bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonalcoholic fatty liver disease: opinions, population served, and management from a sample of French hepato(gastroentero)logists (PERSEPT study)
Authors: Pariente Alexandre , Rosa Isabelle , Dharancy Sébastien , Hanslik Bertrand ,   for the Investigators of PERSEPT Study
Published: March 2022

Objective
The three-fold objective of this study was to describe the opinions, the population served, and tools used for the management of nonalcoholic fatty liver disease (NAFLD) by French hepato(gastro)enterologists (HGEs).

Methods
Seventy-five French HGEs working in hospitals or in private practice, who regularly managed patients with NAFLD, completed three questionnaires: one about their opinions about disease management, one on the 10 first patients with NAFLD they saw in February 2020, and the third about the first five patients meeting the 2016 European Association for the Study of the Liver criteria for specialist referral.

Results
Management of NAFLD was seen as challenging, complex, time-consuming, and frustrating. Available treatments were considered to be unsatisfactory by most participants. In the whole population studied (671 patients), 41% were obese, 50% overweight, 49% had type 2 diabetes, 61% dyslipidemia, 51% arterial hypertension, 57% nonalcoholic steato-hepatitis (NASH), 37% advanced fibrosis, and 19% cirrhosis. In the subgroup of 313 patients needing specialist referral, the use of liver biopsy was low (30%) and decreasing, whereas vibration-controlled transient elastometry was high (66%) and increasing; blood fibrosis tests were rarely used. NASH was usually diagnosed without liver biopsy. Nutritional counseling was provided to 3/4 patients, physical activity counseling in 1/5. A personalized therapeutic project was defined in less than one-third of patients. Ursodeoxycholic acid and vitamin E were used in a minority of patients.

Conclusion
The management of NAFLD is not considered satisfactory by French HGE who care for a relatively severe population. Noninvasive assessment of fibrosis and multidisciplinary management should be improved.
Predictor of primary response to antitumor necrosis factor-α therapy for inflammatory bowel disease: a single-center observational study
Authors: Yoshida Atsushi , Kimura Koji , Morizane Toshio , Ueno Fumiaki 
Published: March 2022

Background
It is necessary to find reliable and appropriate predictors of primary response to anti-TNFα therapy (infliximab and adalimumab) in inflammatory bowel disease (IBD) so as to avoid treatment failure and select optimal treatment. The aim of this study is to reveal useful predictors of the response to anti-TNFα treatment from baseline to 2 months after initial administration of anti-TNFα for individual IBD patients using our pharmacokinetic and pharmacodynamic (PK/PD) model at the time of second administration.

Methods
We retrospectively analyzed 26 IBD patients who received anti-TNFα. In the PK/PD model, inflammation was assumed to be suppressed based on the action of anti-TNFα at the rate constant of K
anti-TNFα (day−1). K
anti-TNFα
0 (day−1) is K
anti-TNFα in the absence of anti-TNFα. We expressed inflammation caused by factors not affected by the action of anti-TNFα using the rate constant K
else (day−1). Using univariate and multivariate linear regressions, we statistically analyzed factors related to the improvement of disease activity index.

Results
The significant correlation between K
anti-TNFα
0/K
else and the improvement of disease activity index was shown in Crohn’s disease patients (univariate: estimated value 2.4; P = 0.003; and multivariate: 1.8; P = 0.012) and ulcerative colitis patients (univariate: 0.12; P = 0.011), and no other factors were significant.

Conclusion
This is the first study to present a useful predictor of primary response to anti-TNFα of individual IBD patients at second administration. The K
anti-TNFα
0/K
else ratio may help to select the optimal therapeutic drug and avoid the improper continuous administration of anti-TNFα in the induction phase.
Relationship with the Father of the Baby and Pregnancy-Related Anxiety among Pregnant Black Women
Authors: Hyer Suzanne , Hu Wenfang , Hu Mengtong , Davis Jean W. , Xie Rui , Giurgescu Carmen 
Published: March 2022

Abstract

Purpose:
Pregnancy-related anxiety may increase the risk of preterm birth. Effective coping strategies and social support may help minimize pregnancy-related anxiety.

Study Design:
Secondary analysis of cross-sectional data.

Methods:
A sample of 408 pregnant non-Hispanic Black women completed questionnaires between 19 and 31 weeks gestation. Mediation analysis with structural equation modeling was used to explore effects of the relationship with the father of the baby on pregnancy-related anxiety.

Results:
Support from the father of the baby was negatively associated with avoidance coping (r = -.22, p < .001) and pregnancy-related anxiety (r = - .17, p < .001), whereas conflict with the father of the baby was positively associated with avoidance coping (r = .37, p < .001) and pregnancy-related anxiety (r = .29, p < .001). Avoidance coping was positively associated with pregnancy-related anxiety (r = .34, p < .001). After adjustment, avoidance coping partially mediated the effect of conflict with the father of the baby on pregnancy-related anxiety.

Clinical Implications:
Discussions with women about management of pregnancy-related anxiety should consider her current social support and coping mechanisms. Providers should offer support and resources on adaptive coping strategies.
Supraventricular Tachycardia in Infants With Congenital Diaphragmatic Hernia: Prevalence, Associations, and Outcomes
Authors: Tella Joseph B. , Dao Duy T. , Alexander Mark E. , Geva Alon , Vitali Sally H. , Zalieckas Jill M. , Mehta Nilesh M. , McManus Michael L. , Buchmiller Terry L. , Mullen Mary P. 
Published: March 2022

OBJECTIVES:
To characterize the prevalence, associations, management, and outcomes of supraventricular tachycardia (SVT) in neonates with congenital diaphragmatic hernia (CDH).

DESIGN:
Retrospective chart and cardiology code review within a cohort of patients with CDH was used to define a subpopulation with atrial arrhythmia. SVT mechanisms were confirmed by electrocardiogram analysis. Cox proportional hazard regression identified risk factors for SVT and association with clinical outcomes.

SETTING:
Medical Surgical ICU in a single, tertiary center, Boston Children’s Hospital.

PATIENTS:
Eligible patients included neonates presenting with classic Bochdalek posterolateral CDH between 2005 and 2017, excluding newborns with Morgagni hernia or late diagnoses of CDH (>28 d).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
SVT arose in 25 of 232 neonates with CDH, (11%); 14 of 25 infants (56%) had recurrent SVT; atrioventricular node-dependent tachycardia was the most frequent mechanism (32%). The majority (71%) of SVT episodes received intervention. Nine patients (36%) received preventative antiarrhythmic medications. SVT was associated with lower Apgar score at 1 min, structural heart disease, larger defect size, extracorporeal membrane oxygenation (ECMO) support, and prostaglandin therapy for ductal patency as well as hospital stay greater than or equal to 8 weeks and use of supplemental oxygen at discharge.

CONCLUSIONS:
SVT can occur in neonates with CDH and frequently requires treatment. Odds of occurrence are increased with greater CDH disease severity, ECMO, and prostaglandin use. In unadjusted logistic regression analysis, SVT was associated with adverse hospital outcomes, underscoring the importance of recognition and management in this vulnerable population.
The Cost of a Learner in the Pediatric Emergency Department
Authors: Corey Patrick , Jadhav Nagesh , Grams Keith , Sigal Adam , Babineau Ryan , Alweis Richard 
Published: March 2022

Objectives
Experimental learning is a foundation of medical education, but a learner in the pediatric emergency department impacts utilization, time and disposition metrics. Our study sought to compare the effect of a resident learner on metrics between 2 pediatric emergency departments.

Methods
This retrospective study was conducted in 2019 in 2 pediatric emergency departments of tertiary care hospitals. We compared various time, utilization, and disposition metrics between resident-covered and nonresident-covered patients.

Results
A total of 62,548 patient encounters were included in our analysis, with 8102 (13%) encounters were resident-managed. Residents were consistently found to see higher-acuity patients, which led to increased relative value unit generation. Residents used more diagnostic testing consistently across both sites. However, we found significant differences between time and disposition metrics between the 2 sites.

Conclusions
Residents see sicker patients and tend to order more ancillary tests, which ultimately leads to increased relative value unit generation. We hypothesize that the difference in metrics seen could be explained by the training background of residents, as well as efficiencies of the department as a whole.
A Standardized Diagnostic Pathway for Suspected Appendicitis in Children Reduces Unnecessary Imaging
Authors: D’Cruz Roshan J. , Linden Allison F. , Devin Courtney L. , Savage Jillian , Zomorrodi Arezoo , Reichard Kirk W. , Choudhary Arabinda , Berman Loren 
Published: March 2022

Introduction:
Ultrasound (US) for the diagnosis of acute appendicitis is often nondiagnostic, and additional imaging is required. A standardized approach may reduce unnecessary imaging.

Methods:
We retrospectively analyzed all patients who had imaging for appendicitis in our emergency department in 2017 and evaluated patient characteristics associated with nondiagnostic US. Using these results, we developed a pediatric appendicitis score (PAS)-based imaging pathway and compared imaging trends prepathway and postpathway implementation.

Results:
A total of 971 patients received imaging for suspected appendicitis prepathway in 2017. Female sex, obesity, and low/intermediate PAS were significantly associated with nondiagnostic US, but not magnetic resonance imaging (MRI) (P < 0.0001). Nearly one-third of patients received multiple imaging studies (US followed by MRI/computed tomography). As low/intermediate PAS was most strongly associated with a nondiagnostic US on multivariate analysis, we developed a PAS-based imaging stewardship pathway to eliminate imaging in low-PAS patients and reduce the number of patients with an intermediate PAS who received multiple imaging studies by obtaining an MRI as the first-line study. After implementation, only 22 low-PAS patients received imaging (compared with 238 preimplementation), and the proportion of intermediate-PAS patients receiving multiple imaging studies decreased from 31.4% to 13% (P < 0.0001). The cost of imaging per 100 patients increased from $24,255 to $31,082.

Conclusion:
A PAS-based imaging stewardship pathway reduces unnecessary imaging for suspected appendicitis.
Factors Influencing Health Equity of Influenza Vaccination in Pediatric Patients
Authors: Donnelly Lane F. , Wood Matthew , Chantra Jean , Loh Ling , Burkart Brendan , Lee Grace M. 
Published: March 2022

Introduction:
Social factors can be a determinate for multiple health outcomes. We evaluated the association of numerous social factors on rates of influenza nonvaccination in a large pediatric primary and subspecialty care system.

Methods:
During the 2019–2020 influenza vaccination season, we calculated the nonvaccination rate for a pediatric healthcare system with both subspecialty and primary care practices. We compared influenza vaccination rates for factors that might affect health equity (patient gender, language preference, health insurance payer category, race and ethnicity, and estimated median household income based on zip code analysis) by creating simultaneous 95% confidence intervals using the Wilson method with continuity correction and a Bonferroni adjustment for the number of categories compared.

Results:
The overall influenza nonvaccination rate was 58.0% (59,375 not vaccinated of 102,377). Statistically significant differences in nonvaccination rate were present for the following health equity indicators: Spanish (75.6%) and Chinese Dialects (78.0%) > English (55.9%) speaking; Hispanic (70.1%) > many other race and ethnicities; Asian (51%) < many other race and ethnicities; Commercial (53.5%) < Public (71.2%) or Self (81.4%) pay; and lower (67.6%–79.1%) > higher median household income (52.9%–56.4%).

Conclusions:
Non-English language preference, Hispanic ethnicity, public insurance, and lower median household income are associated with a decreased likelihood of influenza vaccination. We are using these data to inform our key drivers to improve influenza vaccination in our system.
Improving Primary Care Adolescent Depression Screening and Initial Management: A Quality Improvement Study
Authors: Beck Kristen E. , Snyder Dane , Toth Christina , Hostutler Cody A. , Tinto Jennifer , Letostak Tiasha Barik , Chandawarkar Aarti , Kemper Alex R. 
Published: March 2022

Introduction:
Although recommended, adolescent depression screening with appropriate initial management is challenging. This project aimed to improve adolescent depression screening rates during preventive care visits in 12 primary care clinics from 65.4% to 80%, increase the proportion of documented initial management for those with a positive screen from 69.5% to 85%, then sustain improvements for 12 months.

Methods:
This quality improvement project involved 12 urban primary care clinics serving >120,000 mostly Medicaid-enrolled patients and targeted adolescents 12–17 years. Interventions included standardized depression screening using tablets with electronic health record (EHR) capture and automated scoring, embedding screening results and initial management actions into the EHR, provider education, and individual clinician and clinic performance feedback.

Results:
After standardizing the approach to screening, the process mean depression screening rate was 91.9%. However, after adopting tablets into the clinic flow, there was an unexpected initial decrease in proportion with appropriately documented initial management plans, from 89.7% to 67.6%. In response to this special cause variation, there was additional provider feedback and education, and a redesign of the EHR flow related to the presentation of results and prompts for action after a positive screen. As a result, the proportion with appropriately documented initial management was 87.3% by project completion.

Conclusions:
Tablet-based screening with EHR scoring capture effectively increased depression screening rates but required significant additional work to improve initial management after a positive screen. A full system approach, including EHR modification, clinician education, and performance feedback, is needed to make meaningful, sustained improvements in comprehensive adolescent depression screening.
177Lu-DOTATATE PRRT for Multiple Unusual Metastatic Sites in Neuroendocrine Tumor
Authors: Parghane Rahul V. , Basu Sandip 
Published: March 2022

Abstract
Thyroid gland and orbit are rare sites of metastases in neuroendocrine tumors. We present an extremely rare case of rectal neuroendocrine tumor with metastases to thyroid gland and intra-orbital regions that demonstrated significant reduction in size and uptake of the lesions on somatostatin receptor based 68Ga-DOTATATE PET/CT, following 177Lu-DOTATATE peptide receptor radionuclide therapy. The case illustrates the efficacy of 177Lu-DOTATATE peptide receptor radionuclide therapy for tumor cytoreduction, which can be considered as a promising treatment modality for somatostatin receptor expressing and tracer-avid metastatic lesions at multiple rare locations.
Delayed Nephrotoxicity After 225Ac-PSMA-617 Radioligand Therapy
Authors: Satapathy Swayamjeet , Sharma Amit , Sood Ashwani , Maheshwari Pooja , Gill Harinder Jit Singh 
Published: March 2022

Abstract

177Lu-PSMA-617 radioligand therapy (RLT) has evolved as a suitable alternative to existing therapeutic options in patients with metastatic castration-resistant prostate cancer. With the emergence of α-emitters such as 225Ac, the efficacy of PSMA-RLT has further improved. Xerostomia and myelosuppression are common early treatment-emergent adverse events in patients receiving this therapy; however, data on long-term toxicity are relatively scarce. In this report, we describe a 76-year-old man with metastatic castration-resistant prostate cancer, who after having an initial excellent response to 2 cycles of 225Ac-PSMA-617 RLT, developed delayed nephrotoxicity in the form of tubulointerstitial nephritis.
Adult Tiger Man
Authors: Aksu Ayşegül , Şin Cihan , Yilmaz Burçak 
Published: March 2022

Abstract
The scan demonstrated multiple linear and patchy hypermetabolic lesions in skeletal muscles, mimicking the coat of a tiger, and was referred to as “a tiger man” sign. A 38-year-old man was admitted to our hospital with weakness, shortness of breath, and muscle pain. A CT scan showed a mass in the anterior mediastinum. 18F-FDG PET/CT was performed to evaluate the mass with a preliminary diagnosis of thymoma; heterogeneous 18F-FDG uptake in the mediastinal mass and tiger man findings in skeletal muscles were observed in PET/CT images.
Imaging Characteristics of Coexisting Metastatic Papillary Thyroid Cancer and Prostate Cancer on 18F-Fluciclovine and 68Ga-PSMA-11 PET/CT
Authors: Lu Yang 
Published: March 2022

Abstract
A 76-year-old man with biopsy-proven metastatic papillary thyroid cancer in a mediastinal nodule status post total thyroidectomy is on surveillance. The patient also had prostate cancer and received prostatectomy and androgen deprivation treatment. An 18F-fluciclovine PET revealed avid lesions in the mediastinal nodule and a sclerotic focus at L5 with concurrent prostate-specific antigen level of 0.4 ng/mL. The L5 lesion was later biopsied and confirmed as metastasis from prostate cancer. A 68Ga-PSMA-11 PET 2 months later showed avid radiotracer uptake within L5 metastasis but not the mediastinal nodule. The patient received radiation therapy to the L5 lesion and responded well.
Liver Ultrasound Attenuation
Authors: Gatos Ilias , Drazinos Petros , Yarmenitis Spyros , Theotokas Ioannis , Koskinas John , Koullias Emmanouil , Mitranou Asimina , Manesis Emmanuel , Zoumpoulis Pavlos S. 
Published: March 2022

Objectives
Nonalcoholic fatty liver disease (NAFLD) is the most widespread chronic liver disease type in the Western countries. Ultrasound (US) is used for NAFLD and hepatic steatosis (HS) grading. The most popular US method for NAFLD assessment is the hepatorenal index (HRI), but because of its limitations, other noninvasive methods have been developed. The Resona 7 US system has recently incorporated an US attenuation–related quantitative feature, liver ultrasound attenuation (LiSA), for HS estimation. The purpose of this study is to compare LiSA’s and HRI’s performance on NAFLD assessment.

Methods
A total of 159 NAFLD patients having a magnetic resonance imaging–proton density fat fraction (MRI-PDFF) examination were examined by 2 radiologists, who performed LiSA and HRI measurements in the liver. Correlation of LiSA's and HRI's measurements with MRI-PDFF values was calculated through Pearson correlation coefficient (PCC). To further investigate the performance of LiSA and HRI, optimum cutoffs, provided by the literature, were used to correspond HS grades to MRI-PDFF results. Moreover, a receiver operating characteristic (ROC) analysis on LiSA measurements and steatosis grades was performed.

Results
Magnetic resonance imaging–PDFF was better correlated with LiSA (PCC = 0.80) than HRI (PCC = 0.67). Receiver operating characteristic analysis showed better performance range for LiSA (77.8%–91.8%) than for HRI (72.8%–85.4%) on all HS grades for all studies used for corresponding MRI-PDFF values to HS grades.

Conclusions
The results indicate that LiSA is more accurate than HRI in HS differentiation and can lead to more accurate grading of HS on NAFLD patients.
Identification of rare mutations of the vasoactive intestinal peptide receptor 2 gene in schizophrenia
Authors: Chen Chia-Hsiang , Cheng Min-Chih , Hu Tsung-Ming , Ping Lieh-Yung , Kushima Itaru , Aleksic Branko 
Published: March 2022

Objective
Studies showed that rare copy number variations (CNVs) encompassing the vasoactive intestinal peptide receptor 2 gene (VIPR2) were associated with schizophrenia, indicating VIPR2 is a risk gene for schizophrenia. We hypothesized that besides CNV, rare pathogenic single-nucleotide variant (SNV) or small insertion/deletion (Indel) of VIPR2 might be present in some patients and contribute to the pathogenesis of schizophrenia.

Methods
We performed genome-wide CNV analysis to screen CNV at the VIPR2 locus and targeted sequencing of all the exons of VIPR2 to search for SNV and indel in a sample of patients with chronic schizophrenia from Taiwan.

Results
We detected a 230-kb microduplication encompassing the VIPR2 in 1 out of 200 patients. Furthermore, we identified six ultrarare SNVs, including one splicing SNV and five missense SNVs, in 516 patients. In-silico analyses showed these SNVs had a damaging effect on the function of VIPR2.

Conclusion
Our findings support the idea that besides CNV, rare pathogenic SNVs of VIPR2 might contribute to the pathogenesis of schizophrenia in some patients.
Jiella sonneratiae sp. nov., a novel endophytic bacterium isolated from bark of Sonneratia apetala
Authors: Chen Ming-Sheng , Yi Hai-Bo , Huang Zi-Hao , Yan Xiao-Rui , Chen Xiao-Hui , Ma Xiao , Zheng Zhou-Qing , Tuo Li 
Published: March 2022

A new endophytic bacterium, designated strain MQZ13P-4T was isolated from Sonneratia apetala collected from Maowei sea Mangrove Nature Reserve in Guangxi Zhuang Autonomous Region, PR China. The 16S rRNA gene sequence similarity between strain MQZ13P-4T and its closest phylogenetic neighbour

Jiella endophytica

CBS5Q-3T was 97.9 %. Phylogenetic analyses using 16S rRNA gene sequences and whole-genome sequences showed that strain MQZ13P-4T formed a distinct lineage with

Jiella endophytica

CBS5Q-3T,

Jiella pacifica

40Bstr34T and

Jiella aquimaris

JCM 30119T. The draft genome of strain MQZ13P-4T was 5 153 243 bp in size and its DNA G+C content was 68.1 mol%. Comparative genome analysis revealed that the average nucleotide identity, digital DNA–DNA hybridization and average amino acid identity values among strain MQZ13P-4T and other related species were below the cut-off levels of 95, 70 and 95.5 %, respectively. The cell-wall peptidoglycan of strain MQZ13P-4T contained meso-diaminopimelic acid as the diagnostic diamino acid. The respiratory quinone was Q-10. The major cellular fatty acid was C18 : 1
ω7c. The polar lipids comprised phosphatidylcholine, phosphatidylethanolamine, phosphatidylmonomethylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, two unidentified aminolipids and two unidentified lipids. Strain MQZ13P-4T had a typical chemical compositions of fatty acids, lipids, quinones and diagnostic diamino acid for

Jiella

species, but could be distinguished from known species of the genus

Jiella

. Based on polyphasic evidence, strain MQZ13P-4T represents novel species of the genus

Jiella

, for which the name Jiella sonneratiae sp. nov. is proposed. The type strain is MQZ13P-4T (=CGMCC 1.18727T=JCM 34333T).