bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Sleep Deprivation Does Not Adversely Affect Arterial Stiffness, Wave Reflection and Aortic Pressure in Young Healthy Men
Authors: Lapierre Stephanie , Holmer Brady J , Lim Jisok , Sakarya Yasemin , New William , Eagle Michael , Hwang Chueh‐Lung , Schwartz Cody , Bhattal Gurjaspreet , Maharrey Phillip , Handberg Eileen M , Christou Demetra D , Alviar Carlos L 
Published: April 2020

Sleep deprivation is a common problem and may contribute to increased risk for development of cardiovascular disease. The influence of sleep deprivation on arterial stiffness, wave reflection and aortic pressure, independent predictors of cardiovascular disease, has not been fully elucidated. Therefore, the purpose of this study was to investigate the acute effects of total sleep deprivation (TSD) on arterial stiffness, wave reflection and aortic pressure in young healthy men. Twelve participants (22 ± 1 yrs, means ± SE) completed this study. Participants were free of clinical disease and sleep disorders, and did not use tobacco products, or take medications. Arterial stiffness (carotid to femoral pulse wave velocity; cfPWV), wave reflection (aortic augmentation index; AIx), and aortic blood pressures (systolic and diastolic blood pressure; aoSBP and aoDBP, and pulse pressure aoPP) were assessed using a validated cuff‐based device (SphygmoCor XCEL, AtCor Medical). Measures were obtained at the same time in the morning following a night of regular sleep (CON) and a night of TSD. During TSD, participants rested quietly under supervision and abstained from caffeine for ≥20 hrs. The average duration of sleep deprivation was 26.3 ± 1.3 hrs. In response to TSD, cfPWV did not significantly change (6.6 ± 0.2 vs. 6.4 ± 0.2 m·s−1; CON vs. TSD; P = 0.1). Aortic pressures (aoSBP: 104 ± 2 vs. 105 ± 2 mmHg; aoDBP: 69 ± 2 vs. 71 ± 3 mmHg; and aoPP: 34 ± 2 vs. 34 ± 1 mmHg; P≥0.5) and AIx also remained unchanged in response to TSD (9 ± 3 vs. 5 ± 2 %; P = 0.1). In conclusion, TSD does not adversely affect arterial stiffness, wave reflection or aortic pressure in young healthy men. Future investigations should explore the influence of TSD in populations at high risk for developing cardiovascular disease.Support or Funding InformationThis work was supported by the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Endothelial Estrogen Receptor α/β Protein Ratio is Associated with Circulating Estrogen Levels in Healthy Women
Authors: Park Young‐Min , Keller Amy C , Runchey Shauna S , Brubaker Ashley , Hildreth Kerry L , Moreau Kerrie L 
Published: April 2020

OBJECTIVEVascular aging, featuring endothelial dysfunction, precedes an increased risk of cardiovascular disease (CVD). The menopause transition (i.e., perimenopause) is characterized by changes in ovarian hormone and vascular health. We previously reported a decline in endothelial function that was correlated with lower estradiol (E2) and estrone levels. Biological effects of E2 on endothelial function are mediated via estrogen receptors (ER). We determined whether ER α and β activation (i.e. nuclear translocation) and the ER α/β ratio in endothelial cell (EC)s differed by menopause stages and whether they were associated with reduced endothelial function across menopause stages.METHODSEC samples were harvested from 67 healthy, fasted women (aged 30–70 years) classified as premenopausal (Pre; regular menstrual cycles; n=15, 33±6yrs; mean±SD), early perimenopausal (EPeri; > 2 cycles with cycle length changes of ≥7 days; n=15, 49±3yrs), late perimenopausal (LPeri; ≥2 but <12 months of amenorrhea; n=17, 49±4yrs), or postmenopausal (Post; n=20, 56±5yrs). ECs were analyzed for whole cell and nuclear ER α and β protein content by immunofluorescence. Endothelial‐dependent vasodilation was measured by brachial artery flow‐mediated dilation (FMD) using ultrasound.RESULTSERα nuclear/cell protein ratio (a surrogate marker of nuclear translocation) was lower (p<0.01) in EPeri compared to other menopause stages; ERβ nuclear/cell protein ratio showed a similar trend (p=0.07). ER α/β protein ratio in whole cell showed no difference across stages, but was correlated with serum E2 (r=0.30, p=0.08) and estrone (r=0.38, p=0.03) across menopause stages. FMD was not correlated with any ER protein data.CONCLUSIONThe menopause transition, specifically the early perimenopausal period, may be a vulnerable period for the decline of endothelial ER α and β activation; however, we failed to show any correlation between endothelial function and ER protein content. Whether the decline in endothelial ER function/activity contributes to vascular dysfunction warrants further study.Support or Funding InformationNIH R01AG049762, R01AG027678, R56HL114073, P30DK048520, P50HD073063, NCATS Colorado CTSA UL1TR001082, and Eastern Colorado VA GRECCThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Precision medicine in cow's milk allergy
Authors: D’Auria Enza , Venter Carina 
Published: April 2020

Purpose of review
The aim of this review is to describe the role of precision medicine in the diagnosis, treatment, and monitoring of cow's milk allergy.

Recent findings
The development of ‘omics’ sciences in the field of food allergy has led to a better understanding of the allergenicity of cow's milk proteins and significant advances in the knowledge of the pathogenesis and mechanisms of cow's milk allergy. Omics-based technologies allow the practitioner to better differentiate cow's milk allergy subtypes and to predict cow's milk allergy (CMA) persistence over time. Precision medicine extends the role of the oral food challenge, to determine the individual's threshold doses, and to establish tolerance to baked milk products. Other than symptom relief, dietary strategies are currently being investigated for the potential to induce tolerance. Oral immunotherapy offers a treatment option for patients with severe and persistent IgE-mediated CMA. Individual baseline-immune profiles may be predictive of cow's milk oral immunotherapy safety and efficacy.
Patient data derived from current technology, in combination with the patient's history, can be translated into treatments targeted at patient-tailored interventions.

Summary
The identification of novel biomarkers may improve diagnostic accuracy and also predict patient responsiveness to treatments. Integration of patient data will become increasingly important as omics technologies become more widely used in the clinical setting.
Microbiota in non-IgE-mediated food allergy
Authors: Mennini Maurizio , Fierro Vincenzo , Di Nardo Giovanni , Pecora Valentina , Fiocchi Alessandro 
Published: April 2020

Purpose of review
To perform a nonsystematic review of the literature on the microbiota in the different types of non-IgE-mediated food allergy.

Recent findings
The commonest non-IgE-mediated disorders managed by allergists include: eosinophilic esophagitis, food protein-induced enteropathy, food protein-induced enterocolitis syndrome, and food protein-induced allergic proctocolitis. The review of the literature describes how at phylum level we observe an increase of Proteobacteria in eosinophilic esophagitis esophageal microbiota and in food protein-induced enterocolitis syndrome, and food protein-induced allergic proctocolitis gut microbiota, while we observe an increase of Bacteroidetes in healthy controls. Several studies endorse the concept that a bloom of Proteobacteria in the gut reflects dysbiosis or an unstable gut microbial community structure. In several studies, the type of diet, the use of probiotics and in a single experience the use of fecal microbiota transplantation has produced significant variations of the microbiota.

Summary
Genetic factors alone cannot account for the rapid rise in food allergy prevalence and the microbiome might be contributing to allergy risk. Our review showed that common features of the pathological microbiota among different types of non-IgE-mediated food allergy can be identified. These evidences suggest a possible role of the microbiota in the pathogenesis and non-IgE-mediated food allergies and the need to understand the effects of its modulation on the disorders themselves.
Expert Consensus for a Principle-based Classification for Treatment of Diaphyseal Pediatric Femur Fractures
Authors: Weltsch Daniel , Baldwin Keith D. , Talwar Divya , Flynn John M. 
Published: April 2020

Introduction:
Recent studies demonstrate considerable deviation from the American Academy of Orthopaedic Surgeons (AAOS) evidence-based guidelines for the treatment of pediatric diaphyseal femur fractures (PDFFs). This study aimed to determine if expert-consensus can be reached on a principle-based classification to be applied broadly to a wide variety of PDFF scenarios and if outcomes correspond to adherence to the classification.

Methods:
A 2-stage study was performed. First, a survey of experts using a principle-based approach to PDFF. We conducted a survey of 17 thought-leaders (criteria≥20 y’ experience+authors of the seminal pediatric femur fracture studies) who were asked to classify 15 cases of PDFF using the principle-based classification for agreement. Next, we conducted a retrospective review of 289 consecutive PDFF treated (2011-2015) at a level 1 pediatric trauma center. For each case, we compared the actual treatment and proposed “ideal” principle-based classification. We then compared clinical results and outcome data points including the length of stay, physician visits, and hospital charge data.

Results:
A substantial (κ=0.7) expert-agreement was noted for assigning treatment principles with near-perfect (κ=0.93) agreement on conservative versus surgical management. We obtained agreement on employing a flexible implant (κ=0.84) rigid fixation (κ=0.75) and damage control philosophy (κ=0.64). Suboptimal clinical results were noted in 43% of the undertreated patients (24/56), 18.8% of the adequately treated, and 14.3% of overtreated (P<0.01) patients. An increasing trend for the length of hospital stay and a number of clinic visits was noted as the treatment class increased (P<0.01). Charges were 4.2 times higher for an episode of operative versus nonoperative care (P<0.01). Rigid fixation (class 4) had significantly (P=0.01) higher total and material charges than flexible fixation (class 3).

Discussion:
The proposed classification has a substantial agreement among thought-leaders. Clinical results demonstrated significantly more suboptimal results in undertreated fractures, compared with ideally treated or more invasively treated fractures. More invasive treatments led to increased burden to families and the system in terms of length of stay and hospital charges.

Level of Evidence:
Level III.
Are Preoperative PHQ-9 Scores Predictive of Postoperative Outcomes Following Anterior Cervical Discectomy and Fusion?
Authors: Jenkins Nathaniel W. , Parrish James M. , Yoo Joon S. , Patel Dillon S. , Hrynewycz Nadia M. , Brundage Thomas S. , Singh Kern 
Published: April 2020

Study Design:
This is a retrospective study.

Objective:
The objective of this study was to determine if there is an association between preoperative depression, as quantified by Patient Health Questionnaire-9 (PHQ-9), and postoperative improvement in pain and disability after anterior cervical discectomy and fusion (ACDF).

Summary of Background Data:
Few studies have quantified depression symptoms in the preoperative period using PHQ-9 and have tracked patient-reported outcomes (PROs) following ACDF.

Methods:
Patients undergoing ACDF were retrospectively reviewed and stratified by their preoperative PHQ-9 score. PROs, including Neck Disability Index (NDI), Visual Analogue Scale (VAS) neck and arm pain, and 12-Item Short Form (SF-12) Physical Component Score (PCS), were measured preoperatively and at 6-week, 3-month, 6-month, and 1-year postoperatively. PRO scores were analyzed amongst PHQ-9 cohorts using multiple linear regression. Achievement of minimum clinically important difference (MCID) was compared using χ2 analysis.

Results:
Higher PHQ-9 scores were associated with increased preoperative NDI, VAS neck, and VAS arm scores and significantly lower SF-12 PCS scores preoperatively. Cohorts experienced similar VAS pain scores up to 1-year following surgery, except for VAS neck pain at 3 months when patients with greater depression symptoms had more pain. High PHQ-9 patients had higher NDI values at 6 weeks and 3-month marks but had similar NDI scores at 6 months and 1-year. Similarly, SF-12 PCS scores were lower for patients with a higher PHQ-9 score at 3 and 6 months, however, both groups had similar scores at 1-year follow-up. A greater percentage of the high PHQ-9 cohort achieved MCID for NDI, however, there were no differences in MCID achievement for VAS neck, VAS arm, or SF-12 PCS.

Conclusions:
Patients with worse preoperative mental health reported significantly greater preoperative disability and pain. However, both cohorts demonstrated similar clinical recovery at the 1-year follow-up. These findings suggest patients with worse preoperative mental health can expect significant improvements in PROs following surgery.
Comparison of IV Insulin Dosing Strategies for Hyperkalemia in the Emergency Department
Authors: Moussavi Kayvan , Nguyen Lani T. , Hua Henry , Fitter Scott 
Published: April 2020

Objectives:
The objectives of this study were to evaluate the safety and efficacy of insulin dosing of less than 10 units versus 10 units in patients receiving hyperkalemia treatment.

Design:
Retrospective single-center study.

Setting:
Emergency department at a large academic medical center in the United States.

Patients:
Seven hundred adults treated for hyperkalemia with IV regular insulin between April 1, 2013, and September 27, 2018.

Interventions:
Patients that received less than 10 units of insulin were compared to those that received 10 units of insulin.

Measurements and Main Results:
Patients treated with less than 10 units had significantly lower frequency of hypoglycemia (11.2% vs 17.6%; p = 0.008). Reduction in serum potassium was significantly more modest in size in patients treated with less than 10 units (mean reduction 0.94 ± 0.71 mMol/L) compared with patients treated with 10 units (mean reduction 1.11 ± 0.8 mMol/L; p = 0.008). There were no statistically significant differences between groups in time to hypoglycemia, nadir serum glucose, severe hypoglycemia (<40 mg/dL), dextrose requirements, use of concurrent agents for hyperkalemia, need for repeat insulin dosing, length of stay, or mortality.

Conclusions:
Patients treated for hyperkalemia with insulin doses less than 10 units had reduced frequency of hypoglycemia; however, potassium reduction post treatment was more modest in these patients. These findings suggest providers choosing to administer 10 units IV insulin should ensure patients have adequate monitoring for hypoglycemia.
Effect of Very Low-Dose Hydrocortisone on Shock Reversal in Patients With Septic Shock
Authors: Sbertoli Robert , Hu Zeyu , Henke Jonathan , Wu Eric , Santosh Shrihari , Osmon Stephen , Charbek Edward , Jamkhana Zafar , Santosh Sadashiv 
Published: April 2020

Objectives:
In patients with septic shock, hydrocortisone 200–400 mg/d has been shown to reverse shock compared with placebo. Lower doses of hydrocortisone have not previously been studied, and there are no previous studies comparing two different doses of hydrocortisone. At our institution, some clinicians routinely prescribe doses less than 200 mg/d. This study aims to compare the effect of lower doses of hydrocortisone to standard doses on shock reversal and adverse events in septic shock.

Design:
Retrospective cohort study.

Setting:
Single-center medical ICU.

Subjects:
Patients who received hydrocortisone for septic shock.

Interventions:
Electronic chart review.

Measurements and Main Results:
Patients were divided into low-dose hydrocortisone (75–150 mg/d) and standard-dose hydrocortisone (200–400 mg/d) cohorts based on initial prescribed hydrocortisone dose. Rates of shock reversal and adverse events in the two cohorts were compared. Two-hundred thirteen patients were included—41 in low-dose and 172 in standard-dose cohorts. Baseline characteristics including initial vasopressor requirement and Sequential Organ Failure Assessment scores were similar. Average rates of change in vasopressor needs, conditional hazard rate for vasopressor withdrawal, and cumulative probability for vasopressor withdrawal were all quantitatively similar for low-dose and standard-dose hydrocortisone. Insulin requirement (particularly in those with diabetes mellitus), blood glucose in those with diabetes mellitus, and frequency of secondary infections seemed to be lower in the low-dose hydrocortisone cohort. Mortality and other secondary outcomes were similar.

Conclusions:
In septic shock, hydrocortisone dosed 75–150 mg/d appears to reverse shock as effectively 200–400 mg/d and may cause a lower frequency of adverse events.
Long non-coding RNA small nucleolar RNA host gene 6 aggravates pancreatic cancer through upregulation of far upstream element binding protein 1 by sponging microRNA-26a-5p
Authors: Zhang Xing-Xing , Chen Hua , Li Hui-Ying , Chen Rui , He Lei , Yang Juan-Li , Xiao Lin-Lin , Chen Jin-Lian 
Published: April 2020

AbstractBackgroundPancreatic cancer (PC) is a highly deadly malignancy with few effective therapies. We aimed to unmask the role that long non-coding RNA small nucleolar RNA host gene 6 (SNHG6) plays in PC cells by targeting far upstream element binding protein 1 (FUBP1) via microRNA-26a-5p (miR-26a-5p).MethodsSNHG6expression was predicted by bioinformatics, followed by verification via reverse transcription quantitative polymerase chain reaction. Then, the interactions amongSNHG6,miR-26a-5p, andFUBP1were detected through online software analysis, dual luciferase reporter assay and RNA pull-down. After that, cells were treated with different small interfering RNAs and/or mimic to determine the interactions amongSNHG6,miR-26a-5p, andFUBP1and their roles in PC cells. Finally, the role ofSNHG6in tumor growthin vivowas evaluated by measuring the growth and weight of transplanted tumors in nude mice. At-test, one-way and two-way analysis of variance were used for data analysis.ResultsCompared with that in normal tissues,SNHG6was highly expressed in PC tissues (1.00 ± 0.05vs.1.56 ± 0.06,t = 16.03,P < 0.001). Compared with that in human pancreatic duct epithelial cells (HPDE6-C7),SNHG6showed the highest expression in PANC-1 cells (1.00 ± 0.06vs.3.87 ± 0.13,t = 34.72,P < 0.001) and the lowest expression in human pancreatic cancer cells (MIAPaCa-2) (1.00 ± 0.06vs.1.41 ± 0.07,t = 7.70,P = 0.0015). Compared with the levels in the si-negative control group,SNHG6(0.97 ± 0.05vs.0.21 ± 0.06,t = 16.85,P < 0.001), N-cadherin (0.74 ± 0.05vs. 0.41 ± 0.04,t = 8.93,P < 0.001), Vimentin (0.55 ± 0.04vs.0.25 ± 0.03,t = 10.39,P < 0.001), and β-catenin (0.62 ± 0.05vs.0.32 ± 0.03,t = 8.91,P < 0.001) were decreased, while E-cadherin (0.65 ± 0.06vs.1.36 ± 0.07,t = 13.34,P < 0.001) was increased afterSNHG6knockdown ormiR-26a-5poverexpression, accompanied by inhibited cell proliferation, migration, and invasion.SNHG6overexpression exerted the opposite effects.SNHG6upregulatedFUBP1expression by spongingmiR-26a-5p. SilencingSNHG6blocked the growth of PCin vivo.ConclusionSilencingSNHG6might ameliorate PC through inhibition ofFUBP1by spongingmiR-26a-5p, thus providing further supporting evidence for its use in PC treatment.
Evaluation of an Educational Intervention Utilizing Nurse “Champions” and Nurses' Documentation of Intensive Care Unit Delirium
Authors: DeForge Christine E. , Yip Natalie H. , Dzierba Amy L. , Ryan Patrick G. , Larson Elaine L. 
Published: April 2020

Background
Delirium is a common, underdetected problem that has short- and long-term negative sequelae for critically ill patients. Prompt and accurate delirium identification by nurses can ensure early intervention and treatment to help minimize adverse outcomes.

Objectives
To evaluate the relationship between an educational program and the accuracy of registered nurses' (RNs') documentation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), a delirium screening tool.

Methods
In a medical ICU at a tertiary academic medical center from September 2015 to March 2016, RNs were reinstructed on use of the CAM-ICU. Registered nurse assessment data were collected retrospectively for 12 months before and after intervention and were compared against the CAM-ICU algorithm using χ2 analysis.

Results
A total of 10 736 RN assessments in 1020 patients preintervention and 11 068 in 951 patients postintervention were evaluated. Overall RN accuracy improved from 78% to 80% (P = .054). The algorithm determined delirium to be present in 32% versus 30% of all patients preintervention and postintervention, respectively; there was no difference in rate of nurse detection of delirium preintervention and postintervention (54% vs 55%, not statistically significant). The percentage of “inappropriate unable to assess” ratings by nurses decreased from 42% to 37% postintervention (P < .05).

Conclusions
After a comprehensive training initiative, there was no significant improvement in CAM-ICU documentation and no improvements in patient delirium identification. Future quality improvement efforts should target reducing the number of assessments that RNs judge to be “unable to assess.” Clinical practice must evolve to routinely incorporate RN delirium assessments into the patient's plan of care.
Prediction models for cardiovascular disease risk in the hypertensive population: a systematic review
Authors: Cai Ruixue , Wu Xiaoli , Li Chuanbao , Chao Jianqian 
Published: April 2020

Objective:
The aim of this study was to identify, describe, and evaluate the available cardiovascular disease risk prediction models developed or validated in the hypertensive population.

Methods:
MEDLINE and the Web of Science were searched from database inception to March 2019, and all reference lists of included articles were reviewed.

Results:
A total of 4766 references were screened, of which 18 articles were included in the review, presenting 17 prediction models specifically developed for hypertensive populations and 25 external validations. Among the 17 prediction models, most were constructed based on randomized trials in Europe or North America to predict the risk of fatal or nonfatal cardiovascular events. The most common predictors were classic cardiovascular risk factors such as age, diabetes, sex, smoking, and SBP. Of the 17 models, only one model was externally validated. Among the 25 external validations, C-statistics ranged from 0.58 to 0.83, 0.56 to 0.75, and 0.64 to 0.78 for models developed in the hypertensive population, the general population and other specific populations, respectively. Most of the development studies and validation studies had an overall high risk of bias according to PROBAST.

Conclusion:
There are a certain number of cardiovascular risk prediction models in patients with hypertension. The risk of bias assessment showed several shortcomings in the methodological quality and reporting in both the development and validation studies. Most models developed in the hypertensive population have not been externally validated. Compared with models developed for the general population and other specific populations, models developed for the hypertensive population do not display a better performance when validated among patients with hypertension. Research is needed to validate and improve the existing cardiovascular disease risk prediction models in hypertensive populations rather than developing completely new models.