bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Score to Predict Positive Colonic Histology in Chronic Diarrhea Assessed in Open-access Colonoscopy
Authors: Atieh Jessica , Chedid Victor , Khoshbin Katayoun , Kane Sunanda , Camilleri Michael 
Published: August 2020

Goals:
To evaluate the diagnostic yield of colonoscopy and esophagogastroduodenoscopy with biopsies and to identify predictors of positive colonic histology in patients with chronic diarrhea.

Background:
Colonoscopy with biopsies is performed in chronic diarrhea with negative initial work-up.

Study:
We reviewed electronic medical records of 1022 consecutive patients with chronic diarrhea referred for a first colonoscopy (including 25% open-access referrals). Predictors of positive colonic histology were investigated using logistic regression.

Results:
Four hundred thirteen patients with macroscopically normal colon were divided into derivation (n=275) and validation (n=138) cohorts. All patients underwent colonoscopy; 369 had ileoscopy (biopsies in 43%), and 289 underwent esophagogastroduodenoscopy (duodenal biopsies in 93%). In patients with endoscopically normal colon, histology was positive in 13.3%: 10.6% microscopic colitis; 1.5% other colitides. Among 358 patients with negative histology, the recorded diagnoses were: 48% unexplained, 25% irritable bowel syndrome, 5.6% small intestinal bacterial overgrowth, and 4.7% bile acid diarrhea. The rates of diagnoses based on positive histologies were 4% for ileal and 5% for duodenal biopsies. Older age [odds ratio (OR)=1.05] was a positive predictor, whereas body mass index (OR=0.93) and duration of diarrhea (OR=0.98) were negative predictors of positive histology. A clinical diagnostic scoring system could correctly predict 41% to 54% of patients with normal colonic histology, with a false-negative rate of 0.8% to 2.6% and a negative predictive value of 95% to 98%.

Conclusions:
Positive colonic biopsies were detected in <15% of patients with chronic diarrhea with normal colonoscopy; a clinical score correctly predicts likelihood of normal histology in about half the patients.
Update on celiac disease
Authors: Alkalay Michele J. 
Published: August 2020

Purpose of review
The purpose of this review is to describe current updates in celiac disease.

Recent findings
Recent developments in the understanding of the pathogenesis of celiac disease continue to emerge that may implicate the role of gluten exposure. Several studies have shown that the amount of gluten consumed by the infant may affect the age of onset of celiac disease in genetically predisposed individuals. New guidelines from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition allow serology-based celiac diagnosis, omitting endoscopic biopsies, in children. Recent data and updated guidelines in adults no longer support biopsies in all patients who are genetically susceptible with celiac disease who have been identified by serology with clinical signs and symptoms of celiac disease. A new assay was identified in the immune response to epitopes of the tissue transglutaminase–deamidated gliadin peptide complex. In addition, a recent study shows that serum IL-2 elevations correlate with timing and severity of symptoms after gluten ingested in celiac disease patients. Measuring gluten immunogenic peptides (GIPs) in the stool of celiac patients may help monitor adherence to a gluten-free diet (GFD). Of importance, we should be aware that the quality of life is affected in celiac disease patients. During adolescence, the education on the importance of long-term follow-up with an adult gastroenterologist is associated with more successful rates of medical care transition for young adults with celiac disease. Latiglutenase, an orally administered mixture of two gluten-specific recombinant proteases that degrades gluten proteins into small physiologically irrelevant fragments, is currently in a phase 2 trial. Latiglutenase has shown to be safe and effective in reducing symptoms of celiac disease patients upon a GFD with improvement of quality of life. Lastly, a recent study describes a mouse model that is characteristic of celiac disease.

Summary
Our knowledge of celiac disease continues to grow with increasing evidence of contributory factors to its pathogenesis. There is some evidence that the quantity ingested of gluten by the infant effects the age of onset of celiac disease in genetically susceptible patients. Changes have been made to the guidelines in the diagnosis of celiac disease proposed by new studies. Recent studies have shown the significant effects on quality of life for celiac patients. As improved laboratory methods continue to be developed, these tests can have utility in both diagnosis of celiac disease and monitoring adherence to the GFD. Current therapeutic trials offer promising nondietary treatment for celiac patients. The development of an animal model can provide a better understanding of the pathogenesis of celiac disease.
Ethical considerations in xenotransplantation: a review
Authors: Cengiz Nezerith , Wareham Christopher Simon 
Published: August 2020

Purpose of review
The purpose of this review is to present and analyse recent literature on the patterns, trends, and developments of ethical considerations concerning xenotransplantation by appraising normative aspects within a coherent framework.

Recent findings
Developments within xenotransplantation may soon allow for pig-to-human xenotransplantation to take place. Ethical analysis of xenotransplantation commonly follows an anthropocentric cost–benefit analysis, which may imprecisely measure costs. Xenotransplantation should not merely be approached from an anthropocentric perspective. Rather, the potential risks presented to human and nonhuman donors, recipients, and third parties should all be thoroughly considered.

Summary
The range of feasible alternatives to xenotransplantation to increase organ supply should be examined before resorting to xenotransplantation because of the moral distinction between imposing certain risks on others before, or after, alternative solutions have been exhausted.
The emerging psychosocial profile of the adult congenital heart disease patient
Authors: Coleman Amy , Chan Alice , Zaidi Ali N. 
Published: August 2020

Purpose of review
With advances in the diagnosis and treatment of congenital heart disease (CHD), over 90% of infants born with CHD now reach adulthood. Patients with CHD require lifelong care and are at an increased risk of psychological distress, neurocognitive deficits, social challenges, and a lower quality of life (QOL). There exists limited research on how to best to support the long-term mental healthcare needs of this unique cohort. There remains limited data on directed mental health interventions and their long-term results in adults with CHD (ACHD).

Recent findings
Recent findings indicate high incidences of anxiety and depression in this growing population and how key concepts such as trauma, illness identity, and resilience maybe playing a role in the lives of adult patients with CHD. Attention must be focused to theorize and conduct further research to determine the effectiveness of treatment options based upon these new findings.

Summary
Many individuals with CHD do not receive appropriate mental health screening and care. The authors advocate for effective psychosocial interventions to address patients’ illness identity and resilience, with the goal of an improved QOL in mind.
Research priorities in Fontan-associated liver disease
Authors: Khan Sara , Aziz Hassan , Emamaullee Juliet 
Published: August 2020

Purpose of reviewFontan-associated liver disease (FALD) is an emerging condition in patients who have undergone surgical correction of univentricular congenital heart disease. There is little known about the epidemiology of FALD, including risk factors for end-organ failure or hepatocellular carcinoma nor a consensus on surveillance guidelines. Furthermore, there is a need to understand the role of heart versus combined heart–liver transplantation in this population. Research is limited by systemic barriers hindering the ability to track longitudinal FALD outcomes.Recent findingsNearly all patients post-Fontan develop histological features of FALD as a function of time post-Fontan, regardless of Fontan hemodynamics. In cases of end-organ disease, single-center studies have shown promising outcomes of combined heart–liver transplant in this population, with decreased rates of acute rejection. However, despite the burden of disease, it is not currently possible to identify the population of patients with FALD using existing clinical databases and registries due to a lack of diagnostic codes.SummaryStrategies proposed to address barriers to understanding FALD include developing appropriate diagnostic and transplant-related codes for existing registries. Efforts should also be targeted at initiating prospective studies to understand recognized comorbidities related to Fontan physiology, guided by a team of multidisciplinary subspecialists.
Psychometric Development of an Instrument Measuring Social Bullying in Nursing Academia
Authors: Beitz Janice M. , Beckmann Claudia A. 
Published: August 2020

Background
Social bullying in academic nursing schools is an understudied area, yet extant research shows it is prevalent.

Purpose
The purpose of this study was to generate a formal definition for academic social bullying and content validate an instrument measuring it in academic nursing.

Methods
Classic psychometric theory and survey design were used to develop an instrument measuring academic social bullying. Extensive literature review and analysis of existing instruments were conducted; 108 items indicating bullying behaviors and organizational characteristics were created. This study targeted establishing initial content validity. Forty nurse experts who had experienced or published on academic bullying were invited; 24 responded. Experts rated agreement with relevance/appropriateness of items using a Likert scale and provided comments.

Results
Forty items with content validity indexes near 0.80 and supportive comments were retained. A formal definition was developed from experts' feedback.

Conclusions
Insights regarding differences between bullying and incivility were obtained.
Strategy for Bone Conservation in the Two-Stage Correction of Hypertelorism in Craniofrontonasal Dysplasia
Authors: Paternoster Giovanna , Haber Samer E. , Britto Jonathan A. , Benderbous Djamila , James Syril , Legros Christophe , Khonsari Roman H. , Arnaud Éric 
Published: August 2020

Abstract
Pre-emptive planning to optimize safety and outcome is a defining principle of pediatric craniofacial surgery, in which “procedures that come before” should enhance and not compromise procedures that are planned to follow.
A technical modification of fronto-orbital advancement/remodeling in 2-stage hypertelorism surgery for craniofrontonasal dysplasia is presented, where orbital hypertelorism is accompanied by coronal craniosynostosis. Fronto-orbital advancement/remodeling undertaken by this approach preserves bone in the supero-lateral bandeau and provides optimal quality bone stock for the subsequent orbital box shift osteotomy. In this way the second procedure is protected and enhanced by optimal planning of the primary procedure, with potential benefits to safety, quality, and outcome of the final result.
Long-Term Morphologic Changes on Sagittal Synostosis Patients Who Underwent a Modified Pi Technique
Authors: Monte Thais Miguel , Denadai Rafael , Raposo-Amaral Cesar Augusto , Ghizoni Enrico , Raposo-Amaral Cassio Eduardo 
Published: August 2020

Background:There are paucity of studies focused on the long-term assessment of the craniofacial changes after a pi-plasty procedure and self-reported quality of life outcomes. Thus, this study aimed to assess long-term morphologic changes and quality of life of patients with sagittal synostosis who underwent surgery with a modified pi-plasty.Methods:Consecutive patients with sagittal synostosis who underwent surgery and had more than 5 years of follow-up and standard preoperative and 1, 3, and 5 years right profile view photographs were included. Nasofrontal angle and angle of total facial convexity were evaluated using computerized photogrammetric measurements. Additionally, quality of life outcome was evaluated by the Quality of Life Scale Short Form.Results:The total facial convexity angle and nasofrontal angle increased significantly (P < 0.05), with aP-value of 0.013 and 0.012, respectively. Patients had quality of life scores >80 in all of the 4 domains, with the highest scores being: physical health domain 80.0 ± 0, psychologic domain 85.0 ± 5, social relationships domain 86.6 ± 0, and environmental domain 98.13 ± 2.42.Conclusion:Facial angles significantly changed over 5 years of follow-up. Self-reported quality of life instrument showed that patients are satisfied with their own appearance, contributing positively to their quality of life.
Roberts Syndrome With a Bilateral Cleft Lip and Palate
Authors: Máximo Geiza , Raposo-Amaral Cesar Augusto , Paez Ana Beatriz Affonseca , Raposo-Amaral Cassio Eduardo 
Published: August 2020

Abstract
Roberts syndrome (RBS) is a rare craniofacial anomaly associated with tetraphocomelia, growth and mental retardation, cardiac and renal abnormalities. The RBS is caused by homozygous mutation in the ESCO2 gene on chromosome 8p21. In this report, the authors describe a 5-year-old female infant with RBS and bilateral cleft lip and cleft palate, an extremely rare condition.
A Progressive Enlarging Intraparenchymal Pericatheter Cyst and Cerebral Spinal Fluid Edema Following Ommaya Reservoir Placement
Authors: Chen Yan , Fu Xiaoling , Wang Jing , Cui Lihong , Wang Chunyan , Yuan Xunhui , An Yanyan 
Published: August 2020

Abstract
Spread of cerebral spinal fluid (CSF) into the brain parenchyma is a very rare complication of Ommaya reservoir placement and can take form of CSF edema or an intraparenchymal pericatheter cyst. Herein, we described an extremely rare case of a progressive enlarging intraparenchymal pericatheter cyst and CSF edema in a patient with cerebral cysticercosis following Ommaya reservoir placement. A heightened index of suspicion of this rare complication is required to prevent misdiagnosis as a tumor or brain abscess that may lead to unnecessary surgical explorations.
Three-Dimensional Cephalometric Analysis: The Changes in Condylar Position Pre- and Post-Orthognathic Surgery With Skeletal Class III Malocclusion
Authors: Shrestha Abhinav , Song Shao Hua , Aung Han Nyein , Sangwatanakul Jirayus , Zhou Nuo 
Published: August 2020

Abstract
The study includes 21 adult patients with skeletal class III malocclusion who underwent orthognathic surgery and had computed tomography images records presurgery (T0) up to 6 months after the surgery (T1). The computed tomography images were analyzed three-dimensionally using the Proplan CMF 3.0 software. Different skeletal and dental parameters were used in analyzing the cephalometric analysis of the patients. The change in the condylar axis angle was evaluated on 3 planes: axial, coronal, and sagittal. The anteroposterior position of the condyle in relation to the glenoid fossa was evaluated in the sagittal plane. ∠SNB, ∠ANB, ∠Left Y-axis, ∠Right Y-axis were statistically significant (P < 0.01). Significant differences on the condylar axis angle were found between the groups on the sagittal plane (P < 0.05) whereas no significant differences were noted on the axial and the coronal plane. In the anteroposterior condylar position related to the glenoid fossa, the condyle exhibited different displacement on different condyles. The right condyle exhibited more of the posterior displacement whereas the left condyle exhibited more of anterior displacement of the condyle in relation to the glenoid fossa. Numerous studies have done regarding the changes after postsurgery using the two-dimensional cephalometric analysis. Using the 3D techniques helps us to identify the cephalometric point more accurately which thus enhances the accuracy in the cephalometric analysis. However, care should be taken not to change the axis of rotation of the condyle to prevent from the treatment relapse and to avoid temporo-mandibular disorders.
Morphologic and Aerodynamic Changes of Upper Airway in Pediatric Hemifacial Microsomia Patients Undergoing Distraction Osteogenesis
Authors: Wang Rongyang , Chen Shuai , Yang Ruimei , Liu Hong , Liu Yinli , Liu Dongxu 
Published: August 2020

Abstract
Current studies on hemifacial microsomia (HFM) patients undergoing unilateral distraction osteogenesis (DO) mainly confined to description of facial morphology. This study was to investigate the effect of unilateral DO on upper airway in pediatric HFM patients using computational fluid dynamics. The investigators implemented the present retrospective study composed of 20 patients (age 9.5 ± 2.5 years, 11 males, 9 females) with moderate HFM performed unilateral DO on the ramus of mandible. Computational fluid dynamics models of the upper airway were obtained based on the computed tomography data sets which were taken before and 6 months after distraction. Morphologic and aerodynamic parameters were respectively computed and compared at peak inspiration. Paired t-tests were used to compare the differences between the before and after parameters with the significance set at P < 0.05. The authors observed that after DO, oropharynx and nasopharynx were the major expanded regions, average pressure increased in all cross-sections, average velocity decreased significantly except in the superior border of the epiglottis plane, and the airflow resistance significantly reduced in the whole upper airway (P < 0.05). The results indicate that unilateral DO may expand the constricted oropharynx and nasopharynx, obtain a relatively symmetrical airway shape and decrease the airflow resistance which consequently reduce the workload necessary for breathing and facilitate inspiration.
Coexistence of Cerebral Calcified Cavernous Malformation and Developmental Venous Anomaly
Authors: Aydin Fahri , Ogul Hayri 
Published: August 2020

Abstract
Cerebral cavernous malformations are common vascular malformation of the central nervous system. It may cause various symptoms, such as seizures, intracranial hemorrhage, but most are asymptomatic and diagnosed incidentally. The authors present a case of a 75-year-old man who has a complaint about a headache. On radiological imaging, we descripted that the patient has a calcified cavernoma and a meningioma synchronously. Cavernoma with calcification associated with developmental venous anomaly is a rare condition.
The Effect of Cranial Shape on Esthetic Self-Worth in Bald Men
Authors: Feijen Michelle Marlena Wilhelmina , van Cruchten Cas , van der Hulst Rene Remmelt Willie Johan 
Published: August 2020

Abstract
During the last 3 decades, the incidence of positional plagiocephaly and brachycephaly has increased. Treatment options are conservative and can include physiotherapy and molding helmet therapy. The decision to start therapy is based on patient history and subjective assessment of cranial shape by the physician and the parents. To determine the impact of these deformations on esthetic self-worth, as well as cranial shape, this study was conducted on a population of adult bald men.
Participants were asked to fill in a questionnaire about the amount of comments received on cranial shape, as well as grade their general esthetic and grade craniofacial features using a visual analogue scale. The cranial proportions and symmetry were measured using plagiocephalometry.
50 adult bald men were included in this study. The prevalence of nonsynostotic plagiocephaly was 12%; the prevalence of nonsynostotic brachycephaly was 0%. No significant correlation was found between plagiocephaly or brachycephaly, cranial circumference, width or length and amount of comments on cranial shape, cosmetic assessment of appearance or cosmetic assessment of cranial shape. On average, teeth and eyes were given the highest cosmetic value, eyebrows and chin were given the lowest scores.
Cranial shape does not have a significant impact on the amount of comments received on cranial shape, nor the cosmetic assessment of either overall appearance or cranial shape in bald men. For bald men, eyes and teeth are more important craniofacial features in cosmetic assessment. There is no clear esthetic need to treat deviating cranial shape with helmet therapy in male patients.
Progress in the therapy of myasthenia gravis: getting closer to effective targeted immunotherapies
Authors: Dalakas Marinos C. 
Published: August 2020

Purpose of review
To provide an update on immunomodulating and immunosuppressive therapies in myasthenia gravis and highlight newly approved, or pending approval, therapies with new biologics.

Recent findings
Preoperative IVIg is not needed to prevent myasthenic crisis in stable myasthenia gravis patients scheduled for surgery under general anesthesia, based on controlled data. Rituximab, if initiated early in new-onset myasthenia gravis, can lead to faster and more sustained remission even without immunotherapies in 35% of patients at 2 years. Biomarkers determining the timing for follow-up infusions in Rituximab-responding AChR-positive patients are discussed. Most patients with MuSK-positive myasthenia gravis treated with Rituximab have sustained long-term remission with persistent reduction of IgG4 anti-MuSK antibodies. Eculizumb in the extension REGAIN study showed sustained long-term pharmacological remissions and reduced exacerbations. Three new biologic agents showed promising results in phase-II controlled myasthenia gravis trials: Zilucoplan, a subcutaneous macrocyclic peptide inhibiting complement C5; Efgartigimod, an IgG1-derived Fc fragment binding to neonatal FcRn receptor; and Rozanolixizumab, a high-affinity anti-FcRn monoclonal antibody. Finally, the safety of ongoing myasthenia gravis immunotherapies during COVID19 pandemic is discussed.

Summary
New biologics against B cells, complement and FcRn receptor, are bringing us closer to successful targeted immunotherapies in the chronic management of myasthenia gravis promising an exciting future for antibody-mediated neurological diseases.
The role of stigma in children and adolescents with mental health difficulties
Authors: Telesia Laurence , Kaushik Anya , Kyriakopoulos Marinos 
Published: August 2020

Purpose of review
Children and adolescents with mental health difficulties, and people associated with them, can experience stigma as a result of these difficulties. This article aims to provide an update on the literature pertaining to mental health-related stigma in children and adolescents.

Recent findings
Recent studies have investigated public stigma, self-stigma and affiliate stigma related to child and adolescent mental health difficulties. Research has typically employed a cross-sectional design. Significant variation was identified in both study methodology and study findings. Qualitative studies offer a unique perspective of stigma from the point of view of the stigmatized individual. Significantly, quantitative analysis has found different variables to be associated with stigma in different geographical locations, even when similar measures are used.

Summary
Stigma can have a significant detrimental impact on the quality of life for those affected. Careful attention should therefore be paid to stigma in the assessment and treatment of children and adolescents with mental health difficulties. Furthermore, its impact on their caregivers should not be overlooked. Further research is needed to understand the role of social and cultural factors in the development and impact of stigma, and may aid production of antistigma interventions.