bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mapping global research trends in stem cell therapy for inflammatory bowel disease: a bibliometric analysis from 1991 to 2019
Authors: Chong Yuming , Han Chang , Li Ji , Long Xiao 
Published: October 2020

Background Inflammatory bowel disease (IBD) represents a series of digestive system abnormalities and parenteral manifestations. Stem cell therapy has been regarded as a promising treatment for IBD. Methods We searched Web of Science Core Collection for publications of interest from 1991 to 2019. Publication performance was analyzed using several bibliometric parameters, including Statplanet to reveal the geographic distribution of the publications, VOSviewer to identify the research landscape of hot topics, and CiteSpace to show keywords with the strongest citation bursts. Results A total of 1230 publications were identified, of which 674 articles were analyzed further. The United States was the most productive country and Spanish researchers published the highest quality articles. At a journal level, Gastroenterology published the greatest number of articles, while articles from Gut had the highest citation number. Results from the research landscape analysis of hot topics and the top 20 terms with the strongest citation bursts indicated that animal experiments, immunocytes, intestinal epithelial cells, cytokine expression, and clinical efficacy were the main focuses of research. Conclusion Stem cell therapy for IBD is currently receiving increasing attention by researchers, with focuses on animal experiments, immunocytes, intestinal epithelial cells, cytokine expression, and clinical efficacy.
The Effects of Online Assignments and Weekly Deadlines on Student Outcomes in a Macroeconomics Course
Authors: Miller Laurie A. , Schmidt James R. 
Published: October 2020

This study examined how weekly, externally set deadlines affected the completion of adaptive learning assignments and student outcomes in an introductory macroeconomics course. We imposed different deadline schemes for the same adaptive learning assignments in two sections of the course. One section was given flexible deadlines and the other section was given rigid weekly deadlines. We found that weekly deadlines did not affect assignment completions or total points earned on unit exams. We investigated how the adaptive learning assignments affected student retention of material. A measure of staying on pace in the course provided a positive effect on the comprehensive final exam for students with weekly deadlines. The weekly deadlines may not have influenced assignment completions but consistent engagement with the flow of topics through the course increased student knowledge retention. Regardless of deadline type, completions of adaptive learning assignments positively affected outcomes on the unit exams and final exam. JEL Classifications: A20, A22
Predictors of Delayed Recognition of Critical Illness in Emergency Department Patients and Its Effect on Morbidity and Mortality
Authors: Goel Neha N. , Durst Matthew S. , Vargas-Torres Carmen , Richardson Lynne D. , Mathews Kusum S. 
Published: October 2020

Purpose: Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to identify potential predictors of delayed recognition. Methods: We conducted a retrospective cohort study of Emergency Department (ED) patients admitted to the Intensive Care Unit (ICU) directly from the ED or within 48 hours of ED departure. Cohort characteristics were obtained through electronic and standardized chart abstraction. Operational metrics to estimate ED workload and volume using census data were matched to patients’ ED stays. Delayed recognition of critical illness was defined as an absence of an ICU consult in the ED or declination of ICU admission by the ICU team. We employed entropy-balanced multivariate models to examine the association between delayed recognition and development of persistent organ dysfunction and/or death by hospitalization day 28 (POD+D), and multivariable regression modeling to identify factors associated with delayed recognition. Results: Increased POD+D was seen for those with delayed recognition (OR 1.82, 95% CI 1.13-2.92). When the delayed recognition was by the ICU team, the patient was 2.61 times more likely to experience POD+D compared to those for whom an ICU consult was requested and were accepted for admission. Lower initial severity of illness score (OR 0.26, 95% CI 0.12-0.53) was predictive of delayed recognition. The odds for delayed recognition decreased when ED workload is higher (OR 0.45, 95% CI 0.23-0.89) compared to times with lower ED workload. Conclusions: Increased POD+D is associated with delayed recognition. Patient and system factors such as severity of illness and ED workload influence the odds of delayed recognition of critical illness and need further exploration.
Telemedicine System for Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Nakamoto Hidetomo 
Published: October 2020

Over recent decades, rapid progress in information and telecommunications technology has led to the application of these technologies in the medical field. In 1999, we reported on a telemedicine system (version 1.0) that used an automated peritoneal dialysis machine to collect data on patients with end-stage renal disease. After 2002, we focused on using cellular telephones in a new telemedicine system (version 2.0) to monitor patient data at home, including blood pressure (BP), heart rate, body weight, urine volume, and blood glucose. By 2003, we had developed a fully automatic system called I-converter (version 3.0) to collect data from a fully automatic device and send it via cellular telephone. After the fully automatic device measures a patient's BP, I-converter sends the data directly to the main server in our central data center. That server is directly connected to Web site by application service provider (ASP) technology. Recently, to make the system simpler, we developed a new version called D-converter (version 4.0). The telephone used in this new system is a Personal Handy-phone System (PHS). The PHS has several advantages: high-speed data transmission, low power output, little electromagnetic interference with medical devices, and easy locating of patients. The D-converter system uses a small computer and a PHS card called a Dopa card. Our telemedicine systems monitor continuous ambulatory peritoneal dialysis (CAPD) patients at home. For elderly and handicapped patients, these systems are very advantageous because they reduce visits to the outpatient clinic. In addition, data can be monitored at the patient's home in real time. The present paper reports our recent advances in telemedicine systems for CAPD patients.
Evolution of Antibiotic Resistance Mechanisms and their Relevance to Dialysis-Related Infections
Authors: Wong Samson S.Y. , Ho Pak-Leung , Yuen Kwok-Yung 
Published: October 2020

As the survival of patients with end-stage renal failure has improved, their exposure to antibiotics has also increased. Infections, especially peritoneal dialysis–related peritonitis, are unavoidable because of lapses in technique and the slow worsening of systemic and peritoneal defense associated with aging and dialysis. The selective pressure inherent in the use of antibiotics shapes the pattern of antibiotic resistance in the bacteria causing peritonitis and extraperitoneal infections, and vice versa. Renal function–preserving and non-ototoxic regimens that incorporate double β-lactams (first- and third-generation cephalosporins) for peritonitis have increased the selective pressure in favor of methicillin-resistant staphylococci (MRS) and extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae. Attempts to use the fluoroquinolones as alternatives to β-lactams was met with rocketing quinolone resistance. The high incidence of MRS led many nephrologists to use empiric vancomycin—until the début of vancomycin-resistant enterococci. The recent emergence of heterogeneous and high-level vancomycin resistance in staphylococci (which are especially prevalent in patients on dialysis) calls for further prudence in the use of vancomycin. The coming challenges are ESBL-producing Enterobacteriaceae with carbapenemase, multi-resistant Pseudomonas, and highly virulent community-acquired methicillin-resistant Staphylococcus aureus with Panton–Valentine leukocidin. Antibiotic auditing programs and meticulous patient training by nurses are the only available defense at the moment. Novel approaches such as antibiotic-impregnated Tenckhoff catheters, biocompatible dialysis fluid, and peritoneal immuno-augmentation strategies are eagerly awaited.
The Status of, and Obstacles to, Continuous Ambulatory Peritoneal Dialysis in Thailand
Authors: Tungsanga Kriang , Kanjanabuch Talerngsak , Mahatanan Nanta , Praditpornsilp Kearkiat , Avihingsanon Yingyos , Eiam–Ong Somchai 
Published: October 2020

The prevalence of dialysis in Thailand is 282 per million population, and utilization of peritoneal dialysis (PD) is only 4.6% of the utilization of hemodialysis (HD). The causes of low PD utilization include • a relatively higher cost of PD care, especially from the patient's perspective; • less incentive for PD care on the part of health care providers and hospitals; • fewer continuing medical and nursing education programs in PD; • unavailability of certified PD nurses; • lack of confidence in the quality of PD care; • fewer offers of PD as a renal replacement therapy option during pre-dialysis counseling; • fear of peritonitis on the part of the patient, and also fear of burdening family members; • a less stringent government policy regarding the “PD first” strategy. To increase PD utilization. mandatory strategies are • lower PD cost, • make all PD equipment reimbursable, • launch a stringent “PD first” policy, • provide incentives to health care providers and hospitals, and • improve the quality of PD care.
Training of Peritoneal Dialysis Patients—Taiwan's Experiences
Authors: Chen Tzen-Wen , Li Szu-Yuan , Chen Jinn-Yang , Yang Wu-Chang 
Published: October 2020

In Taiwan, peritoneal dialysis (PD) was launched in 1984. Since then, the Taiwan Society of Nephrology (TSN) has taken the responsibility for supervising PD programs. All PD programs are required to pass evaluations from the TSN before inception. Every new PD patient receives individual training from a qualified PD nurse. The training, accompanied by a review test, is usually provided in the hospital during the week right after catheter implantation. To evaluate the effect of the patient training program on PD outcomes, we designed a retrospective observation study and reviewed the post-training tests of 100 new PD patients. The post-training test has 10 parts: anatomy and physiology, overview of chronic kidney disease, overview of PD, complications of peritonitis and exit-site infection, diet control, cardiovascular complications, PD skills and procedures, aseptic techniques, management of peritonitis, and routine tasks. The relationship between the post-training test scores and peritonitis was analyzed. Results showed that risk of peritonitis is not related to the post-training test score. However, based on our experiences, we believe that PD patient training should be lengthened and repeated periodically as suggested by the International Survey of Peritoneal Dialysis Training Programs. Training on certain issues such as the signs and symptoms of peritonitis should be especially enhanced.
Transforming Growth Factor β1 Induces Epithelial–mesenchymal Transition by Activating the Jnk–SMAD3 Pathway in Rat Peritoneal Mesothelial Cells
Authors: Liu Qinghua , Mao Haiping , Nie Jing , Chen Wei , Yang Qiongqiong , Dong Xiuqing , Yu Xueqing 
Published: October 2020

⋄ Background Peritoneal fibrosis is a serious complication in long-term peritoneal dialysis (PD) patients. Epithelial-mesenchymal transition (EMT) plays an important role in peritoneal fibrosis, and TGFβ1 is the crucial inducer of EMT. Phosphorylation of Smad proteins is required for TGFβ1-induced EMT. It was reported that C-Jun N-terminal kinase (JNK) was involved in the TGFβ1/Smad signaling pathway and might regulate the activation of Smad proteins. However, whether JNK is activated by TGFβ1 in rat peritoneal mesothelial cells (RPMCs) and the role taken by JNK signaling in EMT induced by TGFβ1 remains undetermined. In the present study, we investigated the role of JNK-Smad pathway in EMT induced by TGFβ1 in RPMCs. ⋄ Methods We harvested RPMCs from the peritoneum of male Sprague-Dawley rats and then cultured the cells in Dulbecco modified Eagle medium / F12 medium with 15% (volume:volume) fetal bovine serum. The cells were pretreated with SP600125, a specific inhibitor of JNK, for 4 hours before incubation with TGFβ1. The protein expression levels of phosphorylated JNK, Smad2, and Smad3 were detected by Western blotting. The messenger RNA levels and protein expression of α-smooth muscle actin (α-SMA), E-cadherin, and collagen I were determined with reverse transcriptase polymerase chain reaction and Western blotting respectively. ⋄ Results Expression of α-SMA and collagen I were significantly increased and expression of E-cadherin decreased with TGFβ1 in RPMCs. Transforming growth factor β1 can stimulate phosphorylated JNK expression from 5 minutes, with the peak at 10 minutes, and phosphorylated Smad2 and Smad3 expression from 10 minutes, with the peak at 30 minutes. The addition of SP600125, which blocked activation of JNK, effectively inhibited TGFβ1-induced phosphorylation of Smad3, but not Smad2. Also, our results showed that SP600125 effectively suppressed TGFβ1-induced high expression of α-SMA and collagen I, and prevented TGFβ1-induced downregulation of E-cadherin expression in RPMCs. ⋄ Conclusions This study demonstrated that JNK signaling may play an important role in EMT induced by TGFβ1 in RPMCs through activation of Smad3, suggesting that JNK inhibitor may prove to be a novel therapeutic agent for peritoneal fibrosis.
Differences in Corrective Mode for Divalent Ions and Parathyroid Hormone between Standard- and Low-Calcium Dialysate in Patients on Continuous Ambulatory Peritoneal Dialysis—Result of a Nationwide Survey in Japan
Authors: Yamamoto Hiroyasu , Kasai Kenji , Hamada Chieko , Hasegawa Hirofumi , Higuchi Chieko , Hiramatsu Makoto , Hosoya Tatsuo , Itami Noritomo , Kawanishi Hideki , Kubota Minoru , Masakane Ikuto , Minakuchi Jun , Mitarai Tetsuya , Nakao Toshiyuki , Suzuki Hiromichi , Tomo Tadashi , Kawaguchi Yoshindo 
Published: October 2020

⋄ Background In patients on continuous ambulatory peritoneal dialysis (CAPD), dialysate calcium concentration has a strong influence on correction of serum calcium, phosphorus, and parathyroid hormone (PTH); however, the optimal concentration of Ca in PD solution is still uncertain. The aim of the survey reported here was to evaluate the prevalence of patients treated with standard- [SCD (approximately 3.25 – 4.0 mEq/L)] or low-calcium [LCD (approximately 1.8 – 2.5 mEq/L)] dialysate and differences in the clinical effects for correction of abnormalities in divalent ions and PTH. ⋄ Materials and Methods We used a questionnaire to survey 333 peritoneal dialysis facilities nationwide in Japan. Then, we analyzed serum Ca, P, and PTH levels and the prescription rates for CaCO3 as a P binder and for vitamin D (VitD) analogs. ⋄ Results The 2384 CAPD patients enrolled in this analysis had a mean age of 60.5 ± 14.2 years and a mean duration of CAPD of 44.1 ± 39.2 months. The prevalences of SCD, LCD, and combination of SCD and LCD were, respectively, 49%, 50%, and 1% at initiation, and 40%, 38%, and 22% at the time of the survey. In 735 and 876 patients respectively, LCD and SCD had been prescribed from initiation to the time of the survey. In these two groups, we observed no difference in initiation and current serum levels of Ca and P. But prescription rates for CaCO3 and VitD analogs were higher in the LCD group than in the SCD group, and PTH levels were higher in the LCD group than in the SCD group. ⋄ Conclusions A beneficial effect of LCD was revealed in the increased doses of CaCO3 and VitD analogs seen in that group without the occurrence of hypercalcemia; however, PTH levels in that group were not maintained within an acceptable range. The survey suggests that more serious attention should be paid to the Ca concentration in peritoneal dialysate so as to lessen mineral and PTH disorders in CAPD.
Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients
Authors: Liao Chia-Te , Shiao Chih-Chung , Huang Jenq-Wen , Hung Kuan-Yu , Chuang Hsueh-Fang , Chen Yung-Ming , Wu Kwan-Dun , Tsai Tun-Jun 
Published: October 2020

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.
Effect of intraocular pressure lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with glaucoma
Authors: de Paula Alessandro , Perdicchi Andrea , Di Tizio Federico , Fragiotta Serena , Scuderi Gianluca 
Published: October 2020

Purpose: To evaluate the effect of IOP lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with primary open angle glaucoma. Methods: Twenty eyes of 14 glaucomatous patients and 15 eyes of nine normal patients were enrolled. The most appropriate hypotonic treatment was applied to every patient. A HD Angio Disc 4.5 scan (Avanti-AngioVue) was performed at baseline and after a month in the glaucomatous eyes. The following parameters were analyzed: Radial Papillary Capillaries (RPC) density, inside disc, peripapillary, superior-hemi, inferior-hemi, quadrants, and peripapillary, hemi-superior, hemi-inferior, and quadrants RNFL thickness. Optic nerve head analysis was also evaluated. In addition, the RPC density and the RNFL were assessed in the eight sectors provided by the software. Results: The RPC density did not significantly change after IOP reduction ( p > 0.05). The inferior-temporal ( p = 0.005) and inferior-nasal sectors ( p < 0.001) showed a greater capillary density than the respective superior sectors in healthy eyes. In contrast in the glaucomatous eyes, the superior-nasal exhibited greater capillary density with respect to the inferior-nasal sectors. The aggregate RPC density of the inferior sectors was greater than the superior ones in the control group ( p < 0.001). An improvement of the average disc area ( p = 0.01) and the average cup volume ( p = 0.059) were also observed along with increased RNFL thickness at different locations (all, p < 0.05) after IOP lowering therapy was initiated. Conclusion: The glaucomatous eyes presented rarefaction of the radial papillary capillaries density in the inferior sectors, but no significant changes in the density after IOP-lowering medications.
Long-term evaluation of pars plana vitrectomy in children with Abusive head trauma
Authors: Kozner Pavel , Stepankova Jana , Dotrelova Dagmar 
Published: October 2020

Purpose: To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT). Methods: A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017. Results: 18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months. Conclusions: PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.
Mothering through a child's addiction journey: Linking lived experience to the lenses that shape intervention
Authors: O'Connor Deborah 
Published: October 2020

Summary Someone dies from an opioid overdose every two hours in North America. These statistics became personal when my eldest son died from a drug overdose—he had been in recovery for a year, excited about the prospect of welcoming his unborn daughter into the world, and desperately committed to staying drug-free. He had been struggling with substance abuse for over twelve years. As a mother and Social Worker, I spent those years feeling helpless and deficient as things spiraled further and further out of control, committed to supporting my beloved son in a system that was not working. Findings This article is about this journey. My goal is to critically examine how our treatment lenses for understanding addiction create unacknowledged ethical issues and tensions that stigmatize not only those with substance use issues, but their family as well. Application The purpose is two-fold: to examine how the experience of mothering a child with addictions who dies is constructed as a problematic, and to invite Social Workers to think critically about their practices and the lenses they are drawing on when working with this population.