bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of WeChat and short message service on bowel preparation: an endoscopist-blinded, randomized controlled trial
Authors: Wang Shu-Ling , Wang Qian , Yao Jun , Zhao Sheng-Bing , Wang Li-Sheng , Li Zhao-Shen , Bai Yu 
Published: November 2018

Objective
Adequate bowel preparation is essential for a successful colonoscopy; clinical studies suggest reinforced education can improve the preparation process. However, there have been no trials to compare WeChat directions (the most widely used social media app in China) with those of the short message service (SMS). This study was aimed to assess the effect of WeChat and SMS on the bowel preparation quality.

Participants and methods
This was a single-center, prospective, endoscopically blinded, randomized, controlled study. Patients in reinforced education groups received additional reminder messages by WeChat and SMS 2 days before colonoscopy. The primary outcome was bowel preparation quality evaluated by the Boston bowel preparation scale (BBPS) score and the rate of adequacy (BBPS score ≥6). Secondary outcomes included polyp detection rate, adenoma detection rate, and mean total adenomas detected. Patient tolerance level and subjective feelings were also evaluated.

Results
The total BBPS score and the percentage of adequacy were significantly higher in the reinforced education groups compared with the control (WeChat vs. control, P<0.001; SMS vs. control, P<0.001). Moreover, statistically significant differences between the two interventions were found in the total BBPS score but not in the rate of adequacy (P=0.007 and 0.561, respectively). The detection of adenomas, using multiplicity detection rate, advanced adenoma detection rate, and mean total adenomas detected, was much higher in the intervention groups (P=0.039, 0.037, and 0.019, respectively).

Conclusion
WeChat was superior to SMS for bowel preparation, although both of them may help improving the detection of adenomas.
Can Pediatric Endoscopists Accurately Assess Their Clinical Competency? A Comparison Across Skill Levels
Authors: Scaffidi Michael A. , Khan Rishad , Carnahan Heather , Ling Simon C. , Lightdale Jenifer R. , Mamula Petar , Yu Jeffrey J. , Grover Samir C. , Walsh Catharine M. 
Published: November 2018

ABSTRACTBackground:Assessment is critical to support pediatric endoscopy training. Although trainee engagement in assessment is encouraged, the use of self‐assessment and its accuracy among pediatric endoscopists is not well described. We aimed to determine the self‐assessment accuracy of novice, intermediate, and experienced pediatric endoscopists.Methods:Novice (performed <50 previous colonoscopies), intermediate (50–500), and experienced (>1000) pediatric endoscopists from 3 North American academic teaching hospitals each performed a clinical colonoscopy. Endoscopists were assessed in real‐time by 2 experienced endoscopists using the Gastrointestinal Endoscopy Competency Assessment Tool for Pediatric Colonoscopy (GiECATKIDS). In addition, participants self‐assessed their performance using the same instrument. Self‐assessment accuracy between the externally assessed and self‐assessed scores was evaluated using absolute difference scores, intraclass correlation coefficients, and Bland‐Altman analyses.Results:Forty‐seven endoscopists participated (21 novices, 16 intermediates, and 10 experienced). Overall, there was moderate agreement of externally assessed and self‐assessed GiECATKIDS total scores with an intraclass correlation coefficient of 0.72 (95% confidence interval, 0.55–0.83). The absolute difference scores among the 3 groups were significantly different (P = 0.005), with experienced endoscopists demonstrating a more accurate self‐assessment compared to novices (P = 0.003). Bland‐Altman plots revealed that novice endoscopists’ self‐assessed scores tended to be higher than their externally assessed scores, indicating they overestimated their performance.Conclusions:We found that endoscopic experience was positively associated with self‐assessment accuracy among pediatric endoscopists. Novices were inaccurate in assessing their endoscopic competence and were prone to overestimation of their performances. Our findings suggest novices may benefit from targeted interventions aimed at improving their insight and self‐awareness.
Esophageal Compliance Quantifies Epithelial Remodeling in Pediatric Patients With Eosinophilic Esophagitis
Authors: Hassan Maheen , Aceves Seema , Dohil Ranjan , Gharibans Armen , Newbury Robert , Proudfoot James , Mousa Hayat 
Published: November 2018

ABSTRACTBackground:The management of eosinophilic esophagitis (EoE) relies on the severity of esophageal eosinophilia, yet there is poor evidence of its prediction of esophageal fibrotic remodeling and subsequent complications such as dysphagia, food impactions, or strictures. Functional luminal imaging planimetry (FLIP) has had limited use in pediatric patients to evaluate esophageal tissue mechanics. We aimed to standardize the FLIP technique and to measure esophageal compliance in children with EoE in comparison to controls.Methods:Subjects were enrolled into a prospective observational study and had FLIP performed at the time of endoscopy. We calculated esophageal distensibility and compliance for the total and segmental esophagus independently (ie, proximal, middle, and distal esophageal segments). We evaluated esophageal biopsies for eosinophilia and epithelial remodeling, calculated endoscopy scores, and documented patient symptoms.Results:We enrolled 11 EoE and 12 controls subjects, aged 5 to 18 years old. While EoE subjects had lower esophageal compliance (P = 0.004) than controls, the difference in distensibility did not reach significance (P = 0.151). Epithelial remodeling severity was more strongly correlated with compliance than with distensibility. Epithelial remodeling scores ≥2 had a significant association with lower compliance both segmentally and in the entire esophagus (P = 0.029), but not with distensibility. Compliance measures were more sensitive in detecting subjects with remodeling score ≥2 than distensibility (79% vs 64%).Conclusions:Compliance is a more sensitive measure of esophageal epithelial remodeling in children compared to distensibility, and a more appropriate measure of esophageal tissue mechanics. Standardized placement of the FLIP catheter is important to accurately assess esophageal compliance.
Bacteriophage Therapy Testing Against Shigella flexneri in a Novel Human Intestinal Organoid‐Derived Infection Model
Authors: Llanos‐Chea Alejandro , Citorik Robert J. , Nickerson Kourtney P. , Ingano Laura , Serena Gloria , Senger Stefania , Lu Timothy K. , Fasano Alessio , Faherty Christina S. 
Published: November 2018

ABSTRACTObjective:Enteric bacterial pathogens cause diarrheal disease and mortality at significant rates throughout the world, particularly in children younger than 5 years. Our ability to combat bacterial pathogens has been hindered by antibiotic resistance, a lack of effective vaccines, and accurate models of infection. With the renewed interest in bacteriophage therapy, we sought to use a novel human intestinal model to investigate the efficacy of a newly isolated bacteriophage against Shigella flexneri.Methods:An S. flexneri 2457T‐specific bacteriophage was isolated and assessed through kill curve experiments and infection assays with colorectal adenocarcinoma HT‐29 cells and a novel human intestinal organoid‐derived epithelial monolayer model. In our treatment protocol, organoids were generated from intestinal crypt stem cells, expanded in culture, and seeded onto transwells to establish 2‐dimensional monolayers that differentiate into intestinal cells.Results:The isolated bacteriophage efficiently killed S. flexneri 2457T, other S. flexneri strains, and a strain of 2457T harboring an antibiotic resistance cassette. Analyses with laboratory and commensal Escherichia coli strains demonstrated that the bacteriophage was specific to S. flexneri, as observed under co‐culture conditions. Importantly, the bacteriophage prevented both S. flexneri 2457T epithelial cell adherence and invasion in both infection models.Conclusions:Bacteriophages offer feasible alternatives to antibiotics for eliminating enteric pathogens, confirmed here by the bacteriophage‐targeted killing of S. flexneri. Furthermore, application of the organoid model has provided important insight into Shigella pathogenesis and bacteriophage‐dependent intervention strategies. The screening platform described herein provides proof‐of‐concept analysis for the development of novel bacteriophage therapies to target antibiotic‐resistant pathogens.
High Interest in Doxycycline for Sexually Transmitted Infection Postexposure Prophylaxis in a Multicity Survey of Men Who Have Sex With Men Using a Social Networking Application
Authors: Spinelli Matthew A. , Scott Hyman M. , Vittinghoff Eric , Liu Albert Y. , Coleman Kenneth , Buchbinder Susan P. 
Published: November 2018

Abstract
Current strategies to prevent sexually transmitted infections (STIs) are not controlling the epidemic. The efficacy of doxycycline STI postexposure prophylaxis shows promise in pilot studies, but wider acceptability is unknown. A majority (84%) of diverse individuals using a gay social networking application were interested in doxycycline STI postexposure prophylaxis. Doxycycline STI postexposure prophylaxis should be examined in larger trials.
Tracheal Intubation Practice and Safety Across International PICUs: A Report From National Emergency Airway Registry for Children*
Authors: Lee Jan Hau , Nuthall Gabrielle , Ikeyama Takanari , Saito Osamu , Mok Yee Hui , Shepherd Michael , Jung Philipp , Shetty Rakshay , Thyagarajan Sujatha , Nett Sholeen , Napolitano Natalie , Nadkarni Vinay , Nishisaki Akira 
Published: November 2018

Objectives:
It is unknown if variation in tracheal intubation practice and outcomes exist across PICUs in different geographical regions. We hypothesized there would be differences in the process of care and adverse outcomes for tracheal intubation across PICUs in six different geographical regions (New Zealand, Japan, Singapore, Germany, India, and North America).

Design:
Prospective multicenter pediatric tracheal intubation database (National Emergency Airway Registry for Children)

Setting:
Six non-North American (International) and 36 North American PICUs.

Events:
All PICU tracheal intubation encounters from July 2014 to June 2017

Measurements and Main Results:
Adverse tracheal intubation–associated events and desaturation occurrence (oxygen saturation < 80%) were evaluated. A total of 1,134 and 9,376 TIs from International and North American PICUs were reported, respectively: primary tracheal intubation 9,060, endotracheal tube change 1,450. The proportion of tracheal intubations for endotracheal tube change was greater in International PICUs (37% vs 11%; p < 0.001). Median age for International tracheal intubations was younger compared with North America (0 yr [interquartile range, 0–2 yr] vs 1 yr (0–7 yr); p < 0.001). Among primary tracheal intubations, the most common indication was respiratory (International 67%, North American 63%; p = 0.049). Direct laryngoscopy was the most common device in both International (86%) and North American (74%) tracheal intubations. Occurrence of any adverse tracheal intubation–associated event was New Zealand 8%, Japan 17%, Singapore 9%, Germany 17%, and India 6%; International 11% versus North American 14%; p value equals to 0.003. Desaturation was reported less commonly in International PICUs: 13% versus North American 17%; p equals to 0.001. International PICUs used cuffed endotracheal tube less often (52% vs 95%; p < 0.001). Proportion of cuffed endotracheal tube use per PICU was inversely correlated with the rate of tube change (r = –0.67; p < 0.001).

Conclusions:
There were both similarities and differences in tracheal intubation practice and outcomes across international PICUs. Fewer adverse tracheal intubation–associated events were reported from International versus North American PICUs. International PICUs used cuffed endotracheal tube less often and had higher proportion of endotracheal tube change.
Positive Airway Pressure Versus High-Flow Nasal Cannula for Prevention of Extubation Failure in Infants After Congenital Heart Surgery*
Authors: Richter Robert P. , Alten Jeffrey A. , King R. Wilson , Gans Asaf D. , Rahman AKM Fazlur , Kalra Yuvraj , Borasino Santiago 
Published: November 2018

Objectives:
Compare the impact of initial extubation to positive airway pressure versus high-flow nasal cannula on postoperative outcomes in neonates and infants after congenital heart surgery.

Design:
Retrospective cohort study with propensity-matched analysis.

Setting:
Cardiac ICU within a tertiary care children’s hospital.

Patients:
Patients less than 6 months old initially extubated to either high-flow nasal cannula or positive airway pressure after cardiac surgery with cardiopulmonary bypass were included (July 2012 to December 2015).

Interventions:
None.

Measurements and Main Results:
Of 258 encounters, propensity matching identified 49 pairings of patients extubated to high-flow nasal cannula versus positive airway pressure. Extubation failure was 12% for all screened encounters. After matching, there was no difference in extubation failure rate between groups (positive airway pressure 16% vs high-flow nasal cannula 10%; p = 0.549). However, compared with high-flow nasal cannula, patients initially extubated to positive airway pressure experienced greater resource utilization: longer time to low-flow nasal cannula (83 vs 28 hr; p = 0.006); longer time to room air (159 vs 110 hr; p = 0.013); and longer postsurgical hospital length of stay (22 vs 14 d; p = 0.015).

Conclusions:
In this pediatric cohort, primary extubation to positive airway pressure was not superior to high-flow nasal cannula with respect to prevention of extubation failure after congenital heart surgery. Compared with high-flow nasal cannula, use of positive airway pressure was associated with increased hospital resource utilization. Prospective initiatives aimed at establishing best clinical practice for postoperative noninvasive respiratory support are needed.
Comparing Assessments of Physical Functional Independence in Older Adults With Mobility Limitations
Authors: Mortenson W. Ben , Fuhrer Marcus J. , Bilkey Jessica , Jutai Jeffrey , Alkadri Jamal , Aziz Joseph , Demers Louise 
Published: November 2018

Objectives
The aims of the study were (1) to assess the agreement and correlation between self-reported functional independence and observations of family caregivers in a heterogeneous population of community-dwelling older adults with disabilities and (2) to determine how self-reports and caregiver reports correlate with evaluator rated functional independence over time.

Design
Data were drawn from a larger, randomized controlled trial examining the effects of a caregiver-inclusive intervention on outcomes of care recipients and their family caregivers. Functional independence measures were obtained using a self-report version of the Functional Independence Measure (care recipient self-reported Functional Independence Measure, caregiver self-reported Functional Independence Measure) and the Functional Autonomy Measurement System (evaluator perspective). They were administered at baseline (preintervention) and after the intervention at 6, 22, and 58 wks.

Results
Bivariate correlation analyses of 90 dyads consisting of older care recipients and their family caregivers reported moderate to very strong correlations between the three functional independence measures across all time points (r
S = 0.45–0.91, P < 0.01). Bland-Altman analyses revealed a small systematic bias between care recipient and caregiver assessments of functional independence, with participants reporting higher scores across all time points (mean difference = 2.00–2.97).

Conclusions
There is substantial consistency among the self-assessed, caregiver-assessed, and evaluator assessed functional independence of older adults. Caregivers may be used as proxies for community-dwelling older adults without severe cognitive impairments with functional limitations.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
After reviewing this article, readers will be able to: (1) Describe the strength of association between self-reported functional independence and observations of family caregivers in a heterogeneous population of community-dwelling older adults with disabilities over time; (2) Describe the level of agreement between self-reported functional independence and observations of family caregivers over time; and (3) Describe the associations among self-reported, caregiver reported and evaluator rated functional independence over time.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The Value of Histology in the Diagnosis of Tuberculous Spondylodiscitis
Authors: Romdhane Emna , Rammeh Soumaya , Riahi Hend , Chebbi Yosra , Mouna Chelli Bouaziz , Achour Wafa , Slim-Saidi Leila , Benaissa Hanène Tiouiri , Ladeb Mohamed Fethi 
Published: November 2018

Background
Tuberculous spondylodiscitis (TS) is the most common form of musculoskeletal tuberculosis. Currently, histology is widely used to distinguish tuberculous from nontuberculous disease.

Objectives
The aim of the present study was to assess the accuracy of histology compared with bacteriology in the diagnosis of TS.

Methods
This is a single-center case series carried out from January 2014 to February 2018 in a pathology department. It included 121 discovertebral biopsies of infective spondylodiscitis. The measures of diagnostic accuracy of histology were determined taking bacteriology as criterion standard.

Results
Among the 121 cases, 55 (45.4%) were diagnosed as TS by histological and/or bacteriological findings, 17 (30.9%) were classified as definite TS by bacteriology, and the remaining 38 (69.1%) had positive histology and negative bacteriology. There were 2 false-negatives, which histologically displayed suppuration without granuloma, and 3 false-positives; in one case, histology displayed granulomas without necrosis and culture isolated Brucella. In the 2 others, histology revealed granulomas with caseous-like necrosis and microbiology isolated fungal species. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of histology in the diagnosis of TS were 88.2%, 93.4%, 83.3%, 95.5%, and 92%, respectively.

Conclusions
Histology is proved to be an accurate diagnostic tool in TS. Suppurative forms of TS without granuloma are rare and represent the main cause of false-negative histology. Suggestive histology of TS does not rule out fungal and brucellar spondylodiscitis. Caseous necrosis is not pathognomonic of tuberculosis. Fungal infection can also exhibit such type of necrosis.
Individually Body Weight–Adapted Contrast Media Application in Computed Tomography Imaging of the Liver at 90 kVp
Authors: Martens Bibi , Hendriks Babs M.F. , Eijsvoogel Nienke G. , Wildberger Joachim E. , Mihl Casper 
Published: November 2018

Objectives
The aim of the present study was to evaluate the attenuation and image quality (IQ) of a body weight–adapted contrast media (CM) protocol compared with a fixed injection protocol in computed tomography (CT) of the liver at 90 kV.

Materials and Methods
One hundred ninety-nine consecutive patients referred for abdominal CT imaging in portal venous phase were included. Group 1 (n = 100) received a fixed CM dose with a total iodine load (TIL) of 33 g I at a flow rate of 3.5 mL/s, resulting in an iodine delivery rate (IDR) of 1.05 g I/s. Group 2 (n = 99) received a body weight–adapted CM protocol with a dosing factor of 0.4 g I/kg with a subsequent TIL adapted to the patients' weight. Injection time of 30 seconds was kept identical for all patients. Therefore, flow rate and IDR changed with different body weight. Patients were divided into 3 weight categories; 70 kg or less, 71 to 85 kg, and 86 kg or greater. Attenuation (HU) in 3 segments of the liver, signal-to-noise ratio, and contrast-to-noise ratio were used to evaluate objective IQ. Subjective IQ was assessed by a 5-point Likert scale. Differences between groups were statistically analyzed (P < 0.05 was considered statistically significant).

Results
No significant differences in baseline characteristics were found between groups. The CM volume and TIL differed significantly between groups (P < 0.01), with mean values in group 1 of 110 mL and 33 g I, and in group 2 of 104.1 ± 21.2 mL and 31.2 ± 6.3 g I, respectively. Flow rate and IDR were not significantly different between groups (P > 0.05). Body weight–adapted protocoling led to more homogeneous enhancement of the liver parenchyma compared with a fixed protocol with a mean enhancement per weight category in group 2 of 126.5 ± 15.8, 128.2 ± 15.3, and 122.7 ± 21.2 HU compared with that in group 1 of 139.9 ± 21.4, 124.6 ± 24.8, and 116.2 ± 17.8 HU, respectively.

Conclusions
Body weight–adapted CM injection protocols result in more homogeneous enhancement of the liver parenchyma at 90 kV in comparison to a fixed CM volume with comparable objective and subjective IQ, whereas overall CM volume can be safely reduced in more than half of patients.
Spatiotemporal proteomics uncovers cathepsin-dependent host cell death during bacterial infection
Authors: Selkrig Joel , Li Nan , Bobonis Jacob , Hausmann Annika , Sueki Anna , Imamura Haruna , El Debs Bachir , Sigismondo Gianluca , Florea Bogdan I. , Overkleeft Herman S. , Beltrao Pedro , Hardt Wolf-Dietrich , Krijgsveld Jeroen , Typas Athanasios 
Published: November 2018

SUMMARYImmune cells need to swiftly and effectively respond to invading pathogens. This response relies heavily on rapid protein synthesis and accurate cellular targeting to ensure pathogen destruction. In return, pathogens intercept this response to ensure their survival and proliferation. To gain insight into this dynamic interface, we combined click-chemistry with pulsed stable isotope labeling of amino acids (pSILAC-AHA) in cell culture to quantify the newly synthesised host proteome during macrophage infection with the model intracellular bacterial pathogen,Salmonella entericaTyphimurium (STm). We monitored newly synthesised proteins across different host cell compartments and infection stages, and used available proteomics data in response to lipopolysaccharide to deconvolute theSTm-specific response. Within this rich resource, we detected aberrant trafficking of lysosomal proteases to the extracellular space and the nucleus, the latter of which correlated with signatures of cell death. Pharmacological cathepsin inhibition suppressed Caspase-11 dependent macrophage cell death, thus demonstrating an active role for cathepsins duringSTm induced pyroptosis. Our study illustrates that resolving host proteome dynamics during infection can drive the discovery of biological mechanisms at the host-microbe interface.