bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of high protein, low-glycemic index diet on lean body mass, strength, and physical performance in late postmenopausal women: a randomized controlled trial
Authors: Silva Thaís R. , Lago Suzana C. , Yavorivski Andressa , Ferreira Laís L. , Fighera Tayane M. , Spritzer Poli Mara 
Published: November 2020

Abstract

Objective:
To investigate whether increasing protein consumption to twice the recommended daily allowance (RDA) by The Institute of Medicine affects lean body mass (LBM), muscle strength, and physical performance in late postmenopausal women.

Methods:
Parallel-group randomized trial with 26 apparently healthy women aged ≥ 65 years. Participants were randomly assigned to low-glycemic index diets with protein consumption at current RDA (0.8 g/kg body weight) or twice the RDA (2RDA, 1.6 g/kg body weight). Protein intake was assessed by 24-hours urinary nitrogen excretion. Change in LBM was measured by dual-energy X-ray absorptiometry at 3 and 6 months. Secondary outcomes were appendicular lean mass, handgrip strength by dynamometry, and physical performance by gait speed.

Results:
Mean age was 70.8 ± 3.6 years, and mean BMI was 26.1 ± 3.5 kg/m2 in the overall sample. The RDA and 2RDA groups did not differ regarding baseline dietary intake. Changes from baseline in LBM (0.07 kg; 95% CI, −0.39; 0.52 kg; P = 0.100) and appendicular lean mass (0.07 kg; 95% CI, −0.34; 0.47 kg; P = 0.100) did not differ between the groups. Total body fat (−1.41 kg; 95% CI, −2.62; 0.20 kg; P = 0.019) and trunk fat mass (−0.90 kg; 95% CI, −1.55; −0.24 kg; P = 0.005) decreased similarly in both groups at the end of intervention. Adjusting for baseline BMI did not alter these findings. Handgrip strength and 4-m gait speed increased after the intervention, with no significant difference between the groups.

Conclusions:
Protein intake exceeding the RDA did not increase LBM, strength, and physical performance in a sample of late postmenopausal woman consuming a low-glycemic index diet for 6 months.
Exercise SBP response and incident depressive symptoms: The Maastricht Study
Authors: Zhou Tan Lai , Kroon Abraham A. , Henry Ronald M.A. , Koster Annemarie , Dagnelie Pieter C. , Bosma Hans , van Greevenbroek Marleen M.J. , van der Kallen Carla J.H. , Schalkwijk Casper G. , Wesselius Anke , Reesink Koen D. , Köhler Sebastian , Schram Miranda T. , Stehouwer Coen D.A. , van Sloten Thomas T. 
Published: November 2020

Objective
: An exaggerated exercise SBP, which is potentially modifiable, may be associated with incident depressive symptoms via an increased pulsatile pressure load on the brain. However, the association between exaggerated exercise SBP and incident depressive symptoms is unknown. Therefore, we examined whether exaggerated exercise SBP is associated with a higher risk of depressive symptoms over time.

Methods
: We used longitudinal data from the population-based Maastricht Study, with only individuals free of depressive symptoms at baseline included (n = 2121; 51.3% men; age 59.5 ± 8.5 years). Exercise SBP was measured at baseline with a submaximal exercise cycle test. We calculated a composite score of exercise SBP based on four standardized exercise SBP measures: SBP at moderate workload, SBP at peak exercise, SBP change per minute during exercise and SBP 4 min after exercise. Clinically relevant depressive symptoms were determined annually at follow-up and defined as a Patient Health Questionnaire score of at least 10.

Results
: After a mean follow-up of 3.9 years, 175 participants (8.3%) had incident clinically relevant depressive symptoms. A 1 SD higher exercise SBP composite score was associated with a higher incidence of clinically relevant depressive symptoms [hazard ratio: 1.27 (95% confidence interval: 1.04–1.54)]. Results were adjusted for age, sex, education level, glucose metabolism status, lifestyle, cardiovascular risk factors, resting SBP and cardiorespiratory fitness.

Conclusion
: A higher exercise SBP response is associated with a higher incidence of clinically relevant depressive symptoms.
Associations of household solid fuel for heating and cooking with hypertension in Chinese adults
Authors: Liu Zhiguang , Hystad Perry , Zhang Yuqing , Rangarajan Sumathy , Yin Lu , Wang Yang , Hu Bo , Lu Fanghong , Zhou Yihong , Li Yindong , Bangdiwala Shrikant I. , Yusuf Salim , Li Wei , Tse Lap Ah 
Published: November 2020

Objective:
The association between indoor air pollution resulting from household solid fuel use for heating and cooking with hypertension or blood pressure (BP) remains less clear. This study aims to rectify these knowledge gaps in a large Chinese population.

Methods:
During 2005–2009, 44 007 individuals aged 35–70 years with complete information on household solid fuel use for cooking and heating were recruited from 279 urban and rural communities of 12 centers. Solid fuel referred to charcoal, coal, wood, agriculture crop, animal dung or shrub. Annual concentration of ambient atmospheric particulate matter that have a diameter of less than 2.5 μm for all communities was collected. Generalized linear mixed models using community as the random effect were performed to estimate the association with hypertension prevalence or BP after considering ambient atmospheric particulate matter that have a diameter of less than 2.5 μm and a comprehensive set of potential confounding factors at the individual and household level.

Results:
A total of 47.6 and 61.2% of participants used household solid fuel for heating and cooking, respectively. Solid fuel use for heating was not associated with an increase in hypertension prevalence (adjusted odds ratio = 1.08, 95% confident interval: 0.98, 1.20) or elevated SBP (0.62 mmHg, 95% confident interval: −0.24, 1.48). No association was found between solid fuel for cooking and hypertension or BP, and no additional risk was observed among participants who had both exposures to solid fuel for heating and cooking compared with those used for heating only.

Conclusion:
The current large Chinese study revealed a statistically insignificant increase in the association between solid fuel use for heating and hypertension prevalence or BP. As this cross-sectional study has its inherent limitation on causality, findings from this study would have to be confirmed by prospective cohort studies.
Dapagliflozin decreases ambulatory central blood pressure and pulse wave velocity in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled clinical trial
Authors: Papadopoulou Eirini , Loutradis Charalampos , Tzatzagou Glykeria , Kotsa Kalliopi , Zografou Ioanna , Minopoulou Ioanna , Theodorakopoulou Marietta P. , Tsapas Apostolos , Karagiannis Asterios , Sarafidis Pantelis 
Published: November 2020

Objectives:
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors reduce the incidence of heart failure and death in patients with type-2 diabetes mellitus. Arterial stiffness is a prominent risk factor for heart failure and overall mortality. The aim of this study was to evaluate the effects of dapagliflozin on ambulatory brachial and central blood pressure (BP) levels and arterial stiffness parameters in patients with type-2 diabetes mellitus.

Methods:
This is a double-blind, randomized, placebo-controlled clinical trial including 85 adult patients with type-2 diabetes mellitus on monotherapy or combination therapy with two of: metformin, sulphonylurea, DPP-4 inhibitor, or insulin. Patients were randomized in a 1 : 1 ratio to oral dapagliflozin 10 mg per day or placebo for 12 weeks. Study participants underwent 24-h ambulatory BP monitoring with the Mobil-O-Graph NG monitor at baseline and study-end.

Results:
Baseline demographic, clinical and laboratory parameters were similar in the two groups. During follow-up, 24-h brachial SBP/DBP (129.0 ± 12.6/77.3 ± 7.3 vs. 123.2 ± 12.4/75.1 ± 6.4 mmHg; P < 0.001/P = 0.008) and central SBP/DBP (117.4 ± 10.5/78.9 ± 7.3 vs. 113.3 ± 8.8/77.3 ± 6.5 mmHg; P = 0.002/P = 0.047) significantly decreased in dapagliflozin but not in the placebo group. Corresponding reductions of 24-h brachial SBP (−5.8 ± 9.5 vs. −0.1 ± 8.7, P = 0.005) and central SBP (−4.1 ± 8.0 vs. −0.7 ± 7.8; P = 0.046) were greater with dapagliflozin than placebo. Twenty-four-hour heart-rate adjusted augmentation index significantly decreased with dapagliflozin and insignificantly with placebo. Importantly, there was a significant difference in change of estimated 24-h PWV (−0.16 ± 0.32 vs. 0.02 ± 0.27; P = 0.007) favoring dapagliflozin. In generalized linear mixed models including 24-h brachial SBP as a random covariate, the adjusted marginal means of delta 24-h central SBP and delta 24-h PWV were not significantly different between-groups.

Conclusion:
Treatment with dapagliflozin significantly reduces ambulatory brachial and central BP levels and PWV in patients with type-2 diabetes mellitus. Improvement in these parameters may substantially contribute to the cardiovascular benefits of SGLT-2 inhibitors.
Estimated pulse wave velocity is associated with residual-specific mortality: findings from the National Health and Nutrition Examination Survey
Authors: Heffernan Kevin S. , Jae Sae Young , Loprinzi Paul D. 
Published: November 2020

Introduction:
Estimated pulse wave velocity (ePWV) is emerging as a predictor of cardiovascular and all-cause mortality. Approximately one-third of all deaths are not related to the top nine causes of mortality as defined by the CDC. We examined the association of ePWV with residual-specific mortality in a large sample of US adults.

Methods:
Data from the 1999–2006 National Health and Nutrition Examination Survey (NHANES) were used (n = 13 909 adults between the ages of 18–85 years), with follow-up through 2011 (mean follow-up, 104 months). ePWV was calculated from a regression equation using age and mean blood pressure.

Results:
After adjusting for age, pulse pressure, race/ethnicity, blood lipids, glucose, C-reactive protein, eGFR, smoking, self-reported physical activity, history of hypertension and diabetes, for every 1 m/s increase in ePWV, there was a 17% increased risk of residual-specific mortality (hazard ratio = 1.17, 95% CI = 1.02–1.36; P = 0.03). If using a previously recommended clinical cut-point of 10 m/s, those with an elevated ePWV had an increased risk of 57% (hazard ratio = 1.57; 95% CI = 0.98–2.50; P = 0.06).

Conclusion:
ePWV is associated with residual-specific mortality in a nationally representative sample of adults.
Trends in hypertension prevalence, awareness, treatment and control rates among Chinese adults, 1991–2015
Authors: Ma Shujing , Yang Liu , Zhao Min , Magnussen Costan G. , Xi Bo 
Published: November 2020

Objective:
The upward trends in the prevalence and control of hypertension in Chinese adults have been described, but recent trends based on the most recent guidelines are unavailable. We examined recent trends in the prevalence, awareness, treatment and control of hypertension among Chinese adults from 1991 to 2015 based on the 2018 Chinese Guideline.

Methods:
A total of 72 452 adults aged 20–79 years from the China Health and Nutrition Survey conducted between 1991 and 2015 were included in the study. Hypertension status and control rate were defined according to the 2018 Chinese Guideline. Age-standardized estimates were calculated based on the age distribution of the WHO standard population.

Results:
From 1991 to 2015, the crude/age-standardized hypertension prevalence (14.0/15.3 to 34.1/25.6%), awareness (29.4/24.2 to 43.8/27.2%), treatment (19.2/15.1 to 39.2/23.6%) and control rates (3.5/3.6 to 13.8/8.4%) increased (all P for trend <0.001). The prevalence of hypertension increased at a greater rate in rural regions compared with that in urban regions, whereas the control rate was higher in urban regions than that in rural regions. Compared with middle-aged and older adults aged 40–79 years, young adults aged 20–39 years had a larger increase in the prevalence of hypertension, but the awareness, treatment and control rates in the young adults did not increase.

Conclusion:
The prevalence of hypertension has increased markedly over the past two decades among Chinese adults, and the awareness, treatment and control rates have increased slightly or moderately and they have remained very low. These data underscore the need for effective measures to prevent hypertension and to increase the control of hypertension in Chinese adults.
Circulating senescent angiogenic T cells are linked with endothelial dysfunction and systemic inflammation in hypertension
Authors: Zhang Gaoxing , Liu Yuanya , Qiu Yumin , Zhang Jianning , Sun Jiapan , Zhou Zhe , Wang Zhichao , Zeng Peishan , Tao Jun , He Jiang 
Published: November 2020

Objective:
Angiogenic T cells (Tang cells), a recently discovered T-cell subset, have been reported involved in the repair of endothelial injury. The purpose of this study was to explore the correlation of immunologic senescence and pro-inflammatory capacity of Tang cells with endothelial dysfunction in hypertensive patients.

Methods:
Immunological characteristics of Tang cells (CD3+CD31+CXCR4+) from hypertensive patients with or without endothelial dysfunction were elucidated by surface immunophenotyping and intracellular cytokine staining. Endothelial function was measured by flow-mediated dilation (FMD).

Results:
The frequency of CD28null subset in CD4+ Tang cells was notably elevated in hypertensive patients with endothelial dysfunction, which was negatively associated with FMD. The high frequency of CD28nullCD4+ Tang cells was an independent risk factor of endothelial dysfunction with good diagnostic performance in ROC curve analysis. Immunophenotyping revealed that this specific subset of Tang cells exhibited senescent profile and has low hTERT expression. CD28nullCD4+ Tang cells produced high levels of inflammatory cytokines, IL-6, IFN-γ and TNF-α, and significantly correlated with the systemic inflammation in hypertensive patients with endothelial dysfunction.

Conclusion:
Collectively, our findings demonstrate for the first time that CD28null subset in CD4+ Tang cells with senescent and pro-inflammatory phenotype is dependently correlated with impaired FMD and systemic inflammation, which might contribute to the immunopathologic mechanism of endothelial dysfunction. Identification of a pathogenic CD4+ Tang-cell subset lacking CD28 may offer opportunities for the evaluation and management of endothelial dysfunction in hypertension.
A New Treatment Experience in Pseudomonas Keratitis: Topical Meropenem and Cefepime
Authors: Bozkurt Erdinç , Muhafiz Ersin , Kepenek Hasan Sami , Bozlak Çigdem Eda Balkan , Koç Saltan Seher , Bingol Seyit Ali 
Published: November 2020

Purpose:
To compare the efficacy of topical meropenem and cefepime treatments with respect to moxifloxacin as new treatment options in an experimental Pseudomonas keratitis model.

Methods:
Twenty-four rabbits in which keratitis are induced using Pseudomonas aeruginosa were divided into four groups according to treatment options. A solution of 50 mg/mL meropenem was prepared and topically applied to the first group, 50 mg/mL cefepime solution to the second group, topical 0.5% moxifloxacin drop to the third group, and topical isotonic (0.9% saline) solution to the fourth (control) group. The eyes were examined before and after treatment to score the clinical severity. After the subjects were sacrificed, their corneas were excised. To determine the efficacy of treatments, clinical score, bacterial load, and histopathological and immunohistochemical findings were evaluated.

Results:
When the three treatment groups were compared, there was a significant difference in the colony-forming unit (CFU) value, polymorph-nuclear leukocyte (PMNL) infiltration, and matrix metalloproteinase (MMP)-9 immunoreactivity (P=0.022, P=0.038, and P=0.037, respectively). The CFU values, PMNL infiltration scores and MMP-9 immunoreactivity were significantly lower in the meropenem and moxifloxacin groups compared with the cefepime group (P<0.05 for all). There was no significant difference between the meropenem and moxifloxacin groups in respect of the CFU values, PMNL infiltration, and MMP-9 immunoreactivity (P=0.842, P=0.784, and P=0.699, respectively).

Conclusion:
The results of our study indicate that topical meropenem is at least as effective as topical moxifloxacin in the treatment of Pseudomonas keratitis. The meropenem and moxifloxacin are safer and suitable in the limited corneal invasion than cefepime. Thus, topical meropenem may be an alternative drug in the treatment of this condition. Clinical studies are needed to be conducted to assess this possibility more accurately.
Adverse Skin Reactions to Personal Protective Equipment Among Health-Care Workers During COVID-19 Pandemic: A Multicenter Cross-sectional Study in Indonesia
Authors: Christopher Paulus Mario , Roren Regina Stefani , Tania Clarissa , Jayadi Nana Novia , Cucunawangsih Cucunawangsih 
Published: November 2020

Abstract

Objective:
Health-care workers (HCWs) in Indonesia have been participating in the war against the coronavirus disease-2019 since March 2020. Ever since HCWs were exposed to the regular use of personal protective equipment (PPE) with varying levels and maintain hand hygiene more as recommended by the World Health Organization. Adverse skin reactions to PPE in Indonesia has yet to be acknowledged. This study aimed to study the prevalence and characteristics-, possible risk factors-, and suggest possible solutions towards adverse skin reactions to PPE among HCWs in a multi-center setting of Indonesia.

Methods:
A cross-sectional survey was conducted online among HCWs in the Siloam Hospitals Group of Banten province. HCWs of Banten Province were surveyed from June 1 to August 31, 2020. The data was obtained using avalidated online survey questionnaire including (1) demographic characteristics; (2) occupational-related characteristics; (3) adverse skin reactions.

Results:
A response rate of 40.2% was obtained and 200 valid respondents were yielded. The mean age of respondents was (26.94 ± 7.23) years old. Adverse skin reactions (66.5%) were reported primarily in female (73.7%) working as doctors (82.7%) of a non-referral center for coronavirus disease-2019 (60.2%) wearing level 2 and 3 PPE (43.6% and 37.6%, respectively). The cheeks and chin was the most common site involved (69.9%) with dryness/tightness (63.9%) and acne (77.4%) as the highest symptoms and signs reported. Sex, age group classification, level of PPE worn, hand hygiene frequency, and duration of PPE worn daily were factors considerably associated with adverse skin reactions to PPE (P < 0.05).

Conclusions:
Adverse skin reactions to PPE are common among HCWs in Indonesia. Comprehensive strengthening of the skin condition and awareness on adverse skin reactions should be advocated.
Efficacy and Safety of Prednisolone Monotherapy Versus Prednisolone Plus Methotrexate in Erythema Nodosum Leprosum (Type 2 Lepra Reaction)
Authors: Hasan Zahidul , Mowla Mohammad Rafiqul , Angkur Debashish Mondol , Khan Md. Ismail 
Published: November 2020

Abstract

Objective:
This study was performed to compare the efficacy and safety of methotrexate (MTX) plus prednisolone versus prednisolone monotherapy in patients with erythema nodosum leprosum (ENL).

Methods:
This comparative clinical study was performed in the Chittagong Medical College Hospital, Bangladesh from June 2018 to December 2019. Nineteen patients were selected according to inclusion criteria and randomly allocated to either the MTX plus prednisolone group (Group A, n = 10) or the prednisolone monotherapy group (Group B, n = 9). All patients were followed up until the end of the 6-month duration of therapy to observe the clinical outcomes and adverse effects.

Results:
All patients in both groups showed significant improvement (P = 0.005 and P = 0.008 in Group A and B, respectively). However, prednisolone-related adverse events were more frequent in Group B.

Conclusion:
The present study has demonstrated that a combination of prednisolone and MTX is a safer and more effective treatment than steroid monotherapy in ENL patients including the healing of nodules. However, this combination therapy did not appear to have a significant steroid-sparing effect, possibly because of the small sample size and short study period. Therefore, a well-designed multicenter randomized controlled trial is recommended for validation of MTX with prednisolone for the management of ENL.
Fibrin clot susceptibility to lysis is impaired after on-pump coronary artery by-pass grafting with tranexamic acid: clinical implications
Authors: Mazur Piotr , Ząbczyk Michał , Khan Imran , Litwinowicz Radosław , Iwaniec Teresa , Kędziora Anna , Kapelak Bogusław , Natorska Joanna 
Published: November 2020

Coronary artery bypass grafting (CABG) done on-pump may cause a significant blood loss. Low fibrinogen is associated with perioperative bleeding. The influence of cardiopulmonary bypass on fibrin clot properties is poorly investigated. We studied 55 patients with isolated coronary artery disease on aspirin undergoing on-pump CABG with tranexamic acid. Fibrinogen levels, fibrinolytic capacity expressed as clot lysis time (CLT), thrombin generation potential and platelet count were assessed before and after the surgery (prior to admission to the intensive care unit). A postoperative drop in haemoglobin (–30% from baseline), haematocrit (–31% from baseline) and platelet count (–42% from baseline) was observed (all, P < 0.0001). Postoperative fibrinogen level was lower by 57%, compared with preoperative value (1.5 [1.3–1.8] vs. 3.5 [2.8–3.9] g/l, P < 0.0001). Postoperative CLT was longer by 48 min, compared with preoperative (182 [170–218] vs. 134 [122–165] min, P < 0.0001). Thrombin generation was impaired postoperatively: both lag time and time to peak thrombin were prolonged by 44 and 45%, respectively, whereas endogenous thrombin potential and peak thrombin generation decreased by 45 and 78%, respectively (all P < 0.0001). Median postoperative drainage at 12 h was 400 [290–570] ml. Predictors of blood loss at 12 h identified in multivariable linear regression model adjusted for sex and preoperative fibrinogen level were: BMI (b
= –23.4, P
= 0.048) and postoperative CLT (b
= –2.4, P
= 0.042). Despite decreased fibrinogen levels after on-pump CABG with tranexamic acid, fibrin clot susceptibility to lysis is impaired, as reflected by prolonged CLT. Postoperative CLT is associated with mediastinal drainage at 12 h.