bluuebunny/crossref_metadata_2025_split huggingface dataset:
The immunophenotype of decidual macrophages in acute atherosis
Authors: Gill Navleen , Leng Yaozhu , Romero Roberto , Xu Yi , Panaitescu Bogdan , Miller Derek , Arif Afrah , Mumuni Salma , Qureshi Faisal , Hsu Chaur‐Dong , Hassan Sonia S. , Staff Anne Cathrine , Gomez‐Lopez Nardhy 
Published: February 2019

ProblemAcute atherosis is a uteroplacental arterial lesion that is associated with pregnancy complications such as preeclampsia and preterm birth, the latter being the leading cause of perinatal morbidity and mortality worldwide. However, the immunobiology of acute atherosis is poorly understood.Method of studyPlacental basal plate samples were collected from women who delivered with (n = 11) and without (n = 31) decidua basalis lesions of acute atherosis. Multicolor flow cytometry was used to quantify M1‐ and M2‐like macrophage subsets and the expression of iNOS and IL‐12 by decidual macrophages. Multiplex fluorescence staining and phenoptics were performed to localize M1‐, MOX‐, and Mhem‐like macrophages in the decidual basalis.ResultsMacrophages displayed diverse phenotypes in the decidua basalis with acute atherosis. M2‐like macrophages were the most abundant subset in the decidua; yet, this macrophage subset did not change with the presence of acute atherosis. Decidual M1‐like macrophages were increased in acute atherosis, and such macrophages displayed a pro‐inflammatory phenotype, as indicated by the expression of iNOS and IL‐12. Decidual M1‐like pro‐inflammatory macrophages were localized near both transformed and non‐transformed vessels in the decidua basalis with acute atherosis. MOX and Mhem macrophages were also identified near transformed vessels in the decidua basalis with acute atherosis. Finally, monocyte‐like cells were present on the vessel wall of non‐transformed decidual vessels, indicating a possible intravascular source for macrophages in acute atherosis.ConclusionDecidual macrophages display different phenotypes, namely M1‐like, M2‐like, MOX, and Mhem subsets. Yet, pro‐inflammatory macrophages are enriched in the decidua basalis with acute atherosis. These findings provide a molecular foundation for future mechanistic inquiries about the role of pro‐inflammatory macrophages in the pathogenesis of acute atherosis.
Female genital mutilation: Obstetric outcomes in metropolitan Sydney
Authors: Davis Georgina , Jellins Jessica 
Published: February 2019

BackgroundFemale genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery.AimsTo assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes.MethodsRetrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five‐year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM.ResultsA full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor.ConclusionsFGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high‐risk women.
Iris suture fixation of out‐of‐the‐bag dislocated three‐piece intraocular lenses
Authors: Armonaite Laura , Löfgren Stefan , Behndig Anders 
Published: February 2019

AbstractPurposeTo evaluate the efficacy and safety of iris suture fixation of out‐of‐the‐bag dislocated three‐piece intraocular lenses (IOL).MethodsIn a retrospective interventional consecutive case series, a chart review was performed in two groups of patients: fourteen patients with a dislocated out‐of‐the‐bag three‐piece IOL that underwent IOL fixation to the iris using the Siepser sliding knot technique (Iris group) and 18 patients with in‐the‐bag dislocation that underwent IOL exchange with a new scleral‐sutured IOL (Exchange group). The Iris and Exchange groups were compared regarding surgical safety and efficacy. The median follow‐up time was 13.5 months [interquartile range (IQR), 10–20] in the Iris group and 12.5 (IQR, 10–14) in the Exchange group.ResultsThe best corrected visual acuity (BCVA) improved significantly in both groups (p = 0.005 and 0.00006, respectively). No difference in final BCVA was seen between the groups. Significantly less surgically induced astigmatism (p = 0.03) and a lower number of postoperative visits (p = 0.0006) was noted in the Iris group. Considering the type of surgery, there were few complications in the present material.ConclusionIn the study, suturing dislocated three‐piece IOLs to the iris appeared to be an acceptable surgical management with less surgically induced corneal astigmatism and fewer postoperative visits than IOL exchange. A larger study with a longer follow‐up time would be desirable to confirm the results.
Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease
Authors: Shivaji Uday N. , Sharratt Caroline L. , Thomas Tom , Smith Samuel C. L. , Iacucci Marietta , Moran Gordon W. , Ghosh Subrata , Bhala Neeraj 
Published: February 2019

SummaryBackgroundBiological therapy is currently widely used to treat IBD. Infliximab, adalimumab and golimumab are currently licensed anti‐TNF therapies. Biosimilar anti‐TNF monoclonal antibodies are increasingly used. Anti‐TNF therapies are widely used and their adverse effects are well characterised, and may cause significant morbidity and mortality in a small proportion of exposed patients. Gastroenterologists need to understand the mechanisms for these effects, recognise these swiftly and manage such events appropriately.AimTo cover the range of potential adverse reactions as a result of biologic therapy and specifically management of these events.MethodsA Medline and Pubmed search was undertaken. Search terms included were “anti‐TNF,” “infliximab” or “adalimumab” or “golimumab” combined with the keywords “ulcerative colitis” or “Crohn's disease” or “inflammatory bowel disease” and then narrowed to articles containing the keywords “complications,” “side effects” or “adverse events” or “safety profile.” International guidelines were also reviewed where relevant.ResultsAdverse events discussed in this review include infusion reactions, blood disorders and infections (including bacterial, viral, fungal and opportunistic infections) as well as autoimmune, dermatological disorders, cardiac and neurological conditions. Malignancies including solid organ, haematological and those linked to viral disease are discussed.ConclusionsAnti‐TNF therapy has wide‐ranging effects on the immune system resulting in a spectrum of potential adverse events in a small proportion of patients. Research advances are improving the understanding, recognition and management of these adverse events.
Systematic review with meta‐analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease
Authors: Shah Ayesha , Morrison Mark , Burger Daniel , Martin Neal , Rich Justin , Jones Mike , Koloski Natasha , Walker Marjorie M. , Talley Nicholas J. , Holtmann Gerald J. 
Published: February 2019

SummaryBackgroundCurrent data on small intestinal bacterial overgrowth (SIBO) in patients with inflammatory bowel diseases (IBD) are controversial.AimTo conduct a systematic review and meta‐analysis to determine the prevalence of SIBO in patients with ulcerative colitis (UC) and Crohn's disease (CD).MethodsElectronic databases were searched up to May 2018 for studies reporting prevalence of SIBO in IBD patients. The prevalence rate of SIBO among IBD patients and the odds ratio (OR) and 95% CI of SIBO in IBD patients compared with controls were calculated.ResultsThe final dataset included 11 studies (1175 adult patients with IBD and 407 controls), all utilising breath test for diagnosis of SIBO. The proportion of SIBO in IBD patients was 22.3% (95% CI 19.92‐24.68). The OR for SIBO in IBD patients was 9.51 (95% CI 3.39‐26.68) compared to non‐IBD controls, and high in both CD (OR = 10.86; 95% CI 2.76‐42.69) and UC (OR = 7.96; 95% CI 1.66‐38.35). In patients with CD, subgroup analysis showed the presence of fibrostenosing disease (OR = 7.47; 95% CI 2.51‐22.20) and prior bowel surgery (OR = 2.38; 95% CI 1.65‐3.44), especially resection of the ileocecal valve, increased the odds of SIBO. Individual studies suggest that combined small and large bowel disease but not disease activity may be associated with SIBO.ConclusionsOverall, there is a substantial increase in the prevalence of SIBO in IBD patients compared to controls. Prior surgery and the presence of fibrostenosing disease are risk factors for SIBO in IBD.
Circulating microRNA146b‐5p is superior to C‐reactive protein as a novel biomarker for monitoring inflammatory bowel disease
Authors: Chen Peng , Li Ying , Li Li , Yu Qiao , Chao Kang , Zhou Gaoshi , Qiu Yun , Feng Rui , Huang Shanshan , He Yao , Chen Baili , Chen Minhu , Zeng Zhirong , Zhang Shenghong 
Published: February 2019

SummaryBackgroundOwing to the importance of early treatment, simple and reliable methods for monitoring inflammatory bowel disease (IBD) are needed.AimsTo determine whether circulating microRNAs are reliable biomarkers for IBD monitoring.MethodsSerum levels of 17 candidate microRNAs were measured by quantitative real‐time polymerase chain reaction in a discovery cohort (n = 120). Differentially expressed serum microRNAs were further investigated in an independent training cohort (n = 341). Correlations between relative microRNA levels and disease activity were evaluated. A disease control group was included to investigate the specificity of microRNA. Logistical regression was used to construct a microRNA classifier to identify endoscopic activity. Its predictive value was explored in the validation cohort (n = 66) using the area under the receiver operating characteristic curve (AUC).ResultsSerum microRNA146b‐5p (miR‐146b‐5p) expression was 2.87‐ and 2.72‐fold higher in patients with Crohn's disease and ulcerative colitis, respectively, than in healthy controls. Serum miR‐146b‐5p was significantly correlated with disease activity and was more specific than C‐reactive protein (CRP). A classifier was built for Crohn's disease, ie P [Endoscopically active] = , with a greater AUC of 0.869 [0.764‐0.940] than that for CRP (0.680 [0.554‐0.790]) (P = 0.0043).ConclusionsMiR‐146b‐5p may better reflect mucosal inflammation in IBD than CRP. The Crohn's disease classifier developed in this study may be valuable for identifying endoscopic activity in patients with Crohn's disease.
The positive value of moral distress
Authors: Tigard Daniel W. 
Published: February 2019

AbstractMoral distress in healthcare has been an increasingly prevalent topic of discussion. Most authors characterize it as a negative phenomenon, while few have considered its potentially positive value. In this essay, I argue that moral distress can reveal and affirm some of our most important concerns as moral agents. Indeed, the experience of it under some circumstances appears to be partly constitutive of an honorable character and can allow for crucial moral maturation. The potentially positive value, then, is twofold; moral distress carries both aretaic and instrumental value. Granted, this position is not without its caveats, but by making these clear, I provide a novel framework for policy recommendations regarding when, if ever, we should work to reduce moral distress.
Women desiring less care than recommended during childbirth: Three years of dedicated clinic
Authors: van der Garde Matthijs , Hollander Martine , Olthuis Gert , Vandenbussche Frank , van Dillen Jeroen 
Published: February 2019

AbstractBackgroundSome women decline recommended care during pregnancy and birth. This can cause friction between client and provider.MethodsA designated outpatient clinic was started for women who decline recommended care in pregnancy. All women who attended were analyzed retrospectively. The clinic used a systematic multidisciplinary approach. During the first visit, women told their stories and explained the reasoning behind their birth plan. The second visit was used to present the evidence underpinning recommendations and attempt to reach a compromise if care within recommendations was still not acceptable to the woman. During the third visit, a final birth plan was decided on.ResultsFrom January 1, 2015, until December 31, 2017, 55 women were seen in the clinic, 29 of whom declined items of recommended care during birth and were included in the study. After discussions had been completed, 38% of birth plans were within recommendations, 38% were a compromise, in which both the woman and the care provider had made certain concessions, and 24% did not reach an agreement and delivered with another provider either at home or elsewhere. All maternal and perinatal outcomes were good.ConclusionsUsing a respectful and systematic multidisciplinary approach, in which women feel heard and are invited to explain their motivations for their birth plans, we are able to arrive at a plan either compatible with or much closer to recommendations than the woman’s initial intentions in most cases, thereby preventing negative choices.
GSK2646264, a spleen tyrosine kinase inhibitor, attenuates the release of histamine in ex vivo human skin
Authors: Ramirez Molina Cesar , Falkencrone Sidsel , Skov Per S. , Hooper‐Greenhill Edward , Barker Mike , Dickson Marion C. 
Published: February 2019

Background and PurposeChronic spontaneous urticaria presents as a heterogeneous syndrome characterised by wheals, angioedema, or both for greater than 6 weeks. Spleen tyrosine kinase mediates allergen‐induced mast cell degranulation via the IgE signalling pathway, a central component of wheal formation and inflammation. In this study, we investigated the effects of perfused or topically administered GSK2646264 on IgE‐mediated histamine release from mast cells in an ex vivo human skin model.Experimental ApproachUsing a novel SkiP device, ex vivo human skin from mastectomy surgeries was challenged with anti‐IgE, complement 5a (C5a), and buffer to induce histamine release from skin mast cells. Histamine was collected via microdialysis fibres and measured fluorometrically. GSK2646264 was delivered via perfusion either using microdialysis fibres or topically in a cream. Drug concentrations in the skin were measured by LC–MS, and a pharmacokinetic/ pharmacodynamic (PK/PD) relationship developed.Key ResultsPerfused GSK2646264 significantly inhibited anti‐IgE (but not C5a)‐induced histamine release in a concentration‐dependent manner. The 0.5, 1, and 3% cream delivered GSK2646264 to the dermis above the IC90 and dose‐dependently attenuated anti‐IgE‐induced histamine release.Conclusions and ImplicationsGSK2646264 administered topically or direct to the dermis blocked histamine release from in situ skin mast cells. A PK/PD relationship curve suggests that dermal concentrations above 6.8 μM should lead to approximately 90% inhibition of histamine release from skin mast cells following activation of the Fc fragment of IgE receptor 1a, implicating a potential use for the compound in skin mast cell diseases such as urticaria.
Semaphorin‐3E attenuates intestinal inflammation through the regulation of the communication between splenic CD11C+ and CD4+CD25− T‐cells
Authors: Kermarrec Laëtitia , Eissa Nour , Wang Hongxing , Kapoor Kunal , Diarra Abdoulaye , Gounni Abdelilah S. , Bernstein Charles N. , Ghia Jean‐Eric 
Published: February 2019

Background and PurposeAn alteration in the communication between the innate and adaptive immune cells is a hallmark of ulcerative colitis (UC). Semaphorin‐3E (SEMA3E), a secreted guidance protein, regulates various immune responses.Experimental ApproachWe investigated the expression of SEMA3E in colonic biopsies of active UC patients and its mechanisms in Sema3e−/− mice using an experimental model of UC.Key ResultsSEMA3E level was decreased in active UC patients and negatively correlated with pro‐inflammatory mediators. Colonic expression of SEMA3E was reduced in colitic Sema3e+/+ mice, and recombinant (rec‐) Plexin‐D1 treatment exacerbated disease severity. In vivo rec‐SEMA3E treatment restored SEMA3E level in colitic Sema3e+/+ mice. In Sema3e−/− mice, disease severity was increased, and rec‐SEMA3E ameliorated these effects. Lack of Sema3e increased the expression of CD11c and CD86 markers. Colitic Sema3e−/− splenocytes and splenic CD11c+ cells produced more IL‐12/23 and IFN‐γ compared to Sema3e+/+, and rec‐SEMA3E reduced their release as much as NF‐κB inhibitors, whereas an NF‐κB activator increased their production and attenuated the effect of rec‐SEMA3E. Colitic Sema3e−/− splenic CD11c+/CD4+CD25− T‐cell co‐cultures produced higher concentrations of IFN‐γ and IL‐17 when compared to colitic Sema3e+/+ splenic cell co‐cultures, and rec‐SEMA3E decreased these effects. In vitro, anti‐IL‐12p19 and ‐12p35 antibodies and rec‐IL‐12 and ‐23 treatment confirmed the crosstalk between CD11c+ and CD4+CD25− T‐cells.Conclusion and ImplicationsSEMA3E is reduced in colitis and modulates colonic inflammation by regulating the interaction between CD11c+ and CD4+CD25− T‐cells via an NF‐κB‐dependent mechanism. Thus, SEMA3E could be a potential therapeutic target for UC patients.
Low‐level laser and adipose‐derived stem cells altered remodelling genes expression and improved collagen reorganization during tendon repair
Authors: Lucke Letícia D. , Bortolazzo Fernanda O. , Theodoro Viviane , Fujii Lucas , Bombeiro André L. , Felonato Maíra , Dalia Rodrigo A. , Carneiro Giane D. , Cartarozzi Luciana P. , Vicente Cristina Pontes , Oliveira Alexandre L. R. , Mendonça Fernanda A. S. , Esquisatto Marcelo A. M. , Pimentel Edson R. , de Aro Andrea A. 
Published: February 2019

AbstractObjectivesThe cellular therapy using adipose‐derived mesenchymal stem cells (ASCs) aims to improve tendon healing, considering that repaired tendons often result in a less resistant tissue. Our objective was to evaluate the effects of the ASCs combination with a low‐level laser (LLL), an effective photobiostimulation for the healing processes.Materials and methodsRats calcaneal tendons were divided into five groups: normal (NT), transected (T), transected and ASCs (SC) or LLL (L), or with ASCs and LLL (SCL).ResultsAll treated groups presented higher expression of Dcn and greater organization of collagen fibres. In comparison with T, LLL also up‐regulated Gdf5 gene expression, ASCs up‐regulated the expression of Tnmd, and the association of LLL and ASCs down‐regulated the expression of Scx. No differences were observed for the expression of Il1b, Timp2, Tgfb1, Lox, Mmp2, Mmp8 and Mmp9, neither in the quantification of hydroxyproline, TNF‐α, PCNA and in the protein level of Tnmd. A higher amount of IL‐10 was detected in SC, L and SCL compared to T, and higher amount of collagen I and III was observed in SC compared to SCL.ConclusionsTransplanted ASCs migrated to the transected region, and all treatments altered the remodelling genes expression. The LLL was the most effective in the collagen reorganization, followed by its combination with ASCs. Further investigations are needed to elucidate the molecular mechanisms involved in the LLL and ASCs combination during initial phases of tendon repair.
Performance of new spirometry reference values in preoperative assessment of lung function
Authors: Vogt Barbara , Hennig Victoria , Deuß Kathinka , Balke Lorenz , Weiler Norbert , Frerichs Inéz 
Published: February 2019

AbstractBackgroundPulmonary function is not routinely assessed in patients without respiratory disease and symptoms before surgery, even if they are smokers. We aimed to check whether the new spirometric reference values of the worldwide Global Lung Initiative (GLI) affected the preoperative assessment of lung function in allegedly lung‐healthy patients compared with the still commonly used old predicted values.MethodsTwo hundred nineteen allegedly lung‐healthy non‐smokers, past and current smokers were examined by spirometry before elective surgery. The obtained values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC were transformed into z‐scores according to the GLI guidelines. A comparison between the new and old reference values was performed. FEV1 was used for the grading of airway obstruction.ResultsOne hundred eighty‐three subjects performed the ventilation manoeuvre according to the GLI recommendations and were analysed. Most non‐smokers and past smokers met the new references ranges for spirometric values. Only z‐scores of FEV1/FVC distinguished among all three patient groups, FEV1 between smokers and the other two groups and FVC did not discriminate the groups, irrespective of the reference values used. Airway obstruction was identified in 24% of asymptomatic smokers by z‐scores of FEV1/FVC but in only 14% by the old predicted values. In elderly smokers (>60 years), the corresponding values rose to 50% and 30%. Old predicted values of FEV1 underestimated the degree of airway obstruction mainly in middle‐aged smokers.ConclusionAllegedly lung‐healthy current smokers showed a higher proportion of preoperatively reduced lung function when z‐scores were used, especially in elderly subjects.
Association between allopurinol and cardiovascular outcomes and all‐cause mortality in diabetes: A retrospective, population‐based cohort study
Authors: Weisman Alanna , Tomlinson George A. , Lipscombe Lorraine L. , Perkins Bruce A. , Hawker Gillian A. 
Published: February 2019

AimTo assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol‐treated diabetes cohort.Materials and MethodsWe conducted a population‐based retrospective cohort study in Ontario, Canada. Eligible subjects were ≥ 66 years old with diabetes and a first prescription for allopurinol between 1 April, 2002 and 31 March, 2012 and were followed until 31 March, 2016. The primary outcome was a composite: all‐cause mortality, non‐fatal cardiovascular event (myocardial infarction, revascularization procedure, or stroke) or congestive heart failure (CHF). Secondary outcomes were components of the primary outcome and pneumonia as a negative tracer. Allopurinol was modelled as time‐varying exposed versus unexposed, daily dose category and cumulative dose using sex‐specific multivariable Cox proportional hazards models.ResultsOver a median follow‐up of 4.65 years (interquartile range 1.79–7.81), 16 266/23 103 males and 10 571/15 313 females experienced the primary outcome. Allopurinol was associated with a reduction in the primary outcome [adjusted hazard ratios (aHR) 0.77 (95% confidence interval 0.75–0.80) and 0.81 (0.78–0.84) for males and females, respectively], driven by marked reductions in all‐cause mortality and modest reductions in cardiovascular events/CHF. There was no effect of cumulative allopurinol dose on any outcome, and allopurinol was also associated with reduced risk of pneumonia in males [aHR 0.88 (0.83, 0.93)].ConclusionsAllopurinol was associated with reduced mortality and cardiovascular outcomes. However, lack of cumulative dose effect and a positive tracer outcome in males suggests residual bias. Future research assessing whether allopurinol prevents vascular complications in diabetes requires a clinical trial.