bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polygenic scores for dyslipidemia: the emerging genomic model of plasma lipoprotein trait inheritance
Authors: Trinder Mark , Brunham Liam R. 
Published: January 2021

Purpose of review
Contemporary polygenic scores, which summarize the cumulative contribution of millions of common single-nucleotide variants to a phenotypic trait, can have effects comparable to monogenic mutations. This review focuses on the emerging use of ‘genome-wide’ polygenic scores for plasma lipoproteins to define the etiology of clinical dyslipidemia, modify the severity of monogenic disease, and inform therapeutic options.

Recent findings
Polygenic scores for low-density lipoprotein cholesterol (LDL-C), triglycerides, and high-density lipoprotein cholesterol are associated with severe hypercholesterolemia, hypertriglyceridemia, or hypoalphalipoproteinemia, respectively. These polygenic scores for LDL-C or triglycerides associate with risk of incident coronary artery disease (CAD) independent of polygenic scores designed specifically for CAD and may identify individuals that benefit most from lipid-lowering medication. Additionally, the severity of hypercholesterolemia and CAD associated with familial hypercholesterolemia—a common monogenic disorder—is modified by these polygenic factors. The current focus of polygenic scores for dyslipidemia is to design predictive polygenic scores for diverse populations and determining how these polygenic scores could be implemented and standardized for use in the clinic.

Summary
Polygenic scores have shown early promise for the management of dyslipidemias, but several challenges need to be addressed before widespread clinical implementation to ensure that potential benefits are robust and reproducible, equitable, and cost-effective.
New insights into the indications for intestinal transplantation
Authors: Pironi Loris , Sasdelli Anna Simona 
Published: January 2021

Purpose of review
To discuss the new guidelines on the indications for intestinal transplantation (ITx) devised in 2019 by the Intestinal Rehabilitation and Transplant Association.

Recent findings
Early referral of patients with intestinal failure to expert intestinal rehabilitation/transplant centre is strongly recommended. Listing for a life-saving transplantation is recommended for intestinal failure-associated liver disease (IFALD) evolving to liver failure, invasive intra-abdominal desmoids, acute diffuse intestinal infarction with hepatic failure, re-transplant, and children with loss of at least three of the four upper central venous access sites or with high morbidity intestinal failure. Developments in ITx made the probability of posttransplant survival equal to that on home parenteral nutrition (HPN) and the QoL after successful ITx better than on HPN. However, for patients who have not an actual increased risk of death on HPN, the matter of preemptive listing for ITx is still controversial. For these patients, a careful case-by-case decision is recommended.

Summary
The new guidelines on ITx confirm the straight referral for ITx only for patients at actual risk of death on HPN. Improvements in ITx practice and results, advances in the severity classification of intestinal failure, monitoring of the evolution of IFALD, and measuring patients’ QoL are required for an immediate progression in the treatment of intestinal failure.
Minimizing radiation dose in management of stone disease: how to achieve ‘ALARA’
Authors: Miller David T. , Semins Michelle J. 
Published: January 2021

Purpose of review
Exposure to radiation is known to have adverse effects such as secondary malignancies. Patients with nephrolithiasis are exposed to radiation in the workup and treatment of their condition. Furthermore, exposure to radiation is often repeated due to the high recurrence rate of nephrolithiasis.

Recent findings
We discuss practices inside and outside of the operating room to strive to keep radiation exposure as low as reasonably achievable (ALARA) for patients being treated for nephrolithiasis. These efforts include reduced dose computed tomography scans, fluoroless surgical techniques and new alternative technologies.

Summary
Maintaining radiation exposure ALARA for our patients is increasingly practical. The urologist must make every effort to adhere to ALARA principles to protect patients from the stochastic effects of radiation.
Role of urinary biomarkers for diagnosis and prognosis of kidney stone disease
Authors: Brewin Anna , Sriprasad Sheshadri , Somani Bhaskar K. 
Published: January 2021

Purpose of review
Urinary biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and N-acetyl-B-D-glucosamindase (NAG) are recognised as being useful for the detection of kidney tubular damage but their role in the diagnosis and prognosis of kidney stone disease (KSD) is still unknown. To clarify this, we performed a systematic review of literature in accordance with Cochrane methodology from inception to September 2020.

Recent findings
Twelve studies were included and a variety of urinary biomarkers (KIM-1, NGAL, NAG, proteins/peptides, cytokines, CA19-9) were measured in a total of 998 patients with KSD. Despite some contradicting studies, majority of the biomarkers studied showed a significant rise in patients with KSD compared to healthy controls, with levels decreasing after their surgical management, noticed as early as 4 h postprocedure. There was limited evidence of correlation with stone burden and elevated levels were also associated with hydronephrosis and superimposed infections.

Summary
Urinary biomarkers could be used in the diagnosis, prognosis and stone-treatment response in patients with KSD. However, as novel indicators, they may not be reliable as the sole diagnostic or prognostic tool for KSD as they are readily confounded by other causes of kidney injury. Further studies are needed to determine their ability to separate KSD from other causes of obstructive uropathy and acute renal injury.
Failing to Fail When Disability Is a Factor
Authors: Neal-Boylan Leslie , Miller Michelle , Lussier-Duynstee Patricia 
Published: January 2021

Background
Nursing faculty may be reluctant to fail students for a variety of reasons. Faculty may fear being viewed as discriminatory when failing nursing students with disabilities.

Problem
Schools of nursing may still be using technical standards that are outdated and noncompliant with the Americans with Disabilities Act (ADA) to determine eligibility for admission and may confuse essential functions with academic expectations. Lack of faculty awareness of the ADA may make faculty reluctant to fail nursing students with disabilities.

Approach
All nursing students should be assessed based on whether—not how—they meet academic and clinical standards safely. Disability accommodations should not affect the standards that must be met.

Conclusions
Faculty should base decisions on whether to assign failing grades to students on factors unrelated to a disability. Technical standards, when written correctly, should clarify whether inability or disability contributed to failure. Policies regarding failing should be clear, equitable, and accessible.
Posttraumatic Stress Disorder and Persistent Somatic Symptoms During the COVID-19 Pandemic: The Role of Sense of Threat
Authors: Jowett Sally , Shevlin Mark , Hyland Philip , Karatzias Thanos 
Published: January 2021

ABSTRACT

Objective
Persistent somatic symptoms, such as pain and fatigue, have been referred to as somatization. Somatization is commonly associated with histories of trauma and posttraumatic stress disorder (PTSD). Although previous research has demonstrated that PTSD can predict somatic problems, there has been no examination of this at the level of PTSD symptom clusters and multidimensional assessment of somatic symptoms. We examined the association between the three International Classification of Disease (11th Edition) PTSD symptom clusters (reexperiencing in the here and now, avoidance, and sense of threat), measured in relation to the COVID-19 pandemic as the stressor, and somatic symptoms while statistically adjusting for confounding variables.

Methods
Participants were a nationally representative sample of 1041 adults from the general population of the Republic of Ireland. Physical health problems across the domains of pain, gastrointestinal, cardiopulmonary, and fatigue were assessed by the Patient Health Questionnaire, and PTSD symptoms were assessed using the International Trauma Questionnaire.

Results
Sense of threat was associated with the presence of pain (β = 0.254), fatigue (β = 0.332), gastrointestinal (β = 0.234), and cardiovascular symptoms (β = 0.239). Avoidance was associated with pain (β = 0.347). Reexperiencing was not associated with any physical health variable.

Conclusions
In the context of COVID-19, the sense of threat symptoms in PTSD is most strongly related to somatic problems. Findings suggest that interventions addressing sense of threat symptoms might provide relief from somatization.
The Relationship Between Disproportionate Social Support and Metabolic and Inflammatory Markers: Moderating Role of Socioeconomic Context
Authors: Austin Makeda K. , Drage Jane N. , Dezil Johanna , Siliezar Rebekah , Chen Edith 
Published: January 2021

ABSTRACT

Objective
The present study examines the association of disproportionate social support (the relative balance of support given versus received) on metabolic and inflammatory outcomes and whether effects vary by socioeconomic context.

Methods
We enrolled a sample of 307 parental caregivers living with a child with a chronic illness. Parents were assessed on four dimensions of social support: emotional support received, instrumental support received, emotional support given, and instrumental support given. Disproportionate social support was calculated as the difference between support received and support given. Participants provided sociodemographic information, were interviewed about financial stress, and were assessed on metabolic (systolic blood pressure, diastolic blood pressure, total cholesterol, body fat percent, and body mass index) and inflammatory (interleukin 6 and C-reactive protein) outcomes.

Results
More disproportionate instrumental and emotional support was associated with higher inflammation (b = 0.10, SE = 0.04, p = .014; b = 0.0.09, SE = 0.05, p = .042, respectively). We observed significant interactions between disproportionate social support and income (b = −0.04, SE = 0.02, p = .021). Parents from lower-income households who gave more emotional support than they received had higher inflammation compared with those from higher-income households. We also observed a significant interaction between disproportionate instrumental support and income (b = 0.04, SE = 0.02, p = .006). Parents from lower-income households who received more instrumental support than they gave had worse metabolic outcomes compared with parents from higher-income households. Parallel interaction patterns were observed using an interview-based measure of financial stress.

Conclusions
These findings show that disproportionate social support has implications for physical health, particularly for caregivers from socioeconomically disadvantaged households.
The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis
Authors: Brown Lydia , Rando Alora A. , Eichel Kristina , Van Dam Nicholas T. , Celano Christopher M. , Huffman Jeff C. , Morris Meg E. 
Published: January 2021

ABSTRACT

Objective
Heart rate variability (HRV) is a marker of autonomic nervous system function associated with both physical and mental health. Many studies have suggested that mindfulness and meditation-based interventions (MBIs) are associated with improvements in HRV, but findings are mixed, and to date, no comprehensive meta-analysis has synthesized results.

Methods
Systematic literature searches were conducted using PsycINFO, Embase, Medline, CINAHL, ERIC, and Scopus to identify randomized controlled trials (RCTs) investigating the effects of predominantly seated MBIs on resting-state vagally mediated HRV. Risk of bias was judged using the Cochrane Risk of Bias tool.

Results
Nineteen RCTs met the criteria for inclusion in the meta-analysis. Random-effects meta-analysis found that MBIs were not efficacious in increasing vagally mediated resting-state HRV relative to control conditions (Hedges g = 0.38, 95% confidence interval [CI] = −0.014 to 0.77). When removing an outlier (g = 3.22), the effect size was reduced, CI narrowed, and findings remained nonsignificant (g = 0.19, 95% CI = −0.02 to 0.39). High heterogeneity in results (I
2 = 89.12%) could not be explained by a priori–determined moderators including intervention duration, study setting, and control type.

Conclusions
There is currently insufficient evidence to indicate that MBIs lead to improvements in vagally mediated HRV over control conditions. Future large, well-designed RCTs with low risk of methodological bias could help add to the current evidence to elucidate any role MBIs might play in impacting HRV.
Individual Differences in Cross-System Physiological Activity at Rest and in Response to Acute Social Stress
Authors: Kupper Nina , Jankovic Marija , Kop Willem J. 
Published: January 2021

ABSTRACT

Objective
Individual differences in long-term cardiovascular disease risk are related to physiological responses to psychological stress. However, little is known about specific physiological response profiles in young adults that may set the stage for long-term increased cardiovascular disease risk. We investigated individual differences in profiles of resting cardiovascular physiology and stress reactivity, combining parasympathetic, sympathetic, and hemodynamic measures.

Methods
Participants (n = 744, 71% women, mean [standard deviation] age = 20.1 [2.4] years) underwent the Trier Social Stress Test, while blood pressure (systolic blood pressure, diastolic blood pressure), electrocardiograms (interbeat interval), and impedance cardiograms (preejection period, left ventricular ejection time) were recorded. Respiratory sinus arrhythmia was derived from the combination of the electrocardiogram and the impedance cardiogram. A three-step latent profile analysis (LPA) was performed on resting and reactivity values to derive clusters of individual physiological profiles. We also explored demographic and health behavioral correlates of the observed latent clusters.

Results
For resting physiology, LPA revealed five different resting physiology profiles, which were related to sex, usual physical activity levels, and body mass index. Five cardiovascular stress reactivity profiles were identified: a reciprocal/moderate stress response (Cr1; 29%), and clusters characterized by high blood pressure reactivity (Cr2: 22%), high vagal withdrawal (Cr3; 22%), autonomic coactivation (parasympathetic nervous system and sympathetic nervous system; Cr4; 13%), and overall high reactivity (Cr5; 12%). Men were more likely to belong to the high reactivity (Cr5) cluster, whereas women were more likely to have autonomic coactivation (Cr4).

Conclusions
We identified five cardiovascular physiological reactivity profiles, with individuals displaying generalized hyperreactivity, predominant vagal withdrawal, autonomic coactivation, or blood pressure–specific hyperreactivity. Longitudinal studies are needed to determine whether these profiles are useful in early detection of individuals at high risk for cardiovascular disease.
Personality and Headaches: Findings From Six Prospective Studies
Authors: Stephan Yannick , Sutin Angelina R. , Luchetti Martina , Canada Brice , Terracciano Antonio 
Published: January 2021

ABSTRACT

Objective
The present study examined the association between personality traits and concurrent and incident headaches.

Methods
Participants (n = 34,989), aged 16 to 107 years were from the Midlife in the United States study, the Midlife in Japan study, the Health and Retirement Study, the Wisconsin Longitudinal Study Graduate and Siblings samples, and the Longitudinal Internet Studies for the Social Sciences. Demographic factors, personality traits, and headaches were assessed at baseline. Headaches were assessed again 4 to almost 20 years later.

Results
Across the samples, higher neuroticism was related to a higher likelihood of concurrent (combined odd ratio = 1.41, 95% confidence interval [CI] = 1.28–1.55, p < .001) and incident (combined odd ratio = 1.28, 95% CI = 1.12–1.46, p < .001) headaches, whereas higher extraversion was associated with a lower likelihood of concurrent (combined odd ratio = 0.87, 95% CI = 0.84–0.89, p < .001) and incident (combined odd ratio = 0.90, 95% CI = 0.85–0.96, p = .001) headaches. Higher conscientiousness (combined odd ratio = 0.90, 95% CI = 0.86–0.94, p < .001) and openness (combined odd ratio = 0.95, 95% CI = 0.90–0.99, p = .025) were associated with a lower probability of reporting concurrent headaches. Agreeableness was unrelated to headaches. Sex was not a consistent moderator.

Conclusions
The present study provides robust evidence that neuroticism and introversion are risk factors for headaches in concurrent and prospective analyses across multiple cohorts.
Potential role of new-generation antibiotics in acute bacterial skin and skin structure infections
Authors: Giacobbe Daniele R. , Labate Laura , Vena Antonio , Bassetti Matteo 
Published: January 2021

Purpose of review
To summarize the available results of primary analyses from high-quality randomized studies of either recently approved or possible future agents for the treatment of acute bacterial skin and skin structure infections (ABSSSI).

Recent findings
In the last 2 decades, several novel agents have been approved for the treatment of ABSSSI, that are also active against methicillin-resistant Staphylococcus aureus (MRSA). In addition to already available agents, further molecules are in clinical development that could become available for treating ABSSSI in the forthcoming future.

Summary
The current and future availability of several new-generation antibiotics will allow to modulate therapeutic choices not only on efficacy but also on other relevant factors such as the combination of the drug safety profile and the comorbidities of any given patient, the expected adherence to outpatient therapy, and the possibilities of early discharge or avoiding hospitalization by means of oral formulations, early switch from intravenous to oral therapy, or single-dose administration of long-acting intravenous agents. With the advent of new-generation antibiotics, all these factors are becoming increasingly essential for tailoring treatment to individual patients in line with the principles of personalized medicine, and for optimizing the use of healthcare resources.
Novelty and nuance in the intensive care unit: new options to combat multidrug resistant pneumonia
Authors: Shorr Andrew F. , Zilberberg Marya D. 
Published: January 2021

Purpose of review
To describe the increasing burden of multidrug resistant (MDR) Gram-negative pathogens in severe pneumonia and to examine the clinical trials supporting a role for novel agents for the treatment of this infection.

Recent findings
MDR Gram-negative bacteria cause an increasing proportion of severe pneumonias. Although the epidemiology of resistance varies across the globe, all regions have seen an evolution in resistance, especially among Enterobacterales spp, Pseudomonas aeruginosa, and Acinetobacter bumannii. Fortunately, several clinical trials have established the role for multiple new antibiotics in pneumonia. Although these drugs all have different ranges of in vitro activity and potency, each helps to address the problem of MDR. These studies have varied based on the proportion of subjects undergoing mechanical ventilation and the comparator agents employed. Although all these trials have demonstrated noninferiority to the comparator, the mortality rates across the analyses ranged from <% to >20%. None of the recent investigations included immunocompromised subjects.

Summary
Multiple new agents exist for treating MDR Gram-negative pneumonia. These agents are not interchangeable. Thus, one must approach their adoption with a nuanced eye.
Molecular diagnostic methods for pneumonia: how can they be applied in practice?
Authors: Kerneis Solen , Visseaux Benoit , Armand-Lefevre Laurence , Timsit Jean-François 
Published: January 2021

Purpose of review
Pneumonia represents a major burden in clinical practice. A rapid etiological diagnosis is critical for optimizing the antibiotic use. Owing to the variety of possible pathogens and the time needed for bacterial cultures or usual polymerase chain reaction (PCR) assays, timely and precise diagnosis is a huge challenge. Several new rapid multiplex assays have been developed in the last decade to resolve these issues. This review aims to provide an overview of recent evidence on improvements and limitations of new rapid molecular assays for pneumonia.

Recent findings
Several rapid multiplex-PCR assays are commercially available for upper or lower respiratory tract samples, allowing detection of a wide range of respiratory viruses, bacteria, and, in some cases, of several antibiotic resistance genes. Clinical evaluations demonstrated their good correlation with gold-standard assays but their lack of exhaustiveness, especially for hospital-acquired pneumonia. Studies that evaluated their potential benefits on antibiotic use suffered from important weaknesses with conflicting and limited results.

Summary
New molecular assays may enable improvements in patient management and antibiotic use. Available studies highlight several benefits and the strong interrelations needed between microbiologists and physicians for their implementation and interpretation according to the clinical and epidemiological context.
Dravet syndrome
Authors: Lagae Lieven 
Published: January 2021

Purpose of review
This review will illustrate the electroclinical description of Dravet syndrome, highlighting the difficulty to understand the correlation between the SCN1A mutation and clinical characteristics, including the frequent comorbidities. Therefore, the efficacy of the new treatment options, which now become available, should not only focus on seizure frequency reduction but also on the long-term effects on these comorbidities, such as intellectual disability, motor and sleep problems.

Recent findings
Comprehensive guidelines for a more standardized treatment in children with Dravet syndrome have been published. First-line and second-line treatments actually include only a few antiseizure medications, such as valproate, clobazam, stiripentol, topiramate and bromide. Cannabidiol and fenfluramine were shown to be very effective drugs and will become standard second-line drugs in Dravet syndrome. There are preliminary data showing that both drugs also have a positive effect on quality of life and on cognitive functioning. Genetic treatments in Dravet syndrome most likely will dramatically change the natural course of this refractory epilepsy syndrome.

Summary
A better understanding of the full clinical picture is necessary to understand the potential value of new treatment options in Dravet syndrome. Treatment nowadays with the newer drugs becomes much more standardized and effective, and this will have a positive effect on long-term overall outcome.