bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional status and severity of coronary artery disease
Authors: Kurmus Ozge , Aslan Turgay , Eren Murat , Akbuga Kursat , Erkan Aycan Fahri , Ekici Berkay , Akgul Ercan Ebru , Kervancioglu Celal 
Published: January 2021

Objective
The aim of this study is to evaluate the association between Nutritional Risk Index (NRI), a simple tool to assess nutritional status, and coronary artery disease severity and complexity in patients undergoing coronary angiography.

Methods
This study is a retrospective analysis of 822 patients undergoing coronary angiography. Patients with previous revascularization were excluded. Gensini and SYNTAX scores were calculated according to the angiographic images to determine atherosclerosis severity. NRI was calculated as follows: NRI = [15.19 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. In patients ≥65 years of age, Geriatric NRI (GNRI) was used instead of NRI. GNRI was calculated as follows: GNRI = [14.89 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. Patients were then divided into three groups as previously reported: NRI < 92, NRI 92–98 and NRI > 98. Gensini and SYNTAX scores were compared between three groups.

Results
The mean age of study population was 61.9 ± 11.1 years. NRI < 92, 92–98, and >98 was measured in 212, 321 and 289 patients, respectively. There was no difference regarding to sex, BMI, smoking, hypertension and diabetes mellitus between three groups. Patients with NRI < 92 had the highest mean Gensini score than the patients with NRI 92–98 and NRI > 98 (38.0 ± 40.6 vs. 31.17 ± 42.4 vs. 25.8 ± 38.4, P = 0.005). Also patients with NRI < 92 had the highest mean SYNTAX score than the patients with NRI 92–98 and NRI > 98 (11.8 ± 12.9 vs. 9.3 ± 12.4 vs. 7.7 ± 11.8, P = 0.001). Also, Gensini score of ≥20 and high SYNTAX score of ≥33 were associated with lower NRI (P < 0.001 and P < 0.001, respectively).

Conclusion
In our study, nutritional status evaluated by the NRI was associated with more extensive and complex coronary atherosclerosis in patients undergoing coronary angiography.
Lack of anti-TNF drugs levels in fistula tissue – a reason for nonresponse in Crohn’s perianal fistulating disease?
Authors: Adegbola Samuel O. , Sarafian Magali , Sahnan Kapil , Pechlivanis Alexandros , Phillips Robin K.S. , Warusavitarne Janindra , Faiz Omar , Haddow James , Knowles Charles , Tozer Phil , Holmes Elaine , Hart Ailsa 
Published: January 2021

Introduction
Anti-TNF therapy is recommended as treatment for patients with Crohn´s perianal fistulas. However, a significant proportion of patients have a sub-optimal response to anti-TNF therapy. Higher serum levels of anti-TNF agents have been associated with improved outcomes in perianal Crohn’s disease. Currently, it is unknown whether anti-TNF agent levels can be detected in tissue from fistula tracts themselves and whether this is associated with response.

Aims and methods
We undertook a pilot study to measure fistula tissue levels of anti-TNF medication (infliximab and adalimumab). We used a previously validated targeted proteomic technique, employing ultraperformance liquid chromatography-mass spectrometry, to detect/quantify anti-TNF drugs. Biopsies were obtained from fistula tracts of patients with Crohn’s disease on maintenance treatment; with idiopathic (cryptoglandular) fistula tissues used as negative controls as well as positive controls (by spiking the latter tissues with anti-TNF drugs).

Results
Tissue was sampled from the fistula tracts of seven patients with Crohn’s perianal disease (five patients were on adalimumab and two patients were on infliximab). The anti-TNF drugs, infliximab and adalimumab, were not detected in fistula samples from any of the Crohn’s patients despite detection in ‘spiked’ positive control samples.

Conclusion
Absence of detection of the anti-TNF drugs in fistula tissue raises the question on the role of tissue penetrance of anti-TNF drugs in response to therapy. Further work is required in a larger number of patients to validate the findings observed and investigate if any correlation exists between tissue and serum levels of anti-TNF and clinical outcome.

Summary
Predicting response in Crohn’s fistula patients on biologic therapy is difficult with no reliable biomarkers. This pilot study uses targeted proteomics to investigate the potential role of tissue drug levels in acting as a biomarker of treatment response.
Adding a liquid test meal to a standardized lactulose hydrogen breath test significantly influences abdominal symptom generation and hydrogen values
Authors: Schindler Valeria , Hente Juliane , Murray Fritz Ruprecht , Hüllner Martin , Becker Anton S. , Giezendanner Stéphanie , Schnurre Larissa , Bordier Valentine , Pohl Daniel 
Published: January 2021

Objective
While single sugar tests are controversially discussed, combination tests with meals are gaining more attention. The aim of this study was to analyze the impact of adding a test meal to lactulose hydrogen breath tests (LHBT) on hydrogen values and abdominal symptoms in patients with functional gastrointestinal disorders (FGIDs).

Methods
Data of 81 FGID patients between 2014–2018 were analyzed. Patients underwent LHBT with 30 g lactulose + 300 mL water and a nutrient challenge test (NCT) including 400 mL liquid test meal + 30 g lactulose. To statistically assess the effect of a test meal on abdominal symptoms and H2, mixed-effect models were used.

Results
Adding a test meal to LHBT showed a significant increase in nausea [odds ratio (OR) 1.4; 95% confidence interval (CI), 1.1–1.7], decrease in abdominal pain (OR 0.7; 95% CI, 0.6–0.9), borborygmi (OR 0.5; 95% CI, 0.4–0.6), diarrhea (OR 0.4; 95% CI, 0.3–0.6), and H2 production (estimate −5.3, SE 0.7, P < 0.001). The effect on bloating was only significant in functional dyspepsia, irritable bowel syndrome-functional dyspepsia mixed type and functional abdominal pain/bloating (OR 0.1; 95% CI, 0.0–0.2; OR 1.7; 95% CI, 1.2–2.3 resp OR 4.4; 95% CI, 1.8–10.6).

Conclusions
Significant effects on abdominal symptoms and H2 production by adding a test meal to LHBT in FGID patients are shown. Increased occurrence of nausea may be caused by gastric/duodenal hypersensitivity; decreased H2, diarrhea and borborygmi by slower and more physiologic gastric emptying resulting in later arrival of the test substance in the bowel. We recommend NCTs instead of LHBT to more physiologically represent FGID patients’ meal-induced burden.
Predictive value of noninvasive indices in chronic hepatitis B virus-related fibrosis
Authors: Öznur Meltem , Topçu Birol , Çelikkol Aliye 
Published: January 2021

Objectives
Despite being an invasive method, liver biopsy followed by pathological grading remains the gold standard in evaluating liver fibrosis resulting from chronic hepatitis B virus (HBV) infection. The present study aims to evaluate the utility of biochemical parameters and their derived indices in predicting development of fibrosis related to HBV infection.

Patients and methods
Pathology results and biochemical parameters of patients who underwent liver biopsy were retrieved from electronic archive records dated 2010–2019 and evaluated retrospectively. Pathological fibrosis grading was performed as per Ishak scoring, with scores of 1–2 considered as mild fibrosis and 3–6 as advanced fibrosis.

Results
The mean age of 302 patients was 37.69 ± 11.33 years. Of the 302 patients, 230 (76.2%) had mild fibrosis and 72 (23.8%) had advanced fibrosis. Age-platelet index, aspartate aminotransferase/platelet ratio index, fibrosis-4 (FIB-4), modified fibrosis-4, platelets count, aspartate aminotransferase to alanine aminotransferase ratio/platelet ratio index, Goteborg University Cirrhosis Index and King’s score were markedly and significantly higher in patients with advanced fibrosis than those with mild fibrosis. FIB-4, age-platelet index and King’s score had higher (>80%) area under the curve values than other indices in the receiver operating characteristics analysis. Evaluation of sensitivity, specificity and accuracy of these indices with the specified cut-off values revealed 87% sensitivity with FIB-4, 70% specificity with King’s score and 72% accuracy with the age-platelet index.

Conclusion
In this study, the highest rates of sensitivity, specificity and accuracy in distinguishing and predicting liver fibrosis were observed with the noninvasive indices FIB-4, King’s score and the age-platelet index, respectively.
Mucocutaneous manifestations in patients with inflammatory bowel disease: a decade study from a Greek cohort
Authors: Koumaki Dimitra , Machaira Angeliki , Katoulis Alexander C. , Bitados Panagiotis , Orfanoudaki Eleni , Foteinogiannopoulou Kalliopi , Stefanidou Maria , Krasagakis Konstantinos , Koutroubakis Ioannis E. 
Published: January 2021

Background
We sought to investigate the prevalence of mucocutaneous manifestations (MCM) and potential associations with clinical characteristics in Greek patients with IBD.

Methods
This was a retrospective observational single-center study. Patients with IBD diagnosis attending a tertiary referral hospital in Heraklion, Crete, from January 2010 to January 2020 were included. Data were extracted with relevant medical information from the IBD registry. Standard statistical tests, descriptive statistics tests, chi-square, Pearson correlation and multivariate analysis tests were performed, using IBM SPSS Statistics 25.

Results
A total of 806 IBD patients were included in the study: 463 (57.4%) males, 441 (54.7%) Crohn’s Disease, 352 (43.7%) ulcerative colitis and 13 (1.6%) IBD unclassified (IBD-U). Mean age was 50.67 ± 17.67 years, mean age of IBD diagnosis 36.67 ± 16.53 years and mean disease duration 13.65 ± 9.89 years. The prevalence of MCM was 171/806 (21.2%), 9.65% in ulcerative colitis and 30.84% in CD. The presence of MCM was significantly correlated with younger age of IBD diagnosis, longer IBD duration, CD diagnosis, inflammatory behavior and ileal or ileocolonic location of CD, extensive colitis in ulcerative colitis, intestinal manifestations (EIMs) and treatment with immunosuppressant or anti-TNFa. The development of MCM was independently associated with the presence of other EIMs odds ratio (OR), 4.03 [95% confidence interval (CI), 2.60–6.24; P < 0.001] and treatment with immunosuppressant (OR, 1.87; 95% CI, 01.14–3.07; P = 0.013) or anti-TNFa (OR = 2.47; 95% CI, 1.59–3.84; P < 0.01).

Conclusions
In our study, about one-fifth of IBD patients developed MCM that was more frequently present in CD than in ulcerative colitis.
Factors influencing health-related quality of life in patients with Barrett’s esophagus: a qualitative focus group study
Authors: van der Ende-van Loon Mirjam , Brouwers Marleen , de Munnik Suzanne , Nieuwkerk Pythia , Curvers Wouter , Schoon Erik 
Published: January 2021

Introduction
Barrett’s esophagus is a premalignant condition in the lower part of the esophagus, caused by gastroesophageal reflux disease. Previous studies found that having a Barrett’s esophagus is associated with a significant decrease of health-related quality of life (HRQOL). Over the past decade, a considerable amount of literature has been published on the development of endoscopic treatment for (early) neoplasia in Barrett’s esophagus. Though, currently very little is known about the impact of those endoscopic treatments on HRQOL from the perspective of patients. In this study, we aim to assess the factors influencing HRQOL according to Barrett’s esophagus patients.

Methods
By using a qualitative focus group design, patients with nondysplastic Barrett’s esophagus and patients with a history of endoscopic treatment for Barrett’s dysplasia were included. Data were analysed following the conventional content analyses approach.

Results
A total of 34 patients participated in the four focus group sessions. Experiencing symptoms was valued as the most important factor in both groups. Other factors identified as important HRQOL influencers were: use of medication, fear of cancer and trust in physicians and endoscopic procedures.

Conclusions
In general, Barrett’s esophagus patients experienced a good HRQOL, with a minimal emotional burden from the diagnosis of Barrett’s esophagus. Most influencing factor on HRQOL was: experiencing reflux and dyspepsia symptoms. This study underlines the importance of adequate gastroesophageal reflux treatment and providing information to Barrett’s esophagus patients, tailored to their personal needs.
Molecular analysis of fine-needle aspiration cytology in thyroid disease: where are we?
Authors: Grani Giorgio , Sponziello Marialuisa , Filetti Sebastiano , Durante Cosimo 
Published: January 2021

Purpose of review
The prevalence of thyroid nodules in the general population is high but only about 5% are malignant lesions. Cytology is usually appropriate to rule out malignancy in sonographically suspicious nodules but in many cases, reports are indeterminate. Molecular testing is a more recent approach to rule out malignancy and guide subsequent management.

Recent findings
Although several different molecular testing approaches have proven useful in reducing unnecessary surgery, there are still several remaining issues, such as the possible occurrence of RAS mutations (which are difficult to interpret in clinical management) and the role of molecular analysis in specific histotypes, such as Hürthle cell carcinomas. Furthermore, conclusive evidence is lacking regarding the cost-effectiveness and appropriateness of surgical options following molecular tests.

Summary
To be useful in clinical practice, molecular tests should be applied to appropriate candidates. In truly uncertain thyroid nodules in which diagnostic surgery may be considered, molecular testing may change the clinical approach and ‘save’ a number of thyroids.
In‐hospital Growth of Very Low Birth Weight Preterm Infants
Authors: Kemp Hannelie , Becker Piet , Wenhold Friedeburg Anna Maria 
Published: January 2021

ABSTRACTObjective:Amidst a high prevalence of prematurity, limited research on the growth of very low birth weight (VLBW) preterm infants and the availability of a reformulated fortifier c(RF), the study aimed to compare in‐hospital growth of such infants receiving exclusively human milk fortified with either of 2 different formulations in a tertiary South African hospital.Methods:In a prospective comparative effectiveness design, intakes and growth of VLBW infants on the Original Fortifier (OF; 2016–2017) were compared with those receiving RF (2017–2018). Daily intake was calculated using published composition of preterm and mature milk with fortifier (OF: 0.2 g protein, 3.5kcal/g powder; RF: 0.4 g protein, 4.4 kcal/g powder). Change in z scores from start to end of fortification for weight (WFAZ), length (LFAZ), and head circumference (HCFAZ) for age was the primary outcome. Additionally, weight gain velocity (g · kg−1 · day−1) and gain in length and head circumference (HC) (cm/week) were calculated.Results:Fifty‐eight infants (52% girls; gestational age: 30 ± 2 weeks; birth weight: 1215 ± 187 g) received OF for 16 days and 59 infants (56% girls; gestational age: 29 ± 2 weeks; birth weight 1202 ± 167 g) received RF for 15 days. Protein intake of RF (3.7 ± 0.4 g · kg−1 · day−1) was significantly higher (P < 0.001) than of OF (3.4 ± 0.2 g · kg−1 · day−1). Protein‐to‐energy ratio of RF (2.6 ± 0.2 g/100 kcal) was significantly higher (P < 0.001) than of OF (2.3 ± 0.1 g/100 kcal). In both groups, WFAZ and LFAZ decreased; HCFAZ improved slightly. No significant differences (P > 0.05) were noted between the 2 groups for change in z scores, weight gain velocity, length or HC gain.Conclusions:Despite a modest increase in protein intake and protein‐to‐energy ratio, the growth of VLBW infants on RF was not better than on OF during their hospital stay.
Integration of eHealth Into Pediatric Inflammatory Bowel Disease Care is Safe: 3 Years of Follow-up of Daily Care
Authors: Carlsen Katrine , Frederiksen Nicoline Willum , Wewer Vibeke 
Published: January 2021

ABSTRACT

Objectives:
The aim of the study was to evaluate integration of an eHealth solution,
www.young.constant-care.com
, into daily care (I-eHealth).

Methods:
The I-eHealth solution was offered to inflammatory bowel disease (IBD) patients ages 10 to 17 years old in nonbiological treatment. The application was used monthly and in case of flare-ups. Blood and fecal calprotectin (FC) were tested every 3 months and during flare-ups. A total inflammation score (based on symptoms and FC) was visualized for the patient in a traffic light curve. An IBD nurse followed up on the registrations every 2 weeks. Patients had 1 yearly planned visit at the hospital. On-demand visits were arranged depending on the total inflammation. I-eHealth results were compared with data from a previous randomized clinical trial (RCT)-eHealth study (the control group of which had 4 planned annual visits).

Results:
Thirty-six IBD patients were followed by I-eHealth, mean age 14.7 years (SD 7.75). The median (interquartile range [IQR]) duration of using I-eHealth was 1.9 years (0.29–2.51), equal to 66.11 patient-years, compared with 40.45 in the RCT-eHealth group and 46.49 in the RCT-control group. On-demand visits per patient-year did not differ between the groups: 1.13 (I-eHealth), 1.16 (RCT-eHealth), and 0.84 (RCT-control) (P = 0.84/0.85). Hospitalizations and acute outpatient visits per patient-year did not differ between the groups: 0.11 and 0.11 (I-eHealth), 0.05 and 0.02 (RCT-eHealth), 0.11 and 0.11 (RCT-control) (P = 0.17/0.81 and 0.12/0.81). Time to first escalation of medication, and time to first on-demand visit, did not differ between the I-eHealth group and data from the clinical trial (Log rank: P = 0.25 and P = 0.61).

Conclusions:
I-eHealth is comparably with results from eHealth under RCT supervision.
Impact of COVID-19 on Maternal Mental Health
Authors: Goyal Deepika , Selix Nancy W. 
Published: January 2021

Abstract
The COVID-19 pandemic led to several states mandating social distancing and sheltering in place along with a shift in health care delivery, unprecedented unemployment rates, financial stress, and emotional concerns. For pregnant and postpartum women, limited social support and social isolation with social distancing and fear of COVID-19 exposure or infection for themselves, their fetus, or their newborn infants, have implications for maternal mental health. An overview of the potential impact of COVID-19 on mental health risk for pregnant and postpartum women is presented with implications for nursing practice to promote maternal–infant wellbeing.
PROgesterone Therapy for Endometrial Cancer Prevention in Obese Women (PROTEC) Trial: A Feasibility Study
Authors: Derbyshire Abigail E. , Allen Jennifer L. , Gittins Matthew , Lakhiani Bhavna , Bolton James , Shaw Joseph , Pemberton Philip W. , Needham Michelle , MacKintosh Michelle L. , Edmondson Richard J. , Kitchener Henry C. , Crosbie Emma J. 
Published: January 2021

(Abstracted from Cancer Prev Res (Phila) 2020; doi: 10.1158/1940-6207.CAPR-20-0248)
Approximately 40% of endometrial cancers are thought to be directly attributable to obesity. The mechanism responsible for this association involves stimulation of the endometrium by adipose-derived estrogen unopposed by progesterone in anovulatory and postmenopausal women in addition to the effects of insulin resistance and chronic inflammation.
State-Wide Utilization and Performance of Traditional and Cell-Free DNA-Based Prenatal Testing Pathways: The Victorian Perinatal Record Linkage (PeRL) Study
Authors: Lindquist A. , Hui L. , Poulton A. , Kluckow E. , Hutchinson B. , Pertile M. D. , Bonacquisto L. , Gugasyan L. , Kulkarni A. , Harraway J. , Howden A. , McCoy R. , da Silva Costa F. , Menezes M. , Palma-Dias R. , Nisbet D. , Martin N. , Bethune M. , Poulakis Z. , Halliday J. 
Published: January 2021

(Abstracted from Ultrasound Obstet Gynecol 2020;56:215–224)
In recent years, the use of combined first-trimester screening (CFTS) and cell-free DNA (cfDNA) screening has increased. With the rise of CFTS and cfDNA prenatal testing, there has been a dramatic decrease in the number of invasive diagnostic tests performed during pregnancy.
Expression of Immune Checkpoint Regulators, Cytotoxic T-Lymphocyte Antigen-4, and Programmed Death-Ligand 1 in Epstein-Barr Virus-associated Nasopharyngeal Carcinoma
Authors: Ahmed Mona M. , Gebriel Manar G. , Morad Emad A. , Saber Ibrahim M. , Elwan Amira , Salah Mona , Fakhr Ahmed E. , Shalaby Amany M. , Alabiad Mohamed A. 
Published: January 2021

Background:
Nasopharyngeal carcinoma (NPC) is the most common cancer arising from the nasopharynx with a poor prognosis. Targeting immune checkpoint is one of the new promising lines in cancer treatment. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed death-ligand 1 (PD-L1) are immune checkpoints that regulate T-cell immune function.

Aim:
This work aimed to assess the immunohistochemical expression of PD-L1 and CTLA-4 in NPC and their ability to predict survival and response therapy and to check their validity as immunotherapy targets. Twenty-six cases of NPC were studied by immunohistochemistry for PD-L1 and CTLA-4 and by nested polymerase chain reaction followed by DNA sequencing for the presence of EBNA-1 gene of Epstein-Barr virus (EBV). All investigated cases were diagnosed and treated in the Zagazig University Hospital in the period from August 2015 to July 2018. EBNA-1 gene was identified in 84.6% of the cases. Whereas the expression of PD-L1 was noted in 46.2% of all cases studied, 54.6% of EBV-associated NPCs were found to express PD-L1. There was a significant association between PD-L1 expression and the advanced stage of the tumor (P<0.001). CTLA-4 expression was observed in 88.4% of all NPC cases as cytoplasmic staining in both tumor cells and tumor-infiltrating lymphocytes. CTLA-4 expression in lymphocytes was associated with the presence of EBV. A significant association was detected between CTLA-4 and tumor-infiltrating lymphocyte expression on one side and the stage of the tumor on the other. High expression of CTLA-4 was significantly associated with disease progression and worse overall survival.

Conclusion:

PD-L1 and CTLA-4 are adverse prognostic markers in NPC. The authors propose that targeted therapy against PD-L1 and CTLA-4 will be a hopeful therapy for cases of NPC with resistance to concurrent chemoradiation treatment in Egypt, especially EBV-associated cases.