bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymorphisms in Toll-like receptors 1, 2, 5, and 10 are associated with predisposition to Helicobacter pylori infection
Authors: Kalkanli Tas Sevgi , Kirkik Duygu , Tanoglu Alpaslan , Kahraman Resul , Ozturk Kubra , Esen Muhammed Fevzi , Coskunpinar Mehmet Ender , Cagiltay Eylem 
Published: June 2020

Objective:
Toll-like receptors (TLRs) are significant receptors to the innate immune system which symbolizes a family of pattern recognition receptors. We aimed to investigate associations between rs4833095 polymorphism of TLR1, rs3804099 polymorphism of TLR2, rs5744174 polymorphism of TLR5, and rs10004195 polymorphism of TLR10 in dyspeptic individuals with Helicobacter pylori infection.

Methods:
Genomic DNA was isolated and genotyping of rs4833095 polymorphism in TLR1, rs3804099 polymorphism in TLR2, rs5744174 polymorphism in TLR5, and rs10004195 polymorphism in TLR10 were investigated in 400 individuals (205 in dyspeptic individuals with H. pylori-positive subjects and 195 dyspeptic individuals with H. pylori-negative subjects) by real-time PCR. Statistical analysis was performed by Pearson’s Chi-square test.

Results:
According to our study; rs4833095 polymorphism in TLR1 C allele, rs3804099 polymorphism in TLR2 C allele, rs5744174 polymorphism in TLR5 C allele, and rs10004195 polymorphism in TLR10 A allele increased the risk of H. pylori infection [odds ratio (OR), 2.01; 95% confidence interval (CI), 1.39–3.16; OR, 1.78; 95% CI, 1.19–2.6; OR, 1.87; 95% CI, 1.25–2.78; OR, 2.66; 95% CI, 1.72–4.099, respectively].

Conclusion:
This is the first study that investigates TLRs in H. pylori infection in Turkey. Our findings may support the hypothesis that polymorphisms in certain TLRs may cause a genetic predisposition to H. pylori-related gastric problems.
Patients developing inflammatory bowel disease have iron deficiency and lower plasma ferritin years before diagnosis: a nested case-control study
Authors: Widbom Lovisa , Ekblom Kim , Karling Pontus , Hultdin Johan 
Published: June 2020

Background
Iron deficiency is common among inflammatory bowel disease (IBD) patients, generally reported without comparisons with controls. The aim of this study was to analyse if iron deficiency was more common among those later developing IBD compared to matched controls in a prospective setting.

Methods
We included 96 healthy subjects later developing IBD and 191 matched controls from the Northern Sweden Health and Disease Study. We analysed iron, ferritin, transferrin, and calculated transferrin saturation in plasma sampled at least 1 year prior to IBD diagnosis. Iron deficiency was defined as plasma ferritin <30 µg/L if C-reactive protein (CRP) was <3 mg/L. When CRP was >3 mg/L, iron deficiency could not be excluded if ferritin was <100 µg/L.

Results
Iron deficiency could not be excluded among more male cases vs controls (25.0% vs 2.2%; P < 0.001), whereas with no differences for women (39.6% vs 35.3%; P = 0.538). Ferritin was lower among male IBD cases (P = 0.001) and for ulcerative colitis (P = 0.016 for males and 0.017 for females), but not for Crohn’s disease. Ferritin was associated with a lower risk for IBD and in the ulcerative colitis subgroup when using sex-based z-scores. Ferritin quartiles 2–4 had a 65% lower odds ratio for all IBD, ulcerative colitis, and Crohn’s disease in multivariable analysis.

Conclusions
Lower ferritin was associated with higher risk for developing IBD in a prospective setting. Iron deficiency was more common among healthy males years later developing IBD compared to matched controls, but not among women.
Diabetes Is Associated With the Metastasis of Pancreatic Neuroendocrine Tumors
Authors: Fan Zhiyao , Gong Yitao , Huang Qiuyi , Yang Chao , Cheng He , Jin Kaizhou , Fan Kun , Ni Quanxing , Yu Xianjun , Luo Guopei , Liu Chen 
Published: June 2020

Objectives
Type 2 diabetes mellitus (T2DM) has been associated with several types of cancers, but the role of T2DM in pancreatic neuroendocrine tumors (pNETs) has not been systematically studied.

Methods
In this study, 299 patients with pNETs were recruited, and the clinicopathologic characteristics and prognosis of the diabetic and nondiabetic patients were compared. The association between metformin use and survival was assessed to examine whether metformin impacts the prognosis of pNETs patients.

Results
The prevalence of T2DM in the cohort was 20.7% (n = 62). The proportions of grade 3 tumors, distant metastases, and nerve invasion in pNET patients with T2DM were higher than those in patients without T2DM, and as a result, the survival was worse in patients with T2DM. After adjusting for the tumor stage, diabetic status was not associated with poor survival in the univariate analysis. The results of logistic regression showed that pNET patients with T2DM were at high risk for tumor metastasis (odds ratio [OR], 2.81; P = 0.001), nerve invasion (OR, 2.43; P = 0.029), and grade 3 tumors (OR, 4.97; P = 0.010).

Conclusions
Type 2 diabetes mellitus is associated with pNET metastasis and not an independent risk factor for poor prognosis in pNETs.
Safety and Clinical Outcomes of Using Low–Molecular-Weight Dextran During Islet Autotransplantation in Children
Authors: Ali Hawa M. , Bellin Melena D. , Boucher Alexander A. , Northup Elise F. , Florek Ellen R. , Wilhelm Josh J. , Downs Elissa M. , Schwarzenberg Sarah Jane , Chinnakotla Srinath 
Published: June 2020

Objectives
The objective of this study was to evaluate potential safety and clinical benefit of low–molecular-weight dextran (dextran) use in patients undergoing total pancreatectomy with islet auto transplantation (TPIAT).

Methods
We evaluated 124 children undergoing TPIAT at a single institution, either with (n = 72) or without (n = 52) perioperative dextran infusion. Data on islet graft function and postoperative complications were collected through electronic medical records and patient-reported outcomes from research questionnaires.

Results
Islet graft failure was less likely at 1 year (odds ratio, 0.186; 95% confidence interval, 0.04–0.65) and 2 years (odds ratio, 0.063; 95% confidence interval, 0.003–0.35) post-TPIAT in the dextran group. This finding remained significant at 2 years in multivariate logistic regression modeling adjusting for islet mass, body surface area, and sex. Likewise, in multivariate regression, the odds of partial islet graft function were higher at 1 and 2 years in the dextran group. Dextran use was overall safe, although it did lead to a higher incidence of postoperative bleeding requiring blood transfusions (P < 0.001).

Conclusions
These findings suggest that dextran use may increase the likelihood for sustained post-TPIAT islet graft function, potentially mitigating severity of postoperative diabetes for these children.
The Applicability of a Checklist for the Diagnosis and Treatment of Exocrine Pancreatic Insufficiency
Authors: Pezzilli Raffaele , Capurso Gabriele , Falconi Massimo , Frulloni Luca , Macarri Giampiero , Costamagna Guido , Di Leo Alfredo , Salacone Paola , Carroccio Antonio , Zerbi Alessandro 
Published: June 2020

Objective
To evaluate a rapid checklist capable of identifying exocrine pancreatic insufficiency in outpatients.

Methods
Prospective observational study of a multicenter cohort.

Results
One hundred and two patients were enrolled; 61.8% of the patients had medically-treated benign or malignant pancreatic disease, and 38.2% had a pancreatic resection. Visual examination of the feces was evaluated in 84 patients and it was related to steatorrhea in 51 patients (50.0%). Receiver operating characteristic curves were evaluated for each symptom or clinical sign and four of them (ie, increase in daily bowel movements, number of bowel movements, fatty stools, >10% weight loss) had a satisfactory area under the curve. At multivariate analysis, fatty stools and >10% weight loss entered into this analysis having an area under the curve of 0.916 (95% confidence interval, 0.851–0.981). At 1 month and at one year of follow-up, the pancreatic enzyme replacement therapy administered showed that pancreatic extracts were able to significantly improve the increase in daily bowel movements, the number of bowel movements, fatty and bulky stools and >10% weight loss.

Conclusion
Both fatty stools and >10% weight loss were able to clinically evaluate steatorrhea, and their improvement was sufficient to evaluate substitution therapy.
Positive Orientation and Health‐related Quality of Life in Adult Patients Born With Anorectal Malformations
Authors: Fernandes Mariana , Aminoff Dalia , Violani Cristiano , Grano Caterina 
Published: June 2020

ABSTRACTObjectives:Anorectal malformations (ARMs) are rare congenital colorectal anomalies, which may have a negative impact on health‐related quality of life (HRQoL) due to long‐lasting consequences, like fecal incontinence. The aim of the present study was to test whether a pervasive mode of appraising and viewing life experiences from a positive stance (ie, positivity) mediates the effect of fecal continence on HRQoL.Methods:Participants were enrolled from the Italian Association for Anorectal Malformations. Adult patients with ARMs who completed measures of fecal continence (Hirschsprung Disease/Anorectal Malformation Quality of Life Questionnaire), positivity (Life Satisfaction Scale, Rosenberg Self‐esteem Scale, and Life Orientation Test), and mental/physical HRQoL (SF‐36) were included. Data were analyzed using the PROCESS macro for SPSS statistical software (Model 4).Results:The study included 66 adult patients with ARMs. Mediated regression analyses showed a significant total effect in which patients with higher fecal continence perceived higher physical (β = 0.210, SE = 0.038, 95% CI [0.133, 0.286]) and mental HRQoL (β = 0.226, SE = 0.056, 95% CI [0.115, 0.338]) than patients with lower fecal continence. The indirect effects were also significant, indicating that positivity mediated the impact of fecal continence on physical (β = 0.026, SE = 0.017, 95% CI [0.002, 0.068]), and mental HRQoL (β = 0.146, SE = 0.058, 95% CI [0.047, 0.275]).Conclusions:The findings extend previous literature on ARM patients and additional evidence that an optimistic view of oneself, one's life, and one's future contribute to explain the effects of functional impairments on quality of life.
Outcomes Following Pouch Formation in Paediatric Ulcerative Colitis
Authors: Orlanski‐Meyer Esther , Topf‐Olivestone Chani , Ledder Oren , Dotan Iris , Folmer‐Hansen Lars , Kindermann Angelika , Assa Amit , Kolho Kaija‐Leena , Kolaček Sanja , Carroll Matthew W. , Strisciuglio Caterina , Aloi Marina , Hansen Richard , Navon Dan , Winter Harland S. , Navas‐López Victor M. , de Ridder Lissy , Smets Françoise , Weiss Batia , Turner Dan 
Published: June 2020

ABSTRACTIntroduction:Contemporary pediatric data on pouch outcomes are sparse, especially in the era of laparoscopic surgeries. We aimed to assess outcomes and predictors in children with ulcerative colitis/inflammatory bowel disease (IBD)‐unclassified who underwent colectomy and ileal pouch‐anal anastomosis.Methods:This was a multicenter retrospective cohort study from 17 IBD centers affiliated with the pediatric IBD Porto group of ESPGHAN. An electronic REDcap system was used to collate baseline characteristics, demographic, clinical, management and surgical data, short‐ and long‐term outcomes, and to identify potential predictors of pouch outcome.Results:Of the 129 patients included, 86 (67%) developed pouchitis during follow‐up of median 40 months (interquartile range 26–72), of whom 33 (26%) with chronic pouchitis. Patients operated on by surgeons performing <10 pouch surgeries/year had a higher rate of chronic pouchitis (11/27 [41%] vs 8/54 [15%], P = 0.013) on both univariable and multivariable analyses and also associated with time to pouchitis (P = 0.018) and chronic pouchitis (P = 0.020). At last follow‐up, overall pouch performance was rated good/excellent in 86 (74%) patients. Time from colectomy to pouch formation was not associated with pouch outcomes. Despite higher rate of nonsevere surgical complications among children undergoing colectomy at <10 years of age (7/16 [44%] vs 10/92 [11%], P = 0.003), functional outcome and pouchitis rate did not differ.Conclusions:Pouchitis rate in children with ulcerative colitis/IBD unclassified is high. Surgeon experience is the major modifiable risk factor for pouch outcome. Our analyses suggest that pouch surgery can also be performed successfully in young children.
Observing the Implementation of Shared Decision-making in Routine Radiotherapy Cancer Nursing
Authors: Efverman Anna , Bergius Axelsson Beata 
Published: June 2020

Background
Healthcare professionals have driven decision-making in the past. However, shared decision-making has the potential to increase quality of care.

Objective
To determine to what degree patients undergoing routine pelvic radiotherapy care perceive decision-making as being shared between patient and healthcare professionals.

Methods
This exploratory longitudinal study covered 193 patients undergoing pelvic radiotherapy, mostly women (n = 161 [84%]) treated for a gynecological (n = 132 [68%]) or colorectal (n = 54 [28%]) cancer. We collected data regarding self-perceived level of shared decision-making at the start of radiotherapy and quality of life (QoL) (91%–95% response rate per week) during the radiotherapy period.

Results
The patients reported that they shared the decision-making with the healthcare professionals much (n = 137 [71%]), moderately (n = 33 [17%]), a little (n = 12 [6%]), or not at all (n = 11 [6%]). Male patients (P = .048), patients who did not live with their partner (P = .034), patients with higher education (P = .043), and patients with low functional capacity (P = .018) perceived lower levels of shared decision-making. A higher level of shared decision-making was related to higher QoL at baseline and during the first to third weeks of radiotherapy (P ranged from .001 to .044).

Conclusions
Almost 9 of 10 patients reported that they shared the decision-making moderately or much with the healthcare professionals. The study identified subgroups perceiving lower levels of shared decision-making and found that a higher level of shared decision-making was related to better QoL.

Implications
Healthcare professionals may need to pay extra attention to patients who may perceive that they share decision-making to a low extent.
Predictive Model of Psychological Distress in Patients With Lung Cancer
Authors: Lv Xiao-qing , Wang Bing-qing , Tong Huan-huan , Liu Shan-shan , Tang Hsin-Yi Jean , Hong Jing-fang 
Published: June 2020

Background
Patients with lung cancer suffer from significant psychological distress. The underlying theoretical model that may explain what predicts or mediates the degree of psychological distress has not been elucidated.

Objectives
To describe the incidence of psychological distress in patients with lung cancer and to test a predictive theoretical model of psychological distress based on symptom burden, type D personality, social support, and intrusive thoughts.

Methods
Three hundred eighty-nine patients with stages I to IV lung cancer were recruited. Participants completed a battery of scales, including measures of psychological distress, symptom burden, type D personality, perceived social support, intrusive thoughts, and demographic and clinical characteristics. The predictive theoretical model was tested using structural equation modeling.

Results
Experiencing clinically significant psychological distress was reported by 63.75% of participants. Consistent with the social cognitive processing model, symptom burden, type D personality, social support, and intrusive thoughts all significantly and directly predicted the level of psychological distress in patients with lung cancer. Moreover, intrusive thoughts mediated the effects of type D personality and symptom burden on psychological distress; social support and symptom burden mediated the effects of type D personality on psychological distress.

Conclusions
The majority of the participants experienced psychological distress at a clinically significant level. Intrusive thoughts and social support mediated the effects of type D personality and symptom burden on psychological distress.

Implications for Practice
Patients with type D personality and symptom burden should be identified. Interventions for targeting social support and intrusive thoughts might ultimately reduce their psychological distress.
Psychometric Validation of the Chinese Version of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients With Breast Cancer–Related Lymphedema
Authors: Zhao Huihui , Wu Yanni , Tao Yanling , Zhou Chunlan , De Vrieze Tessa , Li Xiaojin , Chen Liling 
Published: June 2020

Background
Breast cancer–related lymphedema (BCRL) has a notable impact on patients’ quality of life. However, no instrument is available to assess the problems in functioning due to BCRL in China.

Objective
The aims of this study were to translate and validate a Chinese version of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL).

Methods
A process of translation and cultural adaptation was conducted based on international standards. The study included 155 patients with BCRL and 90 patients without lymphedema. Psychometric properties that were tested consisted of internal consistency, test-rest reliability, content, construct and discriminant validity.

Results
The Cronbach’s α was .92, and intraclass correlation coefficient was 0.83. Content validity was confirmed by a sufficient content validity index in item level and scale level. Exploratory factor analysis identified 5 factors accounting for 62.44% of the total variance, and confirmatory factor analysis fit indices were acceptable. Convergent validity was supported by a moderate correlation with the 36-item Short-Form Health Survey Questionnaire and relatively weak correlations with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. There was good divergent validity with all hypotheses evaluating divergent validity were confirmed. Significant differences were found between the lymphedema and nonlymphedema groups.

Conclusion
The Chinese version of the Lymph-ICF-UL is a valid and reliable instrument that can be used in both clinical and scientific settings in China.

Implications
The Chinese version of the Lymph-ICF-UL could be applicable in assessing the impairments in function, activity limitations, and participation restrictions of Chinese patients with BCRL.
Implementing a Transition-to-Practice Program for Novice Clinical Nurse Specialists
Authors: Abel Sarah E. , Carter-Templeton Heather 
Published: June 2020

Purpose
The aim of this study was to determine the impact of a transition-to-practice program on job satisfaction among novice clinical nurse specialists (CNSs) in the US Air Force.

Program Description
A needs assessment was conducted among currently practicing Air Force CNSs (n = 30) to establish the necessity for a transition-to-practice program. Newly graduated CNSs (n = 8) were paired with experienced CNS mentors and met every 2 weeks for 2 months to discuss progress on the CNS core competencies. Before beginning the program, mentees self-reported perceptions related to the core competencies. Mentors focused on areas of self-reported low competency. The Nursing Context Index was administered preintervention and postintervention to assess the program's impact on job satisfaction.

Outcomes
Overall job satisfaction among novice CNSs improved from 5.01 to 5.57 (scale, 1-7) after completing the program. Personal satisfaction (4.30-5.63) and satisfaction with professional support (5.28-6.00) showed the greatest improvement out of the 4 elements of job satisfaction evaluated.

Conclusions
Transition-to-practice programs can be beneficial for novice CNSs in establishing their practice. Future studies with larger sample sizes over longer periods of time are necessary to determine the true impact of similar programs.
High Lifetime Prevalence of Syphilis in Men Who Have Sex With Men and Transgender Women Versus Low Lifetime Prevalence in Female Sex Workers in Lima, Peru
Authors: Hung Phoebe , Osias Ethan , Konda Kelika A. , Calvo Gino M. , Reyes-Díaz E. Michael , Vargas Silver K. , Goldbeck Cameron , Caceres Carlos F. , Klausner Jeffrey D. 
Published: June 2020

Background
The syphilis epidemic continues to cause substantial morbidity worldwide and is worsening despite ongoing control efforts. Syphilis remains an important public health problem among 3 key populations: men who have sex with men (MSM), transgender women, and female sex workers.

Methods
We conducted a retrospective chart review of patients that received rapid point-of-care treponemal antibody tests from January 2019 to July 2019 in 4 sexually transmitted infection (STI) clinics in Lima, Peru. We assessed patient medical records for human immunodeficiency virus (HIV) infection, history of STIs, as well as sociodemographic and behavioral characteristics. Cross-sectional descriptive analyses were used to determine factors associated with treponemal positivity.

Results
We included 401 patient records in our analyses: 252 MSM, 31 transgender women, and 118 female sex workers. The overall median age of patients was 29.0 years (interquartile range, 24.0–36.0 years). Positivity on the treponemal test was 28.9% (95% confidence interval [CI], 24.3%–33.3%) overall, 37.7% (95% CI, 31.7%–44.0%) for MSM, 54.8% (95% CI, 36.0%–72.7%) for transgender women, and 3.4% (95% CI, 0.9%–8.5%) for female sex workers. In the bivariate analysis, treponemal positivity was also associated with receptive anal sex in the last 6 months in MSM (P < 0.01). Additionally, treponemal positivity increased with age (P = 0.0212) and varied by socioeconomic status (P < 0.01). Multivariate Least Absolute Shrinkage and Selection Operator logistic regression showed that treponemal positivity was highly associated with HIV coinfection (adjusted odds ratio, 5.42) and previous STI other than HIV or syphilis (adjusted odds ratio, 1.54).

Conclusions
A review of the medical records of members of 3 key populations who had recently received a rapid point-of-care treponemal test in Lima, Peru, revealed that lifetime prevalence of syphilis was high among MSM and transgender women, but low among female sex workers. Those results may indicate a need for more frequent, regular testing among MSM and transgender women—possibly in conjunction with HIV testing, and appropriate treatment of those shown to be positive.
Primary Extranodal Classical Hodgkin Lymphoma of the Sphenoid Sinus: A Case Report and Brief Review of the Literature
Authors: Odeyemi Olumide O. , Rosser Julie A. 
Published: June 2020

Abstract
Primary sinonasal lymphoma is a relatively rare disease, particularly in Western societies, and the vast majority of these are non-Hodgkin lymphoma. Classical Hodgkin lymphoma (CHL) characteristically originates in lymph nodes; primary extranodal CHL of the sinonasal tract is extremely rare. We report a case of a 63-year-old woman with primary CHL of the sphenoid sinus. The patient presented to the emergency department with complaints of “flashing light” in both eyes. Magnetic resonance imaging studies revealed a 4.2-cm enhancing mass in the sphenoid sinus. Histologic examination of the sphenoid mass revealed a diffuse mixed inflammatory infiltrate, within which were scattered large atypical cells with enlarged nuclei with irregular nuclear contours and prominent eosinophilic nucleoli, consistent with Hodgkin/Reed-Sternberg cells. Immunohistochemical studies showed the large atypical cells to be positive for CD15 and CD30 and negative for CD20 and CD45. In situ hybridization staining for small Epstein-Barr virus–encoded RNA was also positive in the atypical cells. These findings supported the diagnosis of CHL.