bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the correlation of serum leptin levels with evidence of coronary artery disease on myocardial perfusion single-photon emission computed tomography in suspected coronary artery disease patients
Authors: Ghanizadeh Sina , Ghaedian Tahereh , Firuzyar Tahereh , Faghihi Amir , Jahani Taklimi Navid 
Published: December 2021

Background
Cardiovascular disease is currently the most common cause of death worldwide. Several risk factors have been identified for cardiovascular diseases, including hypertension, hyperlipidemia and diabetes. Leptin is a peptide hormone that acts as a proinflammatory cytokine and has a variety of effects in hemostasis and metabolism such as lipid metabolism, production of glucocorticoid, angiogenesis, etc. The aim of this study was to determine the relationship between the concentrations of leptin with evidence of coronary artery disease in the myocardial perfusion scan.

Method
A one year retrospective cross-sectional study was conducted on patients who are suspected of coronary artery disease that referred to the nuclear medicine department for performing myocardial perfusion scan. The patients were classified based on the results of the myocardial perfusion scan. Serum leptin was measured with ELISA assay. The correlation of serum leptin with these parameters and also with different groups of age, sex and coronary artery disease risk factors was also compared.

Results
The mean serum level of leptin was 290.44 ng/ml (82.9-1600 ng/ml). There is no meaningful relation between serum leptin and coronary artery disease risk factors, age and sex; also, none of the quantitative myocardial perfusion scan parameters have a significant correlation with serum leptin.

Conclusion
Based on our findings, there was no significant correlation between myocardial perfusion scan parameters and leptin levels. Serum leptin and different groups of age, sex and coronary artery risk factors were not correlated as well.
VNTR polymorphism in the SLC6A3 gene does not influence dopamine transporter availability measured by [18F]FE-PE2I PET or [123I]FP-Cit SPECT
Authors: Jakobson Mo Susanna , Axelsson Jan , Stiernman Lars J , Larsson Anne , af Bjerkén Sara , Bäckström David , Kellgren Therese Gabrielsson , Varrone Andrea , Riklund Katrine 
Published: December 2021

Objective
To investigate the potential impact of polymorphism in the 3′-untranslated region (3′UTR) of the SLC6A3 gene (DAT1) on normal variation in dopamine transporter (DAT) imaging with [18F]FE-PE2I PET and [123I]FP-Cit SPECT.

Methods
Thirty-six individuals (mean age 70.4±5.4 years) with normal [18F]FE-PE2I PET and [123I]FP-Cit SPECT were genotyped for variable number of tandem repeats (VNTR) in the 3′UTR of the DAT1 gene. The DAT-availability in the caudate and putamen as measured with [18F]FE-PE2I PET and [123I]FP-Cit SPECT, as well as in the substantia nigra with [18F]FE-PE2I PET were compared between the participants carrying one or two 9-repeat alleles (i.e. 9R+10R or 9R+9R; 47%) and the participants without a 9R allele (i.e. 10R+10R or 10R+11R; 53%). Nonparametric tests, linear regression analysis and mixed model analysis were used to assess any statistical difference in measured DAT availability between the two allele groups.

Results
The measured DAT-availability in PET- and SPECT-imaging tended to be slightly higher in the 9R-group; however, the difference did not reach statistical significance in either the caudate or the putamen or the substantia nigra. Instead, age did have a significant effect on the DAT level (P < 0.05) notwithstanding the genotype.

Conclusion
No significant effect of DAT1-genotype was detectable in imaging with [18F]FE-PE2I PET or [123I]FP-Cit, instead, age accounted for the normal variation in DAT-PET and DAT-SPECT.
Therapeutic application of genome editing in dyslipidemia
Authors: Whittaker Madelynn N. , Musunuru Kiran 
Published: December 2021

Purpose of review
To summarize recent advances with respect to the use of genome editing to modify blood lipid levels in vivo.

Recent findings
Genome-editing technologies have been successfully used to target the PCSK9 gene in the livers of nonhuman primates and significantly reduce blood LDL cholesterol levels.

Summary
Multiple proof-of-concept nonhuman primate studies raise the prospect of genome editing empowering ‘one-and-done’ therapies for the treatment of dyslipidemic patients.
Very long-chain saturated fatty acids and diabetes and cardiovascular disease
Authors: Lemaitre Rozenn N. , King Irena B. 
Published: December 2021

Purpose of review
In contrast to other saturated fatty acids, very long-chain saturated fatty acids (VLSFAs) have received limited attention The purpose of this review is to summarize the associations of VLSFAs, including arachidic acid, behenic acid, and lignoceric acid, with cardiovascular disease outcomes and type 2 diabetes; to discuss the findings implications; and to call for future studies of the VLSFAs.

Recent findings
Increased levels of circulating VLSFAs have been found associated with lower risks of incident heart failure, atrial fibrillation, coronary heart disease, mortality, sudden cardiac arrest, type 2 diabetes, and with better aging. The VLSFA associations are paralleled by associations of plasma ceramide and sphingomyelin species carrying a VLSFA with lower risks of heart failure, atrial fibrillation, and mortality, suggesting VLSFAs affect the biological activity of ceramides and sphingomyelins thereby impacting health. For diabetes, there is no such parallel and the associations of VLSFAs with diabetes may be confounded or mediated by triglyceride and circulating palmitic acid, possible biomarkers of de novo lipogenesis.

Summary
In many ways, the epidemiology has preceded our knowledge of VLSFAs biology. We hope this review will spur interest from the research community in further studying these potentially beneficial fatty acids.
Immunological Effects of Adding Bovine Lactoferrin and Reducing Iron in Infant Formula
Authors: Björmsjö Maria , Hernell Olle , Lönnerdal Bo , Berglund Staffan K. 
Published: December 2021

ABSTRACTObjectives:Compared to formula‐fed infants, breastfed infants have a lower risk of infections. Two possible reasons for this are the presence of the anti‐infective and anti‐inflammatory protein lactoferrin and the lower level of iron in breast milk. We explored how adding bovine lactoferrin and reducing the iron concentration in infant formula affect immunology and risk of infections in healthy infants.Methods:In a double‐blind controlled trial, term formula‐fed (FF) Swedish infants (n = 180) were randomized to receive, from 6 weeks to 6 months of age, a low‐iron formula (2 mg/L) with added bovine lactoferrin (1.0 g/L) (Lf+; n = 72); low‐iron formula with no added lactoferrin (Lf−; n = 72); and standard formula at 8 mg/L iron and no added lactoferrin (control formula [CF]; n = 36). Cytokines, infections, and infection related treatments were assessed until 12 months of age.Results:No adverse effects were observed. There were no apparent effects on transforming growth factor beta (TGF‐β)1, TGF‐β2, tumor necrosis factor alfa (TNF‐α) or interleukin2 (IL‐2) at 4, 6, or 12 months, except of higher TGF‐β2 at 6 months in the CF group in comparison to the low iron groups combined (P = 0.033). No significant differences in otitis, respiratory infections, gastroenteritis, or other monitored infections and treatments were detected for any of the study feeding groups during the first 6 months and only a few and diverging effects were observed between 6 and 12 months.Conclusions:Adding bovine lactoferrin and reducing iron from 8 to 2 mg/L in infant formula was safe. No clinically relevant effects on cytokines or infection related morbidity were observed in this well‐nourished and healthy population.
Establishment of Nurse Manager Leadership Competencies to Support Clinicians in Evidence-Based Practice
Authors: Caramanica Laura , Gallagher-Ford Lynn , Idelman Lynda , Mindrila Diana , Richter Sally , Thomas Bindu Koshy 
Published: December 2021

OBJECTIVE
This 2-part study was conducted to validate nurse manager (NM) leadership competencies that support clinicians in using evidence-based practice (EBP).

BACKGROUND
Numerous studies validate the critical need for NM support among clinicians seeking to engage in EBP.

METHODS
In phase 1, a Delphi study was conducted to establish the validity of a set of NM leadership competencies that support EBP. In phase 2, descriptive analyses, tests of significance, and reliability coefficients were used to assess reliability.

RESULTS
An expert panel achieved consensus on a set of 22 NM leadership competencies that constitute effective support for EBP. Further quantitative analyses demonstrated excellent levels of internal consistency and overall consistent outcomes across time.

CONCLUSION
A valid set of 22 NM leadership competencies with evidence of reliability that successfully support clinicians to engage in EBP in clinical settings was established.
Quality Improvement Initiative to Improve Hand Hygiene Compliance in Indian Special Newborn Care Unit
Authors: Rai Reena , Sethi Amanpreet , Kaur Amarpreet , Kaur Gurmeet , Vardhan Gupta Harsh , Kaur Sumandeep , Singh Parihar Man , Paul Singh Satwinder 
Published: December 2021

Introduction:
Pilot data on Hand hygiene (HH) compliance using a standard World Health Organisation checklist for 1-week suggested only 20% compliance. So, we planned a Quality Improvement study to improve HH compliance among health care providers in our Special Newborn Care Unit from 20% to 60% over 12 months.

Methods:
We did this study in 3 phases: Baseline phase (2 months), Intervention phase (8 months), and Postintervention phase (2 months). A multidisciplinary Quality Improvement team composed of doctors, nursing staff, and ward attendants was constituted. The team analyzed potential barriers to HH by Fishbone analysis. Three trained observers randomly selected two target Special Newborn Care Unit patients daily and collected data on HH compliance unobtrusively during the three 8-h shifts over 24 h. In addition, we tested a range of interventions using multiple Plan Do Study Act cycles: Staff education; Displaying posters; Round the clock availability of soap and hand rub; Staff felicitation; Group performance feedback. We also collected data on healthcare-associated infections in all three phases.

Results:
The total observations for HH during the baseline, intervention, and postintervention phase were 1488, 5808, and 1464, respectively. The HH compliance improved from 27.2% to 57.1% in the postintervention phase. There was no difference in the healthcare-associated infections among the three phases.

Conclusions:
The HH compliance rates improved significantly but not to the desired extent. So, we planned to increase our workforce, and improve our training program and infrastructure.
A Quality Improvement Approach to Early Patient Discharge
Authors: Stansbury Nicholas , Marlow Taylor Richard , Wueste Beth 
Published: December 2021

Introduction:
Lack of bed availability is a common problem in our pediatric unit, as in many hospitals. To address this issue, we instituted a quality improvement (QI) initiative involving collaborative nurse–physician rounding. This intervention has been shown to expedite discharge, improve patient care, and increase bed availability in other settings.

Methods:
By utilizing PDCA (Plan, Do, Check, Act) processes, we created two improvement initiatives, “Increasing Patient Discharge Before 12 pm” and “Midnight Rounds with Discharge Focus.” Senior resident and faculty physicians rounded on discharge-ready patients before teaching rounds, and by 10 am, placed discharge orders to allow for a 12 pm discharge. A night team consisting of senior residents and nurses conducted “Midnight Rounds” and identified potential discharges for the morning team. The project aimed to increase patient discharges before 12 pm from a June–November 2018 baseline of 15%–20% by June 2019.

Results:
Patient discharge percentage before 12 pm increased from 15% to 21% (P < 0.01) by June 2019, and as a result, bed availability increased by 16% (P < 0.01).

Conclusions:
QI methodology clarified the root causes of limited bed availability. Understanding the existing discharge process allowed for QI initiatives to develop a consistent and sustainable discharge process. Patient discharge percentages before 12 pm increased by 40%, and bed availability increased by 16% after QI implementations.
Increasing Adherence to Acute Otitis Media Treatment Duration Guidelines using a Quality Improvement Approach
Authors: Uhl Bethany D. , Boutzoukas Angelique , Gallup Nathaniel , Patrick Michael , Stultz Jerry , Porter Courtney , Watson Joshua R. 
Published: December 2021

Introduction:
This quality improvement initiative aimed to improve American Academy of Pediatrics acute otitis media (AOM) guideline adherence in pediatric urgent care sites by increasing the percentage of patients 2 years and older with AOM who received a short duration (7 days or fewer) of antibiotics from a baseline of 7% to a goal of 50%.

Methods:
This quality improvement initiative was conducted in a network of seven urgent care sites affiliated with a large academic children’s hospital. The interventions focused on clinician and family education, clinical decision support, and a discharge template that defaulted to a 7-day duration of antibiotics for patients 2 years and older diagnosed with AOM. The outcome measure was the percentage of patients receiving 7 days or fewer of antibiotics. The process measure was the percentage of prescriptions originating from the new discharge template. A repeat visit for AOM within 30 days from the initial visit was the balancing measure.

Results:
The percentage of patients diagnosed with AOM receiving a short antibiotic course increased from a baseline of 7% to a new centerline mean of 67%, which exceeded the goal. This project resulted in 10,138 antibiotic days being avoided. Eighty-two percent of short-course prescriptions originated from the discharge template. Repeat visits for AOM within 1 month of the initial visit did not increase.

Conclusions:
A quality improvement initiative combining education and clinical decision support improved adherence to AOM treatment duration guidelines and avoided unnecessary antibiotic exposure in a pediatric urgent care network without increasing treatment failures.
Clinical Specialty Setting as Determinant of Management of Psoriatic Arthritis
Authors: da Silva Souza Cacilda , Goldenstein-Schainberg Cláudia , Alvarenga Anti Loduca Lima Sonia Maria , Spelling Gormezano Natali , Ferreira Magalhães Renata , Ranza Roberto 
Published: December 2021

Objective
The aim of this study was to examine the effect of clinical specialty setting on the management of psoriatic arthritis (PsA) as well as disease activity/burden in Brazil.

Methods
This study is a post hoc analysis of the Brazilian population in a cross-sectional, observational study conducted in 17 countries. Patients were 18 years or older with suspected or confirmed PsA attending routine visits at participating sites. Primary end points were time from symptom onset to PsA diagnosis, from diagnosis to first conventional systemic disease-modifying antirheumatic drug (DMARD) or first biologic DMARD, and from first conventional systemic DMARD to first biologic DMARD. Potential associations were assessed using the Student t test or the Mann-Whitney U nonparametric test. Normality was tested using the Shapiro-Wilk and Kolmogorov-Smirnov tests. For qualitative variables, the χ2 test was adopted.

Results
Patients (n = 130) visited dermatology (n = 75) or rheumatology (n = 55) sites. All primary end points were similar between the 2 settings; however, dermatology patients had significantly greater enthesitis counts (2.1 vs 0.6; p = 0.002), absenteeism at work (Work Productivity and Activity Impairment, 19.7% vs 5.2%; p = 0.03), and pain (Health Assessment Questionnaire–Disability Index pain scale, 1.39 vs 1.01; p = 0.032), as well as worse quality of life related to psoriasis (Dermatology Life Quality Index total score, 8.5 vs 5.0; p = 0.019) and mental health (12-item Short-Form Health Survey, version 2.0 subscale, 42.4 vs 47.4; p = 0.029).

Conclusions
In Brazil, PsA disease burden and disease activity were influenced by clinical specialty. Irrespective of setting, patients experienced a delay in being diagnosed with PsA, reinforcing the need for collaborative management of PsA by rheumatologists and dermatologists for better outcomes in these patients.
Comparison Between Radial Forearm Free Flap and Pectora is Major Myocutaneous Flap for Reconstruction in Oral Cavity Cancer Patients: Assessment of the Quality of Life
Authors: Zhang Cheng-Feng , Liu Xiang-Jun , Liu Dong-Wei , Zhang Xu 
Published: December 2021

Abstract
We aimed to evaluate the quality of life of Chinese patients after immediate reconstruction surgery on individuals with oral cavity cancer. In addition, we compared the differences between radial forearm free flap and pectoralis major myocuta- neous flap. Using the University of Washington quality of life v4 questionnaire, 1:1 matched research was performed on patients received PMM or RFF flap. Chi-square test was used to analyze the variables. One hundred twenty four of 179 questionnaires were returned (69.3%). Age, N stage, and postoperative radiotherapy were similar for both groups. However, there were significant differences between two groups in gender, T stage, operation duration, and complication rate. Oral cavity cancer patients reconstructed with radial forearm free flap had better shoulder and speech functions but worse appearance domains. The results of our research provide important information for patients and physicians during their discussion of treatment programs for oral cavity cancers.
Heparin Binding Protein for the Early Diagnosis and Prognosis of Sepsis in the Emergency Department: The Prompt Multicenter Study
Authors: Katsaros Konstantinos , Renieris Georgios , Safarika Asimina , Adami Evangelia-Maria , Gkavogianni Theologia , Giannikopoulos George , Solomonidi Nicky , Halvatzis Stamatios , Koutelidakis Ioannis M. , Tsokos Nikolaos , Tritzali Maroula , Koutoukas Pantelis , Avgoustou Cristina , Vasishta Anil , Giamarellos-Bourboulis Evangelos J. 
Published: December 2021

ABSTRACT

Background:
The validation of new biomarkers for the diagnosis and risk stratification of patients with sepsis at an early point is essential for successful treatment. Recent publications prompted us to investigate of heparin binding protein (HBP) for the emergency department (ED) admissions.

Materials and Methods:
In this multicenter, cross-sectional study, HBP and procalcitonin (PCT) were measured within the first hour upon admission to the ED in plasma samples of 371 patients with signs of infection. Patients were classified into non-sepsis and sepsis by the Sepsis-3 definitions and were followed up for outcome.

Results:
HBP was significantly higher in patients with sepsis and was positively correlated to PCT and C-reactive protein, absolute neutrophil and monocyte counts, creatinine, bilirubin and lactate. Sensitivity, specificity, positive predictive value, and negative predictive value of HBP more than 19.8 ng/mL for the diagnosis of sepsis was 66.3%, 44.9%, 49.3%, and 62.2%, respectively; and for prediction of early death was 100%, 41.0%, 4.5%, and 100%, respectively. Single HBP and PCT could not predict 28-day mortality; this was performed with sensitivity, specificity, positive predictive value, and negative predictive value 44.8%, 81.8%, 17.3%, and 94.6% when used in combination.

Conclusion:
Admission HBP can be used as a tool for the early diagnosis of sepsis and for the risk of early death in the ED.
NRF2 Inhibits Cardiomyocyte Pyroptosis Via Regulating CTRP1 in Sepsis-Induced Myocardial Injury
Authors: Teng Yan , Li Ningjun , Wang Yi , Sun Shuling , Hou Junxia , Chen Yahui , Pan Haiyan 
Published: December 2021

ABSTRACT
C1q/tumor necrosis factor-related protein 1 (CTRP1) has been demonstrated as a crucial regulator in myocardial injury (MI). The present study aims to evaluate the mechanism of CTRP1 in sepsis-induced MI. The septic mouse model was established via cecal ligation and puncture and the in vitro cell model was established via lipopolysaccharide treatment. The mouse survival rate within 96 h was recorded. Morphologic changes of cardiomyocytes were observed and cell viability and cardiac functions were detected. CTRP1 and nuclear factor erythroid 2-related factor (Nrf2) expressions, creatine troponin-T, and creatine phosphokinase isoenzyme levels, and expressions of pyroptotic markers were determined. The binding relationship between Nrf2 and the CTRP1 promotor was predicted and verified. Rescue experiments were designed to confirm the role of CTRP1. CTRP1 was poorly expressed in septic mice. CTRP1 overexpression inhibited cardiomyocyte pyroptosis and improved cardiac functions, MI, and survival rate in septic mice. Nrf2was decreased in cecal ligation and puncture -treated mice. Nrf2 overexpression promoted CTRP1 expression via binding to the CTRP1 promotor and suppressed cardiomyocyte pyroptosis. CTRP1 downregulation abolished the inhibitory effect of Nrf2 overexpression on cardiomyocyte pyroptosis. Overall, Nrf2 promoted CTRP1 expression via binding to the CTRP1 promotor to inhibit cardiomyocyte pyroptosis, thereby alleviating MI in septic mice.
Patient and Clinician Perceptions of Informed Consent and Decision Making About Accepting KDPI > 85 Kidneys
Authors: Schantz Karolina , Gordon Elisa J. , Lee Unsun , Rocha Maria , Friedewald John , Ladner Daniela P. , Becker Yolanda , Formica Richard , Reese Peter P. , Kaufman Dixon , Barah Masoud , Walker Marissa , Mehrotra Om , Viveros Dania , Mehrotra Sanjay 
Published: December 2021

Background.
Although the impact of the kidney donor profile index (KDPI) on kidney discard is well researched, less is known about how patients make decisions about whether to give consent for KDPI > 85 kidney offers.

Methods.
We conducted in-depth, semistructured interviews with 16 transplant recipients, 15 transplant candidates, and 23 clinicians (transplant surgeons, nephrologists, and nurse coordinators) to assess and compare perceptions of transplant education, informed consent for KDPI > 85 kidneys‚ and the decision-making process for accepting kidney offers. Thematic analysis was used to analyze qualitative data.

Results.
Four themes emerged: (1) patients reported uncertainty about the meaning of KDPI or could not recall information about KDPI; (2) patients reported uncertainty about their KDPI > 85 consent status and a limited role in KDPI > 85 consent decision making; (3) patients’ reported willingness to consider KDPI > 85 kidneys depended on their age, health status, and experiences with dialysis, and thus it changed over time; (4) patients’ underestimated the survival benefit of transplantation compared with dialysis, which could affect their KDPI > 85 consent decision making.

Conclusions.
To better support patients’ informed decision making about accepting KDPI > 85 kidneys, centers must ensure that all patients receive education about the trade-offs between accepting a KDPI > 85 kidney and remaining on dialysis. Additionally, education about KDPI and discussions about informed consent for KDPI > 85 kidneys must be repeated at multiple time points while patients are on the waiting list.