bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastroenteropancreatic Neuroendocrine Neoplasms in Patients with Inflammatory Bowel Disease: An ECCO CONFER Multicentre Case Series
Authors: Festa Stefano , Zerboni Giulia , Derikx Lauranne A A P , Ribaldone Davide Giuseppe , Dragoni Gabriele , Buskens Christianne , van Dijkum Els Nieveen , Pugliese Daniela , Panzuto Francesco , Krela-Kaźmierczak Iwona , Mintz Hilla Reiss , Shitrit Ariella Bar-Gil , Chaparro Marìa , Gisbert Javier P , Kopylov Uri , Teich Niels , Vainer Elez , Nagtegaal Iris , Hoentjen Frank , Garcia Maria Jose , Filip Rafal , Foteinogiannopoulou Kalliopi , Koutroubakis Ioannis E , Argollo Marjorie , van Wanrooij Roy L J , Laja Hendrik , Lobaton Triana , Truyens Marie , Molnar Tamas , Savarino Edoardo , Aratari Annalisa , Papi Claudio , Goren Idan 
Published: November 2021

Abstract

Background
Gastroenteropancreatic neuroendocrine neoplasms [GEP-NENs] have rarely been reported in association with inflammatory bowel diseases [IBDs].

Methods
An ECCO COllaborative Network For Exceptionally Rare case reports project [ECCO-CONFER] collects cases of GEP-NENs diagnosed in patients with IBD.

Results
GEP-NEN was diagnosed in 100 IBD patients; 61% female, 55% Crohn’s disease, median age 48 years (interquartile range [IQR] 38-59]). The most common location was the appendix [39%] followed by the colon [22%]. Comprehensive IBD-related data were available for 50 individuals with a median follow-up of 30 months [IQR 11-70] following NEN diagnosis. Median duration of IBD at NEN diagnosis was 84 months [IQR 10-151], and in 18% of cases NEN and IBD were diagnosed concomitantly. At diagnosis, 20/50 were stage-I [T1N0M0], and 28/50 were graded G1 [ki67 ≤2%]. Incidental diagnosis of NEN and concomitantly IBD diagnosis were associated with an earlier NEN stage [p = 0.01 and p = 0.02, respectively]. Exposure to immunomodulatory or biologic therapy was not associated with advanced NEN stage or grade. Primary GEP-NEN were more frequently found in the segment affected by IBD [62% vs 38%]. At the last follow-up data, 47/50 patients were alive, and only two deaths were related to NEN.

Conclusions
In the largest case series to date, prognosis of patients with GEP-NEN and IBD seems favourable. Incidental NEN diagnosis correlates with an earlier NEN stage, and IBD-related therapies are probably independent of NEN stage and grade. The association of GEP-NEN location and the segment affected by IBD may suggest a possible role of inflammation in NEN tumorigenesis
The influence of the 2020 COVID-19 pandemic on the implantation rates of cardiac implantable electronic devices in Germany: changes between 2020 Q1–Q3 and 2019 Q1–Q3
Authors: Schwab Jörg Otto , Wiese Jan , Hauser Tino 
Published: November 2021

Abstract

Aims
During the early phase of the COVID-19 pandemic, hospital admissions for several medical and surgical conditions declined. Few data are available with respect to elective cardiac implantable electronic device (CIED) implantation. The aim of the present study was to determine the impact of the COVID-19 pandemic on the monthly CIED implantation rates in Germany (January-September 2020 vs. 2019).

Methods and results
The monthly rates of CIED implantation for the 2019 pre- and 2020 pandemic periods were retrieved from the Institute für das Entgeltsystem im Krankenhaus using German Operation and Procedure Classification codes to identify pacemakers (PMs), implantable cardioverter/defibrillators (ICDs), and cardiac resynchronization therapy (CRT) systems. Compared with 2019, the COVID-19 pandemic was associated with an overall decline of CIED implantation rates of −2.6%, reaching −22.9% in April 2020. Stratified by device type, the patterns of implantation were similar between PMs and ICDs, with maximal declines of −24.3% and −23.2% in April, respectively. Thereafter, the implantation rates gradually increased before stabilizing to rates similar to those observed in 2019. CRT implantation rates also declined in the early pandemic wave, but the overall 2020 rates increased by +4.3% likely driven by an increase of +16.5% (June–September). All the observed percentage differences of monthly device type related implantation rates demonstrated a statistical significance.

Conclusion
The COVID-19 pandemic had a significant impact on the implantation of CIEDs in Germany. A differential pattern of resource utilization was observed with a catch-up effect for PMs and ICDs. The implantation rates of CRT systems also declined, but they increased rapidly and remained higher than those of 2019.
Risk of cardiovascular events in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis
Authors: Alon Livnat , Corica Bernadette , Raparelli Valeria , Cangemi Roberto , Basili Stefania , Proietti Marco , Romiti Giulio Francesco 
Published: November 2021

Abstract

Aims
Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent disease and has been repeatedly associated with an increased risk of cardiovascular disease. However, the extent of such association is unclear. We conducted a systematic review and meta-analysis of the literature to evaluate the risk of myocardial infarction (MI), ischaemic stroke (IS), atrial fibrillation (AF), and heart failure (HF) in NAFLD patients.

Methods and results
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed and EMBASE, from inception to 6 March 2021, and included all studies reporting the incidence of MI, IS, AF, and HF in patients with and without NAFLD. Random-effect fmodels were used to estimate pooled odds ratio (OR), 95% confidence intervals (CI), and 95% prediction intervals (PI); subgroup analyses, meta-regressions, and sensitivity analyses were additionally performed. Among 3254 records retrieved from literature, 20 studies were included. Non-alcoholic fatty liver disease was associated with an increased risk of MI (OR: 1.66, 95% CI: 1.39–1.99, 95% PI: 0.84–3.30), IS (OR: 1.41, 95% CI: 1.29–1.55, 95% PI 1.03–1.93), AF (OR: 1.27, 95% CI: 1.18–1.37, 95% PI: 1.07–1.52), and HF (OR: 1.62, 95% CI: 1.43–1.84, 95% CI: 1.04–2.51). We identified significant subgroup differences according to geographical location, study design, NAFLD definition, and risk of bias; meta-regressions identified mean age, male sex, and study-level characteristics as potential moderators of the risk of MI and IS.

Conclusions
Non-alcoholic fatty liver disease was associated with increased risk of MI, IS, AF, and HF. Age, sex, and study characteristics may moderate the strength of this association. Further studies are required to evaluate specific cardiovascular prevention strategies in patients with NAFLD.
Patho-epigenetics: histone deacetylases as targets of pathogens and therapeutics
Authors: Schator Daniel , Gomez-Valero Laura , Buchrieser Carmen , Rolando Monica 
Published: November 2021

ABSTRACTIn recent years, the interplay of epigenetics and infection moved into the limelight. Epigenetic regulation describes modifications in gene expression without alterations of the DNA sequence. In eukaryotes, this mechanism is central for fundamental cellular processes such as cell development and differentiation, but it is also involved in more specific tasks such as the response to infection by a pathogen. One of the most common types of epigenetic changes is the modification of histones. Histones, the small protein building blocks that are wrapped with DNA are the fundamental packaging unit of chromatin. Histones can be modified by linking different moieties to them—one of the most abundant ones is acetylation. Histone acetylation is regulated by two main classes of enzymes, histone acetyl transferases (HAT) and their counterparts, histone deacetylases (HDAC). Given the high abundance and importance in regulating gene expression, histone acetylation is an excellent target for pathogens to manipulate the host cell to their advantage. Targeting HDACs gained particular interest in recent years, due to the increased use of HDAC inhibitors in clinical practice. Recently, the possibility to fight an infection with HDAC inhibitors was suggested as an alternative to overcome the ever-growing problem of antibiotic resistance. In this review, we focus on the regulation of HDACs and their involvement in immune cell function. We then highlight different mechanisms employed by pathogens to manipulate histone deacetylases and we discuss the possibility of HDAC inhibitors as therapeutics to fight infections.
Predicting cardiovascular risk from national administrative databases using a combined survival analysis and deep learning approach
Authors: Barbieri Sebastiano , Mehta Suneela , Wu Billy , Bharat Chrianna , Poppe Katrina , Jorm Louisa , Jackson Rod 
Published: November 2021

AbstractBackgroundMachine learning-based risk prediction models may outperform traditional statistical models in large datasets with many variables, by identifying both novel predictors and the complex interactions between them. This study compared deep learning extensions of survival analysis models with Cox proportional hazards models for predicting cardiovascular disease (CVD) risk in national health administrative datasets.MethodsUsing individual person linkage of administrative datasets, we constructed a cohort of all New Zealanders aged 30–74 who interacted with public health services during 2012. After excluding people with prior CVD, we developed sex-specific deep learning and Cox proportional hazards models to estimate the risk of CVD events within 5 years. Models were compared based on the proportion of explained variance, model calibration and discrimination, and hazard ratios for predictor variables.ResultsFirst CVD events occurred in 61 927 of 2 164 872 people. Within the reference group, the largest hazard ratios estimated by the deep learning models were for tobacco use in women (2.04, 95% CI: 1.99, 2.10) and chronic obstructive pulmonary disease with acute lower respiratory infection in men (1.56, 95% CI: 1.50, 1.62). Other identified predictors (e.g. hypertension, chest pain, diabetes) aligned with current knowledge about CVD risk factors. Deep learning outperformed Cox proportional hazards models on the basis of proportion of explained variance (R2: 0.468 vs 0.425 in women and 0.383 vs 0.348 in men), calibration and discrimination (all P &lt;0.0001).ConclusionsDeep learning extensions of survival analysis models can be applied to large health administrative datasets to derive interpretable CVD risk prediction equations that are more accurate than traditional Cox proportional hazards models.
Evaluating an active low-energy cooling upgrade to the building envelope in the hot climates of the Middle East
Authors: Kharrufa Sahar Najeeb , Awad Jihad , Jung Chuloh , Sherzad Mohammed 
Published: November 2021

Abstract
Reducing cooling loads in hot countries requires thermal insulation, and cooling methods be improved. Evaporative cooling, although problematic, is one solution that can be explored since it is significantly more efficient than regular compressor air conditioners, and the net result of using one is cooling. Furthermore, while compressor air conditioner efficiency decreases with rising temperatures in summer, evaporative ones, up to a point, are the exact opposite. A novel hybrid cooling system capable of combining both showed an 80% decrease in cooling load. The system’s efficacy was assessed in this paper by thermally simulating designs that are suitable for the hot Middle East region. Two locations with different environments and building guidelines that are representative of the variations in the area were selected. The first was the hot, dry Baghdad environment; the other was Dubai’s coastal, more humid city. Two different houses were designed to suit the municipal rules of each and accommodate the hybrid cooling system. As expected, the simulation results showed that savings in the dry Baghdad climate were high at 78% compared to a non-insulated alternative. In Dubai, unsurprisingly, they were less at 52% on the more humid coast. Further simulations revealed that this latter figure in the humid coast could also be achieved using good thermal insulation.
Antimicrobial resistance in patients with suspected urinary tract infections in primary care in Assam, India
Authors: Paul Deepjyoti , Anto Nimmy , Bhardwaj Mohit , Prendiville Alison , Elangovan Ravikrishnan , Bachmann Till T , Chanda Debadatta Dhar , Bhattacharjee Amitabha 
Published: November 2021

Abstract

Objectives
We investigated the prevalence and diversity of antimicrobial resistance in bacteria isolated from urine samples of community-onset urinary tract infection (UTI) patients in southern Assam, India.

Methods
Freshly voided midstream urine samples were collected from patients attending primary healthcare centres, with the patients’ epidemiological data also recorded. Species identification was confirmed using a VITEK 2 compact automated system. Phenotypic confirmation of ESBLs was performed using the combined disc diffusion method (CLSI 2017) and carbapenemase production was phenotypically characterized using a modified Hodge test. Common ESBLs and carbapenem-resistance mechanisms were determined in Escherichia coli isolates using PCR assays. Incompatibility typing of the conjugable plasmids was determined by PCR-based replicon typing; the phylotypes and MLSTs were also analysed.

Results
A total of 301 (59.7%) samples showed significant bacteriuria along with symptoms of UTI and among them 103 isolates were identified as E. coli of multiple STs (ST3268, ST3430, ST4671 and others). Among them, 26.2% (27/103) were phenotypically ESBL producers whereas 12.6% (13/103) were carbapenemase producers. This study describes the occurrence of diverse ESBL genes—blaCTX-M-15, blaSHV-148, blaPER-1 and blaTEM—and two E. coli isolates carrying the blaNDM-1 carbapenemase gene. ESBL genes were located within transconjugable plasmids of IncP and IncF type whereas blaNDM-1 was carried in an IncFrepB type plasmid.

Conclusions
This study illustrates the high rate of MDR in E. coli causing UTI in primary care in rural Assam. UTIs caused by ESBL- or MBL-producing bacteria are very difficult to treat and can often lead to treatment failure. Thus, future research should focus on rapid diagnostics to enable targeted treatment options and reduce the treatment failure likely to occur with commonly prescribed antibiotics, which will help to combat antimicrobial resistance and the burden of UTIs.
Embedding electronic health records onto a knowledge network recognizes prodromal features of multiple sclerosis and predicts diagnosis
Authors: Nelson Charlotte A , Bove Riley , Butte Atul J , Baranzini Sergio E 
Published: November 2021

Abstract

Objective
Early identification of chronic diseases is a pillar of precision medicine as it can lead to improved outcomes, reduction of disease burden, and lower healthcare costs. Predictions of a patient’s health trajectory have been improved through the application of machine learning approaches to electronic health records (EHRs). However, these methods have traditionally relied on “black box” algorithms that can process large amounts of data but are unable to incorporate domain knowledge, thus limiting their predictive and explanatory power. Here, we present a method for incorporating domain knowledge into clinical classifications by embedding individual patient data into a biomedical knowledge graph.

Materials and Methods
A modified version of the Page rank algorithm was implemented to embed millions of deidentified EHRs into a biomedical knowledge graph (SPOKE). This resulted in high-dimensional, knowledge-guided patient health signatures (ie, SPOKEsigs) that were subsequently used as features in a random forest environment to classify patients at risk of developing a chronic disease.

Results
Our model predicted disease status of 5752 subjects 3 years before being diagnosed with multiple sclerosis (MS) (AUC = 0.83). SPOKEsigs outperformed predictions using EHRs alone, and the biological drivers of the classifiers provided insight into the underpinnings of prodromal MS.

Conclusion
Using data from EHR as input, SPOKEsigs describe patients at both the clinical and biological levels. We provide a clinical use case for detecting MS up to 5 years prior to their documented diagnosis in the clinic and illustrate the biological features that distinguish the prodromal MS state.
Selection of the Most EffectiveTrichogrammaStrains (Hymenoptera: Trichogrammatidae) From Myanmar to Control Asian Corn Borer,Ostrinia furnacalis(Lepidoptera: Crambidae)
Authors: Myint Yee Yee , Bai Shuxiong , Zhang Tiantao , Babendreier Dirk , He Kanglai , Wang Zhenying 
Published: November 2021

AbstractSelecting the candidate agents or species is a fundamental step in developing effective biological control programs. However, no attempts have been made to evaluate the efficacy of Trichogramma Westwood (Hymenoptera: Trichogrammatidae) strains against the Asian corn borer, Ostrinia furnacalis Guenée (Lepidoptera: Crambidae) in Myanmar. In this study, Trichogramma strains were investigated through a series of glass tube bioassays and under a semifield condition. Ostrinia furnacalis or Corcyra cephalonica egg preferences were compared among six strains of Trichogramma ostriniae, three of Trichogramma chilonis, and four of Trichogramma dendrolimi using a choice-test assay design. Significant differences were observed at the inter- and intraspecific levels. Four strains of T. ostriniae and two of T. dendrolimi showed a strong preference for O. furnacalis eggs, while two strains of T. chilonis and one T. dendrolimi strain preferred Corcyra cephalonica Stainton (Lepidoptera: Pyralidae) eggs. The remaining strains showed no preference. Eleven strains were examined on O. furnacalis eggs only, wherein parasitism, sex ratio, and total progeny per female were highest for two strains of T. ostriniae (respectively: 67.6 ± 3.0%, 82.7 ± 2.3%, 49.6 ± 2.8, and 67.6 ± 3.6%, 90.0 ± 2.4%, 42.7 ± 2.6), and one strain of T. dendrolimi (65.2 ± 3.2%, 84.7 ± 2.6%, 46.3 ± 2.8). Parasitism and searching capacity were evaluated for the three, best performing strains in cages containing maize plants. One T. ostriniae from Southern Shan State, Myanmar parasitized ~81% of egg masses, and should be considered a candidate biological control agent against O. furnacalis in Myanmar.
Preoperative and postoperative prognostic factors of patients with stage II/III lower rectal cancer without neoadjuvant therapy in the clinical trial (JCOG0212)
Authors: Ohue Masayuki , Fujita Shin , Mizusawa Junki , Kanemitsu Yukihide , Hamaguchi Tetsuya , Tsukamoto Shunsuke , Noura Shingo , Yasui Masayoshi , Itoh Masaaki , Shiomi Akio , Komori Koji , Watanabe Jun , Akazai Yoshihiro , Shiozawa Manabu , Yamaguchi Takashi , Bandou Hiroyuki , Katsumata Kenji , Moriya Yoshihiro 
Published: November 2021

Abstract

Background
The JCOG0212 trial was a randomized controlled trial comparing mesorectal excision alone to mesorectal excision with lateral lymph node dissection for stage II/III lower rectal cancer patients without clinical lateral lymph node enlargement. This study aimed to identify clinicopathological prognostic factors for relapse-free survival and overall survival of lower rectal cancer in the trial.

Methods
Prospective data were selected from 663 patients with complete data. Uni and multivariable Cox regression model was applied to evaluate the preoperative and the combined preoperative and postoperative factors, respectively. Preoperative factors included age, sex, performance status, clinical T, clinical N and operative procedures. Postoperative factors included histological grade, pathological T, number of metastatic lymph nodes and number of dissected lymph nodes. No patient received neoadjuvant treatment.

Results
Regarding preoperative factors, multivariable analysis revealed that performance status 1 (vs. 0: HR 2.079, P = 0.0041) and cT4a (vs. cT2–3: HR 2.721, P = 0.0002) were independent risk factors for relapse-free survival, and those for overall survival were male (vs. female: HR 1.660, P = 0.0228) and cT4a (vs. cT2–3: HR 2.486, P = 0.0473). The only independent preoperative risk factor common for relapse-free survival and overall survival was cT4a. Taking preoperative and postoperative factors together, the number of metastatic lymph nodes was the only independent risk factor common for relapse-free survival and overall survival.

Conclusions
Clinical stage II/III lower rectal cancer patients with cT4a should be a target of therapeutic development of neoadjuvant therapy. Postoperatively, intensive chemotherapy should be investigated for patients with more metastatic lymph nodes.
Active small bowel sparing in intracavitary brachytherapy for cervical cancer
Authors: Goh Youngmoon , Kim Dohyeon , Kim Joo-Young , Kim Hak Soo , Jeong Jong Hwi , Lee Sung Uk , Youn Sang Hee , Oh Eun Sang , Ha Bo Ram , Yeo Adam Unjin , Kim Myeongsoo , Shin Dongho , Lee Se Byeong , Kim Yeon-Joo , Kim Tae Hyun , Lim Young Kyung 
Published: November 2021

Abstract

Objective
To propose and evaluate an active method for sparing the small bowel in the treatment field of cervical cancer brachytherapy by prone position procedure.

Methods
The prone position procedure consists of five steps: making bladder empty, prone-positioning a patient on belly board, making the small bowel move to abdomen, filling the bladder with Foley catheter and finally turning the patient into the supine position. The proposed method was applied for the treatment of seven cervical cancer patients. Its effectiveness was evaluated and a correlation between the patient characteristics and the volumetric dose reduction of small bowel was also investigated. Brachytherapy treatment plans were built before and after the proposed method, and their dose-volume histograms were compared for targets and organs-at-risk. In this comparison, all plans were normalized to satisfy the same D90% for high-risk clinical target volume.

Results
For the enrolled patients, the average dose of small bowel was significantly reduced from 75.2 ± 4.9 Gy before to 60.2 ± 4.0 Gy after the prone position procedure, while minor dosimetric changes were observed in rectum, sigmoid and bladder. The linear correlation to body mass index, thickness and width of abdominopelvic cavity and bladder volume were 76.2, 69.7, 28.8 and −36.3%, respectively.

Conclusions
The application of prone position procedure could effectively lower the volumetric dose of the small bowel. The dose reduction in the small bowel had a strong correlation with the patient’s obesity and abdominal thickness. This means the patients for whom the proposed method would be beneficial can be judiciously selected for safe brachytherapy.
Rare case of visceral myopathy
Authors: Dreyer Niloofar Sherazi , Pankratjevaite Lina , Janciauskas Dainius , Saladzinskas Zilvinas 
Published: November 2021

Abstract
Visceral myopathy is a rare bowel disease affecting peristalsis and causing pseudo-obstruction. There is no specific treatment for chronic intestinal pseudo-obstruction caused by visceral myopathy. We report a case of a 30-year-old woman with visceral myopathy who, due to unsuccessful conservative treatment, underwent surgery. However, few surgeries did not give the desired result and the patient still suffers from chronic constipation, abdominal distension and pain. The diagnosis of visceral myopathy is complicated. Neither conservative nor surgical treatment of visceral myopathy is associated with good results.