bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased arterial stiffness in nonalcoholic fatty liver disease: a systematic review and meta-analysis
Authors: Jaruvongvanich Veeravich , Chenbhanich Jirat , Sanguankeo Anawin , Rattanawong Pattara , Wijarnpreecha Karn , Upala Sikarin 
Published: May 2017

Background
Arterial function is a marker of early atherosclerotic changes and cardiovascular disease. Several studies have suggested the possible association between nonalcoholic fatty liver disease (NAFLD) and increased arterial stiffness. Thus, we conducted a systematic review and meta-analysis to better characterize this association.

Patients and methods
A comprehensive search of the databases of the MEDLINE and EMBASE was carried out from inception through September 2016. All observational studies that compared arterial stiffness between NAFLD patients and healthy controls were included. Arterial stiffness was measured by pulse wave velocity (PWV) and augmentation index. We calculated pooled mean difference (MD) with 95% confidence intervals (CIs) using the random-effects model.

Results
Data were extracted from 12 studies involving 9351 NAFLD patients and 17 684 controls. NAFLD is significantly associated with increased arterial stiffness as determined by carotid–femoral PWV (MD=0.75 m/s, 95% CI: 0.43–1.07, I
2=88%), brachial–ankle PWV (MD=0.82 m/s, 95% CI: 0.57–1.07, I
2=92%), and augmentation index (pooled MD=2.54%, 95% CI: 0.07–5.01, I
2=73%) compared with healthy controls.

Conclusion
In conclusion, our study demonstrated a higher degree of arterial stiffness in NAFLD patients compared with controls. However, this association might be related to the higher prevalence of cardiometabolic risk factors in NAFLD patients. Further studies are needed to determine an independent association between NAFLD and arterial stiffness adjusting to cardiometabolic risks.
Predictors of pouchitis after ileal pouch–anal anastomosis in pediatric-onset ulcerative colitis
Authors: Rinawi Firas , Assa Amit , Eliakim Rami , Mozer Glassberg Yael , Nachmias Friedler Vered , Niv Yaron , Rosenbach Yoram , Silbermintz Ari , Zevit Noam , Shamir Raanan 
Published: May 2017

Objectives
Few studies have reported on the incidence and risk factors for pouchitis following colectomy and ileal pouch–anal anastomosis (IPAA) in patients with pediatric-onset ulcerative colitis (UC). We aimed to determine clinical predictors for the development of pouchitis following IPAA in this population.

Patients and methods
We performed a retrospective chart review of all pediatric UC cases that were diagnosed at the Schneider Children’s Medical Center of Israel between 1981 and 2013 and who underwent colectomy during disease course. Potential predictors for pouchitis and chronic pouchitis including various demographic, clinical, endoscopic, and histological variables at diagnosis and at the time of surgery were assessed.

Results
Of 188 patients with pediatric-onset UC, 33 (18%) underwent colectomy and IPAA surgery. During a median postsurgical follow-up of 7.6 (range: 1–21.5) years following IPAA, 20/33 (60%) patients developed pouchitis including 11/33 (33%) patients who developed chronic pouchitis. Kaplan–Meier survival estimates of the cumulative probability for pouchitis were 9% at 1 year and 36 and 55% at 5 and 10 years, respectively. Multivariate Cox models showed that older age at colectomy (hazard ratio: 0.86, P=0.024) was a protective factor, whereas preoperative vitamin-D deficiency (≤20 ng/ml) (hazard ratio: 4.4, P=0.021) increased the risk for pouchitis. Age at diagnosis, sex, disease extent, and preoperative therapeutic regimens did not affect the risk of pouchitis.

Conclusion
Long-term risk for pouchitis is significantly high in pediatric-onset UC after IPAA. Vitamin-D deficiency and younger age at colectomy may increase the risk for pouchitis.
Anti‐transglutaminase 6 Antibody Development in Children With Celiac Disease Correlates With Duration of Gluten Exposure
Authors: De Leo Luigina , Aeschlimann Daniel , Hadjivassiliou Marios , Aeschlimann Pascale , Salce Nicola , Vatta Serena , Ziberna Fabiana , Cozzi Giorgio , Martelossi Stefano , Ventura Alessandro , Not Tarcisio 
Published: May 2017

ABSTRACTObjectives:Antibodies against transglutaminase 6 (anti‐TG6) have been implicated in neurological manifestations in adult patients with genetic gluten intolerance, and it is unclear whether autoimmunity to TG6 develops following prolonged gluten exposure. We measured the anti‐TG6 in children with celiac disease (CD) at the diagnosis time to establish a correlation between these autoantibodies and the duration of gluten exposure. We investigated a correlation between anti‐TG6 and the presence of neurological disorders.Methods:Anti‐TG6 (IgA/IgG) were measured by ELISA in sera of children with biopsy‐proven CD and of children experiencing gastrointestinal disorders. CD patients positive for anti‐TG6 were retested after 2 years of gluten‐free diet (GFD).Results:We analyzed the sera of 274 CD children and of 121 controls. Anti‐TG6 were detected in 68/274 (25%) CD patients and in 19/121 (16%) controls, with significant difference between the 2 groups (P = 0.04). None of the CD patients and of the controls testing positive for anti‐TG6 were experiencing neurological disorders. Eleven of 18 (61%) CD patients with other autoimmune diseases were positive for anti‐TG6. In CD patients, a significant correlation between the gluten exposure before the CD diagnosis and anti‐TG6 concentration was found (P = 0.006 for IgA; P < 0.0001 for IgG). After GFD anti‐TG6 concentrations were significantly reduced (P < 0.001). No significant correlation was observed between anti‐TG6 and anti‐TG2 serum concentrations.Conclusions:Anti‐TG6 are more prevalent in children with untreated CD in the absence of overt neurological disorders. The synthesis of the anti‐TG6 is related to a longer exposure to gluten before the CD diagnosis, and the autoimmunity against TG6 is gluten dependent and disappeared during GFD.
Induction Therapy With Biosimilar Infliximab in Children With Crohn Disease
Authors: Sieczkowska‐Golub Joanna , Meglicka Monika , Plocek Anna , Banaszkiewicz Aleksandra , Jarzębicka Dorota , Toporowska‐Kowalska Ewa , Gawronska Agnieszka , Oracz Grzegorz , Kierkus Jaroslaw 
Published: May 2017

ABSTRACTIntroduction:In most European countries, an infliximab biosimilar (CT‐P13) is currently in common use. In vitro and in vivo studies have proved a high similarity between CT‐P13 and the reference infliximab. CT‐P13 was licensed for use in patients with Crohn disease (CD) based on the extrapolation of data from preclinical studies and clinical trials in rheumatology indications. The aim of this study was to assess the similarity between CT‐P13 and the originator infliximab in induction therapy in CD paediatric patients.Methods:Thirty‐six CD paediatric patients from 3 Polish academic centres who started biological therapy with CT‐P13 were enrolled in this prospective, observational study. Patients received 3 induction doses (5 mg/kg) of CT‐P13 at weeks 0, 2, 6. Assessment was performed before the first infusion and at week 14.Results:Overall 34/36 (94.4%) patients completed induction therapy with CT‐P13. A clinical response or remission after 3 initial doses was achieved in 31/36 (86%) and 24/36 (67%) of patients, respectively. Clinically and statistically significant decreases in Paediatric Crohn's Disease Activity Index, C‐reactive protein, and erythrocyte sedimentation rate were observed in the responders group. An allergic reaction during infusion, which led to treatment discontinuation, was observed in one case.Conclusions:Induction therapy with CT‐P13 in children with CD is effective. The profile appears similar to that reported for the reference infliximab. No unexpected adverse events occurred.
Wolman Disease: A Mimic of Infant Leukemia
Authors: Gopakumar Kaduveettil G. , Thankamony Priyakumari , Nampoothiri Sheela , Bali Deeksha , Raj Jubie , A. Vasudevan Jayasudha , K. Nair Ramachandran 
Published: May 2017

Background:
Infant leukemia most commonly present with pallor and hepatosplenomegaly. The possibility of other differential diagnosis also has to be kept in mind during evaluation, as identifying the precise etiology for this clinical presentation is crucial for management.

Observation:
An infant, was referred to us with suspected infant leukemia and was subsequently diagnosed to have lysosomal acid lipase deficiency/Wolman disease with a novel 5 bp deletion “c.1180_1184del” in the last exon (exon 10) of the lipase A (LIPA) gene.

Conclusions:
Hepatosplenomegaly and pallor resulting from nutritional deficiency or bone marrow involvement in Wolman disease can mimic infant leukemia.
Testing the Implementation of a Pain Self-management Support Intervention for Oncology Patients in Clinical Practice
Authors: Koller Antje , Gaertner Jan , De Geest Sabina , Hasemann Monika , Becker Gerhild 
Published: May 2017

Background:
In oncology, pain control is a persistent problem. Significant barriers to cancer pain management are patient related. Pain self-management support interventions have shown to reduce pain intensity and patient-related barriers. Comparative effectiveness research is a suitable approach to test whether effects are sustained in clinical practice.

Objective:
In this pilot randomized controlled trial, the implementation of the ANtiPain intervention into clinical practice was tested to assess the effects on pain intensity, function-related outcomes, self-efficacy, and patient-related barriers to pain management to prepare a larger effectiveness trial.

Methods:
Within 14 months, 39 adult oncology patients with pain scores of 3 or higher on a 10-point numeric rating scale were recruited in an academic comprehensive cancer center in Southern Germany. Patients in the control group (n = 19) received standard care. Patients in the intervention group (n = 20) received ANtiPain, a cancer pain self-management support intervention based on 3 key strategies: provision of information, skill building, and nurse coaching. An intervention session was performed in-hospital. After discharge, follow-up was provided via telephone calls. Data were collected at baseline and 1 and 6 weeks after discharge. Effect sizes were calculated for all outcomes.

Results:
Large effects were found for activity hindrance (Cohen d = 0.90), barriers (d = 0.91), and self-efficacy (d = 0.90). Small to moderate effects were found for average and worst pain (Cohen d = 0.17-0.45).

Conclusions:
Key findings of this study involved function-related outcomes and self-efficacy.

Implications for Practice:
Because these outcomes are particularly meaningful for patients, the integration of ANtiPain to routine clinical practice may be substantial. A larger study will be based on these findings.
Providing Coordinated Cancer Care—A Qualitative Study of Norwegian Cancer Coordinators’ Experiences of Their Role
Authors: Lie Nataskja-Elena Kersting , Hauken May Aasebø , Solvang Per Koren 
Published: May 2017

Background:
There is a growing need for strategies to improve coordinated, tailored services in cancer care to meet the comprehensive needs of cancer patients. In Norway, cancer coordinators (CCs) have been established to improve coordination and patient-centeredness of services. Little is known about how CCs engage to provide patients with the needed services and support throughout the treatment.

Objective:
The aim of this study was to explore how Norwegian CCs experience their role and how they enact it in order to enhance coordinated cancer care.

Methods:
The study encompasses a qualitative, hermeneutic approach, conducting semistructured in-depth interviews of 26 Norwegian CCs. The data were analyzed using thematic analysis and discussed in the light of the salutogenic theory.

Results:
Cancer coordinators take a holistic approach to patient care, including both patient- and system-level activities. “Providing coordinated cancer care” emerged as an overarching topic for their role. This topic was elaborated by 3 main themes: (1) finding their place and creating their function, (2) meeting the needs of cancer patients and helping them cope, (3) promoting well-functioning cancer care systems.

Conclusions:
Cancer coordinators evolved diversely, in adaption to the local context and patients’ needs. The functions’ diversity challenged the implementation and external role recognition. Cancer coordinators seemed to apply a salutogenic, resource-focused orientation in order to support a positive development at both the patient and the system levels.

Implications for Practice:
The findings reinforce the call for holistic, patient-centered services in cancer care. Cancer coordinators need appropriate support from the local management to establish the role and local collaborations.
Approach to skin and soft tissue infections in non-HIV immunocompromised hosts
Authors: Burke Victoria E. , Lopez Fred A. 
Published: May 2017

Purpose of review
Skin and soft tissue infections are frequent contributors to morbidity and mortality in the immunocompromised host. This article reviews the changing epidemiology and clinical manifestations of the most common cutaneous pathogens in non-HIV immunocompromised hosts, including patients with solid organ transplants, stem cell transplants, solid tumors, hematologic malignancies, and receiving chronic immunosuppressive therapy for inflammatory disorders.

Recent findings
Defects in the innate or adaptive immune response can predispose the immunocompromised host to certain cutaneous infections in a predictive fashion. Cutaneous lesions in patients with neutrophil defects are commonly due to bacteria, Candida, or invasive molds. Skin lesions in patients with cellular or humoral immunodeficiencies can be due to encapsulated bacteria, Nocardia, mycobacteria, endemic fungal infections, herpesviruses, or parasites. Skin lesions may reflect primary inoculation or, more commonly, disseminated infection. Tissue samples for microscopy, culture, and histopathology are critical to making an accurate diagnosis given the nonspecific and heterogeneous appearance of these skin lesions due to a blunted immune response.

Summary
As the population of non-HIV immunosuppressed hosts expands with advances in medical therapies, the frequency and variety of cutaneous diseases in these hosts will increase.
Feasibility and applicability of antimicrobial stewardship in immunocompromised patients
Authors: Robilotti Elizabeth , Holubar Marisa , Seo Susan K. , Deresinski Stan 
Published: May 2017

Purpose of review
Antimicrobial stewardship is the primary intervention in the battle against antimicrobial resistance, but clinicians do not always apply many key antimicrobial stewardship principles to patients with significant immune defects due to lack of data and fear of bad outcomes. We review evidence regarding the application of stewardship principles to immunocompromised patients, with a focus on solid organ and hematopoietic stem cell transplant recipients.

Recent findings
Antimicrobial stewardship programs (ASPs), targeting immunocompromised patient populations such as oncology and transplant, are gaining traction. Emerging literature suggests that several stewardship interventions can be adapted to immunocompromised hosts and improve antimicrobial utilization, but data supporting improved outcomes is very limited.

Summary
The application of antimicrobial stewardship principles to immunocompromised patients is feasible, necessary, and urgent. As antimicrobial stewardship programs gain momentum across a diverse range of healthcare settings more immunocompromised patients will fall under their purview. It is imperative that centers applying antimicrobial stewardship principles share their experience and establish collaborative research efforts to advance our knowledge base in applying antimicrobial stewardship initiatives to immunocompromised host populations, both in terms of programmatic success and patient outcomes.
Modified Dual-Energy Algorithm for Calcified Plaque Removal
Authors: Mannil Manoj , Ramachandran Jaychandran , Vittoria de Martini Ilaria , Wegener Susanne , Schmidt Bernhard , Flohr Thomas , Krauss Bernhard , Valavanis Antonios , Alkadhi Hatem , Winklhofer Sebastian 
Published: May 2017

Objectives
Computed tomography angiography (CTA) is a valuable tool for the assessment of carotid artery stenosis. However, blooming artifacts from calcified plaques might result in an overestimation of the stenosis grade. The aim of this study was to investigate a new dual-energy computed tomography (DECT) technique with a modified 3-material decomposition algorithm for calcium removal in extracranial carotid artery stenosis.

Materials and Methods
In this retrospective, institutional review board-approved study, 30 calcified carotid plaques in 22 patients (15 men; mean age, 73 ± 10 years) with clinical suspicion of stroke were included. Dual-energy computed tomography image data were obtained using second-generation dual-source CT with tube voltages at 80 and 140Sn kVp. Conventional CTA and virtual noncalcium (VNCa) images using the modified DECT algorithm were reconstructed. By assessing spectral characteristics, the modified DECT algorithm allows for a selective removal of calcium independent of blooming. Two independent and blinded readers evaluated subjective image quality, blooming artifacts, amount of (residual) calcification, and performed stenosis measurements according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Differences were tested using a pairwise sign test. Paired sample t tests with Bonferroni correction (P < 0.017) and Bland-Altman analyses were used to test for differences in carotid stenosis measurements between VNCa and conventional CTA using digital subtraction angiography (DSA) as the standard of reference.

Results
Subjective image quality was similar among conventional CTA and VNCa image data sets (P = 0.82), whereas blooming artifacts were significantly reduced in VNCa images compared with conventional CTA (P < 0.001). Residual calcifications in VNCa images were absent in 11 (37%), minor in 12 (40%), medium sized in 2 (7%), and large in 5 (17%) arteries. Stenosis measurements differed significantly between VNCa (mean NASCET stenosis: 27% ± 20%) and conventional CTA images (mean NASCET stenosis: 39% ± 16%; P < 0.001) and between conventional CTA and DSA (23% ± 16%, P < 0.001). No significant differences in stenosis measurements were observed between VNCa and DSA (P = 0.189), with narrow limits of agreement (mean difference ±1.96 standard deviations: −4.7%, −35.1%, and 25.7%).

Conclusions
A modified 3-material decomposition DECT algorithm for calcium removal was introduced, which allows for an accurate removal of calcified carotid plaques in extracranial carotid artery disease. The algorithm might overcome the problem of overestimation of calcified stenosis due to blooming artifacts in conventional CTA.
Spatial organization of the mouse auditory cortex to sound dynamics revealed using automated image segmentation
Authors: Liu Ji , Whiteway Matthew R. , Butts Daniel A. , Kanold Patrick O. 
Published: May 2017

AbstractSound stimuli are characterized by their rich spectral and temporal dynamic properties. Individual neurons in auditory cortex (ACX) encode both spectral and temporal aspects of sounds e.g. sound onset and/or offset. While the different fields of the ACX show gradients of frequency selectivity the large-scale organization of sound dynamics is unknown. We used widefield imaging of GCaMP6s in awake mouse ACX combined with a novel unsupervised image segmentation technique to investigate the spatiotemporal representation of sound onset and offset. Using this technique, we identified known auditory fields but also detected novel ACX areas. Furthermore, we found that ACX areas differed in their responses to tone onset and offset. Multiple areas were preferentially activated by tone offset, and on-response areas were more spatially localized than off-response areas. We also found tonotopy in off-responses. Together our results demonstrate a different spatial distribution of neurons across ACX for processing sound onsets versus offsets.
Sequence Specific Modeling ofE. coliCell-Free Protein Synthesis
Authors: Vilkhovoy Michael , Horvath Nicholas , Shih Che-Hsiao , Wayman Joseph A. , Calhoun Kara , Swartz James , Varner Jeffrey D. 
Published: May 2017

AbstractCell-free protein synthesis (CFPS) is a widely used research tool in systems and synthetic biology. However, if CFPS is to become a mainstream technology for applications such as point of care manufacturing, we must understand the performance limits and costs of these systems. Toward this question, we used sequence specific constraint based modeling to evaluate the performance ofE. colicell-free protein synthesis. A coreE. colimetabolic network, describing glycolysis, the pentose phosphate pathway, energy metabolism, amino acid biosynthesis and degradation was augmented with sequence specific descriptions of transcription and translation and effective models of promoter function. Model parameters were largely taken from literature, thus the constraint based approach coupled the transcription and translation of the protein product, and the regulation of gene expression, with the availability of metabolic resources using only a limited number of adjustable model parameters. We tested this approach by simulating the expression of two model proteins: chloramphenicol acetyltransferase and dual emission green fluorescent protein, for which we have training data sets; we then expanded the simulations to a range of additional proteins. Protein expression simulations were consistent with measurements for a variety of cases. The constraint based simulations confirmed that oxidative phosphorylation was active in the CAT cell-free extract, as without it there was no feasible solution within the experimental constraints of the system. We then compared the metabolism of theoretically optimal and experimentally constrained CFPS reactions, and developed parameter free correlations which could be used to estimate productivity as a function of protein length and promoter type. Lastly, global sensitivity analysis identified the key metabolic processes that controlled CFPS productivity and energy efficiency. In summary, sequence specific constraint based modeling of CFPS offered a novel means toa prioriestimate the performance of a cell-free system, using only a limited number of adjustable parameters. While we modeled the production of a single protein in this study, the approach could easily be extended to multi-protein synthetic circuits, RNA circuits or the cell free production of small molecule products.