bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acetarsol in the management of mesalazine-refractory ulcerative proctitis: a tertiary-level care experience
Authors: Argyriou Konstantinos , Samuel Sunil , Moran Gordon W. 
Published: November 2018

Background
Mesalazine-refractory ulcerative proctitis is common, with a significant proportion of the patients requiring escalation to immunomodulators or biological therapy. Three small preliminary cohort studies suggested good clinical efficacy for the organic arsenic derivative acetarsol in the management of proctitis. Our aim was to describe our experience on the use of acetarsol in proctitis and to review all existing evidence on its safety and efficacy.

Patients and methods
We retrospectively reviewed clinical records of all ulcerative colitis patients exposed to acetarsol at Nottingham University Hospitals since 2012. Clinical response was determined basing on physicians’ global assessments and patients’ improvement over the baseline (reduction in stool frequency and rectal bleeding). Clinical remission was defined as total resolution of symptoms including bleeding cessation. Serum arsenic, C-reactive protein and faecal calprotectin levels reviewed when available. Nonparametric analysis performed.

Results
Twenty-eight (16 males) patients with median (range) age 39 (35) and 9 (19) years disease duration received acetarsol suppositories for proctitis. All had failed mesalazine or corticosteroid topical therapy, with 50% having additionally failed immunomodulators. Median treatment duration was 70 (64) days. 16/28 were prescribed acetarsol more than once. 67.9% achieved clinical response and 46.4% clinical remission. 32.1% required treatment escalation to steroids, thiopurines or antitumour necrosis factor agents. 6/28 patients stopped acetarsol due to side effects.

Conclusion
Acetarsol could be an effective and safe option in the management of refractory proctitis. A definitive trial with long-term safety follow-up is required to investigate the efficacy and safety of this promising drug.
Current indications for balloon sinuplasty
Authors: Cingi Cemal , Bayar Muluk Nuray , Lee Jivianne T. 
Published: November 2018

Purpose of review
The purpose of the review is to evaluate the current indications and contraindications for balloon sinuplasty and review the clinical trials performed in this area.

Recent findings
The indications for balloon sinus dilatation are somewhat similar to those for endoscopic sinus surgery. Balloon sinus ostial dilation (BSD) has been found to be most effective in the treatment of recurrent acute sinusitis (RARS) and chronic rhinosinusitis without nasal polyposis (CRSsNP) that has been refractory to medical therapy. Multiple randomized clinical trials have demonstrated the efficacy of BSD in improving quality-of-life outcomes in patients with limited CRSsNP in both the clinic and operating room settings. However, because BSD merely dilates blocked sinusal ostia without removing tissue, it is typically restricted to addressing disorder involving the frontal, sphenoid, and maxillary sinuses. Individuals who have significant disease of the ethmoid sinus may have BSD adjunctively with endoscopic sinus surgery. BSD is unsuitable as a primary treatment modality in pansinus polyposis, widespread fungal sinusitis, connective tissue disorders at an advanced stage, or potential malignancy. A recent expert clinical consensus statement also concluded that BSD is not appropriate for treatment of patients with headache that do not meet the diagnostic criteria for CRS or RARS or patients who do not have both positive findings of sinus disease on computed tomography and sinonasal symptoms.

Summary
Balloon sinuplasty is an option in the treatment of sinusitis that has failed appropriate medical therapy. Evidence is best for limited disease in patients with CRSsNP affecting the frontal, sphenoid, and maxillary sinuses. Because BSD can be performed in the office setting, it can be a viable therapeutic alternative in patients with comorbidities who are unable to tolerate general anesthesia.
Differences of Immune Reconstitution of Dendritic Cells in Pediatric GvHD Patients After Allogenic Stem Cell Transplantation
Authors: Wiegering Verena , Peter Lisa , Frietsch Marieke , Schlegel Paul G. , Eyrich Matthias 
Published: November 2018

Background:
Hematopoietic stem cell transplantation (HSCT) is a life-saving procedure for children with a variety of (non) malignant conditions. GvHD is a severe complication with high morbidity and mortality. The pathogenesis remains unclear. We studied dendritic cell (DC) reconstitution to detect potential differences, which may improve our knowledge in the development of chronic GvHD (cGvHD).

Procedure:
We examined immune reconstitution (T, B, and NK cells and dendritic cells) at defined time points in a pediatric cohort who underwent 61 allogeneic HSCTs.

Results:
Regarding DC reconstitution we found a fast reconstitution of the DC compartment negatively correlated with age. After HSCT, both myeloid DC (mDC) and plasmacytoid DC (pDC) counts recover to pre-HSCT levels within 2 months. Higher CCR7 positive cell counts were found in patients receiving TBI during engraftment and during the whole posttransplant period we found a correlation with an improved outcome. In cGVHD patients decreased total DC counts and increased pDCs were found after day+100. No relevant correlation was achieved regarding to HLA-matching, stem cell manipulation of the graft as well as HSCT-indication compared with different DC counts.

Discussion:
Pathogenesis of cGvHD remains complex. Our data suggest an influence of dendritic cells, which may contribute to the clinical picture and should be further investigated in future studies.
Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder
Authors: Kramer Ueli , Kolly Stéphane , Maillard Pauline , Pascual-Leone Antonio , Samson Andrea C. , Schmitt Ruth , Bernini Adriano , Allenbach Gilles , Charbon Patrick , de Roten Yves , Conus Philippe , Despland Jean-Nicolas , Draganski Bogdan 
Published: November 2018

Abstract
Changes in emotional processing (EP) and in theory of mind (TOM) are central across treatment approaches for patients with borderline personality disorder (BPD). Although the assessment of EP relies on the observation of a patient's self-criticism in a two-chair dialogue, an individual's TOM assessments is made based on responses to humorous stimuli based on false beliefs. For this pilot study, we assessed eight patients with BPD before and after a 3-month-long psychiatric treatment, using functional magnetic resonance imaging and behavioral tasks. We observed arousal increase within the session of the two-chair dialogue (d = 0.36), paralleled by arousal decrease between sessions (d = 0.80). We found treatment-associated trends for neural activity reduction in brain areas central for EP and TOM. Our exploratory findings using an integrative assessment procedure of changes in EP and TOM point toward evidence for treatment effects at the brain systems level related to behavioral modulation.
Effects of Mind-Body Exercise on Cognitive Function in Older Adults With Cognitive Impairment
Authors: Wang Shuo , Yin Huiru , Jia Yong , Zhao Lijing , Wang Lisheng , Chen Li 
Published: November 2018

Abstract
To quantify the effects of mind-body exercise on cognitive function in older adults with cognitive impairment, we systematically searched five databases. Findings were analyzed according to the mean change of global cognition, memory, and executive function. Subgroup analyses were conducted based on the level of cognitive impairment and types of exercise. Thirteen studies were included. Analyses revealed that mind-body exercise was effective in promoting global cognition in individuals with cognitive impairment (standardized mean difference [SMD] = 0.61; 95% confidence interval, 0.21–1.00; p = 0.003), as well as in individuals with mild cognitive impairment (SMD = 0.46; 95% confidence interval, 0.06–0.85; p = 0.02) or dementia; dance was effective in promoting global cognition (SMD = 0.84; 95% confidence interval, 0.23–1.46; p = 0.007) and memory (SMD = 0.27; 95% confidence interval, 0.02–0.52; p = 0.04) in individuals with cognitive impairment, but tai chi was not. Nevertheless, additional well-designed randomized clinical trials are further needed.
Depressions of Dermestes maculatus (Coleoptera: Dermestidae) on Bones Could be Pupation Chambers
Authors: Zanetti Noelia Inés , Ferrero Adriana Alicia , Centeno Néstor Daniel 
Published: November 2018

Abstract

Dermestes maculatus DeGeer beetles feed and can leave marks on bones. This species is of medical, veterinary, and forensic importance. The aim of this work was to determine if the depressions produced on bones by these beetles could be product of pupation. We studied under controlled conditions the behavior of D. maculatus larvae maintained at 24°C ± 3°C, 52.7% average relative humidity, and a 12:12-hour light/dark cycle and fed on pig carcasses. Observations were made, and photographs were taken. The results indicated that depressions produced by D. maculatus were consequence of feeding or pupation. This is the first time that pupation chambers on bones are confirmed.
Comparison of Dako HercepTest and Ventana PATHWAY Anti-HER2 (4B5) Tests and Their Correlation With Fluorescent In Situ Hybridization in Breast Carcinoma
Authors: Lucas Elena , Jabbar Seema B. , Molberg Kyle , Fang Yisheng , Xie Xian-Jin , Blacketer Sara , Sahoo Sunati 
Published: November 2018

Objectives:
We compared the performance of two Food and Drug Administration–approved HER2 immunohistochemistry (IHC) tests: HercepTest (Dako) and PATHWAY anti-HER2 (4B5) (Ventana).

Materials and Methods:
In total, 180 invasive breast carcinomas previously tested by both HercepTest and fluorescent in situ hybridization (FISH) were retested with 4B5. Three pathologists scored the HER2 IHC using the 2013 American Society of Clinical Oncology/College of American Pathologists guidelines. The HER2 IHC results were correlated with FISH.

Results:
Among 135 equivocal cases by HercepTest, 100 (74.1%) were negative by 4B5. Among 45 positive HercepTest cases 9 (20%) were equivocal by 4B5. Among 135 equivocal HercepTest results, 100 (74.1%) were nonamplified, 18 (13.3%) equivocal, and 17 (12.6%) amplified by FISH. Among the 45 positive results with HercepTest, 2 (4.5%) were nonamplified and 1 (2.2%) was equivocal by FISH. All 37 positive and 3 negative by 4B5 cases were amplified by FISH. The absolute interobserver agreement was high for both tests (Fleiss kappa=0.838 for HercepTest and 0.771 for 4B5).

Conclusions:
PATHWAY anti-HER2 (4B5) significantly reduced the number of equivocal results that require additional testing. Although HercepTest was positive in a small number of HER2 nonamplified cases, 4B5 failed to detect 3 cases that were interpreted as positive by FISH, all with nonclassic or low levels of amplification.
Why Are Newborns Brought to the Emergency Department?
Authors: Ferreira Helena , Ferreira Carla , Tavares Cláudia , Aguiar Isolina 
Published: November 2018

Objectives
Neonatal period is a peculiar life stage. This study aimed to characterize newborns' visits to the emergency department (ED) of a secondary care hospital.

Methods
Retrospective analysis of infants up to 28 days, who resorted to the ED between January and December of 2014, was performed. The data included newborn and maternal demographic characteristics and characterization of visits in the ED.

Results
From 378 newborns' visits in the ED, 77 were excluded because the visits did not meet the inclusion criteria. From the remaining 301 visits, corresponding to 266 newborns, 56 newborns were referred to hospital care by another doctor, and 34 returned to ED in the neonatal period. The majority of newborns were full term (94%), born by vaginal delivery (55.1%), and had an appropriate birth weight for gestational age (94%). The main reasons for ED visits were gastrointestinal symptoms (33.8%), mucocutaneous lesions (21.4%), and jaundice (16.2%). Half (53%) of the newborns' visits were considered nonurgent. Emergency department visits for reasons justifying medical evaluation were higher in those referred by another doctor (P < 0.001). The rate of hospitalization or guidance for consultation was higher in newborns referred by another doctor (P = 0.017), in those whose color attributed by Manchester Triage System was yellow or orange (P = 0.029) and in newborns older than 7 days (P = 0.035).

Conclusions
The majority of ED visits is owing to insufficient caretaker knowledge or benign symptoms without necessity of immediate medical evaluation. These results emphasize the need for parents' education by health professionals.
Findings of a Statewide Environmental Lead Inspection Program Targeting Homes of Children With Blood Lead Levels as Low as 5 μg/dL
Authors: Cluett Rachel , Fleisch Abby , Decker Kathy , Frohmberg Eric , Smith Andrew E. 
Published: November 2018

Context:
There are limited data on the nature of environmental lead hazards identified during residential inspections for child blood lead levels (BLLs) of less than 10 μg/dL. We compare inspection findings for child BLLs of 5 to 9 μg/dL versus 10 μg/dL or more.

Design:
We reviewed inspection reports in Maine from September 2016 to March 2018. We used continuity-adjusted or Fisher's exact test for categorical variables and Wilcoxon rank-sum tests for continuous variables to compare differences in child, family, household, and lead hazard characteristics between BLL categories (5-9 μg/dL vs ≥10 μg/dL). We used Spearman correlation coefficients to assess relationships between home surface lead dust measurements and BLLs.

Results:
Of 351 residential inspections, 272 (77%) were for children with BLLs of 5 to 9 μg/dL. Children with BLLs of 5 to 9 μg/dL as compared with children with BLLs of 10 μg/dL or more were less likely to chew window sills and door frames (8% vs 21%; P = .01), but otherwise were similar with respect to other established risk factors for lead poisoning. Children with BLLs of 5 to 9 μg/dL tended to have fewer paint hazards inside their homes (64% vs 78%; P = .03), and they were more likely to have dust-only hazards (8% vs 3%) or no identified lead paint hazards (23% vs 15%), though these differences were not statistically significant. For children with BLLs of 5 to 9 μg/dL, BLL was weakly correlated with average window sill dust level (Spearman r = 0.16; P = .01) and average floor dust level (r = 0.13; P = .03), but these correlations were not observed for children with BLLs of 10 μg/dL and higher.

Conclusions:
We have found that inspections of homes of children with BLLs of 5 to 9 μg/dL are nearly as likely to identify lead hazards that require abatement as inspections of homes of children with BLLs of 10 μg/dL.
Screening for Elevated Blood Lead Levels: False-Positive Rates of Tests on Capillary Samples, Minnesota, 2011-2017
Authors: Wang Amy , Rezania Zaynab , Haugen Kathryn M. B. , Baertlein Luke , Yendell Stephanie J. 
Published: November 2018

Context:
A typical strategy for identifying children with elevated blood lead levels (BLL) is to use a test on a capillary sample as a screening tool and then perform a confirmatory test on a venous sample following an elevated capillary screen. However, tests on capillary samples are prone to false-positive results, which affect surveillance estimates of the prevalence of elevated BLL.

Objective:
We sought to measure the prevalence and risk of false-positive results in elevated tests on capillary samples based on various potential predictors.

Design, Setting, Participants, and Main Outcome Measures:
We analyzed blood lead results for children aged 0 to 6 years tested during 2011 to 2017 in Minnesota. A false positive was defined as a test on a capillary sample of at least 5 μg/dL, followed by a test result on a venous sample less than 5 μg/dL within 90 days. Binomial regression was used to estimate the probability of false-positive results dependent on the initial test result and the time between initial and confirmatory tests.

Results:
Results from 3898 children were included in analyses. Of these, 2330 (60%) had confirmatory results below 5 μg/dL and were classified as false positives. The proportion of false positives varied with time between tests, dependent on the initial result. Extrapolating the model to zero days between tests, without time for any change in the child's true BLL, we predicted 55% false positives in this study group (95% confidence interval: 53%-57%).

Conclusion:
Caution is warranted when interpreting elevated tests on capillary samples without confirmatory tests on venous samples. Providers should be encouraged to follow up all elevated capillary screens with confirmatory tests on venous samples.
Evaluation of the Blood Lead Screening Component of the Southern Nevada Childhood Lead Poisoning Prevention Program
Authors: Haboush-Deloye Amanda , Marquez Erika , Marshall Melissa , Gerstenberger Shawn L. 
Published: November 2018

Context:
While public health programs and policies have worked to reduce lead exposure, lead poisoning remains a major preventable public health concern in the United States.

Objective:
In Clark County, Nevada, blood lead level (BLL) screening has historically been sparse. Thus, the purpose of this study was to evaluate the impact of the Southern Nevada Childhood Lead Poisoning & Prevention Program (CLPPP) in increasing screening efforts and identifying children with elevated blood lead levels (EBLLs).

Main Outcomes:
The proportion of children screened after the implementation of the CLPPP and the number of children identified with detectable BLLs.

Results:
A total of 43 028 BLL results for children younger than 6 years were assessed from 2006 to 2011. More than 19% of children tested during the project period had a detectable BLL. The number of BLL tests for children younger than 6 years increased from 4180 in 2005-2006 to 9304 in just the second year of CLPPP implementation. Once the initial implementation grant was over and additional funding was unavailable, the BLL screening once again declined to 5541 in 2016-2017.

Conclusion:
Evaluation of CLPPP activities suggests that outreach and education efforts, funded by the Centers for Disease Control and Prevention, played a significant role in increasing blood lead screening in Southern Nevada. However, despite these efforts, less than 5% of all children younger than 6 years were screened, which has declined further after the end of federal support.
Iatrogenic Colonic Perforations: Changing the Paradigm
Authors: Ulla-Rocha Jose Luis , Salgado Angel , Sardina Raquel , Souto Raquel , Sanchez-Santos Raquel , Turnes Juan 
Published: November 2018

Purpose:
The purpose of our study was to investigate the clinical outcomes of colonoscopic perforations in patients.

Materials and Methods:
We retrospectively studied patients with perforations secondary to diagnostic/therapeutic colonoscopy between 2009 and 2015 at the Pontevedra Hospital Complex. We analyzed age, closure method, length of hospitalization, and long-term progress.

Results:
Of the 34 perforations detected, 67.6% occurred in patients aged below 75 years. Most perforations occurred in the descending colon (55%). Perforations occurred in 55.9% of outpatients and 45% of inpatients. Diagnostic and therapeutic colonoscopies caused perforations in 20.6% and 79.4% of patients, respectively. Conservative treatment alone was performed in 5.9%, complete or partial endoscopic closure in 14.7%, and surgery in 79.4% of patients. Patients treated only conservatively or with concomitant endoscopic closure showed no mortality. The mortality rate was 14.8% in those treated surgically, and 55% of these patients required a subsequent ostomy.

Conclusions:
Conservative management with antibiotics and parenteral nutrition concomitant with complete/partial endoscopic closure effectively treats perforations, provided intraprocedural diagnosis is possible with immediate administration of antibiotics after the procedure. Nevertheless, studies with larger number of patients and statistical analysis are necessary in the near future.
Generative modeling and latent space arithmetics predict single-cell perturbation response across cell types, studies and species
Authors: Lotfollahi M. , Wolf F. Alexander , Theis Fabian J. 
Published: November 2018

AbstractAccurately modeling cellular response to perturbations is a central goal of computational biology. While such modeling has been proposed based on statistical, mechanistic and machine learning models in specific settings, no generalization of predictions to phenomena absent from training data (‘out-of-sample’) has yet been demonstrated. Here, we present scGen, a model combining variational autoencoders and latent space vector arithmetics for high-dimensional single-cell gene expression data. In benchmarks across a broad range of examples, we show that scGen accurately models dose and infection response of cells across cell types, studies and species. In particular, we demonstrate that scGen learns cell type and species specific response implying that it captures features that distinguish responding from non-responding genes and cells. With the upcoming availability of large-scale atlases of organs in healthy state, we envision scGen to become a tool for experimental design throughin silicoscreening of perturbation response in the context of disease and drug treatment.
Carbapenem-resistant Pseudomonas aeruginosa bloodstream infection: in vitro synergy, virulence and clinical outcome
Authors: Ramos Jessica Fernandes , Leite Gleice Cristina , Rizek Camila , Rossi Flavia , Guimarães Thais , Sanabani Sabri Saeed , Levin Anna Sara , Rocha Vanderson , Costa Silvia Figueiredo 
Published: November 2018

AbstractIn the current study carbapanem-resistant P. aeruginosa bloodstream infection (CRPA-BSI) was associated with high 14-day mortality. Although, highly resistant to meropenem, half of the isolates achieved in vitro synergy with the combination of meropenem with colistin, and the patients that received this combination therapy showed a tendency towards lower mortality. Our strains did not carry exoU gene, on the other hand, patients with CRPA-BSI caused by strains harboring gene lasB evolved more frequent to death.
Real-time monitoring of bacterial growth and fast antimicrobial susceptibility tests exploiting multiple light scattering
Authors: Han SeungYun , Kim HyunJung , Park Jongchan , Lee SangYun , Lee KyeoReh , Kim Ju-Kang , Chung Hyun Jung , Park YongKeun 
Published: November 2018

Abstract:Antimicrobial susceptibility test (AST) is widely used to provide the minimum inhibitory concentration of bacteria, and crucial to provide appropriate uses of antibiotics and to address the issue of drug-resistance bacteria. However, ASTs require the time-consuming incubation about 16-20 h for the visual determination of the growth of bacterial colonies, which has been a major obstacle to on-site applications of ASTs. In this study, we propose a rapid and non-invasive method based on laser speckles to evaluate the bacterial growth movements in real time, thus reducing the time for the agar dilution method. With a simple configuration compatible with conventional agar plates, the analysis of laser speckle from samples enables the early detection of the presence of growth as well as its detailed history of the colony-forming movement on agar plates. Using the samples prepared through the same procedure as the agar dilution method, we obtained the AST results at least 4-8 hours earlier than the conventional method without compromising the accuracy. This technique does not require for the use of exogenous agents, but works for most bacteria regardless of their species. Furthermore, the distinctive responses of several species to microbial agents were revealed through the present technique supporting a comprehensive analysis of the effect of the antibiotics. The findings suggest that this new method could be a useful tool for rapid, simple, and low-cost ASTs in addition to providing the historical information of the bacterial growth on agar plates.