bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying and matching 12‐level multistained glomeruli via deep learning for diagnosis of glomerular diseases
Authors: He Qiming , Zeng Siqi , Ge Shuang , Wang Yanxia , Ye Jing , He Yonghong , Guan Tian , Wang Zhe , Li Jing 
Published: February 2024

AbstractThe assessment of glomerular lesions is a fundamental step toward the diagnosis of glomerular diseases. This requires diagnosis and fusion of information from all the glomeruli at multiple levels and stainings. The lack of research on multi‐level multistained glomerular identification and matching has resulted in renal pathologists devoting much time and attention to this time‐consuming and labor‐intensive process. This limits the overall efficiency of the diagnosis of glomerular diseases. This paper constructed a dataset consisting of 600 cases, each containing 12 levels of whole slide images from H&E, PAS, Masson trichrome, and PASM staining. The glomeruli identifying and matching was proposed. First, a multistained transformer‐based Mask R‐CNN is proposed to extract the position and contours of the glomeruli. Second, coherent point drift‐based coarse matching and hybrid feature‐based fine matching achieve pairwise matching. Finally, the voting‐based cross‐matching realizes 12‐level multistained matching. This system constitutes a practical human‐computer interface. Intensive experiments were conducted to validate the ability to identify and match 12‐level multistained glomeruli. The mAP@50 for detection and segmentation reached 95.40% and 95.70%, respectively. The basic and comprehensive matching rates of the glomeruli matching reached 98.25% and 74.59%, respectively. Visualization results further demonstrate that the model achieved accurate identification and matching. The proposed system achieves accurate identification and matching of 12 levels of multistained glomeruli and can serve as a tool for pathological diagnosis of glomerular diseases by simplifying the diagnostic process. More importantly, this system can lay the foundation for the fully automated assisted diagnosis of glomerular diseases.
Serial Changes in Titers of Antibody to Hepatitis B Surface Antigen After Immunization of Infants Born to Mothers with Hepatitis B e Antigen
Authors: Fujisawa Tomoo , Onoue Masahiro , Inui Ayano , Kosugi Takeshi 
Published: February 2024

SummaryTo evaluate the long‐term protection provided by hepatitis B (HB) vaccine in a high‐risk environment, we followed 50 infants born to mothers with hepatitis B e (HBe) antigen. These infants were immunized with a three‐dose regimen of plasma‐derived HB vaccine and were followed for up to 10 years. Two infants (4%) acquired hepatitis B virus (HBV) infection before 1 year of age. The 48 other infants remained hepatitis B surface (HBs) antigen‐negative during the follow‐up period. The geometric mean titers of serum antibody to HBs antigen rapidly decreased during the first 4 years but remained at protective levels throughout the follow‐up period. These data suggest that protection against significant HBV infection lasts for at least 10 years. We conclude that the long‐term protection afforded by plasma‐derived HB vaccine is satisfactory and that a routine booster dose before 10 years of age is not necessary.
Fecal Short‐Chain Fatty Acids in Patients with Diarrhea‐Predominant Irritable Bowel Syndrome: In Vitro Studies of Carbohydrate Fermentation
Authors: Treem William R. , Ahsan Naheedt , Kastoff Geraldine , Hyams Jeffrey S. 
Published: February 2024

SummaryColonic bacterial production of short‐chain fatty acids (SCFA) plays an important role in the salvage of unabsorbed carbohydrate and in colonic absorption of electrolytes and water. The objective of this study was to determine whether patients with diarrhea‐predominant irritable bowel syndrome (DP‐IBS) have a different pattern and rate of fermentation of carbohydrate and fiber to SCFA compared with controls. Fecal homogenates from 10 patients with DP‐IBS and 10 age‐matched controls were studied. SCFA were measured by gas chromatography in baseline fecal samples and in fecal homogenates in an in vitro anaerobic fermentation system after incubation with no additional substrate, lactulose, potato starch, citrus pectin, and hemicellulose over a 24‐hour period. Net SCFA production rates were calculated for the first 6 h of the incubation period. Patients with DP‐IBS had a consistently different pattern of less total SCFA, a lower percentage of acetate (p < 0.05), and a higher proportion of n‐butyrate (p < 0.05) than controls. In stool homogenates from both controls and DP‐IBS patients, lactulose fermentation resulted in the highest rate of SCFA production followed by pectin, starch, and hemicellulose. However, at all time points, the fecal homogenates from controls generated a higher concentration of total SCFA, acetate, and propionate with all substrates tested. SCFA production rates were higher in controls incubated with lactulose, starch, and hemicellulose. The fecal SCFA profile of patients with DP‐IBS is characterized by lower concentrations of total SCFA, acetate, and propionate and a higher concentration and percentage of n‐butyrate. Fecal flora from these patients produced less SCFA in an in vitro fermentation system in response to incubations with various carbohydrates and fibers. Differences in SCFA production by colonic bacterial flora in patients with DP‐IBS may be related to the development of gastrointestinal symptoms.
Restoration of Body Composition in Celiac Children after One Year of Gluten‐Free Diet
Authors: Rea Francesco , Polito Cesare , Marotta Antonio , Di Toro Antonino , Iovene Antonio , Collini Rosaria , Rea Luciana , Sessa Giuseppa 
Published: February 2024

SummaryRestoring protein, fat, and bone compartments in celiac children on a gluten‐free diet (GFD) is not yet well understood. Hence, anthropometric, biochemical, and bone densitometric assessment was performed in 23 celiac children, 8 boys and 15 girls, aged 1 to 12 years (mean 4.7), at diagnosis and 1 year after GFD. At diagnosis the patients had height, arm muscle area, triceps skinfolds, subscapular skinfolds, fat area index, and bone mineral content significantly lower than in an age‐ and sex‐matched control group. After 1 year on GFD, no significant difference was found between patients and controls in all the parameters studied except in height and arm muscle area, which, however, were very near to the normal expected. Serum hemoglobin, iron, and zinc values were below the normal range in more than one half of patients at diagnosis and within the normal range in almost all of them after 1 year of GFD. Serum hemoglobin, iron, zinc, triglycerides, proteins, albumin, and calcium values significantly rose during the year of GFD. A year of GFD in celiac children allows a virtually complete return in body mass composition.
Evaluation of Intranasal Midazolam in Children Undergoing Esophagogastroduodenoscopy
Authors: Fishbein Mark , Lugo Ralph A. , Woodland Jennifer , Lininger Barbara , Linscheid Tom 
Published: February 2024

Background:Intravenous midazolam and opioids are used to produce conscious sedation in children undergoing esophagogastroduodenoscopy (EGD). However, children may experience significant fear and anxiety before receiving these medications, especially during separation from parents and during venipuncture. Intranasal administration of midazolam represents a noninvasive method of sedating children before anxiety‐producing events. The objective of this study was to determine whether premedication with intranasal midazolam reduces stress and anxiety of separation from parents and of undergoing venipuncture, while maintaining adequate sedation during EGD.Methods:This was a prospective, randomized, double‐blind study in 40 children, aged 2 to 12 years, who were undergoing EGD. Patients in group I were premedicated with intranasal placebo (0.9% NaCl) followed 10 minutes later by intravenous midazolam (0.05 mg/kg) and intravenous meperidine (1 mg/kg). Patients in group II were premedicated with intranasal midazolam (0.2 mg/kg) followed by intravenous placebo (0.9% NaCl) and intravenous meperidine (1 mg/kg). Anxiolysis and sedation were scored by a blinded observer, who identified minor and major negative behaviors during four observation periods: intranasal drug administration, separation from parents, venipuncture, and EGD.Results:Premedication with intranasal midazolam significantly reduced negative behaviors during separation from parents (p < 0.05); however, no difference between regimens was noted during venipuncture or EGD. Negative behaviors appeared to increase during administration of intranasal midazolam or placebo.Conclusions:Premedication with intranasal midazolam is effective in reducing negative behaviors during separation from parents, while it maintains sedation during the endoscopic procedure. The benefits of intranasal administration may be negated, however, by irritation, and discomfort caused by intranasal drug delivery.
Mucosal Inflammation in Pediatric Diversion Colitis: A Quantitative Analysis
Authors: Grant Neil J. , Van Kruiningen Herbert J. , Haque Salima , West A. Brian 
Published: February 2024

Background:Diversion colitis commonly occurs in bypassed segments of colorectum, and has been described qualitatively in Hirschsprung's disease patients with colostomies. The objective of this study was to characterize quantitatively the changes in the inflammatory cell population in the mucosa of children with diversion colitis.Methods:Paraffin blocks of well‐oriented, full‐thickness colorectal tissues were obtained from 15 children with diversion colitis (all with Hirschsprung's disease), four pediatric controls and four adult controls. Sections were immunostained for B and T lymphocytes, macrophages, IgG, IgM, and IgA. Measurements were made referent to a standard length of muscularis mucosae. Lymphoid follicles were counted and the areas occupied by B and T cells were determined by image analysis. Cells in the interfollicular lamina propria were counted separately, but IgA‐containing plasma cells were too abundant to enumerate.Results:Pediatric diversion colitis was characterized by enlarged and more numerous lymphoid follicles with approximately four times as many B lymphocytes and twice as many T lymphocytes in the follicular compartment of the mucosa when compared to pediatric controls. The interfollicular mucosa was thickened (499 ± 27 versus 380 ± 56 μm) and contained approximately six times as many B cells and eight times as many T cells as controls. Macrophages and plasma cells containing IgG and IgM were not significantly increased.Conclusions:These findings extend the qualitative observations of increased follicular and lamina propria lymphoid tissue in bypassed segments of colon, and are consistent with the hypothesis of persistent antigenic stimulation of the mucosa‐associated lymphoid tissue.
The Effect of Starvation on Brain Carnitine Concentration in Neonatal Rats
Authors: Murakami Ryusuke , Tanaka Akiyoshi , Nakamura Hajime 
Published: February 2024

BackgroundWe examined carnitine concentrations in fasted neonatal rat brain to evaluate the effect of starvation on fatty acid metabolism.MethodsThe free‐ and acylcarnitine concentrations in neonatal rat brain and heart were determined after a 72‐hour starvation period from the 3rd to 6th postnatal day. They were also determined in rats at 3 and 6 days of age fed normally by the mother rats as controls.ResultsIn the brain, the mean free carnitine concentration in the fasted group showed an increase similar to that in normal rats and there was no difference between the fasted and 6‐day‐old control rats. However, the mean acylcarnitine concentration was significantly higher in the fasted group than in the control group at both 3 and 6 days of age. Almost all of the increased acylcarnitine in the fasted group was short‐chain acylcarnitine.In the heart, there was no difference in the mean free carnitine concentration between the fasted group and control group at 6 days of age. The 6‐day‐old rats in both the fasted and control groups showed higher levels compared to 3‐day‐old rats in the control group. The mean acylcarnitine concentration in the fasted group was not different from that in control group at 6 days of age, while the amount of short‐chain acylcarnitine was less than that in the control group at 6 days of age.ConclusionsThese findings suggest that in the brain, carnitine is accumulated as a result of redistribution during starvation, and is utilized for energy supply by fatty acid oxidation.
Circulating Oxyntomodulin‐like Immunoreactivity in Healthy Children and Children with Celiac Disease
Authors: Le Quellec Alain , Clapié Marjorie , Callamand Pierre , Lehmann Michel , Kervran Alain , Bataille Dominique , Rieu Daniel 
Published: February 2024

ABSTRACTBackground:The aim of the study was to evaluate the new hormonal entity oxyntomodulin‐like immunoreactivity in malabsorption states, and to assess its potential in celiac disease management.Methods:We measured basal and postprandial oxyntomodulin‐like immunoreactivity values in 35 children divided into 3 groups: group 1 was composed of 13 children with celiac disease, either under a gluten‐free diet (8 patients) or normal diet (5 patients); group 2 was composed of 8 children hospitalized for gastroenteritis or chronic diarrhea, without biological evidence of malabsorption nor abnormal jejunal mucosa; group 3 was composed of 22 control subjects.Results:Fasting and meal‐stimulated levels in the control group were 71 ± 10 and 130 ± 26 pmol/l, respectively. Mean concentrations were elevated in patients with celiac disease (basal = 349 ± 254 pmol/l, postprandial = 446 ± 332 pmol/l) and in the group 2 (basal = 139 ± 58 pmol/l, postprandial = 218 ± 85 pmol/l), but the difference with control subjects did not reach statistical significance. In children with celiac disease, basal and stimulated values correlated with the degree of malabsorption as assessed by hemoglobin (p = 0.006 and p = 0.01, respectively) and serum folate concentrations (p = 0.03 and p = 0.02, respectively).Conclusions:Oxyntomodulin‐like immunoreactivity is noticeably higher in healthy children than previously measured in healthy adult subjects. This hormonal parameter is not an adequate diagnostic tool in celiac disease. Nevertheless, in the context of celiac disease, its elevation reflects the degree of malabsorption and may provide a quantitative approach of the extent of mucosal damage.
Digestion of Ceramide by Human Milk Bile Salt‐Stimulated Lipase
Authors: Nyberg Lena , Farooqi Aijaz , Bläckberg Lars , Duan Rui‐Dong , Nilsson Åke , Hernell Olle 
Published: February 2024

ABSTRACTBackground:There is a renewed interest in metabolism of sphingolipids because of their role in signal transduction. Sphingomyelin is the dominating phospholipid in human milk but its metabolism and possible function in the gastrointestinal tract of breast fed infants is unknown. We explored whether bile salt‐stimulated milk lipase has a role in sphingolipid metabolism.Methods:In vitro assays of sphingomyelinase and ceramidase activities, using radiolabeled substrates, human milk samples and purified native and recombinant variants of bile salt‐stimulated milk lipase with or without known activators or inhibitors.Results:Human whey and purified lipase catalysed hydrolysis of palmitoyl‐labeled ceramide with the highest rate around pH 8.5‐9.0. 1 mg of lipase hydrolysed 0.7 µmol ceramide in one hour at pH 8.5 in presence of 4 mM bile salt. The activity of whey was inhibited by antibodies towards human bile salt‐stimulated milk lipase, indicating that this lipase accounted for virtually all ceramidase activity in the milk. In contrast, bile salt‐stimulated milk lipase showed no activity against sphingomyelin. However we give evidence of a separate, hitherto unknown, acid sphingomyelinase in human milk. Under the used in vitro conditions this sphingomyelinase could account for hydrolysis of half of milk sphingomyelin in one hour.Conclusions:Human milk bile salt‐stimulated milk lipase hydrolyses ceramide and may thus have a role in sphingomyelin digestion, but only after initial hydrolysis to ceramide and phosphorylcholine. Part of the latter could be carried out in the stomach by the acid milk sphingomyelinase now described. We speculate that these two milk enzymes may be of importance for optimal use of human milk sphingolipids.
Accuracy of the [13C]‐Urea Breath Test in Diagnosing Helicobacter pylori Gastritis in Pediatric Patients
Authors: Delvin Edgard E. , Brazier Jean L. , Deslandres Collete , Alvarez Fernando , Russo Pierre , Seidman Ernest 
Published: February 2024

ABSTRACTBackground:The causal association between Helicobacter pylori (H. pylori) colonization of the gastric mucosa and gastritis is now well established. Histologic examination of endoscopic biopsy specimens has long been regarded as the gold standard for diagnosis. However, the changes can be focal in nature and presence of the organism may be missed in nonsampled areas. The urea breath test, which uses a stable isotope, offers distinct advantages, in that it is noninvasive and measures the activity of the micro‐organism. It thus represents a potentially invaluable tool in the initial diagnosis of the infection and in verifying its eradication.Methods:The study design was that of a prospective, blinded comparison of the [13C]‐urea breath test with histologic assessment of antral biopsy specimens using the Warthin‐Starry stain, to diagnose H. pylori infection in a group of 79 consecutive pediatric patients.Results:Patients classified as negative by histology (n = 67) had breath 13C enrichment of 0.97 ± 0.07 δ‰ (mean ± SEM), with a range of ‐0.20 and 2.83 δ‰. In contrast, those with a positive histologic results (n = 12) had an enrichment of 25.41 ± 5.01 δ‰ (range, 3.43‐58.80; p < 0.001). At the chosen cutoff point of 3 δ‰, the sensitivity and specificity as well as the positive and negative predictive values of the breath test were uniformly 100%.Conclusion:The [13C]‐urea breath test is a highly reliable, noninvasive method for the diagnosis of H. pylori gastritis in children and adolescents.
Helicobacter pylori Infection in Children with Celiac Disease: Prevalence and Clinicopathologic Features
Authors: Luzza Francesco , Mancuso Maria , Imeneo Maria , Mesuraca Luigi , Contaldo Antonio , Giancotti Laura , La Vecchia Anna M. , Docimo Corrado , Pensabene Licia , Strisciuglio Pietro , Pallone Francesco , Guandalini Stefano 
Published: February 2024

ABSTRACTBackground:Celiac disease is frequently associated with chronic gastritis. Helicobacter pylori is the main etiologic agent of chronic gastritis. The aim of this study was to assess the prevalence of H. pylori, the related symptoms, and the endoscopic and histologic gastric features in children with celiac disease.Methods:Eight‐one (24 boys, 57 girls; age range: 1.4‐17.7 years, median 6.8) children with celiac disease were studied. All children had a blood sample taken. In a subgroup of 30 children who underwent endoscopy, three gastric biopsy specimens were taken for histology (hematoxylin and eosin, Giemsa, immunohistochemistry) and urease quick test. Symptom complaints were recorded. Age‐ and sex‐matched (one case, one control) children without celiac disease were used for comparison. Serum H. pylori IgG were measured by means of a locally validated commercial enzyme‐linked immunoassay.Results:Overall, 15 of 81 (18.5%) children with celiac disease and 14 of 81 (17.3%) control children were positive for H. pylori. The percentage of H. pylori positivity was similar in children with untreated and treated celiac disease. Recurrent abdominal pain was the only symptom that helped to distinguish between H. pylori‐positive and H. pylori‐negative children. However, symptoms disappeared in patients with celiac disease after gluten withdrawal, irrespective of H. pylori status. All endoscopic (erythema, nodularity) and histologic (superficial‐, interstitial‐, lymphocytic‐gastritis, activity, lymphoid follicles) findings did not differ between celiac and nonceliac H. pylori‐positive children.Conclusions:Prevalence and clinical expressivity of H. pylori infection is not increased in children with celiac disease. The clinicopathologic pattern of the infection is not specifically influenced in this condition.
Home Parenteral Nutrition in Children: The Polish Experience
Authors: Ksiazyk Janusz , Lyszkowska Malgorzata , Kierkus Jaroslaw , Bogucki Krzysztof , Ratyńska Anna , Tondys Bozenna , Socha Jerzy 
Published: February 2024

ABSTRACTBackground:Home parenteral nutrition has become routine for management of intestinal failure in patients. In Poland the main obstacle to widespread use of home parenteral nutrition is the lack of interest of commercial companies in delivering feedings and ancillaries to patients.Methods:Twenty‐five home parenteral nutrition patients aged from 4 months to more than 13 years were reviewed. The mother or both parents were trained in home parenteral nutrition techniques for 4 to 6 weeks and compounded the nutrients themselves at home.Results:The mean duration of home parenteral nutrition was 10,117 patient days. Hospital stays of patients receiving parenteral feedings were significantly shorter than the duration of administration of home parenteral nutrition (p < 0.001). Eleven children are continuing the home parenteral nutrition program. Eighty‐three catheters were used in these patients. The rate of catheter occlusion decreased within the observation period, and in 1997 not one case of occlusion was observed. In 1997 only three catheters were removed during 7.8 patient years, and the overall incidence of catheter‐related complications was 0.38 per patient year. The overall occurrence of septicemia was one case in 516 days and of catheter infection was one in 459 days. In 1997 a catheter was infected on average of once every 1419 days. There was significant improvement in the z score for weight during therapy. The average monthly cost of nutrients and ancillary items was approximately $1200 (4200 Polish zlotys [PLN]). These costs are 1.6 to 3 times lower than those recorded in other studies.Conclusion:Home parenteral nutrition in children with nutrients mixed by caregivers in the home setting is a safe and appropriate method of treatment that can be used in countries where home parenteral nutrition solutions are not manufactured or where commercial home parenteral nutrition is not economically feasible.