bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential miRNA Expression in Ileal and Colonic Tissues Reveals an Altered Immunoregulatory Molecular Profile in Individuals With Crohn’s Disease versus Healthy Subjects
Authors: Mohammadi Aylia , Kelly Orlaith B , Smith Michelle I , Kabakchiev Boyko , Silverberg Mark S 
Published: April 2019

Abstract

Background
MicroRNAs [miRNAs] are key modulators of gene expression in Crohn’s disease [CD] and may drive tissue-specific molecular alterations underlying CD susceptibility. In this study, we analysed differential miRNA expression between CD and healthy subjects across ileal and colonic tissues.

Methods
A cohort of CD and healthy control [HC] subjects was recruited and clinical data collected. Endoscopically quiescent CD [CDq] was defined as inactive or mild by the Simple Endoscopic Score for CD. Total RNA was extracted from endoscopic biopsies taken from the terminal ileum and sigmoid colon. miRNA expression was quantified using NanoString Technologies. Statistical significance was assessed across biopsy site and diagnosis per miRNA, and corrected for multiple testing.

Results
In total, 23 CDq and 38 HC subjects were enrolled; 112 samples were included in the analysis, 51 from the ileum and 61 from the colon. We found 47 miRNAs differentially expressed by biopsy site in healthy tissue. Nine miRNAs were differentially expressed across HC and CDq, accounting for biopsy location. One of these, miR-223-3p, showed age and sex effects. We identified miRNA expression driven by diagnosis targeting genes involved in chemokine and cytokine signalling. miR-31-5p expression was driven by location and may be a biomarker for location subtypes in CD.

Conclusions
We identified differentially expressed miRNAs in healthy ileal and colonic tissues. We discovered spatial miRNA expression patterns in CD and HC, suggesting site-specific regulation in subjects with no or minimal intestinal inflammation. These miRNAs target genes involved in immunoregulatory processes, suggesting a functional, tissue-specific role in CD.
A 30-year Trend Analysis in the Epidemiology of Inflammatory Bowel Disease in the Songpa-Kangdong District of Seoul, Korea in 1986–2015
Authors: Park Sang Hyoung , Kim Ye-Jee , Rhee Kyoung Hoon , Kim Young-Ho , Hong Sung Noh , Kim Kyung Ho , Seo Seung In , Cha Jae Myung , Park Sun Yong , Jeong Seung Kyu , Lee Ji Hyun , Park Hyunju , Kim Joo Sung , Im Jong Pil , Yoon Hyuk , Kim Sung Hoon , Jang Jisun , Kim Jeong Hwan , Suh Seong O , Kim Young Kyun , Ye Byong Duk , Yang Suk-Kyun ,   Songpa-Kangdong Inflammatory Bowel Disease [SK-IBD] Study Group
Published: April 2019

Abstract

Background and Aims
Although the incidence of inflammatory bowel disease [IBD] is increasing in Asia, data on long-term epidemiological trends are limited. We performed a 30-year longitudinal study to investigate temporal trends in the epidemiology of Crohn’s disease [CD] and ulcerative colitis [UC] in Seoul, Korea.

Methods
This population-based study included 1431 IBD patients [418 CD, 1013 UC] diagnosed between 1986 and 2015 in the Songpa-Kangdong district of Seoul, Korea. Temporal trends in incidence, prevalence, and disease phenotype at diagnosis were analysed.

Results
The adjusted mean annual incidence rates of CD and UC per 100 000 inhabitants increased from 0.06 (95% confidence interval [CI], 0.05–0.07) and 0.29 [95% CI, 0.27–0.31], respectively, in 1986–1990 to 2.44 [95% CI, 2.38–2.50] and 5.82 [95% CI, 5.73–5.92], respectively, in 2011–2015. Average annual percentage change in IBD incidence was 12.3% in 1986–1995, 12.3% in 1996–2005, and 3.3% in 2006–2015. The male-to-female ratio of the adjusted incidence rate was 3.3:1 for CD and 1.2:1 for UC. Perianal fistula/abscess was present in 43.3% of patients before or at CD diagnosis. At diagnosis, 54.3% of UC patients presented only with proctitis. The adjusted prevalence rate in 2015 was 31.59/100 000 [95% CI, 31.10–32.07] for CD and 76.66/100 000 [95% CI, 75.91–77.42] for UC.

Conclusions
The incidence and prevalence of IBD in Korea have continued to increase over the past three decades. Korean patients have distinct demographic and phenotypic characteristics, including a male predominance and high frequency of perianal fistula/abscess in CD and high proportion of proctitis in UC.
Comparative study of the frozen elephant trunk and classical elephant trunk techniques to supplement total arch replacement for acute type A aortic dissection†
Authors: Inoue Yosuke , Matsuda Hitoshi , Omura Atsushi , Seike Yoshimasa , Uehara Kyokun , Sasaki Hiroaki , Kobayashi Junjiro 
Published: April 2019

Abstract

OBJECTIVES
In patients with acute type A aortic dissection, the use of the frozen elephant trunk (FET) procedure with total arch replacement (TAR) has been indicated for emergency operations to obtain thrombosis of the distal false lumen (FL). However, data comparing the FET and the classical elephant trunk (CET) procedures, including the incidences of mortality, morbidity, spinal cord injury and aortic remodelling, have not yet been reported. The goal of this study was to compare the early outcomes of TAR with the FET and the CET procedures.

METHODS
The past 7 years of medical records of 323 patients with type A aortic dissection who underwent emergency surgery were reviewed retrospectively, and 148 patients who underwent TAR were shortlisted for the study. First, the patients were divided into 2 groups, the CET group (n = 115; age 65 ± 12 years) and FET group (n = 33; 67 ± 11 years), to compare the early operative outcomes, including mortality and morbidity. Second, 86 patients (CET 56; FET 30) fulfilling the inclusive criteria (inserted length of elephant trunk ≥5 cm, involvement of dissection at the descending aorta and sufficient computed tomographic evaluation at ≥6 months after the operation) were compared to evaluate the patency and diameter of the FL at each segment of the downstream aorta.

RESULTS
The in-hospital mortality rate was 8.1% (12/148), without significant differences between the 2 groups (CET 8.7% vs FET 6.1%; P = 1). No spinal cord ischaemia was encountered in either group. The incidence of postoperative FL patency at the level of the left lower pulmonary vein was 30% in the FET group, which was significantly lower than that in the preoperative state (73%) and in the CET group (77%). The downsizing of the aortic diameter at the distal edge of the CET or the FET, the left lower pulmonary vein and the coeliac axis was significant in the FET group 6 months after TAR.

CONCLUSIONS
According to our initial experience, the FET compared to the CET procedure showed comparable early complications and an advantage concerning FL thrombosis and aortic remodelling at early follow-up examinations.
Injectable RANKL sustained release formulations to accelerate orthodontic tooth movement
Authors: Chang Joy H , Chen Po-Jung , Arul Michael R , Dutra Eliane H , Nanda Ravindra , Kumbar Sangamesh G , Yadav Sumit 
Published: April 2019

SummaryBackgroundAccelerating orthodontic tooth movement (OTM) through biologically effective methods, such as increasing osteoclast-mediated alveolar resorption, could effectively shorten treatment time.ObjectiveTo evaluate an injectable formulation containing receptor activator of nuclear factor kappa-B ligand (RANKL) on the OTM.Materials and methodsWe fabricated a RANKL formulation from 100 µl of 100 µg/ml RANKL adsorbed on 10 mg of poly(lactic acid-co-glycolic acid) microspheres embedded in a 10 wt% aqueous hydroxyethyl cellulose carrier gel. We characterized these formulations for the rate of RANKL release, and then tested for bioactivity using in vitro cell culture. In vivo OTM studies were conducted using 15 week old male Wistar rats for 14 days. We injected the RANKL formulations palatal to the left maxillary first molar and accomplished OTM with a nickel–titanium (NiTi) coil spring applying 5–8 g force. Control groups involved the application of NiTi coil spring with and without placebo formulation. The outcome measure included the distance of tooth movement, bone volume fraction, tissue density, and root volume determined with micro-computed tomography. We determined the amount of osteoclast activity using tartrate-resistant acid phosphatase (TRAP) staining.ResultsThese formulations were able to sustain the release of RANKL for more than 30 days, and the released RANKL showed a positive effect on mice osteoclast precursor cells (RAW 264.7). Reported injectable RANKL formulations were effective in accelerating OTM compared with other control groups, with 129.2 per cent more tooth movement than no formulation and 71.8 per cent more than placebo formulation, corresponding with a significant increase in the amount of TRAP activity. We did not observe any significant differences in root resorption between the groups.ConclusionOur study shows a significant increase in OTM with injectable formulations containing RANKL.
Back to Square One: Revisiting How We Analyse the Right of Access to Environmental Information
Authors: Whittaker Sean , Mendel Jonathan , Reid Colin T 
Published: April 2019

Abstract
The right of access to environmental information has become a key aspect of contemporary efforts to promote environmental governance in the UK. The right is enshrined in international law through the Aarhus Convention which, alongside other legal developments, has influenced how academics analyse the right in the UK. How research into the right has been conducted is significant because it has led to gaps in how we understand the right and undermines environmental protection efforts. This article identifies and critiques the common analytical trends used to analyse the right of access to environmental information in the UK. The article considers two of these trends, examining their negative impact and the role of the Aarhus Convention in creating these trends. The article concludes by discussing the need to critically engage with these knowledge gaps to improve how the right is guaranteed and, ultimately, the implementation of environmental protection efforts.
Gentzen sequent calculi for some intuitionistic modal logics
Authors: Lin Zhe , Ma Minghui 
Published: April 2019

Abstract
Intuitionistic modal logics are extensions of intuitionistic propositional logic with modal axioms. We treat with two modal languages ${\mathscr{L}}_\Diamond $ and $\mathscr{L}_{\Diamond ,\Box }$ which extend the intuitionistic propositional language with $\Diamond $ and $\Diamond ,\Box $, respectively. Gentzen sequent calculi are established for several intuitionistic modal logics. In particular, we introduce a Gentzen sequent calculus for the well-known intuitionistic modal logic $\textsf{MIPC}$. These sequent calculi admit cut elimination and subformula property. They are decidable.
Utilization of Laboratory Testing Algorithms for Celiac Disease in a Pediatric Hospital
Authors: Ali Mahesheema , Danner Derek J , Fishman Douglas S , Devaraj Sridevi 
Published: April 2019

Abstract

Background
At Texas Children’s Hospital in Houston, numerous celiac tests are ordered from a wide range of nonspecialty healthcare providers.

Objective
To retrospectively examine the ordering of celiac tests before and after a test ordering initiative at our institution, to determine whether the initiative impacted appropriate usage of those tests and affected costs.

Methods
We carefully scrutinized all orders for comprehensive celiac testing from July 2016 through September 2017, implemented an in-house celiac-disease screening cascade, and reflexed it to the comprehensive celiac testing panel if an abnormal screening result was obtained.

Results
A total of 60 celiac test orders were issued during the 14-month study period. The ordering physician was a gastroenterologist in 6 cases and a nongastroenterologist in 54 cases. Of the 60 orders, only 4 were approved for sending out for comprehensive celiac testing; in 52 of the 60 cases, the order was altered to celiac screening. In the remaining 4 cases, the tests were canceled as a result of incorrect orders. Only 1 of the 52 celiac screenings yielded a positive result and thus was reflexed to the comprehensive panel.

Conclusions
We were able to induce appropriate celiac test usage by implementing a celiac-reflexive cascade. Also, our strategy proved to be extremely cost effective.
Doctors’ decisions when disclosing their mental ill-health
Authors: Rees S , Cohen D , Marfell N , Robling M 
Published: April 2019

Abstract

Background
Understanding of what prevents doctors from seeking help for mental ill-health has improved. However, less is known about what promotes timely disclosure and the nature of doctors’ decision making.

Aims
This study aimed to define how doctors make decisions about their own mental ill-health, and what facilitates disclosure. It explored the disclosure experiences of doctors and medical students; their attitudes to their decisions, and how they evaluate potential outcomes.

Methods
Qualitative, semi-structured interviews with UK doctors and medical students with personal experience of mental ill-health. Participants were recruited through relevant organizations, utilizing regular communications such as newsletters, e-mails and social media. Data were subject to a thematic analysis.

Results
Forty-six interviews were conducted. All participants had disclosed their mental ill-health to someone; not all to their workplace. Decision making was complex, with many participants facing multiple decisions throughout their careers. Disclosures were made despite the many obstacles identified in the literature; participants described enablers to and benefits of disclosing. The importance of appropriate responses to first disclosures was highlighted.

Conclusions
Motivations to disclose mental ill-health are complex and multifactorial. An obstacle for one was an enabler for another. Understanding this and the importance of the first disclosure has important implications for how best to support doctors and medical students in need.
Auditory Training for Adult Cochlear Implant Users: A Survey and Cost Analysis Study
Authors: Reis Mariana , Boisvert Isabelle , Beedell Emma , Mumford Virginia 
Published: April 2019

Objectives:
The aims of this study were as follows: (a) to describe audiologists’ practices toward auditory training (AT) for adult cochlear implant (CI) users with a postlingual hearing loss; and (b) to assess the cost of different AT methods for clients and service providers in comparison with no AT delivery.

Design:
A survey was distributed to approximately 230 Australian CI audiologists to investigate the range, magnitude, and rationale of AT practices adopted as part of rehabilitation services with adult CI users. The cost of these different AT practices was then estimated from the perspectives of both clients and service providers, and compared against no AT delivery.

Results:
Seventy-eight audiologists responded to at least one section of the survey (16% to 33% response rate), of which 85.5% reported that they viewed AT as a necessary component of rehabilitation. Home-based and face-to-face were the methods most frequently adopted to deliver AT. Methods used during training, such as stimuli type, feedback, and encouragement for training adherence, varied across respondents. The cost analysis indicated that home-based training resulted in the lowest program costs, whereas face-to-face AT (when delivered independently from routine appointments) was the method with highest cost for clients and service providers.

Conclusions:
The type of AT, recommended frequency of sessions, and overall duration of programs varied widely across respondents. Costs incurred by clients depended mainly on whether the AT was home-based or clinician-led (i.e., face-to-face, group-based), program fees, and travel arrangements made by clients, as well as clinicians’ wages and the method chosen to deliver AT.
Otitis Media in Childhood and Disease in Adulthood: A 40-Year Follow-Up Study
Authors: Aarhus Lisa , Homøe Preben , Engdahl Bo 
Published: April 2019

Objectives:
The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood.

Design:
Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses.

Results:
The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking.

Conclusion:
Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
Children With Congenital Unilateral Sensorineural Hearing Loss: Effects of Late Hearing Aid Amplification—A Pilot Study
Authors: Johansson Marlin , Asp Filip , Berninger Erik 
Published: April 2019

Objectives:
Although children with unilateral hearing loss (uHL) have high risk of experiencing academic difficulties, speech-language delays, poor sound localization, and speech recognition in noise, studies on hearing aid (HA) outcomes are few. Consequently, it is unknown when and how amplification is optimally provided. The aim was to study whether children with mild-to-moderate congenital unilateral sensorineural hearing loss (uSNHL) benefit from HAs.

Design:
All 6- to 11-year-old children with nonsyndromic congenital uSNHL and at least 6 months of HA use were invited (born in Stockholm county council, n = 7). Participants were 6 children (9.7- to 10.8-years-old) with late HA fittings (>4.8 years of age). Unaided and aided hearing was studied with a comprehensive test battery in a within-subject design. Questionnaires were used to study overall hearing performance and disability. Sound localization accuracy (SLA) and speech recognition thresholds (SRTs) in competing speech were measured in sound field to study hearing under demanding listening conditions. SLA was measured by recording eye-gaze in response to auditory-visual stimuli presented from 12 loudspeaker–video display pairs arranged equidistantly within ±55° in the frontal horizontal plane. The SRTs were measured for target sentences at 0° in spatially separated (±30° and ±150°) continuous speech. Auditory brainstem responses (ABRs) were obtained in both ears separately to study auditory nerve function at the brainstem level.

Results:
The mean ± SD pure-tone average (0.5, 1, 2, and 4 kHz) was 45 ± 8 dB HL and 6 ± 4 dB HL in the impaired and normal hearing ear, respectively (n = 6). Horizontal SLA was significantly poorer in the aided compared with unaided condition. A significant relationship was found between aided SLA (quantified by an error index) and the impaired ear’s ABR I to V interval, suggesting a relationship between the two. Results from questionnaires revealed aided benefit in one-to-one communication, whereas no significant benefit was found for communication in background noise or reverberation. No aided benefit was found for the SRTs in competing speech.

Conclusions:
Children with congenital uSNHL benefit from late HA intervention in one-to-one communication but not in demanding listening situations, and there is a risk of degraded SLA. The results indicate that neural transmission time from the impaired cochlea to the upper brainstem may have an important role in unilaterally aided spatial hearing, warranting further study in children with uHL receiving early HA intervention.
Optimum Coupling of an Active Middle Ear Actuator: Effect of Loading Forces on Actuator Output and Conductive Losses
Authors: Gamm Ute A. , Grossöhmichen Martin , Salcher Rolf B. , Prenzler Nils K. , Lenarz Thomas , Maier Hannes 
Published: April 2019

Introduction:
The desired outcome of the implantation of active middle ear implants is maximum coupling efficiency and a minimum of conductive loss. It has not been investigated yet, which loading forces are applied during the process of coupling, which forces lead to an optimum actuator performance and which forces occur when manufacturer guidelines for coupling are followed.

Methods:
Actuator output was measured by laser Doppler vibrometry of stapes motion while the actuator was advanced in 20 μm steps against the incus body while monitoring static contact force. The occurrence of conductive losses was investigated by measuring changes in stapes motion in response to acoustic stimulation for each step of actuator displacement. Additionally, the electrical impedance of the actuator was measured over the whole frequency range at each actuator position.

Results:
Highest coupling efficiency was achieved at forces above 10 mN. Below 1 mN no efficient coupling could be achieved. At 30 mN loading force, which is typical when coupling according to manufacturer guidelines, conductive losses of more than 5 dB were observed in one out of nine TBs. The electrical impedance of the actuator showed a prominent resonance peak which vanished after coupling.

Conclusion:
A minimum coupling force of 10 mN is required for efficient coupling of the actuator to the incus. In most cases, coupling forces up to 100 mN will not result in clinically relevant conductive losses. The electrical impedance is a simple and reliable metric to indicate contact.