bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does periodontal treatment improve rheumatoid arthritis disease activity? A systematic review
Authors: Mustufvi Zhain , Twigg Joshua , Kerry Joel , Chesterman James , Pavitt Sue , Tugnait Aradhna , Mankia Kulveer 
Published: August 2022

AbstractObjectivesThe association of periodontal disease in people diagnosed with RA is emerging as an important driver of the RA autoimmune response. Screening for and treating periodontal disease might benefit people with RA. We performed a systematic literature review to investigate the effect of periodontal treatment on RA disease activity.MethodsMedline/PubMed, Embase and Cochrane databases were searched. Studies investigating the effect of periodontal treatment on various RA disease activity measures were included. The quality of included studies was assessed. Data were grouped and analysed according to RA disease outcome measures, and a narrative synthesis was performed.ResultsWe identified a total of 21 studies, of which 11 were of non-randomized experimental design trials and 10 were randomized controlled trials. The quality of the studies ranged from low to serious/critical levels of bias. RA DAS-28 was the primary outcome for most studies. A total of 9 out of 17 studies reported a significant intra-group change in DAS-28. Three studies demonstrated a significant intra-group improvement in ACPA level after non-surgical periodontal treatment. Other RA biomarkers showed high levels of variability at baseline and after periodontal treatment.ConclusionThere is some evidence to suggest that periodontal treatment improves RA disease activity in the short term, as measured by DAS-28. Further high-quality studies with longer durations of follow-up are needed. The selection of the study population, periodontal interventions, biomarkers and outcome measures should all be considered when designing future studies. There is a need for well-balanced subject groups with prespecified disease characteristics.
Successful integration of an automated patient-reported outcome measure within a hospital electronic patient record
Authors: Neame Matthew T , Reilly David , Puthiyaveetil Ajmal , McCann Liza , Mahmood Kamran , Almeida Beverley , Pain Clare E , Furfie Victoria , Cleary Andrew G 
Published: August 2022

Abstract

Objectives
The objective of this evaluation was to assess the feasibility of implementing a fully integrated, automated, electronic patient-reported outcome measures (ePROM) system into a hospital electronic patient record (EPR; hospital-based clinical record). Additional objectives included evaluating the effect of the system on patient-reported outcome measures (PROM) completion rates and investigating the acceptability of the ePROM.

Methods
The evaluation was conducted in a rheumatology clinic in a specialist children’s hospital in the UK. Paper-based childhood HAQ PROMs were already used in the clinic, and an EPR was the main hospital information system. The technical feasibility of introducing the ePROM technology was assessed using a case study approach; the effect of the system on PROM completion rates was investigated using a before–after design; and acceptability was assessed using semi-structured questionnaires and a focus group.

Results
An automated and integrated ePROM system was implemented successfully in April 2021. After implementation, ∼500 automated SMS text messaging invitations to complete ePROMs were sent to care-givers each month. PROM completion rates increased from 33 of 100 (33%) to 47 of 65 (72%) after the introduction of the ePROM system (χ2 = 11.51; P &lt; 0.05). The ePROM system was highly acceptable to patients and clinical staff. Some clinical staff expressed a concern that an electronic system might represent a barrier to care for families with more limited resources.

Conclusion
High levels of automation and integration with existing technology systems seemed to be key contextual factors associated with the successful implementation and adoption of the ePROM intervention in a paediatric rheumatology clinic.
Rituximab as maintenance therapy following remission induction in relapsing or refractory systemic lupus erythematosus
Authors: Chen Xiaochan , Shi Xiaowei , Xue Han , Lv Honghua , Yu Lishi , Wu Xiudi , Wang Qiaohong , Wu Huaxiang , Han Fei , Xue Jing 
Published: August 2022

AbstractObjectiveTo investigate the efficacy and safety of rituximab (RTX) maintenance therapy compared with traditional immunosuppressive agent (ISA) maintenance therapy in patients with relapsing or refractory SLE.MethodsIt is a prospective observational non-randomized cohort study. The study enrolled SLE patients in four centres who had received at least one course of RTX induction treatment. Patients with a clinical response to RTX were divided into two groups based on their maintenance therapy in the first 12 months: the RTX group and the ISA group. The relapse-free survival times were compared between the two groups. Univariate and multivariate analyses were conducted to identify predictive factors for disease relapse.ResultsAmong the 82 patients included in the cohort, 67 (81.7%) patients had a clinical response at 6 months. RTX maintenance therapy was applied in 34 (50.7%) patients and ISA maintenance therapy was applied in the remaining 33 (49.3%) patients. After a median follow-up of 24 months, a total of 13 (19.4%) patients had experienced disease relapse, comprising three in the RTX group and 10 in the ISA group. Patients in the RTX group had a higher relapse-free survival rate than patients in the ISA group. Multivariate analysis identified hydroxychloroquine use, RTX maintenance therapy and haematological system involvement as independent predictors for sustained remission.ConclusionThis multicentre prospective cohort study demonstrated that long-term RTX maintenance therapy has high efficacy and acceptable safety in relapsing or refractory SLE patients who had a clinical response to RTX induction therapy.
The transcription activator AtxA from Bacillus anthracis was employed for developing a tight-control, high-level, modulable and stationary-phase-specific transcription activity in Escherichia coli
Authors: Liu Ying-Xing , Zhuo Xiao-Zhen , Li Si-Yu 
Published: August 2022

Abstract
The strong transcriptional activity of the virulent gene pagA in Bacillus anthracis has been proven to be anthrax toxin activator (AtxA)-regulated. However, the obscure pagA transcription mechanism hinders practical applications of this strong promoter. In this study, a 509-bp DNA fragment [termed 509sequence, (−508)-(+1) relative to the P2 transcription start site] was cloned upstream of rbs-GFPuv as pTOL02B to elucidate the AtxA-regulated transcription. The 509sequence was dissected into the −10 sequence, −35 sequence, ATrich tract, SLI/SLII and upstream site. In conjunction with the heterologous co-expression of AtxA (under the control of the T7 promoter), the −10 sequence (TATACT) was sufficient for the AtxA-regulated transcription. Integration of pTOL02F + pTOLAtxA as pTOL03F showed that the AtxA-regulated transcription exhibited a strong specific fluorescence intensity/common analytical chemistry term (OD600) of 40 597 ± 446 and an induction/repression ratio of 122. An improved induction/repression ratio of 276 was achieved by cultivating Escherichia coli/pTOL03F in M9 minimal medium. The newly developed promoter system termed PAtxA consists of AtxA, the −10 sequence and Escherichia RNA polymerase. These three elements synergistically and cooperatively formed a previously undiscovered transcription system, which exhibited a tight-control, high-level, modulable and stationary-phase-specific transcription. The PAtxA was used for phaCAB expression for the stationary-phase polyhydroxybutyrate production, and the results showed that a PHB yield, content and titer of 0.20 ± 0.27 g/g-glucose, 68 ± 11% and 1.5 ± 0.4 g/l can be obtained. The positive inducible PAtxA, in contrast to negative inducible, should be a useful tool to diversify the gene information flow in synthetic biology.
Graphical Abstract
Evaluation of the acid-binding capacity of ingredients and complete diets commonly used for weanling pigs
Authors: Stas Ethan B , Tokach Mike D , DeRouchey Joel M , Goodband Robert D , Woodworth Jason C , Gebhardt Jordan T 
Published: August 2022

AbstractSome ingredients bind more acid in the stomach than others which can increase gastric pH in weaned pigs causing decreased protein digestion and allow pathogenic micro-organisms to proliferate. Our objective was to measure acid-binding capacity at a pH of 4 (ABC-4) of common nursery ingredients and determine additivity in diets. Ingredient categories included: cereal grains, vegetable proteins, animal proteins and milk, vitamin premixes and minerals, amino acids, and fiber sources. A 0.5-g sample of each ingredient was suspended in 50 mL of distilled deionized water and titrated with 0.1-N hydrochloric acid. Sample ABC-4 was calculated as the amount of acid in milliequivalents (meq) required to lower 1 kg to a pH of 4. Cereal grains were found to have lower ABC-4 compared to other ingredients. Vegetable proteins had higher ABC-4 with more variation than cereal grains. Soybean meal (SBM) had an ABC-4 of 602 ± 28.2 meq. Soy protein concentrate and enzymatically treated soybean meal (ESBM) had higher ABC-4 compared to SBM while fermented soybean meal (FSBM) was lower. Zinc oxide (ZnO) and calcium carbonate (CaCO3) had the highest ABC-4 among all ingredients with values of 21,863 ± 598.7 and 18,384 ± 769.7 meq, respectively. Following ingredient analysis, a series of diets were analyzed to determine additivity by comparing the differences between calculated and analyzed ABC-4 value. All diets analyzed had lower ABC-4 than calculated values; however, analyzed ABC-4 increased along with calculated values across diets. The first series of diets were arranged in a 2 × 5 factorial consisting of increasing CaCO3 with or without ZnO. There was a ZnO × CaCO3 interaction (P = 0.020) for difference between calculated and analyzed ABC-4. Within the interaction, differences between calculated and analyzed ABC-4 increased (linear, P &lt; 0.001) as CaCO3 increased in diets without ZnO, but not in diets with ZnO. The second series of diets analyzed consisted of different levels of SBM with either FSBM or ESBM included at 5% of the diet. Differences between calculated and analyzed values were not different between treatments (P = 0.640). In conclusion, perfect ABC-4 additivity in diets was not found due to lower analyzed than calculated values; however, analyzed ABC-4 still increased as calculated values increased. This data suggests diet ABC-4 can be adjusted through selection of ingredients but more feeding trials are needed to determine its impact on pig performance.
Utility of Xpert MTB/RIF Ultra and digital chest radiography for the diagnosis and treatment of TB in people living with HIV: a randomised controlled trial (XACT-TB)
Authors: Mukoka Madalo , Twabi Hussein H , Msefula Chisomo , Semphere Robina , Ndhlovu Gabriel , Lipenga Trancizeo , Sikwese Tionge Daston , Malisita Kenneth , Choko Augustine , Corbett Elizabeth L , MacPherson Peter , Nliwasa Marriott 
Published: August 2022

Abstract

Background
TB is a leading cause of morbidity among HIV positive individuals. Accurate algorithms are needed to achieve early TB diagnosis and treatment. We investigated the use of Xpert MTB/RIF Ultra in combination with chest radiography for TB diagnosis in ambulatory HIV positive individuals.

Methods
This was a randomised controlled trial with a 2-by-2 factorial design. Outpatient HIV clinic attendees with cough were randomised to four arms: Arm 1—Standard Xpert/no chest radiography (CXR); Arm 2—Standard Xpert/CXR; Arm 3—Xpert Ultra/no CXR; and Arm 4—Xpert Ultra/CXR. Participants were followed up at days 28 and 56 to assess for TB treatment initiation.

Results
We randomised 640 participants. Bacteriologically confirmed TB treatment initiation at day 28 were: Arm 1 (8.4% [14/162]), Arm 2 (6.9% [11/159]), Arm 3 (8.2% [13/159]) and Arm 4 (5.6% [9/160]) and between Xpert Ultra group (Arms 3 and 4) (6.9% [22/319]) vs Standard Xpert group (Arms 1 and 2) (7.8% [25/321]), risk ratio 0.89 (95% CI 0.51 to 1.54). By day 56, there were also similar all-TB treatment initiations in the x-ray group (Arms 2 and 4) (16.0% [51/319]) compared with the no x-ray group (Arms 1 and 3) (13.1% [42/321]), risk ratio 1.22 (95% CI 0.84 to 1.78); however, the contribution of clinically diagnosed treatment initiations were higher in x-ray groups (50.9% vs 19.0%).

Conclusions
Xpert Ultra performed similarly to Xpert MTB/RIF. X-rays are useful for TB screening but further research should investigate how to mitigate false-positive treatment initiations.
Cardiac Safety of Imatinib for the Treatment of COVID-19: A Secondary Analysis of a Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Duijvelaar Erik , Vanhove Arthur , Schippers Job R. , Smeele Patrick J. , de Man Frances S. , Pinto Yigal , Aman Jurjan , Bogaard Harm Jan ,   CounterCOVID Collaborative Group
Published: August 2022

Abstract:
Although previous studies support the clinical benefit of imatinib regarding respiratory status in hospitalized patients with COVID-19, potential cardiotoxicity may limit its clinical application. This study aimed to investigate the cardiac safety of imatinib in COVID-19. In the CounterCOVID study, 385 hospitalized hypoxemic patients with COVID-19 were randomly assigned to receive 10 days of oral imatinib or placebo in a 1:1 ratio. Patients with a corrected QT interval (QTc) >500 ms or left ventricular ejection fraction <40% were excluded. Severe cardiac adverse events were monitored for 28 days or until death occurred. Electrocardiogram measurements and cardiac biomarkers were assessed repeatedly during the first 10 days. A total of 36 severe cardiac events occurred, with a similar incidence in both treatment groups. No differences were observed in the computer-generated Bazett, manually interpreted Bazett, or Fridericia-interpreted QTcs. No clinically relevant alterations in other electrocardiogram parameters or plasma high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations were observed. Similar findings were observed in a subgroup of 72 patients admitted to the intensive care unit. In the univariate and multivariable linear mixed models, treatment with imatinib was not significantly associated with QT interval duration, hs-cTnT, or NT-proBNP levels. In conclusion, imatinib treatment did not result in more cardiac events, QT interval prolongation, or altered hs-cTnT or NT-proBNP levels. This suggests that treatment with imatinib is safe in hospitalized patients with COVID-19 with a QTc duration of less than 500 ms and left ventricular ejection fraction >40%.
Extending the benefit of nutrition intervention beyond the operative setting
Authors: Nogueira Paulo L. Batista , Dock-Nascimento Diana B. , de Aguilar-Nascimento José E. 
Published: August 2022

Purpose of review
To provide an update of the recent evidence on the potential of perioperative nutritional interventions to benefit adult patients undergoing head and neck and digestive procedures.

Recent findings
Perioperative nutrition within multimodal prehabilitation programs improve postoperative outcomes. Perioperative fasting time can be reduced with beverages containing carbohydrate alone or blended with a nitrogenous source such as whey protein; this approach seems to be safe and improve outcome. The choice of protein-containing formula, as well as diet composition to be recommended early during the postoperative refeeding, can be optimized to reduce complications. Sarcopenia is an important risk factor for surgical patients, as such, prehabilitation along with preoperative nutrition is strongly advised. Perioperative supplementation with β-hydroxy β-methylbutyrate to mitigate sarcopenia requires further investigation. Although perioperative nutritional interventions reduce healthcare costs, recent data suggest it has been scarcely prescribed.

Summary
Nutritional intervention is key in multimodal programs of enhanced recovery after surgery to ensure better outcomes. Perioperative fasting should be shortened, and include clear fluids containing carbohydrates and protein, especially in the early postoperative period. Multimodal prehabilitation is key to mitigate sarcopenia. Action to improve knowledge on the cost-effectiveness of nutritional interventions in the perioperative setting are needed.
Analysis of INSPPIRE‐2 Cohort
Authors: Uc Aliye , Cress Gretchen A. , Wang Fuchenchu , Abu‐El‐Haija Maisam , Ellery Kate M. , Fishman Douglas S. , Gariepy Cheryl E. , Gonska Tanja , Lin Tom K. , Liu Quin Y. , Mehta Megha , Maqbool Asim , McFerron Brian A. , Morinville Veronique D. , Ooi Chee Y. , Perito Emily R. , Schwarzenberg Sarah Jane , Sellers Zachary M. , Serrano Jose , Shah Uzma , Troendle David M. , Wilschanski Michael , Zheng Yuhua , Yuan Ying , Lowe Mark E. ,   Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreatic Cancer
Published: August 2022

Objectives:The objective of this study is to investigate risk factors and disease burden in pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP).Methods:Data were obtained from INternational Study group of Pediatric Pancreatitis: In search for a cuRE‐2 (INSPPIRE‐2), the largest multi‐center prospective cohort study in pediatric patients with ARP or CP.Results:Of 689 children, 365 had ARP (53%), 324 had CP (47%). CP was more commonly associated with female sex, younger age at first acute pancreatitis (AP) attack, Asian race, family history of CP, lower BMI%, genetic and obstructive factors, PRSS1 mutations and pancreas divisum. CFTR mutations, toxic‐metabolic factors, medication use, hypertriglyceridemia, Crohn disease were more common in children with ARP. Constant or frequent abdominal pain, emergency room (ER) visits, hospitalizations, medical, endoscopic or surgical therapies were significantly more common in CP, episodic pain in ARP. A total of 33.1% of children with CP had exocrine pancreatic insufficiency (EPI), 8.7% had diabetes mellitus. Compared to boys, girls were more likely to report pain impacting socialization and school, medical therapies, cholecystectomy, but no increased opioid use. There was no difference in race, ethnicity, age at first AP episode, age at CP diagnosis, duration of disease, risk factors, prevalence of EPI or diabetes between boys and girls. Multivariate analysis revealed that family history of CP, constant pain, obstructive risk factors were predictors of CP.Conclusions:Children with family history of CP, constant pain, or obstructive risk factors should raise suspicion for CP.
Controversy Over Liver Transplantation or Resection for Neuroendocrine Liver Metastasis
Authors: Eshmuminov Dilmurodjon , Studer Debora J. , Lopez Lopez Victor , Schneider Marcel A. , Lerut Jan , Lo Mary , Sher Linda , Musholt Thomas J. , Lozan Oana , Bouzakri Nabila , Sposito Carlo , Miceli Rosalba , Barat Shoma , Morris David , Oehler Helga , Schreckenbach Teresa , Husen Peri , Rosen Charles B. , Gores Gregory J. , Masui Toshihiko , Cheung Tan-To , Kim-Fuchs Corina , Perren Aurel , Dutkowski Philipp , Petrowsky Henrik , Thiis-Evensen Espen , Line Pål-Dag , Grat Michal , Partelli Stefano , Falconi Massimo , Tanno Lulu , Robles-Campos Ricardo , Mazzaferro Vincenzo , Clavien Pierre-Alain , Lehmann Kuno 
Published: August 2022

Background:
In patients with neuroendocrine liver metastasis (NELM), liver transplantation (LT) is an alternative to liver resection (LR), although the choice of therapy remains controversial. In this multicenter study, we aim to provide novel insight in this dispute.

Methods:
Following a systematic literature search, 15 large international centers were contacted to provide comprehensive data on their patients after LR or LT for NELM. Survival analyses were performed with the Kaplan-Meier method, while multivariable Cox regression served to identify factors influencing survival after either transplantation or resection. Inverse probability weighting and propensity score matching was used for analyses with balanced and equalized baseline characteristics.

Results:
Overall, 455 patients were analyzed, including 230 after LR and 225 after LT, with a median follow-up of 97 months [95% confidence interval (CI): 85–110 months]. Multivariable analysis revealed G3 grading as a negative prognostic factor for LR [hazard ratio (HR)=2.22, 95% CI: 1.04–4.77, P=0.040], while G2 grading (HR=2.52, 95% CI: 1.15–5.52, P=0.021) and LT outside Milan criteria (HR=2.40, 95% CI: 1.16–4.92, P=0.018) were negative prognostic factors in transplanted patients. Inverse probability-weighted multivariate analyses revealed a distinct survival benefit after LT. Matched patients presented a median overall survival (OS) of 197 months (95% CI: 143–not reached) and a 73% 5-year OS after LT, and 119 months (95% CI: 74–133 months) and a 52.8% 5-year OS after LR (HR=0.59, 95% CI: 0.3–0.9, P=0.022). However, the survival benefit after LT was lost if patients were transplanted outside Milan criteria.

Conclusions:
This multicentric study in patients with NELM demonstrates a survival benefit of LT over LR. This benefit depends on adherence to selection criteria, in particular low-grade tumor biology and Milan criteria, and must be balanced against potential risks of LT.
Apheresis of Deceased Donors as a New Source of Mobilized Peripheral Blood Hematopoietic Stem Cells for Transplant Tolerance
Authors: Sosa Rebecca A. , Mone Thomas , Naini Bita V. , Kohn Donald B. , Reed Elaine F. , Wheeler Kristina , Campo-Fernandez Beatriz , Davila Alejandra , Chaffin Donald J. , DiNorcia Joseph , Kaldas Fady M. , Cohen Aaron , Lum Erik L. , Veale Jeffrey L. , Kogut Neil M. 
Published: August 2022

Background.
Solid organ transplantation is the therapy of choice for many patients with end-stage organ failure; however, recipients must remain on lifelong immunosuppression, leaving them susceptible to infections and cancer. The study of transplant tolerance to prolong graft survival in the absence of immunosuppression has been restricted to recipients of living donor allografts; however, deceased donors significantly outnumber living donors. Mobilization of hematopoietic stem cells (HSCs) from the bone marrow to peripheral blood (PB) could allow PB-HSCs to be used to induce tolerance in deceased donor kidney recipients; however, a major concern is the well-known concomitant mobilization of immune cells into the liver.

Methods.
We mobilized HSCs to the PD using a protocol of 2 doses of granulocyte colony-stimulating factor and 1 dose of plerixafor, followed by the collection of mobilized cells via apheresis in 3 deceased donors. The physiological, laboratory, and radiographic parameters were monitored throughout the procedure. Longitudinal biopsies were performed to assess the potential for ectopic liver mobilization.

Results.
The use of both agents led to the successful mobilization of peripheral blood CD34+ cells, demonstrating the potential for use in transplant tolerance protocols. Increased immune cell trafficking into the liver was not observed, and apheresis of mobilized cells resulted in a uniform decrease in all liver leukocyte subsets.

Conclusions.
HSCs can be mobilized and collected from the PB of brain-dead donors. This new approach may facilitate the dissemination of immune tolerance trials beyond living-donor kidney transplantation to deceased-donor transplantation, without sacrificing the transplantability of the liver.