bluuebunny/crossref_metadata_2025_split huggingface dataset:
ESRD IN PATIENTS WITH IBD: AN ANALYSIS OF THE NATIONAL INPATIENT SAMPLE 2015-2019
Authors: Chhoun Christopher , Blair Brian , Joo Lucy , Khalid Yaser , Dasu Neethi , Patel Rahul 
Published: January 2023

Abstract

BACKGROUND
Inflammatory Bowel Disease (IBD) can have numerous complications involving all systems of the body. There are limited data investigating the effect of renal disease on outcomes in patients with IBD . The aim of our study was to examine the impact of End-Stage Renal Disease (ESRD) on the outcomes of patients with IBD.

METHODS
The Nationwide Inpatient Sample (NIS) database encompasses approximately 7 million inpatient hospitalizations annually in the United States. Data were extracted from the National Inpatient Sample (NIS) Database for the years 2015-2019. Patients aged 18 years and above with diagnoses of IBD and ESRD were identified using ICD codes. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay (LOS), and hospital charges using STATA 17. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders.

RESULTS
We identified 226,264 patients with IBD of which 44,340 patients were matched to those with diagnoses of ESRD. Average age was 60.4 years. There was a significant increase in inpatient mortality (OR 2.22, CI 1.629486-3.018497, p&lt;0.0001), total cost of hospitalization ($31,461.41, CI 21,365.89 - 41,556.94, p&lt;0.0001), and hospital length of stay (2.03 days, CI 1.392255-2.674399, p&lt;0.0001) in patients with IBD with a concurrent diagnosis of ESRD when compared to IBD patients without ESRD. On multivariate analysis, positive predictors of mortality were sepsis (OR: 6.828519 p-value: &lt;0.001; 95% CI: 5.809829 8.025826), aspiration events,(OR: 3.78247 p-value: &lt;0.001; 95% CI: 2.939117- 4.867815), and malnourishment (OR: 2.919507 p-value: &lt;0.001; 95% CI: 2.447496- 3.482547).
LOS was increased in patients with hospitalizations complicated by sepsis (OR 3.282481; p-value: &lt;0.001; 95% CI: 2.96-3.60), malnutrition (OR 5.60; p-value: &lt;0.001; CI: 5.11- 6.08), and aspiration events (OR 3.58; p-value:&lt;0.001;CI: 2.74-4.42).
Total hospital charges were increased in patients with hospitalizations complicated by sepsis ( $45,351.03; p-value: &lt;0.001; 95% CI: 39,370.62-51,331.44), malnutrition ($63,326.1; p-value: &lt;0.001; CI: 52,921.92-73,730.27), and aspiration events($ 57,778.34; p-value: &lt;0.001; CI: 40,777.18-74,779.5).

CONCLUSIONS
Our study demonstrates the presence of ESRD in hospitalized patients with IBD is associated with poor outcomes in terms of mortality, length of stay, and total hospital charges. Furthermore concurrent aspiration events, malnutrition, and sepsis are also associated with worsened outcomes.
Our study is novel because there are minimal data that investigate the clinical outcomes associated with IBD patients with ESRD. Our study demonstrates that the presence of ESRD poses a significant mortality risk in these patients, among other factors.
INTESTINAL PERFORATIONS IN PATIENTS WITH IBD: AN ANALYSIS OF THE NATIONAL INPATIENT SAMPLE 2015-2019
Authors: Chhoun Christopher , Joo Lucy , Blair Brian , Khalid Yaser , Dasu Neethi , Patel Rahul 
Published: January 2023

Abstract

BACKGROUND
Inflammatory Bowel Disease results in numerous complications due to inflammatory damage to the intestinal mucosa. One complication of IBD is perforation of the intestines. The aim of our study was to study the impact of IBD on clinical outcomes in patients with intestinal perforation.

METHODS
The Nationwide Inpatient Sample (NIS) database encompasses approximately 7 million inpatient hospitalizations annually in the United States. Data were extracted from the National Inpatient Sample (NIS) Database for the years 2015-2019. Patients aged 18 years and above with diagnoses of IBD and intestinal perforation were identified using ICD codes. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay (LOS), and hospital charges using STATA 17. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders.

RESULTS
We identified 221,820 patients with IBD of which 43,509 patients were matched to those with intestinal perforations. Average age was 56.61 years. There was a significant increase in inpatient mortality (OR 3.10, CI 2.06-4.67, p&lt;0.0001), total cost of hospitalization ($140,391, CI 108,576.3 - 172,205.9, p&lt;0.0001), and hospital length of stay (9.42 days, CI 7.67 - 11.2, p&lt;0.0001) in patients with IBD with a concurrent diagnosis of intestinal perforation when compared to IBD patients without intestinal perforations. On multivariate analysis, positive predictors of mortality were Acute Kidney Injury (AKI) (OR: 3.734811 p-value: &lt;0.001; 95% CI: 3.159078 - 4.41547) and sepsis (OR: 5.616263 p-value: &lt;0.001; 95% CI: 4.777288- 6.602577). LOS was increased in patients with hospitalizations complicated by AKI (OR 2.577361; p-value: &lt;0.001; 95% CI: 2.327294-2.827427) and sepsis (OR 3.096738; p-value: &lt;0.001; CI: 2.754462- 3.439013). Total hospital charges were increased in patients with hospitalizations complicated by sepsis ($41,685.55; p-value: &lt;0.001; 95% CI: 35,262.58-48,108.52) and AKI ($34,990.15; p-value: &lt;0.001; CI: $30,215.96-39,764.34).

CONCLUSIONS
Our study demonstrates the presence of intestinal perforations in hospitalized patients with IBD is associated with poor outcomes in terms of mortality, length of stay, and total hospital charges. Furthermore it was found that the presence of both sepsis and AKI are also associated with worsened outcomes.
Our study is novel because there are minimal data that investigate the clinical outcomes associated with IBD patients with intestinal perforations. Our study demonstrates that the presence of intestinal perforations poses a significant mortality risk in these patients, along with concurrent sepsis and AKI.Further studies would be beneficial to identify further risk factors contributing to worsening outcomes.
GUT-BIOME MODULATION WITH HUMAN MILK OLIGOSACCHARIDE (HMO) BASED SYNBIOTIC FOR A COMPLETE AND DEEP REMISSION IN CROHN’S DISEASE: A CASE STUDY
Authors: Tummala Sai , Palle Sirish Kumar , Devalaraja Matt 
Published: January 2023

Abstract

BACKGROUND
Gut microbiome plays a crucial role in modulation of inflammatory and immune pathways. Diverse bacterial species from gut microbiota feed on specific prebiotics (non-digestible dietary fibers) producing metabolites, such as short chain fatty acids (SCFA). These metabolites beneficially affect the intestinal mucosa with their role in metabolic and immunologic homeostasis, and gut barrier integrity. Recently gut-biome modulation and use of metabolites gained interest as potential targets for therapeutic development, for instance in Inflammatory Bowel Disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC).

HYPOTHESIS
Nourishing the gut-biome thru synbiotic formulation can enhance the interspecies synergy with production of metabolites and improved gut barrier integrity more naturally. This is a superior and holistic approach to reduce gut-inflammation.

METHODS (CLINICAL CASE)
An 11 year old male with refractory iron deficiency anemia, fecal calprotectin at 1375 µg/g, on video capsule endoscopy showed discrete linear and serpiginous ulcers with surrounding erythema in duodenum and proximal jejunum. Biopsy of colon showed multiple granulomas in terminal ileum and entire colon suggesting CD (Inflammatory phenotype). Exclusive Enteral Nutrition (EEN) with polymeric formula proved unsustainable. To nourish the gut-biome and its ecosystem a synbiotic formulation (Gastrosyn) that has a blend of specific prebiotics with HMO and complimentary probiotic blend with strains of Lactobacilli and Bifidobacterium was administered and followed for 20 weeks. Formulation also contained powerful antioxidant for synergistic effect in reducing inflammation.

RESULTS
After 4 weeks on synbiotic, fecal calprotectin dropped to 665ug/g which further dropped to 110 ug/g by week 12. Complete and deep remission was observed by 15 weeks as analyzed by endoscopy/colonoscopy (images), histology and lab tests results repeated several times (Calprotectin 65ug/g by week 15). Anemia also improved significantly, and patient continued to tolerate solid foods with no relapse even after 1year.

CONCLUSIONS
Synbiotics utilizing prebiotics that are specific to probiotic strains used is crucial for successful engraftment and biome modulation as established in recent literature. HMO based Synbiotic formulation has proven to nurture the ecosystem, and foster interspecies interactions, cross feeding, and generation of metabolites (SCFAs), providing a holistic and superior approach for remission in IBD.
PCBP1 acts as a regulator of CCL2 expression in macrophages to induce recruitment of monocyte-derived macrophages into the inflamed colon
Authors: Yang Xinquan , Yabe-Wada Toshiki , Han Jia , Saito Fumiji , Ogasawara Chie , Yamada Sohsuke , Onai Nobuyuki 
Published: January 2023

Abstract
Intestinal macrophages with functional plasticity play essential roles in gut immune responses by increasing chemokines and cytokines, thereby contributing to the pathogenesis of inflammatory bowel disease (IBD). Poly(rC)-binding protein 1 (PCBP1), which is widely expressed in immune cells, binds to nucleic acids in mRNA processing, stabilization, translation and transcription. However, little is known about the influence of PCBP1 on macrophages and its specific mechanism in inflamed intestines. In this study, conditional depletion of Pcbp1 in macrophages protected mice from progression of dextran sulfate sodium induced colitis and resulted in significant alleviation of colitis. Pcbp1 deficiency markedly decreased C-C motif chemokine ligand 2 (CCL2) production by colonic CX3C motif chemokine receptor 1+ (CX3CR1+) macrophages and reduced accumulation of pro-inflammatory macrophages and production of pro-inflammatory cytokines, such as IL-6 and TNF-α, in the inflamed colon. RNA-immunoprecipitation analysis indicated that PCBP1 might interact with Ccl2 mRNA and regulate its expression in macrophages. PCBP1 expression in inflamed intestines also correlated significantly with IBD severity in patients, suggesting a critical involvement of PCBP1 in intestinal inflammation. We anticipate that our findings will facilitate the development of novel therapeutic approaches for IBD by targeting the specific function of immune cells in the local microenvironment, thereby helping to reduce adverse effects.
Awareness of antibiotic resistance: a tool for measurement among human and animal health care professionals in LMICs and UMICs
Authors: Pinto Jimenez Chris , Pearson Maddy , Hennessey Mathew , Nkereuwem Esin , Crocker Chloe , Egbujo Uzoamaka , Hendriks Jolijn , Smith Sarah , Whanpuch Phakha , Manongi Rachel , Thi Hoa Ngo , Chandler Clare I R 
Published: January 2023

Abstract

Background
Raising awareness of antimicrobial resistance is a cornerstone of action plans to tackle this global One Health challenge. Tools that can reliably assess levels of awareness of antibiotic resistance (ABR) among human or animal healthcare professionals (HCPs) are required to guide and evaluate interventions.

Methods
We designed and tested an ABR awareness scale, a self-administered questionnaire completed by human and animal HCPs trained to prescribe and dispense antibiotics in six countries—Ghana, Nigeria, Tanzania, Vietnam, Thailand and Peru. Questionnaires also elicited demographic, practice, and contextual information. Psychometric analysis for the scale followed Rasch Measurement Theory. Bivariate analysis was carried out to identify factors associated with awareness scores.

Results
Overall, 941 HCPs (625 human and 316 animal) from Ghana, Nigeria, Tanzania, Vietnam, Thailand and Peru were included in the study. The 23-item ABR awareness scale had high-reliability coefficients (0.88 for human and 0.90 for animal HCPs) but performed better within countries than across countries. Median ABR awareness scores were 54.6–63.5 for human HCPs and 55.2–63.8 for animal HCPs (scale of 0–100). Physicians and veterinarians scored higher than other HCPs in every country tested. HCPs in this study reported working in contexts with limited laboratory infrastructures. More than 95% of HCPs were interested in receiving information or training on ABR and antimicrobial stewardship.

Conclusion
HCPs’ awareness of ABR can be reliably assessed with this validated 23-item scale within the countries tested. Using the scale alongside context questions and objective measurement of practices is recommended to inform interventions to improve antibiotic use.
The primary pharmacology of ceftazidime/avibactam: resistancein vitro
Authors: Nichols Wright W , Lahiri Sushmita D , Bradford Patricia A , Stone Gregory G 
Published: January 2023

AbstractThis article reviews resistance to ceftazidime/avibactam as an aspect of its primary pharmacology, linked thematically with recent reviews of the basic in vitro and in vivo translational biology of the combination (J Antimicrob Chemother 2022; 77: 2321–40 and 2341–52). In Enterobacterales or Pseudomonas aeruginosa, single-step exposures to 8×  MIC of ceftazidime/avibactam yielded frequencies of resistance from &lt;∼0.5 × 10−9 to 2–8 × 10−9, depending on the host strain and the β-lactamase harboured. β-Lactamase structural gene mutations mostly affected the avibactam binding site through changes in the Ω-loop: e.g. Asp179Tyr (D179Y) in KPC-2. Other mutations included ones proposed to reduce the permeability to ceftazidime and/or avibactam through changes in outer membrane structure, up-regulated efflux, or both. The existence, or otherwise, of cross-resistance between ceftazidime/avibactam and other antibacterial agents was also reviewed as a key element of the preclinical primary pharmacology of the new agent. Cross-resistance between ceftazidime/avibactam and other β-lactam-based antibacterial agents was caused by MBLs. Mechanism-based cross-resistance was not observed between ceftazidime/avibactam and fluoroquinolones, aminoglycosides or colistin. A low level of general co-resistance to ceftazidime/avibactam was observed in MDR Enterobacterales and P. aeruginosa. For example, among 2821 MDR Klebsiella spp., 3.4% were resistant to ceftazidime/avibactam, in contrast to 0.07% of 8177 non-MDR isolates. Much of this was caused by possession of MBLs. Among 1151 MDR, XDR and pandrug-resistant isolates of P. aeruginosa from the USA, 11.1% were resistant to ceftazidime/avibactam, in contrast to 3.0% of 7452 unselected isolates. In this case, the decreased proportion susceptible was not due to MBLs.
Population pharmacokinetics and limited sampling strategies of polymyxin B in critically ill patients
Authors: Pi Meng-Ying , Cai Chang-Jie , Zuo Ling-Yun , Zheng Jun-Tao , Zhang Miao-Lun , Lin Xiao-Bin , Chen Xiao , Zhong Guo-Ping , Xia Yan-Zhe 
Published: January 2023

AbstractObjectivesTo characterize the pharmacokinetics (PK) of polymyxin B in Chinese critically ill patients. The factors significantly affecting PK parameters are identified, and a limited sampling strategy for therapeutic drug monitoring of polymyxin B is explored.MethodsThirty patients (212 samples) were included in a population PK analysis. A limited sampling strategy was developed using Bayesian estimation, multiple linear regression and modified integral equations. Non-linear mixed-effects models were developed using Phoenix NLME software.ResultsA two-compartment population PK model was used to describe polymyxin B PK. Population estimates of the volumes of central compartment distribution (V) and peripheral compartment distribution (V2), central compartment clearance (CL) and intercompartmental clearance (Q) were 7.857 L, 12.668 L, 1.672 L/h and 7.009 L/h. Continuous renal replacement therapy (CRRT) significantly affected CL, and body weight significantly affected CL and Q. The AUC0-12h of polymyxin B in patients with CRRT was significantly lower than in patients without CRRT. CL and Q increased with increasing body weight. A limited sampling strategy was suggested using a two-sample scheme with plasma at 0.5h and 8h after the end of infusion (C0.5 and C8) for therapeutic drug monitoring in the clinic.ConclusionsA dosing regimen should be based on body weight and the application of CRRT. A two-sample strategy for therapeutic drug monitoring could facilitate individualized treatment with polymyxin B in critically ill patients.
Binary modal logic and unary modal logic
Authors: de Jongh Dick , Shirmohammadzadeh Maleki Fatemeh 
Published: January 2023

Abstract
Standard unary modal logic and binary modal logic, i.e. modal logic with one binary operator, are shown to be definitional extensions of one another when an additional axiom $U$ is added to the basic axiomatization of the binary side. This is a strengthening of our previous results. It follows that all unary modal logics extending Classical Modal Logic, in other words all unary modal logics with a neighborhood semantics, can equivalently be seen as binary modal logics. This in particular applies to standard modal logics, which can be given simple natural axiomatizations in binary form. We illustrate this in the logic K. We call such logics binary expansions of the unary modal logics. There are many more such binary expansions than the ones given by the axiom $U$. We initiate an investigation of the properties of these expansions and in particular of the maximal binary expansions of a logic. Our results directly imply that all sub- and superintuitionistic logics with a standard modal companion also have binary modal companions. The latter also applies to the weak subintuitionistic logic WF of our previous papers. This logic doesn’t seem to have a unary modal companion.
Application of Geant4-DNA for simulating water radiolysis induced by Auger electron-emitting radionuclides
Authors: Adjei Daniel , Trinh Ngoc Duy , Mostafavi Mehran 
Published: January 2023

AbstractAuger-emitting radionuclides have potential application in targeted radiotherapy, particularly for metastatic cancers. This possibility, especially, is stemmed from their characteristic short-range (a few μm) in biological systems allowing localization of high dose within small tumours. To explore this potential application, a Geant4 Monte Carlo toolkit has been employed to simulate the energy deposition of different radionuclides in a water model. The Geant4 Monte Carlo toolkit has model packages to simulate the interaction of radiation with matter and with diverse applications such as studies in science and medicine. In this study, the Geant4-DNA package was used to simulate the radiolytic yields induced by some Auger electron-emitting (AE) radionuclides including; I-131, I-125 and Pd-103, In-111, Ru-97 and Rh-103 m in water model. The results showed that the transient yield of the radiolytic species is characterized by the kinetic energies of the emitted electrons. It was observed that almost all the radionuclides, except I-131, deposited more energy in their proximity thereby inducing a high density of spurs to interact in a short time. It is, therefore, important to consider the kinetic energies of the emitted particles in choosing a radionuclide for specified targeted radiotherapy. This means that apart from their toxicity, compatibility with chelator and carrier molecules, and method of production, we can predict radionuclides such as In-111, Ru-97, Pb-103 m and I-125 could be relevant for targeted radiotherapy for the treatment of metastasis lesions, or tiny tumours at the cellular level, and tumours after surgical resection.
A comprehensive account of the burden of persuasion in abstract argumentation
Authors: Kampik Timotheus , Gabbay Dov , Sartor Giovanni 
Published: January 2023

AbstractIn this paper, we provide a formal framework for modeling the burden of persuasion in legal reasoning. The framework is based on abstract argumentation, a frequently studied method of non-monotonic reasoning, and can be applied to different argumentation semantics; it supports burdens of persuasion with arbitrary many levels, and allows for the placement of a burden of persuasion on any subset of an argumentation framework’s arguments. Our framework can be considered an extension of related works that raise questions on how burdens of persuasion should be handled in some conflict scenarios that can be modeled with abstract argumentation. An open source software implementation of the introduced formal notions is available as an extension of an argumentation reasoning library. A theoretical analysis shows that our approach can be generalized to a novel method for the preference-based selection of extensions from argumentation frameworks.
Focusing—Finding a Shared Goal
Authors: Starks Tyrel J. 
Published: January 2023

AbstractThis chapter discusses the two stages of establishing and elaborating a focus in couples Motivational Interviewing. Establishing a focus refers to the identification of a target behavior that both partners are at least willing to discuss. Elaborating a focus then subsequently involves clarifying what each partner wants, their beliefs about one another’s preferences, and the extent to which each partner believes that their perspective will be heard without doubt or judgment. In the process of elaborating a focus, challenges may emerge as partners’ initial perceptions about the presence or absence of agreement are informed by disclosures in session. They may also emerge as a result of doubt or judgment expressed by partners toward one another—an absence of trust that impedes successful negotiation around a counseling focus. The purpose of the focusing process is not to achieve agreement about whether or how change should happen, but rather to ensure that all parties have an accurate understanding of one another’s views before an emphasis on evoking change talk emerges as salient.
Evoking Change Talk From a Couple
Authors: Starks Tyrel J. 
Published: January 2023

AbstractThis chapter discusses the impact of dyadic ambivalence on the process of evoking change talk. Dyadic ambivalence occurs when partners have divergent perspectives on change. In such instances, the use of traditional Motivational Interviewing strategies may exacerbate conflict. Counselor utterances that elicit change talk from one partner may elicit counter–change talk from the other. This chapter reviews a set of strategies for mitigating relationship discord—the presence of conflict between partners in session. These strategies are intended to create opportunities for partners to consider one another’s perspective and the potential for consensus. Once some degree of alignment in partners’ perceptions of the target behavior has been achieved, traditional evoking skills common in Motivational Interviewing practice can be employed successfully.
Planning—Taking Action Together
Authors: Starks Tyrel J. 
Published: January 2023

AbstractThis chapter discusses the role of partners in the change-planning process from the perspective of both goal-setting and interdependence theory. Emphasis is placed on the identification of couple-level or shared goals (i.e., joint goals) in which both partners feel a sense of investment. Even when such goals do not involve both partners enacting similar behavior change, partners may serve as a source of support and feedback to one another. For this reason, change planning with couples involves clarifying the role of both partners in the change process. In addition, plans incorporate how partners will communicate with one another during the change process. The chapter presents and discusses the planning process in three prototypical scenarios involving mutual change, individual change with partner support, and planning when shared goals cannot be identified. Special considerations related to planning for relationship termination are also mentioned.