bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Medication Treatment According to Pathological Mechanisms in Abdominal Aortic Aneurysm
Authors: Zhang Shi-lan , Du Xiao , Chen Yan-qiao , Tan Yuan-sheng , Liu Ling 
Published: September 2017

Abstract:
Abdominal aortic aneurysm (AAA) is a vascular disease with high mortality. Because of the lack of effective medications to stop or reverse the progression of AAA, surgical operation has become the most predominant recommendation of treatment for patients. There are many potential mechanisms, including inflammation, smooth muscle cell apoptosis, extracellular matrix degradation, oxidative stress, and so on, involving in AAA pathogenesis. According to those mechanisms, some potential therapeutic drugs have been proposed and tested in animal models and even in clinical trials. This review focuses on recent advances in both pathogenic mechanisms and potential pharmacologic therapies of AAA.
Comparison of Dried Blood Spots Versus Conventional Plasma Collection for the Characterization of Efavirenz Pharmacokinetics in a Large-Scale Global Clinical Trial—The ENCORE1 Study
Authors: Amara Alieu B. , Else Laura J. , Carey Dianne , Khoo Saye , Back David J. , Amin Janaki , Emery Sean , Puls Rebekah L. 
Published: September 2017

Background:
The aim of this study was to determine the utility of dried blood spots (DBS) compared with conventional plasma collection methods for characterization of efavirenz pharmacokinetics, in the setting of a large-scale, global clinical trial (ENCORE1).

Methods:
Six hundred thirty patients were recruited from 38 sites and had single matched whole blood DBS and plasma samples (mid-dose interval) taken at weeks 4 and 12 of treatment. In addition, a subgroup of patients underwent intensive DBS and plasma sampling (0–24 hours) to provide full-profile data for pharmacokinetic parameters. Efavirenz concentrations were determined by validated high-performance liquid chromatography–mass spectrometry methods. A DBS-predicted plasma concentration was derived and linear regression and Bland–Altman plots were used to compare DBS-predicted plasma concentrations with that of measured plasma concentrations.

Results:
Efavirenz DBS and plasma concentrations were significantly correlated (R2 = 0.904, P < 0.001; n = 1094), and DBS concentrations were, on average, 53% ± 9.5% lower than plasma. In the main study, the DBS-predicted plasma values significantly underestimated the true measured concentration of efavirenz in plasma; the mean difference (95% confidence interval) between efavirenz DBS-predicted concentrations and measured plasma concentrations was −0.451 mg/L (−0.504 to −0.398) at week 4 (n = 561). However, in the intensive study, the mean difference was only 0.086 mg/L (−0.006 to 0.178) at 12 hours after dose (n = 46) and was not statistically significant.

Conclusions:
Our data show a high correlation between measurements of efavirenz concentrations in plasma and in DBS. However, DBS concentrations significantly underestimated the true measured plasma concentrations in the sparse samples taken in this large multinational ENCORE1 trial.
Clinical trials in menopause
Authors: Marko Kathryn I. , Simon James A. 
Published: September 2017

Abstract

Objective:
Clinical trials in menopause have undergone much scrutiny over the years. This has led to significant shifts in the treatment of symptomatic menopause and a substantial impact on women. We aim to delineate the key studies contributing to this controversy and highlight new directions specifically related to menopausal hormone therapy (HT) and vascular disease risk.

Methods:
We performed a search of sentinel studies delineating the risks and benefits of HT in otherwise healthy postmenopausal women. Using PubMed we input the following search terms: hormone replacement therapy, cardiovascular disease, coronary artery disease, coronary atherosclerosis, myocardial infarction, angina, coronary heart calcification, carotid intimal thickness, lipids, and/or lipoproteins. We included studies of menopausal women (surgical or natural) using combined estrogen/progestogen therapy or estrogen-only therapy that looked at cardiovascular disease risk factors or outcomes. Studies were evaluated for inclusion by the authors; however, this is not intended to be a systematic or an exhaustive analysis.

Results:
In women close to the time of menopause, there is a decreased risk of subclinical and clinical coronary heart disease with menopausal HT. Additionally, HT confers a significant benefit to vasomotor symptoms of menopause, bone health, and colorectal cancer. There is an increased risk of venous thromboembolism with oral formulations that appears mitigated with transdermal estradiol. Mixed data regarding breast cancer risk are available, with some studies suggesting an increased risk of invasive breast cancer with estrogen/progestogen therapy and a null effect with estrogen-only therapy. Other more long-term epidemiologic studies identify a decreased risk.

Conclusions:
The available literature suggests that HT is a viable option for the primary prevention of cardiovascular disease in postmenopausal women. Newer trials will likely verify this assessment. If this is enough to change clinical practice, however, remains to be seen given the general fear of HT by many with prescriptive authority, and also the women in our care.
Transient Hypothyroidism and Autoimmune Thyroiditis in Children With Chronic Hepatitis C Treated With Pegylated-interferon-α-2b and Ribavirin
Authors: Serranti Daniele , Indolfi Giuseppe , Nebbia Gabriella , Cananzi Mara , D’Antiga Lorenzo , Ricci Silvia , Stagi Stefano , Azzari Chiara , Resti Massimo ,   for the Italian Study Group for Treatment of Chronic Hepatitis C in Children
Published: September 2017

Background:
Autoimmune thyroid disease and thyroid dysfunction are common in adults receiving interferon (IFN)-based treatment for chronic hepatitis C (CHC). Few data are available in children with CHC. This study is aimed to evaluate the appearance and timing of thyroid dysfunction and antithyroid autoimmunity in children with CHC treated with pegylated IFN-α-2b and ribavirin (RBV).

Methods:
Sixty-one otherwise healthy children with CHC, 3–17 years of age, infected perinatally and treatment naïve, receiving therapy with pegylated IFN-α-2b and RBV and 183 age- and sex-matched controls were included in a multicenter, prospective, case-control study. Thyroid-stimulating hormone, free thyroxine, antithyroglobulin antibodies and antithyroid peroxidase antibodies were assessed before, during and 24 weeks after the end of treatment.

Results:
From baseline to the end of treatment, subclinical hypothyroidism and autoimmune thyroiditis were diagnosed in 17 of 61 (27.94%) and in 4 of 61 (6.6%) of the children treated, respectively, and in 5 of 183 (2.7%) and in none of the controls (P < 0.0001, relative risk: 10.2, 95% confidence interval: 3.9–26.5; P = 0.03, relative risk: 26.8, 95% confidence interval: 1.5–489.1, respectively). Twenty-four weeks after the end of treatment, subclinical hypothyroidism persisted in only 4 of 61 (6.6%). Autoimmune thyroiditis persisted in 3 of 4 (75%) of the cases.

Conclusions:
Subclinical hypothyroidism is common in children with CHC receiving treatment with pegylated IFN-α-2b and RBV, but in most cases is transient. Autoimmune thyroiditis, which is less common, generally persists after treatment completion. Thyroid function should be carefully monitored in patients presenting with antithyroid autoantibodies and thyroid dysfunction during and after pegylated IFN-α–based treatment.
Brain oscillations reflecting pain-related behavior in freely moving rats
Authors: Peng Weiwei , Xia Xiaolei , Yi Ming , Huang Gan , Zhang Zhiguo , Iannetti Giandomenico , Hu Li 
Published: September 2017

AbstractRecording oscillatory brain activity holds great promise in pain research. However, experimental results are variable and often difficult to reconcile. Some of these inconsistencies arise from the use of hypothesis-driven analysis approaches that (1) do not assess the consistency of the observed responses within and across individuals, and (2) do not fully exploit information sampled across the entire cortex. Here, we address these issues by recording the electrocorticogram directly from the brain surface of 12 freely moving rats. Using a hypothesis-free approach, we isolated brain oscillations induced by graded nociceptive stimuli and characterized their relation to pain-related behavior. We isolated 4 responses, one phase-locked event-related potential, 2 non–phase-locked event-related synchronizations, and one non–phase-locked event-related desynchronization (ERD), in different frequency bands (δ/θ-ERD, θ/α–event-related synchronization, and gamma-band event-related synchronization). All responses except the δ/θ-ERD correlated with pain-related behavior at within-subject level. Notably, the gamma-band event-related synchronization was the only response that reliably correlated with pain-related behavior between subjects. These results comprehensively characterize the physiological properties of the brain oscillations elicited by nociceptive stimuli in freely moving rodents and provide a foundational work to improve the translation of experimental animal findings to human physiology and pathophysiology.
Functional Outcomes in People with Transtibial Amputation Using Crossover and Energy-Storing Prosthetic Feet: A Pilot Study
Authors: Hafner Brian J. , Halsne Elizabeth G. , Morgan Sara J. , Davidson Greg 
Published: September 2017

ABSTRACT

Introduction
Contemporary prosthetic feet are purposefully designed to address the many functional limitations experienced by people with transtibial amputation (TTA). Choice of materials, geometry, and fabrication techniques contribute to the overall performance of the foot, and ultimately to the functional outcomes achieved by the user. The crossover foot is a novel foot design that integrates features from traditional energy-storing feet and modern, running-specific feet in an effort to maximize performance and energy return. Although initial user feedback is promising, research is needed to determine whether the crossover foot is capable of improving user outcomes relative to other types of contemporary prosthetic feet.

Materials and Methods
A cross-sectional pilot study was conducted to evaluate mobility, endurance, perceived exertion, and walking performance attained by participants wearing prostheses with crossover and energy-storing feet. Participants with unilateral TTA were administered a short battery of performance-based tests while wearing a prosthesis with a crossover foot and a prosthesis with a traditional energy-storing foot. The order of prostheses worn was randomly assigned. Tests included the Timed Up and Go (TUG) performed at comfortable speed, the TUG performed at fast speed, and the 6-minute walk test (6MWT). Spatiotemporal measures (speed, cadence, step length, step width, and step time) were assessed during the 6MWT using a GAITRite electronic walkway. Participants were asked to report their perceived exertion following the 6MWT using the Borg rating of perceived exertion (CR100).

Results
Seven participants completed all pilot study procedures. On average, participants exhibited better mobility at comfortable and fast speeds (0.83 second and 0.63 second faster during the TUG-comfortable and TUG-fast, respectively), improved endurance (19.7 m farther in the 6MWT), reduced perceived exertion (12.9 points less on the Borg CR100), increased speed (0.05 m/s), faster cadence (2 steps/min), and longer sound side steps (3.3 cm) while wearing the crossover foot than when wearing the energy-storing foot. However, not all participants exhibited the same functional benefits from using the crossover foot.

Conclusions
The crossover foot is a promising prosthetic foot design that appears to provide modest functional benefits to transtibial prosthesis users. Given the pilot nature of this study, additional research is needed to assess benefits across a larger and more diverse range of users to inform prescription practices.
Sofosbuvir and daclatasvir plus ribavirin treatment improve liver function parameters and clinical outcomes in Egyptian chronic hepatitis C patients
Authors: Mohamed Mohamed S. , Hanafy Amr S. , Bassiony Mohamed A.A. , Hussein Samia 
Published: September 2017

Background and aims
Interferon-free direct-acting antivirals (DAA) combination therapies, including sofosbuvir (SOF) and daclatasvir (DCV) therapy, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvements in liver function is unclear. The aim of this study was to investigate the changes in clinical and biochemical parameters reflecting liver function and general status in those who achieved HCV eradication by DAA.

Patients and methods
From March 2016 to October 2016, 374 chronic hepatitis C patients were enrolled for this prospective, observational study and received SOF, DCV with ribavirin, to evaluate the changes in liver function parameters, international normalized ratio, complete blood count, model for end-stage liver disease, and Child–Turcotte–Pugh scores after achieving a sustained virological response 12 weeks after treatment.

Results
In those who achieved HCV clearance, liver function parameters, serum albumin, bilirubin, platelet count, and international normalized ratio improved significantly in the majority of patients; the reduction in the model for end-stage liver disease score was (−2.36, SE 0.15, P<0.001). 44% of the patients showed an improved Child–Turcotte–Pugh score, 51% showed no change, and only 5% showed deterioration.

Conclusion
Successful HCV eradication by DAAs including SOF, DCV with ribavirin therapy improved liver function parameters and clinical outcomes in chronic hepatitis C patients.
Vitamin B12 deficiency in inflammatory bowel disease: a prospective observational pilot study
Authors: Battat Robert , Kopylov Uri , Byer Joshua , Sewitch Maida J. , Rahme Elham , Nedjar Hacene , Zelikovic Elana , Dionne Serge , Bessissow Talat , Afif Waqqas , Waters Paula J. , Seidman Ernest , Bitton Alain 
Published: September 2017

Background and aim
Diagnostic and management guidelines for vitamin B12 (cobalamin, Cbl) deficiency in inflammatory bowel disease (IBD) are lacking. True deficiency is defined as Cbl concentrations below reference range combined with elevated methylmalonic acid (MMA) concentrations. Studies analyzing Cbl status in IBD use only Cbl concentrations without confirmatory MMA. This study aims to determine the proportion of IBD patients with Cbl concentrations below reference range and their predisposing clinical and genetic characteristics. We then compared this to the proportion with true deficiency.

Patients and methods
In a prospective observational pilot study of adult IBD outpatients, Cbl concentrations, MMA levels, and fucosyltransferase 2 mutations were measured at clinic visits.

Results
A total of 66 Crohn’s disease (CD) and 30 ulcerative colitis (UC) patients were recruited. Mean Cbl concentrations (pmol/l) in CD (253.7) were not significantly lower than UC (320.5, P=0.24). Serum Cbl below reference range (<148) was observed in 7.6 and 10% of CD and UC patients, respectively (P=0.70). True deficiency in CD and UC was 3 and 3.3%, respectively (P=1.0). Patients with ileal resections more than 30 cm had lower mean Cbl concentrations (177, P=0.02) and a trend toward higher proportions with Cbl levels below reference range (40%, P=0.06), but not increased deficiency rates (0%, P=1.0). Disease location, severity, and fucosyltransferase 2 mutations were not associated with altered Cbl status.

Conclusion
True Cbl deficiency was rare in IBD patients in this study. A disparity in Cbl status exists when confirmatory MMA levels are used compared with Cbl concentrations alone. Asymptomatic IBD patients with low serum Cbl require confirmatory tests to guide management and avoid unnecessary treatment.
Nutrition Practices and Predictors of Postnatal Growth in Preterm Infants During Hospitalization
Authors: McKenzie Briar L. , Edmonds Liza , Thomson Ruth , Haszard Jillian J. , Houghton Lisa A. 
Published: September 2017

ABSTRACTPremature infants are at high risk of undernutrition and extrauterine growth restriction.Aim:The aim of the study was to evaluate the relation between nutrition practices and growth rate in preterm infants from birth to 36 weeks postmenstrual age (PMA).Methods:Longitudinal data were collected retrospectively in 103 infants born <33 weeks gestation admitted to Dunedin Neonatal Intensive Care Unit, New Zealand. Weight, length, and head circumference at birth and 36 weeks PMA z scores were calculated using the INTERGROWTH Preterm Growth Standard. Growth velocity (g · kg−1 · day−1) was determined via exponential model. Time to regain birth weight and nutritional practices including enteral nutrition, withholding feeds, nutrient intake, and feeding at discharge were described. Regression was used to explore associations between growth and nutritional variables.Results:Growth faltering (weight‐for‐age z score <−1.28/10th centile) increased from 9% at birth to 19% at 36 weeks PMA. Mean (standard deviation) growth velocity in‐hospital (14.2 [3.3] g · kg−1 · day−1) was well below the desirable rate of 18 g · kg−1 · day−1. Forty‐one percent of infants had feeds withheld, which was significantly associated with a longer time period to achieve full enteral feedings (P < 0.001) and poorer weight and length z score at 36 weeks PMA (both P < 0.05). The day of life to establish full enteral feedings was longer than recommended yet positively associated with weight at 36 weeks PMA (P = 0.019), whereas controlling for withholding feeds and other known confounders.Conclusions:Extrauterine growth restriction was highly prevalent in this population. The negative association of withholding of feeds on growth reinforces the need to evaluate early life feeding protocols and further assess the longer‐term influence of this practice on postdischarge growth outcomes.
Anti‐TNFα Treatment in Children and Adolescents With Combined Inflammatory Bowel Disease and Autoimmune Liver Disease
Authors: Nedelkopoulou Natalia , Vadamalayan Babu , Vergani Diego , Mieli‐Vergani Giorgina 
Published: September 2017

ABSTRACTObjectives:Inflammatory bowel disease (IBD) and autoimmune liver disease (AILD) are closely associated, the former often dictating progression of the latter. Antibodies to tumor necrosis factor alpha (anti‐TNFα) are effective in the management of IBD, but may cause liver injury.Methods:Retrospective review of medical records of patients with juvenile AILD who received anti‐TNFα for IBD to evaluate the safety and efficacy of anti‐TNFα.Results:Eleven patients (6 boys), ages 9 to 15 years (median 13 years) were identified. Ten had ulcerative colitis and 1 Crohn disease; 2 had autoimmune hepatitis type 1 and 9 autoimmune hepatitis‐sclerosing cholangitis variant. All patients were started on infliximab (IFX, 5 mg/kg) and 2 required dose increase (10 mg/kg); 3 of 11 switched to adalimumab due to allergic reaction or nonresponse. Three received adalimumab after losing response or developing antibodies to IFX. Liver function tests (LFTs) improved in 5, 1 continued to have stably abnormal LFTs and 2 maintained normal LFTs. Patients on adalimumab showed stable or improved liver function compared to pretreatment status. Six of 8 treated with a full course of IFX maintained clinical remission of IBD for 6 months to 2.5 years; of the 6 patients treated with adalimumab, 1 sustained IBD clinical remission for 24 months, 2 achieved remission only after tacrolimus addition and 3 did not respond.Conclusions:IBD in patients with AILD can be aggressive, requiring escalation to anti‐TNFα or switching to other biologics. In this series, anti‐TNFα did not impair liver function and improved gut disease in most of the patients, indicating that it can be beneficial and safe.
Development and Evaluation of Innovative Peer-Led Physical Activity Programs for Mental Health Service Users
Authors: Graham Candida R. , Larstone Roseann , Griffiths Brenda , de Leeuw Sarah , Anderson Lesley , Powell-Hellyer Stephanie , Long Nansi 
Published: September 2017

Abstract
Mental health service users (MHSUs) have elevated rates of cardiometabolic disturbance. Improvements occur with physical activity (PA) programs. We report the development and evaluation of three innovative peer-developed and peer-led PA programs: 1) walking; 2) fitness; and 3) yoga. Qualitative evaluation with 33 MHSUs in British Columbia, Canada, occurred. These programs yielded improvements for participants, highlighted by powerful narratives of health improvement, and improved social connections. The feasibility and acceptability of innovative peer-developed and peer-led programs were shown. Analyses revealed concepts related to engagement and change. Relating core categories, we theorize effective engagement of MHSUs requires accessibility on three levels (geographic, cost, and program flexibility) and health behavior change occurs within co-constituent relationships (to self, to peers, and to the wider community). This study highlights the benefits of peer involvement in developing and implementing PA programs and provides a theoretical framework of understanding engagement and behavior change in health programs for MHSUs.
Rattled
Authors: Blasco Michael A. , Kandinov Aron , Svider Peter F. , Gonik Nathan J. , Hanba Curtis , Zuliani Giancarlo F. , Shkoukani Mahdi A. , Carron Michael A. 
Published: September 2017

Objective
The aim of this study was to determine the national incidence of facial trauma among toddlers and delineate patterns of injury and their causes.

Methods
A retrospective review was designed to explore patterns of maxillofacial trauma within toddler-aged children using the National Electronic Injury Surveillance System from the Consumer Product Safety Commission. The database was searched for emergency department visits involving facial trauma sustained by children 12 months through 3 years of age from 2010 through 2014 and analyzed for patient demographics, primary diagnosis, and associated products/activities. Subset analyses were performed between age groups to determine the relationship between causes of injury and age using extrapolated national incidences.

Results
A sample of 45,249 patients extrapolated to an estimated 1.3 million emergency department visits for facial trauma in toddlers from 2010 to 2014, averaging 260,000 annually. Injuries involving foreign bodies and fractures had a higher incidence in toddlers 2 years or older, and fractures comprised fewer than 1% of facial injuries in any age group. Furniture was the most common source of trauma overall, with a higher frequency among toddlers aged 12 to 17 months. Trauma in the setting of sports was more common in toddlers aged 3 years.

Conclusions
The low incidence of facial fractures further supports recommendations against routine imaging in toddler facial trauma and suggests that more focus should be placed on investigating for concurrent traumas and soft tissue injuries where fractures are involved. Our findings highlight prevention opportunities, particularly in furniture-related injuries for toddlers aged 12 to 17 months and sports-related traumas in toddlers aged 3 years. Our study also suggests restricting certain toys from 3-year-old toddlers to decrease the risk of aspiration.