bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Abdominal Colectomies With Proctectomy Are Associated With Higher 30-Day Readmission Rates in Children With Ulcerative Colitis
Authors: Egberg Matthew D , Phillips Michael , Galanko Joseph A , Kappelman Michael 
Published: May 2020

Abstract

Background
Hospital readmissions are a burden on patients and families and place financial strain on the health care system. Thirty-day readmission rates for adult patients undergoing colectomy are as high as 30%, and inflammatory bowel disease is a risk factor for readmission. We used a multicenter pediatric surgical database to determine the 30-day readmission rate for pediatric patients with ulcerative colitis (UC) undergoing total abdominal colectomy (TAC) and to identify risk factors for 30-day hospital readmission.

Methods
We used the National Surgical Quality Improvement Program-Pediatrics database to identify pediatric patients with UC undergoing a TAC between 2012 and 2017. We identified patient and procedural data from the index hospitalization and used logistic regression to identify risk factors for 30-day readmission rates, adjusting for confounding factors.

Results
We identified 489 pediatric UC TAC hospitalizations between 2012 and 2017, and 19.4% were readmitted within 30 days of surgical discharge. Patient demographics and preoperative laboratory values were not associated with risk of readmission. The TAC procedures that included a proctectomy were at a 2-fold (odds ratio = 2.4; 95% confidence interval, 1.1-5.2) higher risk of 30-day readmission than TAC alone after adjusted analysis.

Conclusions
Nearly 20% of annual pediatric UC hospitalizations involving a colectomy resulted in a 30-day hospital readmission. Notably, TAC procedures that included a proctectomy had significantly higher readmission rates compared to TAC alone. These results can inform risk management strategies aimed at reducing morbidity and hospital readmissions for children with UC.
Favorable Outcomes and Anti-TNF Durability After Addition of an Immunomodulator for Anti-Drug Antibodies in Pediatric IBD Patients
Authors: Colman Ruben J , Portocarrero-Castillo Andrea , Chona Deepika , Hellmann Jennifer , Minar Phillip , Rosen Michael J 
Published: May 2020

Abstract

Background
Anti-drug antibodies (ADAs) to anti-tumor necrosis factor alpha (anti-TNF) drugs are associated with increased drug clearance and loss of response. We aimed to assess the effectiveness of starting an immunomodulator (IM) drug in patients with newly detected ADAs on anti-TNF monotherapy.

Methods
We reviewed the medical records of pediatric patients with inflammatory bowel disease on infliximab or adalimumab monotherapy with first-time detection of significant ADAs between 2014 and 2018. Patients who started an IM within 3 months of ADA detection were compared with those who did not (No-IM). Outcomes included steroid-free clinical and biochemical remission on the same anti-TNF , anti-TNF durability, and ADA reversal.

Results
We identified 89 patients with ADAs: 30 IM patients and 59 No-IM patients. The initial anti-TNF was stopped shortly after ADA detection in 36% of the No-IM patients vs none of the IM patients, driving longer survival on the initial anti-TNF in the IM group (P = 0.005). At 12 months, steroid-free clinical and biochemical remission on the same anti-TNF occurred in 53.9% of the IM group vs 26.8% in the No-IM group (P = 0.025). Drug levels rose higher (P = 0.003) and ADA levels fell farther (P = 0.037) in the IM group than in the No-IM group. Baseline ADA level predicted ADA reversal in the No-IM patients with an area under the receiver operating characteristic of 0.79 (P = 0.006). An ADA level &lt;329 ng/mL had a 76.2% sensitivity and an 83.3% specificity for ADA reversal without IM.

Conclusions
Pediatric patients with inflammatory bowel disease on anti-TNF monotherapy who started an IM for significant ADA levels exhibited longer anti-TNF durability and a higher likelihood of steroid-free clinical and biochemical remission on the same anti-TNF. Patients not treated with an IM were unlikely to reverse ADAs &gt;329 ng/mL.
From “taking” to “tending”: learning about Indigenous land and resource management on the Pacific Northwest Coast of North America
Authors: Turner Nancy J 
Published: May 2020

AbstractIndigenous peoples have occupied the northwestern North American coast for at least 15 000 years—a time when much of the land was covered by a kilometre or more of ice and only patches of land were glacier free. Over the millennia, through difficult times and seasons of plenty, they have built up an immense body of local knowledge, practice, and belief—Indigenous, or Traditional Ecological Knowledge—enabling them to live well, learning about the plants and animals of terrestrial, aquatic, and marine environments on which they have depended, and how to harvest and process them into nutritious foods, healing medicines, and useful materials. Although it has been commonly assumed that these people, as so-called “hunter-gatherers”, were simply helping themselves to nature’s provisions, over decades of learning from Indigenous plant specialists and other knowledge holders as an ethnobotanist, I have come to see First Peoples as resource tenders and managers over countless generations. Their traditional land and resource management systems provide many lessons on how we humans can work with natural processes to ensure the well-being not only of ourselves but also of the species and habitats on which we rely.
Extended ORF8 Gene Region Is Valuable in the Epidemiological Investigation of Severe Acute Respiratory Syndrome–Similar Coronavirus
Authors: Chen Shuaiyin , Zheng Xin , Zhu Jingyuan , Ding Ronghua , Jin Yuefei , Zhang Weiguo , Yang HaiYan , Zheng Yingjuan , Li Xin , Duan Guangcai 
Published: May 2020

Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV) was discovered as a novel pathogen in the 2002–2003 SARS epidemic. The emergence and disappearance of this pathogen have brought questions regarding its source and evolution. Within the genome sequences of 281 SARS-CoVs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and SARS-related CoVs (SARSr-CoVs), a ~430 bp genomic region (from 27 701 bp to 28 131 bp in AY390556.1) with regular variations was investigated. This ~430 bp region overlaps with the ORF8 gene and is prone to deletions and nucleotide substitutions. Its complexity suggested the need for a new genotyping method for coronaviruses related to SARS-similar coronaviruses (SARS-CoV, SARSr-CoV, and SARS-CoV-2). Bat SARSr-CoV presented 3 genotypes, of which type 0 is only seen in bat SARSr-CoV, type I is present in SARS in the early phase, and type II is found in all SARS-CoV-2. This genotyping also shows potential usage in distinguishing the SARS-similar coronaviruses from different hosts and geographic areas. This genomic region has important implications for predicting the epidemic trend and studying the evolution of coronavirus.
HIV-1 Gag mutations alone are sufficient to reduce darunavir susceptibility during virological failure to boosted PI therapy
Authors: Blanch-Lombarte Oscar , Santos José R , Peña Ruth , Jiménez-Moyano Esther , Clotet Bonaventura , Paredes Roger , Prado Julia G 
Published: May 2020

AbstractBackgroundVirological failure (VF) to boosted PIs with a high genetic barrier is not usually linked to the development of resistance-associated mutations in the protease gene.MethodsFrom a cohort of 520 HIV-infected subjects treated with lopinavir/ritonavir or darunavir/ritonavir monotherapy, we retrospectively identified nine patients with VF. We sequenced the HIV-1 Gag-protease region and generated clonal virus from plasma samples. We characterized phenotypically clonal variants in terms of replicative capacity and susceptibility to PIs. Also, we used VESPA to identify signature mutations and 3D molecular modelling information to detect conformational changes in the Gag region.ResultsAll subjects analysed harboured Gag-associated polymorphisms in the absence of resistance mutations in the protease gene. Most Gag changes occurred outside Gag cleavage sites. VESPA analyses identified K95R and R286K (P &lt; 0.01) as signature mutations in Gag present at VF. In one out of four patients with clonal analysis available, we identified clonal variants with high replicative capacity and 8- to 13-fold reduction in darunavir susceptibility. These clonal variants harboured K95R, R286K and additional mutations in Gag. Low susceptibility to darunavir was dependent on the Gag sequence context. All other clonal variants analysed preserved drug susceptibility and virus replicative capacity.ConclusionsGag mutations may reduce darunavir susceptibility in the absence of protease mutations while preserving viral fitness. This effect is Gag-sequence context dependent and may occur during boosted PI failure.
Transcriptome changes underlie alterations in behavioral traits in different types of chicken
Authors: Chen Siyu , Yan Chao , Xiang Hai , Xiao Jinlong , Liu Jian , Zhang Hui , Wang Jikun , Liu Hao , Zhang Xiben , Ou Maojun , Chen Zelin , Li Weibo , Turner Simon P , Zhao Xingbo 
Published: May 2020

AbstractIn recent decades, artificial selection has contributed greatly to meeting the demands for animal meat, eggs, and milk. However, it has also resulted in changes in behavior, metabolic and digestive function, and alterations in tissue development, including the brain and skeleton. Our study aimed to profile the behavioral traits and transcriptome pattern of chickens (broilers, layers, and dual-purpose breeds) in response to artificial selection. Broilers spent less time gathered as a group in a novel arena (P &lt; 0.01), suggesting reduced fearfulness in these birds. Broilers also showed a greater willingness to approach a model predator during a vigilance test but had a greater behavioral response when first exposed to the vocalization of the predator. Genes found to be upregulated and downregulated in previous work on chickens divergently selected for fear responses also showed consistent differences in expression between breeds in our study and indicated a reduction in fearfulness in broilers. Gene ACTB_G1 (actin) was differentially expressed between breeds and is a candidate gene involved with skeletal muscle growth and disease susceptibility in broilers. Furthermore, breed-specific alterations in the chicken domestic phenotype leading to differences in growth and egg production were associated with behavioral changes, which are probably underpinned by alterations in gene expression, gene ontology terms, and Kyoto Encyclopedia of Genes and Genomes pathways. The results highlight the change in behavior and gene expression of the broiler strain relative to the layer and a dual-purpose native breed.
The Chimeric Bud-Sport ‘Delicious’ (Red) Mutant Strain, It, Expresses Lethal-Effect Resistance Against the Obliquebanded Leafroller (Lepidoptera: Tortricidae)
Authors: Schwarz Joseph , Milnes Joshua , Brunner Jay 
Published: May 2020

AbstractThree ‘Red Delicious,’ Malus domestica Borkhausen (Rosales: Rosaceae), apple plantings, each representing a different sport, were evaluated for natural resistance against the obliquebanded leafroller (OBLR), Choristoneura rosaceana (Harris). The establishment of neonate larvae on apple foliage was not different between the three ‘Red Delicious’ plantings. Of the three ‘Red Delicious’ plantings, the one that most negatively impacted OBLR was the ‘It Delicious’ genotype. The ‘It Delicious’ genotype at the Sunrise Research Orchard exhibited essentially 100% mortality against OBLR when fed on spring and summer foliage, and mortality accumulated faster across instars than on other ‘Red Delicious’ plantings. The high mortality observed in the ‘It Delicious’ genotype points to the existence of a putative gene, which we propose as Cro1. The other ‘Red Delicious’ plantings, Columbia River Orchard and Tree Fruit Research and Extension Center Research Orchard treatments, showed negative impacts, especially when exposed to foliage from the summer compared to the spring period. Development rates in these treatments in spring were higher compared to summer, and there were direct relationships between development rates, pupal weights, and adult longevity for both males and females. These latter results suggest that sublethal effects could be present in these ‘Red Delicious’ cultivars, thus offering insights to a gene-pyramiding strategy for breeders to managing leafroller pests in Washington apple.
The Urban Politics of Human Rights Practice
Authors: Fernandez-Wulff Paula , Yap Christopher 
Published: May 2020

AbstractSocial movement organizations are increasingly developing human rights strategies at the municipal level, particularly in European urban contexts. Yet critical scholarly work on human rights has overlooked two related realities: non-state-centric, social movement use of the tools and discourses of rights, and the strategic participation of citizen groups in municipal urban policy spaces. This article builds on critical human rights theory through the experiences of three grassroots organizations claiming and exercising social rights in urban policy spaces of Barcelona, Valladolid, and London. It engages with a number of scholarly critiques of the state and human rights, particularly focusing on those critiques that question their compatibility with autonomy, democracy, and self-government at the local level. While the value of such critical literature is undeniable, we show how urban grassroots practices and experiences with social rights-based strategies in the context of housing, water, and participation can circumvent some of these critiques on the ground, pointing at new avenues for critical legal research when infused with other critical discourses, including urban politics.
Adaptation of an Intervention to Reduce Disparities in School HRQOL for Latino Childhood Cancer Survivors
Authors: Patel Sunita K , Miranda Leticia , Delgado Nicole , Barreto Nicolas , Nolty Anne , Kelly Natalie C , Wilson Karla , Toomey Debbie , Pawlowska Anna 
Published: May 2020

Abstract

Objective
Survivors of childhood leukemia, especially those from low socioeconomic status households, often experience persistent neurocognitive and academic impairment. This study adapted an existing parent training intervention to improve outcomes for low-acculturated, Spanish-speaking Latino parents of children with leukemia and pilot tested that intervention for feasibility.

Methods
Semistructured interviews were conducted with a focus group of 20 Latino parents of children treated for leukemia. Ten Latino families participated in a pilot study of the adapted parenting intervention, consisting of eight sessions over 6 months.

Results
Focus groups revealed that parents unanimously supported a parenting intervention but barriers to participation included time constraints, transportation issues, and anxiety in the hospital environment. The parents also highlighted cultural factors that could contribute to the health disparity, such as lack of knowledge and efficacy in facilitating their child’s progress with learning and school. In the pilot study, adherence was 90%, establishing feasibility, and the adapted intervention was considered beneficial. The median parenting efficacy scores improved from preintervention to postintervention (median 3.40 vs. 3.94; p &lt; .011), as did parent-reported school functioning of the child (median 50.00 vs. 60.00; p = .088).

Conclusions
This study addressed a health disparity by culturally adapting a parenting intervention, which was designed to improve school functioning, to meet the needs and preferences of low-acculturated, Spanish-speaking families of children with leukemia in Southern California. The pilot study demonstrated that the adapted intervention is feasible and acceptable in the target population. A larger trial is underway to test the efficacy of this adapted parenting intervention.
Acute Fulminant Cerebral Edema: A Newly Recognized Phenotype in Children With Suspected Encephalitis
Authors: Krishnan Preetha , Glenn Orit A , Samuel Michael C , Sheriff Heather , Foster-Barber Audrey , Sejvar James J , Roy-Burman Arup , Wadford Debra A , Preas Christopher P , Tureen Jay H , Glaser Carol A 
Published: May 2020

AbstractBackgroundEncephalitis is a severe neurological syndrome associated with significant morbidity and mortality. The California Encephalitis Project (CEP) enrolled patients for more than a decade. A subset of patients with acute and fulminant cerebral edema was noted.MethodsAll pediatric encephalitis patients with cerebral edema referred to the CEP between 1998 and 2012 were reviewed. A case definition was developed for acute fulminant cerebral edema (AFCE) that included the CEP case definition for encephalitis and progression to diffuse cerebral edema on neuroimaging and/or autopsy, and no other recognized etiology for cerebral edema (eg, organic, metabolic, toxin). Prodromic features, demographic and laboratory data, neuroimaging, and outcomes were compared with non-AFCE encephalitis cases.ResultsOf 1955 pediatric cases referred to the CEP, 30 (1.5%) patients met the AFCE case definition. The median age for AFCE and non-AFCE cases was similar: 8.2 years (1–18 years) and 8.0 years (0.5–18 years), respectively. Asian-Pacific Islanders comprised a larger proportion of AFCE cases (44%) compared with non-AFCE cases (14%, P &lt; .01). AFCE cases often had a prodrome of high fever, vomiting, and profound headache. Mortality among AFCE patients was significantly higher than among non-AFCE patients (80% vs 13%, P &lt; .01). A confirmed etiology was identified in only 2 cases (enterovirus, human herpes virus type 6), while 10 others had evidence of a respiratory pathogen.Thirty pediatric patients referred to the California Encephalitis Project with a unique, and often fatal, form of encephalitis are reported. Demographic and clinical characteristics, possible etiologies and a proposed case definition for acute fulminant cerebral edema (AFCE) are described.ConclusionsAFCE is a recently recognized phenotype of encephalitis with a high mortality. AFCE may be triggered by common pediatric infections. Here, we propose a case definition.
Molecular plant responses to combined abiotic stresses put a spotlight on unknown and abundant genes
Authors: Sewelam Nasser , Brilhaus Dominik , Bräutigam Andrea , Alseekh Saleh , Fernie Alisdair R , Maurino Veronica G 
Published: May 2020

AbstractEnvironmental stresses such as drought, heat, and salinity limit plant development and agricultural productivity. While individual stresses have been studied extensively, much less is known about the molecular interaction of responses to multiple stresses. To address this problem, we investigated molecular responses of Arabidopsis to single, double, and triple combinations of salt, osmotic, and heat stresses. A metabolite profiling analysis indicated the production of specific compatible solutes depending on the nature of the stress applied. We found that in combination with other stresses, heat has a dominant effect on global gene expression and metabolite level patterns. Treatments that include heat stress lead to strongly reduced transcription of genes coding for abundant photosynthetic proteins and proteins regulating the cell life cycle, while genes involved in protein degradation are up-regulated. Under combined stress conditions, the plants shifted their metabolism to a survival state characterized by low productivity. Our work provides molecular evidence for the dangers for plant productivity and future world food security posed by heat waves resulting from global warming. We highlight candidate genes, many of which are functionally uncharacterized, for engineering plant abiotic stress tolerance.
The Polish Rider: CH Alexandrowicz and the reorientation of international law, Part I: Madras studies
Authors: Landauer Carl 
Published: May 2020

Abstract
This article analyses the prominent international legal historian, CH Alexandrowicz, known largely for his advocating of the East’s imprint on international law. It places his perspective of the East and South, and his diachronic narrative—the rise of naturalism, its fall to positivism, and eventual promise of return from positivism—in the context of his own traversing of geographies and his intellectual commitments, including his study of the Indian Constitution.
Posttraumatic Encapsulated Orbital Lipoma
Authors: Chorost Matthew S , Yakopson Vladimir , Chou Eva 
Published: May 2020

Abstract
A 43-year-old white male sought treatment for swelling of the left brow, which started after sustaining direct blunt trauma to the left bony orbit 6 months prior. Magnetic resonance imaging with contrast showed a 5.6 × 2.7 mm T1 bright focus at the anterior aspect of the left supraorbital rim. On the postgadolinium fat-saturated axial T1 images, the lesion demonstrated fat signal but was not suppressed in T1 with fat suppression. Upon excision, the lesion was found to be an encapsulated orbital rim lipoma, which was unexpected given the hyperintensity on T1 with fat suppressed magnetic resonance imaging. The lesion did not return after excision. Orbital lipomas are rare benign neoplasms with only a handful of cases in literature. This is the first report of a posttraumatic encapsulated lipoma presenting on the brow or orbit. Although rare, lipomas should be on the differential of post-traumatic lesions affecting the orbit and the orbital rim.
A Comparison of Improvised and Commercially Available Point-of-Wounding Tourniquets in Simulated Traumatic Amputation with Catastrophic Hemorrhage
Authors: Hay-David Aurélie G C , Herron Jonathan B T , Thurgood Andrew , Whittle Craig , Mahmood Ansar , Bodger Owen , Hodgetts Timothy J , Pallister Ian 
Published: May 2020

AbstractIntroductionCatastrophic hemorrhage is the leading cause of preventable trauma deaths in the military and civilian populations. The use of tourniquets by first responders (medical and nonmedically trained) is supported and has the potential to save lives if applied correctly.AimsWe sought to examine the use of 5 tourniquets: 1 improvised and 4 commercially available tourniquets to investigate the time taken to stop simulated bleeding and to secure the device; evidence of rebleeding when the “blood pressure” was restored and to gain qualitative feedback on their application.Materials and MethodsFour commercially available tourniquets (Combat Application Tourniquet [C-A-T], Special Operations Forces Tactical Tourniquet - Wide (SOFTT-W), stretch, wrap, and tuck tourniquet [SWAT-T], and the Tourni-key) and an improvised tourniquet (tie & wooden spoon) were tested on a complex silicone simulation model used to replicate catastrophic hemorrhage from a blast injury with above traumatic knee amputation (SAM 4.1 Trauma Simulation Ltd, UK). To limit the user variability, the same investigator applied each tourniquet and each was tested 3 times. No ethical approval was required to conduct this study.ResultsNone of the devices took longer than 1 minute to secure. The C-A-T and SOFTT-W were quickest to occlude and secure. Although the Tourni-key took longer statistically, this was unlikely to be a clinically important difference. Compared to the others, the SOFTT-W rebled on 2 out of 3 applications. The improvised tourniquet had an obvious ligature effect because of its narrowness, followed by the Tourni-key. This effect was least evident with the SWAT-T; however, particular care was needed to ensure it was safely secured as it was slippery when wet.ConclusionsAll tourniquets tested were effective and swift to apply. The Tourni-key’s antipinch card seems helpful in reducing local pain under the windlass. Reinspection for rebleeding is important and should be routinely performed irrespective of the device. The width of the SWAT-T may be beneficial, thereby, reducing the risk of crush injury.