bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of liver cirrhosis in individuals with hepatitis B virus infection in sub‐Saharan Africa: Systematic review and meta‐analysis
Authors: Surial Bernard , Wyser Dominik , Béguelin Charles , Ramírez‐Mena Adrià , Rauch Andri , Wandeler Gilles 
Published: November 2020

AbstractBackground & AimsChronic hepatitis B virus (HBV) infection accounts for 30%‐50% of cirrhosis related deaths in sub‐Saharan Africa (SSA). Since HBV‐related cirrhosis is an indication for immediate antiviral therapy and cancer surveillance, we aimed to estimate the prevalence of cirrhosis among treatment‐naïve patients with chronic HBV infection in SSA.MethodsWe performed a systematic review of published articles which evaluated liver fibrosis stage among treatment‐naïve HBV‐infected individuals who presented to care in SSA. Our primary outcome was the prevalence of cirrhosis in HBsAg‐positive persons, which was estimated using random‐effects meta‐analysis. Risk factors for cirrhosis were explored using subgroup‐analyses and multivariable meta‐regression.ResultsOf 2129 articles identified, 17 met our eligibility criteria. The studies described 22 cohorts from 13 countries, including 13 cohorts (3204 patients) with chronic HBV mono‐infection and nine cohorts (688 patients) with HIV/HBV‐coinfection. Liver fibrosis was assessed using transient elastography (10 cohorts), APRI score (11 cohorts), and Fibrotest (one cohort). The pooled prevalence of cirrhosis was 4.1% (95% confidence interval [CI] 2.6‐6.4) among studies from primary care facilities or general population, compared to 12.7% (95% CI 8.6‐18.3) in studies performed in referral or tertiary care facilities (adjusted odds ratio 0.29, 95% CI 0.15‐0.56). We found no association between cirrhosis and age, gender, fibrosis test used or HIV‐coinfection.ConclusionsDepending on the setting, between 4% and 13% of HBV‐infected individuals in SSA have cirrhosis and need immediate antiviral therapy. These estimates should be considered when planning HBV treatment strategies and resource allocation.
Host plant diet affects growth and induces altered gene expression and microbiome composition in the wood white (Leptidea sinapis) butterfly
Authors: Näsvall Karin , Wiklund Christer , Mrazek Veronika , Künstner Axel , Talla Venkat , Busch Hauke , Vila Roger , Backström Niclas 
Published: November 2020

AbstractIn a time with decreasing biodiversity, especially among insects, a detailed understanding about specific resource utilization strategies is crucial. The physiological and behavioural responses to host switches in phytophagous insects are poorly understood. Earlier studies indicate that a host plant switch might be associated with distinctive molecular and physiological responses in different lineages. Expanding the assessment of such associations across Lepidoptera will reveal if there are general patterns in adaptive responses, or if each switch event is more of a unique character. We investigated host plant preference, fitness consequences, effects on expression profiles and gut microbiome composition in two common wood white (Leptidea sinapis) populations with different host plant preferences from the extremes of the species distribution area (Sweden and Catalonia). Our results show that female Catalonian wood whites lack preference for either host plant (Lotus corniculatus or L. dorycnium), while Swedish females laid significantly more eggs on L. corniculatus. Individuals from both populations reared on L. dorycnium had longer developmental times and smaller body size as adults. This indicates that both environmental and genetic factors determine the choice to use a specific host plant. Gene expression analysis revealed a more pronounced response to host plant in the Catalonian compared to the Swedish population. In addition, host plant treatment resulted in a significant shift in microbiome community structure in the Catalonian population. Together, this suggests that population specific plasticity associated with local conditions underlies host plant utilisation in wood whites.
A multidecadal Bayesian trend analysis of harbor porpoise(Phocoena phocoena) populations off California relative to past fishery bycatch
Authors: Forney Karin A. , Moore Jeffrey E. , Barlow Jay , Carretta James V. , Benson Scott R. 
Published: November 2020

AbstractHarbor porpoises,Phocoena phocoena, off California, comprise four recognized population stocks: Morro Bay (MOR), Monterey Bay (MRY), San Francisco‐Russian River (SFRR), and Northern California‐Southern Oregon (NCSO). The three southernmost stocks experienced substantial bycatch in gill net fisheries during the 1970s and 1980s. While the SFRR stock received full protection from gill nets in 1989, the MOR and MRY stocks continued to experience at least some bycatch through 2001–2002. We examined long‐term population trends for these four harbor porpoise stocks, based on two sets of systematic, aerial line‐transect surveys conducted off California during summer/fall of 1986–2017. We applied a Bayesian hierarchical framework to specify a process model of population density and an observation model of porpoise counts during line‐transect surveys. Growth rates were estimated for periods with and without bycatch. Posterior distributions indicate the MOR, MRY, and SFRR stocks, respectively, grew at 9.6%, 5.8%, and 6.1% per year after gill nets were largely or fully eliminated for each stock. Abundance off northern California appears stable or slightly increasing. This study provides a first empirical estimate of maximum net reproductive rate for harbor porpoise (at least 9.6%), and demonstrates that porpoise populations can recover from substantial gill net impacts if bycatch is eliminated.
Development of an FhbB based chimeric vaccinogen that elicits antibodies that block Factor H binding and cleavage by the periopathogen Treponema denticola
Authors: O'Bier Nathaniel S. , Patel Dhara T. , Oliver Lee D. , Miller Daniel P. , Marconi Richard T. 
Published: November 2020

AbstractTreponema denticola is a proteolytic anaerobic spirochete and key contributor to periodontal disease of microbial etiology. As periodontal disease develops and progresses, T. denticola thrives in the hostile environment of the subgingival crevice by exploiting the negative regulatory activity of the complement protein, factor H (FH). FH bound to the cell surface receptor, FhbB (FH binding protein B), is competent to serve as a cofactor for the Factor I mediated‐cleavage of the opsonin C3b. However, bound FH is ultimately cleaved by the T. denticola protease, dentilisin. As the T. denticola population expands, the rate of FH cleavage may exceed its rate of replenishment leading to local FH depletion and immune dysregulation culminating in tissue and ligament destruction and tooth loss. The goal of this study was to develop a T. denticola FhbB based‐vaccine antigen that can block FH binding and cleavage and kill cells via antibody‐mediated bactericidal activity. Tetra (FhbB‐ch4) and pentavalent fhbB (FhbB‐ch5) chimerics were engineered to have attenuated FH binding ability. The chimerics were immunogenic and elicited high‐titer bactericidal and agglutinating antibody. Anti‐Fhb‐ch4 antisera blocked FH binding and cleavage by the T. denticola protease, dentilisin, in a dose dependent manner. Precedent for the use of FH binding proteins comes from the successful development of two FDA approved vaccines for type B Neiserria meningitidis. This study is the first to extend this approach to the development of a preventive or therapeutic vaccine (or monoclonal Ab) for periodontal disease.
Epithelioid haemangioma (angiolymphoid hyperplasia with eosinophilia subtype) involving the vermillion border of the lower lip
Authors: Robinson Liam , Lebaka Chidinyane S. , van Heerden Willie F. P. 
Published: November 2020

AbstractEpithelioid vascular tumours include benign epithelioid haemangioma (EH) and epithelioid angiomatous nodule, low‐grade malignant epithelioid haemangioendothelioma and high‐grade epithelioid angiosarcoma. These tumours share epithelioid cell morphologies and intracytoplasmic vacuoles, with distinction based on differing architectural and nuclear features. This report highlights a case of EH, angiolymphoid hyperplasia with eosinophilia subtype, involving the vermillion border of the lower lip in an elderly female patient. The clinical and histological features, differential diagnosis, aetiopathogenesis, molecular basis and treatment options are discussed as part of a comprehensive review of this rare entity.
Midazolam dosage in intravenous conscious sedation
Authors: Irshad Hinna , Loke Stephanie , Lord Tim 
Published: November 2020

AbstractAimMidazolam is the first‐line drug for intravenous conscious sedation in dentistry. A 5‐mL ampoule of midazolam (1 mg/mL) is a widely used preparation for a carefully titrated optimum sedation dose tailored to the individual patient. In past times at Liverpool University Dental Hospital, a 10‐mL pre‐filled syringe of midazolam (1 mg/mL) was used and with the transition to 5‐mL ampoules, a study was undertaken to assess whether this change had an impact on dosages delivered by sedationists.Materials and methodsA retrospective study was carried out to include 100 patients who were sedated on the Oral Surgery department for a range of surgical procedures. A total of 50 patients were sedated using a 10‐mL pre‐filled syringe and 50 patients were sedated using 5‐mL ampoules. Data collection looked at the total midazolam dosage and other factors including operator, procedure complexity, ASA grade, sedation score and operating conditions score.ResultsThere was a statistical difference between the mean dosages for both groups with an overall lower dose administered in patients who were sedated with 5‐mL ampoules.ConclusionsThe study suggested an impact of human factors when behavioural changes occur as a result of change in practice. The outcome of the study suggested revision of the factors which should influence midazolam dosage and are discussed in this study.
Artificial intelligence in the diagnosis of pediatric allergic diseases
Authors: Ferrante Giuliana , Licari Amelia , Fasola Salvatore , Marseglia Gian Luigi , La Grutta Stefania 
Published: November 2020

AbstractArtificial intelligence (AI) is a field of data science pertaining to advanced computing machines capable of learning from data and interacting with the human world. Early diagnosis and diagnostics, self‐care, prevention and wellness, clinical decision support, care delivery, and chronic care management have been identified within the healthcare areas that could benefit from introducing AI. In pediatric allergy research, the recent developments in AI approach provided new perspectives for characterizing the heterogeneity of allergic diseases among patients. Moreover, the increasing use of electronic health records and personal healthcare records highlighted the relevance of AI in improving data quality and processing and setting‐up advanced algorithms to interpret the data. This review aimed to summarize current knowledge about AI and discuss its impact on the diagnostic framework of pediatric allergic diseases such as eczema, food allergy, and respiratory allergy, along with the future opportunities that AI research can offer in this medical area.
Novel SERPING1 gene mutations and clinical experience of type 1 hereditary angioedema from North India
Authors: Jindal Ankur K. , Rawat Amit , Kaur Anit , Sharma Dhrubajyoti , Suri Deepti , Gupta Anju , Garg Ravinder , Dogra Sunil , Saikia Biman , Minz Ranjana W. , Singh Surjit 
Published: November 2020

AbstractBackgroundThere is paucity of literature on long‐term follow‐up of patients with hereditary angioedema (HAE) from developing countries.ObjectiveThis study was carried out to analyze the clinical manifestations, laboratory features, and genetic profile of 32 patients (21 male and 11 female) from 23 families diagnosed with HAE between January 1996 and December 2019.MethodsData were retrieved from medical records of Paediatric Immunodeficiency Clinic, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ResultsMedian age at onset of symptoms was 6.25 years (range 1‐25 years), and median age at diagnosis was 12 years (range 2‐43 years). Serum complement C4 level was decreased in all patients. All patients had low C1‐esterase inhibitor (C1‐INH) quantitative level (type 1 HAE). SERPING1 gene sequencing could be carried out in 20 families. Of these, 11 were identified to have a pathogenic disease‐causing variant in the SERPING1 gene. While 2 of these families had a previously reported mutation, remaining 9 families had novel pathogenic variants in SERPING1 gene. Because of non‐availability of C1‐INH therapy in India, all patients were given long‐term prophylaxis (attenuated androgens or tranexamic acid (TA) or a combination of the 2). Life‐threatening episodes of laryngeal edema were managed with fresh‐frozen plasma (FPP) infusions. We recorded one disease‐related mortality in our cohort. This happened in spite of long‐term prophylaxis with stanozolol and TA.ConclusionsWe report largest single‐center cohort of patients with HAE from India. Attenuated androgens, fibrinolytic agents, and FPP may be used for management of HAE in resource‐limited settings.
Donor‐derived cell‐free DNA (dd‐cfDNA) for detection of allograft rejection in pediatric kidney transplants
Authors: Puliyanda Dechu P. , Swinford Rita , Pizzo Helen , Garrison Jonathan , De Golovine Aleksandra M. , Jordan Stanley C. 
Published: November 2020

ABSTRACTIn pediatric transplantation, acute rejection is a major contributor of graft failure. Current approaches include kidney biopsy in response to graft dysfunction and/or the emergence of donor‐specific HLA antibodies (DSA). However, biopsy is associated with potential complications. Thus, there is a need for non‐invasive diagnostics. Detection of donor‐derived cell‐free DNA (dd‐cfDNA, AlloSure) > 1% is associated with rejection in adult kidney transplants. Here, we evaluate the utility of dd‐cfDNA for identifying allograft rejection in pediatric patients. Between 10/2017 and 10/2019, 67 patients, who underwent initial testing with dd‐cfDNA as part of routine monitoring or in response to clinical suspicion for rejection, were included. Biopsies were performed when dd‐cfDNA > 1.0% or where clinical suspicion was high. Demographics, dd‐cfDNA, antibody status, and biopsies were collected prospectively. Data were analyzed to determine predictive value of dd‐cfDNA for identifying grafts at risk for rejection. 19 of 67 patients had dd‐cfDNA testing as part of routine monitoring with a median dd‐cfDNA score of 0.37 (IQR: 0.19‐1.10). 48 of 67 patients who had clinical suspicion of rejection had median dd‐cfDNA score of 0.47 (0.24‐2.15). DSA‐positive recipients had higher dd‐cfDNA scores than those who were negative or had AT1R positivity alone (P = .003). There was no association between dd‐cfDNA score and strength of DSA positivity. 7 of 48 recipients had a biopsy with a dd‐cfDNA score <1%; two showed evidence of rejection. Neither DSA nor AT1R positivity was statistically associated with biopsy‐proven rejection. However, dd‐cfDNA >1% was diagnostic of rejection with sensitivity of 86% and specificity of 100% (AUC: 0.996, 0.98‐1.00; P = .002). dd‐cfDNA represents a non‐invasive method for early detection of rejection in pediatric renal transplants. Our study shows dd‐cfDNA to be highly predictive of histological rejection and superior to other indicators such as graft dysfunction or antibody positivity alone. Further studies are necessary to refine these initial observations.
Comparative analysis of outcomes and long‐term follow‐up of robot‐assisted pediatric kidney transplantation, with open counterpart
Authors: Bansal Amit , Maheshwari Ruchir , Chaturvedi Samit , Bansal Devanshu , Kumar Anant 
Published: November 2020

AbstractHow does the robotic kidney transplant fare against the open technique, in pediatric patients? No one knows. To address this question, this study compares the outcomes of robotic kidney transplants, with those of open transplant in these patients. This study was a retrospective analysis of outcomes (renal function and complications), of all pediatric patients (<18 years of age), who underwent kidney transplant at our institute, after 2014, till their last follow‐up. Fisher's exact test was used to compare proportions. Continuous variables were analyzed using Mann‐Whitney test. P value of <.05 was considered significant. Of the twenty‐five patients included, 21 belonged to open group, and 4 to the robotic group. Patients in the robotic group had significantly higher Re‐WIT (P value .002) and had lower analgesia requirement (P value .04). Median follow‐up period was 31 months. Both groups were comparable in terms of length of hospital stay, blood transfusion, and renal function post‐operatively till their last follow‐up. Three patients in the open group had surgical site infection as compared to none in the robotic group. All the patients had functioning grafts till their last follow‐up. Robotic transplant is safe and delivers functional results similar to open technique, with lesser pain and better cosmesis. Longer Re‐WIT in robotic transplant has no impact on post‐operative renal function. Ours is the first known effort to compare robotic technology with the established open technique of transplant in this population. A prospective randomized controlled trial should refine the results of the present study.
Long‐term outcome of transplant ureterostomy in children: A National Review
Authors: Costigan Caoimhe S. , Raftery Tara , Riordan Michael , Stack Maria , Dolan Niamh M. , Sweeney Clodagh , Waldron Mary , Kinlough Mairead , Flynn Joan , Bates Marie , Little Dilly M. , Awan Atif 
Published: November 2020

AbstractBackgroundCAKUT are the most common cause of end‐stage renal failure in children (Pediatr Nephrol. 24, 2009, 1719). Many children with CAKUT have poor urinary drainage which can compromise post‐transplant outcome. Identifying safe ways to manage anatomical abnormalities and provide effective urinary drainage is key to transplant success. Much debate exists regarding optimum urinary diversion techniques. The definitive formation of a continent urinary diversion is always preferable but may not always be possible. We explore the role of ureterostomy formation at transplantation in a complex pediatric group.MethodsWe report six pediatric patients who had ureterostomy formation at the time of transplantation at the National Paediatric Transplant Centre in Dublin, Ireland. We compared renal function and burden of urinary tract infection to a group with alternative urinary diversion procedures and a group with normal bladders over a 5‐year period.ResultsThere was no demonstrable difference in estimated glomerular filtration rate between the groups at 5‐year follow‐up. The overall burden of UTI was low and similar in frequency between the three groups.ConclusionsUreterostomy formation is a safe and effective option for temporary urinary diversion in children with complex abdominal anatomy facilitating transplantation; it is, however, important to consider the implications and risk of ureterostomy for definitive surgery after transplantation.
Vaccine‐induced protection against hepatitis B in pediatric solid organ transplant patients
Authors: Ball Michael , Liverman Rochelle , Serluco Anastacia , Yildirim Inci 
Published: November 2020

AbstractBackgroundVaccination against hepatitis B virus (HBV) has led to a worldwide reduction in disease burden and mortality. Vaccine immunogenicity data in transplanted children are limited, and vaccine‐induced protection may be reduced. We evaluated HBV vaccination coverage, seroprotection rates, and factors influencing vaccine immunity among pediatric solid organ transplant (SOT) patients.MethodsWe retrospectively identified patients ≤21 years of age evaluated for SOT and/or transplanted at our center between January 1, 2015, and December 31, 2018. A detailed chart review was conducted using a standard questionnaire to gather information on demographic, clinical, and laboratory features of patients’ HBV vaccination, and hepatitis B surface antibody (HBsAb) titers.ResultsA total of 381 patients undergoing evaluation and/or transplantation were included: 139 (36.5%) liver, 138 (36.2%) kidney, and 104 (27.3%) heart. Overall, HBsAb at evaluation was reactive in 216 (56.7%), indeterminate in 17 (4.5%), non‐reactive in 138 (36.2%), and not available in 10 (2.6%). Of those that completed a primary HBV vaccine series (n = 304), HBsAb was reactive in 164 (53.9%), indeterminate in 13 (4.3%), non‐reactive in 119 (39.1%), and not available in 8 (2.6%). For those up to date for age on HBV vaccinations with non‐reactive/indeterminate titers at evaluation, revaccination and a follow‐up HBsAb were available in 45 patients of which 33 (73.3%) seroconverted to a reactive HBsAb titer.ConclusionVaccine‐induced protection against HBV infection among high‐risk pediatric SOT recipients can be improved by serology‐based intervention. Though the absence of HBsAb does not always indicate loss of protection, boosting or completing primary series is recommended.
Altered vitamin D metabolic system in follicular cysts of sows
Authors: Grzesiak Malgorzata , Socha Magdalena , Hrabia Anna 
Published: November 2020

ContentsThis study aimed to examine 25OHD3 concentration in the fluid of follicular and follicular lutein cysts of sows in comparison with preovulatory follicles as well as immunolocalize vitamin D metabolic enzymes (CYP27B1 and CYP24A1) and determine their protein abundances in the cyst wall. We have shown for the first time that 25OHD3 level in the fluid of both cyst types was significantly lower than in preovulatory follicles. Furthermore, we have demonstrated CYP27B1 and CYP24A1 protein immunolocalization and abundance in follicular and follicular lutein cysts. The abundance of protein for both metabolic enzymes was decreased in ovarian cysts when compared to preovulatory follicles. We propose that altered VD metabolism in ovarian cyst might associate with their formation in sows.
Cell synchronization by Rapamycin improves the developmental competence of buffalos (Bubalus bubalis) somatic cell nuclear transfer embryos
Authors: Xu Jie , Shi Pengfei , Zhao Xin , Shen Penglei , Feng Yun , Lu Fenghua , Shi Deshun 
Published: November 2020

AbstractThis study mainly explored the effects of Rapamycin on the growth of the Buffalo ear fibroblast (BEF) and embryonic developmental competence of somatic cell nuclear transfer (SCNT). The results show that the appropriate concentration (1 μM) of Rapamycin could significantly improve the proportion of the G0/G1 phase in BEF cells treated at a certain time (72 hr). Simultaneously, the percentage of the G0/G1 phase also was significantly higher than the serum starvation and control group. This may be related to Rapamycin inhibiting the phosphorylation of mTOR and affecting the expression of cell cycle‐related genes (CDK2, CDK4, P27, CycleD1, and CycleD3). Besides, compared with the control group and serum‐starved group, Rapamycin significantly decreased BEF cell apoptosis by reducing ROS generation. Moreover, these results also indicated that the proportion of BEF cells with normal chromosome multiples treated by Rapamycin is significantly higher than that of the serum‐starved group (p < .05). Finally, this study explored the effects of Rapamycin and serum starvation on the embryonic developmental competence of SCNT. The results show that Rapamycin significantly increased the rate of 8‐cell and blastocyst, compared with the control group and serum starvation group (p < .05). To summarize, these results indicate that Rapamycin improved the embryonic development competence of SCNT, which may be related to Rapamycin increasing the percentage of G0/G1 phase and maintaining BEF cell quality.