bluuebunny/crossref_metadata_2025_split huggingface dataset:
[18F]fluorothymidine and [18F]fluorodeoxyglucose PET Imaging Demonstrates Uptake and Differentiates Growth in Neurofibromatosis 2 Related Vestibular Schwannoma
Authors: Anton-Rodriguez Jose M. , Lewis Daniel , Djoukhadar Ibrahim , Russell David , Julyan Peter , Coope David , King Andrew T. , Lloyd Simon K. L. , Evans D. Gareth , Jackson Alan , Matthews Julian C. 
Published: April 2019

Objective:
To investigate whether [18F]fluorothymidine (FLT) and/or [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) can differentiate growth in neurofibromatosis 2 (NF2) related vestibular schwannomas (VS) and to evaluate the importance of PET scanner spatial resolution on measured tumor uptake.

Methods:
Six NF2 patients with 11 VS (4 rapidly growing, 7 indolent), were scanned with FLT and FDG using a high-resolution research tomograph (HRRT, Siemens) and a Siemens Biograph TrueV PET-CT, with and without resolution modeling image reconstruction. Mean, maximum, and peak standardised uptake values (SUV) for each tumor were derived and the intertumor correlation between FDG and FLT uptake was compared. The ability of FDG and FLT SUV values to discriminate between rapidly growing and slow growing (indolent) tumors was assessed using receiver operator characteristic (ROC) analysis.

Results:
Tumor uptake was seen with both tracers, using both scanners, with and without resolution modeling. FDG and FLT uptake was correlated (R2 = 0.67–0.86, p < 0.01) and rapidly growing tumors displayed significantly higher uptake (SUVmean and SUVpeak) of both tracers (p < 0.05, one tailed t test). All of the PET analyses performed demonstrated better discriminatory power (AUCROC range = 0.71–0.86) than tumor size alone (AUCROC = 0.61). The use of standard resolution scanner with standard reconstruction did not result in a notable deterioration of discrimination accuracy.

Conclusion:
NF2 related VS demonstrate uptake of both FLT and FDG, which is significantly increased in rapidly growing tumors. A short static FDG PET scan with standard clinical resolution and reconstruction can provide relevant information on tumor growth to aid clinical decision making.
Diagnostic accuracy of different noninvasive scores for detecting advanced fibrosis in chronic hepatitis B
Authors: Hamidi Aziz A. , Oncul Ahsen , Ozguven Banu Y. , Sevgi Dilek Y. , Gunduz Alper , Uzun Nuray , Dokmetas Ilyas 
Published: April 2019

Objectives
The liver biopsy is the gold standard for determining the level of fibrosis in chronic hepatitis B infection (CHBI). Nonetheless, it is possible to predict liver fibrosis through some noninvasive methods such as noninvasive scoring (NIS) of some serum biomarkers obtained from routine blood tests. We aimed to evaluate the diagnostic accuracy of nine NIS for detecting advanced fibrosis in CHBI.

Patients and methods
We reviewed the hospital records of CHBI cases with liver biopsy between January 2011 and December 2016 retrospectively. Using Ishak scoring method, we classified fibrosis stage 1–2 as mild and 3–6 as advanced fibrosis. We calculated the NIS by considering the age, platelet count, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, platelet, and international normalized ratio values at the time of the biopsy.

Results
The mean age of 202 patients was 37.69± 11.33 years. In cases with advanced fibrosis, the age, gammaglutamyltransferase, and international normalized ratio values were higher and platelet count was lower (P < 0.05). Mean platelet volume was not different between the two groups (P = 0.499). The median values of γ-glutamyl peptidase-platelet ratio (GPR), FibroQ, Goteborg University Cirrhosis Index, fibrosis-4 (FIB-4), aspartate aminotransferase-platelet ratio index, age-platelet index, and King scoring were significantly higher in the advanced fibrosis group. The highest area under the curve value was in GPR [AUC = 0.731 (0.639–0.788); P = 0.000] in the receiver operating characteristic curve analysis. Cirrhosis Discriminant Score and Aspartate aminotransferase-to-alanine aminotransferase ratio tests were not valuable in detecting advanced fibrosis. FIB-4 had the highest (0.678) diagnostic accuracy rate.

Conclusion
We found that the calculation of NIS before liver biopsy, especially GPR and FIB-4, may be useful for predicting advanced fibrosis in cases with CHBI.
Role of chromosomal architecture in germinal center B cells and lymphomagenesis
Authors: Rivas Martin A. , Melnick Ari M. 
Published: April 2019

Purpose of review
Chromatin organization during interphase is nonrandom, and dictated by a delicate equilibrium between biophysics, transcription factor expression, and topological regulators of the chromatin. Emerging evidence demonstrate a role for chromosomal conformation at different stages of B-cell development. In the present review, we provide an updated picture of the current knowledge regarding how chromosomal conformation regulates the B-cell phenotype and how disruption of this architecture could lead to B-cell lymphoma.

Recent findings
B-cell development requires proper assembly of a rearranged VDJ locus, which will determine antigen receptor specificity. Recently, evidence pointed to a role for topological regulators during VDJ recombination. Research studies also demonstrated a link between shifts in nuclear chromosomal architecture during B-cell activation and in formation of germinal centers, which is required for immunoglobulin affinity maturation. Class-switch recombination was shown to be dependent on the presence of topology regulators. Loss of topological insulation of enhancers may lead to oncogene activation, suggesting that misfolding of chromatin may constitute a new epigenetic mechanism of malignant transformation. Finally, CCCTC-binding factor and cohesin binding sites have shown a higher probability of mutations and translocations in lymphomas, lending further support to the potential role of chromatin architecture in cancer development.

Summary
Chromosomal conformation is now recognized as a key feature in the development of a robust humoral immune response. Several examples from the literature show that dysregulation of chromosomal architecture may be a foundational event during malignancy. Therefore, understanding the mechanisms that regulate chromosomal folding and drive gene activation are instrumental for a better understanding of immune regulation and lymphomagenesis.
Toll-like receptor signaling in hematopoietic stem and progenitor cells
Authors: Capitano Maegan L. 
Published: April 2019

Purpose of review
The innate immune system is essential in the protection against microbial infection and facilitating tissue repair mechanisms. During these stresses, the maintenance of innate immune cell numbers through stress-induced or emergency hematopoiesis is key for our survival. One major mechanism to recognize danger signals is through the activation of Toll-like receptors (TLRs) on the surface of hematopoietic cells, including hematopoietic stem cell (HSC) and hematopoietic progenitor cell (HPC), and nonhematopoietic cells, which recognize pathogen-derived or damaged-induced compounds and can influence the emergency hematopoietic response. This review explores how direct pathogen-sensing by HSC/HPC regulates hematopoiesis, and the positive and negative consequences of these signals.

Recent findings
Recent studies have highlighted new roles for TLRs in regulating HSC and HPC differentiation to innate immune cells of both myeloid and lymphoid origin and augmenting HSC and HPC migration capabilities. Most interestingly, new insights as to how acute versus chronic stimulation of TLR signaling regulates HSC and HPC function has been explored.

Summary
Recent evidence suggests that TLRs may play an important role in many inflammation-associated diseases. This suggests a possible use for TLR agonists or antagonists as potential therapeutics. Understanding the direct effects of TLR signaling by HSC and HPC may help regulate inflammatory/danger signal-driven emergency hematopoiesis.
Recent advances in lip reconstruction
Authors: Vanison Christopher , Beckmann Nicholas , Smith Aaron 
Published: April 2019

Purpose of review
This article reviews recently described techniques used to reconstruct lip defects. Emphasis is placed on the ability of these flaps to restore function and appearance of the lips as well as their limitations.

Recent findings
The focus of recent advances in lip reconstruction has been to achieve better oral competence, speech and improved cosmetic appearance. New modifications to the traditional Karapandzic and Abbé flaps have expanded their uses. A host of novel local tissue transfer techniques has become available with improved outcomes and less morbidity. Similarly, new free tissue transfer methods have allowed for the creation of a more normal appearing lip with improved sensory and motor function. Although still experimental, tissue engineering of a mucocutaneous junction shows promise in its ability to recreate a normal vermillion.

Summary
Lip reconstruction techniques have continued to become more sophisticated in order to achieve better functional and cosmetic outcomes after resection. Several new local tissue and free tissue transfer techniques have recently been described and can be included in contemporary reconstruction algorithms.
Geographic inequity in transplant access
Authors: Lynch Raymond J. , Patzer Rachel E. 
Published: April 2019

Purpose of review
Scarcity is a defining feature of the modern transplant landscape, and in light of chronic shortages in donor organs, there is cause for concern about geographic inequities in patients’ access to lifesaving resources. Recent policy changes designed to ameliorate unequal donor supply and demand have brought new interest to measuring and addressing disparities at all stages of transplant care. The purpose of this review is to describe an overview of recent literature on geographic inequities in transplant access, focusing on kidney, liver, and lung transplantation and the impact of policy changes on organ allocation.

Recent findings
Despite a major change to the kidney allocation policy in 2014, geographic inequity in kidney transplant access remains. In liver transplantation, the debate has centered on the median acuity score at transplantation; however, a more thorough examination of disparities in access and survival has emerged.

Summary
Geographic differences in access and quality of transplant care are undeniable, but existing disparity metrics reflect disparities only among candidates who are waitlisted. Future research should address major gaps in our understanding of geographic inequity in transplant access, including patients who may be transplant-eligible but experience a wide variety of barriers in accessing the transplant waiting list.
Zinc Absorption and Endogenous Fecal Zinc Losses in Bangladeshi Toddlers at Risk for Environmental Enteric Dysfunction
Authors: Mondal Prasenjit , Long Julie M. , Westcott Jamie E. , Islam M. Munirul , Ahmed Mondar , Mahfuz Mustafa , Ahmed Tahmeed , Miller Leland V. , Krebs Nancy F. 
Published: April 2019

ABSTRACTObjectives:Environmental enteric dysfunction (EED) impairs zinc absorption from food, and zinc deficiency may contribute to the poor growth associated with EED. We examined zinc absorption from a standardized aqueous zinc dose, and habitual daily endogenous fecal zinc excretion (EFZ) and compared these outcomes between children grouped by the lactulose to mannitol ratio (L:M).Methods:Bangladeshi toddlers (18–24 months) with low (<0.09) and high (≥0.09) L:M were administered isotope‐labeled 3 mg aqueous zinc in the fasted state. Fractional absorption of zinc (FAZ) and EFZ were measured by dual stable isotope tracer method and an isotope dilution method, respectively. Secondary aims included examining relationships of biomarkers of systemic and intestinal inflammation and gut function with FAZ and EFZ.Results:Forty children completed the study; nearly all had evidence of EED. No differences in zinc homeostasis measurements (mean ± SD) were observed between high and low L:M groups: FAZ was 0.38 ± 0.19 and 0.31 ± 0.19, respectively; both figures were within estimated reference range. Means of EFZ were 0.73 ± 0.27 and 0.76 ± 0.20 mg/day for high and low L:M, respectively, and were 10% to 15% above estimated reference range. Regression analyses indicated that biomarkers of systemic inflammation were directly associated with increasing FAZ, consistent with increased gut permeability. Biomarkers of intestinal inflammation were negatively associated with EFZ, consistent with low‐zinc intake and chronic deficiency.Conclusions:In these children at risk of EED, endogenous zinc losses were not markedly increased. Results suggest that efforts to improve zinc status in EED should focus on substantially improving zinc intakes.
Probiotic Supplementation Decreases Chemotherapy-induced Gastrointestinal Side Effects in Patients With Acute Leukemia
Authors: Reyna-Figueroa Jesus , Barrón-Calvillo Elsa , García-Parra Cecilia , Galindo-Delgado Patricia , Contreras-Ochoa Carla , Lagunas-Martínez Alfredo , Campos-Romero Freya H. , Silva-Estrada Jorge A. , Limón-Rojas Ana E. 
Published: April 2019

Introduction:In children with acute leukemia, gut microbiota is modified secondary to chemotherapy administration, leading to gastrointestinal side effects. Probiotics are microorganisms that can restore gut microbiota and may help alleviate gastrointestinal symptoms. The aim of this pilot study was to assess the effects of probiotic supplementation on chemotherapy-induced gastrointestinal side effects in children with acute leukemia (AL).Methods:In this randomized pilot study, patients under 17 years of age diagnosed with AL who were on remission induction or remission reinduction chemotherapy were randomly assigned to receive probiotic supplementation (a concentration of 5×109 CFU per sachet was administered at a standard dose twice daily, by mouth) or no probiotic supplementation. The primary endpoint was the prevalence of gastrointestinal side effects. Vomiting, nausea, flatulence, dyspepsia, diarrhea, constipation, abdominal pain, and abdominal distention were assessed in both groups.Results:Gastrointestinal side effects were less prevalent in the probiotic group, and 3 of the 8 gastrointestinal side effects (nausea, vomiting, and abdominal distension) significantly decreased in the probiotic group (P<0.05). We found for diarrhea a relative risk of 0.5 (95% confidence interval [CI], 0.2-1.2;P=0.04); for nausea an RR of 0.5 (95% CI, 0.4-0.8;P=0.04) and for vomiting an RR of 0.4 (95% CI, 0.2-0.9;P=0.04).Conclusions:Daily supplementation withLactobacillus rhamnosusreduced chemotherapy-induced gastrointestinal side effects in children with AL.
The Value of 18F-FDG PET/CT in Detecting Bone Marrow Involvement in Childhood Cancers
Authors: Yağci-Küpeli Begül , Koçyiğit-Deveci Emel , Adamhasan Fulya , Küpeli Serhan 
Published: April 2019

Background:
The aim of this study was to assess the utility of 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in the initial staging of pediatric patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), Ewing sarcoma (ES), and neuroblastoma (NB).

Procedure:
A total of 94 patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) with newly diagnosed NHL, HL, ES, and NB between July 2014 and December 2017, who underwent BMB and 18F-FDG PET/CT before chemotherapy were included in this study. There were 36 patients with NHL, 27 HL, 16 ES, and 15 NB. 18F-FDG PET/CT and BMB results were reviewed and compared retrospectively.

Findings:
Retrospective analysis of data from 94 pediatric patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) was performed. Of the 94 patients, 29 had BMI on 18F-FDG PET/CT. BMB was positive in 14, negative in 13, and insufficient in 2 of these 29 patients. In 65 patients negative on 18F-FDG PET/CT, BMB was also negative in 54 and insufficient in 7. For the whole group, sensitivity, specificity, and positive and negative predictive values of 18F-FDG PET/CT in detecting bone marrow metastasis at the time of diagnosis were 90.6%, 100%, 100%, and 95.4% and those of BMB were 53.1%, 87.1%, 94.4%, and 80.6%, respectively.

Conclusion:
Our study demonstrates that 18F-FDG PET/CT predicts BMI better than BMB. 18F-FDG PET/CT may be used at initial staging of pediatric patients with NHL, HL, ES, and NB.
Safety of Over-the-Counter Medications in Pregnancy
Authors: Stanley Angela Y. , Durham Catherine O. , Sterrett James J. , Wallace Jerrol B. 
Published: April 2019

Abstract
Approximately 90% of pregnant women use medications while they are pregnant including both over-the-counter (OTC) and prescription medications. Some medications can pose a threat to the pregnant woman and fetus with 10% of all birth defects directly linked to medications taken during pregnancy. Many medications have documented safety for use during pregnancy, but research is limited due to ethical concerns of exposing the fetus to potential risks. Much of the information gleaned about safety in pregnancy is collected from registries, case studies and reports, animal studies, and outcomes management of pregnant women. Common OTC categories of readily accessible medications include antipyretics, analgesics, nonsteroidal anti-inflammatory drugs, nasal topicals, antihistamines, decongestants, expectorants, antacids, antidiarrheal, and topical dermatological medications. We review the safety categories for medications related to pregnancy and provide an overview of OTC medications a pregnant woman may consider for management of common conditions.
An Authentic Poverty Simulation for Health Care Profession Students Using Community Volunteers Experiencing Poverty
Authors: Hartman Sheri A. , Kidd Lori I. , Resler Rose M. , Lax Greta A. 
Published: April 2019

Background
Poverty is a harsh reality for more than 40 million Americans, which can lead to detrimental health outcomes.

Problem
Considering health professionals encounter clients of low-income status, increasing awareness and empathy toward this population is essential.

Approach
This article describes a novel approach to conducting poverty simulations by using community volunteers that are currently living or have recently lived in poverty, lending to a more authentic experience for students. The community volunteers acted as resource workers during the simulation.

Outcomes
Five lessons were learned as part of this authentic approach including the importance of orientation, consistent volunteer recruitment, volunteer appreciation, simulation role ownership, and importance of incentives.

Conclusion
This approach is an effective initial step in increasing awareness and empathy among health care profession students toward individuals living in poverty. Use of community volunteers with personal experience with poverty enhances the realism of this experience for students.
A Multigroup Analysis of the Effect of Cognitive Appraisal on Nurses' Psychological Distress
Authors: Simães Clara , Gomes António R. , Costa Patrício 
Published: April 2019

Background
Cognitive appraisal constitutes an important mechanism in the process of human adaptation to work environment and occupational stress. In this domain, nursing professionals are one of the occupational groups most affected by job stress, suffering high levels of psychological distress.

Objectives
The aims of this study were to analyze the moderator effect of shift work and the type of job contract on the relationship between work cognitive appraisal and nurses' psychological distress and to explore the interaction effect of the two moderator variables on that relationship.

Methods
A sample comprised of 2,310 Portuguese registered nurses completed a sociodemographic and professional questionnaire: the Primary and Secondary Cognitive Appraisal Scale and the General Health Questionnaire-12. Data were analyzed through structural equation modeling and multigroup analyses considering the following groups: (a) “shift” versus “nonshift work”; (b) “precarious job contract” versus “nonprecarious job contract”; and (c) “shift and precarious” versus “shift and nonprecarious” versus “nonshift and precarious” versus “nonshift and nonprecarious.”

Results
Data confirmed the invariance for the measurement model, but the structural model presented a significantly worse adjustment for all grouping variables, showing the moderator effect of shift work and job contract and of their interaction. Difference tests in structural path coefficients revealed that shift work moderated the relationship between challenge perception and psychological distress—which was stronger for shift work nurses—and that a higher threat perception was related to greater psychological distress, especially in nurses with a precarious job contract. Among the four categories of interaction between job contract and shift work, cognitive appraisal became central in predicting nurses' mental health, explaining more variance in the group that did shift work and had a nonprecarious job contract.

Discussion
The study results highlight the need to develop occupational health intervention programs to promote nurses' mental health, focusing on reducing work perception as a threat and on making nurses' jobs more challenging and controllable.
Limited availability of global health opportunities in US orthopaedic trauma fellowship programs
Authors: Shaw Jordan , Siy Alexander , Dahm James , Lins Laura , Simske Natasha , Whiting Paul 
Published: April 2019

Abstract

Purpose:
Orthopaedic residents are increasingly seeking international health electives (IHEs) during training, and many such experiences involve providing orthopaedic trauma care. However, little is known about the availability of IHEs during orthopaedic trauma fellowship training. The purpose of our study is to assess the global health opportunities available to US orthopaedic trauma fellows.

Method:
We conducted an online, Research Electronic Data Capture (REDCap)-based survey of orthopaedic trauma fellowship program directors (PDs) in the United States. The survey link was sent by the Orthopaedic Trauma Association (OTA) Fellowship Committee to all US OTA-approved orthopaedic trauma fellowship PDs. Follow-up reminder e-mails were delivered at set time intervals from baseline over a period of 4 weeks.

Results:
The overall response rate was 80% (43/54). Only 3 of 43 responding programs (7%) offer a structured global health program, but over the last 10 years, 12.5% of the remaining programs (5/40) have had a fellow participate in an IHE during fellowship training. Around 100% of PDs reported fellow satisfaction with their IHEs, and all PDs agreed that the educational experience provided by their fellows’ IHE participation was valuable. Among programs with no recent fellow IHE participation and without a structured global health program, 9% of PDs (3/35) expect to institute such a program. Lack of funding, lack of established international partner sites, and fellow time away were the most common perceived barriers to IHE participation. A total of 54% of PDs agree that participation in an IHE during training plays a major role in shaping fellows’ future professional and volunteer activities.

Conclusion:
There are limited global health opportunities among US orthopaedic trauma fellowship programs, with only 7% (3/43) offering a structured global health program. Perceived barriers include lack of funding, lack of established partner sites, and concerns related to clinical/call coverage. Greater efforts to establish sustainable funding and international partnerships may increase opportunities for IHEs during orthopaedic trauma fellowship training.