bluuebunny/crossref_metadata_2025_split huggingface dataset:
P722 Compositional differences of gut microbiome using taxonomic profiling in patients with ulcerative colitis after treatment with vedolizumab
Authors: Yoon A , Kim K , Oh K , Kim E S , Kim E H , Kim S , Jeong J Y , Kweon M N , Hwang S W , Park S H , Myung S J , Yang S K , Ye B D 
Published: January 2022

Abstract

Background
Gut microbial dysbiosis has been suggested to contribute to pathogenesis of inflammatory bowel disease (IBD). Vedolizumab (VDZ), an α4β7 integrin blocker, has been used as an effective agent for patients with IBD. However, effect of VDZ on gut microbiome and its relationship with efficacy outcomes are still unclear. We investigated gut microbial change in patients with ulcerative colitis (UC) during VDZ treatment.

Methods
Patients with UC were prospectively enrolled and were given a 300 mg infusion of VDZ at weeks 0, 2, and 6 as an induction therapy and then every 8 weeks as a maintenance therapy. In cases of insufficient response, the interval of maintenance therapy was shortened to every 4 week infusion. Faecal samples were collected at weeks 0, 14, and 54 and 16S rRNA gene microbiome profiling analysis was performed. Clinical remission (CREM), clinical response (CRES), endoscopic mucosal healing (MH) and biochemical response (BioRES) were evaluated. Compositional differences in microbiome were analysed according to CREM, CRES, MH, and BioRES at weeks 0, 14, and 54.

Results
Faecal samples were collected from 27 patients and patients were classified according to their outcomes (Table 1). In the analyses regarding species richness (ACE, Chao1, Jackknife, The number of OTUs) and diversity indices (NPShannon, Shannon, Simpson, Phylogenetic Diversity), no significant difference was observed among groups at weeks 0, 14, and 54. There were no significant changes in microbial composition at week 14 and 54, respectively compared to basal level. However, compared to baseline, relative abundance of genus Prevotella showed significant differences between groups which achieved normalsation of C-reactive protein or not (p=0.0394) (Figure 1). In the linear discriminant analysis effect size (LEfSe) analysis, the genus Actinomyces and the species Actinomyces odontolyticus group increased in patients who had no response at efficacy outcomes (achievement of clinical remission, achievement of clinical response, achievement of endoscopic mucosal healing, normalisation of C-reactive protein, and normalisation of faecal calprotectin) at week 14, compared to week 0 (Fig 2A). The genus Clostridium_g24, the species Paraprevotella_uc and PAC001224_s were also significantly increased in the same patient group at week 54 (Fig 2B).

Conclusion
In UC patients treated with VDZ, microbial composition showed differences depending on the achievement of efficacy outcomes. Further studies regarding the causal relationship between microbial composition and outcomes are warranted with a larger number of patients.
N04 A systematic review of the impact of Inflammatory Bowel Disease (IBD) on family members
Authors: Thapwong P , Norton C , Rowland E , Farah N , Czuber- Dochan W 
Published: January 2022

Abstract

Background and Aims
Inflammatory Bowel Disease (IBD) impacts the individuals’ quality of life and affects all family members considerably. Previous reviews have focused on the impact of IBD on the patient, with limited exploration of the impact of IBD on family members. Therefore, this review aims to synthesise existing knowledge on the impact of IBD on family members, their coping strategies, the support needed, and interventions for family members to prevent and alleviate the burden of IBD.

Methods
A systematic review using the mixed-method systematic review approach suggested by Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews (PRISMA) was undertaken. A systematic search of six bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL, British Nursing Index, and Web of Science, was performed in February 2021. The search focused on the impact of IBD on family members and coping strategies and interventions for this population. A narrative synthesis was conducted.

Results
In total, 3,258 records were identified, from which 33 relevant papers (2,748 participants) were included in the review, with case-control, cross-sectional, and qualitative designs. Synthesis of these papers found three themes: the impact of IBD on family members; the coping strategies for family members to overcome the negative impact of IBD; and the support needed. The IBD affects the family members in term of emotional well-being, fear and concern, relationship and social life, work and financial impacts, and leisure time and travelling. The coping strategy theme shows that family members use adaptive coping patterns such as acceptance, resilience, and emotional support from others. Maladaptive coping patterns such as denial following the initial relief of diagnosis, self-distraction, and self-blame were also used. In the theme ‘support needed’, family members reported the need for improved information about IBD, social support groups, self-help groups, educational meetings, and providing easy access to a counsellor or psychologist to support family members. There have been no studies assessing outcomes of interventions to relieve family members’ burden in the IBD population.

Conclusion
Our findings suggest that policymakers in healthcare services should emphasise the multidisciplinary professional care model such as a family therapist, IBD nurse, and psychologist. Researchers could incorporate a bio-psycho-social approach into their work on IBD to improve quality of life of both patients and their family members.
N09 Disease knowledge and quality of life perception in Inflammatory Bowel Disease: a randomised controlled trial
Authors: Martinato M , Comoretto R I , Monaco E , Ocagli H , Gregori D 
Published: January 2022

Abstract

Background
Inflammatory bowel diseases (IBD) negatively impact daily activities and perceived quality of life (QoL); good information of IBD patients on disease, diagnostics, and treatments may change this perception, even if the evidence on this topic is lacking; moreover, too much information overwhelms the patient, which inhibits both understanding and recall. No studies are available on the impact produced by different techniques or amounts of information provided. This study aimed at assessing the impact of essential, patient-centred information on the level of knowledge and on the QoL in IBD patients.

Methods
Patients with a recent diagnosis of IBD in follow-up at a third-level referral centre were randomly assigned to two different interventions, the “standard of care” information package or the experimental one. The latter is a synthetic, standardised, and structured informative intervention developed with a “less is more” approach in collaboration with local IBD patients’ associations. The knowledge level was measured with the Crohn’s and Colitis Knowledge score – CCKNOW – (Eaden, Abrams, and Mayberry, 1999), while the perception of QoL with the Short Inflammatory Bowel Disease Quality of life - S-IBDQ – (Irvine, Zhou, and Thompson, 1996). Disease activity was assessed with the Modified Trulove and Witt Severity Index - MTWSI - (Lichtiger et al., 1994) in ulcerative colitis and the Harvey Bradshaw Index – HBI – (Harvey and Bradshaw, 1980) in Crohn’s disease.CCKNOW, S-IBDQ and MTWSI or HBI were administered at baseline and two months after the intervention.

Results
68 patients were assessed for study participation and 49 were enrolled. At baseline, the patients’ level of knowledge was very low, with correct answers ranging from 2 to 50% in different domains, positively correlated with the patient’s instruction level (ρ = 0.40; p&lt;0.01) and negatively with age (ρ = -0.30; p&lt;0.05). QoL, disease activity, gender, disease duration, type of IBD, number of outpatient visits, and hospital admissions were not related to the level of knowledge. Two months after the administration of the educational intervention, patients in the experimental group showed a higher level of knowledge than the control group (p&lt;0.01) and better perception of QoL (p&lt;0.01), while disease activity remained stable in both groups.

Conclusion
Increasing patients’ knowledge improves QoL and an educational intervention with less information performed shortly after diagnosis significantly improves the patient’s knowledge and QoL, regardless of disease activity.
What Happens on the Back Table? Viability and Osteogenic Potential of Reamed Autogenous Bone Graft as a Function of Time and Temperature—A Pilot Study
Authors: Kantor Adam H. , Uffmann William , Marchand Lucas S. , Haller Justin M. , Higgins Thomas F. , Rothberg David L. 
Published: January 2022

Objectives:
To provide guidelines for reamed autogenous bone graft (R-ABG) in nonunion surgery to best manage modifiable intraoperative factors, like storage temperature and time, for optimal graft viability. Our hypothesis was that R-ABG graft will show decreased cell viability as a function of increased time and storage temperature.

Methods:
R-ABG samples were obtained using an RIA system from 10 patients undergoing harvest for the treatment of a nonunion. A 10 cm3 sample of cancellous bone graft was divided into 10 samples. A control sample was processed immediately and analyzed using fluorescence activated cell sorting to determine its cell viability. The remaining samples were stored at 0, 15, and 37°C and processed similarly after 60 and 120 minutes. A paired t test was used to compare the mean change in percent viability.

Results:
The mean percent cell viability for the experimental conditions was not significantly different from the initial percent cell viability (P ≥ 0.08). There were no significant differences in the change in mean percentage of viable cells (P ≥ 0.07). After 60 and 120 minutes of storage, there were no significant differences in mean cell viability based on storage temperature (P ≥ 0.53 and P ≥ 0.68, respectively). A power analysis estimated that a sample size of 52 patients would be needed to detect a difference.

Conclusions:
The results of our pilot study indicate that storage conditions may have less effect on cell viability than previously hypothesized. Further research with more patients is needed to confirm these preliminary results.

Level of Evidence:
Level II.
Treg/Th17 Ratio Regulation May Play an Important Role in Epigallocatechin-3-Gallate–Mediated Attenuation of Increased Afterload-Induced Cardiac Hypertrophy
Authors: Luo Min , Mou Qiuhong , Liu Lingjuan , Tian Jie , Liu Lifei 
Published: January 2022

Abstract:
The aim of this study was to investigate whether Treg/Th17 ratio regulation plays an important role in epigallocatechin-3-gallate (EGCG) in attenuating increased afterload-induced cardiac hypertrophy. Three-month-old male C57BL/6 mice were divided into sham + vehicle, abdominal aortic constriction (AAC) + vehicle, and AAC + EGCG groups. Intraperitoneal EGCG (50 mg/kg/d) administration was conducted. Cardiac structure and function were examined by ultrasonography. Pathology was examined by hematoxylin and eosin staining, wheat germ agglutinin staining, and Masson's trichome staining. T-lymphocyte subtypes were analyzed using immunofluorescence and flow cytometry assays. Ultrasonography showed that the ventricular wall in the AAC + vehicle group was thicker than that in the sham + vehicle group (P < 0.05). Hematoxylin and eosin staining revealed cardiomyocyte hypertrophy accompanied by a small amount of inflammatory cell infiltration in the AAC + vehicle group. The results of wheat germ agglutinin staining demonstrated the presence of hypertrophic cardiomyocytes in the AAC + vehicle group (P < 0.01). Masson's trichome staining showed cardiac fibrosis in the AAC + vehicle group, and the immunofluorescence assay revealed infiltration of CD4+ cells in both AAC + vehicle and AAC + EGCG groups. Splenic flow cytometry showed a significant increase in the proportion of Treg cells in the AAC + EGCG group (P < 0.05). The proportion of Th17 cells in the AAC + vehicle group was significantly higher than that in the sham + vehicle group (P < 0.05). In conclusion, changes in the Treg/Th17 ratio are associated with the occurrence of myocardial hypertrophy caused by increased afterload. Moreover, regulation of the Treg/Th17 ratio by EGCG may play an important role in the attenuation of myocardial hypertrophy.
Impact of Laparoscopic Sleeve Gastrectomy on Cardiovascular Pharmacotherapy in Left Ventricular Assist Device Patients
Authors: Al-Ani Mohammad A. , Murray Melissa R. , Taha Mohamad Badie , Meece Lauren , Elsayed Abdelrahman H. , Jeng Eric I. , Arnaoutakis George J. , Wu Yu , Friedman Jeffrey E. , Vilaro Juan R. , Parker Alex M. , Aranda Juan M. , Ahmed Mustafa M. 
Published: January 2022

Abstract:
Left ventricular assist device (LVAD) implantation is increasingly utilized in patients with advanced heart failure and morbid obesity. Laparoscopic sleeve gastrectomy (LSG) can facilitate weight loss in this population and can ultimately change the pharmacokinetics of heart failure therapeutics. In this study, we aimed to explore the changes in cardiovascular pharmacotherapy post LSG intervention. We conducted a retrospective observational cohort study of morbidly obese LVAD patients between 2013 and 2019 at the University of Florida with available pharmacotherapeutic data at 1 and 6 months. Thirteen post-LSG patients and 13 control subjects were included in the final analysis. In the post-LSG group, the mean body mass index decreased significantly (44 ± 5 vs. 34 ± 4.9, P < 0.001), and 7 patients were successfully bridged to cardiac transplantation. Only 3 patients required adjustment of their LVAD speed. Mean return to flow decreased by 8 mm Hg, despite a 45% reduction in the mean number of vasodilators per patient (1.2 vs. 0.7, P = 0.03). Mean weekly warfarin dose decreased by 35% after 6 months (32.9 ± 20.9 vs. 50.7 ± 26.6, P = 0.01). The use of diuretics, vasodilators, and beta-blockers was significantly reduced by 50%, 45%, and 35%, respectively. None of these changes were observed in the control group at 6-month follow-up post LVAD. In this single-center experience, weight loss post LSG is associated with decreased vasodilator, diuretic, and anticoagulant medication requirements in LVAD patients.
Management of a Highly Vascular Low-grade Myofibroblastic Sarcoma of the Mandible
Authors: Emanuelli Elisa , O’Connor Michaela , Garg Ravi K. 
Published: January 2022

Summary:
An 11-year-old male patient presented with a large, highly vascular, destructive mandibular mass. An intraoral biopsy showed pleomorphic spindle cells arranged in intersecting fascicles, with scattered atypia. A diagnosis of low-grade myofibroblastic sarcoma was made. The lesion was treated with preoperative arterial embolization followed by surgical resection and reconstruction with a fibular osteomyocutaneous free flap. To our knowledge, no reports of highly vascular mandibular low-grade myofibroblastic sarcoma are available in the literature.
Demonstrating Excellence in Plastic Surgery Residency
Authors: Hackenberger Paige N. , Janis Jeffrey E. 
Published: January 2022

Background:
Residents can achieve distinction by discerning which areas of achievement are worth additional focus at each stage in training. Our survey examines the perspectives of faculty members affiliated with Accreditation Council for Graduation Medical Education–accredited plastic surgery residency programs regarding qualities indicative of resident excellence.

Methods:
A survey including Likert scales and rank-ordering was distributed to plastic surgery program directors and faculty with the intent to assess perspectives regarding resident excellence at each stage of training. Responses were analyzed using marginal homogeneity tests and summary tables.

Results:
In total, 90 respondents completed the survey. An estimated 94.5% believe it is possible for residents to achieve excellence at any stage of clinical training, and 87.7% report their definition of excellence differs by training level. Top three metrics indicative of resident excellence for interns and junior residents were preparation for operative cases, bedside manner, and personality. For seniors: preparation for operative cases, leadership capability, and bedside manner. For chief residents: preparation for operative cases, leadership capability, and technical operative expertise.

Conclusions:
A resident who displays excellence inspires mentorship, which can propel future career success. Faculty agree excellence can be achieved by residents of any stage, although the qualities that define this evolve by training year. Preparation for operative cases is considered a critical component of resident performance at all levels. Bedside manner and personality are ways intern and junior level residents excel, whereas leadership ability and technical expertise in the operating room become significant in senior and chief trainees.
Increased Health Risk in Office Workers in the COVID-19 Era
Authors: Suka Machi , Shimazaki Takashi , Yamauchi Takashi , Yanagisawa Hiroyuki 
Published: January 2022

Objective:
To examine whether the incidence of health problems increases during the COVID-19 pandemic.

Methods:
Using the health examination data (April 2018–March 2021) of Japanese workers aged 15 to 64 years, the 1-year incidence of five health problems (overweight, hypertension, hypercholesterolemia, hyperglycemia, and liver damage) and four unhealthy habits (snacking, heavy drinking, physical inactivity, and sleep deprivation) were compared before and during the COVID-19 pandemic.

Results:
The 1-year incidence of overweight, hypertension, hyperglycemia, and liver damage increased by 15% to 65% during the COVID-19 pandemic. Increased weight gain, related to decrease physical activity during the COVID-19 pandemic, was significantly associated with increased incidence of health problems.

Conclusions:
The COVID-19 pandemic have deteriorated workers’ health even without the COVID-19 infection. Lifestyle interventions should be promptly started particularly targeting workers with gained weight to avoid more serious consequences.
Impact of Cochlear Implantation on Canal and Otolith Function
Authors: Kwok Belinda Y. C. , Rosengren Sally M. , Kong Jonathan H. K. , Birman Catherine S. , Hoskisson Emma , Young Allison S. , Argaet Emma C. , Fratturo Luke , Rivas Cheryl , Greenberg Simon L. , Saxby Alex J. , Welgampola Miriam S. 
Published: January 2022

Objective:
To quantify the impact of cochlear implantation (CI) on all five vestibular end-organs and on subjective ratings of post-CI dizziness.

Methods:
Seventy-two patients undergoing unilateral CI were recruited for the study. All participants completed pre- and post-CI three-dimensional video head-impulse tests (3D vHITs) to assess semicircular-canal (SC) function, air- and bone-conducted (AC and BC) cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) to assess otolith-function and the dizziness handicap inventory (DHI) to measure self-perceived disability.

Results:
Nineteen percent of patients reported new or worsened dizziness postsurgery. Post-CI abnormalities (new lesions and significant deteriorations) were seen in the AC cVEMP (48%), AC oVEMP (34%), BC cVEMP (10%), and BC oVEMP (7%); and lateral (L) (17%), posterior (P) (10%), and anterior (A) (13%) SC vHITs. CI surgery was more likely to affect the AC cVEMP compared with the other tests (χ2 test, p < 0.05). Fifty percent of patients reported no dizziness pre- and postsurgery. In the implanted ear, normal pre-CI vHIT gain was preserved in lateral semicircular canal (LSC) (69%), anterior semicircular canal (ASC) (74%), and posterior semicircular canal (PSC) (67%), and normal reflex amplitudes were found in AC cVEMP (25%), AC oVEMP (20%), BC cVEMP (59%), and BC oVEMP (74%). Statistically significant decreases were observed in LSC vHIT gain, AC cVEMP amplitude, and AC oVEMP amplitude postsurgery (p < 0.05). There was a significant moderate positive correlation between change in DHI scores and the summed vestibular deficit postsurgery (r
(51) = 0.38, p < 0.05).

Conclusion:
CI can impact tests that assess all five vestibular end-organs and subjective ratings of dizziness. These results support pre and post-surgical vestibular testing and assist preoperative counseling and candidate selection.
A rare case report of obstructive jaundice caused by mucus-producing cholangiocarcinoma
Authors: Duan Botao , Zhao Xuekai , Fan Songsong , Zhou Lei , Zhang Xingyuan 
Published: January 2022

Abstract

Rationale:
Cholangiocarcinoma is a common cause of obstructive jaundice but is mainly associated with solid mass and not semisolid secretion. In this report, the patient was admitted to the hospital with obstructive jaundice; however, no solid mass was found to lead to jaundice.

Patient concerns:
The patient developed symptoms of obstructive jaundice for 10 days, including fatigue and yellow skin staining.

Diagnoses:
Postoperative pathological examination of the bile duct wall revealed cholangioadenocarcinoma, and the jelly like contents were inflammatory secretions.

Interventions:
The patient underwent laparotomy and was diagnosed with obstructive jaundice. An exploratory laparotomy revealed that the content in the biliary duct tree was a jelly like inflammatory secretion.

Outcomes:
Follow-up data revealed that the levels of total bilirubin and aminotransferase were normal, and a computed tomography scan showed no tumor mass.

Lessons:
There are very few reports about obstructive jaundice caused by inflammatory secretion that almost filled up the biliary tree. Internal drainage of the cholestatic bile can be achieved through endoscopic retrograde cholangiopancreatograpy, or external drainage can be achieved through percutaneous transhepatic biliary drainage, which can relieve the symptoms of biliary obstruction and improve the patient's quality of life.