bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chromium picolinate balances the metabolic and clinical markers in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled trial
Authors: Kooshki Fateme , Moradi Fardin , Karimi Arash , Niazkar Hamid Reza , Khoshbaten Manouchehr , Maleki Vahid , Pourghassem Gargari Bahram 
Published: August 2020

Objective
Nonalcoholic fatty liver disease (NAFLD) is a complicated disease and is considered as a severe global health problem affecting 30% of adults worldwide. The present study aimed to evaluate changes in oxidative stress, adipokines, liver enzyme, and body composition following treatment with chromium picolinate (CrPic) among patients with NAFLD.

Participants and methods
The current randomized, double-blind, placebo-controlled study was conducted on 46 NAFLD patients with the age range of 20–65 years. Patients were randomly classified into two groups, receiving either 400 µg CrPic tablets in two divided doses of 200 µg (23 patients) or placebo (23 patients) daily for 12 weeks. The participants’ body composition and biochemical parameters were evaluated at the baseline and after 12 weeks.

Results
Serum levels of liver enzymes reduced significantly only in the CrPic group (P < 0.05 for all), but not between the groups after the intervention. Besides, there were significant differences between the study groups regarding body weight and body fat mass, total antioxidant capacity, superoxide dismutase, malondialdehyde, leptin, and adiponectin post-intervention (P = 0.017, P = 0.032, P = 0.003, P = 0.023, P = 0.012, P = 0.003, and P = 0.042, respectively). However, glutathione peroxidase and resistin levels did not differ significantly between groups (P = 0.127 and P = 0.688, respectively).

Discussion and conclusion
This study showed that consuming 400 µg/day of CrPic for 12 weeks in patients with NAFLD causes a significant change in leptin, adiponectin, oxidative stress (expect glutathione peroxidase), and body weight, compared to baseline. Nevertheless, it does not affect liver enzymes. Therefore, the CrPic supplementation may improve adipokines, some anthropometric indices, and oxidative stress in patients with NAFLD.
Consensus document on the management preferences of patients with ulcerative colitis: points to consider and recommendations
Authors: Casellas Francesc , Guinard Vicens Daniel , García-López Santiago , González-Lama Yago , Argüelles-Arias Federico , Barreiro-de Acosta Manuel , Marín Sánchez Laura , Mendive Juan Manuel , Saldaña Roberto , Cabez Ana , Gómez Susana , Loza Estíbaliz 
Published: August 2020

Background and aims
Our objective was to define, describe and organize (on the basis of consensus) the patient’s preferences in the management of ulcerative colitis (UC), in order to further incorporate them in daily practice and improve patients satisfaction, adherence to the treatment and quality of care.

Methods
Qualitative study. A narrative literature review in Medline using Mesh and free-text terms was conducted to identify articles on UC patient preferences as well as clinical scenarios that may influence the preferences. The results were presented and discussed in a multidisciplinary nominal group meeting composed of six gastroenterologists, one primary care physician, one nurse practitioner and one expert patient. Key clinical scenarios and patient preferences were then defined, generating a series of points to consider and recommendations. The level of agreement with the final selection of preferences was established following a Delphi process.

Results
The narrative review retrieved 69 articles of qualitative design and moderate quality. The following key clinical scenarios were identified: diagnosis, follow-up, surgery, and special situations/patients profiles such as adolescents or women. Patient preferences were classified into information, treatment (pharmacological and non-pharmacological), follow-up, relations with health professionals, relations with the health system and administration. Finally, 11 recommendations on patient preferences for UC in relation to its management reached the level of agreement established.

Conclusion
The consensual description of patient’s preferences contribute to identify different areas for improvement in healthcare practice.
A novel value-based scoring system for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a single-centre comparative study of plastic and lumen-apposing metal stents (NOVA study)
Authors: Parihar Vikrant , Basir Yasir , Nally Deirdre , Mellotte Gregory , Manoharan Thilagraj , Walker Caroline , Ridgway P.F. , Conlon K.C. , Breslin Niall , Harewood Gavin C. , Ryan Barbara M. 
Published: August 2020

Objective
Healthcare resources are finite. Value in healthcare can be defined as patient health outcomes achieved per monetary unit spent. Attempts have been made to quantify the value of luminal endoscopy, but there is little in the medical literature describing the value of the complex therapeutic endoscopic activity. This study aimed to characterise the value of endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) with either plastic or lumen-apposing metal stents (LAMSs).

Methods
This is a single-centre, retrospective–prospective comparative study of 39 patients, who underwent EUS-guided PFC drainage between 2009 and 2018. Procedure value was calculated using the formula Q/(T/C), where Q is the quality of procedure adjusted for complications, T procedure duration and C is the complexity adjustment. Quality and complexity were estimated on a 1–4 Likert scale based on the American Society for Gastrointestinal Endoscopy criteria. Time (in minutes) was recorded from the patient entering and leaving the procedure room. Endoscopy time calculated from procedure time was considered a surrogate marker of cost as individual components of procedure cost were not itemized.

Results
Of 39 identified patients who underwent EUS-guided PFC drainage, 11 received double pigtail plastic stents (DPPSs) and 28 received LAMSs. The two groups were comparable in age, gender and aetiology. Nearly 40% of the LAMS interventions were considered high value but only 11% of the plastic stent interventions achieved the same. The difference predominantly was due to a higher rate of complications and longer procedure time.

Conclusion
In this single-centre study, EUS-guided PFC drainage using LAMS was found to be a higher value procedure compared to the use of DPPS.
Mixed histology poses a greater risk for noncurative endoscopic resection in early gastric cancers regardless of the predominant histologic types
Authors: Ozeki Yuichiro , Hirasawa Kingo , Sawada Atsushi , Ikeda Ryosuke , Nishio Masafumi , Fukuchi Takehide , Kobayashi Ryosuke , Makazu Makomo , Sato Chiko , Taguri Masataka , Inayama Yoshiaki , Maeda Shin 
Published: August 2020

Objectives
Clinicopathologic characteristics and treatment outcomes of mixed-histological-type (MT) early gastric cancers (EGCs) treated with endoscopic submucosal dissection (ESD) have not been sufficiently elucidated. We aimed to clarify them in comparison with pure-histological-type EGCs.

Methods
We used 3022 consecutive EGCs in 2281 patients treated with ESD from our prospectively maintained database. Cases were stratified into four groups according to the final diagnosis of the resected specimen are as follows: 2780 pure differentiated-type (DT), 127 DT-predominant MT (D-MT), 87 pure undifferentiated-type (UDT), and 28 UDT-predominant MT (U-MT). Clinicopathologic characteristics and treatment outcome were compared between pure DT and D-MT, and between pure UDT and U-MT separately. Risk factors for deep submucosal invasion, lymphovascular invasion, and a final diagnosis of MT were identified using multivariate analysis.

Results
Both D-MT (41.7 vs. 92.0%; P < 0.0001) and U-MT (35.7 vs. 75.9%; P = 0.0002) showed a significantly lower curative resection rate than their pure histologic counterparts. Multivariate analysis revealed that MT was an independent risk factor for deep submucosal (OR 6.55; 95% CI, 4.18–10.14) and lymphovascular (OR 4.74; 95% CI, 2.72–8.29) invasion. Preoperative biopsy results that did not show well-differentiated tubular adenocarcinoma (OR 28.2; 95% CI, 18.9–42.9) were an independent risk factor for a final diagnosis of MT.

Conclusions
MT poses a greater risk for noncurative resection regardless of the predominant histologic types, reflecting more aggressive malignant potential. Although a biopsy examination rarely shows MT, clinicians should consider the possibility of MT when a biopsy examination does not show well-differentiated tubular adenocarcinoma.
Comparative study of allicin-containing quadruple therapy vs. bismuth-containing quadruple therapy for the treatment of Helicobacter pylori infection: a prospective randomized study
Authors: Li Huan , Xia Xiu-Juan , Zhang Lin-Fang , Chi Jing-Shu , Liu Peng , Wu Hao , Xie Xiao-Ran , Tian De-Lin , Kun Kai-Xiao , Gong Ren-jie , Liu Xiao-Ming , Xu Can-Xia 
Published: August 2020

Background
Bismuth has antimicrobial activity and can improve the efficacy of triple Helicobacter pylori (H. pylori) therapy. Allicin added to conventional therapy for H. pylori infection also improves H. pylori eradication rates. Thus, this study aims to evaluate and compare the efficacy, safety and tolerability of allicin-containing quadruple therapy and bismuth-containing quadruple therapy and to investigate the factors that affect the eradication rates.

Methods
Two hundred twenty H. pylori-infected patients were included and randomly (1:1) assigned to 14-day quadruple therapy: ilaprazole (5 mg bid), doxycycline (100 mg bid), and furazolidone (100 mg bid) with an allicin soft capsule (40 mg of DATS tid) (IDFA) or colloidal bismuth tartrate (220 mg of elemental bismuth bid) (IDFB). Eradication was confirmed by urea breath tests. Symptom improvement, adverse events, and adherence were assessed by a questionnaire.

Results
In the intention-to-treat and per-protocol analysis, the eradication rates for IDFA and IDFB groups were 87.5% (70/80) vs. 86.3% (69/80, P = 0.815) and 91.9% (68/74) vs. 91.8% (67/73, P = 0.980) as first-line therapies; 83.3% (25/30) vs. 83.3% (25/30, P = 1) and 89.3% (25/28) vs. 88.9% (24/27, P = 1) as second-line therapies. Symptom improvement rates were 96.1% and 97.0% for IDFA and IDFB (P = 1). The adverse event rates were 10.9% in IDFA and 14.5% in IDFB groups (P = 0.418). Nausea occurred frequently in IDFB than IDFA (1.8% vs. 8.2%, P = 0.030). Smoking and sharing utensils significantly affected the efficacy.

Conclusion
Allicin-containing quadruple therapy might be regarded as a promising alternative to bismuth-containing quadruple therapy in H. pylori eradication.
Impact of sustained virological response on metabolic disorders in diabetic chronic hepatitis C virus patients after treatment with generic sofosbuvir and daclatasvir
Authors: Abdo Mahmoud , Rabiee Ahmed , Abdellatif Zeinab , Abdel Alem Shereen , Moustafa Ahmed 
Published: August 2020

Objectives
To evaluate the effect of generic sofosbuvir and daclatasvir (SOF/DCV) treatment on the glycemic state and insulin resistance as well as lipid profiles of those who achieved sustained virological response (SVR) in diabetic chronic hepatitis C virus (CHC) patients.

Methods
We retrospectively reviewed 114 CHC patients with evidence of type 2 diabetes that were treated with generic SOF/DCV between May 2016 and August 2017. Baseline demographic and laboratory data were recorded. At 12-week post end of therapy (SVR12), glycemic state and insulin resistance as well as lipid profiles were re-evaluated and compared with baseline.

Results
A total of 98 diabetic CHC patients were finally included and were responders. A significant decline in the glycemic state as well as Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) values (P ≤ 0.0001) was observed, but HOMA-S showed a statistically significant increase (P ≤ 0.0001) at SVR12 in comparison to baseline values. Also, a significant increase in serum total cholesterol, low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels was observed at SVR12 compared to baseline, but serum triglycerides levels showed a significant decrease. Logistic regression showed that the higher baseline HOMA-IR was a significant predictive variable of a decrease ≥20% of HOMA-IR, while higher baseline HOMA-IR and baseline triglycerides emerged as the only significant predictors of the Δ increase LDL-C level at SVR12.

Conclusion
SOF/DCV-based therapy led to an improvement of glycemic state associated with a global worsening of lipid profile. Further studies are strongly warranted to evaluate the cardiovascular balance between amelioration of insulin resistance and negative changes of the lipid profile.
Fluoroquinolone-resistant strains in cirrhotic patients with spontaneous bacterial peritonitis: microbiological and molecular aspects
Authors: Ghweil Ali A. , Bazeed Shamardan Ezzeldin S. , Al Rawy M.H. , Khodeary Ashraf , El-Amir Mostafa I. 
Published: August 2020

Objectives
This study aimed to determine the causative bacterial agents of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and to define antibiotic-resistance patterns in addition to identifying the genetic mutations in the quinolone resistance determining regions (QRDRs).

Patients and methods
Twenty milliliters of ascetic fluid was obtained from 51 patients with SBP. The antibiotic-sensitivity patterns of different strains were determined by the Kirby–Bauer method. Extracted bacterial DNA was used to determine the mutations in four different genes in QRDRs (gyrA, gyrB, parC, and parE) by sequencing after gene amplification by PCR.

Results
Gram-negative bacilli were detected in 60.7% of the patients. Escherichia coli was detected in 33.3% of the patients, and Staphylococcus aureus was detected in 21.6%. Gram-negative bacilli showed the best sensitivity to meropenem (90.3%), followed by amikacin (83.9%). Gram-positive cocci were sensitive to vancomycin and oxacillin at 90 and 80%, respectively. Fluoroquinolone resistance was detected in 27% of the bacterial strains. Mutations in the gyrA and parC genes were detected in quinolone-resistant strains (64.3 and 35.7%, respectively). Several mutations were found in the gyrA gene (Ser83Leu, Ser81Phe, and Ser-84Leu). Ser80Ile and Ser79Tyr mutations were detected in the parC gene. No mutation was detected in the parE gene.

Conclusion
Frequent use of antibiotics as prophylaxis against SBP leads to an increase in antibiotic resistance and changes the microbial pattern of causative agents. The gyrA gene mutation was the most common mutation detected in fluoroquinolone-resistant strains.
Impact of a Prior Nonpancreatic Malignancy on Survival Outcomes of Patients With Stage IV Pancreatic Neuroendocrine Tumor
Authors: Li Gang , Tian Mao-Lin , Bing Yun-Tao , Yuan Chun-Hui , Xiu Dian-Rong 
Published: August 2020

Objective
The aim of the study was to investigate the impact of a previous nonpancreatic malignancy on the survival outcomes in patients with a stage IV pancreatic neuroendocrine tumor (PanNET).

Methods
The Surveillance, Epidemiology, and End Results database was reviewed, and patients diagnosed with a stage IV PanNET between 2004 and 2015 were selected. Patients were divided into 2 groups according to the presence or absence of a previous nonpancreatic malignancy. Clinicopathological characteristics and survival outcomes were compared.

Results
A total of 1582 patients with stage IV PanNET were identified, of whom 116 (7.3%) had a prior malignancy. Prostate (33.62%), breast (17.24%), and gastrointestinal (12.07%) malignancies were the most common. Most prior malignancies (84.48%) were localized and regional. Patients with intervals of 36 months or less, 36 to 60 months, 60 to 120 months, and more than 120 months account for 25.86%, 14.66%, 31.03%, and 28.45% of all cases, respectively. Before and after propensity score matching, there was no significant difference detected regarding survival outcomes.

Conclusions
Stage IV PanNET patients with a history of a prior cancer had comparable survival outcomes with patients without such history. These patients could be candidates for clinical trials if otherwise appropriate, and aggressive and potentially curative therapies should be offered.
Proteomic Analysis of Cell Lines and Primary Tumors in Pancreatic Cancer Identifies Proteins Expressed Only In Vitro and Only In Vivo
Authors: Coleman Orla , Henry Michael , O'Neill Fiona , Roche Sandra , Swan Niall , Geoghegan Justin , Conlon Kevin , McVey Gerard , Moriarty Michael , Meleady Paula , Clynes Martin 
Published: August 2020

Objectives
A limited repertoire of good pancreatic ductal adenocarcinoma (PDAC) models is one of the main barriers in developing effective new PDAC treatments. We aimed to characterize 6 commonly used PDAC cell lines and compare them with PDAC patient tumor samples using proteomics.

Methods
Proteomic methods were used to generate an extensive catalog of proteins from 10 PDAC surgical specimens, 9 biopsies of adjacent normal tissue, and 6 PDAC cell lines. Protein lists were interrogated to determine what extent the proteome of the cell lines reflects the proteome of primary pancreatic tumors.

Results
We identified 7973 proteins from the cell lines, 5680 proteins from the tumor tissues, and 4943 proteins from the adjacent normal tissues. We identified 324 proteins unique to the cell lines, some of which may play a role in survival of cells in culture. Conversely, a list of 63 proteins expressed only in the patient samples, whose expression is lost in culture, may place limitations on the degree to which these model systems reflect tumor biology in vivo.

Conclusions
Our work offers a catalog of proteins detected in each of the PDAC cell lines, providing a useful guide for researchers seeking model systems for PDAC functional studies.
The Impact of Delays in Low-Income Women’s Breast Cancer Experiences
Authors: Jerome-D’Emilia Bonnie , Suplee Patricia D. , Robles-Rodriguez Evelyn , D’Emilia Wyatt 
Published: August 2020

Background
Low-income, underinsured and uninsured women are less likely to be diagnosed via mammogram and more often diagnosed at later stages, with a resultant negative impact on survival. The New Jersey Cancer Education and Early Detection Program provides access to cancer screening services for low-income, underinsured and uninsured individuals. This program was recently evaluated, and it was found that enrollees were more likely to be diagnosed at later stages than nonenrollees, which may be related to delays in diagnosis and treatment

Objective
The aim of this study was to determine if there were delays in diagnosis and treatment for program enrollees and, if so, what were the causes of these delays.

Methods
A qualitative methodology was used incorporating in-depth interviews with 20 women diagnosed with breast cancer through the New Jersey Cancer Education and Early Detection Program. Qualitative content analysis was used for data analysis.

Results
Three themes emerged: poor access to healthcare, lack of knowledge, and sense of spirituality. Nineteen of 20 women experienced delays in care; 9 were diagnosed with late stage (III or IV) disease.

Conclusions
While the lack of insurance was a factor, fear, family needs, and a tendency to not prioritize their own health were additional reasons for delays in diagnosis and treatment.

Implications for Practice
Programs such as this are integral to the care of low-income, uninsured individuals. However, such programs are not sufficient to meet the needs of low-income women. The lack of a usual source of care is likely to be a factor in the delays these women experienced.
Variable Mechanisms of Dog-Related Deaths
Authors: Byard Roger W. , Langlois Neil E.I. 
Published: August 2020

AbstractAs the literature has tended to focus on injuries and deaths due to active dog attacks, the following review was undertaken to examine the range of circumstances and mechanisms that may be associated with all types of fatal encounters with dogs. A search was undertaken of the literature and the Forensic Science SA, Australia, autopsy database for cases where deaths had been caused by dog-related activity. Only 2 cases were found in the autopsy database over a 15-year period from 2005 to 2019. The first was a 55-year-old man who bled to death from a large degloving dog bite to his forehead exacerbating underlying cardiovascular disease. The second was a 40-year-old previously splenectomized man who died ofCapnocytophaga canimorsussepsis shortly after being bitten by his dog. Dogs may be involved in vehicle crashes if drivers swerve to avoid them or if pedestrians attempt to rescue dogs that have strayed onto roads. In the literature, trauma has also occurred from “non-bite dog-related injuries” where individuals have been pulled over by, or tripped on, dogs. Dogs may also be responsible for specific types of infections such as echinococcosis andC. canimorsus, which may have potentially lethal consequences. Thus, the types of cases of injuries, illnesses, and deaths associated with dogs encountered by pathologists in a forensic context may be extremely diverse and not always straightforward.
Primary Palate Reconstruction Combined With Cranio-Maxillo-Facial Fixation After Self-Inflicted Gunshot Wound Injury: Critical Incision Planning for Regional Flap Reconstruction
Authors: Brennan Tara E. , Nicholas Robert G. 
Published: August 2020

Abstract
Self-inflicted gunshot wounds (GSW) to the palate result in complex bony and soft tissue trauma to the mid and upper face. Patients who survive these injuries are faced with significant speech and feeding difficulties. Upper and midface fractures open reduction and internal fixation (ORIF) is required for many of these patients, and consideration to incision planning is critical in order to preserve a primary option for oroantral fistula repair. The temporoparietal fascia (TPF) flap is an excellent option for primary palate repair as it is often exposed in the operative field during facial fracture ORIF and can be readily used for this purpose if its blood supply and width is not inadvertently compromised while making a temporal incision. This flap is easy to elevate, does not require any microvascular expertise, and using the TPF to reconstruct the palate injury primarily may save the patient years of wearing an obturator and/or subsequent trips to the OR for operative fistula management. In contrast to the temporalis muscle flap, this flap does not create temporal hollowing after elevation, which is a significant aesthetic complaint among patients. Proper incision planning is critical to preserve this flap as an option for palate fistula repair as the fascial layer is often incised when making coronal incisions. Primary repair of palate injuries using the TPF flap at the same time as upper facial ORIF has very little morbidity in this setting, and greatly augments patients’ quality of life.