bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory bowel disease: adherence to immunomodulators in a biological therapy era
Authors: Campos Sara , Portela Francisco , Sousa Paula , Sofia Carlos 
Published: August 2016

Background
Combination therapy, with anti-tumor necrosis factor-α agents and immunomodulators, is the most effective option to induce and maintain remission in inflammatory bowel disease (IBD). Infliximab, with its administration features, determines particular conditions of adherence; the same is not possible with thiopurines. Nevertheless, research on adherence to these treatments is scarce. Nonadherence worsens the prognosis of IBD.

Aim
(a) Assess adherence to immunomodulators and (b) determine therapeutic nonadherence predictors.

Patients and methods
We included all IBD outpatients consecutively evaluated over a 6-month period in our center. Participants completed a study-specific questionnaire on IBD, IBD therapeutic adherence (Morisky Medication Adherence Scale-8-item), Therapeutics Complexity questionnaire, Beliefs about Medication questionnaire, and Hospital Anxiety and Depression Scale.

Results
A total of 112 patients under azathioprine were considered; 49.1% were also under anti-tumor necrosis factor-α. Self-assessed questionnaire showed that 70.5% were adherent to immunosuppression. Similar adherence was found with and without infliximab (68.4%-monotherapy vs. 72.7%-combination therapy; P=0.61). Nonintentional nonadherence was documented in 57.6%; 42.4% reported voluntary nonadherence. Nonadherence was higher in male patients [odds ratio (OR): 3.79; 95% confidence interval (CI): 1.2–11.95; P=0.023], younger patients (OR: 0.93; 95% CI: 0.87–0.98; P=0.01), nonsmokers (OR: 4.90; 95% CI: 1.22–19.73; P=0.025), and those who had depression (OR: 2.22; 95% CI: 1.36–3.62; P=0.001). Most of the IBD patients believed in the necessity of maintaining immunosuppression (86.7%), but 36.6% reported concerns about drugs.

Conclusion
Nonadherence to thiopurines plays a significant role in IBD. Nonetheless, it does not increase with association with biological agents. Involuntary nonadherence is higher. Male sex, younger age, nonsmoker, and presence of depression were independent predictors of nonadherence to immunomodulators. More than one-third of IBD patients had concerns about drugs. Optimizing the discussion on patients’ concerns to overcome perceptual barriers related to drugs may obviate the negative course of IBD related to nonadherence.
Symptoms and biomarkers associated with celiac disease: evaluation of a population-based screening program in adults
Authors: Kårhus Line L. , Thuesen Betina H. , Rumessen Jüri J. , Linneberg Allan 
Published: August 2016

Objectives
To identify possible early predictors (symptoms and biomarkers) of celiac disease, compare symptoms before and after screening, and evaluate the diagnostic efficacy of serologic screening for celiac disease in an adult Danish population.

Methods
This cross-sectional population-based study was based on the 5-year follow-up of the Health2006 cohort, where 2297 individuals were screened for celiac disease; 56 were antibody positive and thus invited to clinical evaluation. Eight were diagnosed with biopsy-verified celiac disease. A follow-up questionnaire was sent to antibody-positive individuals 19 months after the clinical evaluation to obtain information on their symptoms and their experience with participation in the screening.

Results
Before screening, participants subsequently diagnosed with celiac disease did not differ from the rest of the population with respect to symptoms, but had significantly lower total cholesterol. Tissue transglutaminase IgA antibodies with a cut-off of 10 U/ml had a positive predictive value of 88%. The majority of participants were satisfied with their participation in the screening program. Individuals with celiac disease were generally satisfied with having been diagnosed and 71% felt better on a gluten-free diet.

Conclusion
There were no differences in the prevalence of symptoms between participants with and without screening-detected celiac disease, confirming that risk stratification in a general population by symptoms is difficult. The majority of participants diagnosed with celiac disease felt better on a gluten-free diet despite not reporting abdominal symptoms before diagnosis and participants in the clinical evaluation were generally satisfied with participation in the screening program.
Community nurse-led initiation of antiviral therapy for chronic hepatitis C in people who inject drugs does not increase uptake of or adherence to treatment
Authors: Lewis Heather , Kunkel Jan , Axten David , Dalton Jane , Gardner Hayley , Tippett Andrew , Wynne Stephanie , Wilkinson Mandie , Foster Graham R. 
Published: August 2016

Background
Chronic hepatitis C is common in people who inject drugs (PWID) and this population serves as a reservoir for infection. Treatment levels are low among this group, ranging from 1 to 19%. We explored whether a nurse-initiated community treatment model increased uptake of and adherence to interferon-based therapies.

Methods
This was a cluster randomized trial of nurse-initiated versus physician-initiated antiviral therapy with pegylated interferon and ribavirin for hepatitis C virus in community clinics (trial registration: ISRCTN07774040).

Results
The proportion of participants initiating treatment during follow-up was 10% with nurse-initiated (6/62) and 9% with physician-initiated (6/76) therapy. Adherence was similar in both groups, with only one patient in each arm not adhering to therapy. There were no serious adverse events, but interferon-related side effects were common. Drug and alcohol use did not change during therapy.

Conclusion
Despite easy access to antiviral therapy, uptake of treatment was poor, with no significant difference between the groups. Nurse-led initiation of interferon-based antiviral therapy in PWID did not lead to increased uptake of, response to or adherence with treatment. Further service improvement is unlikely to increase the proportion of PWID undergoing antiviral therapy for hepatitis C virus and early adoption of interferon-free regimens may increase the proportion initiating and completing treatment.
Cytomegalovirus disease in inflammatory bowel disease: epidemiology and disease characteristics in a large single-centre experience
Authors: Bontà Jonas , Zeitz Jonas , Frei Pascal , Biedermann Luc , Sulz Michael C. , Vavricka Stephan R. , Scharl Sylvie , Fried Michael , Rogler Gerhard , Scharl Michael 
Published: August 2016

Background
Patients with inflammatory bowel disease (IBD) show an increased risk of developing cytomegalovirus (CMV) disease because of immunosuppressive medication and malnutrition. Here, we aimed to investigate the prevalence and clinical characteristics of CMV disease in our cohort of IBD patients.

Patients and methods
We carried out a retrospective analysis of 1023 IBD patients treated at our IBD clinic at the University Hospital Zurich between 2007 and 2014. CMV disease was defined as a positive immunohistochemistry for CMV and 14 patients were identified.

Results
The prevalence of CMV disease in our IBD cohort was 1.37%. Twelve patients had ulcerative colitis and two had Crohn’s disease with colonic involvement. All patients who developed CMV disease received immunosuppressive medication or, as in one case, had HIV infection. The most used immunosuppressive medications were steroids and azathioprine. The most common therapeutic strategy was the consecutive use of ganciclovir and valganciclovir. Ten patients recovered and two were treatment refractory; among these, one required colectomy and two had a relapse.

Conclusion
CMV disease may influence the clinical course of IBD. There is probably an association between CMV disease and IBD-specific medication. Risk factors, epidemiology and therapeutic strategy need to be further investigated.
Role of noncoding RNA in vascular remodelling
Authors: Deng Lin , Bradshaw Angela C. , Baker Andrew H. 
Published: August 2016

Purpose of review
Noncoding RNAs (ncRNAs), such as microRNAs (miRNAs) and long noncoding RNAs (lncRNAs) are becoming fundamentally important in the pathophysiology relating to injury-induced vascular remodelling. We highlight recent studies that demonstrate the involvement of ncRNAs in vein graft disease, in in-stent restenosis and in pulmonary arterial hypertension, with a particular focus on endothelial cell and vascular smooth muscle cell function. We also briefly discuss the emerging role of exosomal-derived ncRNAs and how this mechanism impacts on vascular function.

Recent findings
ncRNAs have been described as novel regulators in the pathophysiology of vascular injury, inflammation, and vessel wall remodelling. In particular, several studies have demonstrated that manipulation of miRNAs can reduce the burden of pathological vascular remodelling. Such studies have also shown that exosomal miRNA-mediated, cell-to-cell communication between endothelial cells and vascular smooth muscle cells is critical in the disease process. In addition to miRNAs, lncRNAs are emerging as regulators of vascular function in health and disease. Although lncRNAs are complex in both their sheer numbers and mechanisms of action, identifying their contribution to vascular disease is essential.

Summary
Given the important roles of ncRNAs in vascular injury and remodelling together will their capacity for cell-to-cell communication, manipulating ncRNA might provide novel therapeutic interventions.
Plaque angiogenesis and its relation to inflammation and atherosclerotic plaque destabilization
Authors: de Vries Margreet R. , Quax Paul H.A. 
Published: August 2016

Purpose of review
The review discusses the recent literature on plaque angiogenesis and its relation to inflammation and plaque destabilization. Furthermore, it discusses how plaque angiogenesis can be used to monitor atherosclerosis and serve as a therapeutic target.

Recent findings
Histopathologic studies have shown a clear relationship between plaque angiogenesis, intraplaque hemorrhage (IPH), plaque vulnerability, and cardiovascular events. Hypoxia is a main driver of plaque angiogenesis and the mechanism behind angiogenesis is only partly known. IPH, as the result of immature neovessels, is associated with increased influx of inflammatory cells in the plaques. Experimental models displaying certain features of human atherosclerosis such as plaque angiogenesis or IPH are developed and can contribute to unraveling the mechanism behind plaque vulnerability. New imaging techniques are established, with which plaque angiogenesis and vulnerability can be detected. Furthermore, antiangiogenic therapies in atherosclerosis gain much attention.

Summary
Plaque angiogenesis, IPH, and inflammation contribute to plaque vulnerability. Histopathologic and imaging studies together with specific experimental studies have provided insights in plaque angiogenesis and plaque vulnerability. However, more extensive knowledge on the underlying mechanism is required for establishing new therapies for patients at risk.
Lost in translation: impact of language barriers on children's healthcare
Authors: Goenka Pratichi K. 
Published: August 2016

Purpose of review
As the cultural and linguistic diversity of the United States grows, a greater number of patients with limited English proficiency will enter the healthcare system. Best practices for the care of these individuals include identification of their language assistance needs and prompt provision of interpreter services. This review will summarize the legal basis for providing language access in the healthcare setting, discuss the impact of interpretation services on clinical care, and explore the effects of language barriers on health outcomes.

Recent findings
There has been greater awareness of language as an important and independent determinant in the racial and ethnic disparities that exist in healthcare. Studies have shown that there is suboptimal identification of patients who require linguistic assistance and, as such, there are missed opportunities to bridge language gaps with many of our patients. The lack of interpretation, or use of informal, untrained interpreters, has significant effects on patient safety, quality of care, and patient satisfaction.

Summary
Though federal and regulatory guidelines mandate meaningful access to language services, such processes are still a work in progress in many healthcare settings. Further research and quality improvement initiatives are needed to provide clinicians the knowledge and skills needed to effectively communicate with their limited English proficient patients.
Pokémon Go and augmented virtual reality games: a cautionary commentary for parents and pediatricians
Authors: Serino Maeve , Cordrey Kyla , McLaughlin Laura , Milanaik Ruth L. 
Published: August 2016

Purpose of review
The recent release of Pokémon Go has ushered in a new set of challenges for parents and pediatricians, highlighting the importance of parents setting guidelines for video game use with their children. Within 1 week of its launch, the game attracted over 65 million users, many of whom are young children. Despite the potential benefits of the game described in our article, this location-based game format poses specific threats to the safety and physical wellbeing of children.

Recent findings
Reports have discussed both the benefits and adverse effects of this extremely popular video game. Benefits include increased exercise, socialization, and outdoor activity. Negative effects include increased risk of injury, abduction, trespassing, violence, and cost.

Summary
Pediatricians play a key role in counseling parents and children about safety precautions and setting appropriate limits for impressionable youth. Parents and pediatricians should be aware of this new and remarkably popular game that appeals to a wide variety of individuals. To protect children from injury, predators, and inappropriate situations, parents and pediatricians must regulate children's participation in this game and maintain vigilance for potentially dangerous circumstances.
Prevalence and Significance of Autoantibodies in Children With Acute Liver Failure
Authors: Narkewicz Michael R. , Horslen Simon , Belle Steven H. , Rudnick David A. , Ng Vicky L. , Rosenthal Philip , Romero Rene , Loomes Kathleen M. , Zhang Song , Hardison Regina M. , Squires Robert H. ,   Pediatric Acute Liver Failure Study Group
Published: August 2016

ABSTRACTObjectives:The purpose of the present study is to estimate autoantibody (auto‐AB) frequency, clinical characteristics, and 21‐day outcome of participants in the Pediatric Acute Liver Failure Study Group (PALFSG) by antinuclear antibody, smooth muscle antibody, and liver‐kidney microsomal (LKM) antibody status.Methods:Auto‐ABs were determined at local and/or central laboratories. Subjects were assigned to autoimmune hepatitis (AIH), indeterminate, and other diagnoses groups.Results:Between 1999 and 2010, 986 subjects were enrolled in the PALFSG. At least 1 auto‐AB result was available for 722 (73.2%). At least 1 auto‐AB was positive for 202 (28.0%). Diagnoses for auto‐AB+ subjects were AIH (63), indeterminate (75), and other (64). Auto‐ABs were more common in Wilson disease (12/32, 37.5%) compared with other known diagnoses (52/253, 20.6%, P = 0.03). LKM+ subjects were younger (median 2.4 vs 9.1 years, P < 0.001) and more likely to undergo liver transplantation (53.3% vs 31.4% P = 0.02) than other auto‐AB+/LKM− subjects. Steroid treatment of subjects who were auto‐AB+ was not significantly associated with survival and the subgroup with known diagnoses other than AIH had a higher risk of death.Conclusions:Auto‐ABs are common in children with acute liver failure, occurring in 28%. Auto‐AB+ subjects have similar outcomes to auto‐AB negative subjects. LKM+ children are younger and more likely to undergo liver transplantation compared with other auto‐AB+ subjects. Although auto‐AB may indicate a treatable condition, positivity does not eliminate the need for a complete diagnostic evaluation because auto‐ABs are present in other conditions. The significance of auto‐AB in pediatric acute liver failure remains uncertain, but LKM+ appears to identify a unique population of children who merit further study.
Comparison of Nasal Potential Difference and Intestinal Current Measurements as Surrogate Markers for CFTR Function
Authors: Wilschanski Michael , Yaakov Yasmin , Omari Ibrahim , Zaman Munir , Martin Camilia R. , Cohen‐Cymberknoh Malena , Shoseyov David , Kerem Eitan , Dasilva Deborah , Sheth Sunil , Uluer Ahmet , O'Sullivan Brian P. , Freedman Steven 
Published: August 2016

ABSTRACTObjectives:Nasal potential difference (NPD) measurement is part of the diagnostic criteria for cystic fibrosis (CF) and now used routinely as an endpoint in clinical trials of correcting the basic defect in CF. Intestinal current measurement (ICM), measured ex vivo on a rectal biopsy, has been used to study cystic fibrosis transmembrane conductance regulator (CFTR) function but has not been compared to NPD in the same subject in adults and children. The aim of the study is to evaluate the potential usefulness of ICM as a marker of CFTR function for treatment studies compared NPD in patients with CF and in healthy control subjects.Methods:ICM and NPD were performed on healthy controls and patients with CF. The healthy adults were individuals undergoing routine screening colonoscopy at the Beth Israel Deaconess Medical Center. The healthy children were undergoing colonoscopy for suspicion of inflammation in Hadassah Hebrew University Medical Center. The CF adults were recruited from Boston Children's Hospital CF Center and CF Center Worcester Mass, the children with CF from Hadassah CF Center.Results:ICM measurements in healthy control subjects (n = 16) demonstrated a mean (±SE) carbachol response of 16.0 (2.2) μA/cm2, histamine response of 13.2 (2.1) μA/cm2 and a forskolin response of 6.3 (2.0) μA/cm2. Basal NPD of −15.9 (1.9) and response to Cl− free + isoproterenol of −13.8 (2.0). These responses were inverted in CF subjects (n = 12) for ICM parameters with carbachol response of −3.0 (0.5) μA/cm2, histamine −1.0 (0.8) μA/cm2 and a forskolin response of 0.5 (0.3) and also for NPD parameters; basal NPD of −42.2 (4.3) and response to Cl− free + isoproterenol of 4.3 (0.7). Pearson correlation test showed the comparability of ICM and NPD in assessing CFTR function.Conclusions:ICM is equivalent to NPD in the ability to distinguish patients with CF from controls and could be used as surrogate markers of CFTR activity in treatment protocols.
Psychometric Properties of the Chinese Version of the Acceptance of Chronic Health Conditions (Stoma) Scale for Patients With Stoma
Authors: Lim Siew Hoon , He Hong-Gu , Chan Sally Wai Chi 
Published: August 2016

Background:
Formation of a stoma is a common outcome in surgical treatment of colorectal cancer. A higher acceptance of stoma was shown to improve quality of life of patients. No instrument in Chinese is available that can be used to measure the acceptance of stoma among patients with colorectal cancer.

Objectives:
The aims of this study were to translate and test the psychometric properties of Chinese version of Acceptance of Chronic Health Conditions (ACHC) (Stoma) scale.

Methods:
A sample of 100 Chinese-speaking patients with stoma was recruited from a public tertiary care hospital in Singapore. The scale was translated into Chinese and reviewed by an expert panel for semantic equivalence and content validity testing. Convergent validity was established by exploring correlations between scores of the Chinese version of the ACHC (Stoma) scale and those of the 5-level version of European Quality of Life Questionnaire—5 Dimensions. Reliability was assessed by internal consistency and test-retest reliability.

Results:
The newly translated scale had high content validity (content validity index = 94%) and acceptable internal consistency (Cronbach’s α = .846). The test-retest reliability was satisfactory with an intraclass coefficient of 0.997. A positive correlation was found between both scores on ACHC (Stoma) scale and EQ-5D utility score (r = 0.63, P < .01) and EQ-5D global visual analog scale (r = 0.70, P < .01).

Conclusions:
The Chinese version of the ACHC (Stoma) scale demonstrated satisfactory content validity, good convergent validity, and adequate internal consistency and stability.

Implications for Practice:
This scale can be used as a convenient screening tool in clinical settings to assess the level of acceptance in Chinese-speaking patients with stoma.
Knowledge and Beliefs Regarding Breast and Cervical Cancer Screening Among Mexican-Heritage Latinas
Authors: Szalacha Laura A. , Kue Jennifer , Menon Usha 
Published: August 2016

Background:
Lower participation rates in mammography and Papanicolaou test are common among Latinas compared with other ethnic groups. Suboptimal screening rates are attributed to lack of knowledge, access to services, and cultural influences.

Objective:
The purpose of this study is to qualitatively examine an alternative framework for examining cultural influences on Mexican-heritage Latinas’ understandings of breast and cervical cancer screening and how to leverage their beliefs to positively influence screening practices.

Methods:
The study is based on the analysis of 4 focus groups with 47 Latinas residing in greater Phoenix, Arizona.

Results:
Iterative qualitative analyses identified 5 major themes: (1) knowledge and beliefs about cancer cause and risk in general, (2) knowledge and beliefs specific to breast and cervical cancer screening, (3) experiences with breast and cervical cancer screening, (4) facilitators and barriers to breast and cervical screening, and (5) desired information about cancer and screening.

Conclusions:
Rather than focusing on Latinas’ knowledge and/or misconceptions of breast and cervical cancer in screening-related education, researchers must examine what Latinas believe and leverage those convictions to expand their perceptions and behaviors related to breast and cervical cancer prevention practices.

Implications for Practice:
Practitioners should recognize that Latinas may differ in beliefs from other minorities, and that even within-group, there may be cultural differences that influence cancer screening behaviors.
Sensory Gating Deficits in First-Episode Psychosis
Authors: Morales-Muñoz Isabel , Jurado-Barba Rosa , Fernández-Guinea Sara , Rodríguez-Jiménez Roberto , Jiménez-Arriero Miguel Ángel , Criado José R. , Rubio Gabriel 
Published: August 2016

Abstract
Sensory gating deficits are commonly found in patients with schizophrenia. However, there is still scarce research on this issue. Thirty-eight patients with first-episode psychosis (FEP) were compared to thirty-eight controls. A condition-test paradigm of event-related potentials (ERP), prepulse inhibition (PPI), and some specific tasks of the MATRICS Consensus Cognitive Battery (MCCB) were used (i.e., TMT, BACS-SC, and Fluency for processing speed and CPT-IP for attention and vigilance). The ERP components measured were P50, N1, and P2. The PPI intervals examined were 30, 60, and 120 msec. Regarding the MCCB, processing speed and attention/vigilance cognitive domains were selected. FEP patients showed significant deficits in N1 and P2 components, at 30 and 60 PPI levels and in all the MCCB subtests selected. We obtained significant relationships in N1 with PPI-60, and with one MCCB subtest for processing speed. In addition, this same subtest showed significant association with P2. Therefore, sensory gating functioning is widely impaired since the very early stages of schizophrenia.