bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world Safety and Effectiveness of Infliximab in Pediatric Patients With Acute Kawasaki Disease
Authors: Miura Masaru , Kobayashi Tohru , Igarashi Toru , Hamada Hiromichi , Iwata Naomi , Sasaki Yoshifumi , Matsukawa Miyuki , Sato Noriko , Kubo Hajime , Takei Syuji 
Published: December 2019

Background:
In 2015, infliximab was approved for the treatment of patients with intravenous immunoglobulin-refractory Kawasaki disease (KD) in Japan. However, limited real-world data exist on the usefulness of infliximab for acute KD patients. We conducted a postmarketing surveillance study in patients with acute KD refractory to conventional therapies to evaluate the safety (including any live vaccine-related infections) and the effectiveness of infliximab.

Methods:
This was a multicenter, prospective, open-label, single-cohort, observational study in patients with acute KD refractory to conventional therapy who were prescribed a single 5 mg/kg dose of infliximab. Safety and effectiveness of infliximab were evaluated at 1 month, and live vaccine-related infections were further observed until 6 months from KD onset. Effectiveness assessments included fever resolution rate, the incidence of coronary artery lesions and change in coronary diameter Z scores.

Results:
A total of 291 patients were enrolled, and all patients completed the study. Adverse drug reactions and serious adverse drug reactions were reported in 12.4% and 3.1% of patients, respectively. Live vaccine-related infections were not observed. In the 208 patients with effectiveness assessments, the fever resolution rate within 48 hours after infliximab infusion was 77.4% (95% confidence interval: 71.1–82.9). Median time until fever resolution was 16.6 hours. After infliximab administration, the incidence (at baseline: 10.9%; at the final observation point: 12.0%; maximum value: 14.6%) and severity of coronary artery lesions did not change notably.

Conclusions:
In this study, Infliximab for patients with acute KD refractory to conventional therapies was well tolerated and effective.
Acceptability and Feasibility of Using Raltegravir Oral Granules for the Treatment of Neonates in a Low-resource Setting
Authors: Archary Moherndran , Zanoni Brian , Lallemant Marc , Suwannaprom Puckwipa , Clarke Diana , Penazzato Martina 
Published: December 2019

Background:
Raltegravir granules for oral suspension, now recommended by World Health Organization for use in neonates with HIV infection, may be challenging for caregivers because of the multistep preparation required.

Methods:
We evaluated the acceptability and feasibility of preparing granules for oral suspension in a low-to-middle-income country setting. Thirty-four caregivers and 10 health-care workers were enrolled from an HIV clinic in Durban, South Africa. Health-care workers were provided with pictorial instruction booklet, demonstration kit and guidance on preparation of granules for oral suspension. The health-care workers then trained caregivers on the preparation of granules for oral suspension. Caregivers were evaluated during the preparation process and instructed to practice at home with a sample kit and return to the clinic for repeat evaluation 5–7 days later. Caregivers and health-care workers were interviewed and participated in a focus group discussion regarding their experiences.

Results:
The median age of the caregivers was 31 years (interquartile range: 9.7); 70% had received secondary-level education, 37% were employed. The median preparation time was 7.95 minutes (interquartile range: 5.08 minutes) and 7.48 minutes (3.55 minutes) at initial and repeated observation, respectively. Major errors were insufficient mixing time and incorrect suspension volume. The average number of errors between the 2 observation time points was significantly reduced at the repeat session (2.5 vs. 0.87, P = 0.023). Most participants found the preparation difficult at first but gained confidence over time.

Conclusion:
Despite the complexity involved in the preparation of the granules for oral suspension, with practice, this formulation was found to be acceptable and feasible to majority of participants in this low-resource setting. As a result, this formulation was included in the 2018 World Health Organization recommendations for first line in neonates living with HIV.
Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach
Authors: Roquelaure Yves , Garlantézec Ronan , Evanoff Bradley A. , Descatha Alexis , Fassier Jean-Baptiste , Bodin Julie 
Published: December 2019

Abstract
This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), psychosocial (job strain model), biomechanical (Borg's rating perceived exertion, wrist bending, pinching, and hand-transmitted vibrations), and personal factors at baseline. Symptomatic CTS risk was directly increased by biomechanical factors (standardized coefficient = 0.19, P = 0.011), female gender (0.25, P < 0.001), and age (0.15, P = 0.042). No psychosocial factors had a direct impact on CTS, but decision authority and skill discretion had an indirect impact by influencing biomechanical exposure. Exposure to machine-paced work had an indirect impact on increasing CTS, either by raising biomechanical exposure (0.19, P < 0.001) or by lowering decision authority (−0.18, P < 0.001) and skill discretion (−0.20, P < 0.001), which in turn increased biomechanical exposure. Similar complex relationships were observed between risk factors and CTS defined by a more strict case definition. Biomechanical exposure had a direct impact on CTS, while organizational factors and psychosocial factors had an indirect impact on CTS. The findings support conceptual models linking work organization to CTS.
Activation of µ-δ opioid receptor heteromers inhibits neuropathic pain behavior in rodents
Authors: Tiwari Vinod , He Shao-Qiu , Huang Qian , Liang Lingli , Yang Fei , Chen Zhiyong , Tiwari Vineeta , Fujita Wakako , Devi Lakshmi A. , Dong Xinzhong , Guan Yun , Raja Srinivasa N. 
Published: December 2019

Abstract
Several reports support the idea that µ- and δ-opioid receptors (ORs) may exist as heterodimers in brain regions involved in pain signaling. The unique pharmacology of these heteromers may present a novel analgesic target. However, the role of µ-δ heteromers in sensory neurons involved in pain and opioid analgesia remains unclear, particularly during neuropathic pain. We examined the effects of spinal nerve injury on µ-δ heteromer expression in dorsal root ganglion (DRG) neurons and the effects of a µ-δ heteromer–targeting agonist, CYM51010, on neuropathic pain behavior in rats and mice. An L5 spinal nerve ligation (SNL) in rats significantly decreased µ-δ heteromer expression in L5 DRG but increased heteromer levels in uninjured L4 DRG. Importantly, in SNL rats, subcutaneous injection of CYM51010 inhibited mechanical hypersensitivity in a dose-related manner (EC50: 1.09 mg/kg) and also reversed heat hyperalgesia and attenuated ongoing pain (2 mg/kg, subcutaneously). HEK-293T cell surface-labeled with µ- and δ-ORs internalized both receptors after exposure to CYM51010. By contrast, in cells transfected with µ-OR alone, CYM51010 was significantly less effective at inducing receptor internalization. Electrophysiologic studies showed that CYM51010 inhibited the C-component and windup phenomenon in spinal wide dynamic range neurons of SNL rats. The pain inhibitory effects of CYM51010 persisted in morphine-tolerant rats but was markedly attenuated in µ-OR knockout mice. Our studies show that spinal nerve injury may increase µ-δ heterodimerization in uninjured DRG neurons, and that µ-δ heteromers may be a potential therapeutic target for relieving neuropathic pain, even under conditions of morphine tolerance.
Temporal instability of salience network activity in migraine with aura
Authors: Veréb Dániel , Szabó Nikoletta , Tuka Bernadett , Tajti János , Király András , Faragó Péter , Kocsis Krisztián , Tóth Eszter , Bozsik Bence , Kincses Bálint , Vécsei László , Kincses Zsigmond Tamás 
Published: December 2019

Abstract
This study aims to investigate whether intranetwork dynamic functional connectivity and causal interactions of the salience network is altered in the interictal term of migraine. Thirty-two healthy controls, 37 migraineurs without aura, and 20 migraineurs with aura were recruited. Participants underwent a T1-weighted scan and resting-state fMRI protocol inside a 1.5T MR scanner. We obtained average spatial maps of resting-state networks using group independent component analysis, which yielded subject-specific time series through a dual regression approach. Salience network regions of interest (bilateral insulae and prefrontal cortices, dorsal anterior cingulate cortex) were obtained from the group average map through cluster-based thresholding. To describe intranetwork connectivity, average and dynamic conditional correlation was calculated. Causal interactions between the default-mode, dorsal attention, and salience network were characterised by spectral Granger's causality. Time-averaged correlation was lower between the right insula and prefrontal cortex in migraine without aura vs with aura and healthy controls (P < 0.038, P < 0.037). Variance of dynamic conditional correlation was higher in migraine with aura vs healthy controls and migraine with aura vs without aura between the right insula and dorsal anterior cingulate cortex (P < 0.011, P < 0.026), and in migraine with aura vs healthy controls between the dorsal anterior cingulate and left prefrontal cortex (P < 0.021). Causality was weaker in the <0.05 Hz frequency range between the salience and dorsal attention networks in migraine with aura (P < 0.032). Overall, migraineurs with aura exhibit more fluctuating connections in the salience network, which also affect network interactions, and could be connected to altered cortical excitability and increased sensory gain.
Incretin therapy for diabetes mellitus type 2
Authors: Holst Jens Juul 
Published: December 2019

Purpose of review
Among the gastrointestinal hormones, the incretins: glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 have attracted interest because of their importance for the development and therapy of type 2 diabetes and obesity. New agonists and formulations of particularly the GLP-1 receptor have been developed recently showing great therapeutic efficacy for both diseases.

Recent findings
The status of the currently available GLP-1 receptor agonists (GLP-1RAs) is described, and their strengths and weaknesses analyzed. Their ability to also reduce cardiovascular and renal risk is described and analysed. The most recent development of orally available agonists and of very potent monomolecular co-agonists for both the GLP-1 and GIP receptor is also discussed.

Summary
The GLP-1RAs are currently the most efficacious agents for weight loss, and show potential for further efficacy in combination with other food-intake-regulating peptides. Because of their glycemic efficacy and cardiorenal protection, the GLP-1 RAs will be prominent elements in future diabetes therapy.
Peptide-based therapy in portal hypertension
Authors: Mohanty Arpan 
Published: December 2019

Purpose of review
To summarize the use of gastrointestinal peptides in the management of portal hypertension.

Recent findings
Vasoactive peptides are commonly used in the management of acute variceal hemorrhage and hepatorenal syndrome, which are portal hypertensive complications of cirrhosis. The main vasoactive peptides that are used are somatostatin and its long-acting analogue octreotide, and vasopressin and its analogue terlipressin. Early initiation of vasoactive peptides in the management of acute variceal hemorrhage and hepatorenal syndrome is associated with improved outcomes. Octreotide is the available vasoactive peptide in the Unites States. Recent developments and ongoing clinical trials may improve our understanding of hepatorenal syndrome and influence the use of vasoactive peptides, particularly terlipressin.

Summary
Here, we review the literature on the use of vasoactive peptides in the management of acute variceal hemorrhage and hepatorenal syndrome.
Clubfoot for the primary care physician: frequently asked questions
Authors: Yau Annie , Doyle Shevaun M. 
Published: December 2019

Purpose of reviewThis review aims to provide primary care physicians with updates on recent literature regarding clubfoot and answer questions asked by parents and caregivers of children with clubfoot. The topics discussed include prenatal counseling, relapse after Ponseti treatment, long-term outcomes following successful treatment of clubfoot, and the effect of diagnosis and treatment on the parent or caregiver.Recent findingsClubfoot is one of the most commonly searched orthopaedic conditions on the internet by parents. There is a lack of evidence-based guidelines on clubfoot worldwide. Recent systematic reviews have identified emerging evidence of genetic and modifiable risk factors that lead to clubfoot. Patients treated by the Ponseti method show better ankle power and strength compared with those treated with surgery for residual deformity or recurrence.SummaryThe treatment of clubfoot is a long and involved process. Exposure to and familiarity with the Ponseti method will aid primary care physicians and parents in the optimization of children's clubfoot deformity correction using largely nonoperative management.
Update on mesenchymal stromal cell studies in organ transplant recipients
Authors: Fiori Sonia , Remuzzi Giuseppe , Casiraghi Federica 
Published: December 2019

Purpose of reviewMesenchymal stromal cells (MSC) have been proposed as a novel cell therapy for immune-mediated diseases, including solid organ transplantation. Here, we provide an overview of recent preclinical and clinical studies in solid organ transplantation using MSC immunomodulatory therapy.Recent findingsMSC have been tested successfully in models of corneal and lung transplantation, suggesting that either the programmed cell death protein 1/programmed death ligand 1 pathway or the generation of intermediary immune-regulatory monocyte-macrophage population are the main mechanisms of the protolerogenic effect of MSC. In clinical transplantation, allogeneic MSC from bone marrow or umbilical cord have been evaluated in kidney and lung transplantation with an excellent safety profile. Recent data from kidney transplant patients given autologous bone marrow-MSC enrolled in our phase 1 study demonstrated a good long term safety profile. Extensive immunomonitoring of this initial cohort provided evidence of the development of a protolerogenic environment in some MSC-treated patients. One of these patients has been weaned off immunosuppression successfully.SummaryThe available clinical studies in kidney, liver and lung transplantation indicate that autologous and allogeneic MSC therapy from different sources are safe. Now it's time to focus on well-designed efficacy clinical trials, possibly including extensive immunomonitoring.
Importance of Magnetic Resonance Imaging With Diffusion-weighted Imaging in Guiding Biopsy of Nodular Ganglioneuroblastoma: A Case Report
Authors: Jain Neha , Halbert Jay , Patel Premal A. , Biassoni Lorenzo , Anderson John , Sebire Neil , McHugh Kieran , Barone Giuseppe 
Published: December 2019

Background:
Nodular ganglioneuroblastoma is a rare peripheral neuroblastic tumor of variable prognosis. Accurate diagnosis, staging, and risk categorization can be particularly challenging in patients with nodular ganglioneuroblastoma due to the inherent heterogeneity of these lesions.

Case Presentation:
We illustrate the use of diffusion-weighted magnetic resonance imaging to identify tumor nodules and guide tumor biopsy in an almost 5-year-old boy with a large abdominal tumor.

Conclusions:
Diffusion-weighted magnetic resonance imaging was successful in detecting and guiding biopsy of a poorly differentiated neuroblastoma nodule within the context of a well-differentiated ganglioneuroma, allowing the diagnosis and characterization of a ganglioneuroblastoma nodular, thus influencing the child’s prognosis and treatment.
Neonatal Cancer Epidemiology and Outcome: A Retrospective Study
Authors: Geurten Claire , Geurten Marie , Rigo Vincent , Dresse Marie-Françoise 
Published: December 2019

Objective:
Our study aimed at describing neonatal cancer incidence, distribution by type, location, outcome, and long-term toxicity, by comparison with tumors occurring later in infancy.

Methods:
The authors led a single-center retrospective analysis of 118 cases of tumors diagnosed in the first year of life and compared tumors’ types incidence, presentation, location, and outcome according to age group at diagnosis (below or over 28 d of life).

Results:
The most frequent neonatal tumor types in our series were germ cell tumors, mainly teratoma, followed by neuroblastoma and renal tumors, whereas in children below 1 year of age, brain tumors, neuroblastoma, and leukemia were the most common types. Genetic predisposition syndromes were present in 14% of these infants and antenatal sonography enabled 68% of diagnosis for tumors presenting at birth. Other patients presented with mass syndrome, hydrops, or skin lesions. Six percent of neonates with cancer died from their malignancies, and up to 18% experienced a chronic health condition as a consequence of therapy.

Conclusions:
Tumor pattern differs in neonates and infants, with a higher percentage of benign tumors in children below 28 days of life. Yet, long-term therapy-related toxicity is significant in younger patients. Enhancing knowledge of neonatal tumors, their epidemiology, clinical presentation, genetic background, and prognosis should help promote better management and introduce follow-up programs to improve surviving rates and the quality of life of survivors.
Parental Concerns about Newborn Feeding Post Hospital Discharge
Authors: Fuhrman Lauren , Ross Erin Sundseth 
Published: December 2019

Abstract

Background:
Post hospital discharge newborn feeding education mostly focuses on breastfeeding and is primarily targeted at term infants. Preterm and late-preterm infants are at risk for poor feeding postdischarge, and feeding challenges are common after discharge from the neonatal intensive care unit (NICU). Families often have questions about feeding their infants after hospital discharge.

Purpose:
The goal of this project was to collect data on what questions parents have about feeding their baby after discharge and what strategies may be helpful to improve feeding experiences. These data were intended to inform plans to offer a no-cost newborn feeding clinic for all new parents after hospital discharge.

Methods:
A speech-language pathologist attended a preexisting lactation support group to meet with families and provide feeding support. The speech-language pathologist collected data on types of questions parents asked, education provided, and changes made during the visit to improve feeding experiences.

Results:
Sixty-eight families were seen in the first 6 months of the clinic. Fifty-eight were families of babies cared for in the well baby nursery; 10 were families of graduates from the NICU. Seventy-five percent of the infants were born full-term. Maternal questions focused primarily on bottles and recognizing satiety. The most commonly provided changes included trials of different bottles or positions to improve infant comfort during feedings.

Clinical Implications:
New parents often have questions about breastfeeding and bottle feedings after going home. Using these data, a decision was made to continue the no-cost infant feeding support group to address questions and provide guidance to parents after hospital discharge.
Robotic assisted fixation of sacral fractures
Authors: Weil Yoram A. , Khoury Amal , Mosheiff Rami , Kaplan Leon , Liebergall Meir , Schroeder Josh E. 
Published: December 2019

Abstract

Objectives:
Sacral fractures that require fixation are a challenge for the orthopaedic surgeon. Due to anatomical consideration, implant insertion is not risk free, and requires a steep learning curve. A robotic system has been successfully used in pedicle screws insertion and can be also used for iliosacral screws. The aim of the study was to demonstrate the use of the robot in the treatment of unstable sacral fractures.

Design:
Retrospective case series.

Setting:
An academic level I trauma center.

Patients:
Fourteen patients with sacral fractures were eligible for robotic assisted treatment. These included 9 high-energy fractures, 4 osteoporotic fractures, and 1 pathological fracture.

Intervention:
Fixation constructs included iliosacral screws, transiliac screws, lumbopelvic fixation, sacroplasty, or a combination of the above techniques. A Renaissance robot was mounted on a multidirectional bridge that was attached to the patients spine and implant trajectories were planned either on preoperative or intraoperative 3D scans. Guide wires were inserted percutaneously and screws were placed subsequently.

Main outcome measurements:
Accuracy of implant placement, operating room and fluoroscopy time.

Results:
Mean patient age was 36 (17–84), and number of screws, including iliosacral and pedicular ranged 1–14 per patient (average 4.25). Mean operative time was 150 minutes (range 90–300). Average fluoroscopic time was 18 seconds (7–42) for 2D and 40 seconds (12–72) for 3D imaging. All fractures healed, no hardware failure was observed. All hardware was always within bony confines, and no procedure-related neurological deficits were observed.

Conclusion:
Robotic assisted fixation of sacral fracture is a safe and reproduceable method, allowing precise and accurate implant placement.