bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Fecal Microbiota Transplantation for C. difficile Infection in Inflammatory Bowel Disease
Authors: Tariq Raseen , Syed Tausif , Yadav Devvrat , Prokop Larry J. , Singh Siddharth , Loftus Edward V. , Pardi Darrell S. , Khanna Sahil 
Published: December 2021

Background:
Fecal microbiota transplantation (FMT) is a safe and effective therapy for recurrent Clostridioides difficile infection (CDI). Data on FMT for CDI in patients with underlying inflammatory bowel disease (IBD) are emerging but conflicting. We performed a systematic review and meta-analysis to describe the efficacy and safety of FMT for CDI in IBD and its impact on IBD outcomes.

Methods:
A systematic search of multiple databases including Embase, Scopus, and Web of Science was performed. Our primary analysis focused on pooled rate of CDI resolution after single and multiple FMTs in IBD patients. Additional analyses included rates of IBD-associated outcomes (flare, surgery, symptom improvement) after FMT. The random-effects model was used to calculate pooled rates.

Results:
Among 457 adult patients, 363 had CDI resolution after first FMT with a pooled cure rate of 78% [95% confidence interval (CI): 73%-83%; I
2=39%]. Overall pooled rate cure rate with single and multiple FMTs was 88% (95% CI: 81%-94%; I
2=73%). The pooled rate of an IBD flare after FMT was 26.8% (95% CI: 22.5%-31.6%; I
2=9%) and of colectomy was 7.3% (95% CI: 4.7%-10.5%; I
2=56%). Among 141 pediatric patients, 106 had CDI resolution after first FMT with pooled cure rate of 78% (95% CI: 58%-93%; I
2=59%). Overall pooled cure rate with single and multiple FMTs was 77% (95% CI: 50%-96%; I
2=63%). The pooled rate of an IBD flare after FMT was 10.8% (95% CI: 5.7%-18.5% I
2=43%), and of colectomy was 10.3% (95% CI: 2.1%-30.2% I
2=23%).

Conclusions:
FMT appears to be a highly effective therapy for preventing recurrent CDI in patients with IBD. Patients who fail a single FMT may benefit from multiple FMTs.
Polypharmacy in Patients With Inflammatory Bowel Disease
Authors: Mesonero Francisco , Fernández Cristina , Sánchez-Rodríguez Eugenia , García-García Paredes Ana , Senosiain Carla , Albillos Agustín , López-Sanromán Antonio 
Published: December 2021

Background:
Polypharmacy can complicate the course and management of chronic diseases, and has been little explored in patients with inflammatory bowel disease (IBD) to date.

Aim:
The aim of this study was to determine the prevalence of polypharmacy in a series of IBD patients, describing associated factors and its correlation with poor disease outcomes.

Materials and Methods:
Retrospective study of a single-center series. Polypharmacy was defined as the simultaneous use of 5 or more drugs. Disease outcomes, IBD treatment nonadherence and undertreatment were evaluated at 1 year.

Results:
A total of 407 patients were included [56% males, median age: 48 y (interquartile range, 18 to 92 y)], of whom 60.2% had Crohn’s disease; Chronic comorbidity and multiple comorbidities were present in 54% and 27% of patients, respectively. Median number of prescriptions per patient was 3 (range: 0 to 15). Polypharmacy was identified in 18.4% of cases, inappropriate medication in 10.5% and use of high-risk drugs in 6.1% (mainly opioids). In multivariate analysis, polypharmacy was associated with chronic comorbidity [odds ratio (OR)=10.1, 95% confidence interval (CI): 2.14-47.56; P˂0.003], multiple comorbidities (OR=3.53, 95% CI: 1.46-8.51; P=0.005) and age above 62 years (OR=3.54, 95% CI: 1.67-7.51; P=0.001). No association with poor disease outcomes was found at 12 months. However, polypharmacy was the only factor associated with IBD treatment nonadherence (OR=2.24, 95% CI: 1.13-4.54, P=0.02).

Conclusions:
Polypharmacy occurs in around 1 in 5 patients with IBD, mainly in older adults and those with comorbidity. This situation could interfere with adherence to IBD treatment and therapeutic success.
Maximizing diabetes education efforts in vulnerable populations – newer delivery concepts
Authors: Torres Hugo A. , Schmidt Vanessa A. 
Published: December 2021

Purpose of review
Patients from ethnic/minority backgrounds or low socioeconomic status face numerous barriers to achieving ideal diabetes care goals. The purpose of this review is to describe the burden of diabetes in vulnerable populations; discuss the etiologic factors leading to health disparities in diabetes; and present challenges and solutions to improving diabetes care through novel diabetes self-management education and support interventions.

Recent findings
Recent interventions to alleviate health disparities utilize a combination of community health workers, peer leaders and technology-based approaches to provide diabetes self-management education and support and overcome barriers to diabetes control such as low literacy, difficulty with transportation, and cultural beliefs. These interventions achieve clinically meaningful improvements in blood glucose control as measured by haemoglobin A1C and are effective in addressing psychosocial outcomes such as diabetes distress. Research is underway to address food insecurity through food delivery and use behavioural economics principles to provide financial incentives to diabetes control.

Summary
Combining human interaction through peer or community health worker led diabetes educational efforts and support with technology-based interventions shows promise in improving diabetes outcomes for vulnerable populations.
Growth and development in type 1 diabetes
Authors: Koren Dorit 
Published: December 2021

Purpose of review
The purpose of this review is to summarize the current literature on the subject of linear growth in children and adolescents with or at risk for type 1 diabetes mellitus (T1DM).

Recent findings
Poor glycemic control in T1DM is associated with growth hormone resistance, and improving glycemic control can improve linear growth. Newer reports suggest that the increasingly popular very low carbohydrate diets, may reduce linear growth velocity.

Summary
Linear growth during childhood is a complex process regulated influenced by genetic, hormonal, nutritional and environmental factors. Linear growth may be impaired in children with T1DM, correlating with poor metabolic control; an extreme example is Mauriac syndrome. This decrement in linear growth appears to be driven in part by a reduction in growth hormone responsiveness, leading to low insulin-like growth factor-1 (IGF-1) levels. Improving glycemic control can lead to improved IGF-1 levels and linear growth. Other factors associated with poor linear growth in T1DM include celiac disease and dietary alterations, with early reports suggesting that very low carbohydrate diets, if not carefully managed, may increase risk of attenuated linear growth. This review examines the latest data regarding the associations between T1DM and linear growth in children.
Growth and development in monogenic forms of neonatal diabetes
Authors: Hammoud Batoul , Greeley Siri Atma W. 
Published: December 2021

Purpose of review
Neonatal diabetes mellitus (NDM) is a rare disorder in which 80–85% of infants diagnosed under 6 months of age will be found to have an underlying monogenic cause. This review will summarize what is known about growth and neurodevelopmental difficulties among individuals with various forms of NDM.

Recent findings
Patients with NDM often have intrauterine growth restriction and/or low birth weight because of insulin deficiency in utero and the severity and likelihood of ongoing growth concerns after birth depends on the specific cause. A growing list of rare recessive causes of NDM are associated with neurodevelopmental and/or growth problems that can either be related to direct gene effects on brain development, or may be related to a variety of co-morbidities. The most common form of NDM results in spectrum of neurological disability due to expression of mutated KATP channels throughout the brain.

Summary
Monogenic causes of neonatal diabetes are characterized by variable degree of restriction of growth in utero because of deficiency of insulin that depends on the specific gene cause. Many forms also include a spectrum of neurodevelopmental disability because of mutation-related effects on brain development. Longer term study is needed to clarify longitudinal effects on growth into adulthood.
Derivation and validation of a 18F-FDG PET/CT scoring model to predict malignant pleural effusion
Authors: Lu Peiou , Sun Yajuan , Liang Bangyu , Yu Lijuan 
Published: December 2021

Objective
To develop an 18F-fluorodeoxyglucose PET/computed tomography (CT) scoring model based on metabolic and radiologic findings of the pleura and fluid to identify malignant pleural effusion.

Methods
The PET and CT findings from patients with pleural effusion in the derivation dataset were used to develop a scoring model. Then, the diagnostic accuracy of the predictive score was verified by the validation dataset.

Results
Eight parameters independently predicting malignancy were retained in the scoring model, including pleural nodules or masses (4 points), focal pleural thickening (2 points), absence of pleural loculation (2 points), thickness of mediastinal pleura involvement ≥0.5 cm (2 points), maximum standardized uptake value (SUVmax) of mediastinal pleura involvement ≥2.3 (2 points), thickness of nonmediastinal pleura involvement ≥0.5 cm (1 point), SUVmax of nonmediastinal pleura involvement ≥3.0 (1 point) and fluid SUVmax ≥1.6 (1 point). The operating characteristics of the PET/CT score were 0.958 area under the curve (AUC), 88.6% sensitivity, 91.2% specificity, 10.09 positive likelihood ratio and 0.13 negative likelihood ratio, with 6 points as the threshold. These values in the validation dataset were 0.947, 91.7%, 88.4%, 7.91 and 0.094, respectively. No difference was found in AUCs between the derivation and validation datasets (z = 0.517, P = 0.697). The negative predictive value was 99.4% in the score from 0 to 2, and the positive predictive value was 98.3% for patients with score between 9 and 15.

Conclusions
The PET/CT scoring model is a valuable strategy to help physicians to distinguish malignant–benign pleural effusion and stratify patients who will benefit from invasive procedures.
Reduction of radiation accumulation in salivary glands through oral vitamin C during 68Ga-PSMA-11 total-body dynamic PET/CT imaging
Authors: Yu Haojun , Lv Jing , Hu Pengcheng , Chen Shuguang , Shi Hongcheng 
Published: December 2021

Objective
This study explored the utility of oral vitamin C in reducing radiation accumulation in the salivary glands during total-body dynamic PET/computed tomography (CT) imaging with 68Ga labeled Prostate-specific membrane antigen (68Ga-PSMA-11).

Methods
We enrolled 31 patients who underwent total-body dynamic PET/CT imaging with 68Ga-PSMA-11, of which 11 were given oral vitamin C 30 min after starting the dynamic PET acquisition, whereas the others did not. The volume of interest was automatically segmented on the parotid and submandibular salivary glands once the PET acquisition was completed. The standard uptake value (SUV)mean and its slope during 30–60 min of the acquisition were compared between the trial and control groups.

Results
The SUVmean of the left and right parotid and submandibular glands in the trial group were 15.37 ± 3.07, 15.03 ± 2.64, 14.92 ± 4.38 and 15.38 ± 4.18, respectively. The respective values of the control group were 19.37 ± 3.82, 20.08 ± 3.55, 22.61 ± 5.62 and 22.73 ± 5.90. The SUVmean slope during 30–60 min of acquisition for the left and right parotid and submandibular glands in the trial group were 0.63 ± 0.13, 0.64 ± 0.14, 0.56 ± 0.25 and 0.62 ± 0.26, respectively. The respective values of the control group were 0.84 ± 0.21, 0.84 ± 0.17, 1.01 ± 0.34 and 1.02 ± 0.37.

Conclusion
Oral vitamin C could reduce the accumulation of radiation in the salivary glands during 68Ga-PSMA-11 total-body dynamic PET/CT imaging.
Distinguishing between primary central nervous system lymphoma and glioblastoma using [18F]fluoromisonidazole and [18F]FDG PET
Authors: Uchinomura Satoshi , Mitamura Katsuya , Norikane Takashi , Yamamoto Yuka , Oishi Akihiro , Hatakeyama Tetsuhiro , Miyake Keisuke , Nishiyama Yoshihiro 
Published: December 2021

Objective
The purpose of this study was to assess the diagnostic value of [18F]fluoromisonidazole (FMISO) and 2-deoxy-2-[18F]fluoro-D-glucose (FDG) PET to discriminate primary central nervous system lymphoma (PCNSL) from glioblastoma.

Methods
FMISO and FDG PET/CT scans before therapy obtained in 13 patients with PCNSL and in 62 patients with glioblastoma were retrospectively reviewed. PET results were evaluated by visual and semiquantitative analysis. For semiquantitative analysis, the maximum standardized uptake value (SUV) for tumor (T) and the mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. The performance in discriminating PCNSL and glioblastoma was evaluated using a receiver-operating characteristics analysis. Area-under-the-curve (AUC) values for the discrimination were calculated.

Results
On visual analysis, 54% of PCNSL and 89% of glioblastoma showed positive on FMISO PET. All patients with PCNSL and glioblastoma were FDG positive. FMISO T/N ratio in PCNSL (mean ± SD = 1.80 ± 0.59) was significantly lower than that in glioblastoma (mean ± SD = 2.75 ± 0.84) (P < 0.001). FDG T/N ratio in PCNSL (mean ± SD = 3.01 ± 1.11) was significantly higher than that in glioblastoma (mean ± SD = 1.77 ± 0.79) (P < 0.001). For discrimination of patients with PCNSL from glioblastoma, the AUC values for the FMISO T/N ratio, FDG T/N ratio and combination of the two parameters were 0.833, 0.825 and 0.900, respectively.

Conclusion
FMISO PET is as helpful for differentiating PCNSL from glioblastoma as FDG PET.
Effect of Bayesian penalty likelihood algorithm on 18F-FDG PET/CT image of lymphoma
Authors: Wang Yongtao , Lin Lejun , Quan Wei , Li Jinyu , Li Weilong 
Published: December 2021

Objective
Recently, a new Bayesian penalty likelihood (BPL) reconstruction algorithm has been applied in PET, which is expected to provide better image resolution than the widely used ordered subset expectation maximization (OSEM). The purpose of this study is to compare the differences between these two algorithms in terms of image quality and effects on clinical diagnostics and quantification of lymphoma.

Methods
A total of 246 FDG-positive lesions in 70 patients with lymphoma were retrospectively analyzed by using BPL and OSEM + time-of-flight + point spread function algorithms. Visual analysis was used to evaluate the effects of different reconstruction algorithms on clinical image quality and diagnostic certainty. Quantitative analysis was used to compare the differences between pathology and lesion size.

Results
There were significant differences in lesion-related SUVmax, total-lesion-glycolysis (TLG), and signal-to-background ratio (SBR) (P < 0.01). The variation Δ SUVmax% and Δ SBR% caused by the two reconstruction algorithms were negatively correlated with tumor diameter, while Δ MTV% and Δ TLG% were positively correlated with tumor diameter. In the grouped analysis based on pathology, there were significant differences in lesion SUVmax, lesion SUVmean, and SBR. In non-Hodgkin’s lymphoma (diffuse large B cells and follicular lymphoma), diversities were significantly found in SUVmax, SUVmean, SBR, and TLG of the lesions (P < 0.05). According to the grouped analysis based on lesion size, for lesions smaller than 1 cm and 2 cm, there was a significant difference in SUVmean, SUVmax, SBR, and MTV, but not in lesions larger than or equal to 2 cm (P > 0.05), and the liver background SUVmean (P > 0.05) remained unchanged.

Conclusion
BPL reconstruction algorithm could effectively improve clinical image quality and diagnostic certainty. In quantitative analysis, there were no significant differences among different pathological groups, but there were significant diversities in lesion sizes. Especially for small lesions, lesion SUVmax increased and SBR was significantly improved, which may better assist in the diagnosis of small lesions of lymphoma.
Patient selection for heart transplant: balancing risk
Authors: Mantha Aditya , Lee Ramon O. , Wolfson Aaron M. 
Published: December 2021

Purpose of review
Heart failure incidence continues to rise despite a relatively static number of available donor hearts. Selecting an appropriate heart transplant candidate requires evaluation of numerous factors to balance patient benefit while maximizing the utility of scarce donor hearts. Recent research has provided new insights into refining recipient risk assessment, providing additional tools to further define and balance risk when considering heart transplantation.

Recent findings
Recent publications have developed models to assist in risk stratifying potential heart transplant recipients based on cardiac and noncardiac factors. These studies provide additional tools to assist clinicians in balancing individual risk and benefit of heart transplantation in the context of a limited donor organ supply.

Summary
The primary goal of heart transplantation is to improve survival and maximize quality of life. To meet this goal, a careful assessment of patient-specific risks is essential. The optimal approach to patient selection relies on integrating recent prognostication models with a multifactorial assessment of established clinical characteristics, comorbidities and psychosocial factors.
Noninvasive biomarkers in heart transplant: 2020–2021 year in review
Authors: Qian Xiaoxiao , Shah Palak , Agbor-Enoh Sean 
Published: December 2021

Purpose of review
Endomyocardial biopsy (EMB), the current gold standard for cardiac allograft monitoring is invasive, may have a low sensitivity and is associated with significant variability in histopathologic interpretation. Fortunately, on-going research is identifying noninvasive biomarkers that address some of these limitations. This review provides an update on noninvasive blood-based methods for rejection surveillance and diagnosis in heart transplantation.

Recent findings
Recent studies highlight good test performance to detect acute rejection for donor-derived cell-free DNA (dd-cfDNA) and microRNAs (miR). dd-cfDNA is sensitive, nonspecific, and has a high negative predictive value for acute cellular and antibody-mediated rejection. Clinical utility trials are being planned to test its role as a rule-out test for acute rejection as compared to the EMB. miRs may have an added advantage as it may phenotype the subtypes of rejection alleviating the need for an EMB or permitting the initiation of targeted therapy while awaiting the results of the EMB.

Summary
In this review, we discuss recent advances in the field of noninvasive biomarkers to detect allograft rejection after heart transplant. We provide a perspective of additional studies needed to prove their clinical utility and bring these biomarkers to widescale clinical use.
The Role of Human U Three Protein 14a as a Predictor for Hepatocellular Carcinoma Recurrence After Microwave Ablation
Authors: Abdelkhalek Elhefni Mariam M. , Abd El Moety Amr A. , Baddour Nahed M. , El Sayed Salem Perihan 
Published: December 2021

Background:
Human U three protein 14a (hUTP14a) is a nucleolar protein which promotes carcinogenesis by causing degradation of the tumor suppressor protein, p53.

Aims:
This study aimed to investigate hUTP14a expression in hepatocellular carcinoma (HCC) and its value as a predictor for HCC recurrence after treatment with microwave ablation (MWA).

Materials and Methods:
The hUTP14a expression was evaluated using immunohistochemistry on ultrasound-guided fine needle aspiration biopsy material from the tumor and the surrounding cirrhotic nontumor tissues. The relation between hUTP14a expression and clinic-pathologic variables was analyzed.

Results:
Nuclear hUTP14a showed significant high expression in HCC tumor tissue compared with corresponding nontumor tissue (P<0.001). Tumoral hUTP14a expression was significantly higher in patients who experienced recurrence than those who were recurrence-free after MWA (P<0.001).

Conclusion:
We concluded that, hUTP14a has an oncogenic potential, as it is highly expressed in HCC tissues compared with surrounding nontumor cirrhotic tissues. Moreover, nuclear hUTP14a could be used as a promising prognostic biomarker for prediction of HCC recurrence after treatment with MWA.
The Observational Gait Scale Can Help Determine the GMFCS Level in Children With Cerebral Palsy
Authors: Zapata Karina A. , Rushing Charter L. , Delgado Mauricio R. , Jo Chanhee 
Published: December 2021

Purpose:
To evaluate the association between the Observational Gait Scale (OGS) and the Gross Motor Function Classification System (GMFCS) in walking children with cerebral palsy (CP).

Methods:
The charts of 512 children with CP GMFCS levels I to IV were reviewed for the OGS score and GMFCS level at their initial visit.

Results:
The OGS score decreased with increasing GMFCS levels. The average OGS for GMFCS level I was 13.1 (2.8), level II was 11.3 (2.7), level III was 7.7 (2.7), and level IV was 6.1 (2.0). A significant negative relationship was seen between the OGS and the GMFCS. In particular, each GMFCS level was different across all levels in a pairwise comparison. In addition, multivariate modeling analysis confirmed that the association between the OGS and the GMFCS was still valid, after adjusting for age and gender.

Conclusions:
The OGS is a quick tool to rate gait and help confirm a child's GMFCS level.
Mobility Analysis of AmpuTees (MAAT 7)
Authors: England Dwiesha L. , Miller Taavy A. , Stevens Phillip M. , Campbell James H. , Wurdeman Shane R. 
Published: December 2021

Objective
The aim of the study was to establish normative values of lower limb amputation mobility across primary etiologies based on age and amputation level.

Design
This study is a cross-sectional observational analysis of outcomes. A total of 11,995 lower limb prosthesis users were included in the analysis. Participants were grouped by etiology into four categories: cancer, congenital, trauma, and diabetes/dysvascular. Mobility was assessed by using the Prosthetic Limb Users Survey of Mobility.

Results
Mobility across seven age groups for the four etiologies was established for both above-the-knee amputation and below-the-knee amputation. Differences were found between age groups for individuals: above-the-knee amputation: cancer (χ2 (6) = 40.97, P < 0.001), congenital (χ2 (3) = 9.41, P = 0.024), trauma (χ2 (6) = 18.89, P = 0.004), and dysvascular (χ2 (5) = 39.73, P < 0.001; below-the-knee amputation: cancer (χ2 (6) = 29.77, P < 0.001), trauma (χ2 (6) = 28.22, P < 0.001), and dysvascular (χ2 (6) = 144.66, P < 0.001).

Conclusions
The awareness of differences across amputation etiologies extending across the lifespan of ages can assist the goal-setting process as part of prosthetic rehabilitation. In addition, refined normative values provide the ability to benchmark new and innovative changes in clinical practice.