bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Dietary Fatty Acids Intake and its Correlation with Body Fat Accumulation in Korean College Students
Authors: Bu So Young 
Published: June 2021

Recent findings indicated that rather than amount of energy consumption, type and compositional balance of energy‐deriving nutrients significantly contributes body fat accumulation and consequential diseases. This study was conducted to investigate the status of nutrition intake including fatty acids, lipids and lipid soluble nutrients between obese and lean college students and to analyze the relationship between intake of individual fatty acids from diet and body fat accumulation. Anthropometric assessment including BMI and body composition was performed and a 24hr dietary recall with questionnaires for dietary behaviors was collected for total of 114 Korean college students in Gyeongbuk area. As a result intake of total calorie and total lipids from daily diet were not significantly different between obese and lean subjects in both male and female students. However male obese subjects eat more plant lipids and palmitic acids (C16:0) from their diet (p<0.05) while female obese subjects consumed more linolenic acids (C18:3) compared to lean subjects (p<0.01). Correlation analysis revealed that the consumption of palmitoleic acid (C16:1) and lipid soluble Vitamin D were negatively (p<0.05) correlated with body fat accumulation in all subjects and these findings were supported by simple linear regression analyses for those variables. These results implicate that rather than only considering the amount of lipids, suggesting a proper type of lipids or lipid metabolites can be suggested in nutrition counseling or education.This study was financially supported by a 2013 start‐up grant for junior faculty from Daegu University.
Cardiac Hypertrophy in Obesity Model Induced by High Fat Diet: Participation of Immune System
Authors: Gasler Silva Fernanda , Christoffolete Marcelo , Carneiro Ramos Marcela 
Published: June 2021

AimAs the world population has become more sedentary more often have become obesity and diabetes mellitus, known risk factors for cardiovascular diseases leading to increased risk of sudden death. It is also well established that inflammatory factors play a role in obesity. The aims of this study are to investigate obesity related inflammatory mechanisms and their relationship to the development of cardiac hypertrophy.MethodsC57Bl/6 mice were divided in two groups, one group was fed with a high fat diet containing 23% of protein, 35,5% of carbohydrate and 35,9% of fat for 68 days, the other group was fed with a normal diet containing 19% of protein, 56% of carbohydrate, 3,5% of fat. Heart weight/tibia length was measured. Biometrics parameters and blood chemistry was analyzed in all animals. Gene expression analysis: Alfa‐actin, TLR2, TLR4 and gp130 were evaluated by Q‐PCR. Results were expressed as mean±SD.ResultsAs expected, High Fat animals showed higher weight gain than chow, about 7 times. mRNA levels of alfa‐actin, a hypertrophy marker was significant increased in high fat animals. Gp130 and TLR4 mRNA levels in cardiac tissue were modulated.ConclusionThese results show that our model was able to evoke obesity induced cardiac hypertrophy. Gene markers suggests a putative local immune system role mediating cardiac hypertrophy.Financial Support: FAPESP 2008/10175‐4, 2008/10700‐1.
Maximal and Submaximal Handgrip Exercise Stimulates Thrombocytosis
Authors: Walsh Jeremy , Bentley Robert , Tschakovsky Michael 
Published: June 2021

IntroductionBlood platelets sequester, store, and release a majority of blood‐borne brain‐derived neurotrophic factor (BDNF), which is a major orchestrator of exercise‐induced brain plasticity. Exercise involving large muscle mass transiently increases platelet and serum BDNF levels in an intensity‐dependent manner. During exercise, augmented sympathetic outflow causes splenic contractions, which increases platelet levels in the blood (exercise‐induced thrombocytosis). Interestingly, very brief (60 s) submaximal activation of small muscle mass induces splenic constriction and a 2% elevation in platelet levels. If small muscle exercise is sufficient enough of a stimulus to increase platelet levels, then by extension, it could stand as a viable strategy for increasing BDNF availability; however, the platelet response to dynamic handgrip exercise (HGEX) is currently unknown.PurposeTo examine the response of platelets following both short‐duration maximal and prolonged submaximal intensity dynamic HGEX.MethodsHealthy males (n = 6; 21.7 ±2.5 yrs old) have been recruited. Exercise protocols were performed on separate days. The high‐intensity exercise was a critical power test (CP), consisting of maximal squeezing for 10 minutes. Submaximal exercise (SE) consisted of HGEX performed at 15% below critical power for 30 minutes. Both protocols used a 2:2 contraction:relaxation duty cycle. Platelets were derived from a complete blood count analysis performed by a haematology lab.ResultsPlatelets increased by 8% from rest to CP (n = 6; 217.9 vs. 236.4 x109/L; p < .05) and 6% from rest to SE (n = 3; 193.3 vs. 206 x109/L, p = .06).ConclusionPreliminary data demonstrate that platelets increase in a similar fashion to HGEX, regardless of exercise intensity.
Passing the Certified Nurse Educator Exam: Innovative Strategies
Authors: Basley Sandra A. , Erickson-Owens Debra , McGrane Christine , Palmer Michelle , Cloud Mary E. , Dugas Joan R. 
Published: June 2021

Abstract
Certification in nursing education demonstrates expertise in teaching. The National League for Nursing Certified Nurse Educator credential is a hallmark of excellence. Six academic nurse educators obtained a 100 percent first-time pass rate as the result of a novel cohort model built upon accountability. This article’s purpose is to share innovative approaches that can lead to successfully passing the exam.
Association Between Hemoglobin A1C and Midurethral Sling Complications in Diabetic Women: A Cohort Study
Authors: Ortega Marcus V. , Bangura Marie , Ayati Elnaz , James Kaitlyn , Mitchell Caroline , Weinstein Milena M. , Von Bargen Emily 
Published: June 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:159–162)
Stress urinary incontinence (SUI), affecting up to one third of the US adult population of women, is treated with pelvic floor muscle training, physical therapy, supportive devices including pessary, and surgery. The midurethral sling (MUS) is considered a standard of care surgical treatment given its low risk of complication and high success rate.
Surgical site infections in gynecology: the latest evidence for prevention and management
Authors: Seaman Sierra J. , Han Esther , Arora Chetna , Kim Jin Hee 
Published: June 2021

Purpose of review
Surgical site infection (SSI) remains one of the most common postoperative surgical complications. Prevention and appropriate treatment remain paramount.

Recent findings
Evidence-based recommendations include recognition and reduction of preoperative risks including hyperglycemia and smoking, treatment of preexisting infections, skin preparation with chlorhexidine gluconate, proper use of preoperative antibiotics, and implementation of prevention bundles. Consideration should be given to the use of dual antibiotic preoperative treatment with cephazolin and metronidazole for all hysterectomies.

Summary
Despite advancements, SSI in gynecologic surgery remains a major cause of perioperative morbidity and healthcare cost. Modifiable risk factors should be evaluated and patients optimized to the best extent possible prior to surgery. Preoperative risks include obesity, hyperglycemia, smoking, and untreated preexisting infections. Intraoperative risk-reducing strategies include appropriate perioperative antibiotics, correct topical preparation, maintaining normothermia, and minimizing blood loss. Additionally, early recognition and prompt treatment of SSI remain crucial.
Minimally invasive management of retained products of conception and the adherent placenta
Authors: Namazi Golnaz , Haber Hilary R. , Tavcar Jovana , Clark Nisse V. 
Published: June 2021

Purpose of review
Retained products of conception (POC) may occur independently or as a consequence of placenta accreta spectrum (PAS). Managing these conditions depends on the clinical scenario, and in some cases, can involve the use of minimally invasive techniques. This review presents the role of hysteroscopy and laparoscopy in the treatment of retained POC and the adherent placenta.

Recent findings
Hysteroscopic resection of retained POC is reported to have favorable outcomes compared to blind dilation and curettage, including higher success rates and a lower risk of intrauterine adhesion formation. Hysteroscopic and laparoscopic techniques for managing PAS are limited to select cases where uterine preservation is desired, or a laparoscopic gravid or postpartum delayed hysterectomy is feasible. Data on these methods are limited to case reports.

Summary
A hysteroscopic approach is preferred over dilation and curettage for retained POC. Minimally invasive surgery may have a role in unique cases of PAS.
Circadian blood pressure profile and blood pressure changes following oral appliance therapy for obstructive sleep apnoea
Authors: Sutherland Kate , Dissanayake Hasthi U. , Trzepizur Wojciech , Gagnadoux Frederic , Cistulli Peter A. 
Published: June 2021

Objectives:
Oral appliance therapy for obstructive sleep apnoea (OSA) reduces blood pressure (BP) but there is little information on relationship to circadian BP pattern (nocturnal BP dipping or non-dipping). The aims of this study were to determine whether nocturnal dipping pattern influences BP changes following oral appliance therapy, and to determine the effect of oral appliance therapy on circadian BP pattern.

Methods:
Participants in two randomized trials of oral appliance therapy (1–2 months) with 24-h ambulatory BP monitoring (ABPM) data were included (N = 152). Nocturnal BP Dippers (nocturnal/diurnal SBP ratio <0.9) and non-dippers were compared for BP changes following oral appliance therapy and the effect of oral appliance therapy on nocturnal BP dipping was assessed.

Results:
Of 152 participants, 64.5% were dippers. Dippers were on average younger and less likely to be hypertensive (42 vs. 82.7%, P < 0.001). Nondippers showed greater reduction in nocturnal BP measures, related to higher BP measures at baseline. There was no difference in the relationship between treatment effectiveness and BP changes between groups. Oral appliance therapy converted only 23% of baseline non-dippers to a nocturnal dipping profile.

Conclusion:
Baseline circadian BP profile influenced the BP response to oral appliance therapy, largely because of higher baseline BP in the non-dipper subgroup. Oral appliance therapy did not convert OSA patients to a more favourable circadian BP profile. Further work is required to understand the effect of oral appliance therapy on circadian BP profile and of the individuals who will receive cardiovascular benefit from oral appliance therapy.
Cryptococcus neoformans Infective Endocarditis After Lung Transplantation
Authors: Fountain John H. , Rajagopalan Kartik N. , Carroll Maggie , Robbins Hilary , Benvenuto Luke J. , Shimbo Daichi , Marboe Charles C. , Arcasoy Selim M. , Pereira Marcus R. 
Published: June 2021

Abstract

Cryptococcus neoformans infective endocarditis is rarely reported. In this report, we present a case of infective endocarditis secondary to C. neoformans in a lung transplant recipient and review the relevant literature. A 65-year-old man was hospitalized with hypoxemic respiratory failure and underwent left-sided single lung transplantation. In the setting of worsening hypoxemia, blood cultures were drawn, which grew C. neoformans. Lumbar puncture was performed, and cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was also positive for Cryptococcus. Further exposure history revealed that he had raised chickens while living in Peru. Transesophageal echocardiography showed an aortic valve vegetation, and he was diagnosed with cryptococcal infective endocarditis. He received liposomal amphotericin B and flucytosine for 2 weeks and was later transitioned to fluconazole. This case highlights the need for thorough social history before lung transplantation, as pulmonary colonization with C. neoformans may result in infective endocarditis after immunosuppression.
High-Dose Oral Vancomycin for Treatment of Clostridioides difficile Is Associated With High Risk of Subsequent Cultures With Gram-Negative Organisms
Authors: Bader Mazen S. , Someili Ali , Alosali Abdulmajeed , Hadzic Amir , Irfan Neal , Leto Daniela , Mertz Dominik , Brooks Annie A. 
Published: June 2021

Background
Vancomycin is associated with disruption of the indigenous microbiota, potentially predisposing patients to overgrowth of endogenous pathogens. Our objective was to determine whether high-dose oral vancomycin is associated with cultures growing gram-negative organisms in adult patients with Clostridioides difficile infection (CDI).

Methods
This is a retrospective cohort study of 632 adult patients with CDI from January 2015 to December 2017. The primary outcome was prevalence of cultures growing gram-negative organisms within 6 months after onset of the first episode of CDI. A multivariate logistic regression analysis was used to determine predictors of the outcome.

Results
One hundred fifty-three patients (24.2%) had cultures growing gram-negative organisms after onset of CDI, where urine (97, 63.4%) and blood (27, 17.7%) were the most common sources. The most commonly isolated gram-negative organisms were Escherichia coli (49, 32.0%) and Klebsiella species (34, 22.2%). A total of 38 (38/100, 38.0%) and 48 (48/199, 24.1%) of the patients who received high- and standard-dose oral vancomycin, respectively, had gram-negative organism growth on culture (odds ratio [OR], 2.22, 95% confidence interval [CI], 1.41–3.5; P = 0.02). The multivariate analysis showed that high-dose oral vancomycin (OR, 2.21; 95% CI, 1.29–3.79; P = 0.004) and recent use of antibiotic therapy within 3 months (OR, 2.11; 95% CI, 1.27–3.52; P = 0.004) were associated with positive cultures growing gram-negative organisms.

Conclusions
High-dose oral vancomycin therapy for CDI was associated with increased risk of gram-negative organisms probably throughout disruption of the indigenous microbiota.
Substance Use Disorders and Diabetes Care
Authors: Forthal Sarah , Choi Sugy , Yerneni Rajeev , Zhang Zhongjie , Siscovick David , Egorova Natalia , Mijanovich Todor , Mayer Victoria , Neighbors Charles 
Published: June 2021

Background:
Individuals that have both diabetes and substance use disorder (SUD) are more likely to have adverse health outcomes and are less likely to receive high quality diabetes care, compared with patients without coexisting SUD. Care management programs for patients with chronic diseases, such as diabetes and SUD, have been associated with improvements in the process and outcomes of care.

Objective:
The aim was to assess the impact of having coexisting SUD on diabetes process of care metrics.

Research Design:
Preintervention/postintervention triple difference analysis.

Subjects:
Participants in the New York State Medicaid Health Home (NYS-HH) care management program who have diabetes and a propensity-matched comparison group of nonparticipants (N=37,260).

Measures:
Process of care metrics for patients with diabetes: an eye (retinal) exam, HbA1c test, medical attention (screening laboratory measurements) for nephropathy, and receiving all 3 in the past year.

Results:
Before enrollment in NYS-HH, individuals with comorbid SUD had fewer claims for eye exams and HbA1c tests compared with those without comorbid SUD. Diabetes process of care improvements associated with NYS-HH enrollment were larger among those with comorbid SUD [eye exam: adjusted odds ratio (AOR)=1.08; 95% confidence interval (CI): 1.01–1.15]; HbA1c test: AOR=1.20 (95% CI: 1.11–1.29); medical attention for nephropathy: AOR=1.21 (95% CI: 1.12–1.31); all 3: AOR=1.09 (95% CI: 1.02–1.16).

Conclusions:
Individuals with both diabetes and SUD may benefit moderately more from care management than those without comorbid SUD. Individuals with both SUD and diabetes who are not enrolled in care management may be missing out on crucial diabetes care.
Clinical impact of targeted single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy on the assessment of bone metastasis in cancer patients
Authors: Kapsoritakis Nikolaos , Stathaki Maria , Bourogianni Olga , Tsaroucha Angeliki , Papadaki Emmanouela , Simos Panagiotis , Koukouraki Sophia 
Published: June 2021

Objectives
We investigated the clinical impact of single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy combined with 16-slice CT on metastatic workup and treatment planning in a large cancer patient series.

Methods
Between January 2019 and January 2020, a total of 600 cancer patients were prospectively evaluated with whole-body planar bone scan (wbPBS) for staging or restaging purposes. 272/600 had equivocal lesions on wbPBS and 265/272 underwent additionally a targeted SPECT/CT bone scintigraphy on designated regions. Findings were classified as benign (score 1), metastatic (score 2) and inconclusive (score 3). Findings from SPECT/CT bone scintigraphy were compared with the results of wbPBS.

Results
A total of 668 lesions were considered as unclear οn wbPBS and were re-evaluated through targeted SPECT/CT bone scintigraphy. Definite diagnostic findings on SPECT/CT bone scintigraphy were obtained in 227/265 (85.7%) patients and in 592/668 (88.6%) lesions vs. 15.4% of wbPBS alone. On per-patient analyses, 38.9% of patients were considered definitely nonmetastatic and 46.8% as definitely metastatic. On per lesion analyses using SPECT/CT bone scintigraphy, corresponding diagnostic rates were 47.5 and 41.2%. Although the addition of SPECT/CT bone scintigraphy significantly reduced the rate of equivocal wbPBS results (83.1%), it failed to provide a conclusive diagnosis in a relatively small proportion of lesions 76/668 (11.4%) in 38 patients.

Conclusions
SPECT/CT bone scintigraphy afforded a significant reduction of the number of patients with equivocal findings who needed further evaluation with other imaging modalities, preventing unnecessary delays in diagnosis and potential changes in disease staging and treatment planning. Moreover, SPECT/CT bone scintigraphy slightly increased diagnostic sensitivity.
New drugs for difficult bugs: management of multidrug-resistant gram-negative infections in solid organ transplant recipients
Authors: Pouch Stephanie M. 
Published: June 2021

Purpose of review
Multidrug-resistant Gram-negative bacteria remain a significant threat to patient and allograft survival. Management of these infections in solid organ transplant (SOT) recipients remains challenging due to a limited antimicrobial pipeline and reliance on novel agents, which have not been systematically evaluated in the transplant population.

Recent findings
Novel antimicrobials, including the second-generation β-lactam/β-lactamase inhibitors, cefiderocol, plazomicin and eravacycline, have been developed to combat infections due to multidrug-resistant Gram-negative infections, but each has microbiologic and therapeutic niches and warrant further study in SOT recipients.

Summary
This review summarizes therapeutic options for extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa with difficult-to-treat resistance in SOT recipients and emphasizes recently approved antimicrobial agents.
Patient-reported outcomes and health-related quality of life after urinary diversions
Authors: Nuijens Siberyn T. , Cobussen-Boekhorst Hanny , Heesakkers John P.F.A. , Witjes J. Alfred 
Published: June 2021

Purpose of review
To study the recent literature on health-related quality of life (HRQOL) in patients after radical cystectomy followed by urinary diversion.

Recent findings
General consensus regarding, which urinary diversion is superior in terms of HRQOL has not been reached. Although there is an increase in studies favoring the orthotopic neobladder, overall quality of these studies is poor. Other studies suggest that HRQOL outcomes in different types of urinary diversions is similar and that other factors, such as age, comorbidities and sex are more important instead. Patient choice, in consultation with the treating surgeon should be the determinant of which urinary diversion is performed. Furthermore, sexual function can play an important role in HRQOL. However, practice shows that counselling on the option of sexual-preserving techniques is still not implemented in routine clinical practice. Furthermore, studies regarding differences in HRQOL after urinary diversion between male and female individuals are lacking.

Summary
Thorough preoperative counselling on the different types of urinary diversion and options for sexual-preserving techniques decreases decision regret and increases HRQOL in patients after radical cystectomy.
HIV-1 viral blips are associated with repeated and increasingly high levels of cell-associated HIV-1 RNA transcriptional activity
Authors: Suzuki Kazuo , Levert Angelique , Yeung Julie , Starr Mitchell , Cameron Jane , Williams Raffaella , Rismanto Nikolas , Stark Tayla , Druery Dylan , Prasad Salzeena , Ferrarini Cristina , Hanafi Imelda , McNally Leon Patrick , Cunningham Philip , Liu Zhixin , Ishida Takaomi , Huang Chin-Shiou , Oswald Velma , Evans Louise , Symonds Geoffrey , Brew Bruce James , Zaunders John 
Published: June 2021

Objective:
Some HIV+ patients, virally suppressed on ART, show occasional ‘blips’ of detectable HIV-1 plasma RNA. We used a new highly sensitive assay of cell-associated HIV-1 RNA to measure transcriptional activity in PBMCs and production of infectious virus from the viral reservoir, in patients with and without ‘blips’.

Design/methods:
RNA and DNA extracted from cells in 6 ml of peripheral blood, from suppressed patients with one to two ‘blip’ episodes over the past 2 years of ART (n = 55), or no ‘blips’ (n = 52), were assayed for HIV-1 RNA transcripts and proviral DNA targeting the highly conserved ‘R’ region of the LTR. Follow-up samples were also collected. Purified CD4+ T cells were cultured with anti-CD3/CD28/CD2 T-cell activator to amplify transcription and measure replication competent virus.

Results:
HIV-1 RNA transcripts ranged from 1.3 to 5415 copies/106 white blood cells. ‘Blip’ patients had significantly higher levels vs. without blips (median 192 vs. 49; P = 0.0007), which correlated with: higher levels of inducible transcripts after activation in vitro, sustained higher HIV-1 transcription levels in follow-up samples along with increasing HIV-1 DNA in some, and production of replication-competent HIV-1.

Conclusion:
Viral ‘blips’ are significant reflecting higher transcriptional activity from the reservoir and contribute to the reservoir over time. This sensitive assay can be used in monitoring the size and activity of the HIV-1 reservoir and will be useful in HIV-1 cure strategies.