bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Antitumor Necrosis Factor Biologics in Very Early Onset Inflammatory Bowel Disease: A Multicenter Retrospective Cohort Study From North America
Authors: Kerur Basavaraj , Fiedler Karoline , Stahl Marisa , Hyams Jeffrey , Stephens Michael , Lu Ying , Pfefferkorn Marian , Alkhouri Raza , Strople Jennifer , Kelsen Judith , Siebold Leah , Goyal Alka , Rosh Joel R. , LeLeiko Neal , Van Limbergen Johan , Guerrerio Anthony L. , Maltz Ross M. , Karam Lina , Crowley Eileen , Griffiths Anne M. , Heyman Melvin B. , Deneau Mark , Benkov Keith , Noe Joshua , Moulton Dedrick , Pappa Helen , Galanko Joseph , Snapper Scott , Muise Aleixo M. , Kappelman Michael D. , Benchimol Eric I. 
Published: May 2022

Background:
Research on the utilization and effectiveness of antitumor necrosis factor (TNF) biologics in children with very early onset inflammatory bowel disease (VEOIBD) is urgently needed. Here we describe anti-TNF use and durability in a multicenter cohort.

Methods:
We performed a retrospective cohort study of patients diagnosed with VEOIBD (<6 years) between 2008 and 2013 at 25 North American centers. We performed chart abstraction at diagnosis and 1, 3, and 5 years after diagnosis. We examined the rate of initiation and durability of infliximab and adalimumab and evaluated associations between treatment durability and the following covariates with multivariate Cox proportional hazard regression: age at diagnosis, sex, disease duration, disease classification, and presence of combined immunomodulatory treatment versus monotherapy.

Results:
Of 294 children with VEOIBD, 120 initiated treatment with anti-TNF therapy and 101 had follow-up data recorded [50% Crohn disease (CD), 31% ulcerative colitis (UC), and 19% IBD unclassified (IBD-U)]. The cumulative probability of anti-TNF treatment was 15% at 1 year, 30% at 3 years, and 45% at 5 years from diagnosis; 56 (55%) were treated between 0 and 6 years old. Anti-TNF durability was 90% at 1 year, 75% at 3 years, and 55% at 5 years. The most common reason for discontinuation of anti-TNF were loss of response in 24 (57%) children. Children with UC/IBD-U had lower durability than those with CD (hazard ratio [HR] 0.17; 95% confidence interval [CI], 0.06–0.51; P = 0.001).

Conclusions:
Utilization and durability of anti-TNF in VEOIBD is relatively high and comparable with older children. Having Crohn disease (compared with UC/IBD-U) is associated with greater durability.
Impact of Pancreatic Enzymes on Enteral Fat and Nitrogen Absorption in Short Bowel Syndrome
Authors: Sainath Nina N. , Bales Christina , Brownell Jefferson N. , Pickett-Blakely Octavia , Sattar Aisha , Stallings Virginia A. 
Published: May 2022

Objectives:
Patients with short bowel syndrome (SBS) can have a high morbidity rate. To minimize morbidity, enteral autonomy is the primary goal in clinical management of patients with SBS. This is often difficult to achieve because of significant malabsorption. To date, there are limited therapies that improve absorption in patients with SBS. The impact of pancreatic enzyme replacement treatment on enteral absorption has not been studied in this population and was the primary aim of this study.

Subjects/methods:
This was an interventional study in 11 subjects (6 pediatric subjects ages 4.0–17.9 years, 5 adult subjects 18–75 years) that compared enteral absorption in each subject before and after pancreatic enzyme medication (Creon). Coefficient of fat absorption (CFA) and coefficient of nitrogen absorption (CNA) were used as markers of enteral absorption of fat and protein, respectively.

Results:
There was no statistically significant mean change in CFA and CNA before and after pancreatic enzyme medication therapy. Six subjects demonstrated an increase in CFA and 8 subjects demonstrated an increase in CNA after the use of pancreatic enzyme medication therapy.

Conclusions:
There was no statistically significant improvement in enteral fat and protein absorption in the cohort as a whole, though several subjects demonstrated an improvement. These results suggest that some patients with SBS may benefit from treatment with pancreatic enzymes. Further studies are needed to better evaluate the effect of pancreatic enzyme therapy on enteral absorption in subjects with SBS and to characterize factors that may predict a positive response.
Report From the Field: Public Health Equity Through Innovative Multisector Data Sharing
Authors: Tanner Clare , Strzyzykowski Trevor , Mannor Kara , Hendricks-Sturrup Rachele 
Published: May 2022

Context:
Data sharing across sectors for the purpose of driving health equity is a particularly innovative yet emerging concept in public health practice and research, although the extent to which public health entities engage in multisector data sharing and initiatives is currently underexplored. This practice report examines the nature and extent to which public health entities are sharing data across sectors in ways that are innovative and supportive of their organizational missions to promote community health equity and well-being.

Program:
As a program office of the Robert Wood Johnson Foundation, Data Across Sectors for Health (DASH) seeks to promote and support data sharing systems leveraged toward equitable improvements to health.

Implementation:
We pilot tested, revised, and disseminated the 2021 All In National Inventory, a survey implemented to scan the environment to track progress and challenges in the field of data sharing, and feed lessons learned back into communities to cultivate further public health innovations involving shared data and infrastructure development.

Evaluation:
Use case development, engaging communities to cocreate shared data systems.

Discussion:
Findings show public health plays a pivotal role in innovation to share data across sectors to serve as a community health improvement foundation. While public health often leads these initiatives to improve health and promote health equity, national data suggest there is much room for improvement in incorporating equitable data sharing practice.
The Public Health National Center for Innovations: An Initial Qualitative Evaluation
Authors: Siegfried Alexa L. , Kennedy Mallory , Gonick Shannon A. , Liotta Madeleine 
Published: May 2022

Context:
The Public Health National Center for Innovations (PHNCI) was launched in 2015 as a division of the Public Health Accreditation Board (PHAB) to serve as a hub for fostering public health innovation and transformation.

Objectives:
We explored perspectives of key informants to assess PHNCI's work in its first 5 years, including implementation of activities, outputs, accomplishments, and opportunities.

Design:
This qualitative study involved a Web site review; secondary document review; 15 interviews with 17 key informants purposively sampled from 2 groups—PHNCI and PHAB staff and leadership (PHNCI respondents), and external partners and collaborators (external respondents); and thematic analysis of qualitative data.

Setting:
United States.

Results:
PHNCI implemented its planned activities over the past 5 years—including grant programs and learning communities; large-scale public health initiatives; conferences, events, and convenings; webinar trainings; and resources, tools, and materials—resulting in more than 150 outputs. According to key informants, PHNCI's major accomplishments were as follows: contributed to an increased understanding and awareness of innovation in the public health field; provided grants and learning communities to support innovation; developed and disseminated materials to help practitioners innovate; established partnerships and promoted cross-sector collaboration; supported systems transformation; incorporated innovation into public health accreditation; and focused efforts to advance health equity.

Conclusions:
Going forward, PHNCI should continue to prioritize its core activities that support public health innovation and transformation; expand its work by addressing innovation in new public health topic areas; strengthen and expand its cross-sector work, partnerships, and activities to advance health equity and antiracism; and increase its visibility and reach, particularly within other sectors. Continued commitment and leadership are important for strengthening the capacity of the public health system to innovate, respond to ongoing and emerging public health threats and challenges, and advance health equity.
Characteristics of office workers who benefit most from interventions for preventing neck and low back pain: a moderation analysis
Authors: Akkarakittichoke Nipaporn , Jensen Mark P. , Newman Andrea K. , Waongenngarm Pooriput , Janwantanakul Prawit 
Published: May 2022

Abstract

Introduction:
Neck and low back pain are significant health problem in sedentary office workers. Active break and postural shift interventions has been proved to reduce the incidence of new onset of both neck and low back pain.

Objectives:
To identify variables that moderate the effects of active breaks and postural shift interventions on the development of neck and low back pain in office workers.

Methods:
Using data from a 3-arm (active break, postural shift, and control group) cluster randomized controlled trial (N = 193), we evaluated the moderating effects of age, job position, education level, sex, perceived psychological work demands, number of working hours, and using a chair with lumbar support on the benefits of 2 interventions designed to prevent the development of neck and low back pain in office workers. Moderation analyses were conducted using the Hayes PROCESS macro, with post hoc Johnson–Neyman techniques and logistic regressions.

Results:
Significant interactions between intervention groups and 3 moderators assessed at baseline emerged. For the prevention of neck pain, the effect of the active break intervention was moderated by the number of working hours and the effect of the postural shift intervention was moderated by the level of perceived psychological work demands and the number of working hours. For the prevention of low back pain, the effect of postural shift intervention was moderated by having or not having a chair with lumbar support.

Conclusions:
The study findings can be used to help determine who might benefit the most from 2 treatments that can reduce the risk of developing neck and low back pain in sedentary workers and may also help us to understand the mechanisms underlying the benefits of these interventions.
Tele-Untethered: Telemedicine Without Waiting Rooms
Authors: Meyer Brett C. , Perrinez Emily S. , Payne Keith , Carreño Shivon , Partridge Brittany , Braunlich Brian , Tangney Jeff , Sylwestrzak Marc , Kremer Brendan , Kane Christopher J. , Longhurst Christopher A. 
Published: May 2022

Background and Objectives:
Telemedicine bridges the gap between care needs and provider availability. The value of telemedicine can be eclipsed by long wait times, especially if patients are stuck in virtual waiting rooms. UCSD Tele-Untethered allows patients to join visits without waiting in virtual waiting rooms. Tele-Untethered uses a text-to-video link to improve clinic flow, decrease virtual waiting room reliance, improve throughput, and potentially improve satisfaction.

Methods:
This institutional review board (IRB)-approved quality improvement pilot (IRB #210364QI) included patients seen in a single vascular neurology clinic, within the pilot period, if they had a smartphone/cell phone, and agreed to participate in a flexible approach to telehealth visits. Standard work was disseminated (patient instructions, scripting, and workflows). Patients provided a cell phone number to receive a text link when the provider was ready to see them. Metrics included demographics, volumes, visit rates, percentage seen early/late, time savings, and satisfaction surveys.

Results:
Over 2.5 months, 22 patients were scheduled. Of those arriving, 76% were “Tele-Untethered” and 24% were “Standard Telemedicine.” Text-for-video link was used for 94% of Tele-Untethered. Fifty-five percent were seen early. There was a 55-minute-per-session time savings.

Conclusion:
This UCSD Tele-Untethered pilot benefitted patients by allowing scheduling flexibility while not being tied to a “virtual waiting room.” It benefited providers as it allowed them to see patients in order/not tied to exact times, improved throughput, and saved time. Even modest time savings for busy providers, coupled with Lean workflows, can provide critical value. High Tele-Untethered uptake and use of verbal check-in highlight that patients expect flexibility and ease of use. As our initial UCSD Tele-Untethered successes included patient flexibility and time savings for patients and providers, it can serve as a model as enterprises strive for optimal care and improved satisfaction. Expansion to other clinic settings is underway with a mantra of “UCSD Tele-Untethered: Your provider can see you now.”
Resolution of Misleading COVID-19 Vaccination–Related Nodal and Splenic FDG Uptake in the Follow-up Study
Authors: Bhimaniya Sudhir , Jahromi Amin 
Published: May 2022

Abstract
Newly diagnosed low-grade bilateral breast lymphoma in 63-year-old woman demonstrated intense FDG uptake in the left axillary lymph nodes and the spleen, concerning for lymphomatous involvement. Subsequent ultrasound-guided biopsy did not demonstrate any pathologic left axillary lymph nodes. Further investigation revealed COVID-19 vaccination in the left arm, 5 days prior to the 18F-FDG PET/CT study. Six-month follow-up 18F-FDG PET/CT showed resolution of the intense FDG uptake in the left axillary lymph nodes and spleen without any treatment, suggesting a self-remitting acute local and systemic immune response to COVID-19 vaccination.
Hemodynamic Response to Acute Volume Load and Endomyocardial NO-synthase Gene Expression in Heart Transplant Recipients
Authors: Kobediona Monika , Bartunek Jozef , Delrue Leen , Van Durme Frederik , Lau Chirik Wah , Moya Ana , Verstreken Sofie , Heggermont Ward , Dierckx Riet , Goethals Marc , Vanderheyden Marc 
Published: May 2022

Background.
A pulmonary capillary wedge pressure (PCWP) >18 mm Hg following volume load has been proposed as a partition value for the detection of heart failure with preserved ejection fraction. As hemodynamic changes in filling pressures (FP) have been attributed to a nitric oxide (NO)-mediated rightward shift of the pressure-volume relationship, we investigated the hemodynamic response to volume load in heart transplant recipients (HTx) and examined the role of inducible NO synthase (iNOS) gene expression on diastolic function changes.

Methods.
In 36 HTx, FPs were measured before and after volume load, following which Starling curves were constructed using PCWP and cardiac index (CI). Patients were categorized into those with normal (group A, n = 21) and abnormal hemodynamics (group B, n = 15, PCWP >15 mm Hg at rest or >18 mm Hg following volume load). For the establishment of the potential role of NO, endomyocardial iNOS gene expression level was measured.

Results.
Except for PCWP (P < 0.001) and mean pulmonary artery pressure (P < 0.001) no differences in age, baseline characteristics, and ejection fraction were observed between both groups, and volume load significantly increased PCWP in both groups (group A: P < 0.001 and group B: P < 0.001) without any change in heart rate. Interestingly, volume load significantly increased CI in group A (P < 0.001) but not in group B (P = 0.654), and the Starling curves revealed a higher CI at any given PCWP in group A together with significantly higher iNOS gene expression (P = 0.009).

Conclusions.
In HTx, volume load increases FP and unmasks the presence of left ventricular diastolic dysfunction. Interestingly, following saline load group B shows a blunted Starling response, with higher PCWP and lack of CI increase at any given PCWP. The higher iNOS gene expression level in group A suggests a potential role of NO as mediator of diastolic function.
Longitudinal Evaluation of Cytopenias in the Renal Transplant Population
Authors: Johnson Aileen C. , Karadkhele Geeta , Magua Wairimu , Vasanth Payas , Larsen Christian P. 
Published: May 2022

Background.
Cytopenias, a common complication for immunosuppressed patients, are known to be associated with adverse transplant outcomes. However, there is little information on cytopenias in recipients treated with the costimulation blockade agent, belatacept.

Methods.
We compared cytopenia incidence and manifestations in patients undergoing kidney transplant at Emory University Hospital on tacrolimus and belatacept. To reduce selection bias, the tacrolimus group was narrowed to include only patients eligible for belatacept.

Results.
Of 1651 patients transplanted between 2009 and 2019, 187 (11%) experienced severe anemia, 309 (19%) experienced leukopenia, and 62 (4%) thrombocytopenia. On multivariable regressions, deceased-donor transplant, cytomegalovirus viremia, and thymoglobulin treatment were associated with risk of developing leukopenia, anemia, and thrombocytopenia. High-risk cytomegalovirus status was also associated with development of leukopenia and anemia. Additionally, azathioprine was associated with development of anemia, and both tacrolimus therapy and Caucasian race were associated with thrombocytopenia. Longitudinal quantifications of hematologic cell lines over the first-year posttransplant were extracted from generalized linear models fit using splines. Only hemoglobin range was significantly different between groups (greater in belatacept patients). Plots of mean cell count for each group suggest an earlier recovery from posttransplant anemia in belatacept patients.

Conclusions.
Belatacept patients are not at increased risk of cytopenia but may have improved recovery from posttransplant anemia.
Nitrofurantoin-resistant Escherichia coli in the UK: genetic determinants, diversity, and undetected occurrences
Authors: Wan Yu , Mills Ewurabena , Leung Rhoda C. Y. , Vieira Ana , Jauneikaite Elita , Zhi Xiangyun , Croucher Nicholas , Ellington Matthew J. , Sriskandan Shiranee 
Published: May 2022

Background
Antimicrobial resistance in enteric or urinary E. coli might predispose invasive E. coli infection and bacteraemia. Nitrofurantoin resistance occurs in <6% of UK urinary E. coli isolates, however, 2018 national recommendations to prescribe nitrofurantoin for uncomplicated urinary tract infection (UTI) raised concerns for increased prevalence of nitrofurantoin-resistant E. coliin the future. Therefore, we investigated mechanisms of nitrofurantoin resistance in UK E. coli isolates and assessed their occurrences in a large dataset of E. coli genomes.

Methods
To elucidate chromosomal and acquired genetic determinants of nitrofurantoin resistance in E. coli, we analysed whole-genome sequences of nine randomly selected nitrofurantoin-resistant UTI E. coli isolates from West London. We then performed targeted analysis of 12,412 E. coli genomes collected from across the UK and predicted nitrofurantoin susceptibility from identified genotypes.

Results
Using comparative genomics, we found known and novel point mutations or insertion sequences (ISs) in chromosomal genes encoding oxygen-insensitive nitroreductases NfsA and NfsB in the nine isolates. Most of these genetic alterations resulted in gene inactivation. We also identified the same kinds of mutations in NfsA, NfsB, and their associated enzyme RibE in a number of 12,412 E. coli genomes. We also observed homoplasic mutations in all these proteins. By contrast, multidrug efflux pump OqxAB, which confers resistance when horizontally transferred, was only encoded by one genome.

Conclusions
Chromosomal de novo mutations and ISs are main causes of nitrofurantoin resistance in UK E. coli. Prevalence of nitrofurantoin resistance should be monitored among urine, blood, and enteric isolates as nitrofurantoin exposure increases.
Clostridioides difficile surveillance at the University Hospital in Košice reveals high prevalence of the ribotype 176
Authors: Čurová Katarína , Toporová Annamária , Krůtová Marcela , Novotný Martin , Ambro Ĺuboš , Kamlárová Anna , Hockicko Ján , Siegfried Leonard 
Published: May 2022

Background
Clostridioides difficile infection (CDI) has become a serious health problem worldwide in recent years, the severity of which lies in the ability to spread epidemically in hospitals and in frequent diseases relapses. CDI Surveillance was performed at the Louis Pasteur University Hospital in Košice from January to February 2020 to analyse the molecular characteristics ofC. difficile(CD) isolates from local patients with CDI.

Methods
CDI was initially diagnosed using the C. difficile rapid test (for enzyme GDH and toxin A/B). A total of 36 stool samples (29 GDH and toxin positive, 7 GDH positive and toxin negative) were cultured anaerobically on selective media (Brazier’s agar). Culture was positive for CD in 31 samples. Bacterial DNA was extracted from all CD isolates. Genes tcdA, tcdB, cdtA and cdtB encoding toxin A, toxin B and binary toxin were detected by multiplex PCR and ribotypes of CD were analysed by capillary electrophoresis-based PCR.

Results
Molecular typing showed that toxin A as well as toxin B was confirmed in 30 of 31 isolates, binary toxin in 18 isolates. Ribotype 176, characterized by production of all 3 toxins, was the most prevalent and was detected in 18 isolates (58%). Toxin A and toxin B producing ribotypes 001, 014 and 020 were also confirmed.

Conclusion
The high incidence of epidemic ribotype 176 with higher capacity to spread in a hospital setting emphasises the need to implement strict epidemic measures and the importance of implementing continuous surveillance programmes for CDI in Slovakia.
Evaluation of Drug Activity Against Staphylococcal Biofilms – Settings of Conditions Leading to Reproducible and Robust Biofilm Formation in vitro
Authors: Diepoltová Adéla , Konečná Klára , Jandurek Ondřej , Nachtigal Petr 
Published: May 2022

Staphylococcus aureus(SA)andepidermidis(SE) are the most common pathogens of the genus Staphylococcus, causing biofilm-associated infections. Bacteria in biofilms are difficult to eradicate due to their resistance and serve as a reservoir for recurring persistent infections. A variety of protocols for in vitro drug activity testing against biofilms has been introduced. However, there are often fundamental differences. In our pilot study, we developed optimal conditions for staphylococcal biofilm formation on plastic pegs in order to set a methodology for an evaluation of the antibiofilm activity of candidate molecules. The convenience of the plastic pegs lies in their removability from the lid for easy access to multiple equivalent biofilms, and in possibility of in situ detection and quantification by confocal laser microscopy. For the purpose of enhancement in staphylococcal biofilm formation, the impact of peg surface modification with 3 different coating materials was studied as well. An increase of biofilm biomass was evaluated by crystal violet staining method. The basic precondition for obtaining relevant and reproducible data regarding antibiofilm activity is the formation of robust biofilms with typical attributes such as the presence of a biofilm matrix. In our study, in vitro conditions revealed that we fully met the preconditions for the SA and methicillin-resistant SA strains. In conclusion, we demonstrated statistically significant enhancement of biofilm formation in all studied staphylococcal strains, including either strong biofilm producer phenotype (SA, methicillin-resistant SA) and weak biofilm producer phenotype (SE).
Supported by the SVV Project No. 260549 and by the Czech Science Foundation project No. 20-19638Y.