bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORING SELF-MANAGEMENT CHALLENGES OF ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE IN AN ONLINE INSTAGRAM SUPPORT COMMUNITY
Authors: Malloy Caeli , Rawl Susan , Miller Wendy 
Published: January 2022

Abstract

PURPOSE
The purpose of this qualitative study was to explore disease self-management challenges posted in an online Instagram support community by adolescents and young adults (AYAs) with inflammatory bowel disease (IBD).

BACKGROUND
For the estimated 6.8 million people worldwide living with IBD, effective disease self-management is paramount to supporting positive disease outcomes including quality of life. IBD self-management is highly individualized and can include a combination of medication management, ostomy management, and lifestyle modification. Self-management can be a complex process as it is often influenced by unpredictable disease trajectory. AYAs are disproportionately affected by IBD and experience myriad psychosocial and self-management challenges considering their stage of development and disease status. Youth with chronic conditions often turn to social media as a source of information and support. Instagram is a popular social media platform among AYAs, with more than one-third of users falling between 13 and 24 years of age. Harnessing this real-world data can reveal the authentic self-management challenges of AYAs with IBD.

METHODS
Public Instagram posts between January and December 2019 were manually extracted from an online IBD support community with over 16,7000 followers (see examples in Figure 1). We extracted posts about self-management from Instagram users who: 1) indicated they had IBD; and 2) stated they were 13-24 years old or in middle school, high school, or college. Using thematic analysis, authors independently coded and identified emerging themes about IBD self-management challenges (Figure 2). Authors discussed any disagreement about identified themes through an iterative process until consensus was reached.

RESULTS
Out of 2,700 posts assessed for eligibility, 83 met inclusion criteria. Six major themes about self-management emerged: Desire for Normalcy, Dietary Changes, Education and Career, Healthcare System, Relationships with Others, and Symptoms and Complications. Additionally, nine subthemes emerged: Finding Balance, Wanting a Normal Life, Transitioning to College and Work, Handling School, Understanding Diagnosis, Accessing Health Services, Navigating Treatment and Side Effects, Managing Significant Relationships, and Seeking Peers with IBD. Self-management challenges permeated every aspect of life, including relationships, school activities, and aspirations for the future.

CONCLUSIONS
Our findings represent the first thematic analysis of Instagram posts in an online IBD community and provide a crucial perspective of the concerns of AYAs with IBD. Self-management challenges were wide-ranging and complex, highlighting the gap between self-management needs and skills in this population. Future research should further explore these challenges to develop tailored self-management interventions to improve quality of life in AYAs with IBD.
TRANSPORTATION ACCESS AND DELAY IN DIAGNOSIS FOR PEDIATRIC INFLAMMATORY BOWEL DISEASE PATIENTS
Authors: Zeky Nicole , LeBlanc Colleen , McDonough Elizabeth , Moulton Dedrick 
Published: January 2022

Abstract

PURPOSE
Inflammatory bowel disease (IBD), consisting of both Crohn’s Disease (CD) and ulcerative colitis (UC), affects nearly 80,000 children in the United States. African American patients have more perirectal phenotype which might indicate more severe disease activity however it is unclear why. There is no published data on transportation access and how it relates to pediatric IBD. The purpose of this study is to compare pediatric IBD patients with low access to care to those with more access to care and their severity of disease at diagnosis. Our hypothesis is that those patients who live farther from the children’s hospital and bus stops will have more of a lag time in their diagnosis as defined by two or more visits with another provider for complaints concerning for IBD compared to those patients with more ease of access to care. We aim to assess the impact of proximity to care facilities, bus stops and primary children’s hospital and disease severity at the time of diagnosis for pediatric IBD population.

METHODS
This study is a retrospective chart review of patients seen by the Louisiana State University Health Science Center Pediatric Gastroenterology division at Children’s Hospital New Orleans from 2019 until 2021. A list of patients with the diagnosis of either CD or UC after 2019 was generated. Both qualitative and quantitative data was collected. Patient’s addresses were used to determine the distance to their primary gastroenterologist clinic. Data collected also included their proximity location to bus stops, number of visits prior to diagnosis of IBD.

RESULTS
There were 71 pediatric patients diagnosed during the study period. The patients were predominantly male (51%) and white (65%) with average age at diagnosis of 12 years old (± 3.3 years). Forty-eight (68%) patients were diagnosed with CD. More Crohn’s Disease patients had 2 or more visits before diagnosis compared to those with UC (48% versus 30%). The average distance for African American patients to the children’s hospital was 50.5 miles (± 55.9 miles) which was similar to the white patients (53.0 ± 59.8 miles). Of the 23 African American patients included in the study 14 (61%) had at least 2 visits before being diagnosed with IBD. In comparison, 15 of the 46 (33%) white patients had at least 2 visits before receiving a diagnosis of IBD. Most patients had a pediatrician listed as their primary care provider for both African American and white patients (70% versus 80%).

CONCLUSION
The significance of a delay in diagnosis and pediatric IBD is unclear, however further studies to determine if less access of care is predictive of greater disease severity and activity at presentation may be warranted. Additional studies will be completed to determine the relationship between proximity to bus stops and disease burden at diagnosis.
HIGH DOSE TOFACITINIB AS SALVAGE THERAPY IN STEROID REFRACTORY ACUTE SEVERE ULCERATIVE COLITIS FOLLOWING NON-RESPONSE TO INFLIXIMAB
Authors: Khan Muhammad , Mushtaq Kamran , Yakoob Rafie , AlSoub Deema 
Published: January 2022

Abstract

INTRODUCTION
Acute Severe Ulcerative Colitis (ASUC) requiring hospitalization remains a serious concern in patients with Ulcerative colitis. In patients with steroid-refractory disease, Intravenous infliximab salvage therapy is used. Colectomy is reserved for patients refractory, even to salvage therapy. We present a young female with ASUC, who was successfully treated with high dose Tofacitinib after Steroids and Infliximab failure.

CASE HISTORY
A 23 years old female was diagnosed with pan-UC six months prior to the first presentation at our center. Since then, she has had a Steroid dependent disease. She was on the maximum 5-Aminosalicylic dose and could not tolerate azathioprine in the past. At the presentation, she had iron deficiency anemia (10.1 gm/dL), hypoalbuminemia (27 gm/L), C-reactive protein
4 mg/L and calprotectin of 670 mg/Kg. The colonoscopy showed pan-colitis Mayo score 3. Given her steroid dependency for the last six months, she was started on Infliximab induction followed by maintenance. After the second Induction dose of Infliximab, the patient was admitted with worsening of her clinical symptoms. Sigmoidoscopy was performed for the patient, which showed severe colitis. Biopsy showed cytomegalovirus inclusion by immunohistochemistry. The third dose of Infliximab was postponed, and the patient received IV ganciclovir followed by oral therapy for two weeks duration. She responded clinically but before her third dose again had worsening of the disease. At the time of admission, she had a hemoglobin of 7.1 gm/dL, albumin 21 gm/L, CRP 72 mg/L, and calprotectin of 1352 mg/Kg. She met Truelove and Witts criteria for ASUC with a Mayo score of 12. Sigmoidoscopy again showed pan-colitis but was negative for cytomegalovirus. The patient did not respond to 60 mg methylprednisolone daily for five days. She was re-inducted with High dose infliximab and was given two doses 10 mg/Kg one week apart. However, the Mayo score showed no improvement, and surgery was consulted for possible colectomy. After discussing with the patient, we started her on a high dose Tofacitinib of 10 mg three times a day as salvage therapy. She showed dramatic improvement within the next 72 hours, and by day five, was discharged home. Her hemoglobin improved, CRP normalized. At three months, calprotectin was less than 100 mg/Kg, and colonoscopy showed mucosal healing with a Mayo score of 1.

DISCUSSION
In Steroid refractory ASUC, with non-response to Infliximab, High-dose tofacitinib can be used as rescue therapy. Our patient showed clinical and biochemical remission within three days. At three months follow up, the patient remained colectomy-free and was in sustained remission.
IMPACT OF THIOPURINE DOSE IN COMBINATION THERAPY IN INFLAMMATORY BOWEL DISEASE
Authors: Nawaz Ahmad , Glick Laura , Li Darrick , Gaidos Jill , Proctor Deborah , Al-Bawardy Badr 
Published: January 2022

Abstract

BACKGROUND
Multiple studies have suggested that combination therapy with thiopurines and anti-TNFs is superior to monotherapy in Crohn’s disease (CD) and ulcerative colitis (UC). The optimal dose of thiopurines in combination therapy remains unclear. Our aim was to determine the impact of thiopurine dosing in combination therapy on the formation of anti-TNF antibodies and clinical outcomes in inflammatory bowel disease (IBD).

METHODS
This is a single-center, retrospective cohort study of all IBD patients treated with thiopurine and anti-TNF combination therapy between 1/1/2012 and 11/1/2020. Therapeutic dose of thiopurines was defined as ≥ 1 mg/kg for 6-mercaptopurine (6-MP) and ≥ 2 mg/kg for azathioprine (AZA). The primary outcome was anti-TNF antibody formation between patients on a therapeutic dose of thiopurines (TD) versus those on non-therapeutic doses (NTD). Secondary outcomes included steroid-free clinical remission (SFCR), endoscopic healing (absence of ulcers/erosions in CD and Mayo endoscopic score ≤ 1 for UC), and normal serum C-reactive protein (CRP) (defined as ≤ 5 mg/L) in patients who were on combination therapy. Continuous variables were analyzed using an unpaired student’s t-test. Categorical variables were analyzed using a chi-square test.

RESULTS
A total of 108 patients were included. The median age was 31.5 years (range 13-69), and 58.3% were male (Table 1). A total of 81 patients (75%) were on infliximab (IFX), while 27 patients (25%) were on adalimumab (ADA). Therapeutic dose of thiopurine was used in 19% (n=21). TPMT activity data was available for 56 patients. Normal TPMT activity was noted in 100% (n=7) in the TD group vs. 81.6% (n=40) in the NTD group (p=0.10). There were no significant differences between the TD vs. NTD groups in terms of baseline and disease characteristics (Table 2).
Anti-TNF antibody formation was observed in 31 patients (32.1% of patients on IFX and 18.5% of patients on ADA). In the TD group 23.8% developed anti-TNF antibodies vs. 29.9% (p=0.58) in the NTD group. The mean anti-TNF drug level was 19.8 ± 13.8 vs. 16.9 ± 15.5 μg/mL (p=0.44) in the TD vs. NTD groups, respectively. SFCR was observed in 57.1% vs. 60.9% (p=0.75) and 38.1% vs. 37.9% discontinued anti-TNF treatment in the TD vs. NTD groups, respectively. Endoscopic healing was achieved in 55 % vs 60% (p=0.69), and normal CRP was observed in 52.4% vs. 46% (p=0.27) in the TD vs. NTD groups, respectively.

CONCLUSION
In our cohort, a therapeutic dose of thiopurine in combination therapy was not associated with lower rates of anti-TNF antibody formation compared to non-therapeutic doses. In addition, there were no significant differences in clinical outcomes such as normal CRP, SFCR, and endoscopic healing. Larger and prospective studies are needed to further elucidate the effect of thiopurine dosing in combination therapy for IBD.
The Androgen Receptor: A Therapeutic Target in Desmoplastic Small Round Cell Sarcoma
Authors: Lamhamedi-Cherradi Salah-Eddine , Maitituoheti Mayinuer , Menegaz Brian A. , Krishnan Sandhya , Vetter Amelia M. , Camacho Pamela , Wu Chia-Chin , Beird Hannah C. , Porter Robert W. , Ingram Davis R. , Ramamoorthy Vandhana , Mohiuddin Sana , McCall David , Truong Danh D. , Cuglievan Branko , Futreal P. Andrew , Velasco Alejandra Ruiz , Anvar Nazanin Esmaeili , Utama Budi , Titus Mark , Lazar Alexander J. , Wang Wei-Lien , Rodriguez-Aguayo Cristian , Ratan Ravin , Livingston John A. , Rai Kunal , MacLeod A. Robert , Daw Najat C. , Hayes-Jordan Andrea , Ludwig Joseph A. 
Published: January 2022

ABSTRACTDesmoplastic small round cell tumor (DSRCT) is an aggressive, usually incurable sarcoma subtype that predominantly occurs in post-pubertal young males. Recent evidence suggests that the androgen receptor (AR) can promote tumor progression in DSRCTs. However, the mechanism of AR-induced oncogenic stimulation remains undetermined. Herein, we demonstrate that enzalutamide and AR-directed antisense oligonucleotides (AR-ASO) block 5α-dihydrotestosterone (DHT)-induced DSRCT cell proliferation and reduce xenograft tumor burden. Gene expression analysis and chromatin immunoprecipitation sequencing (ChIP-seq) were performed to elucidate how AR signaling regulates cellular epigenetic programs. Remarkably, ChIP-seq revealed novel DSRCT-specific AR DNA binding sites adjacent to key oncogenic regulators, including WT1 (the C-terminal partner of the pathognomonic fusion protein) and FOXF1. Additionally, AR occupied enhancer sites that regulate the Wnt pathway, neural differentiation, and embryonic organ development, implicating AR in dysfunctional cell lineage commitment. Our findings have immediate clinical implications given the widespread availability of FDA-approved androgen-targeted agents used for prostate cancer.ONE SENTENCE SUMMARYWe demonstrate that DSRCT, an aggressive pediatric cancer, is an AR-driven malignancy capable of responding to androgen deprivation therapy.
Neutralization of Omicron SARS-CoV-2 by 2 or 3 doses of BNT162b2 vaccine
Authors: Xia Hongjie , Zou Jing , Kurhade Chaitanya , Cai Hui , Yang Qi , Cutler Mark , Cooper David , Muik Alexander , Jansen Kathrin U. , Xie Xuping , Swanson Kena A. , Shi Pei-Yong 
Published: January 2022

AbstractWe report the antibody neutralization against Omicron SARS-CoV-2 after 2 and 3 doses of BNT162b2 mRNA vaccine. Vaccinated individuals were serially tested for their neutralization against wild-type SARS-CoV-2 (strain USA-WA1/2020) and an engineered USA-WA1/2020 bearing the Omicron spike glycoprotein. Plaque reduction neutralization results showed that at 2 or 4 weeks post-dose-2, the neutralization geometric mean titers (GMTs) were 511 and 20 against the wild-type and Omicron-spike viruses, respectively, suggesting that two doses of BNT162b2 were not sufficient to elicit robust neutralization against Omicron; at 1 month post-dose-3, the neutralization GMTs increased to 1342 and 336, respectively, indicating that three doses of vaccine increased the magnitude and breadth of neutralization against Omicron; at 4 months post-dose-3, the neutralization GMTs decreased to 820 and 171, respectively, suggesting similar neutralization decay kinetics for both variants. The data support a three-dose vaccine strategy and provide the first glimpse of the neutralization durability against Omicron.
The Goldilocks Principle conferred by LDH isoenzymes controls murine T cell glycolysis and differentiation
Authors: Chen Xuyong , Liu Lingling , Wang Ruoning 
Published: January 2022

AbstractIsoenzyme divergence is a prevalent mechanism governing tissue-specific and developmental stage-specific metabolism in mammals. The isoenzyme pattern (spectrum) of lactate dehydrogenase (LDH) reflects the status of glucose metabolism in different organs such as muscle, liver, and heart. T cells are highly dependent on glucose metabolism for survival, proliferation, and differentiation. However, the LDH isoenzyme spectrum in T cells and its potential impact on T cell-mediated immune response remain unclear. Here, we discovered that the LDH spectrum in murine T cells is characterized by three tetrameric isoenzymes composed of LDHA and LDHB (LDH-3/4/5). Genetic deletion of LDHA or LDHB altered the isoenzyme spectrum by removing all heterotetramers and leaving T cell with LDH-1 (the homotetramer of LDHB) or LDH-5 (the homotetramer of LDHA), respectively. Accordingly, altering the isoenzyme spectrum by deleting LDHA or LDHB compromises T cell metabolic fitness and effector cell differentiation in vivo. Unexpectedly, deleting LDHA suppressed glycolysis, whereas deleting LDHB further enhanced it, indicating that an optimal zone of glycolytic activity is critical to driving effector T cell differentiation. Mechanistically, the LDH isoenzyme spectrum imposed by LDHA and LDHB is required to optimize glycolysis to maintain a balanced NAD+/NADH pool, a hallmark of metabolic fitness. Together, our results suggest that the LDH isoenzyme spectrum enables “Goldilocks levels” of glycolytic and redox activity (i.e., not too high, not too low, but just right) to control T cell differentiation function.
Price promotion in omnichannel retailing: how much is too much?
Authors: Quach Sara , Barari Mojtaba , Thaichon Park , Moudrý Dann Vit 
Published: January 2022

PurposeThe study aims to investigate customers' emotional and behavioral responses to price promotion in omnichannel retailing through the integration of the expectancy-disconfirmation theory, feelings-as-information-theory and regret regulation theory.Design/methodology/approachAn online survey was designed in Qualtrics and distributed by an online survey to collect data from 786 (main study) and 150 (a follow-up study) customers from the USA. The participants were randomly assigned to different scenarios related to the need to purchase a toothbrush, laptop or health supplement. After the first purchase, the participants received a discount on the same product that has just been purchased. The discount can be used at an online store or a physical store. The three levels of price promotion after the purchase were 10% (low), 25% (moderate) and 50% (high).FindingsThe study found that consumers are likely to feel more surprised and less discontented when being offered a higher discount. The emotions further significantly impact their anticipated regret. Further, different discount levels influence patronage intention and omnichannel usage via emotional responses and anticipated regret. These relationships are moderated by product involvement.Originality/valueThe study extends knowledge of price promotion and provides insights that can assist retailers in increasing the effectiveness of their sales promotion strategy. Addressing the lacuna in the current literature, which predominantly focuses on the cost and benefits analysis of sales promotion, the study revealed that cross-channel price promotion results in consumers' sophisticated emotional responses.
What’s hidden behind bulk deals? A study on Indian stock market
Authors: Rajvanshi Vivek , Paul Samit 
Published: January 2022

Purpose Emerging market, like India, is characterised by poor institutional structure, weaker regulations and higher information asymmetry which may lead to stock price manipulation. This study shed some light on such manipulation by investigating front-running behaviour around the bulk deals of stocks traded at the National Stock Exchange (NSE) from 2010 to 2019.Design/methodology/approach The authors employ an event study methodology to identify front-running in pre-event period of bulk deals. The bulk deals are classified into Only Buy, Only Sell, Partial Buy and Partial Sell trades. They are further subsampled based on the category of investors. Through cross-sectional regression, the authors also identify factors explaining such front-running.Findings The results show that the front-runners can achieve 5%–7% returns within a week around the event day. Abnormal Returns (AR) before the deals are higher for “Buy” deals than “Sell” deals. The authors also examine the role of volume and delivery in explaining the AR and cumulative abnormal returns (CAR). Lagged CAR, change in volume and change in delivery explain the AR. The results are robust after controlling for Bullish and Bearish Periods.Originality/value To the best of authors’ knowledge, this is the first study that explores the front-running in “Partial Buy” and “Partial Sell” bulk deals. Further, it investigates whether the category of investors has any role in front running. It empirically tests the asymmetric market reaction between “Buy” and “Sell” trades. Finally, it examines the role of volume and delivery in front-running.
Break-even inflation rates: the Italian case
Authors: Fanari Marco , Di Iorio Alberto 
Published: January 2022

Purpose
This work aims to study the break-even inflation rates (BEIRs), a widely used market-based measure of expected inflation. The authors focus on Italian Government bonds, one of the most liquid debt markets in the euro area.

Design/methodology/approach
The authors set up an auto-regressive distributed lag model and regress the BEIR on a set of variables that proxy inflation, market risk aversion, protection against deflation, credit as well as liquidity risk to get some insights into the importance of these factors. Subsequently, to disentangle market participants’ inflation expectations from their associated risk premia, the authors estimate a term structure model for the joint pricing of the Italian Government’s nominal and real yield curves, considering also a credit and a liquidity pricing factor.

Findings
The results show that BEIRs could be a misleading measure of the expected inflation due to the importance of the inflation risk premium and the credit risk effect. According to the estimates, the decrease of market-based measures of inflation observed in the last part of the sample period seems to reflect a lowering of both inflation expectations and risk premia. Inflation premia co-move with a measure of the tail risk of the long-term inflation distribution, signalling that investors become more concerned with downside risks.

Originality/value
This study complements the existing literature primarily based on the USA and euro area data focusing on the Italian market. To this end, the authors modify and adapt a well-known term structure model developed for nominal and real curves.