bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical nutrition for the gastroenterologist: the physiologic rationale for providing early nutritional therapy to the hospitalized patient
Authors: McClave Stephen A. , Omer Endashaw 
Published: January 2020

Purpose of review
Conflicting reports in the literature have been misinterpreted by clinicians, who conclude that nutritional therapy for the hospitalized patient is of marginal value. The true benefit of such therapy is derived from the provision of early enteral nutrition. This article describes the physiologic response to enteral feeding, which accounts for the outcome benefits, and illustrates how use of the gut alters immune responses and the intestinal microbiota.

Recent findings
The provision of early enteral nutrition has been shown to reduce infection and mortality in high-risk hospitalized patients (compared with not providing such therapy). Early feeding maintains gut integrity, reduces permeability, promotes tolerance and appropriate immune responses, and supports commensalism of the intestinal microbiota. Early enteral nutrition influences cross-talk signaling between luminal bacteria and the intestinal epithelium. Failure to utilize the gut in acute illness can amplify the systemic inflammatory response syndrome and worsen disease severity, while at the same time promoting antibiotic resistance and increased septic morbidity.

Summary
Appropriate nutritional therapy does change outcomes in the hospitalized patient, especially for those who are at risk on the basis of disease severity and/or poor nutritional status. Greatest benefit is seen from those therapeutic regimens that specifically target gut defenses and the intestinal microbiome.
Parasitic skin infections: neglected diseases or just challenging for diagnosis?
Authors: Gardini Giulia , Tomasoni Lina Rachele , Castelli Francesco 
Published: January 2020

Purpose of review
The aim of the article is to review the most recent evidence concerning parasitic skin infections.

Recent findings
Parasitic skin infections are increasingly reported worldwide. Special at-risk categories are migrants, returning travelers, and immunocompromised individuals, who are at higher risk to present disseminated disease. The number of reported cases is growing even outside the endemic areas as a consequence of international travels, migration flows, increasing immunocompromised population, climate change, and natural disasters.

Summary
Skin parasitoses are neglected infections. Funding assigned to prevent and treat them is limited, even if they affect millions of persons worldwide. Diagnosis could be a challenge for clinicians of high-income countries who are facing an increasing number of such infections related to great epidemiological events.
Prevalence of Female Urinary Incontinence in Crossfit Practitioners and Associated Factors: An Internet Population-Based Survey
Authors: Poli de Araújo Maita , Brito Luiz Gustavo Oliveira , Rossi Fabiana , Garbiere Maria Luiza , Vilela Maria Eduarda , Bittencourt Vitor Ferraz 
Published: January 2020

Objectives
CrossFit comprises a set of high-intensity, high-impact exercises that includes movements that may increase intra-abdominal pressure and cause involuntary loss of urine. There is scant literature about the prevalence of urinary incontinence (UI) in female crossfitters, as well as its associated factors.

Methods
A population-based Internet survey stored in a website created with information on the benefits and risks of CrossFit for women’s health (https://crosscontinencebr.wixsite.com/crosscontinencebr) invited female crossfitters. In total, 551 women answered an online questionnaire, and the demographic variables (age, marital status, and parity), anthropometric data (weight, height, and body mass index), and the presence of UI during exercises were also investigated. The prevalence of UI and its associated factors were calculated using a logistic regression model. The significance level was set at 5%.

Results
The overall prevalence of UI during CrossFit exercises was 29.95%, and most women with UI reported loss of urine during at least one exercise (16.70%). Women with UI were older (33.77 ± 8.03 years) than those without UI (30.63 ± 6.93 years; P < 0.001). Double under (20.15%) and single under (7.99%) were the exercises that were most frequently associated with UI and also the only variables that remained in the final model that caused UI. The duration of CrossFit practice, number of days per week practicing CrossFit, daily time practice, previous vaginal delivery, and mean birth weight were not statistically associated with UI.

Conclusions
One-third of female crossfitters presented with UI during exercise. Double under was the exercise that was the most associated with UI.
When to Remove the Indwelling Catheter After Minimally Invasive Sacrocolpopexy? CARESS (CAtheter REmoval after Sacrocolpopexy Surgery)
Authors: Aslam Muhammad Faisal , Bazzi Ali A. , Hagglund Karen H. , Osmundsen Blake C. 
Published: January 2020

Objective
The aim of the study was to determine the best practice guidelines regarding the use of indwelling catheters after minimally invasive sacrocolpopexy.

Methods
Multicenter (3 sites) randomized control trial comparing the standard overnight indwelling urethral catheterization (group 2) with removal of catheter immediately after surgery (group 1). Our primary outcome is the need for recatheterization. Secondary outcomes include the number of patients discharged with a catheter, length of hospital stay, number of urinary tract infections, patient satisfaction/pain scores, and whether patients would use the same treatment again.

Results
There were 32 patients (43.8%) in group 1 and 41 patients (56.2%) in group 2. On average, patients in group 1 required straight catheterization 0.8 (SD = 0.9) times versus 0.6 (SD = 0.9) times for group 2 (P = 0.239). The number of days with a catheter between the 2 groups was not statistically significant. There was no statistical significance between group 1 and group 2 in terms of operative time, times to leave the operating room, and hospital. Zero patients in group 1 and 2 patients in group 2 had a urinary tract infection. After dividing the groups based on whether or not they underwent a transvaginal tape procedure, the final results were similar.

Conclusions
We did not observe a difference in the risk of recatheterization or discharge home with a urinary catheter between the 2 groups. Addition of transvaginal tape to sacrocolpopexy did not show a difference in the risk of recatheterization. One reason for the lack of difference between the 2 groups could be due to a lack of power in our study.
Is Fluid Intake Associated With Fecal Incontinence in Women?
Authors: Halani Priyanka Kadam , Harvie Heidi S. , Arya Lily A. , Andy Uduak U. 
Published: January 2020

Objective
The primary aim of this study was to determine if fecal incontinence (FI) is associated with self-reported fluid intake in women seeking care for pelvic floor disorders. The secondary aim was to determine the association between bowel symptoms and fluids associated with FI.

Methods
We conducted a retrospective cross-sectional study of women presenting for evaluation of pelvic floor disorders from 2009 to 2015. The presence of FI was defined as an affirmative response of any frequency to the question, “During the last 4 weeks, how often have you leaked or soiled yourself with stool?” Data on fluid intake and bowel symptoms were collected using the Questionnaire-based Voiding Diary and Colorectal-Anal Distress Inventory short form, respectively. The relationship between FI and quartiles of fluid intake, as well as the relationship between bowel symptoms and fluids associated with FI, was analyzed.

Results
Nine hundred twenty-four women were included: 379 (41%) with and 545 (59%) without FI. There was an association between FI and increasing total carbonated fluid intake (P = 0.009) and decreasing water intake (P = 0.009). The associations between FI and carbonated fluid intake and FI and water intake remained significant after controlling for patient characteristics (P < 0.05). There was a significant association between the symptom of straining to defecate and carbonated beverage intake (P = 0.046), which remained significant after controlling for patient characteristics (P < 0.001).

Conclusions
Consumption of carbonated beverages is associated with FI in women. Intake of carbonated fluids is associated with bowel symptoms that may exacerbate FI symptoms.
Plasma proteomics reveals markers of metabolic stress in HIV infected children with severe acute malnutrition
Authors: Gonzales Gerard Bryan , Njunge James M , Gichuki Bonface M , Wen Bijun , Potani Isabel , Voskuijl Wieger , Bandsma Robert H J , Berkley James A 
Published: January 2020

AbstractHIV infection affects up to 30% of children presenting with severe acute malnutrition (SAM) in Africa and is associated with increased mortality. Children with SAM are treated similarly regardless of HIV status, although mechanisms of nutritional recovery in HIV and/or SAM are not well understood. We performed a secondary analysis of a clinical trial and plasma proteomics data among children with complicated SAM in Kenya and Malawi. Compared to children with SAM without HIV (n = 113), HIV-infected children (n = 54) had evidence (false discovery rate (FDR) corrected p<0.05) of metabolic stress, including enriched pathways related to inflammation and lipid metabolism. Moreover, we observed reduced plasma levels of zinc-α-2-glycoprotein, butyrylcholinesterase, and increased levels of complement C2 resembling findings in metabolic syndrome, diabetes and other non-communicable diseases. HIV was also associated (FDR corrected p<0.05) with higher plasma levels of inflammatory chemokines. Considering evidence of biomarkers of metabolic stress, it is of potential concern that our current treatment strategy for SAM regardless of HIV status involves a high-fat therapeutic diet. The results of this study suggest a need for clinical trials of therapeutic foods that meet the specific metabolic needs of children with HIV and SAM.
Spinach Growers Value Host Resistance and Synthetic Fungicides in the Fight against Downy Mildew
Authors: Choudhury Robin A. , McRoberts Neil 
Published: January 2020

AbstractCalifornia spinach growers struggle to manage spinach downy mildew disease. The disease is especially difficult in the organic crop, which currently relies on resistant varieties to maintain disease-free crop. Alternative control measures are available, but it is not clear how growers perceive the efficacy of these methods. It is also not clear who growers contact to find out information on spinach downy mildew disease management. In this study, we conducted an online survey of people involved in spinach production, asking about their beliefs in the efficacy of different control methods and who they contact frequently to discuss spinach downy mildew control. We found that respondents were most positive about the efficacy of resistant varieties and synthetic pesticides, with much lower perceived efficacy for the practices of disking diseased fields, roguing diseased plants, and organic pesticides. Growers most frequently contacted pest control advisors (PCAs) about management strategies for spinach downy mildew. These results suggest that respondents are most confident about the efficacy of resistant varieties and synthetic pesticides and may be hesitant to adopt new control strategies like organic pesticides. The results also suggest that future extension efforts can be focused on PCAs to reach the most stakeholders with up to date research on downy mildew control.
AMPK activation by metformin promotes survival of dormant ER+ breast cancer cells
Authors: Hampsch Riley A. , Wells Jason D. , Traphagen Nicole A. , McCleery Charlotte F. , Fields Jennifer L. , Shee Kevin , Dillon Lloye M. , Pooler Darcy B. , Lewis Lionel D. , Demidenko Eugene , Huang Yina H. , Marotti Jonathan D. , Kinlaw William B. , Miller Todd W. 
Published: January 2020

AbstractPurposeDespite adjuvant anti-estrogen therapy for patients with estrogen receptor alpha (ER)-positive breast cancer, dormant residual disease can persist for years and eventually cause tumor recurrence. We sought to deduce mechanisms underlying the persistence of dormant cancer cells to identify therapeutic strategies.Experimental DesignMimicking the aromatase inhibitor-induced depletion of estrogen levels used to treat patients, we developed preclinical models of dormancy in ER+ breast cancer induced by estrogen withdrawal in mice. We analyzed tumor xenografts and cultured cancer cells for molecular and cellular responses to estrogen withdrawal and drug treatments. Publicly available clinical breast tumor gene expression datasets were analyzed for responses to neoadjuvant anti-estrogen therapy.ResultsDormant breast cancer cells exhibited upregulated 5’ adenosine monophosphate-activated protein kinase (AMPK) levels and activity, and upregulated fatty acid oxidation. While the anti-diabetes AMPK-activating drug metformin slowed the estrogen-driven growth of cells and tumors, metformin promoted the persistence of estrogen-deprived cells and tumors through increased mitochondrial respiration driven by fatty acid oxidation. Pharmacologic or genetic inhibition of AMPK or fatty acid oxidation promoted clearance of dormant residual disease, while dietary fat increased tumor cell survival.ConclusionsAMPK has context-dependent effects in cancer, cautioning against the widespread use of an AMPK activator across disease settings. The development of therapeutics targeting fat metabolism is warranted in ER+ breast cancer.Statement of Translational RelevanceDormant cancer cells that survive adjuvant therapy can ultimately give rise to recurrent/advanced tumors that frequently develop resistance to all approved therapies. Patients with early-stage estrogen receptor alpha (ER)-positive breast cancer are typically treated with surgical resection followed by ≥5 years of adjuvant anti-estrogen therapy that neutralizes ER and suppresses, but often does not eliminate, tumor-initiating cells. Estrogen withdrawal, which mimics aromatase inhibitor therapy, induced activation of the metabolic sensor 5’ adenosine monophosphate-activated protein kinase (AMPK) and upregulated fatty acid oxidation (FAO) in preclinical models. Treatment with the anti-diabetes AMPK-activating drug metformin or high dietary fat intake promoted survival of dormant ER+ breast cancer cells, while anti-anginal drugs that inhibit FAO induced clearance of dormant tumor cells. These findings caution against using AMPK modulators with anti-estrogens in patients with ER+ breast cancer, and warrant testing of FAO inhibitors as anti-cancer agents in combination with anti-estrogens.
Anin vivostrategy for knockdown of circular RNAs
Authors: Pamudurti Nagarjuna Reddy , Patop Ines Lucia , Krishnamoorthy Aishwarya , Ashwal-Fluss Reut , Bartok Osnat , Kadener Sebastian 
Published: January 2020

ABSTRACTExonic circular RNAs (circRNAs) are highly abundant and evolutionarily conserved RNAs generated mostly from exons of protein-coding genes. Assaying the functions of circRNAs is not straightforward as common approaches for circRNA depletion tend to also alter the levels of mRNAs generated from the hosting gene. Here we describe a methodology for specific knockdown of circRNAsin vivowith tissue and cell resolution. We also describe an experimental and computational platform for determining the potential off-target effects as well as for verifying the obtained phenotypes. Briefly, we utilize miRNA-derived shRNAs targeted to the circRNA-specific back-splice junction to specifically downregulate the circRNA. We utilized this methodology to downregulate five circRNAs that are highly expressed in the fly nervous system. There were no effects on levels of the linear RNA or any RNA with complementarity to the expressed shRNA. Interestingly, downregulation of circCtrip resulted in developmental lethality that was recapitulated with a second shRNA. Moreover, we found that downregulation of individual circRNAs caused specific changes in the fly head transcriptome, suggesting roles for these circRNAs in the fly nervous system. Together, our results provide a methodological approach that enables the comprehensive study of circRNAs at the organismal and cell levels.
Interpretable Clinical Genomics with a Likelihood Ratio Paradigm
Authors: Robinson Peter N. , Ravanmehr Vida , Jacobsen Julius O.B. , Danis Daniel , Zhang Xingmin Aaron , Carmody Leigh C. , Gargano Michael , Thaxton Courtney L. ,   UNC Biocuration Core, Reese Justin , Holtgrewe Manuel , Köhler Sebastian , McMurry Julie A. , Haendel Melissa A. , Smedley Damian 
Published: January 2020

AbstractHuman Phenotype Ontology (HPO)-based analysis has become standard for genomic diagnostics of rare diseases. Current algorithms use a variety of semantic and statistical approaches to prioritize the typically long lists of genes with candidate pathogenic variants. These algorithms do not provide robust estimates of the strength of the predictions beyond the placement in a ranked list, nor do they provide measures of how much any individual phenotypic observation has contributed to the prioritization result. However, given that the overall success rate of genomic diagnostics is only around 25–50% or less in many cohorts, a good ranking cannot be taken to imply that the gene or disease at rank one is necessarily a good candidate. Likelihood ratios (LR) are statistics for summarizing diagnostic accuracy, providing a measure of how much more (or less) a patient with a disease has a particular test result compared to patients without the disease. Here, we present an approach to genomic diagnostics that exploits the LR framework to provide an estimate of (1) the posttest probability of candidate diagnoses; (2) the LR for each observed HPO phenotype, and (3) the predicted pathogenicity of observed genotypes. LIkelihood Ratio Interpretation of Clinical AbnormaLities (LIRICAL) placed the correct diagnosis within the first three ranks in 92.9% of 384 cases reports comprising 262 Mendelian diseases, with the correct diagnosis having a mean posttest probability of 67.3%. Simulations show that LIRICAL is robust to many typically encountered forms of genomic and phenomic noise. In summary, LIRICAL provides accurate, clinically interpretable results for phenotype-driven genomic diagnostics.
Non-pharmacological management of Alzheimer’s disease a qualitative study, in Mauritius
Authors: Goorah Smita , Dorkhy Geeta Devi 
Published: January 2020

AbstractIntroductionThe major form of dementia is Alzheimer’s disease (AD). In Mauritius it was estimated in 2015 that around 10,000 persons had Alzheimer’s disease from Alzheimer disease International report1. This represent 16% of the total population and it is expected to rise. Therefore, apart from pharmacological therapies, non-pharmacological treatment (NPT) which can improve cognitive performance such as cognitive training, occupational therapy, reminiscence therapy, are being highly investigated.Aim and objectiveTo determine the outcome(s) and to highlight the effective strategies in the management of Alzheimer’s Disease in Mauritius using NPT. Information obtained from this research will add to the current knowledge and expansion.Materials and methodsThe only NGO in Mauritius is “Alzheimer’s Association”, from where the persons with AD were recruited. Non-interventional methods of qualitative study involving interviews of person with AD, lasting 30-45 minutes were audio-recorded. An informed consent from the carer or patient-relative prior to starting was ensured. Both semi-structured interviews and open-ended questions were used, relating to NPT. Thematic analysis in qualitative research, followed by coding and decoding raw data. Similar categories of data were grouped and themes emerged.ResultsIn-depth responses of the person with AD related with their experiences, perceptions, opinions, feelings, and knowledge. Qualitative study (n=20) emerged with 6 main themes. Among these, dependency on family identified as an important theme. It has also been associated as an important form of cognitive and functional engagement for person with AD.DiscussionNon-pharmacological interventions has an important role to prolong the active age of older individuals, as well as to maintain quality of life.ConclusionThere is still a greater demand on the market for non-pharmacological interventions and Mauritius should plan and devise national guidelines to deal with this unmet proportion of elderly so as to curb for future health equality and stability.
Epidemiological identification of a novel infectious disease in real time: Analysis of the atypical pneumonia outbreak in Wuhan, China, 2019-20
Authors: Jung Sung-mok , Kinoshita Ryo , Thompson Robin N. , Hayashi Katsuma , Linton Natalie M. , Yang Yichi , Akhmetzhanov Andrei R. , Nishiura Hiroshi 
Published: January 2020

ABSTRACTObjectiveVirological tests indicate that a novel coronavirus is the most likely explanation for the 2019-20 pneumonia outbreak in Wuhan, China. We demonstrate that non-virological descriptive characteristics could have determined that the outbreak is caused by a novel pathogen in advance of virological testing.MethodsCharacteristics of the ongoing outbreak were collected in real time from two medical social media sites. These were compared against characteristics of ten existing pathogens that can induce atypical pneumonia. The probability that the current outbreak is due to “Disease X” (i.e., previously unknown etiology) as opposed to one of the known pathogens was inferred, and this estimate was updated as the outbreak continued.ResultsThe probability that Disease X is driving the outbreak was assessed as over 32% on 31 December 2019, one week before virus identification. After some specific pathogens were ruled out by laboratory tests on 5 Jan 2020, the inferred probability of Disease X was over 59%.ConclusionsWe showed quantitatively that the emerging outbreak of atypical pneumonia cases is consistent with causation by a novel pathogen. The proposed approach, that uses only routinely-observed non-virological data, can aid ongoing risk assessments even before virological test results become available.
Evaluation of the accuracy of a smartphone-based artificial intelligence system, PlantVillageNuru,in diagnosing of the viral diseases of cassava
Authors: Mrisho Latifa , Mbilinyi Neema , Ndalahwa Mathias , Ramcharan Amanda , Kehs Annalyse , McCloskey Peter , Murithi Harun , Hughes David , Legg James 
Published: January 2020

ABSTRACTPremise of the studyNuruis an artificial intelligence system for diagnosis of plant diseases and pests developed as a public good by PlantVillage (Penn State University), FAO, IITA and CIMMYT. It provides a simple, inexpensive and robust means of conducting in-field diagnosis without requiring internet connection and provides real-time results and advice. The present work evaluates the effectiveness ofNuruas an in-field diagnostic tool by comparing the diagnosis capability ofNuruto that of cassava experts (researchers trained on cassava pests and diseases), agricultural extension agents and farmers.MethodsThe diagnosis capability ofNuruand that of the assessed individuals was determined by inspecting cassava plants in-field and by using the cassava symptom recognition assessment tool (CaSRAT) to score images of cassava leaves.ResultsNuru’s accuracy for symptom recognition when using six leaves (74 - 88%, depending on the condition) was similar to that of experts, 1.5-times higher than agricultural extension agents and two-times higher than farmers.DiscussionThese findings suggests that Nuru can be an effective tool for in-field diagnosis of cassava diseases and has a potential of being a quick and cost-effective means of disseminating knowledge from researchers to agricultural extension agents and farmers.