also improved. While the corticosteroid dose was subsequently reduced, no relapse was observed. Approximately 2 years later, the corticosteroid was discontinued. After the discontinuation of the corticosteroid, the patient continued treatment with MPZ alone and has remained in remission for approximately 6 months. Therefore, MPZ may be useful as a remission induction therapy in ANCA-negative EGPA resistant to steroids.
Allogeneic stem cell transplantation for trisomy 8-positive myelodysplastic syndrome or myelodysplastic/myeloproliferative disease with refractory Behçet’s disease: Case report and the review of literature
Authors: Onaka Takashi , Nakano Kazuhisa , Uemoto Yuri , Miyakawa Naoto , Otsuka Yasuyuki , Ogura-Kato Aiko , Iwai Fumie , Tanaka Yoshiya , Yonezawa Akihito 
Published: April 2022

ABSTRACT
We had two cases of trisomy 8-positive myelodysplastic syndrome (MDS) with incomplete Behçet’s disease (BD) in which the remissions of both diseases were maintained by allogeneic stem cell transplantation (allo-SCT). Among MDS with BD patients, sometimes it is difficult to control the symptoms of BD with standard therapies such as corticosteroids and tumor necrosis factor (TNF) inhibitors. Although there should be careful consideration regarding indications for transplantation, our two cases, in which refractory BD was completely controlled by allo-SCT, suggest that allo-SCT can be one of the treatment options for higher-risk MDS with BD patients.
Youth Vaping During the Early Stages of the COVID-19 Pandemic Period: Adjusted Annual Changes in Vaping Between the Pre-COVID and Initial COVID-Lockdown Waves of the COMPASS Study
Authors: Leatherdale Scott T , Bélanger Richard E , Gansaonré Rabi Joël , Cole Adam G , Haddad Slim 
Published: April 2022

Abstract

Background
Adolescence is a critical period for vaping onset. The purpose of this article was to examine the effect of the early stages of the COVID-19 pandemic period on youth vaping.

Methods
We used 3-year linked data from the COMPASS study, including 7585 Canadian (Quebec, Ontario) adolescents from which 1949 completed all three survey waves (pre-COVID-19 [2018, 2019] and online [2020] during the early pandemic period [May–July 2020]) and provided vaping data. Structural equation modeling (SEM) and difference-in-difference (DD) models were used to estimate pre-COVID-19 to initial COVID-19 pandemic period change (2019–2020) in vaping (monthly, weekly, daily) compared with 2018–2019 change to adjust for age-related effects. Models were adjusted for age of entry into the cohort and sociodemographic characteristics.

Results
In the SEM and DD models, the proportion of youth who were monthly and weekly vaping increased from 2018 to 2019 but decreased from 2019 to 2020; daily vaping increased across all waves. However, for all vaping outcomes modeled, the expected increases from the pre-COVID-19 wave (2019) to the initial COVID-19 period wave (2020) were lesser relative to the changes seen across the 2018 to 2019 waves.

Conclusion
The early stages of the COVID-19 pandemic period appear to be associated with a reduction in the proportion of youth who were monthly and weekly vapers in our adjusted longitudinal models. While daily vaping increased over this same period of time, the magnitude of the increase in our adjusted longitudinal models appears attenuated by the early stages of the pandemic.

Implications
This large prospective study of youth that included pre-pandemic data is unique in that we were able to identify that the early stages of the COVID-19 pandemic period was associated with a reduction in the proportion of youth who were monthly and weekly vapers in our adjusted longitudinal models. Conversely, the proportion of youth who were daily vaping increased over this same period of time, but the magnitude of the increase appears smaller than expected during the early stages of the pandemic in our adjusted longitudinal models. This study provides novel robust evidence that the patterns of vaping most aligned with onset and progression (i.e., monthly and weekly use) appear attenuated during the initial pandemic period.
Remote Versus In-Person Learning During COVID-19: Comparison of E-Cigarette Susceptibility and Ever Use Among a Diverse Cohort of 6th-Grade Students in Texas
Authors: Mantey Dale S , Omega-Njemnobi Onyinye , Ruiz Felisa A , Chen Baojiang , Springer Andrew E , Kelder Steven H 
Published: April 2022

Abstract

Background
In response to SARS-CoV2 (COVID-19), school districts incorporated remote learning as a mitigation strategy. This study examines the association between classroom setting (ie, on-campus versus remote) and e-cigarette susceptibility or ever use among a sample of Texas public middle school students.

Methods
Data from n = 985 students enrolled in the CATCH My Breath E-Cigarette Prevention Program trial were collected in Spring 2021. Participants were 6th-grade students in urban Texas. E-cigarette use was examined using the “at-risk” definition described by FDA, indicating either: (1) susceptible never user; or (2) experimental ever use. A multilevel, logistic regression model examined the association between classroom setting and e-cigarette susceptibility/ever use. Covariates included sex, race/ethnicity, academic achievement, household e-cigarette use, perceived school connectedness, and school-level economic status. Models account for nesting within school district. Analyses stratified by race/ethnicity were also conducted.

Results
Overall, 36.3% of the sample were susceptible never users or ever e-cigarette users. The sample was comprised of 55.0% on-campus and 45.0% remote learners. On-campus learners had greater odds of reporting e-cigarette susceptibility or ever use (aOR: 1.45; p = .014). These findings were observed among Latino (aOR: 1.77; p = .026) and White (aOR: 2.10; p = .099) but not African American/Black (aOR: 0.86; p = .728) youth.

Conclusions
On-campus learning during the Spring 2021 semester was associated with greater risk for e-cigarette susceptibility or ever use among a diverse sample of 6th-grade students. E-cigarette susceptibility and ever use is a risk factor for progression to long-term e-cigarette use in later adolescence.

Implications
As school districts prepare to return to on-campus learning in 2022, a focused approach to e-cigarette prevention may be needed to prevent widespread e-cigarette initiation and continued use. Further, study findings demonstrate a need for further research on the school environment as a determinant of e-cigarette use.
Delayed Tuberculosis Treatment and Cost of Care in a Low-Incidence Country
Authors: O’Connell James , Reidy Niamh , McNally Cora , de Barra Eoghan , Stanistreet Debbi , McConkey Samuel 
Published: April 2022

Abstract

Background
Tuberculosis (TB) elimination requires high-quality, timely care. In countries with a low incidence of TB, such as Ireland, delayed diagnosis is common. This evaluation aimed to determine the factors that predict patient-related and health care provider–related delays in TB management and to establish how TB care cost is affected by care delays.

Methods
Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1, 2018, and December 31, 2019, were reviewed to measure and determine predictors of patient-related delays, health care provider–related delays, and the cost of TB care. Outcomes were compared against benchmarks derived from the literature.

Results
Thirty-seven patients were diagnosed with TB, and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider–related delay among patients with PTB was 16 days and, although similar to the benchmark (median, 22 days; minimum, 11 days; maximum, 36 days), could be improved. The health care provider–related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298 and, while similar to that reported in the literature (median, €9319; minimum, €6486; maximum, €14 750), could be improved. Patient-related delays among those with PTB predicted care costs.

Conclusions
Patient-related and health care provider–related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.
Relative Effectiveness of MF59 Adjuvanted Trivalent Influenza Vaccine vs Nonadjuvanted Vaccines During the 2019–2020 Influenza Season
Authors: Imran Mahrukh , Puig-Barbera Joan , Ortiz Justin R , Fischer Lauren , O’Brien Dan , Bonafede Machaon , Mansi James A , Boikos Constantina 
Published: April 2022

Abstract

Background
Age-related immunosenescence may impair the immune response to vaccination in older adults. Adjuvanted influenza vaccines are designed to overcome immune senescence in older adults. This study estimated the relative vaccine effectiveness (rVE) of MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3) vs egg-derived quadrivalent inactivated influenza vaccine (IIV4e) and high-dose trivalent inactivated influenza vaccine (HD-IIV3) in preventing influenza-related medical encounters in the 2019–2020 US season.

Methods
This retrospective cohort study used electronic medical records linked to pharmacy and medical claims data. The study population included adults age ≥65 years with a record of aIIV3, IIV4e, or HD-IIV3 vaccination. A doubly robust inverse probability of treatment weighting model was used to derive adjusted odds ratios (ORs). rVE was calculated by (1 – ORadjusted)*100 and was determined overall and separately for age subgroups. An exploratory analysis evaluated the outcome separately in inpatient and outpatient settings.

Results
Subjects received aIIV3 (n = 936 508), IIV3e (n = 651 034), and HD-IIV3 (n = 1 813 819), and influenza-related medical encounters were recorded in 0.5%, 0.9%, and 0.7% of each cohort, respectively. Overall, the rVE of aIIV3 was 27.5% (95% CI, 24.4% to 30.5%) vs IIV4e and 13.9% (95% CI, 10.7% to 17.0%) vs HD-IIV3. aIIV3 had a more favorable rVE in inpatient and outpatient settings. Findings remained consistent across age subgroups and during alternative seasonal dates.

Conclusions
Adults age ≥65 years vaccinated with aIIV3 had fewer influenza-related medical encounters compared with IIV4e or HD-IIV3 during the 2019–2020 US influenza season.
An evaluation of the validity of an in vitro and an in situ/in vitro procedure for assessing protein digestibility of blood meal, feather meal and a rumen-protected lysine prototype
Authors: Estes Kari A , Yoder Peter S , Stoffel Clayton M , Hanigan Mark D 
Published: April 2022

Abstract
In vitro procedures are commonly used to estimate rumen protein degradability and protein digestibility of feed ingredients. However, it is unclear how well these assays correlate to in vivo data. The objectives of this work were to compare postruminal protein availability estimates from one in vitro procedure and one in situ/in vitro procedure with in vivo observations for blood meal (BM), feather meal (FM), and a rumen-protected lysine prototype (RP-Lys). The FM and BM used for this experiment were subsamples of material assessed in vivo by an isotope-based method and the RP-Lys subsamples were of a prototype tested in two in vivo trials: a lactation trial and by plasma appearance. Subsamples of the BM (n = 14) and the FM (n = 22) were sent to each of three different laboratories for in vitro or in situ/in vitro analysis of crude protein (CP) and determination of rumen undegraded protein (RUP) and digested RUP (dRUP). Subsamples of the RP-Lys (n = 5) were sent to one laboratory for in vitro analysis of CP, RUP, and dRUP. Two diets containing BM or FM were assessed using the Cornell Net Carbohydrate and Protein System (CNCPS) v6.55 with ingredient inputs derived from either the CNCPS feed library, the isotope dilution method, or an average of the in vitro results from the three laboratories to determine how much the differences among estimates affected ingredient values. In vitro dRUP estimates for BM from one laboratory closely matched those determined in vivo (66.7% vs. 61.2%, respectively), but no in vitro estimates for FM matched the in vivo values. Surprisingly, there were significant differences in protein digestibility estimates from the modified three-step procedure across the two laboratories for BM (P &lt; 0.0001) and for FM (P &lt; 0.0001) indicating significant variation among laboratories in application of the method. Within all laboratories, BM estimates were reported in a narrow range (CV values of 2.6 or less). However, when testing multiple samples of FM or the RP-Lys prototype, CV values within a laboratory ranged up to 11 and 34, respectively. For the RP-Lys, dRUP estimates from the in vitro method were roughly half of that determined by the in vivo methods suggesting poor concordance between the in vitro and in vivo procedures for this ingredient. The inconsistencies within and among laboratories accompanied with dissimilarities to in vivo data is problematic for application in nutrition models. Additional refinement to the in vitro techniques is warranted.
More than a Virulence Factor: Patulin Is a Non-Host-Specific Toxin that Inhibits Postharvest Phytopathogens and Requires Efflux for Penicillium Tolerance
Authors: Bartholomew Holly P. , Bradshaw Michael J. , Macarisin Otilia , Gaskins Verneta L. , Fonseca Jorge M. , Jurick Wayne M. 
Published: April 2022

Mycotoxin contamination is a leading cause of food spoilage and waste on a global scale. Patulin, a mycotoxin produced by Penicillium spp. during postharvest pome fruit decay, causes acute and chronic effects in humans, withstands pasteurization, and is not eliminated by fermentation. While much is known about the impact of patulin on human health, there are significant knowledge gaps concerning the effect of patulin during postharvest fruit–pathogen interactions. Application of patulin on six apple cultivars reproduced some blue mold symptoms that were cultivar-independent and dose-dependent. Identical symptoms were also observed in pear and mandarin orange. Six Penicillium isolates exposed to exogenous patulin exhibited delayed germination after 24 h, yet all produced viable colonies in 7 days. However, four common postharvest phytopathogenic fungi were completely inhibited by patulin during conidial germination and growth, suggesting the toxin is important for Penicillium to dominate the postharvest niche. Using clorgyline, a broad-spectrum efflux pump inhibitor, we demonstrated that efflux plays a role in Penicillium auto-resistance to patulin during conidial germination. The work presented here contributes new knowledge of patulin auto-resistance, its mode of action, and inhibitory role in fungal–fungal interactions. Our findings provide a solid foundation to develop toxin and decay mitigation approaches.
Cancer diagnosis in primary care after second pandemic year in Catalonia: a time-series analysis of primary care electronic health records covering about five million people
Authors: Mora Núria , Guiriguet Carolina , Cantenys Roser , Méndez-Boo Leonardo , Marzo-Castillejo Mercè , Benítez Mència , Fina Francesc , Fàbregas Mireia , Hermosilla Eduardo , Mercadé Albert , Medina Manuel , Coma Ermengol 
Published: April 2022

AbstractBackgroundDuring COVID-19 pandemic, incidence of chronic disease had drastically been reduced due to health care interruptions. The aim of this study is to analyze cancer diagnosis during the two years of the COVID-19 pandemic.MethodsTime-series study of malignant neoplasms, using data from the primary care electronic health records from January 2014 to December 2021. We obtained the expected monthly incidence using a temporary regression adjusted by trend and seasonality. We additionally compared cancer incidence in 2019 with those of 2020 and 2021 using the T-Test. We performed analysis globally, by sex and by type of cancer.ResultsDuring 2020, the incidence of cancer had reduced by -21% compared to 2019 (p-value <0.05). Greater reductions were observed during lockdown in early 2020 (>40%) and with some types of cancers, especially prostate and skin cancers (−29.6% and -26.9% respectively, p-value<0.05). Lung cancers presented statistically non-significant reductions in both years. Cancer diagnosis returned to expected around March 2021, and incidence in 2021 was similar to that of 2019 (overall difference of 0.21%, p=0.967). However, -11% reduction still was found when comparing pandemic months of 2020-2021 with pre-pandemic months (2019-2020)ConclusionsAlthough primary care cancer diagnostic capacity in 2021 has returned to pre-pandemic levels, missing diagnoses during the last two years have not been fully recovered.Key messagesCancer diagnoses have dramatically dropped during 2020 worldwide.We observe a -21% decline in 2020, but a return to pre-pandemic diagnosis capacity in 2021.A -11% outstanding drop was still found comparing pre-pandemic to pandemic months.Reductions were greater during the lockdown (>40%).Lung and breast cancers presented fewer reductions while prostate and skin cancers had greater drops.Missing diagnoses during the last two years have not been fully recovered
Mechanisms of central brain atrophy in multiple sclerosis
Authors: Klistorner Samuel , Barnett Michael H , Graham Stuart L , Yiannikas Con , Parratt John , Klistorner Alexander 
Published: April 2022

Background and objectivesThe measurement of longitudinal change in ventricular volume has been suggested as an accurate and reliable surrogate of central brain atrophy (CBA), potentially applicable to the everyday management of patient with multiple sclerosis (MS). To better understand mechanisms underlying central brain atrophy in RRMS patients we investigated the contribution of inflammatory activity in different lesion compartments to the enlargement of ventricular CSF volume. In addition, we investigated the role of the severity of lesional tissue damage in CBA progression.MethodsPre- and post-gadolinium 3D-T1, 3D fluid-attenuated inversion recovery (FLAIR) and diffusion tensor images were acquired from 50 patients with relapsing MS. Lesional activity between baseline and 48 months was analysed on FLAIR images using custom-build software, which independently segmented expanding part of the chronic lesions, new confluent lesions and new free-standing lesions. The degree of lesional tissue damage was assessed by change in Mean Diffusivity (MD). Volumetric change of lateral ventricles was used as a measure of central brain atrophy.ResultsDuring follow-up ventricles expanded on average by 12.6+/-13.7%. There was significant increase of total lesion volume, 69.3% of which was due to expansion of chronic lesions and 30.7%-to new (confluent and free-standing) lesional activity. There was high degree of correlation between volume of combined lesional activity and CBA (r2=0.67), which became considerably stronger when lesion volume was adjusted by the degree of tissue damage severity (r2=0.81). Linear regression analysis explained 90% of CBA variability and revealed that chronic lesion expansion was by far the largest contributor to ventricular enlargement (Standardized Coefficient Beta 0.68 (p<0.001) for expansion of chronic lesions compared to 0.29 (p=<0.001) for confluent lesions and 0.23 (p=0.001) for free-standing new lesions). Age and baseline ventricular volume also provided significant input to the model.DiscussionOur data suggest that central brain atrophy is almost entirely explained by the combination of the volume and severity of lesional tissue activity. Furthermore, the expansion of chronic lesions plays a central role in this process.
A distinct four-value blood signature of pyrexia under combination therapy of malignant melanoma with BRAF/MEK-inhibitors evidenced by an algorithm-defined pyrexia score
Authors: Schaefer Hannah , Rübben Albert , Esser André , Araujo Arturo , Persa Oana-Diana , Leijs Marike 
Published: April 2022

ABSTRACTPyrexia is a frequent adverse event of BRAF/MEK-inhibitor combination therapy in patients with metastasized malignant melanoma (MM). The study’s objective was to identify laboratory changes which might correlate with the appearance of pyrexia. Initially, data of 38 MM (14 with pyrexia) patients treated with dabrafenib plus trametinib were analysed retrospectively. Graphical visualization of time series of laboratory values suggested that a rise in C-reactive-protein, in parallel with a fall of leukocytes and thrombocytes, were indicative of pyrexia. Additionally, statistical analysis showed a significant correlation between lactate dehydrogenase (LDH) and pyrexia. An algorithm based on these observations was designed using a deductive approach in order to calculate a pyrexia score (PS) for each laboratory assessment in treated patients. A second independent data set with 28 MM patients (8 with pyrexia) was used for the validation of the algorithm. PS based on the four parameters CRP, LDH, leukocyte and thrombocyte numbers, were statistically significantly higher in pyrexia patients, differentiated between groups (F=20,8; p=<0,0001) and showed a significant predictive value for the development of pyrexia (F=6,24; p=0,013). We provide first evidence that pyrexia in patients treated with BRAF/MEK-blockade can be identified and predicted by an algorithm that calculates a score.SUMMARY STATEMENTPyrexia is a severe side effect of BRAF/MEK-inhibitor therapy of malignant melanoma. An algorithm based on the four laboratory values, leukocyte and thrombocyte counts, CRP and LDH, was designed for detecting pyrexia. The used heuristic approach might serve as a blueprint for analysing unevenly sampled or even incomplete clinical data.