bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness of a tailored Helicobacter pylori eradication strategy based on the presence of a 23S ribosomal RNA point mutation that causes clarithromycin resistance in Korean patients
Authors: Cho Jun‐Hyung , Jeon Seong Ran , Kim Hyun Gun , Jin So‐Young , Park Suyeon 
Published: July 2018

AbstractBackground and AimThe Helicobacter pylori eradication rate using conventional triple therapy has decreased due to clarithromycin (CAM) resistance in H. pylori. Recently, dual priming oligonucleotide (DPO)‐based multiplex polymerase chain reaction (PCR) can be used to detect H. pylori and point mutations in the 23S ribosomal RNA gene causing CAM resistance. This study aimed to evaluate the success rate and cost‐effectiveness of tailored H. pylori eradication using DPO‐PCR.MethodsThe H. pylori‐positive patients diagnosed by a rapid urease test or DPO‐PCR were enrolled from a single academic hospital. The patients with positive rapid urease test results received a CAM‐based triple regimen. In the tailored therapy group that underwent DPO‐PCR testing, patients with A2142G and/or A2143G point mutations were treated with a bismuth‐containing quadruple regimen. The cost‐effectiveness of H. pylori eradication success was evaluated according to the average cost per patient and the incremental cost‐effectiveness ratio.ResultsA total of 243 patients were allocated to the triple therapy group and 124 patients to the tailored therapy group. The first‐line eradication rate of H. pylori was significantly higher in the tailored therapy group than in the conventional triple therapy group (92.7% vs 76.5%, P < 0.001). The average costs per patient for tailored therapy were $307.37 and $299.59 for first‐line and second‐line treatments, respectively. Compared with triple therapy, the incremental cost‐effectiveness ratios of tailored therapy were $3.96 and −$3.81 per patient for first‐line and second‐line treatments, respectively.ConclusionIn Korea, tailored H. pylori eradication using DPO‐PCR may be more cost‐effective than conventional triple therapy.
Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity
Authors: Love Heather A. , Torgerson Chelsey N. 
Published: July 2018

The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self‐medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma‐related symptoms via alcohol or drug use. The purpose of this study is to identify through which specificPTSDsymptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N = 627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma‐informed approaches that aim to decrease arousal/reactivity and subsequently substance use.
Evaluation of the efficacy of transdermal drug delivery of calcipotriol plus betamethasone versus tacrolimus in the treatment of vitiligo
Authors: Ibrahim Zeinab A. , Hassan Ghada F. , Elgendy Hoda Y. , Al‐shenawy Hanan A. 
Published: July 2018

SummaryBackgroundVitiligo is a common pigmentary disorder affecting about 1% of the general population. There are numerous medical and surgical treatments. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. It is used also to augment transdermal drug delivery through pores created in the stratum corneum.AimTo evaluate the efficacy of microneedling with tacrolimus versus its efficacy with calcipotriol plus betamethasone in vitiligo treatment.MethodsTwenty‐five patients having vitiligo were selected and their symmetrical patches were divided into side A (right side) which received microneedling with dermapen and topical calcipotriol plus betamethasone and side B (left side) which received microneedling and topical tacrolimus. Every patient received a session every 2 weeks for a maximum 6 months (12 sessions) and follow‐up for 3 months. Skin biopsies were taken before and after the treatment to evaluate the clinical results.ResultsOn side A, 60% of the patients showed excellent improvement while 32% showed excellent response on side B. The mean percentage of improvement was significantly higher on side A than side B (P = 0.017*). It was effective in the most resistant sites of vitiligo such as: elbows, knees, extremities, and acral area. Histopathological examination showed a significant expression of HMB45 on side A more than side B (P = 0.005*).ConclusionThe combination of microneedling with calcipotriol plus betamethasone is more effective than its combination with tacrolimus. They are both effective in resistant sites. Both methods are safe, cheap, and good tolerated office techniques with minimal side effects.
Wrinkles, brown spots, and cancer: Relationship between appearance‐ and health‐based knowledge and sunscreen use
Authors: Cao Hongjing , Brehm Mary , Hynan Linda , Goff Heather W. 
Published: July 2018

SummaryBackgroundThere is increasing understanding that sunscreen use is associated with reduced photoaging and that appearance‐based messages are more effective than health‐based messages in promoting daily sunscreen use. We hypothesized that persons with greater awareness of the effects of photoaging use sunscreen more consistently.MethodsCross‐sectional survey of adults in Dallas, TX, assessing sunscreen‐related knowledge, behavior, and information source.ResultsEach respondent averaged 2.5 ± 1.7 hours of self‐reported sun exposure daily with the least reported time being 0.15 hours. Eighty‐eight percent reported that sun exposure caused skin cancer “a lot.” Eighty‐nine percent “agreed” or “strongly agreed” that “sun exposure causes most signs of skin aging.” Over 70% “agreed” or “strongly agreed” to an appearance‐based reason for their sunscreen use. Sixty‐six percent reported they would consider using sunscreen if anticipating sun exposure lasting 2 hours or less. Only 30% reported using sunscreen daily. Greater photoaging knowledge was positively associated with sunscreen adherence (at least P < 0.05 with each knowledge item). Those with darker complexions or skin less likely to burn reported less knowledge of photoaging (ρ = −0.219, P ≤ 0.001) and had lower sunscreen use (ρ = 0.301, P < 0.001).ConclusionDespite most respondents reporting knowledge of health and appearance risks of sun exposure and a motivation to prevent them with sunscreen, most do not use sunscreen adequately. This discrepancy could be due to people perceiving risks of sun exposure based on duration of continuous exposure. There may be misconceptions that short‐interval sun exposure that does not result in sunburn is less harmful than extended exposure.
The Impact of Delivery in a Rural County on a Cohort of Women Living with HIV Infection and Their Infants
Authors: Lazenby Gweneth B. , Powell Anna M. , Sullivan Scott A. , Soper David E. 
Published: July 2018

AbstractPurposeWe sought to determine if infants born in rural counties had an increased risk of contracting HIV.MethodsData were obtained from the South Carolina Department of Health and Environmental Control for all women living with HIV delivering from 2004 to 2014. In this retrospective cohort study, maternal and neonatal outcomes from urban and rural counties were compared. Binomial statistical analyses were conducted using Wilcoxon Rank Sum Tests, χ2 or Fisher's exact tests. Logistic regression analyses were performed to evaluate factors associated with perinatal HIV infection.FindingsSix hundred and sixty‐six women living with HIV had 868 pregnancies and delivered 885 infants; 17% (148) were born in rural counties. Eleven infants (1.2%) were diagnosed with perinatal HIV infection. The proportion of women taking antenatal antiretroviral therapy (ART) was similar between rural and urban counties (84% vs 87%; P = .3), but women in urban counties were more likely to have an HIV RNA viral load <40 copies/mL before delivery (32% vs 42%; P = .05). Factors associated with perinatal HIV infection were intra‐ and postpartum maternal HIV diagnosis (aOR 61.4 [95% CI: 6.7‐562.5]; P < .001), parenteral drug use (aOR 7.5 [1.6‐34.7]; P = .01), and preterm birth (<37 weeks gestation) (aOR 4.6 [1.2‐17.8]; P = .3).ConclusionsDelivery in a rural county was not associated with an increased risk of perinatal HIV transmission. Women delivering in rural counties taking ART were less likely to have HIV viral suppression, which is a risk factor for perinatal HIV infection.
Knockdown of a mucin‐like gene in Meloidogyne incognita (Nematoda) decreases attachment of endospores of Pasteuria penetrans to the infective juveniles and reduces nematode fecundity
Authors: Phani Victor , Shivakumara Tagginahalli N. , Davies Keith G , Rao Uma 
Published: July 2018

SummaryMucins are highly glycosylated polypeptides involved in many host–parasite interactions, but their function in plant‐parasitic nematodes is still unknown. In this study, a mucin‐like gene was cloned from Meloidogyne incognita (Mi‐muc‐1, 1125 bp) and characterized. The protein was found to be rich in serine and threonine with numerous O‐glycosylation sites in the sequence. Quantitative real‐time polymerase chain reaction (qRT‐PCR) showed the highest expression in the adult female and in situ hybridization revealed the localization of Mi‐muc‐1 mRNA expression in the tail area in the region of the phasmid. Knockdown of Mi‐muc‐1 revealed a dual role: (1) immunologically, there was a significant decrease in attachment of Pasteuria penetrans endospores and a reduction in binding assays with human red blood cells (RBCs), suggesting that Mi‐MUC‐1 is a glycoprotein present on the surface coat of infective second‐stage juveniles (J2s) and is involved in cellular adhesion to the cuticle of infective J2s; pretreatment of J2s with different carbohydrates indicated that the RBCs bind to J2 cuticle receptors different from those involved in the interaction of Pasteuria endospores with Mi‐MUC‐1; (2) the long‐term effect of RNA interference (RNAi)‐mediated knockdown of Mi‐muc‐1 led to a significant reduction in nematode fecundity, suggesting a possible function for this mucin as a mediator in the interaction between the nematode and the host plant.
Silenced retrotransposons are major rasiRNAs targets in Arabidopsis galls induced by Meloidogyne javanica
Authors: Ruiz‐Ferrer Virginia , Cabrera Javier , Martinez‐Argudo Isabel , Artaza Haydeé , Fenoll Carmen , Escobar Carolina 
Published: July 2018

SUMMARYRoot‐knot nematodes (RKNs, Meloidogyne spp.) are sedentary biotrophic pathogens that establish within the vascular cylinder of plant roots, forming a gall and inducing several feeding cells, giant cells (GCs), essential for completion of their life cycle. GCs suffer gene expression changes, repeated mitosis and endoreduplication events. Transcriptomics has revealed that an extensive down‐regulation of transcripts, a molecular signature of early‐developing galls and GCs that is conserved in tomato and Arabidopsis, may be achieved through small RNA (sRNA) gene silencing pathways. The role of some microRNAs (miRNAs) in plant–RKN interactions has recently been addressed, but little is known about the regulatory roles of other sRNA types. Here, we perform a differential accumulation analysis to show which repeat‐associated small interfering RNAs (rasiRNAs) are distinctive or enriched in early Arabidopsis galls vs. uninfected roots. Those distinctive from galls are preferentially located in pericentromeric regions with predominant sizes of 24 and 22 nucleotides. Gall‐distinctive rasiRNAs target primarily GYPSY and COPIA retrotransposons, which show a marked repression in galls vs. uninfected roots. Infection tests and phenotypic studies of galls from Meloidogyne javanica in Arabidopsis mutants impaired in post‐transcriptional gene silencing and/or canonical RNA‐directed DNA methylation (RdDM) pathways, as well as quantitative polymerase chain reaction analysis, suggest the implication of canonical and non‐canonical RdDM pathways during gall formation, possibly through the regulation of retrotransposons. This process may be crucial for the maintenance of genome integrity during the reprogramming process of galls/GCs from their vascular precursor cells, and/or to ensure a faithful DNA replication during the repeated mitosis/endoreduplication that concurs with feeding site formation.
Molecular mechanisms that limit the costs of NLR‐mediated resistance in plants
Authors: Richard Manon M. S. , Gratias Ariane , Meyers Blake C. , Geffroy Valérie 
Published: July 2018

SummaryCrop diseases cause significant yield losses, and the use of resistant cultivars can effectively mitigate these losses and control many plant diseases. Most plant resistance (R) genes encode immune receptors composed of nucleotide‐binding and leucine‐rich repeat (NLR) domains. These proteins mediate the specific recognition of pathogen avirulence effectors to induce defence responses. However, NLR‐triggered immunity can be associated with a reduction in growth and yield, so‐called ‘fitness costs’. Recent data have shown that plants use an elaborate interplay of different mechanisms to control NLR gene transcript levels, as well as NLR protein abundance and activity, to avoid the associated cost of resistance in the absence of a pathogen. In this review, we discuss the different levels of NLR regulation (transcriptional, post‐transcriptional and at the protein level). We address the apparent need for plants to maintain diverse modes of regulation. A recent model suggesting an equilibrium ‘ON/OFF state’ of NLR proteins, in the absence of a pathogen, provides the context for our discussion.
Multidimensional improvement in connective tissue disease‐associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low‐dose prednisone and tacrolimus
Authors: Yamano Yasuhiko , Taniguchi Hiroyuki , Kondoh Yasuhiro , Ando Masahiko , Kataoka Kensuke , Furukawa Taiki , Johkoh Takeshi , Fukuoka Junya , Sakamoto Koji , Hasegawa Yoshinori 
Published: July 2018

ABSTRACTBackground and objectiveCorticosteroids and immunosuppressive agents are considered mainstays of therapy for connective tissue disease‐related interstitial lung disease (CTD‐ILD); however, tacrolimus with corticosteroid therapy has not been fully investigated. Our objectives were to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD‐ILD.MethodsIn this retrospective case series, we identified consecutive CTD‐ILD patients treated with tacrolimus plus intravenous (i.v.) methylprednisolone (1000 mg i.v. 3 days a week for 2 weeks) followed by low‐dose prednisolone (10 mg/day). We assessed the multidimensional therapeutic benefit and tolerability including lung physiology, exercise capacity, exercise oxygen desaturation, modified Medical Research Council (MMRC) and St George's Respiratory Questionnaire (SGRQ).ResultsA total of 26 ILD patients with the underlying CTD diagnoses included 11 with rheumatoid arthritis, 9 with dermatomyositis, 4 with Sjögren's syndrome and 2 others. From baseline to 12 months, the combined therapy significantly improved forced vital capacity (FVC; 77.8% to 94.6%, P < 0.001), diffusing capacity of the lung for carbon monoxide (DLCO; 66.1% to 75.1%, P < 0.001), 6‐min walk distance (6MWD; 530 to 568 m, P = 0.02), lowest oxygen saturation on pulse oximetry (SpO2; 85% to 89%, P = 0.01), MMRC (1.3 to 0.8, P = 0.01) and SGRQ (38 to 21, P < 0.001). During the study period, only one patient's therapy was discontinued due to an adverse event and none had a life‐threatening adverse event attributed to the combined therapy.ConclusionIn our cohort of CTD‐ILD, two courses of pulse dose methylprednisolone therapy followed by prednisone and oral tacrolimus appeared to be well tolerated, and to have multidimensional efficacy.
Fecal microbiota transplantation for recurrent Clostridium difficile infection in patients with solid organ transplants: an institutional experience and review of the literature
Authors: Lin Steven C. , Alonso Carolyn D. , Moss Alan C. 
Published: July 2018

AbstractClostridium difficile, an anaerobic gram‐positive, spore‐forming bacillus, has become the most common cause of nosocomial infectious diarrhea, and is associated with increased mortality in all populations. Patients who have received solid organ transplants (SOT) are at increased risk of Clostridium difficile infection (CDI) and CDI recurrence (rCDI). This may be related to chronic immunosuppression, frequent antibiotic exposure, and increased or prolonged hospitalizations. Increased morbidity and mortality from CDI is well‐described in SOT patients. Conventional treatments for index and recurrent CDI include vancomycin and fidaxomicin. Fecal microbiota transplantation has emerged as an effective and safe alternative for treating rCDI in the general population. Reports of its safety in certain immunocompromised populations, such as those with inflammatory bowel disease, appear reassuring, but outcomes among SOT patients are less well known. Here, we summarize the experiences published to date on the treatment of rCDI with FMT in SOT patient, and also describe our detailed FMT protocol and experience in treating a series of SOT patients with rCDI. In addition to reporting the safety and efficacy of our FMT experience, we also discuss the diagnostic challenges and considerations in this population of solid organ transplant recipients.
Epidemiology and outcomes of Clostridium difficile infection among hospitalised patients: results of a multicentre retrospective study in South Africa
Authors: Legenza Laurel , Barnett Susanne , Rose Warren , Bianchini Monica , Safdar Nasia , Coetzee Renier 
Published: July 2018

IntroductionLimited data exist on Clostridium difficile infection (CDI) in low-resource settings and settings with high prevalence of HIV. We aimed to determine baseline CDI patient characteristics and management and their contribution to mortality.MethodsWe reviewed adult patients hospitalised with diarrhoea and a C. difficile test result in 2015 from four public district hospitals in the Western Cape, South Africa. The primary outcome measures were risk factors for mortality. Secondary outcomes were C. difficile risk factors (positive vs negative) and CDI treatment.ResultsCharts of patients with diarrhoea tested for C. difficile (n=250; 112 C. difficile positive, 138 C. difficile negative) were reviewed. The study population included more women (65%). C. difficile-positive patients were older (46.5 vs 40.7 years, p<0.01). All-cause mortality was more common in the C. difficile-positive group (29% vs 8%, p<0.0001; HR 2.0, 95% CI 1.1 to 3.6). Tuberculosis (C. difficile positive 54% vs C. difficile negative 32%, p<0.001), 30-day prior antibiotic exposure (C. difficile positive 83% vs C. difficile negative 46%, p<0.001) and prior hospitalisation (C. difficile positive 55% vs C. difficile negative 22%, p<0.001) were also more common in the C. difficile-positive group. C. difficile positive test result (OR 4.7, 95% CI 2.0 to 11.2; p<0.001), male gender (OR 2.8, 95% CI 1.1 to 7.2; p=0.031) and tuberculosis (OR 2.3, 95% CI 1.0 to 5.0; p=0.038) were independently associated with mortality. Of patients starting treatment, metronidazole was the most common antimicrobial therapy initiated (70%, n=78); 32 C. difficile-positive (29%) patients were not treated.ConclusionPatients testing positive for C. difficile are at high risk of mortality at public district hospitals in South Africa. Tuberculosis should be considered an additional risk factor for CDI in populations with high tuberculosis and HIV comorbidity. Interventions for CDI prevention and management are urgently needed.
Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study
Authors: Dalton Bethan , Bartholdy Savani , McClelland Jessica , Kekic Maria , Rennalls Samantha J , Werthmann Jessica , Carter Ben , O’Daly Owen G , Campbell Iain C , David Anthony S , Glennon Danielle , Kern Nikola , Schmidt Ulrike 
Published: July 2018

ObjectiveTreatment options for severe, enduring anorexia nervosa (SE-AN) are limited. Non-invasive neuromodulation is a promising emerging intervention. Our study is a feasibility randomised controlled trial of repetitive transcranial magnetic stimulation (rTMS) in individuals with SE-AN, which aims to inform the design of a future large-scale trial.DesignDouble-blind, parallel group, two-arm, sham-controlled trial.SettingSpecialist eating disorders centre.ParticipantsCommunity-dwelling people with anorexia nervosa, an illness duration of ≥3 years and at least one previous completed treatment.InterventionsParticipants received 20 sessions (administered over 4 weeks) of MRI-guided real or sham high-frequency rTMS to the left dorsolateral prefrontal cortex in addition to treatment-as-usual.OutcomesPrimary outcomes were recruitment, attendance and retention rates. Secondary outcomes included body mass index (BMI), eating disorder symptoms, mood, quality of life and rTMS safety and tolerability. Assessments were conducted at baseline, post-treatment and follow-up (ie, at 0 month, 1 month and 4 months post-randomisation).ResultsThirty-four participants (17 per group) were randomly allocated to real or sham rTMS. One participant per group was withdrawn prior to the intervention due to safety concerns. Two participants (both receiving sham) did not complete the treatment. rTMS was safe and well tolerated. Between-group effect sizes of change scores (baseline to follow-up) were small for BMI (d=0.2, 95% CI −0.49 to 0.90) and eating disorder symptoms (d=0.1, 95% CI −0.60 to 0.79), medium for quality of life and moderate to large (d=0.61 to 1.0) for mood outcomes, all favouring rTMS over sham.ConclusionsThe treatment protocol is feasible and acceptable to participants. Outcomes provide preliminary evidence for the therapeutic potential of rTMS in SE-AN. Largest effects were observed on variables assessing mood. This study supports the need for a larger confirmatory trial to evaluate the effectiveness of multi-session rTMS in SE-AN. Future studies should include a longer follow-up period and an assessment of cost-effectiveness.Trial registration numberISRCTN14329415; Pre-results.