bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peer Support as an Ideal Solution for Racial/Ethnic Disparities in Colorectal Cancer Screening: Evidence from a Systematic Review and Meta-analysis
Authors: Hu Jieman , Wu Yuanyu , Ji Fujian , Fang Xuedong , Chen Fangfang 
Published: March 2020

BACKGROUND:
Low implementation of colorectal cancer screening in ethnic minorities is the main reason for racial and ethnic disparities in colorectal cancer morbidity and mortality. Peer support is widely used for promoting health care in ethnic minorities. However, whether it improves their acceptance to undergo the screening remains controversial.

OBJECTIVE:
We performed a meta-analysis of the currently available studies to further explore its effectiveness.

DATA SOURCES:
This meta-analysis was undertaken using PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO for randomized controlled trials.

STUDY SELECTION:
We included studies that compared peer support interventions among ethnic minorities versus other interventions to promote uptake of colorectal cancer screening.

RESULTS:
Thirteen studies comprising 8090 participants met the eligibility criteria. Peer support intervention can increase colorectal cancer screening implementation and raise awareness and intention to undergo the screening in ethnic minorities more significantly than fecal occult blood test outreach, print, and usual care. Subgroup analysis showed that peer support intervention achieved great results in Asian Americans and intervention of peer counseling.

LIMITATIONS:
The results of subgroup analysis had substantial heterogeneity, which may decrease the precision of our estimates.

CONCLUSIONS:
Peer support can significantly improve the awareness about and the intention for receiving colorectal cancer screening in ethnic minorities and is an ideal choice for promoting the screening among ethnic minorities, particularly in a diverse community. Peer support intervention is recommended to promote the implementation of screening in Asian Americans. Peer counseling is worth promoting; however, church-based peer counseling programs require enhanced management to maintain their fidelity.
Chrysin Alleviates Monocrotaline-Induced Pulmonary Hypertension in Rats Through Regulation of Intracellular Calcium Homeostasis in Pulmonary Arterial Smooth Muscle Cells
Authors: Dong Fang , Zhang Jun , Chen Xiuqing , Zhang Suya , Zhu Licheng , Peng Yufei , Guo Zhiping 
Published: March 2020

Abstract:
Chrysin (CH) is the main ingredient of many medicinal plants. Our previous study showed that CH could suppress hypoxia-induced pulmonary arterial smooth muscle cells proliferation and alleviate chronic hypoxia-induced pulmonary hypertension by targeting store-operated Ca2+ entry (SOCE)-[Ca2+]i pathway. In this study, we investigated the effect of CH on monocrotaline-induced pulmonary hypertension (MCTPH) and the mechanism behind it. Results show that, in MCTPH model rats, (1) CH significantly reduced the enhancement of right ventricular pressure, right ventricular hypertrophy, and pulmonary vascular remodeling; (2) CH markedly suppressed the promotion of SOCE and [Ca2+]i in pulmonary arterial smooth muscle cells; and (3) CH obviously inhibited the MCT-upregulated proliferating cell nuclear antigen, TRPC1, TRPC4, and TRPC6 expression in distal pulmonary arteries. These results demonstrate that CH likely alleviates MCTPH by targeting TRPC1,4,6-SOCE-[Ca2+]i pathway.
Pillars of Hospital Preparedness in Radiation Emergency Management
Authors: Ghaedi Hossein , Nasiripour Amir Ashkan , Tabibi Seyed Jamaledin , Assadi Majid 
Published: March 2020

Abstract
Human beings have always suffered and have incurred irreparable damages from different disasters. The most logical way to deal with disaster is to be comprehensively prepared. In line with this, the readiness of hospitals in the vicinity of nuclear centers is of great importance, as this could lead to reduced injuries and damage. In this study, we aimed to develop a model by which hospitals could effectively react to nuclear incidents. This is a comparative study using library studies, including examining existing patterns, recommended policies and instructions of WHO and IEAE, and articles and documents of selected countries that have models for radiation disaster management. The primary developed model was discussed in expert panels and, ultimately, with some modifications, was finalized. The findings of the research indicated that the most important factors in the success of crisis management are skill in predicting a crisis and having a preparation plan for necessary measures at the time of an incident. Different countries have developed various approaches toward radiation incident management that are mostly focused on human resources, medical equipment, and physical space. The model plan developed here includes a two-part foundation with seven pillars. Intra- and intersectorial arrangements are considered as the foundation, and the pillars are physical structure, medical equipment, human resources, process and instructions, intra- and intrasectorial coordination, information systems, and organizational structure. Having an appropriate model for coping with radiation incidents is pivotal for hospitals active in areas with nuclear centers. Undoubtedly, existence of an effective and comprehensive model could reduce the consequences of radiation crises.
Decreasing Door-to-Groin Puncture Times in a Nonacademic Comprehensive Stroke Center
Authors: Hill Michelle , Roshon Kristen , Bladen Cassondra , Haley Everett , McClelland Jamie , Suter Megan 
Published: March 2020

ABSTRACT

BACKGROUND AND PURPOSE: Our organization was experiencing a delay in treatment of large vessel occlusions. With a goal of door-to-groin puncture in less than 90 minutes, our organization was averaging a door-to-groin puncture time of greater than 100 minutes and identified the need for a process change. METHODS: A multidisciplinary group was formed to process map current state and define future state. Lean methodology was used to implement rapid cycle change and create standard work. Because this was an improvement on a current process, institutional review board approval was not needed. RESULTS: The result was achieving door-to-groin puncture times less than 90 minutes and a subsequent decrease in door-to-groin puncture goal to less than 80 minutes. In addition, improved communication was seen between multiple departments responsible for the care of large vessel occlusion patients. CONCLUSION: Using Lean methodology with a multidisciplinary team is effective for implementing and sustaining process change.
Lung Function Decline in Farm and Nonfarm Rural Residents of Saskatchewan
Authors: Chu Luan M. , Karunanayake Chandima P. , Dosman James A. , Pahwa Punam 
Published: March 2020

Objective:
This study aims to assess the annual changes in lung function among farm and nonfarm adult residences in rural Saskatchewan, Canada.

Methods:
Data from the Saskatchewan Rural Health Study survey (2010 to 2014) among 724 adults were used.

Results:
For forced expiratory volume in 1 second (FEV1) measurements, estimates of annual decline (in milliliters) were highest in older age male (65+ years) (Mean, SD) (−42.63, 21.16); and among old heavy smokers (−57.79, 24.30). Estimates of annual decline in forced vital capacity (FVC) were highest in current smokers without the use of natural gas (−25.78, 14.78) and among old heavy smokers (−33.88, 20.28). Living on a farm is associated with decreased FEV1 and FVC, but not statistically significant by sex and age.

Conclusions:
A complex mix of personal and contextual factors may affect these estimates.
The Effect of Supramalleolar Orthotic Use on Activity and Participation Skills in Children with Down Syndrome
Authors: Looper Julia , Martin Kathy 
Published: March 2020

ABSTRACTIntroductionThis study aimed to determine if supramalleolar orthosis (SMO) use improved activity level skill and participation levels in children with Down syndrome (DS) who have been walking for at least 1 year.MethodsTwenty children with DS (aged 2–10 years) wore no orthoses for 4 weeks followed by SMOs for 4 weeks. At the initial visit, using goal attainment scaling (GAS), families determined two participation goals and expected outcomes. After both the no-orthoses and orthoses phases, goal attainment, Gross Motor Function Measure-Scale E, single-limb stance time, and shuttle run time were measured.ResultsSMO use led to improvements in Gross Motor Function Measure-Scale E (P= 0.01) and GAS scores (P≥ 0.001), as well as a time by condition interaction for shuttle run time (P= 0.049).ConclusionsThe use of SMOs led to improvements in activity level outcomes in family-selected participation goals.
Relationship between fragmented QRS complexes and ejection fraction recovery in anterior ST-segment elevation myocardial infarction patients undergoing thrombolytic treatment
Authors: Eren Hayati , Kaya Ülker , Öcal Lütfi , Gürbüz Ahmet Seyfeddin , Kalçik Macit , Abaci Adnan 
Published: March 2020

Background
Acute anterior ST-segment elevation myocardial infarction (STEMI) is a life-threatening disease. Adverse cardiac events of acute anterior STEMI include cardiovascular death or worsening congestive heart failure. This study investigated the role of fragmented QRS complex (fQRS) in predicting insufficient ejection fraction (EF) recovery in acute anterior STEMI.

Methods
Patients with acute anterior STEMI who received thrombolytic therapy were prospectively enrolled in this study. Twelve-lead electrocardiography (ECG) was obtained from all patients during admission and 24 and 48 h after admission. We divided the patients into two groups according to the presence of fQRS appearance within 48 h: absence of fQRS in any lead (fQRS−), and its presence in two or more contiguous leads (fQRS+). All patients were evaluated with transthoracic echocardiography at admission, and at follow-up 6 and 12 months later.

Results
A total of 138 consecutive patients were included in the study. Seventy-three patients (52.9%) had fQRS in the ECG. EF recovery in the fQRS(+) group was significantly lower than that of the fQRS(−) group (39% vs. 43.9%, P < 0.001). Multiple logistic regression analysis showed that the fQRS (odds ratio: 4.147, 95% confidence interval: 1.607–10.697, P = 0.003) were an independent predictor of poor EF recovery.

Conclusion
The presence of fQRS is an independent predictor for inadequate EF recovery in acute anterior STEMI patients undergoing thrombolytic treatment. Assessment of fQRS on surface ECG may be used in determining high-risk patients for poor EF recovery after acute anterior STEMI.
One-year clinical outcomes of coronary chronic total occlusion intervention in patients with acute coronary syndrome versus stable angina: from the Korean chronic total occlusion registry
Authors: Choi Jah Yeon , Choi Byoung Geol , Rha Seung-Woon , Mashaly Ahmed , Abdelshafi Kareem , Choi Cheol Ung , Yu Cheol Woong , Gwon Hyeon-Cheol , Chae In-Ho , Kim Hyo-Soo , Sik Park Hun , Lee Seung-Hwan , Kim Moo-Hyun , Hur Seung-Ho , Jang Yangsoo 
Published: March 2020

Background:
Chronic total occlusion intervention remains challenging and detailed real-world data on the safety and efficacy of which are limited. This study sought to determine whether there are differences in the 1-year clinical outcomes between chronic total occlusion patients with acute coronary syndrome and stable angina following chronic total occlusion intervention.

Patients and methods:
Data from the Korean chronic total occlusion registry were collected from May 2003 to September 2012, and a total of 3268 patients who underwent chronic total occlusion intervention were enrolled. Cardiovascular outcomes up to 12 months in the acute coronary syndrome group were compared with stable angina group.

Results:
The acute coronary syndrome group consisted of 1657 patients, and stable angina group consisted of 1264 patients. In the acute coronary syndrome group, patients with successful chronic total occlusion intervention had a lower incidence of total death and cardiac death compared to patients with failed intervention. However, there were no significant differences in cardiovascular events in the stable angina group. The successful chronic total occlusion intervention was a significant prognostic factor for lower total death (P = 0.006, hazard ratio = 0.46) and cardiac death (P = 0.003, hazard ratio = 0.36) within acute coronary syndrome group. On the other hand, successful chronic total occlusion intervention was not a prognostic factor for cardiovascular events within stable angina group.

Conclusions:
Successful chronic total occlusion intervention in acute coronary syndrome patients was associated with a lower incidence of cardiovascular outcome compared to patients with failed chronic total occlusion intervention.
Stop Blaming the Weatherman! A Retrospective Study of Endoscopy Show Rates at a Midwest Urban Safety-Net Hospital
Authors: Desai Aakash , Twohig Patrick , Waghray Abhijeet , Gonakoti Sripriya , Skeans Jacob , Waghray Nisheet , Sandhu Dalbir S. 
Published: March 2020

Background:
Weather patterns are well-known to affect human health and behavior and are often arbitrarily blamed for high no-show rates (NSRs). The NSR for outpatient gastrointestinal procedures ranges from 4% to 41% depending on the population and procedure performed. Identifying potential causes will allow for the optimization of endoscopy resource utilization.

Aim:
The aim of this study was to evaluate the effects of a day of the year and weather conditions have on NSRs for outpatient endoscopic procedures at a safety-net hospital in Cleveland, Ohio, United States.

Methods:
A 12-month, retrospective cohort study of the NSR for outpatient endoscopic procedures was performed using local weather data from January 1, 2017 to December 31, 2017. Data was assessed by analysis of variance/t test, and the χ2 test was used to analyze weather impact on NSR.

Results:
A total of 7935 patients had an average overall NSR of 11.8%. Average NSR for esophagogastroduodenoscopies (EGDs) were 9.9%, colonoscopies 12.3%, and advanced endoscopy procedures 11.1%. The NSR was highest in April (15.3%, P=0.01) and lowest in September (9.0%, P=0.04). There is a greater likelihood of procedural no-show for colonoscopies compared with EGDs when mean temperatures were at or below freezing (P=0.02) and with snowfall (P=0.03). NSR were also high for EGDs on federal holidays (25%, P=0.03) and colonoscopies on days following federal holidays (25.3%, P<0.01). Day of the week, wind speed, presence of precipitation, wind chill, the temperature change from the prior day, and temperature (high, low, and mean) had no significant impact on NSR.

Conclusions:
Our study demonstrates that scheduling adjustments on federal holidays, days when temperatures are below freezing, and snowfall may improve department resource utilization. These data, along with other variables that affect NSR for endoscopic procedures, should be taken into consideration when attempting to optimize scheduling and available resources in a safety-net hospital.
Accuracy of Noninvasive Fibrosis Scores to Detect Advanced Fibrosis in Patients With Type-2 Diabetes With Biopsy-proven Nonalcoholic Fatty Liver Disease
Authors: Singh Amandeep , Gosai Falgun , Siddiqui Mohamed T. , Gupta Mohit , Lopez Rocio , Lawitz Eric , Poordad Fred , Carey William , McCullough Arthur , Alkhouri Naim 
Published: March 2020

Background:
Recent guidelines have recommended screening for nonalcoholic fatty liver disease (NAFLD) and case finding of advanced disease with fibrosis in patients with type-2 diabetes (T2D). The aim of this study is to assess the accuracy of commonly used noninvasive scores to predict the presence of advanced fibrosis (AF) in a large cohort of diabetics in real-life settings.

Patients and Methods:
Using International Classification of Diseases, Ninth Revision (ICD-9) codes, all patients with the diagnosis of T2D who had a liver biopsy for suspected NAFLD between January 2000 and December 2015, were identified and analyzed. Patients with secondary causes of hepatic steatosis were excluded. AST/ALT ratio, aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4 (FIB-4) index, and Nonalcoholic fatty liver disease Fibrosis Score (NFS) were calculated to predict advanced disease. Sensitivity, specificity, and area under the receiver operator curve were calculated and compared with liver biopsies to predict the overall accuracy of each score.

Results:
A total of 1319 patients with T2D underwent liver biopsy for suspected NAFLD. After exclusions, 1,157 subjects were included in the final analysis. Our cohort consisted of 64.6% females and 88.4% were whites. Overall, 85% of the population was overweight or obese (body mass index>25 kg/m2). Liver biopsy showed 31.7% with AF [Nonalcoholic Steatohepatitis Clinical Research Network (NASH-CRN) stage 3 to 4]. In comparison to liver biopsy, for the diagnosis of AF, AST/ALT>1.4, APRI>1.5, FIB-4>2.67, and NFS>0.676 had reasonable specificities of 84.2%, 97.4%, 69.9%, and 93% but poor sensitivities of 27.4%, 16.5%, 6.7%, and 44.1%, respectively. Even at lower cutoff values of AST/ALT≥1, APRI≥1, and FIB-4≥1.45 sensitivities remained low at 60.7%, 27.9%, and 72.6%, respectively, except for NFS ≥−1.455 with sensitivity of 94.6%, but at this cutoff, its specificity decreased to 16.9%. The area under the receiver operator curve to detect AF was 0.62, 0.74, 0.77, and 0.72, respectively.

Conclusions:
In this large cohort of adult patients with T2D and NAFLD, commonly used fibrosis scores had reasonable specificity, but poor sensitivity for detecting AF in diabetics. The development of reliable biomarkers for NAFLD/NASH in diabetics is urgently needed.
Changes in Cortical Activation During Dual-Task Walking in Individuals With and Without Visual Vertigo
Authors: Hoppes Carrie W. , Huppert Theodore J. , Whitney Susan L. , Dunlap Pamela M. , DiSalvio Nikki L. , Alshebber Kefah M. , Furman Joseph M. , Kwon Yong H. , Rosso Andrea L. 
Published: March 2020

Background and Purpose:Persons with vestibular disorders are known to have slower gait speed with greater imbalance and veering during dual-task walking than healthy individuals, but the cerebral mechanisms are unknown. The purpose of this study was to determine whether individuals with visual vertigo (VV) have different cerebral activation during dual-task walking compared with control subjects.Methods:Fourteen individuals with VV and 14 healthy controls (CON) were included (mean 39 years old, 85% women). A cross-sectional experimental study consisting of 4 combinations of 2 surfaces (even and uneven) and 2 task conditions (single- and dual-task) was performed. Participants walked over an even (level flooring) or uneven (wood prisms underneath carpeting) surface, either quietly or while reciting every other letter of the alphabet. Changes in cerebral activation over the bilateral prefrontal cortices were recorded using functional near-infrared spectroscopy during 4 task conditions relative to quiet standing. Gait speed and cognitive performance were recorded.Results:There were no between-group differences in cognitive performance. Both groups slowed when walking on an uneven surface or performing a dual-task; participants in the VV group walked more slowly than those in the CON group in all conditions. Participants with VV had decreased cerebral activation in the bilateral prefrontal regions in comparison to CON participants in all conditions.Discussion and Conclusions:Participants with VV had lower prefrontal cortex activation than CON participants during dual-task walking. Lower cortical activity in those with VV may be due to shifted attention away from the cognitive task to prioritize maintenance of dynamic balance.Video Abstract availablefor more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A303).
Factors Associated With Early Resumption of Condomless Anal Sex Among Men Who Have Sex With Men After Rectal Chlamydia Treatment
Authors: Lau Andrew , Kong Fabian Y.S. , Fairley Christopher K. , Templeton David J. , Amin Janaki , Boyd Mark A. , Bradshaw Catriona , Chen Marcus Y. , Donovan Basil , Khaw Carole , Lewis David A. , McNulty Anna , Regan David G. , Ratnayake Mahesh , Hocking Jane S. 
Published: March 2020

Background
The resumption of sexual activity shortly after commencing treatment for sexually transmitted infections (STIs) is poorly described despite contributing to onward transmission. With azithromycin remaining an option for rectal Chlamydia trachomatis, resuming sex too early after treatment may contribute to antimicrobial resistance because of exposure of newly acquired STIs to subinhibitory concentrations.

Methods
Clinical and sexual behavioral data were collected from men participating in a trial assessing treatment efficacy for rectal chlamydia. Data were collected at recruitment and weekly for 3 weeks after commencing treatment. Outcome measures were resumption of any sexual activity or condomless receptive anal sex within 1, 2, or 3 weeks after commencing treatment. Generalized linear regression was used to calculate adjusted risk ratios (aRR) to identify associated factors.

Results
Almost 1 in 10 men (9.5%; 95% confidence interval [CI], 7.2–12.1) resumed condomless receptive anal sex within 1 week of commencing treatment. This was associated with current preexposure prophylaxis use (aRR, 3.4; 95% CI, 2.5–4.8]) and having 9 or more sexual partners in the last 3 months (aRR, 3.2; 95% CI, 1.6–5.0). Most men (75.0%; 95% CI, 71.3–78.5) resumed any sexual activity within 3 weeks; this was associated with a greater number of sexual partners (4–8 partners; aRR, 1.2; 95% CI, 1.1–1.5; ≥9 partners; aRR, 1.5; 95% CI, 1.3–1.7).

Conclusions
Resuming condomless receptive anal sex early after treatment may facilitate onward transmission and promote antimicrobial resistance for STIs. Although azithromycin remains a treatment option, this analysis highlights the need for new health promotion messages regarding early resumption of sex and continued surveillance for antimicrobial resistance.