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  1. AU="Hulscher, Jan B F"
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  1. Article: Editorial: Artificial intelligence and machine learning in pediatric surgery.

    Verhoeven, Rosa / Hulscher, Jan B F

    Frontiers in pediatrics

    2024  Volume 12, Page(s) 1404600

    Language English
    Publishing date 2024-04-09
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2024.1404600
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Necrotizing enterocolitis: a potential protective role for intestinal alkaline phosphatase as lipopolysaccharide detoxifying enzyme.

    Martins, Raquel Dos Santos / Hulscher, Jan B F / Timmer, Albert / Kooi, Elisabeth M W / Poelstra, Klaas

    Frontiers in pediatrics

    2024  Volume 12, Page(s) 1401090

    Abstract: Introduction: Necrotizing enterocolitis (NEC) is a life-threatening inflammatory disease. Its onset might be triggered by Toll-Like Receptor 4 (TLR4) activation via bacterial lipopolysaccharide (LPS). We hypothesize that a deficiency of intestinal ... ...

    Abstract Introduction: Necrotizing enterocolitis (NEC) is a life-threatening inflammatory disease. Its onset might be triggered by Toll-Like Receptor 4 (TLR4) activation via bacterial lipopolysaccharide (LPS). We hypothesize that a deficiency of intestinal alkaline phosphatase (IAP), an enzyme secreted by enterocytes that dephosphorylates LPS, may contribute to NEC development.
    Methods: In this prospective pilot study, we analyzed intestinal resection specimens from surgical NEC patients, and from patients undergoing Roux-Y reconstruction for hepatobiliary disease as controls. We assessed IAP activity via enzymatic stainings and assays and explored IAP and TLR4 co-localization through immunofluorescence.
    Results: The study population consisted of five NEC patients (two Bell's stage IIb and three-stage IIIb, median (IQR) gestational age 25 (24-28) weeks, postmenstrual age at diagnosis 28 (26-31) weeks) and 11 controls (unknown age). There was significantly lower IAP staining in NEC resection specimens [49 (41-50) U/g of protein] compared to controls [115 (76-144),
    Conclusion: This study suggests a significantly lower IAP level in resection specimens of NEC patients compared to controls. This lower IAP activity suggests a potential role of IAP as a protective agent in the gut, which needs further confirmation in larger cohorts.
    Language English
    Publishing date 2024-04-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2024.1401090
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Biliary Atresia in 2021: Epidemiology, Screening and Public Policy.

    Schreiber, Richard A / Harpavat, Sanjiv / Hulscher, Jan B F / Wildhaber, Barbara E

    Journal of clinical medicine

    2022  Volume 11, Issue 4

    Abstract: Biliary atresia (BA) is a rare newborn liver disease with significant morbidity and mortality, especially if not recognized and treated early in life. It is the most common cause of liver-related death in children and the leading indication for liver ... ...

    Abstract Biliary atresia (BA) is a rare newborn liver disease with significant morbidity and mortality, especially if not recognized and treated early in life. It is the most common cause of liver-related death in children and the leading indication for liver transplantation in the pediatric population. Timely intervention with a Kasai portoenterostomy (KPE) can significantly improve prognosis. Delayed disease recognition, late patient referral, and untimely surgery remains a worldwide problem. This article will focus on biliary atresia from a global public health perspective, including disease epidemiology, current national screening programs, and their impact on outcome, as well as new and novel BA screening initiatives. Policy challenges for the implementation of BA screening programs will also be discussed, highlighting examples from the North American, European, and Asian experience.
    Language English
    Publishing date 2022-02-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11040999
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The role of intestinal alkaline phosphatase in the development of necrotizing enterocolitis.

    Martins, Raquel Dos Santos / Kooi, Elisabeth M W / Poelstra, Klaas / Hulscher, Jan B F

    Early human development

    2023  Volume 183, Page(s) 105797

    Abstract: Necrotizing enterocolitis (NEC) is a devastating neonatal disease that affects neonates worldwide and often leads to high morbidity and mortality rates. Despite extensive research, the cause of NEC remains unclear, and current treatment options are ... ...

    Abstract Necrotizing enterocolitis (NEC) is a devastating neonatal disease that affects neonates worldwide and often leads to high morbidity and mortality rates. Despite extensive research, the cause of NEC remains unclear, and current treatment options are limited. An important novel finding is the potential role of intestinal Alkaline Phosphatase (IAP) in both pathogenesis and treatment of NEC. IAP can play a vital role in detoxifying liposaccharides (LPS), a key mediator of many pathological processes, thereby reducing the inflammatory response associated with NEC. Furthermore, IAP can help prevent dysbiosis, improve intestinal perfusion, and promote autophagy. In this comprehensive review, we present evidence of the possible connection between IAP and the LPS/Toll-like receptor 4 (TLR4) pathway, impaired gut immunity, and dysbiosis in the preterm gut. Based on these findings, the administration of exogenous IAP might provide promising preventive and therapeutic avenues for the management of NEC.
    MeSH term(s) Infant, Newborn ; Humans ; Alkaline Phosphatase/metabolism ; Alkaline Phosphatase/therapeutic use ; Enterocolitis, Necrotizing/drug therapy ; Dysbiosis/drug therapy ; Lipopolysaccharides/therapeutic use ; Infant, Newborn, Diseases/drug therapy
    Chemical Substances Alkaline Phosphatase (EC 3.1.3.1) ; Lipopolysaccharides
    Language English
    Publishing date 2023-06-07
    Publishing country Ireland
    Document type Journal Article ; Review
    ZDB-ID 752532-1
    ISSN 1872-6232 ; 0378-3782
    ISSN (online) 1872-6232
    ISSN 0378-3782
    DOI 10.1016/j.earlhumdev.2023.105797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1373: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Odevixibat Treatment Induces Biliary Bile Acid Secretion in Responsive Patients With Bile Salt Export Pump Deficiency.

    Nomden, Mark / Kuipers, Folkert / Hulscher, Jan B F / Lindström, Erik / Valcheva, Velichka / Verkade, Henkjan J

    Gastroenterology

    2023  Volume 165, Issue 2, Page(s) 496–498.e1

    MeSH term(s) Humans ; ATP Binding Cassette Transporter, Subfamily B, Member 11 ; Liver ; Bile ; Bile Acids and Salts
    Chemical Substances ATP Binding Cassette Transporter, Subfamily B, Member 11 ; odevixibat (2W150K0UUC) ; Bile Acids and Salts
    Language English
    Publishing date 2023-03-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2023.03.226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui V Zs.44: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 572: Show issues

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  6. Article: Fetal-neonatal exposure to antibiotics and NEC development: A systematic review and meta-analysis.

    Klerk, Daphne H / van Avezaath, Lisanne K / Loeffen, Erik A H / Hulscher, Jan B F / Kooi, Elisabeth M W

    Frontiers in pediatrics

    2023  Volume 10, Page(s) 1102884

    Abstract: Background: Fetal and neonatal exposure to antibiotics may contribute to the development of necrotizing enterocolitis (NEC) in preterm infants. This systematic review and meta-analysis investigate whether exposure to third trimester maternal antibiotics ...

    Abstract Background: Fetal and neonatal exposure to antibiotics may contribute to the development of necrotizing enterocolitis (NEC) in preterm infants. This systematic review and meta-analysis investigate whether exposure to third trimester maternal antibiotics (MAB) and/or prolongation of empirical antibiotics (PEAB) are associated with NEC development in preterms.
    Method: We included observational and randomized controlled studies, including those on preterm or very low birth weight (VLBW) infants, from MEDLINE and EMBASE, published between 1990 and June 2021. Exposure was defined as third trimester MAB and/or PEAB. The two reviewers independently performed study selection, data extraction, and quality assessment.
    Results: Three cohort studies compared third trimester MAB with no antibiotics. MAB was associated with lower NEC incidence, unadjusted pooled odds ratio (OR) is 0.57 (95% CI: 0.35-0.93). Twelve cohort studies showed that PEAB was associated with an increased risk of NEC. Ten observational cohort studies show an unadjusted OR of 2.72 (1.65-4.47), and two case-control studies show an unadjusted mean difference of 2.31 (0.94-3.68). Moderate to substantial heterogeneity was observed but decreased in studies with low risk of bias and large sample size.
    Conclusion: Evidence suggests an association between MAB and decreased risk of NEC and an association between PEAB and increased risk of NEC. Further studies should confirm these associations and explore causality.
    Systematic review registration: identifier [CRD42022304937].
    Language English
    Publishing date 2023-01-16
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2022.1102884
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Surgery or comfort care for neonates with surgical necrotizing enterocolitis: Lessons learned from behavioral artificial intelligence technology.

    van Varsseveld, Otis C / Ten Broeke, Annebel / Chorus, Caspar G / Heyning, Nicolaas / Kooi, Elisabeth M W / Hulscher, Jan B F

    Frontiers in pediatrics

    2023  Volume 11, Page(s) 1122188

    Abstract: Background: Critical decision making in surgical necrotizing enterocolitis (NEC) is highly complex and hard to capture in decision rules due to case-specificity and high mortality risk. In this choice experiment, we aimed to identify the implicit weight ...

    Abstract Background: Critical decision making in surgical necrotizing enterocolitis (NEC) is highly complex and hard to capture in decision rules due to case-specificity and high mortality risk. In this choice experiment, we aimed to identify the implicit weight of decision factors towards future decision support, and to assess potential differences between specialties or centers.
    Methods: Thirty-five hypothetical surgical NEC scenarios with different factor levels were evaluated by neonatal care experts of all Dutch neonatal care centers in an online environment, where a recommendation for surgery or comfort care was requested. We conducted choice analysis by constructing a binary logistic regression model according to behavioral artificial intelligence technology (BAIT).
    Results: Out of 109 invited neonatal care experts, 62 (57%) participated, including 45 neonatologists, 16 pediatric surgeons and one neonatology physician assistant.
    Conclusion: We demonstrated how BAIT can analyze the implicit weight of factors in the complex and critical decision for surgery or comfort care for (surgical) NEC. The findings reflect Dutch expertise, but the technique can be expanded internationally. After validation, our choice model/BAIT may function as decision aid.
    Language English
    Publishing date 2023-02-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2023.1122188
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Human precision-cut cystic duct and gallbladder slices: a novel method for studying cholangiopathies.

    Fridrichs, Jeske / Hamel, Bart / Kelder, Wendy / van den Hoed, Ewoud / van den Heuvel, Marius C / Hulscher, Jan B F / Olinga, Peter

    Frontiers in pediatrics

    2023  Volume 11, Page(s) 1058319

    Abstract: Background and aims: Precision-cut tissue slices (PCTS) are widely used as an : Methods: Cystic duct and gallbladder tissue derived from patients undergoing a cholecystectomy were collected, preserved and used for preparation of precision-cut cystic ... ...

    Abstract Background and aims: Precision-cut tissue slices (PCTS) are widely used as an
    Methods: Cystic duct and gallbladder tissue derived from patients undergoing a cholecystectomy were collected, preserved and used for preparation of precision-cut cystic duct slices (PCCDS) and precision-cut gallbladder slices (PCGS). The PCCDS and PCGS were prepared using a mechanical tissue slicer and subsequently incubated for 24 and 48 h respectively in William's Medium E (WME) culture medium. Viability was assessed based on ATP/protein content and tissue morphology [hematoxylin and eosin (H&E) staining].
    Results: It was shown that viability, assessed by the ATP/protein content and morphology, of the PCCDS (
    Conclusion: This study is the first to report on the use of the PCTS model for human gallbladder and cystic duct tissue. PCCDS and PCGS remain viable for an incubation period of at least 24 h, which makes them suitable for research purposes in the field of cholangiopathies, including biliary atresia.
    Language English
    Publishing date 2023-07-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2023.1058319
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Gene expression in the intestine of newborn piglets after hypoxia-reoxygenation.

    Dotinga, Baukje M / Bao, Mian / Solberg, Rønnaug / Saugstad, Ola D / Hulscher, Jan B F / Bos, Arend F / Plösch, Torsten / Kooi, Elisabeth M W

    Pediatric research

    2023  Volume 94, Issue 4, Page(s) 1365–1372

    Abstract: Background: In preterm infants, intestinal hypoxia may partly contribute to the pathophysiology of necrotizing enterocolitis through changes in gene expression. Splanchnic hypoxia can be detected with monitoring of regional splanchnic oxygen saturation ( ...

    Abstract Background: In preterm infants, intestinal hypoxia may partly contribute to the pathophysiology of necrotizing enterocolitis through changes in gene expression. Splanchnic hypoxia can be detected with monitoring of regional splanchnic oxygen saturation (r
    Methods: Forty-two newborn piglets were randomized to control or intervention groups. Intervention groups were subjected to hypoxia until they were acidotic and hypotensive. Next, they were reoxygenated for 30 min according to randomization, i.e., 21% O
    Results: The expression of selected genes was not significantly different between control and intervention groups. No associations between mean r
    Conclusion: Our study suggests that hypoxia and reoxygenation cause reduced vascular adaptability, which seems to be associated with the upregulation of apoptosis and downregulation of inflammation.
    Impact: Our results provide important insight into the (patho)physiological significance of changes in the variability of r
    MeSH term(s) Animals ; Humans ; Infant, Newborn ; Animals, Newborn ; Gene Expression ; Hypoxia ; Infant, Premature ; Inflammation/complications ; Intestines ; Oxygen ; Swine ; Random Allocation ; Disease Models, Animal
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-05-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-023-02657-4
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 564: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 373: Show issues

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  10. Article ; Online: Outcome Reporting in Interventional Necrotizing Enterocolitis Studies: A Systematic Review.

    van Varsseveld, Otis C / Klerk, Daphne H / Jester, Ingo / Lacher, Martin / Kooi, Elisabeth M W / Hulscher, Jan B F

    Journal of pediatric surgery

    2023  Volume 58, Issue 11, Page(s) 2105–2113

    Abstract: Background: Despite an increasing necrotizing enterocolitis (NEC) incidence, treatment strategies have failed to make major advancements towards improved NEC outcomes. Heterogeneity in outcome reporting and a lack of treatment efficacy studies ... ...

    Abstract Background: Despite an increasing necrotizing enterocolitis (NEC) incidence, treatment strategies have failed to make major advancements towards improved NEC outcomes. Heterogeneity in outcome reporting and a lack of treatment efficacy studies potentially hamper these advancements. We aimed to analyze outcome reporting in recent interventional NEC studies.
    Methods: We performed a systematic review identifying interventional studies on NEC between 1st of January 2016 and 1st of June 2023 in MEDLINE, Embase, CENTRAL and Cochrane reviews. Systematic reviews, clinical trials and change-in-practice cohort studies reporting any therapeutic intervention for NEC patients (Bell's stage ≥ IIa) were eligible. We excluded studies on NEC diagnostics or prevention and non-English publications. Outcomes were categorized into five core areas and presented descriptively. The review was registered with PROSPERO (CRD42022302712).
    Results: Out of 1.642 screened records, 65 were eligible for full-text review and 15 were finally included for data extraction. Median number of reported outcomes per article was six (range 1-19). We identified 66 unique outcomes, which were mapped to 53 outcome terms. Thirty-four out of the 53 of the outcome terms (64%) were only reported in a single article. Mortality was the most reported outcome (11/15 articles, 73%). Core area 'Adverse outcomes' contained the most outcome terms (n = 19), whereas 'Life impact' contained the least outcome terms (n = 4) and was represented in 3 articles (20%).
    Conclusions: Considerable heterogeneity in outcome reporting and a paucity of outcomes concerning 'Life impact' exist in interventional NEC studies. Development of a NEC core outcome set may improve consistency and patient-relevance in outcome reporting.
    Study type: Systematic Review and Meta-Analyses.
    Level of evidence: III.
    Language English
    Publishing date 2023-07-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2023.06.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 607: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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