bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial Metabolic Networks at the Mucus Layer Lead to Diet-Independent Butyrate and Vitamin B12Production by Intestinal Symbionts
Authors: Belzer Clara , Chia Loo Wee , Aalvink Steven , Chamlagain Bhawani , Piironen Vieno , Knol Jan , de Vos Willem M. 
Published: September 2017

ABSTRACTAkkermansia muciniphilahas evolved to specialize in the degradation and utilization of host mucus, which it may use as the sole source of carbon and nitrogen. Mucus degradation and fermentation byA. muciniphilaare known to result in the liberation of oligosaccharides and subsequent production of acetate, which becomes directly available to microorganisms in the vicinity of the intestinal mucosa. Coculturing experiments ofA.muciniphilawith non-mucus-degrading butyrate-producing bacteriaAnaerostipes caccae,Eubacterium hallii, andFaecalibacterium prausnitziiresulted in syntrophic growth and production of butyrate. In addition, we demonstrate that the production of pseudovitamin B12byE. halliiresults in production of propionate byA. muciniphila, which suggests that this syntrophy is indeed bidirectional. These data are proof of concept for syntrophic and other symbiotic microbe-microbe interactions at the intestinal mucosal interface. The observed metabolic interactions betweenA.muciniphilaand butyrogenic bacterial taxa support the existence of colonic vitamin and butyrate production pathways that are dependent on host glycan production and independent of dietary carbohydrates. We infer that the intestinal symbiontA. muciniphilacan indirectly stimulate intestinal butyrate levels in the vicinity of the intestinal epithelial cells with potential health benefits to the host.IMPORTANCEThe intestinal microbiota is said to be a stable ecosystem where many networks between microorganisms are formed. Here we present a proof of principle study of microbial interaction at the intestinal mucus layer. We show that indigestible oligosaccharide chains within mucus become available for a broad range of intestinal microbes after degradation and liberation of sugars by the speciesAkkermansia muciniphila. This leads to the microbial synthesis of vitamin B12, 1,2-propanediol, propionate, and butyrate, which are beneficial to the microbial ecosystem and host epithelial cells.
FISHing Out the Hidden Enemy: Advances in Detecting and Measuring Latent HIV-Infected Cells
Authors: Prasad Vinayaka R. , Kalpana Ganjam V. 
Published: September 2017

ABSTRACT

The indomitable aspect of HIV-1 infection is not that HIV-1 proviral DNA is integrated into host DNA but that it can also turn itself off, remaining invisible to drug or immune surveillance. Thus, the goals of eradication include ways to precisely excise HIV-1 DNA or wake up the silent HIV-1 provirus and eliminate the infected cells thus identified. Methods to identify and fish out the latently infected cells or to delineate their characteristics are being rapidly developed. In 2016, Baxter et al. (A. E. Baxter, J. Niessl, R. Fromentin, J. Richard, F. Porichis, R. Charlebois, M. Massanella, N. Brassard, N. Alsahafi, G. G. Delgado, J. P. Routy, B. D. Walker, A. Finzi, N. Chomont, and D. E. Kaufmann, Cell Host Microbe 20:368–380, 2016,
https://doi.org/10.1016/j.chom.2016.07.015
) and Martrus et al. (G. Martrus, A. Niehrs, R. Cornelis, A. Rechtien, W. García-Beltran, M. Lütgehetmann, C. Hoffmann, and M. Altfeld, J Virol 90:9018–9028, 2016,
https://doi.org/10.1128/JVI.01448-16
) reported using the fluorescence
in situ
hybridization-flow cytometry technique to identify and quantify cells expressing HIV-1 RNA and Gag protein, as well as bearing unique cell surface markers. In a recent article in
mBio
, Grau-Expósito et al. (J. Grau-Expósito, C. Serra-Peinado, L. Miguel, J. Navarro, A. Curran, J. Burgos, I. Ocaña, E. Ribera, A. Torrella, B. Planas, R. Badía, J. Castellví, V. Falcó, M. Crespo, and M. J. Buzon, mBio 8:e00876-17, 2017,
https://doi.org/10.1128/mBio.00876-17
) reported a similar method that they claim to be more sensitive. With these methods, researchers are one step closer to measuring latent reservoirs and eliminating critical barriers to HIV eradication.
Outcomes of lensectomy and risk factors for failure in spherophakic eyes with secondary glaucoma
Authors: Rao Divya P , John Praveen J , Ali Mohammed Hasnat , Kekunnaya Ramesh , Jalali Subhadra , Garudadri Chandra Sekhar , Senthil Sirisha 
Published: September 2017

PurposeTo report the outcomes of lensectomy in spherophakic eyes with subluxated or dislocated crystalline lenses and secondary glaucoma.MethodsLensectomy was performed in 52 eyes, 36 eyes with lens subluxation and 16 eyes with lens dislocation with secondary glaucoma from 1991 to 2016. Glaucoma was diagnosed based on intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage. Complete success was defined as IOP ≥5 and ≤21 mm Hg without antiglaucoma medications (AGMs) or surgery, and eyes needing oral AGM or surgical intervention for IOP control or those with complication causing loss of light perception were considered failure.ResultsMedian (IQR) age at lensectomy was 12 (6–18) years, and median spherical equivalent was −14.5D (−23.7to −13). Median follow-up was 30.6 (5.4–103.4) months. Median logMAR (logarithm of minimal angle of resolution) visual acuity improved from 0.95 (0.6–1.8) to 0.4 (0.2–1.3) after lensectomy (p=0.01). Median IOP decreased from 22 mm Hg (17–31) to 14 mm Hg (11–19) at final follow-up (p=0.01). Median number of AGM decreased from 2 (2–3) to 1 (0–2) at final follow-up (p<0.0001), and glaucoma surgery was needed in four eyes (7.7% eyes). Complete success probability was 69% at 1 year and 51% at 5 years. Younger age (<6 years), higher presenting IOP (>32 mm Hg) and larger cup to disc ratio at presentation were found to be significant risk factors for failure.ConclusionLensectomy was effective in controlling IOP in close to half of all eyes with spherophakia and secondary glaucoma, 40% eyes needed AGM and only 7.7% eyes needed glaucoma surgery for IOP control. In this cohort, younger age, higher IOP and larger cup to disc ratio at presentation were risk factors for poor glaucoma control after lensectomy.
Replacement of warfarin with a novel oral anticoagulant in endoscopic mucosal resection: a multicentre, open-label, randomised controlled trial
Authors: Yamada Takuya , Kada Akiko , Uraoka Toshio , Kuwai Toshio , Watanabe Noriko , Sasaki Yoshihiro , Mabe Katsuhiro , Takahashi Yasuo , Kagaya Takashi , Kimura Toshihisa , Hamada Hiroshige , Saito Akiko M , Harada Naohiko 
Published: September 2017

IntroductionThis randomised controlled trial aims to compare the efficacy of warfarin replacement with apixaban without postoperative resumption of heparin with that of conventional heparin bridging in patients taking warfarin and scheduled to undergo endoscopic mucosal resection (EMR): specifically, by checking for reduction in proportion of postoperative bleeding following EMR.Methods and analysisThe multicentre, open-label randomised parallel-group, controlled intervention study regards patients taking warfarin who are scheduled to undergo colon EMR. Enrolled patients have been taking oral warfarin for non-valvular atrial fibrillation or venous thrombosis on an outpatient basis, and have been found to have a colorectal polyp (including adenoma or early-stage cancer) for which EMR was indicated. They are assigned to one of two groups.The primary endpoint is proportion of postoperative bleeding. The secondary endpoints are hospital stay length, therapeutic endoscopy outcomes such as proportion of en bloc resection, proportion of perforation, proportion of intraoperative bleeding, incidence of cerebral infarction/systemic embolism events, incidence of adverse events and serious adverse events, and proportion of postoperative therapeutic endoscopy.Ethics and disseminationThis trial was approved by the National Hospital Organization Central Review Board for Clinical Trials (19 April 2016).DiscussionThe paucity of reports with high evidence levels was considered problematic when the Japan Gastroenterological Endoscopy Society’s gastroenterological endoscopy guidelines were revised in 2012. The results of this trial will have high medical significance, as its data could serve as the basis for revisions in the next edition of the guidelines.Trial registration numberThis trial was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) accepted from the International Committee of Medical Journal Editors (ICMJE). UMIN000021947; Pre-results.
How income and food prices influence global dietary intakes by age and sex: evidence from 164 countries
Authors: Muhammad Andrew , D’Souza Anna , Meade Birgit , Micha Renata , Mozaffarian Dariush 
Published: September 2017

BackgroundWhile income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.MethodsWe used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income and prices for each food category, accounting for differences by national income, world region, age, and sex.ResultsWe identified several differences in intake responsiveness. For example, rising income was estimated to increase milk intake most strongly in Sub-Saharan Africa and fruit intake most strongly among older women globally. Comparing our intake results to previous findings based on expenditure data, we found more goods that exhibited declining intake in response to rising incomes, fewer significant relationships for a number of food categories, particularly for higher income regions, and whereas in prior studies, elasticities mostly decrease with national income, we identified food categories where this was not the case.ConclusionThe results of this study show heterogeneous associations among income, prices, and food intakes. Policymakers should consider the price and income elasticities of certain foods, as well as the role of demographics within and across countries, as they address global nutrition and health challenges.
Cohort profile of a study on outcomes related to tuberculosis and antiretroviral drug concentrations in Uganda: design, methods and patient characteristics of the SOUTH study
Authors: Sekaggya-Wiltshire Christine , Castelnuovo Barbara , von Braun Amrei , Musaazi Joseph , Muller Daniel , Buzibye Allan , Gutteck Ursula , Henning Lars , Ledergerber Bruno , Corti Natascia , Lamorde Mohammed , Fehr Jan , Kambugu Andrew 
Published: September 2017

PurposeTuberculosis (TB) is a leading cause of death among people living with HIV in sub-Saharan Africa. Several factors influence the efficacy of TB treatment by leading to suboptimal drug concentrations and subsequently affecting treatment outcome. The aim of this cohort is to determine the association between anti-TB drug concentrations and TB treatment outcomes.ParticipantsPatients diagnosed with new pulmonary TB at the integrated TB-HIV outpatient clinic in Kampala, Uganda, were enrolled into the study and started on first-line anti-TB treatment.Findings to dateBetween April 2013 and April 2015, the cohort enrolled 268 patients coinfected with TB/HIV ; 57.8% are male with a median age of 34 years (IQR 29–40). The median time between the diagnosis of HIV and the diagnosis of TB is 2 months (IQR 0–22.5). The majority of the patients are antiretroviral therapy naive (75.4%). Our population is severely immunosuppressed with a median CD4 cell count at enrolment of 163 cells/µL (IQR 46–298). Ninety-nine per cent of the patients had a diagnosis of pulmonary TB confirmed by sputum microscopy, Xpert/RIF or culture and 203 (75.7%) have completed TB treatment with 5099 aliquots of blood collected for pharmacokinetic analysis.Future plansThis cohort provides a large database of well-characterised patients coinfected with TB/HIV which will facilitate the description of the association between serum drug concentrations and TB treatment outcomes as well as provide a research platform for future substudies including evaluation of virological outcomes.Trial registration numberNCT01782950; Pre-results.
Burden of non-adherence to latent tuberculosis infection drug therapy and the potential cost-effectiveness of adherence interventions in Canada: a simulation study
Authors: Patel Anik R , Campbell Jonathon R , Sadatsafavi Mohsen , Marra Fawziah , Johnston James C , Smillie Kirsten , Lester Richard T 
Published: September 2017

ObjectivePharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI in Canada.DesignA microsimulation model of LTBI progression over 25 years.SettingGeneral practice in Canada.ParticipantsIndividuals with LTBI who are initiating drug therapy.InterventionsA hypothetical intervention with a range of effectiveness was evaluated. Existing drug adherence interventions including peer support, two-way text messaging support, enhanced adherence counselling and adherence incentives were also evaluated.Primary and secondary outcome measuresSimulation outcomes included healthcare costs, TB incidence, TB deaths and quality-adjusted life years (QALYs). Base case results were interpreted against a willingness-to-pay threshold of $C50 000/QALY.ResultsCompared with current adherence levels, full adherence to LTBI drug therapy could reduce new TB cases from 90.3 cases per 100 000 person-years to 35.9 cases per 100 000 person-years and reduce TB-related deaths from 7.9 deaths per 100 000 person-years to 3.1 deaths per 100 000 person-years. An intervention that increases relative adherence by 40% would bring the population near full adherence to drug therapy and could have a maximum allowable annual cost of approximately $C450 per person to be cost-effective. Based on estimates of effect sizes and costs of existing adherence interventions, we found that they yielded between 900 and 2400 additional QALYs per million people, reduced TB deaths by 5%–25% and were likely to be cost-effective over 25 years.ConclusionFull adherence could reduce the number of future TB cases by nearly 60%, offsetting TB-related costs and health burden. Several existing interventions are could be cost-effective to help achieve this goal.
Effectiveness, cost-utility and implementation of a decision aid for patients with localised prostate cancer and their partners: study protocol of a stepped-wedge cluster randomised controlled trial
Authors: Al-Itejawi Hoda H M , van Uden-Kraan Cornelia F , van de Ven Peter M , Coupé Veerle M H , Vis André N , Nieuwenhuijzen Jakko A , van Moorselaar Jeroen A , Verdonck-de Leeuw Irma M 
Published: September 2017

IntroductionPatient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care.Methods/analysisA stepped-wedge cluster randomised trial will be conducted. The PDA will be sequentially implemented in 18 hospitals in the Netherlands, over a period of 24 months. Every 3 or 6 months, a new cluster of hospitals will switch from usual care to care including a PDA.The primary outcome measure is decisional conflict experienced by the patient. Secondary outcomes comprise the patient’s quality of life, treatment preferences, role in the decision making, expectations of treatment, knowledge, need for supportive care and decision regret. Furthermore, societal cost-utility will be valued. Other outcome measures considered are the partner’s treatment preferences, experienced participation to decision making, quality of life, communication between patient, partner and health care professional, and the effect of prostate cancer on the relationship, social contacts and their role as caregiver. Patients and partners receiving the PDA will also be asked about their satisfaction with the PDA.Baseline assessment takes place after the treatment choice and before the start of a treatment, with follow-up assessments at 3, 6 and 12 months following the end of treatment or the day after deciding on active surveillance. Outcome measures on implementation include the implementation rate (defined as the proportion of all eligible patients who will receive a PDA) and a questionnaire for health care professionals on determinants of implementing an innovation.Ethics and disseminationThis study will be conducted in accordance with local laws and regulations of the Medical Ethics Committee of VU University Medical Center, Amsterdam, The Netherlands. The results from this stepped-wedge trial will be presented at scientific meetings and published in peer-reviewed journals.Trial registrationNederlands Trial Register NTR TC5177, registration date: May 28th2015.Pre-results.
Qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care
Authors: Halls Amy , van’t Hoff Catherine , Little Paul , Verheij Theo , Leydon Geraldine M 
Published: September 2017

ObjectiveTo explore parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care.DesignQualitative semistructured interview study.SettingUK primary care.Participants23 parents of children aged 6 months to 10 years presenting with LRTI in primary care.MethodThematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI.ResultsFour major themes were identified and these are perspectives on: (1) infection, (2) antibiotic use, (3) the general practitioner (GP) appointment and (4) decision making around prescribing. Symptomatic relief was a key concern: the most troublesome symptoms were cough, breathing difficulty, fever and malaise. Many parents were reluctant to use self-care medication, tended to support antibiotic use and believed they are effective for symptoms, illness duration and for preventing complications. However, parental expectations varied from a desire for reassurance and advice to an explicit preference for an antibiotic prescription. These preferences were shaped by: (1) the age of the child, with younger children perceived as more vulnerable because of their greater difficulty in communicating, and concerns about rapid deterioration; (2) the perceived severity of the illness; and (3) disruption to daily routine. When there was disagreement with the GP, parents described feeling dismissed, and they were critical of inconsistent prescribing when they reconsult. When agreement between the parent and the doctor featured, parents described a feeling of relief and legitimation for consulting, feeling reassured that the illness did indeed warrant a doctor’s attention.ConclusionSymptomatic relief is a major concern for parents. Careful exploration of expectations, and eliciting worries about key symptoms and impact on daily life will be needed to help parents understand when a no antibiotic recommendation or delayed antibiotic recommendation is made.
‘Just like a normal pain’, what do people with diabetes mellitus experience when having a myocardial infarction: a qualitative study recruited from UK hospitals
Authors: Berman Nikita , Jones Melvyn Mark , De Coster Daan A 
Published: September 2017

ObjectiveThe objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service.SettingThree London (UK) hospitals (coronary care units and medical wards).ParticipantsPatients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest). A total of 43 participants were recruited, and 39 interviews met the study criteria and were analysed. They were predominantly male (n=30), aged 40–90 years and white British (18/39), and just over a half were from other ethnic groups. The majority had type 2 DM (n=35), 24 had an NSTEMI, 10 had an STEMI and five had other cardiac events.Definitions of selection/exclusion criteriaA diagnosis of MI and DM and the ability to communicate enough English to complete the interview. Ward staff made a clinical judgement that the participant was post-treatment, clinically stable and well enough to participate.MethodsA qualitative study using taped and transcribed interviews analysed using a thematic analysis.ResultsWhile most participants did experience chest pain, it was often not their most striking symptom. As their chest pain did not match their expectations of what a ‘heart attack’ should be, participants developed narratives to explain these symptoms, including the symptoms being effects of their DM (‘hypos’), side effects of medication (oral hypoglycaemics) or symptoms (such as breathlessness and indigestion) related to other comorbidities, often leading to delays in seeking care.ConclusionsWhile truly absent chest pain during MI among people with DM was rare in this study, patients’ attenuated symptoms often led to delay in seeking attention, and this may result in delays in receiving treatment.