bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring experiences associated with aortic stenosis diagnosis, treatment and life impact among middle-aged and older adults
Authors: Picou Kylie , Heard Debra G. , Shah Pinak B. , Arnold Suzanne V. 
Published: April 2022

ABSTRACT

Background and purpose:
Although multiple studies have examined the clinical aspects of diagnosis, treatment, and management of patients with aortic stenosis (AS), limited data exist regarding patient experiences related to symptoms, diagnosis, treatment, and personal impacts of living with AS.

Methodology:
Adults aged ≥40 years diagnosed with AS were recruited and separated into three cohorts: medically managed, surgical aortic valve replacement (SAVR), and transcatheter aortic valve implantation (TAVI). Forty-five semi-structured interviews were conducted (15 per treatment group) via teleconference using open-ended questions and probes. Interview recordings were transcribed, and inductive thematic analyses were conducted.

Results:
The majority of participants were male (55.6%), White (95.6%), and non-Hispanic (93.3%). Participants noting longer times to diagnosis also reported mild symptom onset and experiences of misdiagnoses. Participants described a strong reliance on their health care professionals (HCPs) to guide them through their treatment decisions, which were influenced by the effects of anticoagulation, future valve interventions, and recovery. Medically managed participants reported having to make lifestyle modifications to manage symptoms, while participants who underwent TAVI or SAVR reported positive sentiments in their ability to return to normal life following their treatment.

Conclusions and implications:
Due to the varied experiences of AS patients, there is a need to improve patient resources to advance patient understanding and facilitate informed treatment decisions. Reported experiences also indicate a need for additional HCP education on early referral to a multidisciplinary heart valve team.
Telehealth for Pediatric Gastroenterology Care Now
Authors: Setty Mala , Mougey Edward B. , Berg Elizabeth , Rosen John M. , Lee Jennifer , Li B.U.K. , Venkatesh Rajitha D. , Franciosi James P. 
Published: April 2022

Objectives:
With the coronavirus disease 2019 public health emergency (PHE), telehealth (TH) became essential for continued delivery of care. Members of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) formed the Telehealth for Pediatric Gastrointestinal Care Now (TPGCN) working group and rapidly organized a telemedicine webinar to provide education and guidance. We aim to describe the webinar development and prospectively assess the effectiveness of this webinar-based educational intervention.

Methods:
NASPGHAN members who registered for the TPGCN webinar received pre- and post-webinar surveys. Outcome measures included a modified Telehealth Acceptance Model (TAM) survey and a Student Evaluation of Educational Quality (SEEQ) standardized instrument.

Results:
Seven hundred seventy-six NASPGHAN members participated in the webinar, 147 (33%) completed the pre-webinar survey; of these, 25 of 147 (17%) completed a post-webinar survey. Before the PHE, 50.3% of the pre-webinar survey participants had no TH knowledge. Webinar participants trended to have increased acceptance of TH for follow-up visits (pre-webinar, 68% versus post-webinar, 81%; P = 0.15) and chronic disease care (pre-webinar, 57% vs post-webinar, 81%; P = 0.01). The overall acceptance of TH as shown by TAM pre-webinar was 1.74 ± 0.8, which improved to 1.62 ± 0.8 post-webinar (lower scores indicate greater acceptance; P < 0.001). SEEQ results indicate that webinar material was understandable (post-webinar, 95%). Participants found breakout sessions informative and enjoyable (post-webinar, 91%).

Conclusion:
The TPGCN TH webinar was an effective educational intervention that fostered increased TH usage for follow-up and chronic care visits, improved TAM scores, and was well received by participants as seen by high SEEQ scores. Sustained and expanded pediatric gastrointestinal TH usage beyond the coronavirus disease 2019 PHE is expected.
Xanthan- and Rice Cereal-Based Thickeners in Infants: A Multidisciplinary Single-Center Experience
Authors: Abdulezer Andrea , Mooney Patrick , Besner Marie-Eve , Laniel Sophie , Milton Sarah , Labelle Christine , Sant’Anna Guilherme M. , Sant’Anna Ana 
Published: April 2022

Background:
Some infants aspirate thin liquids and must be fed thickened liquids in order to protect the lungs. However, thickeners have not been fully studied for safety. Xanthan-based thickeners have been implicated in the development of necrotizing enterocolitis and rice cereal-based thickeners have been associated with constipation and excessive weight gain. The aim of this study was to compare rates of adverse events between both thickeners.

Methods:
Single-center retrospective chart review conducted at a tertiary pediatric care center between January 2013 and July 2017. All infants deemed unsafe for oral feeding and treated with xanthan- or rice cereal-based milk thickeners were included. Data were extracted from the medical records and patients categorized according to the type of thickener. Primary outcome was the occurrence of diarrhea, constipation, overweight, and obesity at 3–6 and 6–12 months after thickener initiation. Appropriate statistical tests were used. In addition, an e-mail was sent to 14 level III Canadian Pediatric hospitals inquiring about their practice.

Results:
We identified 53 patients to be included in the study; 20 used xanthan-based- and 33 used rice cereal-based milk thickeners. Rates of diarrhea, constipation, overweight, and obesity at 3–6 and 6–12 months after initiation were not different between thickeners. Important variability concerning thickening practices was reported by the 8 centers that responded.

Conclusions:
In infants treated with milk thickeners, xanthan-based or rice cereal-based thickeners may have similar safety profiles that require further investigation including a larger number of patients.
Sarcopenia and Fat Mass in Children With Chronic Liver Disease and Its Impact on Liver Transplantation
Authors: Kyrana Eirini , Williams Jane E. , Wells Jonathan C. , Dhawan Anil 
Published: April 2022

Background:
In adults, weight loss and sarcopenia are prognostic indicators of poor outcomes for patients awaiting liver transplant (LT). We tested the hypothesis that sarcopenia in children awaiting LT was related to poor outcomes.

Methods:
Children with end-stage chronic liver disease undergoing assessment for LT were recruited into an observational longitudinal study. Anthropometry and body composition (BC; whole-body dual-energy x-ray absorptiometry scan) were assessed before and, on average, 1 year after LT.

Results:
Eleven children (6 females:5 males) were assessed (4.7 to 17.2 years; median, 9.9) at baseline. Nine children went on to have an LT. The aspartate aminotransferase-to-platelet ratio index had a significant positive correlation with trunk lean mass and trunk lean mass index (LMI) SD score (SDS). At baseline, 4 patients were sarcopenic with appendicular LMI SDS less than −1.96. All fat mass and fat mass index (FMI) SDSs were within the normal range (above −1.96). There was a strong negative correlation between FMI SDS and height SDS. After transplant, there was a significant reduction in trunk LMI from 1.20 to −0.51 (95% CI, 1.03-2.4; P < 0.01). Body mass index SDS had a negative correlation with days to discharge after transplant. The majority of patients discharged after 16 days were sarcopenic. One year after transplantation, all patients were alive with normal graft function regardless of BC before LT.

Conclusion:
FMIs were normal regardless of LMIs and correlated negatively with height. BC was related to days to discharge after LT but not to outcomes a year after LT.
Trajectories of Depression Symptoms From Pregnancy Through 24 months Postpartum Among Kenyan Women Living With HIV
Authors: Larsen Anna M. , Osborn Lusi , Ronen Keshet , Richardson Barbra A. , Jiang Wenwen , Chohan Bhavna , Matemo Daniel , Unger Jennifer A. , Drake Alison L. , Kinuthia John , John-Stewart Grace 
Published: April 2022

Background:
We examined longitudinal patterns and cofactors of depressive symptoms among pregnant and postpartum women living with HIV (WLWH).

Methods:
This study used data from a randomized trial of a text messaging intervention. WLWH were serially assessed for depressive symptoms from pregnancy through 24 months postpartum at 6 time points (pregnancy, 6 weeks, and 6, 12, 18, and 24 months postpartum). Depressive symptoms were assessed using Patient Health Questionnaire-9 and longitudinal patterns using group-based trajectory modeling. Moderate-to-severe depressive symptoms (MSD) correlates were assessed using generalized estimating equations.

Results:
Among 824 enrolled women, 14.6% ever had MSD during pregnancy or postpartum; 8.6% of WLWH had MSD in pregnancy and 9.0% any postpartum MSD. MSD was associated with abuse [RR: 3.8, 95% confidence interval (CI): 2.6 to 5.4], stigma (RR: 4.4, 95% CI: 3.1 to 6.3), and food insecurity (RR: 2.7, 95% CI: 1.9 to 3.8). Unintended pregnancy (RR: 1.6, 95% CI: 1.1 to 2.3) and recent HIV diagnosis (RR: 1.8, 95% CI: 1.2 to 2.6) were associated with higher MSD risk, whereas HIV status disclosure to partner (RR: 0.3, 95% CI: 0.2 to 0.6) and social support (RR: 0.97, 95% CI: 0.96 to 0.98) were associated with lower risk. Trajectory modeling identified 4 phenotypes of peripartum depressive symptoms: persistent no/low symptoms (38.5%), mild symptoms resolving postpartum (12.6%), low symptoms increasing slightly in postpartum (47.9%), and persistent moderate–severe symptoms throughout (1.1%).

Conclusions:
WLWH attending PMTCT services had varied patterns of depressive symptoms, which were associated with stressors (recent diagnosis and food insecurity) and factors reflecting low social power (abuse, stigma, and unintended pregnancy). Women experiencing concurrent abuse, stigma, and food insecurity should be prioritized for interventions to prevent persistent depression.
Effectiveness of Intraoperative Versus Dedicated Islet Cell Laboratory Isolation for Total Pancreatectomy With Islet Autotransplant
Authors: Navas Christopher M. , Smith Kerrington D. , Chaidarun Sushela S. , Fischer Dawn A. , Gardner Timothy B. 
Published: April 2022

Background.
Total pancreatectomy with islet autotransplantation (TPIAT) requires a complex islet isolation process of the explanted pancreas. Islet isolation has historically required a specialized laboratory to perform islet isolation. We report our experience with a novel technique of intraoperative islet isolation that does not require a specialized islet laboratory, thereby making the isolation process simpler, more accessible, and less costly.

Methods.
We performed a retrospective, comparative effectiveness analysis of 50 adult patients who underwent TPIAT from 2012 to 2020 (TPIAT with remote isolation [n = 20] versus intraoperative isolation of islet cells [n = 30]). The primary outcome was islet equivalents per body weight (IEQ/kg) for patients in each group.

Results.
Mean IEQ/kg‘s (4294 remote group versus 3015 intraoperative group, P = 0.06) and 1-y postoperative C-peptide levels (1.51 ng/mL remote group versus 0.91 ng/mL intraoperative group, P = 0.10) were not different between groups. Mean 1-y HbA1c levels (7.7% in the remote group versus 7.1% intraoperative group, P = 0.67) and 1-y insulin requirements (P = 0.31) were not statistically different. Lower average cost of hospitalization was seen in the intraoperative group, although this was not statistically significant ($104 398 remote versus $78 986 intraoperative, P = 0.81).

Conclusions.
Intraoperative islet isolation has similar effectiveness in regard to glycemic outcomes compared with the use of a dedicated islet cell isolation laboratory at a lower cost.
Outcomes in Adult Liver Transplant Recipients Using Pediatric Deceased Donor Liver Grafts
Authors: Vargas Paola A. , Wang Haowei , Dalzell Christina , Argo Curtis , Henry Zachary , Su Feng , Stotts Matthew J. , Northup Patrick , Oberholzer Jose , Pelletier Shawn , Goldaracena Nicolas 
Published: April 2022

Background.
The use of pediatric grafts for liver transplantation (LT) into adult recipients is rare, and reported outcomes are conflicting. The aim of this study is to evaluate the outcomes in adult recipients following LT with grafts from deceased pediatric donors.

Methods.
A retrospective study identifying adult LT between 2010 and 2020 using pediatric deceased donor liver grafts was conducted. Adults undergoing LT with deceased donor pediatric grafts (age ≤ 12) were identified and matched 1:2 with adults receiving adult grafts (age ≥ 18) based on recipient age (±10 y), model for end-stage liver disease (MELD) score at transplant (±5 points) and etiology of liver disease. To assess real liver size differences between the pediatric-donor and adult-donor groups, patients receiving a graft from a donor between 13 and 17 y were excluded from the main analysis and studied independently. Outcomes between the groups were compared. Complication rates were identified and graded using Clavien–Dindo classification. Graft and patient survival were assessed by Kaplan–Meier curves.

Results.
Twelve adult LT recipients with whole liver grafts from deceased pediatric donors were matched with 24 adult recipients of adult donors. Recipient age and MELD score were similar between groups. Recipients of pediatric grafts were more likely to be female (66.7% versus 16.7%, P = 0.007) and leaner (body mass index = 24.4 versus 29.9, P = 0.013). Alcohol-related cirrhosis was the most prevalent liver disease etiology in both groups (P = 0.96). There was no significant difference in length of stay, readmissions, early complications, or major complications between groups. Vascular and biliary complication rates were similar. Actuarial graft and patient survival at 1, 3, and 5 y were 100/100/100 versus 96/96/96 (P = 0.48).

Conclusions.
Excellent patient and graft survival is achievable with LT using young pediatric deceased donor grafts in smaller adult recipients. Outcomes are comparable with recipients of age and MELD-matched adult donors. Careful donor MELD-score recipient matching and close monitoring for potential biliary and vascular complications are crucial to achieve acceptable outcomes.
Early Experience Using Donor-derived Cell-free DNA for Surveillance of Rejection Following Simultaneous Pancreas and Kidney Transplantation
Authors: Williams Michael D. , Fei Mingwei , Schadde Erik , Hollinger Edward F. , Chan Edie Y. , Olaitan Oyedolamu 
Published: April 2022

Background.
Allograft biopsy is the gold standard for diagnosing graft rejection following simultaneous pancreas and kidney (SPK) transplant. Intraperitoneal biopsies are technically challenging and can be burdensome to patients and the healthcare system. Donor-derived cell-free DNA (dd-cfDNA) is well-studied in kidney transplant recipients; however, it has not yet been studied in the SPK population.

Methods.
We hypothesized that dd-cfDNA could be utilized for rejection surveillance following SPK transplant. We prospectively collected dd-cfDNA in 46 SPK patients at a single institution.

Results.
There were 10 rejection events, 5 of which were confirmed with biopsy. The other 5 were treated based on dd-cfDNA and clinical data alone with favorable outcomes. Among all patients who did not have rejection, 97% had dd-cfDNA <0.5%. Dd-cfDNA may also help differentiate rejection from graft injury (ie, pancreatitis) with median values in rejection 2.25%, injury 0.36%, and quiescence 0.18% (P = 0.0006).

Conclusions.
Similar to kidneys, dd-cfDNA shows promise for rejection surveillance in SPK transplant recipients.
Proteasome inhibition enhances myeloma oncolytic reovirus therapy by suppressing monocytic anti-viral immune responses
Authors: Dona Ada Alice , Caserta Enrico , Singer Mahmoud , Tandoh Theophilus , Nigam Lokesh , Winchester Janet , Chowdhury Arnab , Zhu Yinghui , Murtadha Mariam , Pozhitkov Alex , Sanchez James F , Vahed Hawa , Coffey Matt , Marcucci Guido , Krishnan Amrita , Nuovo Gerard , Sborov Douglas W. , Hofmeister Craig C , Pichiorri Flavia 
Published: April 2022

AbstractReovirus is an oncolytic virus with natural tropism for cancer cells. We previously showed that reovirus intravenous administration in myeloma patients was safe, but disease control associated with viral replication in the cancer cells was not observed. Here we show that ex vivo proteasome inhibitors (PIs) potentiate reovirus replication in circulating classical monocytes, increasing viral delivery to myeloma cells. We found that the anti-viral signals in monocytes primarily rely on the NF-kB activation and that this effect is impaired by the addition of PIs. Conversely, PIs improved reovirus-induced monocyte and T cell activation against cancer cells. Based on these preclinical data, we conducted a phase 1b trial of the reovirus Pelareorep together with the PI carfilzomib in 13 heavily pretreated bortezomib-resistant MM patients. Objective responses associated with reovirus active replication in MM cells, T cell activation and monocytic expansion were noted in 70% of patients.
Exploring the use of UmbiFlow™ to assess the impact of heat stress on fetoplacental blood flow in field studies
Authors: Bonell Ana , Vannevel Valerie , Sonko Bakary , Mohammed Nuredin , Vicedo-Cabrera Ana M. , Haines Andy , Maxwell Neil S , Hirst Jane , Prentice Andrew M 
Published: April 2022

AbstractObjectiveTo evaluate the impact of heat stress on umbilical artery resistance index (RI) measured by UmbiFlow™ in field settings and the implications for pregnancy outcomes.MethodsThis feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy. The umbilical artery RI was measured at rest, during and at the end of a typical working shift in women ≥ 28 weeks’ gestation. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal.ResultsA total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency around 32ºC by universal thermal climate index. Preliminary evidence suggests the fetoplacental circulation response to heat stress differs in APO versus normal outcome.ConclusionsThe Umbiflow™ device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO.FundingThe Wellcome Trust (216336/Z/19/Z)SynopsisExtreme heat exposure is increasing and a low-cost umbilical artery doppler device, UmbiFlow™, can aid understanding of fetoplacental function under heat stress conditions.
Non-cancer stem cell-derived Fibromodulin activates Integrin-dependent Notch signaling in endothelial cells to promote tumor angiogenesis and growth
Authors: Sengupta Shreoshi , Mondal Mainak , Prasasvi Kaval Reddy , Mukherjee Arani , Magod Prerna , Urbach Serge , Friedmann-Morvinski Dinorah , Marin Philippe , Somasundaram Kumaravel 
Published: April 2022

AbstractCancer stem cells alone can initiate and maintain tumors, but the function of non-cancer stem cells that form the tumor bulk remains poorly understood. Proteomic analysis showed a higher abundance of the extracellular matrix small leucine-rich proteoglycan Fibromodulin (FMOD) in the conditioned medium of non-cancer stem cells (DGCs; differentiated glioma cells) of glioma compared to that of glioma stem-like cells (GSCs). DGCs silenced for FMOD fail to cooperate with co-implanted GSCs to promote tumor growth. FMOD downregulation neither affects GSC growth and differentiation nor DGC growth and reprogramming in vitro. DGC-secreted FMOD promotes angiogenesis by activating Integrin-dependent Notch signaling in endothelial cells. Furthermore, conditional silencing of FMOD in newly generated DGCs in vivo inhibits the growth of GSC-initiated tumors due to poorly developed vasculature and increases mouse survival. Collectively, these findings demonstrate that DGC-secreted FMOD promotes glioma tumor angiogenesis and growth through paracrine signaling in endothelial cells and identifies a DGC-produced protein as a potential therapeutic target in glioma.
Effect of Heat inactivation and bulk lysis on Real-Time Reverse Transcription PCR Detection of the SARS-COV-2: An Experimental Study
Authors: Leta Dereje , Gutema Gadissa , Hagos Gebremedhin Gebremichael , Diriba Regasa , Bulti Gutema , Sura Tolawak , Ayana Desta , Chala Dawit , Lenjiso Boki , Bulti Jaleta , Abdella Saro , Tola Habteyes Hailu 
Published: April 2022

AbstractThe outbreak of the severe acute respiratory syndrome coronavirus - 2 has quickly turned into a global pandemic. Real-time reverse transcription Polymerase chain reaction is commonly used to diagnose as “gold standard”. Many coronaviruses are sensitive to heat and chemicals. Heat and chemical inactivation of samples is considered a possible method to reduce the risk of transmission, but the effect of heating and chemical treatment on the measurement of the virus is still unclear. Thus, this study aimed to investigate the effect of heat inactivation and chemical bulklysis on virus detection. The laboratory-based experimental study design was conducted in Ethiopian Public Health Institute from August to November 2020 on the samples referred to the laboratory for Coronavirus disease-19 testing. Tests were performed on eighty Nasopharyngeal/Oropharyngeal swab samples using the Abbott Real-time severe acute respiratory syndrome coronavirus - 2 assays, a test for the qualitative detection of virus in the sample. Data were analyzed and described by mean and standard deviation. Repeated measurement analysis of variance was used to assess the mean difference between the three temperatures and bulk lysis on viral detection. Post-hock analysis was employed to locate the place of significant differences. P-values less than 0.05 was used to declare statistical significance. About 6.2% (5/80) of samples were changed to negative results in heat inactivation at 60°C and 8.7% (7/80) of samples were changed to negative in heat inactivation at 100°C. The Cyclic threshold values of heat-inactivated samples (at 60°C, at 100°C, and bulk lysis) were significantly different from the temperature at 56°C. The efficacy of heat-inactivation varies greatly depending on temperature and duration. Therefore, local validation and verification of heat-inactivation are essential.