bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of Melatonin Supplementation for Sleep Disorders in Pediatric Special Populations
Authors: Abramova Rachel , Campbell Peter , Baron Jessica , Patel Khilna , Parmar Sapna 
Published: May 2019

Objective To determine which pediatric populations, if any, benefit from exogenous melatonin supplementation. Methods PubMed was utilized for the purposes of this systematic review. The studies selected evaluated melatonin use in pediatric special populations and included randomized controlled trials, crossover studies, and meta-analyses. Each study’s objectives, measures of outcomes, and dosing strategies of melatonin were reviewed along with the results and author’s conclusions. Results Our analysis of the available data offers mixed results and recommendations with regard to the decision of whether to add supplementation of melatonin. Conclusion With further regulation of melatonin supplements, it may be plausible to hold larger, multicenter trials and come to a firm recommendation in the future. At this time, we believe that the benefit of exogenous melatonin supplementation outweighs the risks of adverse events and therefore would recommend its use in aiding patients in improving their sleep. Exogenous supplementation with melatonin should be used at the physician’s and patient’s discretion.
Lymphocyte and its CD4+ and CD8+ subgroup changes after paraquat poisoning
Authors: Gao Y , Guo S , Wang Y , Yu S , Wang M , Lu X , Li Y 
Published: May 2019

Objective: Paraquat (PQ) poisoning is a significant cause of mortality and morbidity in developing countries. Poor prognostic outcomes have been attributed to the herbicide’s toxicity and the lack of effective treatments. Our study aims to investigate the changes in lymphocyte count in both patients who survived and died from PQ poisoning and explore the prognostic value. Method: This is a retrospective case serials observational study. Adult patients admitted with acute PQ poisoning. The notes of 1000 patients who presented with acute PQ poisoning were reviewed. One hundred thirty patients having the T lymphocyte met the inclusion criteria and were grouped into those that survived the poisoning (95) and non-survivors (35). Results: On admission, non-survivors had a higher ingestion volume of PQ and urine PQ concentration as well as higher severity indices (Acute Physiology and Chronic Health Evaluation 2, Sequential Organ Failure Assessment, and Poisoning Severity Score). Patients in the survival group had a higher dosage of immunosuppressant and a longer hospital stay. Leukocytes, especially neutrophils, were higher among non-survivors; however, the converse was found with lymphocytes. T lymphocyte (CD3) count was consistently higher among survivors as well as the subgroups CD4+ and CD8+. No differences in the ratio of CD4/CD8 were found between the groups. Conclusion: Our study has shown that changes in lymphocyte count as its subgroups could indicate a host’s immune status and lymphocytes play an important role as a surrogate marker of host immunity, which could be a useful prognostic tool in the assessment of this disease.
Perception of hematologists and oncologists about the biosimilars: A prospective Tunisian study based on a survey
Authors: Hadoussa Selma , Bouhlel Mehdi , Soussi Mohamed A , Drira Chema , Hadoussa Myriam , Khrouf Myriam R 
Published: May 2019

Introduction Biosimilar drugs have significantly shaken the global pharmaceutical market through a better access to the health care services. The aim of this study is to establish a state of play in Tunisia based on the knowledge and perceptions of doctors on biosimilars in order to identify the problems related to these drugs and to propose solutions for improvement. Materials and methods In our study, we conducted a prospective, descriptive survey using a questionnaire, destinated to oncologists and hematologists with different grades, from both public and private sectors and from several regions. The questions focused on physicians' general knowledge of biosimilars and their comparison with reference on safety, quality, efficacy, and indication. Finally, we explored the proportion of physicians who are favorable to the policy encouraging biosimilar use. Results One hundred and seven doctors among 150 answered the questionnaire; 57% were oncologists and 43% were hematologists. About one over five physicians defines biosimilar as a chemical drug. About 29% do not differentiate between a biosimilar and a generic one. A percentage of 68 believe that a biosimilar can have all the indications of its reference following complementary clinical studies. On the other side, 68.2% support the policy encouraging these drugs. Last, only 3.7% of the practitioners believe that they are well informed about biosimilars. Discussion Our results are comparable to other surveys described in the literature. However, this is the first study that targets oncologists and hematologists specifically. Conclusion Our study showed a lack of information from oncologists and hematologists about biosimilars in Tunisia. Thus, health authorities should carry out training programs on biosimilars and introduce clear and effective legislation in order to allow better access to health care services.
“Yokoyama procedure” efficacy on non-highly myopic patients with acquired esotropia and hypotropia
Authors: Serafino Massimiliano , Scaramuzzi Matteo , Villani Edoardo , Nucci Paolo 
Published: May 2019

Objective: To assess the efficacy of “Yokoyama Procedure,” on non-highly myopic patients with acquired esotropia and hypotropia. Methods: The study involved 10 eyes of 5 patients with eso-hypotropia. Inclusion criteria were acquired esotropic-hypotropic strabismus with lateral rectus inferior displacement and superior rectus nasal displacement confirmed by magnetic resonance imaging, refractive errors between ±6 D, and axial length < 27 mm. Range of full duction movements and maximum angles of abduction-sursumduction was measured in each eye before and after surgery. All patients underwent T1- and T2-weighted magnetic resonance imaging. The surgery was aimed at creating a junction between the muscle bellies of the superior and lateral rectus muscles. This junction was made approximately 14 mm behind the insertions using a non-absorbable mersilene 5/0 suture (Yokoyama procedure). Results: Mean patient age was 64.8 ± 4.8 years. The mean globe axial length was 25.4 ± 0.76 mm and a mean corresponding spherical equivalent refraction of −3.7 ± 1.7 D was observed. Eight eyes on 10 had mild limitation in abduction, while the remaining 2 had no limitation. Three out of 10 eyes showed a moderate limited sursumduction, 5 eyes were categorized as mild, and the remaining 2 had no limitation. No evident post-operative limitation was present in any eye, in both abduction and sursumduction (p < 0.01). Pre-operative esotropia and hypotropia were, respectively, 32 ± 11 prismatic diopters and 25 ± 5 prismatic diopters, and they were significantly reduced after surgery as 9 ± 1.7 prismatic diopters and 6 ±1 prismatic diopters (p = 0.043), respectively. Conclusion: Yokoyama procedure is an effective, fast, reversible procedure to face eso-hypotropic acquired strabismus, even in patients with a clear magnetic resonance imaging displacement of superior and lateral rectus muscles, and absence of globe dislocation and of elevated myopia.
Does Neuromuscular Electrical Stimulation Improve Recovery Following Acute Ankle Sprain? A Pilot Randomised Controlled Trial
Authors: Wainwright Thomas W , Burgess Louise C , Middleton Robert G 
Published: May 2019

Aim: Following soft tissue ankle injury, patients are often referred for out-patient physiotherapy and present symptoms including pain, reduced range of movement and function, and oedema. In this study, we assess the use of a neuromuscular electrical stimulation (NMES) device as an adjunctive therapy to reduce oedema in patients recovering from grade I and II ankle sprains. Methods: This was a single-centre, pilot randomised controlled study, recruiting patients referred to physiotherapy following an ankle sprain. Participants presenting with oedema were randomised to one of two treatment groups: (1) the current standard of care and (2) the current standard of care plus NMES use. Participants were identified in an emergency department and referred to a physiotherapy department for treatment 1 to 5 days following the injury and returned to clinic 7 days later. Results: Twenty-two participants completed the study and had full data sets for analysis (11 in each group). Mean volumetric displacement was reduced in the intervention group in comparison to the standard care group ( P = .011); however, there were no between-group differences in figure of eight measurements, function or pain scores. The device was well tolerated, with no device-related adverse events recorded. Conclusions: In this pilot, randomised controlled trial, NMES was well tolerated by patients following ankle sprain and demonstrated statistically significant improvements in oedema reduction as measured by fluid displacement. No other changes were observed. Further work will need to confirm the clinical significance and effect on longer term recovery post-ankle sprain.
Epicardial adipose tissue and its association with cardiovascular risk factors and mitral annular calcium deposits
Authors: Nabati Maryam , Salehi Alireza , Hatami Ghazal , Dabirian Mozhdeh , Yazdani Jamshid , Parsaee Homa 
Published: May 2019

Introduction Epicardial fat is a variety of visceral adipose tissue that secretes pro-inflammatory cytokines that can lead to progression of atherosclerosis. Previous studies have shown a correlation between cardiovascular risk factors and severity of mitral annular calcification. The aim of our study was to assess the correlation between epicardial fat thickness and mitral annular calcification. Methods This study recruited 188 patients who were considered for coronary angiography and underwent echocardiography within 24 hours of admission. Epicardial fat thickness was measured in the parasternal long axis view at the end-systole. Mitral annular calcification was visualized in the parasternal short-axis view and was grade as none, mild, moderate, and severe. Furthermore, left atrial diameter, severity of mitral regurgitation, left ventricular ejection fraction, and early diastolic velocities ( E wave) determined by transmitral pulsed Doppler, the early mitral annular velocities measured by tissue Doppler ( e′), and E/ e′ were obtained. Results Patients with an epicardial fat thickness ≥7 mm had higher prevalence of hypertension and higher SYNTAX score ( p value = 0.002 and 0.0014, respectively). Also, mitral annular calcification was both more prevalent and more extensive ( p value = 0.007 and <0.001, respectively) and left atrial diameter was larger in these patients compared with patients with epicardial fat thickness <7 mm ( p value = 0.001). Conclusions Our study showed significant association between increased epicardial fat thickness and calcium deposits in the mitral valve annulus that is a degenerative process associated with cardiovascular risk factors.
Efficacy and safety of a ready-to-drink bowel preparation for colonoscopy: a randomized, controlled, non-inferiority trial
Authors: Hookey Lawrence , Bertiger Gerald , Lee Johnson Kenneth , Ayala Julia , Seifu Yodit , Brogadir Stuart P 
Published: May 2019

Background: We performed a randomized, controlled, assessor-blinded, multicenter, non-inferiority (NI) study to compare the safety and efficacy of a ready-to-drink formulation of sodium picosulfate, magnesium oxide, and citric acid (SPMC oral solution) with a powder formulation (P/MC powder) for oral solution. Methods: Eligible participants (adults undergoing elective colonoscopy) were randomized 1:1 to split-dose SPMC oral solution or P/MC powder. The primary efficacy endpoint assessed overall colon-cleansing quality with the Aronchick Scale (AS), and the key secondary efficacy endpoint rated quality of right colon cleansing with the Boston Bowel Preparation Scale (BBPS). Assessments were performed by a treatment-blinded endoscopist. Tolerability was assessed using the Mayo Clinic Bowel Prep Tolerability Questionnaire. Safety assessments included adverse events and laboratory evaluations. Results: The study included 901 participants: 448 for SPMC oral solution; 453 for P/MC powder. SPMC oral solution demonstrated non-inferiority to P/MC powder {87.7% (393/448) responders versus 81.5% (369/453) responders [difference (95% confidence interval): 6.3% (1.8, 10.9)]}. The key secondary efficacy objective assessing the right colon was also met. According to the prespecified hierarchical testing, after meeting the primary and key secondary objectives, SPMC oral solution was tested for superiority to P/MC powder for the primary endpoint ( p = 0.0067). SPMC oral solution was well tolerated. Most common adverse events were nausea (3.1% versus 2.9%), headache (2.7% versus 3.1%), hypermagnesemia (2.0% versus 5.1%), and vomiting (1.3% versus 0.7%) for SPMC oral solution and P/MC powder, respectively. Conclusions: Ready-to-drink SPMC oral solution showed superior efficacy of overall colon cleansing compared with P/MC powder, with similar safety and tolerability. [ClinicalTrials.gov identifier: NCT03017235.]
Dietary risk factors for inflammatory bowel diseases in a high‐risk population: Results from the Faroese IBD study
Authors: Hammer T , Lophaven S Nymand , Nielsen K Rubek , Petersen M Skaalum , Munkholm P , Weihe P , Burisch J , Lynge E 
Published: May 2019

BackgroundThe Faroe Islands currently have the highest recorded inflammatory bowel disease (IBD) incidence in the world.ObjectiveThis study investigated environmental risk factors for IBD in the Faroese population.MethodsEnvironmental exposure data including lifestyle risk factors and neurotoxicants collected for over 30 years were retrieved from the Children's Health and the Environment in the Faroes (CHEF) cohorts including mainly mother–child pairs, with exposure data collected from pregnant mothers. For lifestyle risk factors, the incidence of IBD and ulcerative colitis (UC) was calculated as the rate ratio (RR) with 95% confidence intervals (CI) in exposed versus non‐exposed persons. For neurotoxicants RR was calculated for persons with high versus low exposure.ResultsSix cohorts included 5698 persons with complete follow‐up data and at least one exposure, and 37 were diagnosed with IBD. For pilot whale/blubber, the RR was 1.02 (95% CI, 0.48–2.18); RR of 1.01 for fish (95% CI, 0.35–2.91); and of the pollutants studied, a statistical significantly increased risk was found for 1,1,1,‐trichloro‐2,2‐bis‐(p‐chlorophenyl) ethane (p,p'‐DDT); RR 3.04 (95% CI, 1.12–8.30). RRs were 1.96 (95% CI, 1.03–3.73) for smoking and 1.10 (95% CI, 0.55–2.19) for alcohol intake.ConclusionThe high IBD incidence is unlikely to be caused by special dietary habits or by environmental pollutants.
Fos-related antigen-1 transgenic mouse as a model for systemic sclerosis: A potential role of M2 polarization
Authors: Yasuoka Hidekata , Tam Yuen Yu Angela , Okazaki Yuka , Tamura Yuichi , Matsuo Koichi , Feghali-Bostwick Carol , Takeuchi Tsutomu , Kuwana Masataka 
Published: May 2019

Objectives: To investigate the systemic sclerosis–related phenotype in fos-related antigen-1 transgenic mice and its underlying mechanisms. Methods: Lung and skin sections of constitutive fos-related antigen-1 transgenic mice and wild-type mice were examined by tissue staining and immunohistochemistry. The tricuspid regurgitation pressure gradient was measured by transthoracic echocardiography with a Doppler technique. To assess the impact of fos-related antigen-1 expression on macrophage function, bone marrow–derived mononuclear cells were derived from mice that expressed fos-related antigen-1 under the control of doxycycline and wild-type littermates. These bone marrow–derived mononuclear cells were induced to differentiate into macrophages with or without doxycycline, and analyzed for gene and protein expression. Finally, lung explants obtained from systemic sclerosis patients and control donors were subjected to immunohistochemistry. Results: The lungs of fos-related antigen-1 transgenic mice showed excessive fibrosis of the interstitium and thickening of vessel walls, with narrowing lumen, in an age-dependent manner. The tricuspid regurgitation pressure gradient was significantly elevated in fos-related antigen-1 transgenic versus control mice. Increased dermal thickness and the loss of subdermal adipose tissue were also observed in the fos-related antigen-1 transgenic mice. These changes were preceded by a perivascular infiltration of mononuclear cells, predominantly consisting of alternatively activated or M2 macrophages. Overexpressing fos-related antigen-1 in bone marrow–derived mononuclear cell cultures increased the expression of M2-related genes, such as Il10, Alox15, and Arg1. Finally, fos-related antigen-1-expressing M2 macrophages were increased in the lung tissues of systemic sclerosis patients. Conclusions: The fos-related antigen-1 transgenic mouse serves as a genetic model of systemic sclerosis that recapitulates the major vascular and fibrotic manifestations of the lungs and skin in systemic sclerosis patients. M2 polarization mediated by the up-regulation of fos-related antigen-1 may play a critical role in the development of systemic sclerosis.
Fatty Liver Has Stronger Association With Insulin Resistance Than Visceral Fat Accumulation in Nonobese Japanese Men
Authors: Kadowaki Satoshi , Tamura Yoshifumi , Someya Yuki , Takeno Kageumi , Kaga Hideyoshi , Sugimoto Daisuke , Kakehi Saori , Funayama Takashi , Furukawa Yasuhiko , Suzuki Ruriko , Nishitani-Yokoyama Miho , Shimada Kazunori , Daida Hiroyuki , Aoki Shigeki , Kanazawa Akio , Kawamori Ryuzo , Watada Hirotaka 
Published: May 2019

Abstract

Context
Asians have a high prevalence of insulin resistance, even in the nonobese state. Whereas both visceral fat accumulation (VFA) and fatty liver (FL) have been shown to be associated with insulin resistance, it is still unclear which is a better marker to predict insulin resistance in nonobese Asians.

Objective
The aim of this study was to investigate the relation between VFA or FL and insulin resistance in nondiabetic nonobese Japanese men who do not have diabetes.

Design and Participants
We studied 87 nonobese (body mass index <25 kg/m2) Japanese men without diabetes. Using a two-step hyperinsulinemic euglycemic clamp, we evaluated insulin sensitivity in adipose tissue, muscle, and liver. Intrahepatic lipid and abdominal visceral fat area were measured by 1H-magnetic resonance spectroscopy and MRI, respectively. Subjects were divided into four groups based on the presence or absence of VFA (visceral fat area ≥100 cm2) and FL (intrahepatic lipid ≥ 5%): control (non-VFA, non-FL; n = 54), VFA only (n = 18), FL only (n = 7), and VFA plus FL (n = 8).

Results
Subjects in the FL only and VFA plus FL groups had insulin resistance in adipose tissue and muscle, as well as relatively lower hepatic insulin sensitivity. The specific insulin sensitivities in these organs were comparable in the VFA only and control groups.

Conclusions
In nonobese Japanese men without diabetes, subjects with FL only or VFA plus FL but not VFA only had insulin resistance, suggesting that FL may be a more useful clinical marker than VFA to predict insulin resistance in nonobese Japanese men without diabetes.
Resistance to GHRH but Not to PTH in a 15-Year-Old Boy With Pseudohypoparathyroidism 1A
Authors: Munteanu Martin , Kiewert Cordula , Matar Nora , Hauffa Berthold P , Unger Nicole , Hiort Olaf , Thiele Susanne , Buiting Karin , Bramswig Nuria C , Grasemann Corinna 
Published: May 2019

Abstract
Pseudohypoparathyroidism 1A (PHP1A) consists of signs of Albright hereditary osteodystrophy (AHO) and multiple, variable hormonal resistances. Elevated PTH levels are the biochemical hallmark of the disease. Short stature in PHP1A may be caused by a form of accelerated chondrocyte differentiation leading to premature growth plate closure, possibly in combination with GH deficiency in some patients. Treatment of short stature with recombinant growth hormone (rhGH) in pediatric patients may improve final height if started during childhood. The 10 11/12-year-old boy with clinical signs of AHO presented for evaluation of short stature [height standard deviation score (SDS) −2.72]. Clinically his mother was affected by AHO as well. A heterozygous mutation c.505G>A (p.E169K) in exon 6 of the GNAS gene confirmed a diagnosis of PHP1A in the boy. However, hormonal assessment was unremarkable except for low serum IGF-1 (SDS −2.67). On follow-up, GH deficiency due to GHRH resistance was suspected and confirmed by clonidine and arginine stimulation tests. Treatment with rhGH (0.035 mg/kg) for 2 years resulted in catch-up growth (height SDS −1.52). At age 15 years the PTH levels and bone age of the patient remain within the normal range. In patients with PHP1A, short stature is caused by the effects of Gs-α deficiency on the growth plate. However, resistance to GHRH and the resulting GH deficiency might also contribute. Recombinant GH treatment increases growth in these patients. Diagnostic workup for GH deficiency as a factor contributing to short stature is recommended even in the absence of other hormonal resistances.
Supraspinal Control of Recurrent Inhibition during Anisometric Contractions
Authors: BARRUÉ-BELOU SIMON , MARQUE PHILIPPE , DUCLAY JULIEN 
Published: May 2019

ABSTRACT

Purpose
Increase in recurrent inhibition was observed during eccentric compared with isometric and concentric maximal voluntary contractions but the neural mechanisms involved in this specific control of the Renshaw cell activity are unknown. This study was designed to investigate the supraspinal control of the recurrent inhibition during anisometric contractions of the plantar flexor muscles.

Methods
To that purpose, the paired Hoffmann-reflex (H-reflex) technique permitted to assess changes in homonymous recurrent pathway by comparing the modulations of test and conditioning H-reflexes (H′ and H
1, respectively) in the soleus (SOL) muscle during maximal and submaximal isometric, concentric and eccentric contractions. Submaximal contraction intensity was set at 50% of the SOL electromyographic activity recorded during maximal isometric contraction. Fourteen volunteer subjects participated in an experimental session designed to assess the activity of the recurrent inhibition pathway.

Results
The results indicate that the amplitude of H
1 normalized to the maximal M-wave were similar (P > 0.05) regardless of the muscle contraction type and intensity. Whatever the contraction intensity, the ratio between H′ and H
1 amplitudes was significantly decreased (P < 0.05) during eccentric compared with isometric and concentric contractions. Furthermore, this ratio was significantly smaller (P < 0.05) during submaximal compared with maximal contractions whatever the muscle contraction type.

Conclusion
Together, the current results confirm the supraspinal control of the Renshaw cell activity when muscle contraction intensity is modulated and show that this control remains similar for isometric, concentric and eccentric contractions. Data further suggest that recurrent inhibition pathway may serve as variable gain regulator at motoneuronal level to improve resolution in the control of motor output for the SOL during eccentric contractions.