bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Effectiveness of Azithromycin and Doxycycline in Uncomplicated Rectal and Vaginal Chlamydia trachomatis Infections in Women: A Multicenter Observational Study (FemCure)
Authors: Dukers-Muijrers Nicole H T M , Wolffs Petra F G , De Vries Henry , Götz Hannelore M , Heijman Titia , Bruisten Sylvia , Eppings Lisanne , Hogewoning Arjan , Steenbakkers Mieke , Lucchesi Mayk , Schim van der Loeff Maarten F , Hoebe Christian J P A 
Published: January 2019

AbstractBackgroundRectal infections with Chlamydia trachomatis (CT) are prevalent in women visiting a sexually transmitted infection outpatient clinic, but it remains unclear what the most effective treatment is. We assessed the effectiveness of doxycycline and azithromycin for the treatment of rectal and vaginal chlamydia in women.MethodsThis study is part of a prospective multicenter cohort study (FemCure). Treatment consisted of doxycycline (100 mg twice daily for 7 days) in rectal CT–positive women, and of azithromycin (1 g single dose) in vaginally positive women who were rectally untested or rectally negative. Participants self-collected rectal and vaginal samples at enrollment (treatment time-point) and during 4 weeks of follow-up. The endpoint was microbiological cure by a negative nucleic acid amplification test at 4 weeks. Differences between cure proportions and 95% confidence intervals (CIs) were calculated.ResultsWe analyzed 416 patients, of whom 319 had both rectal and vaginal chlamydia at enrollment, 22 had rectal chlamydia only, and 75 had vaginal chlamydia only. In 341 rectal infections, microbiological cure in azithromycin-treated women was 78.5% (95% CI, 72.6%–83.7%; n = 164/209) and 95.5% (95% CI, 91.0%–98.2%; n = 126/132) in doxycycline-treated women (difference, 17.0% [95% CI, 9.6%–24.7%]; P &lt; .001). In 394 vaginal infections, cure was 93.5% (95% CI, 90.1%–96.1%; n = 246/263) in azithromycin-treated women and 95.4% (95% CI, 90.9%–98.2%; n = 125/131) in doxycycline-treated women (difference, 1.9% [95% CI, –3.6% to 6.7%]; P = .504).ConclusionsThe effectiveness of doxycycline is high and exceeds that of azithromycin for the treatment of rectal CT infections in women.Clinical Trials RegistrationNCT02694497.
The Juncture Between Clostridioides difficile Infection and Inflammatory Bowel Diseases
Authors: Beniwal-Patel Poonam , Stein Daniel J , Munoz-Price L Silvia 
Published: January 2019

AbstractThe detection of Clostridioides difficile in inflammatory bowel disease (IBD) patients is a common occurrence, in part due to the standard clinical practice of testing for the presence of C. difficile during acute IBD exacerbations. Given the clinical overlap between C. difficile infections and acute IBD exacerbations (ie, increased frequency of loose stools, abdominal pain), it is hard to differentiate C. difficile infections versus colonizations in patients with underlying IBD who test positive for C. difficile. Here, we review the epidemiology, clinical presentation, risk factors, diagnosis, treatment, and outcomes of IBD patients with positive C. difficile tests.
Relevant Infections in Inflammatory Bowel Disease, and Their Relationship With Immunosuppressive Therapy and Their Effects on Disease Mortality
Authors: Zabana Yamile , Rodríguez Lorena , Lobatón Triana , Gordillo Jordi , Montserrat Antonia , Mena Raquel , Beltrán Belén , Dotti Marina , Benitez Olga , Guardiola Jordi , Domènech Eugeni , Garcia-Planella Esther , Calvet Xavier , Piqueras Marta , Aceituno Montserrat , Fernández-Bañares Fernando , Esteve Maria 
Published: January 2019

Abstract

Background and Aims
There is controversy as to whether the risk of relevant infection in IBD is related to immunosuppressants or the disease itself. The aims of this study were to evaluate: [1] the life-long prevalence and types of relevant infections in patients with IBD related to immunosuppressive treatment, and [2] the relationship of both infection and patient comorbidity to mortality.

Methods
Observational multicentre retrospective study of IBD patients that presented a relevant infection. For each case, four periods of infection exposure were analysed: P1: pre-IBD diagnosis, P2: from IBD diagnosis to immunosuppressant initiation, P3: during immunosuppressant therapy, and P4: after treatment withdrawal.

Results
The life-long prevalence of relevant infection in the total cohort of patients [6914] was 3%, and 5% in immunosuppressed patients [4202]. 366 relevant infections were found in 212 patients [P1: 9, P2: 17, P3: 334, and P4: 6]. Differences between periods were significant [p &lt; 0.0001]. The most frequent types of infection were respiratory, intestinal and urinary. The most frequent opportunistic infections were tuberculosis [prevalence: 2.6/1000] and herpes zoster [prevalence: 3.9/1000]. Herpes zoster infection was associated with thiopurines alone or in combination with anti-TNF in 75% of the cases, whereas tuberculosis was associated with anti-TNF in 94% of patients. The overall mortality was 4.2%. Infection-related mortality was 2.8% and it was not influenced by comorbidity.

Conclusions
Relevant infections in IBD patients are rare and appear to be related to immunosuppression. Relevant infection is a major cause of death in IBD.
Why Parental Unemployment Matters for Children’s Educational Attainment: Empirical Evidence from The Netherlands
Authors: Mooi-Reci Irma , Bakker Bart , Curry Matthew , Wooden Mark 
Published: January 2019

Abstract
This study examines the effect of parents’ unemployment on their children’s subsequent educational attainment. Its theoretical significance lies on its focus to test the mediating role of parents’ changing work ethics during spells of unemployment. Integrating multiple survey and administrative data sources, our estimates are based on a sample of Dutch children (n = 812) who were exposed to their parents’ unemployment during the previous economic crisis in the early 1980s. Our results reveal a direct negative effect between fathers’ unemployment duration and their children’s educational attainment and also an indirect effect through mothers’ changing attitudes towards work. We also find empirical evidence that mothers’ and fathers’ whose views about work become more pessimistic lead to reduced educational attainment among their children.
Blockade of the fractalkine–CX3CR1 axis ameliorates experimental colitis by dislodging venous crawling monocytes
Authors: Kuboi Yoshikazu , Nishimura Miyuki , Ikeda Wataru , Nakatani Tomoya , Seki Yukie , Yamaura Yui , Ogawa Kana , Hamaguchi Akiko , Muramoto Kenzo , Mizuno Keiko , Ogasawara Hideaki , Yamauchi Toshihiko , Yasuda Nobuyuki , Onodera Hiroshi , Imai Toshio 
Published: January 2019

AbstractChemokine systems modulate inflammatory and immune responses in inflammatory bowel disease (IBD). The colons of IBD patients show increased levels of fractalkine (FKN) and high numbers of FKN receptor-positive (CX3CR1+) cells; however, the FKN–CX3CR1 axis’s role in intestinal inflammation, especially in intravascular leukocyte behaviors, still remains unclear. Here, we show that interruption of the FKN–CX3CR1 axis by anti-FKN monoclonal antibody (mAb) ameliorates murine colitis through regulation of intravascular monocyte behaviors in murine colitis models. FKN expression was detectable in vascular endothelium and CX3CR1+ macrophages accumulated in the mucosal lamina propria and submucosa of the inflamed colons. CD115+ monocytes tethered to the venous endothelium and expressed pro-inflammatory mediators. The anti-FKN mAb improved colitis symptoms, markedly reduced pro-inflammatory factors in the colon, maintained blood vessel integrity and reduced tethered monocytes in the inflamed veins. Intravital imaging revealed that CD115+Gr-1low/− monocytes crawled on the apical surfaces of venous endothelium, and anti-FKN mAb rapidly dislodged the crawling monocytes and inhibited their patrolling behavior. These findings suggest that the FKN–CX3CR1 axis triggers the patrolling behavior of crawling monocytes on the venous endothelium of inflamed colons, and accelerates the subsequent leukocyte activation and infiltration by locally producing inflammatory cytokines and chemokines. The mAb also ameliorated symptoms in another IBD model, T-cell-transferred colitis. Blocking the FKN–CX3CR1 axis with an anti-FKN mAb considerably inhibits the colitis-triggered inflammatory cascades, which may be an alternative strategy to treat IBD.
Gemini IFU, VLA, and HST observations of the OH Megamaser Galaxy IRAS17526 + 3253★
Authors: Sales Dinalva A , Robinson A , Riffel R A , Storchi-Bergmann T , Gallimore J F , Kharb P , Baum S , O’Dea C , Hekatelyne C , Ferrari F 
Published: January 2019

AbstractWe present a multiwavelength study of the OH megamaser galaxy IRAS17526 + 3253, based on new Gemini multi-object spectrograph integral field unit (GMOS/IFU) observations, Hubble Space Telescope F814W, and H α + [N ii] images, and archival 2MASS and 1.49 GHz VLA data. The Hubble Space Telescope(HST) images clearly reveal a mid-to-advanced stage major merger whose northwestern and southeastern nuclei have a projected separation of ∼8.5 kpc. Our HST/H α + [N ii] image shows regions of ongoing star formation across the envelope on ∼10 kpc scales, which are aligned with radio features, supporting the interpretation that the radio emission originates from star-forming regions. The measured H α luminosities imply that the unobscured star formation rate (SFR) is ∼10–30 M⊙ yr−1. The GMOS/IFU data reveal two structures in northwestern separated by 850 pc and by a discontinuity in the velocity field of ∼ 200 km s−1. We associate the blueshifted and redshifted components with, respectively, the distorted disc of northwestern and tidal debris, possibly a tail originating in southeastern. Star formation is the main ionization source in both components, which have SFRs of ∼2.6–7.9 M⊙ yr−1 and ∼1.5–4.5 M⊙ yr−1, respectively. Fainter line emission bordering these main components is consistent with shock ionization at a velocity ∼200 km s−1 and may be the result of an interaction between the tidal tail and the northwestern galaxy’s disc. IRAS17526 + 3253 is one of only a few systems known to host both luminous OH and H2O masers. The velocities of the OH and H2O maser lines suggest that they are associated with the northwestern and southeastern galaxies, respectively (Martin et al.; Wagner).
A short and sudden increase of the magnetic field strength and the accompanying spectral variability in the O9.7 V star HD 54879
Authors: Hubrig S , Küker M , Järvinen S P , Kholtygin A F , Schöller M , Ryspaeva E B , Sokoloff D D 
Published: January 2019

Abstract
Only 11 O-type stars have been confirmed to possess large-scale organized magnetic fields. The presence of a −600 G longitudinal magnetic field in the O9.7 V star HD 54879 with a lower limit of the dipole strength of ∼2 kG was discovered a few years ago in the framework of the ESO large program ‘B-fields in OB stars’. Our FORS 2 spectropolarimetric observations from 2017 October 4 to 2018 February 21 reveal the presence of short- and long-term spectral variability and a gradual magnetic field decrease from about −300 G down to about −90 G. Different scenarios are discussed in an attempt to interpret our observations. Our FORS 2 radial velocity measurements indicate that HD 54879 is a member of a long-period binary.
Clinical impact of subgrouping ANCA-associated vasculitis according to antibody specificity beyond the clinicopathological classification
Authors: Deshayes Samuel , Martin Silva Nicolas , Khoy Kathy , Yameogo Seydou , Mariotte Delphine , Lobbedez Thierry , Aouba Achille 
Published: January 2019

Abstract

Objectives
In ANCA-associated vasculitis (AAV), classifications have emerged to individualize homogeneous clinical and outcomes patterns, including the recently defined anti-MPO granulomatosis with polyangiitis (GPA) subgroup. This study aimed to retrospectively evaluate the impacts of re-classification based on clinicopathological criteria and/or ANCA specificity.

Methods
A retrospective monocentric study conducted at Caen University Hospital led to the identification of PR3 or MPO-ANCA AAV patients from January 2000 or September 2011, respectively, to June 2016. Eosinophilic GPA patients were excluded. AAVs were thereby also classified either as GPA or microscopic polyangiitis (MPA) according to the European Medicines Agency vasculitis algorithm.

Results
A total of 150 AAV patients were included (94 GPA, 56 MPA; 87 anti-PR3 and 63 anti-MPO patients). GPA patients exhibited a worse relapse-free survival but a better renal survival (P &lt; 0.001 and P = 0.021, respectively) than MPA patients. Overall, relapse-free and renal survival rates were similar between anti-PR3 and anti-MPO patients (P = 0.35, 0.17 and 0.15, respectively). Similarly, the prognosis was identical between anti-MPO MPA patients and anti-PR3 MPA patients (P = 0.33, 0.19 and 0.65, respectively), and between anti-MPO GPA patients and anti-PR3 GPA patients (P = 0.06, 0.99 and 0.64, respectively). Moreover, anti-PR3 GPA and anti-MPO GPA patients exhibited no differences in clinical manifestations or BVAS score.

Conclusion
Clinicopathological classification appeared to be the strongest criterion for distinguishing among homogeneous prognoses of AAV. Individualizing the anti-MPO GPA subgroup does not appear to bring additional value to clinical practice, but multicentre studies are required to confirm this trend.
Quantitative Analysis of Heel Skin Microcirculation Using Laser Doppler Flowmetry and Tissue Spectrophotometry
Authors: Held Manuel , Bender Dominik , Krauß Sabrina , Wenger Andrea , Daigeler Adrien , Rothenberger Jens 
Published: January 2019

ABSTRACT

OBJECTIVE:
To examine perfusion changes in the heel skin of individuals with and without diabetes mellitus to understand how skin is pathologically affected by diabetes mellitus.

METHODS:
This case-control study was conducted at an academic hospital in Tuebingen, Germany. A total of 30 subjects were enrolled in the study: 15 with known type 2 diabetes mellitus and 15 without. Each subject was asked to lie in a supine position on a hard lateral transfer mat for 10 minutes.

MAIN OUTCOME MEASURES:
Heel perfusion was quantitatively assessed directly after relief of pressure and after 3 and 6 minutes after relief of pressure using laser Doppler flowmetry and tissue spectrophotometry.

MAIN RESULTS:
Directly after relief of pressure, blood flow increased in the superficial skin layers (2 mm below the surface of the skin) in both groups. However, in deep skin layers (8 mm below the surface of the skin), blood flow increased in patients with diabetes mellitus and decreased in healthy patients. Oxygen saturation (SO2) was higher in healthy subjects directly after pressure relief.

CONCLUSIONS:
The increase in blood flow in superficial skin layers indicates reactive hyperemia after exposure in both groups. The prolonged hyperemia in deep skin layers in patients with diabetes indicates increased tissue vulnerability. Despite the increase in blood flow in deep skin layers, the SO2 and thus supply of tissue in patients with diabetes were reduced.
Diagnosis and Management of Cutaneous Psoriasis: A Review
Authors: Brandon Alisa , Mufti Asfandyar , Gary Sibbald R. 
Published: January 2019

ABSTRACT
Psoriasis is a chronic inflammatory disease that is characterized by plaque, inverse, guttate, pustular, and erythrodermic variants. This review focuses on the epidemiology, diagnosis, and treatment of cutaneous psoriasis. Other related topics discussed include peristomal psoriasis, the Koebner phenomenon, and the relationship between biologic therapy and wound complications.

GENERAL PURPOSE:
To provide information about the diagnosis and management of cutaneous psoriasis.

TARGET AUDIENCE:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:
After completing this continuing education activity, the provider should be better able to:
Role of the Hospital in the 21st Century Opioid Overdose Epidemic: The Addiction Medicine Consult Service
Authors: Priest Kelsey C. , McCarty Dennis 
Published: January 2019

Objective:
The aim of the study was to explore and describe the structure and design elements of addiction medicine consult (AMC) services within selected US hospitals.

Methods:
As part of a larger mixed methods study, 10 qualitative semi-structured telephone interviews were completed with board-certified addiction medicine physicians affiliated with the Addiction Medicine Foundation's Addiction Medicine Fellowship Programs at 9 US hospitals. Interviews were transcribed, coded, and analyzed using a directed content analysis.

Results:
Interviews completed with established AMC services in 9 hospitals probed AMC structure and design commonalities and differences across 4 domains: (1) availability and coverage, (2) team composition, (3) scope and responsibility, and (4) financing. Only 1 service provided weekend consults and most services did not provide coverage in the emergency department. Interprofessional teams were common with a variety of discipline combinations. AMC service scope and responsibility, generally, included 3 types of activities: (1) education and culture change, (2) the delivery of psychosocial and medical services, and (3) hospital guidance document development. Finally, most AMC services existed within a fragile financial environment with idiosyncratic arrangements.

Conclusions:
As opioid use disorder (OUD)-related hospitalizations increase stakeholders look to innovative care delivery mechanisms to improve care and outcomes for persons with OUD. The implementation of an AMC service may be an organizational intervention for achieving these aims. Understanding the shared and different approaches to AMC service structure and design is an important first step for delivery systems interested in implementing or expanding these services.
Predictors for 30-Day and 90-Day Hospital Readmission Among Patients With Opioid Use Disorder
Authors: Moreno Jessica L. , Wakeman Sarah E. , Duprey Matthew S. , Roberts Russell J. , Jacobson Jared S. , Devlin John W. 
Published: January 2019

Objectives:
To identify the incidence, characteristics, and predictors for 30 and 90-day readmission among acutely hospitalized patients with opioid use disorder (OUD).

Methods:
This retrospective, cohort study evaluated consecutive adults with OUD admitted to an academic medical center over a 5-year period (10/1/11 to 9/30/16). Multivariable logistic regression was used to determine independent predictors for 30 and 90-day readmissions based on pertinent admission, hospital, and discharge variables collected via chart review and found to be different (with a P < 0.10) on univariate analysis.

Results:
Among the 470 adults (mean age 43.1 ± 12.8 years, past heroin use 77.9%; admission opioid agonist therapy use [buprenorphine 22.6%; methadone 27.0%]; medical [vs surgical] admission 75.3%, floor [vs ICU] admission 93.0%, in-hospital mortality 0.9%), 85 (18.2%) and 151 (32.1%) were readmitted within 30 and 90 days, respectively. Among the 90-day readmitted patients, median time to first readmission was 26 days. Buprenorphine use (vs no use) at index hospital admission was independently associated with reduced 30-day (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.24–0.93) and 90-day (OR 0.57, 95% CI 0.34–0.96) readmission; prior heroin (vs prescription opioid) use was associated with reduced 90-day readmission (OR 0.59, 95% CI 0.37–0.94) and length of hospital stay was associated with both greater 30-day (OR 1.02, 95% CI 1.01–1.05) and 90-day (OR 1.04, 95% CI 1.01–1.06) readmission rates.

Conclusions:
Among patients with OUD taking buprenorphine at the time of hospital admission, 30-day and 90-day hospital readmission was reduced by 53% and 43%, respectively.
A Dosimetry Study of Portable X-ray Fluorescence in Vivo Metal Measurements
Authors: Specht Aaron J. , Zhang Xinxin , Goodman Benjamin D. , Maher Ed , Weisskopf Marc G. , Nie Linda H. 
Published: January 2019

Abstract
Portable x-ray fluorescence devices have grown in popularity for possible metal exposure assessment using in vivo measurements of bone and toenail. These measurements are accompanied by a small radiation dose, which is typically assessed by radiation safety committees to be minimal. However, an understanding of precise dose under different instrument conditions is still needed. This study set out to do a thorough investigation of the exact dose measurements using optically stimulated dosimeters, thermoluminescent dosimeters, and simulation with a Monte Carlo N-Particle transport code to assess the skin and total-body effective dose typical of portable x-ray fluorescence devices. We showed normal linear relationships between measurement time, x-ray tube current, and radiation dose with the device, and we showed a second order polynomial relationship with increasing voltage and radiation dose. Dose was quantified using thermoluminescent dosimeters, optically stimulated dosimeters, and simulations, which gave similar dose estimations. Skin dose for a standard 50-kV, 40-μA measurement for bone and toenail in vivo was 48.5 and 28.7 mSv, respectively, according to simulation results. Total-body effective dose was shown as 3.4 and 2.0 μSv for in vivo bone and toenail measurements, respectively, for adults using the portable x-ray fluorescence device.
Seminal vesicle metastasis after liver transplantation for hepatocellular carcinoma
Authors: Shen Yonghua , Nie Ling , Yao Yuling , Yuan LiQing , Liu Zhenqing , Lv Ying 
Published: January 2019

Abstract

Rationale:
Cancer recurrence and metastasis after liver transplantation (LT) is common in some hepatocellular carcinoma (HCC) patients. The most common sites of extrahepatic metastases are lung, regional lymph node, adrenal gland, and bone. To our knowledge, HCC metastasis to the seminal vesicle after LT has not been reported in the literature.

Patient concerns:
A 56-year-old Asian man presented at hospital with a 9-year history of orthotopic LT because of HCC. The patient underwent surgery and radiotherapy for HCC metastasis to adrenal gland and 1 year later, chemotherapy for peritoneal metastasis. A few months later, the patient presented with computed tomography (CT) image showing masses in right lobe of liver, seminal vesicle, and space occupying mass between the spleen and stomach.

Diagnoses:
Combination of clinical and pathological features revealed the seminal vesicle mass as metastasis from HCC.

Interventions:
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for liver and seminal vesicle lesions was performed and the postoperative pathology revealed malignancy. Thus, the patient underwent surgery and the diagnosis of seminal vesicle metastasis of HCC was confirmed by pathology and immunohistochemical analysis.

Outcomes:
The patient died due to systemic failure.

Lessons:
Seminal vesicle metastasis from HCC after LT is rare and there is no consensus on its treatment. Further research into the pathogenesis and therapy of seminal vesicle from HCC after LT is needed to improve outcomes in the rare disease.