bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute flywheel exercise does not impair the brachial artery vasodilation in healthy men of varying aerobic fitness
Authors: Zubac Damir , Obad Ante , Ivančev Vladimir , Valić Zoran 
Published: February 2021

BackgroundThe cardiovascular response to variable load exercise on a flywheel ergometer is still unknown.ObjectiveThis study examined the effects of flywheel exercise on cardiovascular response and brachial artery vasodilation capacity in healthy, active men.MethodsIn this cross-sectional study, nineteen men (20–57 years old) completed three laboratory visits, including a ramp exercise test to determine their maximal oxygen uptake JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic1/v/2023-09-27T234149Z/r/image-tiff max, and exercise intervention on a flywheel ergometer set at 0.075 kg·m2moment of inertia. After the ramp test cessation, all participants were allocated into aerobically untrained (n= 10) and trained (n= 9) groups. Throughout the flywheel exercise, cardiovascular demands were continuously monitored via Finapres, while a pre/postflow-mediated dilation (FMD) assessment was performed using ultrasound imaging.ResultsThere were no differences observed between the groups in their anthropometrics, age or resting brachial artery diameter, while the JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic2/v/2023-09-27T234149Z/r/image-tiff max was ~15% higher (P= 0.001) in trained compared to aerobically untrained group. The cardiovascular response to the flywheel exercise was similar between the groups, with peak mean arterial pressure and heart rate readings reaching ~160 mmHg and ~140 bpm, respectively. The flywheel exercise did not impair the FMD (%) response, which was comparable between the groups (P= 0.256). When these data were pooled, the regression analysis showed an inverse relationship among FMD (%), age (β = −0.936,P= 0.001) and JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic3/v/2023-09-27T234149Z/r/image-tiff max. (β = −0.359,P= 0.045).ConclusionAlthough aerobic fitness alone does not directly explain the FMD response to flywheel exercise, aerobically untrained individuals, as they get older, tend to have lower brachial artery FMD.
Investigation of Cushing’s and subclinical Cushing’s syndromes using adrenocortical scintigraphy
Authors: Okada Yukinori , Matsushita Shoichiro , Yamaguchi Keiichiro 
Published: February 2021

Objectives
This study assessed the factors related to the intake rate of adrenocortical scintigraphy in Cushing’s and subclinical Cushing’s syndromes, in addition to the methods for differentiating between the two.

Methods
Clinical findings, blood sampling, and adrenocortical scintigraphy collected at St. Marianna University School of Medicine from 1 January 2010 to 31 December 2019 were used to diagnose initial-onset Cushing’s syndrome and subclinical Cushing’s syndrome, and patients who underwent 131I-NP-59 adrenocortical scintigraphy were used as study subjects.

Results
A total of 24 (8 male and 16 female) patients were selected. Of them, 7 had Cushing’s syndrome and 17 had subclinical Cushing’s syndrome. A correlation coefficient of −0.474 (P = 0.026) was determined between the intake rate after 7 days and adrenocorticotropic hormone levels. Intake rates after 5 days were 0.51% and 0.31% for Cushing’s and subclinical Cushing’s syndromes, respectively, and were statistically significant (P = 0.03). Intake rates after 7 days were 0.47% and 0.30% for Cushing’s and subclinical Cushing’s syndromes, respectively, and were statistically significant (P = 0.04). Receiver operating characteristic analysis results of Cushing’s and subclinical Cushing’s syndromes for intake rates after 7 days were as follows: cutoff value, 0.248; area under curve, 0.769; and 95% confidence interval, 0.561–0.977.

Conclusion
There were differences in the intake rates of adrenocortical scintigraphy between the Cushing’s syndrome group and subclinical Cushing’s syndrome group, making it possible to differentiate between the two using the intake rate.
Delayed kidney transplantation in combined liver-kidney transplantation
Authors: Ekser Burcin , Goggins William C. 
Published: February 2021

Purpose of review
To review the impact of delayed kidney transplantation approach in combined (simultaneous) liver-kidney transplantation (CLKT).

Recent findings
CLKT offers a life-saving procedure for patients with both end-stage liver disease and chronic kidney disease or prolonged acute kidney injury. It is the most common multiorgan transplant procedure in the US accounting for 9–10% of all liver transplants performed. The number of CLKT has also been increasing in other countries with a better understanding of hepato-renal syndrome. US is the only country which implemented a national allocation policy for CLKT in 2017. Due to the different physiological needs of liver and kidney allografts immediately after transplantation, delayed kidney transplantation approach in CLKT has been introduced for the first time by the Indiana Group, naming it as ‘the Indiana Approach’. Over the years, many other groups in the US and in Europe published better outcomes in CLKT using the delayed kidney transplantation approach with the support of hypothermic machine perfusion.

Summary
Several groups have shown that delayed kidney transplantation in CLKT is a safe procedure with better outcomes in graft(s) and patient survival.
I Wouldn't Let it Get to Me
Authors: Dove-Medows Emily , Thompson Lucy , McCracken Lindsey , Kavanaugh Karen , Misra Dawn P. , Giurgescu Carmen 
Published: February 2021

Abstract

Purpose:
Non-Hispanic Black women in the United States experience disproportionately higher rates of adverse birth outcomes including preterm birth and low birth weight infants compared with White women. Racial discrimination has been associated with these adverse outcomes. However, not all Black women experience discrimination in the same way. The majority of studies that report on the relationship between racial discrimination and maternal health have used quantitative methods that may present a monolithic understanding of this relationship. Qualitative methods, specifically those that incorporate intersectionality, may illuminate the nuances in pregnant Black women's experiences of discrimination. We present a qualitative analysis of Black women's experiences of racial discrimination and pregnancy to shed light on some of these complexities.

Study Design and Methods:
Qualitative interviews that addressed racial discrimination and pregnancy were conducted as part of a larger study of pregnant Black women that examined social support, neighborhood disorder, and racial discrimination. Interviews were coded for descriptions of racial discrimination and within and across case analysis was conducted.

Results:
Women described varying experiences of racial discrimination in different contexts. Shielding emerged as a recurring theme in women's accounts of dealing with racial discrimination during pregnancy.

Clinical Implications:
Nurses engaged in maternity care need an understanding of how pregnant Black women experience racial discrimination in different ways. Black women may be likely to take personal responsibility for managing discrimination-related stress in pregnancy as a consequence of direct experiences of discrimination. Nurses can support pregnant Black women by recognizing varied experiences of racial discrimination, and by not blaming them for experiences or potential resultant outcomes.
Sudden Unexpected Postnatal Collapse Resulting in Newborn Death in the United States
Authors: Anderson Tatiana M. , Ferres Juan M. Lavista , Ramirez Jan-Marino , Mitchell Edwin A. 
Published: February 2021

Abstract

Background:
The sudden collapse of an apparently healthy newborn, or sudden unexpected postnatal collapse (SUPC) is fatal in about half of cases. Epidemiological characteristics of sudden unexpected infant death (SUID) in the first week of life differ from those in the postperinatal age group (7-365 days).

Aim:
To describe the characteristics of SUPC resulting in neonatal death.

Methods:
We analyzed the Centers for Disease Control and Prevention Birth Cohort Linked Birth/Infant Death Data Set (2003-2013: 41,125,233 births and 37,624 SUIDs). SUPC was defined as infants born ≥35 weeks gestational age, with a 5-minute Apgar score of ≥7, who died suddenly and unexpectedly in the first week of life.

Results:
Of the 37,624 deaths categorized as SUID during the study period, 616 met the SUPC criteria (1.5/100,000 live births). Eleven percent occurred on the first day of life and nearly three quarters occurred during postnatal days 3-6. SUPC deaths differed statistically from SUID deaths occurring 7-364 days of age, in particular for sex, marital status, and live birth order.

Implications:
These data support the need for adequate nurse staffing during the immediate recovery period and for the entire postpartum stay as well as nurse rounding for new mothers in the hospital setting.
Maternal Sepsis
Authors: Sundin Courtney Stanley , Rigg Kendall , Ellis Kathleen Kistner 
Published: February 2021

Abstract

Purpose:
The current adult definition of sepsis and septic shock, as developed in 1992, does not adequately define sepsis in the pregnant and peripartum women due to the alteration of sepsis presentation in the maternal population. The purpose of this study was to determine potential causative factors for sepsis with the aim of prevention and reducing morbidity and mortality.

Study Design and Methods:
A descriptive observational design via a retrospective medical record review was used with a convenience sample of 22 women who were identified after admission as having sepsis. The setting was the labor and delivery unit of a large urban hospital in Fort Worth, Texas, with over 5,000 births per year.

Results:
The most common diagnoses related to maternal sepsis included urinary tract infections, endometritis, chorioamnionitis, and wound infections. Main causative agents identified were predominantly Escherichia coli (E. coli), followed by group B streptococcus (GBS), and group A streptococcus (group A strep). The most prevalent presenting symptom was hypothermia or hyperthermia, followed by tachycardia. Primary laboratory results included above and below normal white blood cell count and elevated lactate levels. Sixty-four percent of patients diagnosed with sepsis were readmitted postpartum and 41% gave birth via cesarean.

Clinical Implications:
Findings are applicable for nursing care and maternal sepsis protocol development. Early identification of mothers at risk for maternal sepsis and tool development for early diagnosis would be beneficial to support the ongoing work on decreasing maternal morbidity and mortality that have a devastating effect on women, their families, and their health care team. Early warning signs of sepsis can be shared by nurses with new mothers and their families as part of routine postpartum discharge teaching so they know when to call their primary health care provider and when to seek care in person.
Intrapartum and Postpartum Management of Intra-amniotic Infection
Authors: Ryan Emma S. , Varvoutis Megan , Kuller Jeffrey A. , Dotters-Katz Sarah 
Published: February 2021

Importance
Intra-amniotic infection (IAI) is a common condition with potentially devastating maternal and neonatal complications. However, there are incomplete data regarding the most effective antimicrobial treatment regimen for this condition.

Objective
This article aims to review the current evidence and recommendations for intrapartum and postpartum management of IAI.

Evidence Acquisition
Original research articles, review articles, and guidelines on IAI were reviewed.

Results
Numerous known risk factors for IAI exist, some of which are modifiable. Serious neonatal complications can result from exposure to IAI including increased risk of preterm birth and neonatal death. Possible maternal complications include increased risk of cesarean delivery, postpartum hemorrhage, and postpartum endometritis. Antibiotics are the mainstay of treatment for IAI for both mothers and neonates, although there is no consensus on which antimicrobial agents are best and the appropriate duration of therapy.

Conclusions and Relevance
Monitoring patients for signs of IAI, proper treatment, and communication of the diagnosis with the pediatric team are essential for preventing maternal and neonatal complications of IAI. More research is needed to determine the proper treatment regimens for both mothers diagnosed with IAI and their neonates.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After participating in this activity, the provider should be better able to assess the etiology, risk factors, and current guidelines for diagnosis of IAI; describe the maternal and neonatal complications of IAI; and outline the current recommendations for management of IAI in the intrapartum and postpartum periods.
Prevalence of and Risk Factors for Oral Human Papillomavirus Infection With Multiple Genotypes in the United States
Authors: Bui Thanh Cong , Tran Ly Thi-Hai , Thai Thuy Nhu , Shete Sanjay S. , Vidrine Damon J. , Sturgis Erich M. 
Published: February 2021

Background
This study investigated the prevalence of and risk factors for oral human papillomavirus (HPV) infection with multiple genotypes in the United States.

Methods
Data were from the nationally representative 2009–2012 National Health and Nutrition Examination Survey. This analysis comprised 9257 participants for whom data on oral HPV (37 genotypes) and associated risk factors were available.

Results
The weighted prevalence of multitype (2–6 types) oral HPV infection was 1.5% (2.5% for men, 0.4% for women) in the whole sample and 19.7% (22.0% for men, 12.1% for women) in those who had any type of oral HPV positivity. Most multitype oral HPV cases (83.8%) harbored one or more oncogenic types. In the adjusted multinominal logistic regression model, being male (relative risk ratio [RRR] = 3.69; 95% confidence interval [CI], 1.57–8.65), being a current cigarette smoker (RRR = 2.57; 95% CI, 1.23–5.36), and having a new sex partner in the past year (RRR = 2.10; 95% CI, 1.03–4.28) were associated with an increased risk of multitype oral HPV infection over single-type HPV infection.

Conclusions
Men, smokers, and those who had new sexual partners were at a significantly higher risk for multitype oral HPV infection.
Resistance to Ceftriaxone and Azithromycin in Neisseria gonorrhoeae Isolates From 7 Countries of South America and the Caribbean: 2010–2011
Authors: Thakur Sidharath Dev , Araya Pamela , Borthagaray Graciela , Galarza Patricia , Hernandez Alina Llop , Payares Daisy , Sanabria Cruz Olga Marina , Carvallo Maria Elena Trigoso , Corredor Aura Helena , Dillon Jo-Anne R. 
Published: February 2021

Abstract
Seven countries in Latin America and the Caribbean report on (2010 and 2011) the susceptibility of 2235 isolates of Neisseria gonorrhoeae to 6 antibiotics. Thirteen isolates had ceftriaxone minimum inhibitory concentrations (MICs) of 0.125 to ≥ 0.25 mg/L. The percentage of resistant isolates to the following antibiotics was: azithromycin, 1.0% to 1.7%; ciprofloxacin, 42.1% to 36.2%; penicillin, 31% to 35%; tetracycline, 21.8% to 22.6%.
Sudden Unexpected Death in a Child From Acute Myeloid Leukemia
Authors: Fenu Elena M. , O'Neill Stacey S. , Insuasti-Beltran Giovanni , Pettenati Mark J. , Giffen Mark , Harrison William T. 
Published: February 2021

Abstract
Acute myeloid leukemia can rarely cause sudden, unexpected death in children. Presentation may be non-specific and death may occur in children with no prior medical history. Herein we present the case of a previously healthy 2-year and 2 month-old White girl, who on autopsy, was found to have acute myeloid leukemia with KMT2A rearrangement extensively involving all major thoracic and abdominal organs. This case is presented to the forensic community to discuss the presentation and findings in sudden death caused by acute leukemia. The case highlights when acute leukemia should enter the differential as a potential cause of death, as well as potential resources available in the postmortem workup of acute leukemias.
Finding the Optimal Alternative for Immediate Hypersensitivity to Low-Osmolar Iodinated Contrast
Authors: Sohn Kyoung-Hee , Seo Jang-ho , Kang Dong-Yoon , Lee Suh-Young , Kang Hye-Ryun 
Published: February 2021

Objectives
Avoiding culprit agents is recommended for subjects who have had previous hypersensitivity reaction (HSR) to low-osmolar contrast media (LOCM). However, the guidelines for choosing optimal alternatives have not been determined. We investigated the outcomes of reexposure in patients with previous immediate HSRs to provide a safe option.

Materials and Methods
The outcomes of reexposure were assessed in a cohort with previous LOCM-associated HSR based on skin testing results and the presence of a common N-(2,3-dihydroxypropyl) carbamoyl side chain.

Results
Among 482 skin tests, 38.7% (31/80), 45.8% (99/216), and 64.0% (119/186) of mild, moderate, and severe index HSRs showed positivity to at least 1 LOCM, of which 62.8% showed positivity to at least 2 different LOCM. The overall recurrent HSRs were reduced from 43.8% upon reexposure to the culprit LOCM to 12.3% upon using nonculprit skin test negative LOCM (P = 0.004); those with severe index HSRs exhibited a significant reduction (11.3% vs 100%), but those with non-severe HSRs to LOCM did not. In subjects with severe index HSRs, the skin test cross-reactivity between LOCM was associated with sharing the common side chain (20.7% vs 11.5%, P = 0.003), and the recurrence rate of HSRs was effectively reduced by avoiding the common side chain (24.0% vs 7.8%, P = 0.039). However, these differences were not observed in those with non-severe index HSRs.

Conclusions
In patients who experienced a severe index HSR to LOCM, skin test negative LOCM without a common side chain could be suggested as an option for safe reexposure.
Short-term Effects of Canceled Elective Procedures Due to COVID-19
Authors: Tran Linda Diem , Rose Liam , Urech Tracy , Dalton Aaron , Wu Siqi , Vashi Anita A. 
Published: February 2021

Objective:
To determine whether delayed or canceled elective procedures due to COVID-19 resulted in higher rates of ED utilization and/or increased mortality.

Summary of Background Data:
On March 15, 2020, the VA issued a nationwide order to temporarily pause elective cases due to COVID-19. The effects of this disruption on patient outcomes are not yet known.

Methods:
This retrospective cohort study used data from the VA Corporate Data Warehouse. Surgical procedures canceled due to COVID-19 in 2020 (n = 3326) were matched to similar completed procedures in 2018 (n = 151,863) and 2019 (n = 146,582). Outcome measures included 30- and 90-day VA ED use and mortality in the period following the completed or canceled procedure. We used exact matching on surgical procedure category and nearest neighbor matching on patient characteristics, procedure year, and facility.

Results:
Patients with elective surgical procedures canceled due to COVID-19 were no more likely to have an ED visit in the 30- [Difference: –4.3% pts; 95% confidence interval (CI): –0.078, –0.007] and 90 days (–0.9% pts; 95% CI: –0.068, 0.05) following the expected case date. Patients with cancellations had no difference in 30- (Difference: 0.1% pts; 95% CI: –0.008, 0.01) and 90-day (Difference: –0.4% pts; 95% CI: –0.016, 0.009) mortality rates when compared to similar patients with similar procedures that were completed in previous years.

Conclusions:
The pause in elective surgical cases was not associated with short-term adverse outcomes in VA hospitals, suggesting appropriate surgical case triage and management. Further study will be essential to determine if the delayed cases were associated with longer-term effects.
Single-cell RNA sequencing reveals a novel cell type and immunotherapeutic targets in papillary thyroid cancer
Authors: Wang Zhengshi , Rixiati Youlutuziayi , Jiang Wenli , Ye Chen , Huang Caiguo , Tang Chuangang , Yin Zhiqiang , Jiao Binghua 
Published: February 2021

AbstractPapillary thyroid cancer (PTC) is the most common thyroid malignancy. Although PTC usually has a favorable prognosis, some aggressive PTC subtypes and lymph node (LN) metastasis contribute to high rates of recurrence and poor clinical outcomes. We analyzed single-cell RNA sequencing (scRNA-seq) data from 15 samples, including primary tumors of PTC, metastatic LNs, and paracancerous tissues. After quality filtering, 28,205 cells were detected. Of these, 13,390 cells originated from 7 tumor tissues, 2,869 cells from 2 metastatic LNs, and 11,945 cells from 6 paracancerous tissues. The increase in the proportion of CD4+ Tregs may be a key factor responsible for the immunosuppressive property of PTC. A novel cell type was identified, named Protective EGR1+CD4+ T cell, which might be antagonistic to the CD4+ Tregs and inhibit the formation of the immunosuppressive microenvironment and tumor immune evasion. Inhibitory checkpoints TIGIT and CD96 were found to be better targets than PD-1 for immune therapy in PTC patients with LN metastasis. For PTC patients without LN metastasis, however, PD-1, TIGIT, and CD96 could be suitable targets of immunotherapy. These findings would contribute to the further understanding of molecular mechanisms resulting in occurrence and development of PTC, and provide a theoretical rationale for targeted therapy and immunotherapy.
A prospective evaluation of the analytical performance of GENECUBE® HQ SARS-CoV-2 and GENECUBE® FLU A/B
Authors: Kiyasu Yoshihiko , Akashi Yusaku , Sugiyama Akio , Takeuchi Yuto , Notake Shigeyuki , Naito Asami , Nakamura Koji , Ishikawa Hiroichi , Suzuki Hiromichi 
Published: February 2021

AbstractBackgroundMolecular tests are the mainstay for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, their accessibility can be limited by the long examination time and inability to evaluate multiple samples at once. This study evaluated the analytical performance of the newly developed rapid molecular assays GENECUBE® HQ SARS-CoV-2 and the GENECUBE® FLU A/B.MethodThis prospective study was conducted between December 14, 2020, and January 9, 2021, at a polymerase chain reaction (PCR) center. Samples were collected from the nasopharynx with flocked swabs. Molecular tests were performed with the GENECUBE® system and reference reverse transcription (RT)-PCR, and the results of the two assays were compared.ResultAmong 1065 samples, 81 (7.6%) were positive for SARS-CoV-2 on the reference RT-PCR. Three showed discordance between GENECUBE® HQ SARS-CoV-2 and the reference RT-PCR; the total, positive and negative samples of concordance for the two assays were 99.7%, 100%, and 99.7%, respectively. All discordant cases were positive for GENECUBE® HQ SARS-CoV-2 and negative for the reference RT-PCR. SARS-CoV-2 was detected from all three samples by another molecular assay for SARS-CoV-2. For the GENECUBE® FLU A/B, the total, positive and negative samples of concordance for the two assays were 99.5%, 100%, and 99.1%.ConclusionThe GENECUBE® HQ SARS-CoV-2 and GENECUBE® FLU A/B demonstrated sufficient analytical performance to detect SARS-CoV-2 and influenza virus A/B.Key pointsWe prospectively evaluated the analytical performance of the newly developed rapid molecular assays GENECUBE® HQ SARS-CoV-2 and the GENECUBE® FLU A/B. The two assays showed >99% concordance rate compared with a reference PCR, which indicated their sufficient analytical performance to detect SARS-CoV-2 and influenza virus A/B.