bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Maintenance Adalimumab Trough Levels are Associated With Achievement of Advanced Remission Targets in Patients With Inflammatory Bowel Disease
Authors: Ritter Einat , Hirsch Ayal , Isakov Naomi F. , Ron Yulia , Cohen Nathaniel A. , Maharshak Nitsan 
Published: October 2020

Background:
Biomarker normalization and endoscopic remission are superior to clinical remission in achieving improved long-term clinical outcomes in patients with inflammatory bowel diseases.

Goal:
To study whether higher maintenance adalimumab levels are associated with clinical remission, biomarker normalization, and endoscopic remission.

Study:
Data were collected retrospectively from the patients’ medical records. We defined clinical remission as a Harvey Bradshaw Index ≤5 or a partial Mayo score ≤2 for Crohn’s disease (CD) and ulcerative colitis (UC), respectively, biomarker normalization as a C-reactive protein <0.5 mg/dL and/or calprotectin <250 (mg/kg), endoscopic remission as a (simple endoscopic score-CD) ≤3/4 for ileal/extensive CD, respectively, or an endoscopic Mayo score ≤1 for UC, and deep remission as the combination of clinical and endoscopic remission with normal biomarkers.

Results:
Ninety-seven patients were included (82 CD and 15 UC). Patients who achieved clinical remission, biomarker normalization, or endoscopic remission had higher serum trough adalimumab levels compared with patients not in remission [mean (M)±standard error (SE)=8.98±0.78 vs. 5.92±0.96 μg/mL; P=0.016, 9.38±0.85 vs. 5.48±0.87 μg/mL; P=0.002; 9.13±0.88 vs. 6.02±0.77 μg/mL; P=0.019, respectively]. Receiver-operating curve analysis showed that an adalimumab level of ≥8.25 μg/mL was associated with deep remission (sensitivity 84%, specificity 70%, area under the curve 0.775; P<0.001).

Conclusion:
Clinical remission, biomarker normalization, and endoscopic remission are positively associated with adalimumab trough levels. Adalimumab level of ≥8.25 μg/mL is associated with deep remission. This study provides additional data to guide therapeutic drug monitoring with adalimumab.
Infection Control Practices and Outcomes of Endoscopy Units in the Lombardy Region of Italy
Authors: Capurso Gabriele , Archibugi Livia , Vanella Giuseppe , Testoni Sabrina G.G. , Petrone Maria C. , Fanti Lorella , Greco Salvatore , Cavenati Sergio , Gaffuri Nicola , Lella Fausto , Pace Fabio , Cengia Gianpaolo , Spada Cristiano , Lovera Mauro , Missale Guido , Rosato Stenio , Radaelli Franco , Buscarini Elisabetta , Parente Fabrizio , Pilati Stefano , Luigiano Carmelo , Passoni Giovanni R. , Salerno Raffaele , Bargiggia Stefano , Penagini Roberto , Cantù Paolo , Fregoni Fiorenza , Giannetti Aurora , Devani Massimo , Manes Gianpiero , Fiori Giancarla , Fontana Paola , Gambitta Pietro , Masci Enzo , Mutignani Massimiliano , Gatti Mario , Canani Marcella B. , Vailati Cristian , Dinelli Marco Emilio , Marzo Vincenza , Alvisi Costanza , Caramia Vitantonio , Di Sabatino Antonio , Mauro Aurelio , De Grazia Federico , Balzarini Marco , Segato Sergio , Nella Giovanni A. , Giannini Patrizia , Leoni Piera , Testoni Pier A. , Mariani Alberto , Arcidiacono Paolo G. 
Published: October 2020

Goals:
The present survey from the Italian Society of Digestive Endoscopy (SIED—Società Italiana di Endoscopia Digestiva) was aimed at reporting infection control practice and outcomes at Digestive Endoscopy Units in a high-incidence area.

Background:
Lombardy was the Italian region with the highest coronavirus disease-2019 (COVID-19) prevalence, at the end of March 2020 accounting for 20% of all worldwide deaths. Joint Gastro-Intestinal societies released recommendations for Endoscopy Units to reduce the risk of the contagion. However, there are few data from high-prevalence areas on adherence to these recommendations and on their efficacy.

Methods:
A survey was designed by the Lombardy section of SIED to analyze (a) changes in activity and organization, (b) adherence to recommendations, (c) rate of health care professionals’ (HCP) infection during the COVID-19 outbreak.

Results:
In total, 35/61 invited centers (57.4%) participated; most modified activities were according to recommendations and had filtering face piece 2/filtering face piece 3 and water-repellent gowns available, but few had negative-pressure rooms or provided telephonic follow-up; 15% of HCPs called in sick and 6% had confirmed COVID-19. There was a trend (P=0.07) toward different confirmed COVID-19 rates among endoscopists (7.9%), nurses (6.6%), intermediate-care technicians (3.4%), and administrative personnel (2.2%). There was no correlation between the rate of sick HCPs and COVID-19 incidence in the provinces and personal protective equipment availability and use, whereas an inverse correlation with hospital volume was found.

Conclusions:
Adherence to recommendations was rather good, though a minority were able to follow all recommendations. Confirmed COVID-19 seemed higher among endoscopists and nurses, suggesting that activities in the endoscopy rooms are at considerable viral spread risk.
Endoscopic Gastrointestinal Anastomosis Using Lumen-apposing Metal Stent (LAMS) for Benign or Malignant Etiologies
Authors: Hakim Seifeldin , Khan Zubair , Shrivastava Ashish , Koroglu Emine , Patil Prithvi , Akyuz Filiz , Akyuz Umit , Ramireddy Srinivas , Badillo Ricardo , DaVee Tomas , Thosani Nirav 
Published: October 2020

Background and Aim:
Endoscopic gastrointestinal anastomosis using lumen-apposing metal stents (EGAL) is a new technique that is used as an alternative method to bypass benign or malignant strictures. Endoscopists take advantage of 2 bowel loops that are close to each other and place a stent between the lumen of these 2 bowel loops. The authors performed this systematic review and meta-analysis to evaluate the efficacy and safety of this rising procedure.

Methods:
Electronic database searches were conducted for full eligible articles that were published from the inception to July 2019 using the EGAL procedure to bypass malignant or benign obstruction or to restore bowel integrity after a gastrointestinal altering surgery. The primary outcome of this meta-analysis was to assess efficacy through technical and clinical success. Secondary outcomes were to assess safety through adverse events and to assess the rate of stent maldeployment and the rate of reintervention during the study period.

Results:
Eight studies were eligible, providing data on 269 patients who underwent 271 EGAL procedures. The median age was 65 years (interquartile range: 63 to 66) with 46% male individuals. Out of 269 patients, 203 underwent EGALs because of malignant etiology and 66 underwent EGAL for benign etiology. The median duration of follow-up was 114 days (interquartile range: 78 to 121). Technical success rate was 94.1% [95% confidence interval (CI), 91.4%-96.9%]. Clinical success rate was 91.4% (95% CI, 88.1%-94.7%). Adverse events rate was 8.5% (95% CI, 4.7%-12.3%). Stent maldeployment rate was 9.5% (95% CI, 3.5%-15.4%) of the total performed EGALs and the reintervention rate was 6.0% (95% CI, 2.3%-9.8%).

Conclusion:
EGAL procedure has high efficacy and a relatively safe profile and it can be performed in selected patients. Comparison between EGAL and other conventional therapies is difficult because of the lack of randomized trials.
Proprotein convertase subtilisin/kexin type 9 inhibition as the next statin?
Authors: Rakipovski Günaj , Hovingh G. Kees , Nyberg Michael 
Published: October 2020

Purpose of review
Despite the wide use of statins and other LDL-cholesterol (LDL-C)-lowering therapies, atherosclerotic cardiovascular disease remains an important cause of mortality and morbidity. Here, we discuss efficacy, side effects and convenience of current and future therapies inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9).

Recent findings
Clinical trials with mAbs administered every 2–4 weeks and small interfering RNAs given two to four times per year have consistently demonstrated substantial LDL-C-lowering (40–60%) and improved outcome when added to existing lipid-lowering therapies. Pleiotropic effects of PCSK9 inhibition are somewhat different from those observed with statin treatment as evidenced by reduced levels of triglycerides and lipoprotein(a) with no apparent effect on inflammatory markers in patients treated with PCSK9 inhibitors. Treatment with mAb and small interfering RNA are associated with a high-cost, however, small molecules and vaccines may improve cost and convenience if development of these are successful.

Summary
PCSK9 inhibitors are currently considered to be an add-on therapy and whether these drugs will be used as stand-alone and/or as a first choice is dependent on clinical readouts from ongoing and future trials, real-world evidence, convenience and treatment costs.
Digital systems for improving outcomes in patients with primary immune defects
Authors: Rider Nicholas L. 
Published: October 2020

Purpose of review
Healthcare has already been impacted by the fourth industrial revolution exemplified by tip of spear technology, such as artificial intelligence and quantum computing. Yet, there is much to be accomplished as systems remain suboptimal, and full interoperability of digital records is not realized. Given the footprint of technology in healthcare, the field of clinical immunology will certainly see improvements related to these tools.

Recent findings
Biomedical informatics spans the gamut of technology in biomedicine. Within this distinct field, advances are being made, which allow for engineering of systems to automate disease detection, create computable phenotypes and improve record portability. Within clinical immunology, technologies are emerging along these lines and are expected to continue.

Summary
This review highlights advancements in digital health including learning health systems, electronic phenotyping, artificial intelligence and use of registries. Technological advancements for improving diagnosis and care of patients with primary immunodeficiency diseases is also highlighted.
Current and future regulatory and financial challenges in vascularized composite allotransplantation
Authors: Cooney Carisa M. , Brandacher Gerald 
Published: October 2020

Purpose of review
To discuss current and future regulatory and financial issues affecting the field of vascularized composite allotransplantation (VCA).

Recent findings
Vascularized composite allografts are regulated by the US Department of Health and Human Services Organ Procurement and Transplantation Network Final Rule (42 CFR part 121) in the United States and Directive 2010/53/EU of the European Parliament and the Council of 7 July 2010 in the European Union (EU). However, in the United States and most of the EU, VCA is not yet paid for by insurance or third-party payers and many centers depend upon grant funding, philanthropic gifts, and/or supplemental hospital/institutional funding strategies to pay for the transplants and postoperative care.

Summary
In the absence of randomized clinical trial data, which is infeasible for studying VCA outcomes, consensus data sets are needed to document these procedures’ value proposition and have them accepted as part of the standard of care. Procedure and immunosuppression protocol variability applied to a small patient cohort necessitates collaborative efforts by field experts to devise creative approaches, such as determining return-on-investment for anatomical subunits, to better understand these transplants’ value and impact on patient quality-of-life.
Recruiting Nurses Via Social Media for Survey Studies
Authors: Bethel Claire , Rainbow Jessica G. , Dudding Katherine M. 
Published: October 2020

Background
Nurses are a difficult population to recruit for research. Barriers to recruitment of nurses include survey fatigue, hospital structures and institutional review boards as gatekeepers to accessing participants, and limited generalizability of findings. Social media present innovative opportunities to recruit participants for survey research. However, there is limited information about best practices for recruiting nurses through social media.

Objectives
The aim of this report was to examine the advantages and disadvantages of and determine the best practices for recruiting nurses for survey studies via social media.

Methods
We examined recruitment strategies of three survey studies involving nurse participants. Each study used social exchange theory and leverage-saliency theory to guide recruitment. The studies included were (a) the Travel Nurse Onboarding Study, which recruited participants from a single closed group on Facebook; (b) the Presenteeism and Nursing Study where participants were recruited using association listservs, healthcare organizations, and paid ads and postings on social media; and (c) the Pain and Nursing Study in which participants were recruited through social media, association listservs, and in person at conferences.

Results
Social media offer accessible, low-cost, high-yield approaches to recruitment of nurses for survey studies.

Discussion
Useful strategies for crafting effective recruitment via social media are presented, including how, where, when, and how often to post. The generalizability of social media research is also discussed. Suggestions are provided for researchers using social media as well as guidelines for institutional review boards to address gray areas of social media research. Data integrity protection techniques are proposed to ensure social media survey data are not corrupted by malicious bots. This report outlines best practices for the recruitment of nurses for survey studies using social media.
Comparison of Regularly Scheduled Ibuprofen Versus “Pro Re Nata” for Ankle Sprains in Children Treated in the Emergency Department
Authors: Lim Rodrick , Sangha Gurinder , Lepore Natasha , Bartlett Katelyn M. , Seabrook Jamie A. , Rieder Michael 
Published: October 2020

Objective
We compared pain and degree of disability in patients with acute ankle sprains receiving regular scheduled ibuprofen versus pro re nata (PRN).

Methods
This study is a randomized single-blinded controlled trial of children aged 7 to 17 years presenting with acute ankle sprain to an emergency department. Patients were randomized to receive 10 mg/kg of ibuprofen per dose (maximum 600 mg) every 6 hours regular scheduled versus PRN. Outcome measures included a 100-mm visual analog scale pain and degree of disability at day 4. A sample size of 72 children had a power of 80% to detect a clinically meaningful difference of 20 mm between the regular and PRN group.

Results
We randomly assigned 99 patients to receive regular scheduled (n = 50) or PRN (n = 49) ibuprofen. Pain scores and degree of disability at day 4 showed no significant differences between groups. The rate of reported adverse effects was higher in the regular scheduled group (11.4% vs 9.5%) versus the PRN group.

Conclusions
Our study suggests that there is little benefit from routinely using a regular scheduled ibuprofen regimen for acute pediatric ankle sprains.
Perceived Social Support and Children’s Physiological Responses to Stress: An Examination of the Stress-Buffering Hypothesis
Authors: Chen Lihua , Zilioli Samuele , Jiang Yanping , Wang Xiaolei , Lin Danhua 
Published: October 2020

ABSTRACT

Objective
The current study aimed to examine the stress-buffering effect of children’s perceived social support on their hypothalamic-pituitary-adrenocortical axis and autonomic nervous system reactivity to an acute laboratory stressor.

Methods
A sample of 150 children (aged 9–13 years, mean [standard deviation] age = 10.69 [0.93] years, 74 girls) reported perceived social support, stressful life events, and underwent the Modified Trier Social Stress Test, during which six saliva samples were collected. A two-piece multilevel growth curve model with landmark registration was used to detect trajectory differences in the reactivity and recovery phases of the stress response and account for individual variation in the timing of poststressor peak hormone concentrations.

Results
The interaction between stressful life events and perceived social support significantly predicted poststressor peak cortisol levels (β = 0.0805, SE = 0.0328, p = .015) and cortisol recovery slope (β = −0.0011, SE = 0.0005, p = .040). Children with more life events and low social support exhibited the lowest poststressor peak cortisol levels and the flattest cortisol recovery slope. In contrast, children high in stressful life events and high in social support displayed cortisol response profiles more similar to those of children with low stressful life events. Conversely, there were no statistically significant two-way interactions of stressful life events and perceived social support on salivary α-amylase parameters (i.e., poststressor peak [p = .38], reactivity slope [p = .81], and recovery slope [p = .32]).

Conclusions
These results provide preliminary evidence for the buffering effect of children’s perceived social support on the association between life stress and hypothalamic-pituitary-adrenocortical axis response profiles.
Blood Interleukin-6 Levels Predict Multiple Organ Dysfunction in Critically Ill Patients
Authors: Shimazui Takashi , Nakada Taka-aki , Yazaki Megumi , Mayumi Toshihiko , Takasu Osamu , Matsuda Kenichi , Sasaki Junichi , Otsubo Hiroki , Teshima Yuto , Nabeta Masakazu , Moriguchi Takeshi , Shibusawa Takayuki , Oda Shigeto 
Published: October 2020

ABSTRACT

Background:
Predicting multiple organ dysfunction (MOD) in the late phase of critical illnesses is essential. Cytokines are considered biomarkers that can predict clinical outcomes; however, their predictive value for late-phase MOD is unknown. This study aimed to identify the biomarker with the highest predictive value for late-phase MOD.

Methods:
This observational study prospectively evaluated data on adult patients with systemic inflammatory response syndrome, those who presented to the emergency department or were admitted to intensive care units in five tertiary hospitals (n = 174). Seven blood biomarkers levels (interleukin-6 [IL-6], IL-8, IL-10, tumor-necrosis factor-α, white blood cells, C-reactive protein, and procalcitonin) were measured at three timepoints (days 0, 1, and 2). The area under the receiver operating characteristic curve (AUC) was analyzed to evaluate predictive values for MOD (primary outcome, MOD on day 7 [late-phase]; secondary outcome, MOD on day 3 [early-phase]).

Results:
Of the measured 7 biomarkers, blood IL-6 levels on day 2 had the highest predictive value for MOD on day 7 using single timepoint data (AUC 0.825, 95% confidence interval [CI] 0.754–0.879). Using three timepoint biomarkers, blood IL-6 levels had the highest predictive value of MOD on day 7 (AUC 0.838, 95% CI 0.768–0.890). Blood IL-6 levels using three timepoint biomarkers had also the highest predictive value for MOD on day 3 (AUC 0.836, 95% CI 0.766–0.888).

Conclusion:
Of the measured biomarkers, blood IL-6 levels had the highest predictive value for MOD on days 3 and 7. Blood IL-6 levels predict early- and late-phase MOD in critically ill patients.
Sphingobacterium chungjuense sp. nov., isolated from a freshwater lake
Authors: Song Jaeho , Joung Yochan , Li Shan-Hui , Hwang Juchan , Cho Jang-Cheon 
Published: October 2020

A Gram-stain-negative, rod-shaped, aerobic, non-flagellated, chemoheterotrophic bacterium, designated strain IMCC25678T, was isolated from an artificial freshwater reservoir, Chungju Lake, in the Republic of Korea. The 16S rRNA gene sequence analysis indicated that strain IMCC25678T belongs to the genus

Sphingobacterium

with ≤98.7 % sequence similarities to

Sphingobacterium

species. Whole genome sequencing of strain IMCC25678T revealed a 3.9 Mbp genome size with a DNA G+C content of 42.2 mol%. The IMCC25678T genome shared ≤89.7 % average nucleotide identity and ≤21.4 % digital DNA–DNA hybridization values with closely related species of the genus

Sphingobacterium

, indicating that the strain represents a novel species. Summed feature 3 (C16 : 1
ω6c and/or C16 : 1
ω7c), iso-C15 : 0 and iso-C17 : 0 3-OH were found to be the predominant cellular fatty acid constituents in the strain. The major respiratory quinone was MK-7. The major polar lipids were phosphatidylethanolamine, one unidentified phosphoglycolipid, one unidentified sphingolipid and three unidentified polar lipids. Based on the phylogenetic and phenotypic characteristics, strain IMCC25678T was considered to represent a novel species within the genus

Sphingobacterium

, for which the name Sphingobacterium chungjuense sp. nov. is proposed. The type strain is IMCC25678T (=KACC 19485T=NBRC 113130T).
Education and income show heterogeneous relationships to lifespan brain and cognitive differences across European and US cohorts
Authors: Walhovd Kristine B. , Fjell Anders M. , Wang Yunpeng , Amlien Inge K. , Mowinckel Athanasia M. , Lindenberger Ulman , Düzel Sandra , Bartrés-Faz David , Ebmeier Klaus P. , Drevon Christian A , Baaré William , Ghisletta Paolo , Johansen Louise Baruël , Kievit Rogier A. , Henson Richard N. , Madsen Kathrine Skak , Nyberg Lars , Harris Jennifer , Solé-Padullés Cristina , Pudas Sara , Sørensen Øystein , Westerhausen René , Zsoldos Enikő , Nawijn Laura , Lyngstad Torkild Hovde , Suri Sana , Penninx Brenda , Røgeberg Ole J. , Brandmaier Andreas M. 
Published: October 2020

AbstractSocio-economic status (SES) has been proposed to have facilitating and protective effects on brain and cognition. Here we show that relationships between SES, brain volumes and general cognitive ability differ significantly across European and US cohorts (4-97 years, N ≈ 500,000; 54,000 with brain imaging). Education was positively related to intracranial (ICV) and total brain gray matter (GM) volume. Income was related to ICV, but not GM. Relationships varied significantly across samples, and SES was more strongly related to brain and cognition in US than European cohorts. Differences in neuroanatomical volumes explained part of the SES-cognition relationships. SES was more strongly related to ICV than to GM, implying that SES-cognition relations in adulthood are less likely grounded in neuroprotective effects on GM volume in aging. Rather, a relationship may be established early in life. The findings underscore that SES has no uniform association with, or impact on, brain and cognition.