bluuebunny/crossref_metadata_2025_split huggingface dataset:
Veränderte intestinale bakterielle Zusammensetzung bei Patienten mit Histaminintoleranz
Authors: Schink Monic , Konturek Peter C. , Tietz Esther , Dieterich Walburga , Neurath Markus F. , Zopf Yurdagül 
Published: October 2019

Zusammenfassung
Hintergrund Die Existenz der Histaminintoleranz (HIT) ist umstritten. Als Ursache wird ein gestörter Histaminabbau infolge einer Diaminooxidase(DAO)-Defizienz vermutet. Doch auch andere Faktoren, z. B. eine erhöhte Histaminproduktion durch Darmbakterien, können zu erhöhten Histaminspiegel beitragen. Ziel dieser Untersuchung war es, eine mögliche Veränderung der Darmbakterien in histaminintoleranten Patienten im Vergleich zu gesunden Personen zu detektieren.
Material und Methodik Bei allen Studienprobanden erfolgte die Bestimmung von Gesamt-IgE, nahrungsmittelspezifischen IgEs, TNF-α, Plasmahistamin sowie der Serum-DAO-Aktivität. Anhand von Stuhlproben wurde die Histamin- und Zonulinkonzentration sowie die bakterielle Zusammensetzung mittels 16S-rRNA-Sequenzierung unter Verwendung der Illumina Plattform analysiert.
Ergebnisse Insgesamt 18 Probanden (30,2 ± 12,5 Jahre, 94,4 % weiblich) wurden in die Studie eingeschlossen. Diese umfassten Patienten mit HIT (n = 8; 28,9 ± 11,2 Jahre) und gesunde Kontrollen (n = 10; 31,3 ± 13,9 Jahre). Innerhalb der Studiengruppen wurden keine signifikanten Unterschiede in der Histaminkonzentration im Stuhl festgestellt, wohingegen die HIT-Patienten tendenziell erhöhte Zonulinkonzentration im Stuhl aufwiesen. Die Mikrobiomanalyse zeigte eine erniedrigte bakterielle α-Diversität (p = 0,05) und ein erhöhtes Vorkommen von Proteobacteria in der HIT-Gruppe. Weiterhin wiesen die HIT-Patienten ein signifikant geringeres Vorkommen der Butyrat-produzierenden Bakteriengattungen Faecalibacterium (p = 0,045) und Butyricimonas (p = 0,003) auf. Zudem waren die Anteile an Sutterella (p = 0,043) und Hespellia (p = 0,043) erniedrigt. In keiner Studiengruppe wurden vermehrt histaminproduzierende Bakterien detektiert.
Schlussfolgerung Unsere Ergebnisse deuten auf eine veränderte Darm-Mikrobiota in Patienten mit HIT hin. Der erhöhte Anteil von Proteobacteria und der erniedrigte Anteil an Butyrat-produzierenden Bakterien sowie höhere Zonulinwerte im Stuhl weisen dabei auf eine mögliche Dysbiose oder eine gestörte Darmbarriere hin. Eine erhöhte intestinale Histaminexposition durch Darmbakterien scheint in der Pathogenese der Histaminintoleranz hingegen unwahrscheinlich.
Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors
Authors: Tahara Tomomitsu , Horiguchi Noriyuki , Terada Tsuyoshi , Yamada Hyuga , Yoshida Dai , Okubo Masaaki , Funasaka Kohei , Nagasaka Mitsuo , Nakagawa Yoshihito , Tsukamoto Tetsuya , Shibata Tomoyuki , Kuroda Makoto , Ohmiya Naoki 
Published: October 2019

Abstract
Background and study aims Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings.
Patients and methods pCLE scanning of 20 SNADET lesions including 16 adenomas and four carcinomas was retrospectively evaluated to explore abnormal pCLE findings in relation to histological features. Diagnostic yield of pCLE findings was prospectively evaluated in an additional 20 SNADET lesions including 16 adenomas and four carcinomas.
Results In a retrospective study, we identified four abnormal pCLE findings of SNADETs: (1) dark epithelium, (2) columnar cells irregularly extending to the lumen, (3) distorted crypt structure, and (4) fluorescein leakage. Dark epithelium distinguished neoplastic lesions (adenomas and carcinomas) from non-neoplastic duodenal mucosa with a sensitivity of 90 % and a specificity of 100 %. Distorted crypt structure distinguished carcinomas from adenomas and non-neoplastic duodenal mucosa with a sensitivity of 100% and a specificity of 94 %. In the prospective study, the sensitivity and the specificity of the dark epithelium for the diagnosis of neoplastic lesions (adenomas + carcinomas) was 75% and 100 %. Sensitivity and the specificity of the distorted crypt structure for discrimination of carcinoma from adenoma were 100 % and 94 %, respectively.
Conclusions The pCLE findings correlated with the histopathology of the SNADETs. Dark epithelium and distorted crypt structure were informative pCLE findings to predict presence of neoplasia and cancer in the SNADET, respectively.UMIN-CTR UMIN000013857 TRIAL REGISTRATION: Single-Center, prospective observational trial UMIN000013857 at upload.umin.ac.jp
Concussion, Sensation-Seeking and Substance use among US Adolescents
Authors: Veliz Phil , McCabe Sean Esteban , Eckner James T. , Schulenberg John E. 
Published: October 2019

Background No large-scale epidemiological survey of adolescents in the US has assessed the association between lifetime history of concussion, propensity toward sensation-seeking, and recent substance use. Methods This study assesses the association between lifetime history of diagnosed concussions, sensation-seeking, and recent substance use (i.e., cigarette use, binge drinking, marijuana use, illicit drug use, and nonmedical prescription drug use) using the 2016 and 2017 Monitoring the Future study of 25,408 8th, 10th, and 12th graders. Results Lifetime diagnosis of concussion was associated with greater odds of past 30-day/2-week substance use. Adolescents who indicated multiple diagnosed concussions (versus none) had two times greater odds of all types of recent substance use, after adjusting for potential confounding factors. Adolescents indicating multiple diagnosed concussions also had higher adjusted odds of cigarette use, binge drinking, and marijuana use) when compared to adolescents who only indicated one diagnosed concussion. Accounting for adolescents’ propensity toward sensation-seeking did not significantly change the association between substance use and multiple diagnosed concussions. Conclusions This study provides needed epidemiological data regarding concussion and substance use among US adolescents. Exposure to a single diagnosed concussion is associated with a modest increase in the risk of substance use and this association increases with the accumulation of multiple diagnosed concussions. These associations hold when controlling for sensation-seeking. Substance use prevention efforts should be directed toward adolescents who have a history of multiple concussions.
Understanding why Patients with Substance use Disorders Leave the Hospital against Medical Advice: A Qualitative Study
Authors: Simon Rachel , Snow Rachel , Wakeman Sarah 
Published: October 2019

Background Hospital discharges against medical advice (AMA) is associated with negative health outcomes and re-admissions. Patients with substance use disorders (SUD) are up to three times more likely to be discharged AMA as compared to those without SUD. Studies suggest that undertreated withdrawal and a perception of stigma may increase the risk, however, to date, there are no published qualitative studies exploring the specific reasons why patients with SUD leave prematurely. Methods Semi-structured interviews with patients ( n = 15) with SUD with documented AMA discharges from our hospital between 9/2017 and 9/2018. Maximum variation sampling was employed to display diversity across gender, race, age, and type of substance use disorder (alcohol vs opioids). Patients were interviewed until no new concepts emerged from additional interviews. Two coders separately coded all transcripts and reconciled code assignments. Results Four core issues were identified as patients’ reasons for leaving the hospital prematurely: undertreated withdrawal and ongoing craving to use drugs, uncontrolled acute and chronic pain, stigma and discrimination by hospital staff about their SUD, and hospital restrictions, including not being allowed to intermittently leave the hospital floor. For patients with histories of criminal involvement, being hospitalized reminded them of being incarcerated. Conclusion These findings shed light on the reasons patients with SUD are discharged from the hospital AMA, an event that is associated with increased thirty-day mortality and hospital re-admission. AMA discharges represent missed opportunities for the health care system to engage with patients struggling with a SUD. Our findings support the need for inpatient addiction treatment, particularly for management of withdrawal and co-occurring pain, and the need to address health care provider associated stigma surrounding addiction.
Impact of the Take ACTION Train-The-Trainer Model of Opioid Overdose Education with Naloxone Distribution– who Benefits?
Authors: Dahlem C. H. , Scalera M. , Chen B. , McCabe S. E. , Boyd C. J. 
Published: October 2019

Background Overdose education with naloxone distribution (OEND) is a key national strategy to reduce morbidity and mortality related to opioid overdoses. Train-the-trainer model has been one method to increase the pool of trainers to facilitate greater dissemination of OEND. This exploratory study seeks to (1) evaluate participant's change in knowledge and confidence, (2) examine if pre- and post-training test outcomes differed by occupation and level of experience, and (3) determine if train-the-trainer participants trained others 6 months later. Methods Fifteen train-the-trainer sessions were delivered to staff from community organizations who served high-risk clients in four counties whose overdose death rates ranged from 11.2 to 32.8 per 100,000. Participants were administered pre- and post-training tests from September 2017 to December 2018. A follow-up survey was conducted 6 months post-training to evaluate outcomes. Final paired pre-and post-training surveys of 109 participants were used for analysis. Paired sample t-tests were used to evaluate changes in the knowledge and confidence in teaching others. One-way ANOVA compared the change scores across groups with different demographic or experiential characteristics. Kruskal-Wallis Test was used for Likert scales. Results The one and one-half hour train-the-trainer curriculum increased participants’ knowledge and confidence to teach others ( p < .001). This was particularly true for participants who had no prior experience compared to those who had some experience with naloxone ( p = .0003). Changes in confidence to teach others significantly improved among demographic subgroups of participants. At 6 months after completing the train-the-trainer curriculum, 14 participants had trained 243 new trainees. Conclusions Implementing a train-the-trainer model for OEND increases knowledge and participants’ confidence to teach others. This demonstrates the important potential of the train-the-trainer model to respond to the growing opioid overdose epidemic.
Effectiveness of Music Therapy on Improving Treatment Motivation and Emotion in Female Patients with Methamphetamine Use Disorder: A Randomized Controlled Trial
Authors: Wu Qianying , Chen Tianzhen , Wang Zhe , Chen Shujuan , Zhang Jingying , Bao Jiayi , Su Hang , Tan Haoye , Jiang Haifeng , Du Jiang , Zhao Min 
Published: October 2019

Objectives The purpose of the study was to investigate whether Group Music Therapy (GMT) could enhance the treatment motivation and change the negative emotion among female patients with methamphetamine use disorder in a randomized clinical trial. Methods Participants ( N = 60) were randomized to the group of GMT combined with treatment as usual (TAU) or the group with TAU only. Questionnaire of Motivation for Abstaining from Drugs was used to measure the motivation for abstaining from drugs of the female patients. And Self-Rating Depression Scale and Self-Rating Anxiety Scale were used to measure negative emotion of participants. The measurements were conducted at T0 (baseline), T1 (post 13 sessions of intervention) and T2 (3-month follow-up after T1) by the independent trained researcher. Results The postintervention and 3-month follow-up results according to the intention-to-treat principle indicated that GMT + TAU intervention showed significantly positive group-by-time effect on the scores of the subscale-tending to rehabilitation-internal motivation ( p = 0.01) and avoiding abuse-external motivation ( p = 0.04). In 3-month follow-up, total scores of the questionnaire of motivation for abstaining from drugs ( p = 0.02), scores of avoiding abuse-internal motivation subscale ( p = 0.05), and scores of confidence of abstaining from drugs subscale ( p = 0.01) in GMT + TAU were also presented with significantly positive group x time effect. The changes of total score of Questionnaire of Motivation for Abstaining from Drugs (from baseline to 3-month follow-up) was significantly positive association with the changes of scores of SAS in GMT + TAU group ( r = −0.55, p = 0.00). Conclusions The present study suggests that GMT could be used as an effective treatment strategy to enhance treatment motivation of female patients with methamphetamine use disorder.
Specific energy cost for nitrogen fixation as NOx using DC glow discharge in air
Authors: Pei Xuekai , Gidon Dogan , Graves David B 
Published: October 2019

Abstract
We report on factors influencing the specific energy costs of producing NO
x
from pin-to-pin DC glow discharges in air at atmospheric pressure. Discharge current, gap distance, gas flowrate, exterior tube wall temperature and the presence and position of activated Al2O3 catalyst powder were examined. The presence of heated catalyst adjacent to the plasma zone improved energy efficiency by as much as 20% at low flows, but the most energy efficient conditions were found at the highest flowrates that allowed a stable discharge (about 10–15 l min−1). Under these conditions, the catalyst had no effect on efficiency in the present study. The lowest specific energy cost was observed to be between about 200–250 GJ/tN. The transport of active chemical species and energy are likely key factors controlling the specific energy costs of NO
x
production in the presence of a catalyst. Air plasma device design and operating conditions must ensure that plasma-generated active intermediate chemical species transport is optimally coupled with catalytically active surfaces.
Palm seed and fruit lipid composition: phylogenetic and ecological perspectives
Authors: Guerin Chloé , Serret Julien , Montúfar Rommel , Vaissayre Virginie , Bastos-Siqueira Aldecinei , Durand-Gasselin Tristan , Tregear James , Morcillo Fabienne , Dussert Stéphane 
Published: October 2019

Abstract

Background and aims
Palms are vital to worldwide human nutrition, in particular as major sources of vegetable oils. However, our knowledge of seed and fruit lipid diversity in the family Arecaceae is limited. We therefore aimed to explore relationships between seed and fruit lipid content, fatty acid composition in the respective tissues, phylogenetic factors and biogeographical parameters.

Methods
Oil content and fatty acid composition were characterized in seeds and fruits of 174 and 144 palm species respectively. Distribution, linear regression and multivariate analyses allowed an evaluation of the chemotaxonomic value of these traits and their potential relationship with ecological factors.

Key Results
A considerable intra-family diversity for lipid traits was revealed. Species with the most lipid-rich seeds belonged to the tribe Cocoseae, while species accumulating oil in the mesocarp occurred in all subfamilies and two-thirds of the tribes studied. Seed and fruit lipid contents were not correlated. Fatty acid composition of mesocarp oil was highly variable within tribes. By contrast, within-tribe diversity for seed lipid traits was low, whereas between-tribe variability was high. Consequently, multivariate analyses of seed lipid traits produced groupings of species belonging to the same tribe. Medium-chain fatty acids predominated in seeds of most palm species, but they were also accumulated in the mesocarp in some cases. Seed unsaturated fatty acid content correlated with temperature at the coldest latitude of natural occurrence.

Conclusion
Several previously uncharacterized palms were identified as potential new sources of vegetable oils for comestible or non-food use. Seed lipid traits reflect genetic drift that occurred during the radiation of the family and therefore are highly relevant to palm chemotaxonomy. Our data also suggest that seed unsaturated fatty acids may provide an adaptive advantage in the coldest environments colonized by palms by maintaining storage lipids in liquid form for efficient mobilization during germination.
The Bell Pattern: A Novel Breast Incision Approach to Skin-Reducing Mastectomies
Authors: Albright William B , Hawkes Patrick J 
Published: October 2019

Abstract

Background
As immediate direct to permanent implant-based breast reconstruction (IBBR) continues to gain in popularity, surgeons seek to apply these techniques to patients with large or ptotic breasts. A new bell pattern skin excision is described and limits major complications in this high-risk population.

Objective
The authors describe a novel skin excision pattern for patients with large or ptotic breasts who desire IBBR and assess its safety. The authors also evaluated the ability of the pattern to account for intraoperative developments.

Methods
This retrospective analysis of a single surgeon’s experience included 17 consecutive patients (31 breasts) with large or ptotic breasts undergoing skin-reducing mastectomy with attempted utilization of the bell pattern approach and IBBR with acellular dermal matrix.

Results
Mean age was 50 years, mean body mass index was 27.4 kg/m2, and mean breast specimen weight was 683 g. A bell pattern excision was planned for all breasts preoperatively. Three breasts (10%) required an alternative closure pattern due to intraoperative ischemia (n = 1), or additional oncologic resection (n = 2). The pattern successfully accommodated flap ischemia in 8 (26%) other breasts. After a median follow-up of 5.1 months, the number of bell pattern breasts with major and minor complications was 0 (0%) and 9 (32%), respectively. The most common minor complication was seroma (n = 5, 18%), and minor incision wound (n = 3, 11%). There were no reconstruction failures utilizing the bell pattern.

Conclusion
The bell pattern approach is a safe and adaptable alternative to traditional skin-reducing mastectomy in patients with large or ptotic breasts.

Level of Evidence: 4
Constitution Making in Asia
Authors: Saunders Cheryl 
Published: October 2019

Abstract
This short article is an introduction to a Symposium on Constitution Making in Asia and the Pacific. It seeks to place constitution making in Asia in the context of the broader global debate. In doing so, it develops the theme of the relationship between the local and the global in constitution-making projects. It suggests four sets of factors that deserve consideration in examining the relationship between local and global influences: ownership, implementation, accountability, and legitimacy. A final section reflects on the experiences of constitution making in Asia and the Pacific and the way in which these factors play out in the various case studies.
Clinical review on triglycerides
Authors: Laufs Ulrich , Parhofer Klaus G , Ginsberg Henry N , Hegele Robert A 
Published: October 2019

AbstractHypertriglyceridaemia is a common clinical problem. Epidemiologic and genetic studies have established that triglyceride-rich lipoproteins (TRL) and their remnants as important contributors to ASCVD while severe hypertriglyceridaemia raises risk of pancreatitis. While low-density lipoprotein is the primary treatment target for lipid lowering therapy, secondary targets that reflect the contribution of TRL such as apoB and non-HDL-C are recommended in the current guidelines. Reduction of severely elevated triglycerides is important to avert or reduce the risk of pancreatitis. Here we discuss interventions for hypertriglyceridaemia, including diet and lifestyle, established treatments such as fibrates and omega-3 fatty acid preparations and emerging therapies, including various biological agents.
Which patients with atrial fibrillation undergo an ablation procedure today in Europe? A report from the ESC-EHRA-EORP Atrial Fibrillation Ablation Long-Term and Atrial Fibrillation General Pilot Registries
Authors: Tilz Roland Richard , Dagres Nikolaos , Arbelo Elena , Blomström-Lundqvist Carina , Crijns Harry J , Kirchhof Paulus , Kautzner Josef , Temporelli Pier Luigi , Laroche Cécile , Roberts Paul R , Pehrson Steen , Lip Gregory Y H , Brugada Josep , Tavazzi Luigi ,   the Atrial Fibrillation Ablation and Atrial Fibrillation Registries Investigators Groups
Published: October 2019

Abstract

Aims
Rhythm control management in patients with atrial fibrillation (AF) may be unequal across Europe. The aim of this study was to investigate how selective the patient cohort referred for AF ablation is, as compared to the general AF population in Europe, and to describe the governing mechanisms for such selection.

Methods and results
Descriptive comparative statistical analyses of the baseline characteristics were performed between the cohorts of Atrial Fibrillation Ablation Long-Term (ESC EORP AFA-LT) registry, designed to provide a picture of contemporary real-world AF ablation, and the AF population from the AF-General (ESC EORP AF-Gen) pilot registry. Data collection was performed using a web-based system. In the AFA and in the Atrial Fibrillation General (AFG) pilot registries, 3593 and 3049 patients were enrolled, respectively. Patients who underwent AF ablation were younger, more commonly male, and had significantly less comorbidities. Atrial Fibrillation Ablation patients often presented without comorbidities, resulting in a lower risk of stroke (CHA2DS2-VASc ≥5: 2.9% vs. 24.5%, all P &lt; 0.001) and bleeding (HAS-BLED ≥2: 8.5% vs. 40.5%, P &lt; 0.001) but with European Heart Rhythm Association (EHRA) scores &gt;1 and more prevalent AF-related symptoms such as palpitations, fatigue, and weakness (all P &lt; 0.001) as compared to the general AF patients. Atrial Fibrillation Ablation patients were significantly more often male, had higher left ventricular ejection fraction (59.5% vs. 52.4%) and smaller left atrial size on echocardiogram (P &lt; 0.001 each).

Conclusion
The comparison of the patient cohorts in the AFA and AFG registries showed that AF ablation in European clinical practice is mostly performed in relatively young, symptomatic and relatively healthy patients.