bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bovine Lactoferrin Supplementation Does Not Disrupt Microbiota Development in Preterm Infants Receiving Probiotics
Authors: Grzywacz Kelly , Butcher James , Li Jennifer , Barrington Keith , Mohamed Ibrahim , Stintzi Alain 
Published: May 2020

ABSTRACTObjective:The aim of the study was to assess whether bovine lactoferrin (bLf) supplementation disrupts intestinal microbiota development in preterm infants less than 31 weeks gestational age receiving prophylactic probiotic administration.Methods:Subjects were recruited from the LACUNA trial (ISRCTN66482337), designed to assess bLf safety. These subjects were randomized to daily receive either probiotic supplements or probiotics supplemented with 100 mg bLf mixed with their feeds (human milk or formula). Stools were collected weekly from enrolled infants for 1 month and the microbiota characterized using V6‐16S rRNA gene amplicon profiling.Results:Infants’ microbiomes did not increase in alpha diversity over time in both feeding interventions. Infants receiving bLf supplementation had overall higher species richness as compared with those not receiving these supplements and lactoferrin supplementation had differing effects on infant microbiota species richness depending on the infant's gestational age. Principal co‐ordinate analysis revealed that the infant microbiotas did not separate by intervention group, gestational age bracket at birth or sampling time and the main factor dictating sample clustering was infant identity. There were very few detectable differences in taxa relative abundance or functional gene content between the microbiotas in the 2 study groups.Conclusions:Bovine lactoferrin supplementation has minimal impact on microbiota composition/function in preterm infants receiving probiotics, and therefore, is unlikely to disrupt microbiota development.
Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards
Authors: Niţă Andreia F. , Hill Chris J. , Lindley Richard M. , Marven Sean S. , Thomson Mike A. 
Published: May 2020

ABSTRACTTrichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed “Rapunzel syndrome.” Removal has traditionally been by laparotomy; however, successful endoscopic removal has also been described. We report the case of a 9‐year‐old‐girl with undiagnosed coeliac disease and Rapunzel syndrome who underwent endoscopic removal of a large trichobezoar, which was followed by unexpected multiple perforations of the small bowel and stomach. Argon plasma coagulation (APC) and snare electrocautery were employed during endoscopy to remove the trichobezoar piecemeal, and approximately 70% was removed without any clear signs of damage to the mucosa. It was discovered subsequently that about 20 of her dolls were found without hair. On investigating the composition of a specific doll hair from the manufacturer, it was discovered that it could be hazardous if burned. It was, therefore, hypothesized that a constellation of factors had conspired to lead to perforation, that is, the potentially hazardous gas produced from the electrical energy applied to the synthetic hair and possible mucosal damage by the physical abrasion of this hair. A review of the literature on endoscopic attempts to remove trichobezoars irrespective of the result reveals a success rate of 30.7%.
Impact of Transanal Irrigation Device in the Management of Children With Fecal Incontinence and Constipation
Authors: Patel Samit , Hopson Puanani , Bornstein Jeffrey , Safder Shaista 
Published: May 2020

ABSTRACTObjectives:Children with fecal incontinence and constipation can be classified into 3 groups: neurogenic bowel dysfunction (NBD) related to spinal cord defects (NBD), refractory constipation (RC), or anorectal malformations (ARMs). The transanal irrigation (TAI) device (Peristeen) was approved in 2012 by the Food and Drug Administration. This system uses a pump rather than gravity to instill water as a colonic irrigant and uses balloon occlusion of the rectum. Our aim was to evaluate the effectiveness of TAI (Peristeen) in children who failed to respond to conservative measures for stool incontinence and constipation.Methods:Retrospective study of 147 patients prescribed TAI between January 2014 and January 2020. Data collected included demographics, prior bowel regimen, symptoms before and after, patient satisfaction scores, and NBD scores.Results:Of the 147 patients initiated, 114 remain active users (13 lost to follow‐up and 20 discontinued use). Multiple bowel regimens including laxatives (n = 139), cone enema (n = 40), and cecostomy (n = 7) were tried previously. The majority of our patients (n = 85) have NBD, primarily spina bifida, followed by RC (n = 43), and ARM (n = 19). For all patient groups, there was significant improvement in symptoms of fecal incontinence and constipation (P ≤ 0.001). Abdominal pain was improved in the NBD and RC group, but not significantly in the ARM group.Conclusions:We provide a single‐center review of a large pediatric cohort using TAI (Peristeen) for management of fecal incontinence and constipation. Peristeen offered significant improvement in patients with NBD, RC, and ARM.
The Correlation of Symptom Clusters and Functional Performance in Adult Acute Leukemia Patients Under Chemotherapy
Authors: Chen Fengjiao , Leng Yamei , Zhang Li , Xu Juan , Zhang Dan , Qin Yu , Li Jiping , Zheng Yuhuan 
Published: May 2020

Background
Adult acute leukemia (AL) patients who receive chemotherapy usually experience multiple symptoms during the treatment course. The symptom clusters (SCs) as well as subsets of concurrent symptoms in AL patients have not yet been demonstrated.

Objective
To investigate the SCs of adult AL patients who were receiving chemotherapy and to determine their correlations with functional performance.

Methods
A total of 132 hospitalized adult AL patients were included in this study. A cross-sectional survey aimed to examine symptoms and functional performance was conducted. The patients’ symptoms were assessed using the Chinese version of the Condensed Memorial Symptom Assessment Scale, and functional performance was evaluated through activities of daily living and quality of life.

Results
We identified 4 SCs in adult AL patients: psychological SC, pain-fatigue-sleep SC, dry mouth–constipation SC, and nutrition-impaired SC. The psychological SC was the most common and most distressing SC. The different SCs were each differentially correlated with patient characteristics. The distress of the psychological SC, pain-fatigue-sleep SC, and nutrition-impaired SC was adversely correlated with functional performance.

Conclusions
Adult AL patients undergoing chemotherapy experience multiple symptoms that can be further categorized into 4 SCs. The distress from some SCs is negatively associated with patients’ functional performance.

Implications for Practice
Symptom burden remains a major problem for adult AL patients undergoing chemotherapy. Identifying SCs of AL patients should be the basis for accurate and cost-effective interventions. Personalized SC management may improve the functional performance and healthcare quality of adult AL patients.
Toward an Understanding of the Factors Associated With Reproductive Concerns in Younger Female Cancer Patients
Authors: Bártolo Ana , Santos Isabel M. , Monteiro Sara 
Published: May 2020

Background
Cancer treatments may compromise fertility and family building in reproductive-age women. Previous research has shown that younger women with cancer experienced several reproductive health concerns.

Objective
The aim of this study was to conduct a focused review of existing research about the subjective perceptions of reproductive concerns among young women with cancer (aged 15-49 years) and identify their potential predictors and outcomes.

Methods
A systematic synthesis of mixed-methods research was conducted including peer-reviewed articles in English. Relevant studies were identified through the electronic databases Scopus, Web of Science, PubMed, ProQuest, and Psychology & Behavioral Sciences Collection (through EBSCOhost).

Results
A total of 22 reports met the eligibility criteria (8 qualitative and 14 quantitative). Research showed that younger women reported concerns related to their fertility status and/or own health after conception, their children’s health, and their dyadic relationships. Redefinition of the motherhood role and the family future were also a source of concern. However, there is variance among women in concerns and experiences based on life stages and expectations.

Conclusions
Reproductive concerns seem to be affected by personal circumstances and previous therapeutics. These concerns constitute a potential risk factor, simultaneously, for psychosocial maladjustment and adherence to endocrine therapy and fertility care.

Implications for Practice
This article proposes a conceptual framework to understand the dimensions and potential predictors and outcomes of perceived concerns among reproductive-age cancer patients. Our data allow us to look at these concerns from a multifactorial perspective, identifying areas to be addressed in providing clinical care, namely, by nurses accompanying patients over an extended period.
Patient Activation Among Community-Dwelling Persons Living With Chronic Obstructive Pulmonary Disease
Authors: Wetzstein Marnie M. , Shanta Linda L. , Chlan Linda L. 
Published: May 2020

Background
Vigilant self-management is associated with positive health outcomes in people living with chronic obstructive pulmonary disease (COPD), yet the predictors of activated self-managers are not well understood.

Objectives
The aims of the study were to identify and describe the predictors of patient activation among a sample of community-dwelling adults with COPD in the United States.

Methods
A postal survey of demographic, mood, symptom, function, health perception, life quality measures, and the patient activation measure was completed by 64 participants. Descriptive and inferential statistics were used to examine and describe associations between personal characteristics, health outcomes, and patient activation measure scores (0–100). Multivariate, linear regression analysis was conducted to identify predictors of patient activation score.

Results
Patient activation was high among the sample. Multivariate analysis revealed positive affect, smoking pack-years, overall quality of life, and female gender collectively explained 45.4% of the variance in patient activation.

Discussion
Positive life view, gender, and lifestyle factors present novel predictors of high activation in self-managers of COPD that warrant explication through future research.
Evaluation of an Emergency Department and Hospital-Based Data Exchange to Improve HIV Care Engagement and Viral Suppression
Authors: Avoundjian Tigran , Golden Matthew R. , Ramchandani Meena S. , Guthrie Brandon L. , Hughes James P. , Baseman Janet G. , Dombrowski Julia C. 
Published: May 2020

Background
Emergency department (ED) visits and inpatient (IP) admissions may provide an opportunity to reengage poorly engaged people living with HIV and facilitate viral suppression. In 2015, Public Health Seattle and King County partnered with the University of Washington Medicine to implement a real-time data exchange to identify virally unsuppressed people living with HIV seen at the ED/IP hospital and reengage them in HIV care. We evaluated the impact of the data exchange on care engagement and viral suppression.

Methods
Public Health Seattle and King County received a text alert on weekdays 8 am to 6 pm for ED/IP patients previously diagnosed with HIV with a most recent viral load ≥200 copies/mL. We compared viral load testing <3 months and viral suppression <6 months after an alert-eligible visit in the 2 years after intervention and the 7 to 30 months before intervention. To account for secular trends, we used difference-in-differences models to compare patients with alert-window visits to patients with visits outside the alert window before and after intervention.

Results
Patients with visits within the alert window in the postintervention period were 1.08 (95% confidence interval [CI], 0.97–1.20) times more likely to have a viral load test within 3 months after an ED visit/IP admission and 1.50 (95% CI, 1.27–1.76) times more likely to achieve viral suppression within 6 months than patients in the preintervention period. However, care engagement (difference-in-differences relative risk, 1.00; 95% CI, 0.84–1.18) and viral suppression (difference-in-differences relative risk, 1.01; 95% CI, 0.84–1.20) trends were similar among patients with visits outside the alert window.

Conclusions
Real-time data exchange with ED/IP hospitals was associated with improved viral suppression, but not increased care engagement. However, our results may reflect secular trends resulting from diverse interventions, of which ours was only one. More efforts are needed to improve the effectiveness of relinkage interventions guided by real-time data exchange.
Monitoring and Handing of 89Sr Injection Site Extravasation in a Patient With Breast Cancer
Authors: Tang Jiali , Fu Xiaolin , Hu Yishu , Zhang Yiyuan , Shao Fuqiang 
Published: May 2020

Abstract
Extravasation of various imaging tracers during administration was not a rare complication during nuclear medicine practice. However, the occurrence of extravasation of therapeutic radiopharmaceutical was rarely reported. Here we reported a 60-year-old woman with breast cancer and diffuse painful bone metastases who received strontium chloride (89SrCl2) therapy to palliate her bone pain. Accidental subcutaneous extravasation in the injection site occurred. The extravasated 89Sr was absorbed rapidly by arm elevation, squeezing a stress ball, local warming, and gently massaging. Follow-up results showed the patient's bone pain significantly relieved and her right arm remained normal.
68Ga-PSMA PET/CT and 18F-FDG PET/CT in Renal Cell Carcinoma
Authors: Chen Ew-Jun , Tan Teik Hin , Chew Ming Tsuey , Chye Ping Ching 
Published: May 2020

Abstract
Recent case reports and series have demonstrated the usefulness of 68Ga/18F-PSMA PET/CT in restaging recurrent renal cancer after nephrectomy. We presented a case of a patient with renal mass who had undergone both 18F-FDG and 68Ga-PSMA PET/CT for diagnosis and staging. Concordant tracer uptake in the primary tumor and metastatic lesions was demonstrated by both radiotracers. Final histopathological reports revealed clear cell renal cell carcinoma. Furthermore, unusual left metacarpal bone metastasis was also detected.
Decreased Vision and Headache as the Initial Symptoms of Hepatocellular Carcinoma
Authors: Xu Tingting , Zhang Xinyi , Cao Jianpeng , Chen Yue 
Published: May 2020

Abstract
Sphenoid sinus metastasis is extremely rare. Herein, we report a case of occult hepatocellular carcinoma with initial symptoms of decreased vision and headache, which were caused by sphenoid sinus metastasis. A 44-year-old man recently complained of bilateral decreased vision and headache. Head MRI showed a soft tissue mass in the sphenoid sinus. Pathological examination of the resected sphenoid sinus mass indicated metastatic carcinoma. Subsequently, 18F-FDG PET/CT and immunohistochemical analysis of the sphenoid sinus mass confirmed the hepatic origin of the primary lesion.
18F-FDG PET/CT of a Rare Case of an Adenomatoid Tumor of the Adrenal Gland
Authors: Dietz Matthieu , Neyrand Sophie , Dhomps Anthony , Decaussin-Petrucci Myriam , Tordo Jeremie 
Published: May 2020

Abstract
A 28-year old man, with previous history of chronic abdominal pain, was referred to our nuclear medicine center for an 18F-FDG PET/CT following the fortuitous discovery of a 48-mm right adrenal gland lesion of heterogeneous density at the CT scan. The PET/CT showed an isolated heterogeneous significant uptake evocative of neoplasia. Surprisingly, the anatomopathological analysis after surgery revealed an adenoid tumor of the adrenal gland. This case of a rare benign tumor can be a source of false-positive and mimicking malignancies in the exploration of adrenal lesions.
Hemizygous mutations in L1CAM in two unrelated male probands with childhood onset psychosis
Authors: Sato Mitra S. , Kyriakopoulos Marinos , James Anthony , Marwedel Susanne , Borsay Clare , Gutierrez Armandina Almanza , Blakemore Alexandra I. , Need Anna C. 
Published: May 2020

ObjectiveTo identify genes underlying childhood onset psychosis.MethodsPatients with onset of psychosis at age 13 or younger were identified from clinics across England, and they and their parents were exome sequenced and analysed for possible highly penetrant genetic contributors.ResultsWe report two male childhood onset psychosis patients of different ancestries carrying hemizygous very rare possibly damaging missense variants (p.Arg846His and p.Pro145Ser) in theL1CAMgene.L1CAMis an X-linked Mendelian disease gene in which both missense and loss of function variants are associated with syndromic forms of intellectual disability and developmental disorder.ConclusionsThis is the first study reporting a possible extension of the phenotype ofL1CAMvariant carriers to childhood onset psychosis. The family history and presence of other significant rare genetic variants in the patients suggest that there may be genetic interactions modulating the presentation.
Low doses of radiation increase the immunosuppressive profile of lung macrophages during viral infection and pneumonia
Authors: Meziani Lydia , Robert Charlotte , Classe Marion , Da Costa Bruno , Mondini Michele , Clemenson Céline , Mordant Pierre , Ammari Samy , Le Goffic Ronan , Deutsch Eric 
Published: May 2020

AbstractSevere pneumonia and acute respiratory distress syndrome (ARDS) have been described in patients with severe COVID-19. Recently, early clinical data reported the efficacy of low doses of radiation therapy (RT) in the treatment of ARDS in patients with severe COVID-19. However, the involved mechanisms remained unknown. Here, we used airways-instilled lipopolysaccharide (LPS) and influenza virus (H1N1) as murine models of pneumonia, and Tolllike receptor (TLR)-3 stimulation in human lung macrophages. Low doses RT (0.5-1 Gy) decreased LPS induced pneumonia, and increased the percentage of Nerve- and Airway-associated Macrophages (NAMs) producing IL-10. During H1N1 viral infection, we observed decreased lung tissue damage and immune cell infiltration in irradiated animals. Low doses RT increased IL-10 production by infiltrating immune cells into the lung. Irradiation of TLR-3 ligand-stimulated human lung macrophagesex vivoincreased IL-10 secretion and decreased IFNγ production in the culture supernatant. The percentage of human lung macrophages producing IL-6 was also decreased. Our data highlight one of the mechanisms by which low doses RT regulate lung inflammation and skew lung macrophages towards an anti-inflammatory profile. These data provide the preclinical rationale for the use and for the optimization of low doses RT in situations such as COVID-19-induced ARDS.
Gaining Accuracy for Gene Expression Data by Parsimonious Models
Authors: Gauch Hugh G. , Zhang Yehao , Chen Chang 
Published: May 2020

AbstractGene expression data must be accurate in order to promote extensive, reliable, and repeatable results and to compare treatments with few false positives and false negatives. One way to gain accuracy is by advanced experimental techniques, and another is by good experimental design, including replication. But these may not be enough to achieve even one significant digit, as shown by an example using oat data. This article introduces an additional opportunity to increase accuracy that involves parsimonious models, which has not yet been implemented in the gene expression literature to the best of our knowledge. Basically, a parsimonious model gains accuracy by selectively recovering signal in its model while selectively relegating noise to a discarded residual. Typically, this accuracy gain is equivalent to averaging over several times as many replications, but its cost is trivial, merely some computation. Consequently, this neglected way to gain accuracy is quite cost effective. For gene expression research, accuracy gain by parsimonious models should be a standard component of best practices.
Transcriptional regulation of genes involved in Zn transport after foliar Zn application toMedicago sativa
Authors: Cardini Alessio , Pellegrino Elisa , White Philip J. , Mazzolai Barbara , Mascherpa Marco C. , Ercoli Laura 
Published: May 2020

ABSTRACTZinc (Zn) is an essential micronutrient for both plants and animals, and Zn deficiency is one of the most widespread problems for agricultural production. Although many studies have been performed on the biofortification of staple crops with Zn, few studies have focused on forage crops. In this study the molecular mechanisms of Zn transport-related inMedicago sativaL. were investigated following foliar Zn applications aimed at increasing the accumulation of Zn in edible tissues. Zinc uptake and redistribution between shoot and root were determined following the application of six Zn doses to leaves (0, 0.01, 0.1, 0.5, 1, 10 mg Zn plant-1). Twelve putative genes encoding proteins involved in Zn transport (MsZIP1-7, MsZIF1, MsMTP1, MsYSL1, MsHMA4andMsNAS1) were identified and the changes in their expression following foliar Zn application were quantified using newly designed RT-qPCR assays. Shoot and root Zn concentration was increased following foliar Zn applications ≥ 0.1 mg plant-1. Increased expression ofMsZIP2, MsHMA4andMsNAS1in shoots, and ofMsZIP2andMsHMA4in roots, was observed with the largest Zn dose. By contrast,MsZIP3was downregulated in shoots at Zn doses ≥ 0.1 mg plant-1. Three functional modules were identified in theM. sativaresponse to foliar Zn application: genes involved in Zn uptake by cells, genes involved in vacuolar Zn sequestration and genes involved in Zn redistribution within the plant. These results will inform genetic engineering strategies aimed at increasing the efficiency of crop Zn biofortification.One-sentence summaryUpregulation ofZIP2, NASIandHMA4and downregulation ofZIP3are associated with Zn sequestration and shoot-to-root translocation inMedicago sativafollowing foliar Zn biofortification