bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
Authors: Kato Motohiko , Abe Keiichiro , Kubosawa Yoko , Sunata Yukie , Hirai Yuichiro , Hirata Tetsu , Takada Yoshiaki , Wada Michiko , Takatori Yusaku , Banno Shigeo , Kinoshita Satoshi , Mori Hideki , Takabayashi Kaoru , Kikuchi Masahiro , Shiraishi Junichi , Uraoka Toshio 
Published: August 2018

Abstract
Background and study aims Although cold polypectomy (CP) is widely used for colorectal polyps < 10 mm, appropriateness of indications for CP or endoscopic mucosal resection (EMR) are still unclear. The aim of this study was to validate the endoscopic treatment algorithm based on the Japan NBI Expert Team (JNET) classification.
Patients and methods Consecutive patients with at least one colorectal non-pedunculated polyp < 10 mm between July 2014 and October 2016 were included in this retrospective study. During the period, EMR was performed for JNET ≥ 2B lesions and CP for JNET < 2A. Among a total of 3966 lesions, 3368 lesions with JNET ≤ 2A were resected by CP in compliance with the treatment algorithm but 565 resections for JNET ≤ 2A were not compliant (by EMR), while all 24 JNET > 2B lesions were removed by EMR in compliance with the algorithm. Polypectomy outcomes were compared between the compliant and non-compliant groups. Histological outcomes were analyzed in accordance with JNET classification.
Results Post-polypectomy bleeding rate in the compliant group (0 %) was lower than that in the non-compliant group (0.53 %, P < 0.01). Proportion of lesions diagnosed as cancer (38 % vs 0.36 %, P < 0.01) or submucosal cancer (4.2 % vs 0.03 %, P = 0.012), and the lesion with free resection margin (91 % vs 64 %, P < 0.01) was higher in the JNET ≥ 2B than JNET ≤ 2A.
Conclusion This study indicated our algorithm would be valid: CP is suitable for most polyps < 10 mm as incidence of post-polypectomy bleeding is low, whereas EMR is recommended for JNET ≥ 2B lesions for histological complete removal.
Metallic vs plastic stents to treat biliary stricture after liver transplantation: a systematic review and meta-analysis based on randomized trials
Authors: Visconti Thiago Arantes de Carvalho , Bernardo Wanderley Marques , Moura Diogo Turiani Hourneaux , Moura Eduardo Turiani Hourneaux , Gonçalves Caio Vinicius Tranquillini , Farias Galileu Ferreira , Guedes Hugo Gonçalo , Ribeiro Igor Braga , Franzini Tomazo Prince , Luz Gustavo Oliveira , dos Santos Marcos Eduardo dos Lera , de Moura Eduardo Guimarães Hourneaux 
Published: August 2018

Abstract
Background and study aims The first-line approach to anastomotic biliary stricture after orthotopic liver transplantation (OLTX) involves endoscopic retrograde cholangiopancreatography (ERCP). The most widely used technique is placement of multiple plastic stents, but discussions are ongoing on the benefits of fully-covered self-expandable metallic stents (FCEMS) in this situation. This study aimed to compare results from use of plastic and metal stents to treat biliary stricture after transplantation.
Patients and methods Searches were performed in the Medline, EMBASE, SciELO/LILACS, and Cochrane databases, and only randomized studies comparing the two techniques were included in the meta-analysis.
Results Our study included four randomized clinical trials totaling 205 patients. No difference was observed between the stricture resolution rate (RD: 0.01; 95 %CI [−0.08 – 0.10]), stricture recurrence (RD: 0.13; 95 %CI [−0.03 – 0.28]), and adverse events (RD: −0.10; 95 %CI [−0.65 – 0.44]) between the plastic and metallic stent groups. The metallic stent group demonstrated benefits in relation to the number of ERCPs performed (MD: −1.86; 95 %CI [−3.12 to −0.6]), duration of treatment (MD: −105.07; 95 %CI [−202.38 to −7.76 days]), number of stents used (MD: −10.633; 95 %CI [−20.82 to −0.44]), and cost (average $ 8,288.50 versus $ 18,580.00, P < 0.001).
Conclusions Rates of resolution and recurrence of stricture are similar, whereas the number of ERCPs performed, number of stents used, duration of treatment, and costs were lower in patients treated with FCEMS, which shows that this device is a valid option for initial treatment of post-OLTX biliary stricture.
Neue Therapien der spinalen Muskelatrophie
Authors: Walter Maggie , Schoser Benedikt 
Published: August 2018

ZusammenfassungDie 5q-assoziierte spinale Muskelatrophie (5q-SMA) ist eine progressive autosomal rezessive Motoneuronerkrankung mit einer Inzidenz von 1 in 10 000 Geburten. Die 5q-SMA ist durch den Verlust des Survival Motor Neuron 1 Gens (SMN1) verursacht. Sie stellt die häufigste neurodegenerative Erkrankung im Kindesalter dar. 126 Jahre nach der Erstbeschreibung durch Hofmann kam es 2017 zur Erstzulassung einer spezifischen Therapie der SMA in Deutschland. Durch eine Erhöhung des Anteils an funktionsfähigem SMN-Protein, die entweder durch Einschluss von Exon 7 in SNM2-Transkripte, Erhöhung der SMN2-Genexpression oder durch direkten Genersatz von SMN1 erzielt werden kann, ist eine spezifische Therapie nun möglich geworden. Zahlreiche Fragen – was ist der Zeitpunkt für eine optimale therapeutische Intervention, welche therapeutische Maßnahme ist die geeignetste, was sind mögliche Wechselwirkungen gentherapeutischer Maßnahmen – bleiben derzeit noch ungeklärt. Die Kenntnis der klinischen Symptome der SMA und das Wissen um eine spezifische Therapie werden diese bislang als unbehandelbar geltende Erkrankung neu in den medizinischen Fokus bringen, sodass ein früher, nach Möglichkeit präsymptomatischer Therapiebeginn das Outcome im Vergleich zu einem späteren Therapiebeginn entscheidend verbessern wird.
Spätkomplikationen permanenter intestinaler Stomata
Authors: Stoffels Burkhard , Sommer Nils , Berteld Christine , Vilz Tim , von Websky Martin , Kalff Jörg , Pantelis Dimitrios 
Published: August 2018

Zusammenfassung
Einführung Komplikationen nach Anlage permanenter intestinaler Stomata sind häufig und führen zu gravierenden Problemen in der Stomaversorgung betroffener Patienten. Ziel dieser prospektiven, unizentrischen Nachbeobachtungsstudie war es, Spätkomplikationen im eigenen Patientenkollektiv zu erfassen und potenzielle Risikofaktoren herauszuarbeiten.
Methoden Sämtliche Patienten unserer Klinik mit einer permanenten intestinalen Stomaanlage im Zeitraum 2006 – 2016 wurden in die Studie eingeschlossen. 50 Patienten haben einer Nachuntersuchung zugestimmt (14 weiblich [28%], 36 männlich [72%]). Es erfolgte die Analyse stomaassoziierter Komplikationen im Rahmen einer systematischen Nachuntersuchung (standardisierter Fragebogen, klinische Untersuchung, Sonografie Bauchdecke).
Ergebnisse Das Indikationsspektrum beinhaltete Malignome (n = 27; 54%), Anastomoseninsuffizienzen (n = 10; 20%), akute Divertikulitiden (n = 7; 14%), chronisch entzündliche Darmerkrankungen (n = 5; 10%) sowie seltenere Indikationen. Die 3 häufigsten Spätkomplikationen waren peristomale Hautirritation (n = 25; 50%), parastomale Hernie (n = 14; 28%) und Stomaprolaps (n = 9; 18%). Akute Divertikulitiden führten zu vermehrten Stomaretraktionen (p = 0,012). Doppelläufige Stomata wiesen vermehrt Hernien (p = 0,044) und Prolabierungen (p = 0,047) auf. Ileostomata sind bezüglich peristomaler Hautirritationen problematisch (p = 0,021). Patientenalter, Geschlecht oder eine Stomaanlage im Rahmen einer Notfalloperation stellten in unserem Kollektiv keine unabhängigen Risikofaktoren für das Auftreten von Spätkomplikationen dar.
Schlussfolgerung Die professionelle prä- und postoperative Stomatherapie/-pflege inklusive präoperativer Stomamarkierung und strukturierter stomaspezifischer Nachsorge durch Stomatherapeuten und Chirurgen sowie Hausärzte, ebenso wie eine stringente und zeitnahe Behandlung struktureller Komplikationen, können Spätkomplikationen permanenter intestinaler Stomata vorbeugen und mildern. Interessanterweise war die Stomaanlage im Rahmen einer Notfalloperation kein unabhängiger Risikofaktor für das Auftreten von Spätkomplikationen.
Peroral endoscopic myotomy for the treatment of achalasia patients with Roux-en-Y gastric bypass anatomy
Authors: Sanaei Omid , Draganov Peter , Kunda Rastislav , Yang Dennis , Khashab Mouen 
Published: August 2018

Abstract
Background The outcome of peroral endoscopic myotomy (POEM) in patients with prior Roux-en-Y gastric bypass (RYGB) is not known and some experts have recommended against its performance in this patient population because of the risk of postoperative regurgitation. The aim of this study was to report on the outcomes of POEM in patients with RYGB anatomy.
Methods Patients with RYGB anatomy who underwent POEM for the treatment of achalasia at three tertiary centers were included. POEM was performed in standard fashion using the anterior or posterior approach. Clinical response was defined by a decrease in Eckardt score to ≤ 3. Results of esophageal acid exposure testing/pH-impedance and manometric testing after POEM were reported when available.
Results A total of 10 achalasia patients with prior RYGB surgery underwent POEM. All procedures were technically successful with anterior myotomy performed in seven patients. The mean submucosal tunnel length and myotomy length were 12.9 cm and 11.1 cm, respectively. The mean procedure time was 72 minutes and mean length of hospital stay was 1.5 days. Clinical success was achieved in all 10 patients with a significant decrease in Eckardt score from 6.5 to 1 (P < 0.001). None of the patients experienced post-procedural regurgitation. Post-procedural pH testing was obtained in six patients and was normal in all of them.
Conclusions This study suggests the feasibility, safety, and efficacy of POEM in patients with prior RYGB surgery. The risk of gastroesophageal reflux disease in these patients seems to be minimal after POEM.
High incidence of advanced colorectal neoplasia during endoscopic surveillance in serrated polyposis syndrome
Authors: Rodríguez-Alcalde Daniel , Carballal Sabela , Moreira Leticia , Hernández Luis , Rodríguez-Alonso Lorena , Rodríguez-Moranta Francisco , Gonzalo Victoria , Bujanda Luis , Bessa Xavier , Poves Carmen , Cubiella Joaquín , Castro Inés , González Mariano , Moya Eloísa , Oquiñena Susana , Clofent Joan , Quintero Enrique , Esteban Pilar , Piñol Virginia , Fernández Francisco , Jover Rodrigo , Cid Lucía , Saperas Esteve , López-Cerón María , Cuatrecasas Miriam , López-Vicente Jorge , Rivero-Sánchez Liseth , Jung Gerhard , Vila-Casadesús María , Sánchez Ariadna , Castells Antoni , Pellisé María , Balaguer Francesc ,   for the Gastrointestinal Oncology Group of the Spanish Gastroenterological Association
Published: August 2018

Abstract
Background Serrated polyposis syndrome (SPS) has been associated with an increased risk of colorectal cancer (CRC). Accordingly, intensive surveillance with annual colonoscopy is advised. The aim of this multicenter study was to describe the risk of advanced lesions in SPS patients undergoing surveillance, and to identify risk factors that could guide the prevention strategy.
Methods From March 2013 to April 2015, 296 patients who fulfilled criteria I and/or III for SPS were retrospectively recruited at 18 centers. We selected patients in whom successful clearing colonoscopy had been performed and who underwent subsequent endoscopic surveillance. Advanced neoplasia was defined as CRC, advanced adenoma, or advanced serrated lesion that were ≥ 10 mm and/or with dysplasia. Cumulative incidence of advanced neoplasia was calculated and independent predictors of advanced neoplasia development were identified.
Results In 152 SPS patients a total of 315 surveillance colonoscopies were performed (median 2, range 1 – 7). The 3-year cumulative incidence of CRC and advanced neoplasia were 3.1 % (95 % confidence interval [CI] 0 – 6.9) and 42.0 % (95 %CI 32.4 – 51.7), respectively. Fulfilling both I + III criteria and the presence of advanced serrated lesions at baseline colonoscopy were independent predictors of advanced neoplasia development (odds ratio [OR] 1.85, 95 %CI 1.03 – 3.33, P  = 0.04 and OR 2.62, 95 %CI 1.18 – 5.81, P  = 0.02, respectively). During follow-up, nine patients (5.9 %) were referred for surgery for invasive CRC (n = 4, 2.6 %) or because of polyp burden (n = 5, 3.3 %). After total colectomy, 17.9 % patients developed advanced neoplasia in the retained rectum.
Conclusions Patients with SPS have a substantial risk of developing advanced neoplasia under endoscopic surveillance, whereas CRC incidence is low. Personalized endoscopic surveillance based on polyp burden and advanced serrated histology could help to optimize prevention in patients with SPS.
Hemodynamic Results and Mid-term Follow-up of 850 19 to 23 mm Perimount Magna Ease Valves
Authors: Anselmi Amedeo , Ruggieri Vito Giovanni , Belhaj Soulami Réda , Flécher Erwan , Langanay Thierry , Corbineau Hervé , Leguerrier Alain , Verhoye Jean-Philippe 
Published: August 2018

Background Aortic valve replacement (AVR) in small aortic roots remains a surgical dilemma with a higher risk of patient-prosthesis mismatch (PPM). The Perimount Magna Ease aortic valve (PMEAV) represents an attractive device in such cases. We examined the early hemodynamic performance, the mid-term outcomes of the PMEAV, and the impact of PPM on outcome and functional class.
Methods We performed a retrospective analysis of prospectively collected in-hospital data, and a prospective single-center follow-up of 849 patients who received a 19 to 23 mm PMEAV (2008–2014). Concomitant mitral or tricuspid replacement was the exclusion criterion. Early hemodynamic features were prospectively collected; mid-term follow-up was conducted according to current guidelines.
Results Size of implanted prosthesis was 19 mm in 11.5% of patients, 21 mm in 36.9%, and 23 mm in 51.5%. Operative mortality was 4.5% (3.1% for isolated AVR). The rate of severe and moderate PPMs was significantly higher in the 19 mm group. Follow-up was 99.9% complete (3.7 ± 2 years). Actuarial freedom from structural valve deterioration (SVD) at 5 years was 99.1%. At stratified Kaplan–Meier's analysis, PPM and age <70 years were associated with SVD. PPM was not associated with worse functional status (New York Heart Association class) or mortality at follow-up.
Conclusion This series shows satisfactory clinical outcomes of the PMEAV implanted in small aortic annuli at mid-term follow-up. Although PPM may occur in smaller sizes, it has limited clinical impact, and it is not associated with mid-term mortality or worse functional class. Few SVD events are evidenced; nonetheless, limited follow-up duration and its methodology need to be considered.
A National Long-Term Study of Neuroendocrine Tumors of the Appendix in Children: Are We Too Aggressive?
Authors: Sommer Christelle , Gumy Pause Fabienne , Diezi Manuel , Rougemont Anne-Laure , Wildhaber Barbara E. 
Published: August 2018

Introduction Pediatric neuroendocrine tumors (NETs) of the appendix are mostly detected incidentally after appendectomy for acute appendicitis. NET management is a matter of controversy. In this national, multicenter study, we aimed to establish guidelines based on our results and the literature.
Materials and Methods Medical records of children (0–16 years) with NET of the appendix, treated in Switzerland (1991–2012), were reviewed.
Results Forty cases (28 girls) were analyzed. Median age at diagnosis was 12.7 years (interquartile range [IQR]: 4.0). Tumor size was 0.1–24 mm (median: 0.6, IQR: 0.6). Four patients (10%) underwent additional surgery because of either tumor size > 15 mm (1/4), extension to the mesoappendix (1/4), or incomplete resection (2/4). Three patients with a tumor of ≥ 20 mm had no additional surgery. No patient had lymph node metastases. All patients were in complete remission at the last follow-up (median: 3.0 years, IQR: 10.9).
Conclusion We conclude from this study and from an extensive review of the literature that two criteria may point to the need for additional surgery, i.e., the possibility of regional lymph node involvement: tumor size > 20 mm and incomplete surgical resection margins. Childhood NET of the appendix has an excellent prognosis.
Evolution and diversification of the plant gibberellin receptor GID1
Authors: Yoshida Hideki , Tanimoto Eiichi , Hirai Takaaki , Miyanoiri Yohei , Mitani Rie , Kawamura Mayuko , Takeda Mitsuhiro , Takehara Sayaka , Hirano Ko , Kainosho Masatsune , Akagi Takashi , Matsuoka Makoto , Ueguchi-Tanaka Miyako 
Published: August 2018

Significance
The plant gibberellin receptor GID1 shows sequence similarity to carboxylesterase, suggesting that it is derived from an enzyme. However, how GID1 evolved and was modified is unclear. We identified two amino acids that are essential for GID1 activity, and we found that adjustment of these residues caused GID1 to recognize novel GAs carrying 13-OH as active GAs and to strictly refuse inactive GAs. Phylogenetic analysis of 169 GID1s revealed seven subtypes, and the B-type in core eudicots showed unique characteristics. In fact, certain B-type GID1s showed a higher nonsynonymous-to-synonymous divergence ratio in the region determining GA affinity. Such B-type GID1s with higher affinity were preferentially expressed in the roots in some core eudicot plants and conferred adaptive growth under stress.
Spatial arrangement of proteins using scCro-tag: application for an in situ enzymatic microbead assay
Authors: Kojima Takaaki , Hata Jumpei , Oka Hiroya , Hayashi Kenta , Hitomi Kiyotaka , Nakano Hideo 
Published: August 2018

ABSTRACT
In natural systems, various metabolic reactions are often spatially organized to increase enzyme activity and specificity. Thus, by spatially arranging enzyme molecules in synthetic systems to imitate these natural systems, it is possible to promote a high rate of enzymatic turnover. In this present study, a normal and mutant form of the scCro DNA-binding protein were shown to bind orthogonally to specific recognition sequences under appropriate conditions. Furthermore, these DNA-binding tags were used to establish an enzyme assay system based on the spatial arrangement of transglutaminase and its substrate at the molecular level. Together, the results of the present study suggest that the scCro-tag may be a powerful tool to facilitate the synthetic spatial arrangement of proteins on a DNA ligand.
Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project
Authors: Biswas Arunava , Bhattacharya Sangeeta Das , Singh Arun Kumarendu , Saha Mallika 
Published: August 2018

Abstract

Objective
Our goal for this study was to quantify healthcare provider compliance with hand hygiene protocols and develop a conceptual framework for increasing hand hygiene compliance in a low-resource neonatal intensive care unit.

Materials and Methods
We developed a 3-phase intervention that involved departmental discussion, audit, and follow-up action. A 4-month unobtrusive audit during night and day shifts was performed. The audit results were presented, and a conceptual framework of barriers to and solutions for increasing hand hygiene compliance was developed collectively.

Results
A total of 1308 hand hygiene opportunities were observed. Among 1227 planned patient contacts, hand-washing events (707 [58.6%]), hand rub events (442 [36%]), and missed hand hygiene (78 [6.4%]) events were observed. The missed hand hygiene rate was 20% during resuscitation. Missed hand hygiene opportunities occurred 3.2 times (95% confidence interval, 1.9–5.3 times) more often during resuscitation procedures than during planned contact and 6.14 times (95% confidence interval, 2.36–16.01 times) more often when providers moved between patients. Structural and process determinants of hand hygiene noncompliance were identified through a root-cause analysis in which all members of the neonatal intensive care unit team participated. The mean hand-washing duration was 40 seconds. In 83% of cases, drying hands after washing was neglected. Hand recontamination after hand-washing was seen in 77% of the cases. Washing up to elbow level was observed in 27% of hand-wash events. After departmental review of the study results, hand rubs were placed at each bassinet to address these missed opportunities.

Conclusions
Hand hygiene was suboptimal during resuscitation procedures and between patient contacts. We developed a conceptual framework for improving hand hygiene through a root-cause analysis.
Effects of Intranasal Oxytocin on Stress-Induced Cigarette Craving in Daily Smokers
Authors: Van Hedger Kathryne , Bershad Anya K , Lee Royce , de Wit Harriet 
Published: August 2018

Abstract

Background
Cigarette smoking is a well-known public health concern, and there is an urgent need to develop new treatments to reduce smoking or facilitate abstinence. One factor that is known to contribute to relapse is stress, making the stress response an important target for treatment. The neuropeptide oxytocin (OT) is believed to have stress-reducing effects, and in addition there is evidence that it reduces drug craving. The purpose of the present study was to examine the effects of intranasal OT on stress-induced cigarette craving in regular smokers after 12 h of abstinence.

Method
Daily smokers (n = 48) completed a stress induction task and a nonstressful control task at two different sessions, receiving intranasal OT (40 IU) or placebo (PBO) before or after the task. Subjects were randomly assigned to one of three groups: Group PP (n = 16) received PBO before and after the stress/control tasks, Group OP (n = 16) received OT before the tasks and PBO after, and Group PO (n = 16) received PBO before the tasks and OT shortly after completing the tasks. Cigarette craving as well as subjective and physiological responses to stress was assessed.

Results
OT did not alter responses to stress, whether it was administered before or after the stressful task, on measures of cigarette craving, anxiety, heart rate, blood pressure, and cortisol levels.

Conclusions
The current study findings do not support several previous reports that OT reduced either stress or drug craving.

Implications
This study finds a null result of the neuropeptide oxytocin on stress-induced cigarette craving. Reporting null findings is part of the process of identifying potential treatments for addictive disorders.
TRPC1 intensifies house dust mite–induced airway remodeling by facilitating epithelial‐to‐mesenchymal transition and STAT3/NF‐κB signaling
Authors: Pu Qinqin , Zhao Yuanyu , Sun Yuyang , Huang Ting , Lin Ping , Zhou Chuanmin , Qin Shugang , Singh Brij B. , Wu Min 
Published: August 2018

ABSTRACTAirway remodeling with progressive epithelial alterations in the respiratory tract is a severe consequence of asthma. Although dysfunctional signaling transduction is attributed to airway inflammation, the exact mechanism of airway remodeling remains largely unknown. TRPC1, a member of the transient receptor potential canonical Ca2+ channel family, possesses versatile functions but its role in airway remodeling remains undefined. Here, we show that ablation of TRPC1 in mice alleviates airway remodeling following house dust mite (HDM) challenge with decreases in mucus production, cytokine secretion, and collagen deposition. HDM challenge induces Ca2+ influx via the TRPC1 channel, resulting in increased levels of signal transducer and activator of transcription 3 (STAT3) and proinflammatory cytokines. In contrast, STAT3 expression was significantly decreased in TRPC1−/− mouse lungs compared with wild‐type controls after HDM challenge. Mechanistically, STAT3 promotes epithelial‐to‐mesenchymal transition and increases mucin 5AC expression. Collectively, these findings identify TRPC1 as a modulator of HDM‐induced airway remodeling via STAT3‐mediated increase in mucus production, which provide new insight in our understanding of the molecular basis of airway remodeling, and identify novel therapeutic targets for intervention of severe chronic asthma.—Pu, Q., Zhao, Y., Sun, Y., Huang, T., Lin, P., Zhou, C., Qin, S., Singh, B. B., Wu, M TRPC1 intensifies house dust mite–induced airway remodeling by facilitating epithelial‐to‐mesenchymal transition and STAT3/NF‐κB signaling. FASEB J. 33, 1074–1085 (2019). www.fasebj.org