bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity Is More Common in Children Newly Diagnosed With Ulcerative Colitis as Compared to Those With Crohn Disease
Authors: Chandrakumar Abin , Wang Angus , Grover Kanika , El‐Matary Wael 
Published: January 2020

ABSTRACTObjective:This prospective observational study aimed to examine the prevalence of obesity in a population‐based cohort of children and young adults newly diagnosed with inflammatory bowel disease (IBD) and assess their outcome in comparison to newly diagnosed normal/underweight patients.Methods:Our longitudinal population‐based cohort comprised all children younger than 17 years diagnosed with IBD in the province of Manitoba, Canada between 2012 and 2018. Cox regression model with adjustment for a priori covariates was used to examine the time to first relapse among patients who were obese/overweight at the time of IBD diagnosis in comparison to patients who were normal or underweight.Results:A total of 139 patients with IBD were followed up for a median duration of 1.09 (interquartile range: 0.53–2.62) years. Obesity was more common in children newly diagnosed with ulcerative colitis (UC) compared to those with Crohn disease (CD) (12.7% vs 0.0%; P = 0.005). Age at diagnosis poorly correlated with the body mass index z score (R = 0.23; P = 0.01). The proportions of patients who were underweight at the time of IBD diagnosis among patients with UC and CD were 6.3% and 20.0%, respectively (P = 0.01). The time to initial relapse was not found to be significantly associated with weight category at diagnosis in UC (adjusted hazard ratio = 0.77; 95% confidence interval: 0.40–1.63) or CD (adjusted hazard ratio  = 0.83; 95% confidence interval: 0.20–3.51).Conclusion:Obesity was more common in children and young adults newly diagnosed with UC. The majority of the underweight children had CD.
Barrett Esophagus and Intestinal Metaplasia of the Gastroesophageal Junction in Children
Authors: Putra Juan , Arva Nicoleta C. , Tan Serena Y. , Melin‐Aldana Hector , Bass Lee M. , Mitchell Paul D. , Fox Victor L. , Goldsmith Jeffrey D. 
Published: January 2020

ABSTRACTObjectives:Barrett esophagus (BE) and intestinal metaplasia of gastroesophageal junction (IMGEJ) are rare in the pediatric population. This multi‐institutional retrospective study evaluated the clinicopathologic characteristics and natural history of BE and IMGEJ in children.Methods:Data from 20 BE patients (70% boys, mean age: 14.9 years) and 17 IMGEJ patients (71% boys, mean age: 14 years) were retrospectively obtained from chart review. Endoscopic and pathologic findings from index and follow‐up endoscopies were analyzed.Results:Most patients (70% BE and 59% IMGEJ) had underlying conditions which put them at risk for gastroesophageal reflux disease. Increased body mass index (BMI) was observed in patients without underlying conditions (BE: 30.1 ± 9.8; IMGEJ: 23.9 ± 6.3) compared with those with underlying conditions (BE: 19.6 ± 7.8; IMGEJ: 16.4 ± 2.1) (BE, P = 0.02; IMGEJ, P = 0.01). Incomplete intestinal metaplasia (IM) was the predominant histology seen in BE (80%) and IMGEJ patients (75%). Dysplasia and malignancy were not identified in the initial and follow‐up biopsies. Concurrent gastric biopsies showed various findings (79% BE and 40% IMGEJ were normal), with 1 IMGEJ patient showing coexisting gastric IM (7%). Follow‐up in 12 BE patients (mean follow‐up time 51.6 months) showed 100% persistent endoscopic disease and 58% persistent IM histologically. Three of 6 IMGEJ patients (mean follow‐up time 24 months) demonstrated endoscopic and histologic features consistent with BE on subsequent procedures. Moreover, a subset of BE (57%) and IMGEJ patients (67%) who underwent endoscopy before initial diagnosis showed nongoblet columnar mucosa above the anatomic gastroesophageal junction.Conclusions:Increased BMI may be a risk factor for BE and IMGEJ in pediatric patients without underlying conditions. Nongoblet columnar metaplasia and IMGEJ might represent incomplete forms of BE. Our data suggest that these patients should be closely monitored.
Perinatal Anxiety and Depression in Minority Women
Authors: Gennaro Susan , O'Connor Caitlin , McKay Elizabeth Anne , Gibeau Anne , Aviles Melanie , Hoying Jacqueline , Melnyk Bernadette Mazurek 
Published: January 2020

Abstract
Depression and anxiety are common during pregnancy and are experienced at higher rates among women who are racial and ethnic minorities. Because depression and anxiety influence maternal and infant outcomes, intervening to improve perinatal mental health should be a priority for all healthcare providers. However, in the United States, a number of barriers including lack of mental health providers, lack of perinatal behavioral health systems, and stigma, limit access to care. Universal screening has been recommended and here we examine how universal screening can help nurses improve the mental health of childbearing women. Interventions that are currently in use to improve perinatal anxiety and depression are reviewed and include: psychopharmacology, cognitive behavioral therapy, interpersonal psychotherapy, and mindfulness. Recommendations for future research and healthcare system changes are made.
Comparison of the Sleep Problems Among Adolescents Who Attempted Suicide and Healthy Adolescents
Authors: Yildiz Eren , Sac Rukiye , Işik Ümit , Özaydin Mustafa S. , Taşar Medine Ayşin , Cakir İlyas , Alioglu Bulent 
Published: January 2020

Abstract
The aim of this study was to compare sleep problems among adolescents who attempted suicide and healthy adolescents who never attempted suicide. Adolescents who attempted suicide (study group, n = 103) and healthy adolescents (control group, n = 59) completed a questionnaire prepared by researchers including demographic factors. In addition, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were administered to both groups. The median age was 16 years and 73% were girls, in both groups. The study group had lower rate of attending to school (88.3% vs. 100%; p = 0.001), academic achievement (45.7% vs. 83.1%; p = 0.001), higher rate of smoking (37.9% vs. 13.8%; p = 0.001), socializing problems (31.1% vs. 3.4%; p = 0.001), and appetite changes (57.3% vs. 39.7%; p = 0.032) than controls. The rate of those with PSQI scores 6 or higher was 53.4% in the attempted suicide group and 37.3% in the control group (p = 0.048). Adolescents, classified as sleepy according to the ESS, did not differ significantly between the groups (p = 0.214). Adolescents who attempted suicide had poor sleep quality. It is crucial to examine the kinds of sleep problems adolescents who have attempted suicide have experienced. Among adolescents attending outpatient clinics with poor sleep quality, PSQI can be a useful screening tool. Those with high scores should be evaluated for suicide risk.
Does Organizational Compassion Matter? A Cross-sectional Survey of Nurses
Authors: Lown Beth A. , Manning Colleen F. , Hassmiller Susan B. 
Published: January 2020

OBJECTIVE
To examine factors that influence nurses' perceptions of organizational compassion and their engagement with the organization.

BACKGROUND
Despite agreement about the importance of compassionate healthcare, it is difficult for employees to consistently act compassionately when organizational leaders, managers, and systems of care fail to support compassion as a value.

METHODS
The study used a cross-sectional design, and quantitative and qualitative data were collected through an online survey of nurses.

RESULTS
Higher individual compassion and team compassion were associated with higher perceived organizational compassion, and higher organizational compassion was associated with greater engagement with the hospital. In contrast, high turnover rates and inadequate staffing were associated with lower perceived organizational compassion and lower engagement with one's organization.

CONCLUSIONS
Adequate staffing, resource allocation, and practices that contribute to the sense that one is a supported member of a caring team focused on addressing patients' needs build the capacity for compassion within an organization.
Collateral Damage: Maternal Obesity During Pregnancy Continues to Rise
Authors: Davis Anne M. 
Published: January 2020

Importance
The pandemic of obesity during pregnancy now afflicts 1 out of every 2 pregnant women in the United States. Even though unintended pregnancy has decreased to 45% of all pregnancies, 50% of those unintended pregnancies occur in obese women.

Objective
This study aims to identify why current lifestyle interventions for obese pregnancy are not effective and what the newer complications are for obesity during pregnancy.

Evidence Acquisition
Available literatures on current treatments for maternal obesity were reviewed for effectiveness. Emerging maternal and infant complications from obesity during pregnancy were examined for significance.

Results
Limitations in successful interventions fell into 3 basic categories to include the following: (1) preconception weight loss; (2) bariatric surgery before pregnancy; and (3) prevention of excessive gestational weight gain during pregnancy. Emerging significant physiological changes from maternal obesity is composed of inflammation (placenta and human milk), metabolism (hormones, microbiome, fatty acids), and offspring outcomes (body composition, congenital malformations, chronic kidney disease, asthma, neurodevelopment, and behavior).

Conclusions and Relevance
Are current prepregnancy lifestyle and behavioral interventions feasible to prevent maternal obesity complications? Epigenetic and metabolomic research will be critical to determine what is needed to blunt the effects of maternal obesity and to discover successful treatment.

Target Audience
Obstetricians, gynecologists, family physicians, midwives, nurse practitioners, and dietitians

Learning Objectives
After participating in this activity, the learner should be better able to identify lifestyle interventions used to prevent complications from an obese pregnancy; describe emerging maternal obesity complications; classify the severity of maternal obesity in the United States; and explain barriers to lifestyle intervention success in obese pregnancy.
High Interest in Syphilis Pre-exposure and Post-exposure Prophylaxis Among Gay, Bisexual and Other Men Who Have Sex With Men in Vancouver and Toronto
Authors: Fusca Laura , Hull Mark , Ross Patrick , Grennan Troy , Burchell Ann N. , Bayoumi Ahmed M. , Tan Darrell H. S. 
Published: January 2020

Background
We assessed the acceptability of doxycycline-based syphilis pre-exposure and post-exposure prophylaxis (PrEP/PEP) as well as human immunodeficiency virus (HIV) PrEP/PEP in gay, bisexual, and other men who have sex with men (gbMSM).

Methods
We recruited gbMSM from Toronto and Vancouver sexually transmitted infection (STI) clinics during routine visits from June 2018 to August 2018. We analyzed data using descriptive statistics and constructed multivariable logistic regression models for willingness to use syphilis and HIV PrEP and PEP respectively.

Results
Among 424 participants (56.4% Toronto, 43.6% Vancouver), median (interquartile range [IQR]) age was 31.0 years (26.0–39.0 years), 61.7% had completed postsecondary education and 54.4% were white. Median (IQR) number of male partners in the past 6 months was 6.0 (3.0–13.0), and 18.2% had 1 or more prior syphilis diagnosis. 60.1%/44.1% indicated willingness to use syphilis PEP/PrEP; 36.6% were unwilling to use either. Among HIV-negative participants, 74.0% and 75.2% were willing to use HIV PrEP and PEP, respectively. Most participants were familiar with antibiotic resistance (89.0%) and agreed that syphilis rates are rising in Canada (68.2%), but only 55.4% believed they were at risk for syphilis. Agreement with the latter statement was associated with willingness to use syphilis PrEP (adjusted odds ratio [aOR], 1.6; 95% confidence interval [95%CI], 1.0–2.5), as was previous/existing HIV PrEP use (aOR, 2.2; 95% CI, 1.1–4.3) and being “very concerned” about STI acquisition (aOR, 1.9; 95% CI, 1.0–3.4). Odds of being willing to use syphilis PEP were higher in Toronto versus Vancouver (aOR, 2.0; 95% CI, 1.2–3.4) and increased with the number of different STIs previously diagnosed (aOR, 1.4; 95% CI, 1.2,1.7).

Conclusions
There is considerable interest in syphilis PrEP/PEP in gbMSM attending Toronto/Vancouver STI clinics.
Lateral Condyle Fracture of the Humerus Among Children Attending a Pediatric Emergency Department
Authors: James Vigil , Chng Abigail Chin Chii , Ting Francesca Lim May , Chan Yiong Huak , Ganapathy Sashikumar 
Published: January 2020

Background
The lateral humeral condyle fractures in children accounts for one fifth of all elbow fractures. These fractures have a propensity to displace because of the pull of the extensor muscles on the condyle.

Objectives
The aim of this study was to examine the epidemiology, injury patterns, complications, and predictors for conservative/surgical management in patients with lateral condyle humeral fractures between 0 and 18 years of age.

Methods
This was a single-center retrospective study conducted between January 2006 and December 2016.

Results
There were 268 patients identified with lateral condyle elbow fracture. Majority of the patients (81.4%) with lateral condyle humeral fractures presented with either undisplaced or minimally displaced (<2 mm) fractures. The initial management in majority (90.7%) of the patients was conservative. Of the patients, 26.8% had secondary displacement at follow-up. The overall proportion of patients who required surgical intervention was 36.2%. Varus deformity of elbow (2.2%) and malunion (0.4%) were the complications noticed on long-term follow-up. Increased age and undisplaced fracture were statistically significant positive predictors for conservative management. The presence of concurrent elbow injuries and type of fracture (displaced >2 mm) were statistically significant positive predictors for surgical management.

Conclusions
Our study demonstrated that majority of the patients with lateral condyle humeral fractures had presented with either undisplaced or minimally displaced (<2 mm) fractures. The positive predictors for conservative management of fractures were increased age and undisplaced fracture. The positive predictors for surgical management of lateral condyle humerus fractures were concurrent injuries in elbow and type of fracture (displaced >2 mm). Physician vigilance to the possibility of additional migration of lateral condyle fractures initially managed conservatively, and the need for subsequent surgical stabilization plays an important role in the management of these fractures.
Brief Report: Temporal Changes in HIV Transmission Patterns Among Young Men Who Have Sex With Men, United States, 2009–2016
Authors: Panneer Nivedha , France Anne Marie , Whiteside Y. Omar , Zhang Tianchi , Wertheim Joel O. , Oster Alexandra M. 
Published: January 2020

Background:
In the United States, young men (aged 13–24 years) who have sex with men (MSM) bear a disproportionate burden of HIV. Transmission among MSM has been found to be disassortative by age.

Methods:
We analyzed HIV-1 pol sequences reported to the US National HIV Surveillance System from MSM with HIV diagnosed during 2009–2016. Using an HIV genetic transmission network, we identified persons with closely related viruses (ie, genetic distance ≤1.5%) and used multivariable logistic regression to examine changes from 2009–2012 to 2013–2016 in proportions of MSM linked to young MSM who were >5 years older or of the same race/ethnicity.

Results:
Among 9510 young MSM linked to another MSM with a closely related virus, 37% linked to an older MSM and 62% linked to an MSM of the same race/ethnicity. Comparing 2013–2016 with 2009–2012, we found increases in linkage of older MSM to young MSM, with the most substantial increases seen in Hispanic/Latinos aged 13–19 [adjusted prevalence ratio (APR) = 1.31, 95% confidence interval (CI) = 1.11 to 1.56] and blacks aged 13–19 (APR = 1.23, CI = 1.06 to 1.41) and 20–24 years (APR = 1.14, CI = 1.02 to 1.28). By contrast, change in linkage patterns among racial/ethnic groups was unremarkable.

Conclusions:
We found evidence of increased age mixing among MSM with respect to HIV transmission over time, which coincides temporally with changes in partner-seeking behavior such as increased use of mobile applications. These findings indicate the importance of social factors on HIV sexual and transmission networks and suggest that prevention efforts need to effectively reach MSM of all ages.
Temperature-Sensitive Frozen-Tissue Imaging for Cryoablation Monitoring Using STIR-UTE MRI
Authors: Tokuda Junichi , Wang Qun , Tuncali Kemal , Seethamraju Ravi T. , Tempany Clare M. , Schmidt Ehud J. 
Published: January 2020

Purpose
The aim of this study was to develop a method to delineate the lethally frozen-tissue region (temperature less than −40°C) arising from interventional cryoablation procedures using a short tau inversion-recovery ultrashort echo-time (STIR-UTE) magnetic resonance (MR) imaging sequence. This method could serve as an intraprocedural validation of the completion of tumor ablation, reducing the number of local recurrences after cryoablation procedures.

Materials and Methods
The method relies on the short T
1 and T
2* relaxation times of frozen soft tissue. Pointwise Encoding Time with Radial Acquisition, a 3-dimensional UTE sequence with TE = 70 microseconds, was optimized with STIR to null tissues with a T
1 of approximately 271 milliseconds, the threshold T
1. Because the T
1 relaxation time of frozen tissue in the temperature range of −40°C < temperature < −8°C is shorter than the threshold T
1 at the 3-tesla magnetic field, tissues in this range should appear hyperintense. The sequence was evaluated in ex vivo frozen tissue, where image intensity and actual tissue temperatures, measured by thermocouples, were correlated. Thereafter, the sequence was evaluated clinically in 12 MR-guided prostate cancer cryoablations, where MR-compatible cryoprobes were used to destroy cancerous tissue and preserve surrounding normal tissue.

Results
The ex vivo experiment using a bovine muscle demonstrated that STIR-UTE images showed regions approximately between −40°C and −8°C as hyperintense, with tissues at lower and higher temperatures appearing dark, making it possible to identify the region likely to be above the lethal temperature inside the frozen tissue. In the clinical cases, the STIR-UTE images showed a dark volume centered on the cryoprobe shaft, V
inner, where the temperature is likely below −40°C, surrounded by a doughnut-shaped hyperintense volume, where the temperature is likely between −40°C and −8°C. The hyperintense region was itself surrounded by a dark volume, where the temperature is likely above −8°C, permitting calculation of V
outer. The STIR-UTE frozen-tissue volumes, V
inner and V
outer, appeared significantly smaller than signal voids on turbo spin echo images (P < 1.0 × 10−6), which are currently used to quantify the frozen-tissue volume (“the iceball”). The ratios of the V
inner and V
outer volumes to the iceball were 0.92 ± 0.08 and 0.29 ± 0.07, respectively. In a single postablation follow-up case, a strong correlation was seen between V
inner and the necrotic volume.

Conclusions
Short tau inversion-recovery ultrashort echo-time MR imaging successfully delineated the area approximately between −40°C and −8°C isotherms in the frozen tissue, demonstrating its potential to monitor the lethal ablation volume during MR-guided cryoablation.
Advanced Case of Achalasia That Appeared on 68Ga–Prostate-Specific Membrane Antigen PET/CT
Authors: Shakeri Sara , Farahmandfar Fatemeh , Gholami Golnaz , Norouzbeigi Nasim , Sadeghi Ramin 
Published: January 2020

Abstract
We report a known case of severe achalasia that appeared on 68Ga–prostate-specific membrane antigen (PSMA) PET/CT. The patient was a known case of high-grade transitional cell carcinoma and suspicious diagnosis of prostate cancer referred for 68Ga-PSMA PET/CT. 68Ga-PSMA PET/CT showed linear increased activity in the esophageal wall as well as a distended esophagus.
Recurrent Immunoglobulin G4–Related Disease Shown on 18F-FDG and 68Ga-FAPI PET/CT
Authors: Pan Qingqing , Luo Yaping , Zhang Wen 
Published: January 2020

Abstract
A 21-year-old man had been diagnosed with immunoglobulin G4–related disease (IgG4-RD) for 5 years, and the disease recurred 1 month ago. 18F-FDG PET/CT revealed intense FDG activity in the pituitary stalk, submandibular gland, pleura, pericardium, pancreas, liver, prostate, and multiple lymph nodes, which were considered the involvements of IgG4-RD. 68Ga-FAPI PET/CT also showed intense 68Ga-FAPI uptake in the above FDG-avid lesions except the lymph node involvement. Additionally, involvement in the lacrimal glands was detected by 68Ga-FAPI. The positive findings of 68Ga-FAPI in the current case highlighted that 68Ga-FAPI may have value in the evaluation of IgG4-RD.
Comparison of 18F-FDG PET/CT Criteria for the Prediction of Therapy Response and Clinical Outcome in Patients With Metastatic Melanoma Treated With Ipilimumab and PD-1 Inhibitors
Authors: Annovazzi Alessio , Vari Sabrina , Giannarelli Diana , Pasqualoni Rosella , Sciuto Rosa , Carpano Silvia , Cognetti Francesco , Ferraresi Virginia 
Published: January 2020

Immunotherapy currently represents one of the most effective therapies in metastatic melanoma. However, its indirect antineoplastic activity through the immune system has raised relevant challenges for diagnostic imaging in the evaluation of the response to treatment.

Purpose
The aim of this retrospective study was to compare the diagnostic accuracy of different 18F-FDG PET/CT criteria to predict therapy response and clinical outcome in melanoma patients treated with immune checkpoint inhibitors.

Patients and Methods
Fifty-seven patients with metastatic melanoma treated with ipilimumab (n = 25; group 1) or with PD-1 inhibitors (n = 32; group 2) who performed an 18F-FDG PET/CT scan before treatment (PET0) and 12 to 18 weeks later (PET1) were retrospectively evaluated. Response at PET1 was evaluated according to RECIST 1.1, EORTC, PERCIMT (PET Response Evaluation Criteria for Immunotherapy), and by percentage change of metabolic tumor volume (MTV) and total lesion glycolysis of up to 5 target lesions. Performance of each criterion at PET1 to predict clinical benefit at 6 months since starting immunotherapy was assessed and correlated to progression-free survival.

Results
In group 1, the best predictor of therapy response was MTV combined with PERCIMT criteria (accuracy, 0.96). In group 2, overlapping results were found for EORTC, MTV, and total lesion glycolysis (accuracy, 0.97). The reliability of the above parameters was also confirmed in the progression-free survival analysis.

Conclusions

18F-FDG PET/CT performed after 3 to 4 months since starting immunotherapy can correctly evaluate response to treatment and can also able to predict long-term clinical outcome. Performance of 18F-FDG PET/CT and criteria for response assessment is influenced by the class of treatment.
The Complementary Role of 68Ga-DOTATATE PET/CT in Neuroblastoma
Authors: Telli Tuğçe , Lay Ergün Eser , Volkan Salanci Bilge , Özgen Kiratli Pinar 
Published: January 2020

Abstract
A girl diagnosed with neuroblastoma at 33 months underwent 123I-MIBG scan after surgery and chemoradiotherapy. Although MIBG scan showed complete response, the bone marrow biopsy showed refractory disease. Therefore, she underwent 68Ga-DOTATATE PET/CT, which revealed bone marrow involvement and 68Ga-DOTATATE–avid brain metastasis. Rare physiological pineal gland uptake was also depicted. 68Ga-DOTATATE PET/CT showed active progressive disease earlier, before it was detectable with MIBG scan. For patients with MIBG-negative relapsed/refractory disease, 68Ga-DOTATATE may have an important role in restaging, detecting unsuspected metastasis, therapy planning.