bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal medical therapy after coronary artery bypass grafting: a primer for surgeons
Authors: Eikelboom Rachel , Amir Takhliq , Gupta Saurabh , Whitlock Richard P. 
Published: June 2021

Purpose of review
After coronary artery bypass grafting (CABG), patients remain at increased risk of cardiovascular events and death. Cardiac surgeons have the opportunity to reduce this risk by optimizing post-CABG patients’ medical therapy.

Recent findings
Recent developments in lipid-lowering, diabetes management, antithrombotic therapy, and anti-inflammatory therapy can significantly improve prognosis in patients with chronic coronary artery disease. PCSK-9 inhibitors should be used in patients with elevated LDL cholesterol despite maximally tolerated statin therapy. Icosapent ethyl should be considered in patients with elevated triglycerides despite maximally tolerated statin therapy. Long-acting GLP-1 receptor agonists or SLGT-2 inhibitors should be used in all post-CABG patients with type 2 diabetes. Intensified antithrombotic therapy with DAPT or DPI reduces MACE (and DPI reduces mortality) in patients with high atherosclerotic burden. Colchicine has not yet been incorporated into guidelines on OMT for stable CAD but it is reasonable to consider using it in high-risk patients.

Summary
We review the foundations of optimal medical therapy after CABG, and summarize recent advances with a focus on practical application for the busy cardiac surgeon.
Intestinal dysfunction in chronic disease
Authors: Kirschner Sarah K. , Deutz Nicolaas E.P. , Engelen Mariëlle P.K.J. 
Published: June 2021

Purpose of review
This review will discuss recent studies showing that patients with chronic wasting diseases suffer from a variety of small intestinal impairments which might negatively impact the colonic microbiota and overall well-being. New insights will be addressed as well as novel approaches to assess intestinal function.

Recent findings
Small intestinal dysfunction can enhance the amount and alter the composition of undigested food reaching the colon. As a result of reduced protein digestion and absorption, a large amount of undigested protein might reach the colon promoting the presence of pathogenic colonic bacteria and a switch from bacterial fiber fermentation to protein fermentation. While microbial metabolites of fiber fermentation, such as short-chain fatty acids (SCFA), are mainly considered beneficial for overall health, metabolites of protein fermentation, i.e. ammonia, branched SCFAs, hydrogen sulfide, polyamines, phenols, and indoles, can exert beneficial or deleterious effects on overall health. Substantial advances have been made in the assessment of small intestinal dysfunction in chronic diseases, but studies investigating the connection to colonic microbial metabolism are needed. A promising new stable isotope approach can enable the measurement of metabolite production by the colonic microbiota.

Summary
Several studies have been conducted to assess intestinal function in chronic diseases. Impairments in intestinal barrier function, sugar absorption, protein digestion, and absorption, as well as small intestinal bacterial overgrowth were observed and possibly might negatively impact colonic bacterial metabolism. We suggest that improving these perturbations will improve overall patient health.
Correlation analysis of expression of CC and CXC chemokines in children with autism spectrum disorder
Authors: Peng Guangyang , Peng Xiaofei , Tong Tingting , Zhang Xiuyun , Xu Min , Peng Xiaofang 
Published: June 2021

Abstract
To investigate the relationship between the expression of CC and CXC chemokines and autism spectrum disorder (ASD).
A total of 62 children with ASD (ASD group) and 60 gender- and age-matched normal children (control group) admitted to our hospital from January 2019 to January 2020 were included in the study. Monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), macrophage inflammatory protein-1β (MIP-1β), regulated upon activation, normal T-cell expressed and secreted (RANTES), interleukin-8 (IL-8), monokine induced by interferon (IFN)-γ (MIG), and purified human interferon-γ-induced protein-10 (IP-10) were detected in the ASD group. The correlation between the above indexes and the severity of the ASD group was analyzed.
Significantly increased MCP-1 levels (P < .01) along with the markedly decreased MIP-1α and MIP-1β levels (P < .01) were detected in the venous blood of the ASD group compared with the control group. In addition, they exhibited no significant difference (yet a downward trend) in the level of RANTES (P > .05). Children in the ASD group showed significantly decreased IP-10 levels (P < .01); however, they had no noticeable change (yet a decreasing trend) in the levels of IL-8 and MIG (P > .05). MCP-1 level was positively related to the Module 1 scores of Autism Diagnostic Observation Schedule-second edition (ADOS-2), whereas the levels of Childhood Autism Rating Scale MIP-1α, MIP-1β, IL-8, IP-10, and MIG were negatively correlated with the ADOS-2 Module 1 scores (P < .01). However, no significant correlation was found between RANTES and the ADOS-2 Module 1 scores (P > .05).
The levels of CC chemokines (MCP-1, MIP-1α, MIP-1β, and RANTES) and CXC chemokines (IL-8, IP-10, and MIG) are positively correlated with the pathogenesis of ASD. Inflammation is an important contributing factor to ASD.
Interpersonal and Social Functioning Among Psychotherapy Patients
Authors: Aafjes-van Doorn Katie , McCollum James , Silberschatz George , Kealy David , Snyder John 
Published: June 2021

Abstract
This study examined the mediating role of pathogenic beliefs on the relationship between patients’ recollections of experienced adverse parenting in childhood and adult interpersonal and social problems. A total of 210 psychotherapy outpatients rated their experiences of perceived adverse parenting in childhood and completed measures of psychological distress, interpersonal problems and social impairment, and internalized beliefs about self and others. Significant mediation effects were observed for two of the three belief domains: “cannot rely on others” and “undeserving.” Although both were significant mediators between adverse parenting and symptom distress, only “cannot rely on others” was a significant mediator predicting interpersonal problems, and only “undeserving” was a significant mediator predicting impaired social functioning. Thus, patients' underlying convictions regarding their self-worth seem to play a role in the ability to develop social roles, whereas the beliefs about the steadfastness of others play an important role in the capacity for interpersonal relating.
The Impact of Diagnostic Decisions on Patient Experience in the Pediatric Emergency Department
Authors: Gorski Jillian K. , Mendonça Eneida A. , Showalter Cory D. 
Published: June 2021

ObjectivePatient experience serves as both a subjective measure of value-based health care delivery and a metric to inform operational decision making. The objective of this study was to determine if specific diagnostic and therapeutic interventions affect patient experience scores for children seen in the emergency department.MethodsWe performed a retrospective observational study in the emergency department of a large quaternary care children's hospital on patients who were discharged to home and later completed a National Research Corporation Health patient experience survey. We matched the survey results to electronic health record (EHR) data and were able to extract demographics, operational metrics, and order information for each patient. We performed multiple logistic regression analyses to determine the association of image acquisition, laboratory test ordering, medication administration, and discharge prescribing with likelihood to recommend the facility as our measure of patient experience.ResultsOf the 4103 patients who met inclusion criteria for the study, 75% strongly recommended the facility. Longer wait times were associated with lower patient experience scores [odds ratio (OR) per waiting room hour increase, 0.72; 95% confidence interval (CI), 0.65–0.81]. Significant diagnostic factors associated with higher patient experience included magnetic resonance imaging ordering (OR, 2.38; 95% CI, 1.00–5.67), x-ray ordering (OR, 1.19; 95% CI, 1.00–1.42), and electrocardiogram ordering (OR, 1.62; 95% CI, 1.07–2.44). Of the treatment factors studied, only antibiotic prescribing at discharge was found to have a significant positive association with patient experience (OR, 1.32; 95% CI, 1.08–1.63).ConclusionThe positive association between more intensive diagnostic workups and patient experience could have implications on the utility of patient experience scores to evaluate pediatric care teams. Consideration should be taken to interpret patient experience scores in the context of compliance with approaches in evidence-based medicine.
Tubular Cell Dropout in Preimplantation Deceased Donor Biopsies as a Predictor of Delayed Graft Function
Authors: Avigan Zachary M. , Singh Nikhil , Kliegel Judith A. , Weiss Marlene , Moeckel Gilbert W. , Cantley Lloyd G. 
Published: June 2021

Background.
Delayed graft function (DGF) affects over 25% of deceased donor kidney transplants (DDKTs) and is associated with increased cost, worsened graft outcomes, and mortality. While approaches to preventing DGF have focused on minimizing cold ischemia, donor factors such as acute tubular injury can influence risk. There are currently no pharmacologic therapies to modify DGF risk or promote repair, in part due to our incomplete understanding of the biology of preimplantation tubular injury.

Methods.
We collected intraoperative, preimplantation kidney biopsies from 11 high-risk deceased donors and 10 living donors and followed transplant recipients for graft function. We performed quantitative high-dimensional histopathologic analysis using imaging mass cytometry to determine the cellular signatures that distinguished deceased and living donor biopsies as well as deceased donor biopsies which either did or did not progress to DGF.

Results.
We noted decreased tubular cells (P < 0.0001) and increased macrophage infiltration (P = 0.0037) in high-risk DDKT compared with living donor biopsies. For those high-risk DDKTs that developed postimplant DGF (n = 6), quantitative imaging mass cytometry analysis showed a trend toward reduced tubular cells (P = 0.02) and increased stromal cells (P = 0.04) versus those that did not (n = 5). Notably, these differences were not identified by conventional histopathologic evaluation.

Conclusions.
The current study identifies donor tubular cell loss as a precursor of DGF pathogenesis and highlights an area for further investigation and potential therapeutic intervention.
Effects of Bihemispheric Transcranial Direct Current Stimulation Combined With Repetitive Peripheral Nerve Stimulation in Acute Stroke Patients
Authors: Yagüe Sara , Veciana Misericordia , Martínez-Yélamos Antonio , Pedro Jordi , Cardona Pere , Quesada Helena , Lara Blanca , Kumru Hatice , García Belia , Montero Jordi , Valls-Solé Josep 
Published: June 2021

Purpose:
Transcranial direct current stimulation (tDCS) can change the excitability of the central nervous system and contribute to motor recovery of stroke patients. The aim of our study was to examine the short- and long-term effects of real versus sham bihemispheric tDCS combined with repetitive peripheral nerve stimulation in patients with acute stroke and a severe motor impairment.

Methods:
The study was prospective, randomized, double blind, and placebo controlled. Nineteen acute stroke patients (ischemic and hemorrhagic) with upper limb Fugl-Meyer mean score of <19 were randomized in two groups: one group received five consecutive daily sessions of anodal tDCS over the affected hemisphere and cathodal over unaffected hemisphere combined with repetitive peripheral nerve stimulation and the other received sham tDCS associated to repetitive peripheral nerve stimulation. Clinical and neurophysiological assessment was applied before tDCS, 5 days after tDCS, and 3, 6, and 12 months after tDCS.

Results:
There were significant time-related changes in both groups of patients in motor evoked potentials, somatosensory evoked potentials, Hmax:Mmax ratio, upper limb Fugl-Meyer scores, and Modified Ashworth scales scores (P < 0.05). However, no significant differences between groups were present at any time (P > 0.05).

Conclusions:
Bihemispheric tDCS and repetitive peripheral nerve stimulation with the parameters of our study did not add significant short- or long-term clinical improvement or change in neurophysiological data in severe acute stroke patients in comparison to sham stimulation. The severity of motor impairment in stroke patients may influence a possible response to an interventional tDCS treatment.
Primary open angle glaucoma management in a tertiary eye care center in Saudi Arabia: a best practice implementation pilot project
Authors: Alshowaeir Daniah , Almasoud Nouf , Aldossari Sheikhah , Alsirhy Ehab Y. , Osman Essam , Turjoman Abdulsalam , Amer Yasser , Munn Zachary , McArthur Alexa 
Published: June 2021

ABSTRACT

Aim:
Primary open angle glaucoma (POAG) is a leading cause of permanent visual loss affecting significant numbers in Saudi Arabia. There is no cure for glaucoma but there is mounting evidence to guide ophthalmologists in diagnosing and managing this disease. The aim of this pilot project was to assess the compliance with evidence-based criteria and to implement an adapted clinical practice guideline (CPG) for the management of patients with POAG at a tertiary eye care center in Riyadh, Saudi Arabia that will lead to improving quality, consistency and optimizing patients’ care.

Methods:
The project consisted of three phases using audit and feedback strategy. It has utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. Eleven evidence-based audit criteria were developed. A baseline audit was then conducted. Barriers behind areas of noncompliance were identified and a number of strategies were implemented to overcome them. A follow-up postimplementation audit was then conducted.

Results:
Twenty electronic medical files were randomly selected for baseline audit. The results of the audit have identified a number of possible areas to improve in the diagnosis and management of POAG in compliance with the adapted CPG with compliance rate as low as 20% (4/20) in some criteria. Multifaceted interventions were implemented targeting mainly attitude and lack of knowledge and time and resource barriers. Significant improvement occurred in most criteria audited postimplementation.

Conclusion:
The project demonstrates that audit and feedback is a feasible and effective tool to change glaucoma practice in a teaching hospital in Saudi Arabia. The success was due to multifaceted interventions including clear communication to promote awareness, an easily accessible CPG, and regular reminders to improve knowledge and change behavior. We propose our pilot implementation to be generalized to promote implementing evidence-based ophthalmology.
Effectiveness and Safety of Niclosamaide as Add-on Therapy to the Standard of Care Measures in COVID-19 Management: Randomized controlled clinical trial
Authors: Abdulamir Ahmed S. , Gorial Faiq I. , Saadi Sattar Jabar , Maulood Mohammed Fauzi , Hashim Hashim Ali , abdulrrazaq Manal K. 
Published: June 2021

AbstractBackgroundCOVID-19 pandemic has ignited the urge for repurposing old drugs as candidate antiviral medicines to treat novel challenges of viral infections. Niclosamide (NCS) is an anti-parasitic drug of known antiviral potential. Therefore, this study attempts to investigate the antiviral effect and safety of NCS on SARS-CoV-2 caused COVID-19 patients.MethodsRandomized controlled open label clinical trial encompassed 75 COVID-19 patients treated with standard of care plus NCS were included as experimental group and 75 COVID-19 patients treated with only standard of care therapy as control group. Each group was composed of 25 mild, 25 moderate and 25 severe patients. Survival rate, time to recovery, and side effects were the main endpoints for the assessment of the therapeutic effect and safety of NCS.ResultsNCS did not enhance survival rate as three of severe COVID-19 patients in NCS and in control groups died (P>0.05). However, NCS, compared to control group, reduced the time to recovery in moderate and severe COVID-19 patients about 5 and 3 days, respectively but not in mild patients (P≤0.05). Most interestingly, NCS lowered time to recovery up to five days in patients with co-morbidities (P≤0.05) whereas only one day lowered in patients without co-morbidities (P>0.05).ConclusionIt is concluded that NCS accelerates time to recovery about 3 to 5 days in moderate to severe COVID-19 patients especially those with co-morbidities; hence, NCS is of clinical benefit for freeing hospital beds for more patients in pandemic crisis.
Visible and real dynamics of the COVID-19 pandemic in Ukraine in the spring of 2021
Authors: Nesteruk Igor 
Published: June 2021

ABSTRACTThe visible and real sizes the last COVID-19 epidemic wave in Ukraine, estimated in March 2021 with the use of generalized SIR-model, are compared with number of cases registered in the spring of 2021. We have used the optimal value of the visibility coefficient in order to estimate the real numbers of accumulated cases, real daily numbers of new cases and real number of infectious persons. The results show that the latest prediction for Ukraine is in rather good agreement with observations, but the daily number of new cases decreases more slowly than theoretical predictions. The large real number of infectious people threatens the emergence of new strains of coronavirus and the beginning of new epidemic waves.
Age-Based Disparities in Hospitalizations and Mortality for Coronavirus Disease 2019 (COVID-19)
Authors: Wisk Lauren E. , Bhagat Santi K.M. , Sharma Niraj 
Published: June 2021

ABSTRACTPurposeEvidence suggests that older adults, racial/ethnic minorities, and those with comorbidities all face elevated risk for morbidity and mortality from COVID-19; but there are limited reports describing the potential for interactions between these factors.MethodsWe sought to evaluate age-based heterogeneity in observed disparities in hospitalization, ICU admission, and mortality related to COVID-19 using CDC public use surveillance data on 3,662,325 COVID-19 cases reported from January 1 to August 30, 2020.ResultsRacial/ethnic and comorbidity disparities in hospitalization were most pronounced during ages 20-29 and ages 10-19, with similar elevation seen for disparities in ICU risk.Racial/ethnic disparities in mortality were most pronounced during ages 20-29 while risk from comorbidity peaks among ages 10-39.ConclusionsAs COVID-19 continues to affect younger populations, special attention to the implications for the most vulnerable subgroups are clearly warranted.Implications and ContributionAdolescents and young adults appear to have experienced the greatest inequities in COVID-19 outcomes by race/ethnicity and comorbidity. Careful monitoring of trends in this population is warranted as they re-enter school, work, and social settings while being the last group to receive priority for vaccination.
Screening for Cardiac Disease with Genetic risk scoring, Advanced ECG, Echocardiography, Protein Biomarkers and Metabolomics
Authors: Gladding Patrick A. , Dugo Clementina , Wynne Yvonne , Semple Heather , Smith Kevin , Larsen Peter , Shepherd Phillip , Zarate Erica , Villas-Boas Silas , Schlegel Todd T. 
Published: June 2021

IntroductionScreening patients for cardiovascular disease has not been widely advocated due to cost implications and is reserved for high risk or symptomatic patients. We undertook an exploratory study to evaluate the promising low-cost methods for screening, including genetic risk scoring (GRS), advanced ECG (A-ECG), echocardiography and metabolomics.Methods78 patients underwent advanced 5-min ECG and echocardiography, including global longitudinal strain (GLS), and echocardiographic calcium scoring (eCS). A GRS of 27 SNPs (GRS27) related to coronary disease and 3 SNPs for atrial fibrillation was used, as well as hs-troponin (Abbott, Singulex, Roche), NTproBNP (Roche) testing and targeted plasma metabolomics using GC-MS. Results were correlated with the presence of coronary artery disease (CAD) (CT coronary angiography (CTCA)), measures of left ventricular hypertrophy (LVH) (echocardiography and CTCA), and LV systolic dysfunction (LVSD) (echocardiography).ResultsLV dysfunction was accurately identified by using either A-ECG (AUC 0.97, 0.89 to 0.99) or NTproBNP. eCS demonstrated accurate discrimination of CAD (AUC 0.84, 95% CI 0.72 to 0.92, p < 0.0001. Troponin I (Abbott/Singulex) had the highest sensitivity and accuracy for the detection of LVH measured by either CT or echocardiography (AUC 0.85, 95% CI 0.73 to 0.92), however specificity was reduced by the presence of LV systolic dysfunction. Metabolomics and A-ECG identified underlying abnormal mechanisms related to both LVH (glycine metabolism) and LV dysfunction, (Citric Acid cycle). Metabolomics provided incidental utility by identifying metformin adherence and nutritional biomarkers.ConclusionA multi-omic approach to screening can be achieved at relatively low cost, and high accuracy, but will need to be evaluated in larger populations to prove its utility.
‘Superbugs: A Pop-up Science Shop’: Increasing public awareness and knowledge of antimicrobial resistance by taking science to the city
Authors: Tyrrell Jonathan M. , Conlon Christie S. , Aboklaish Ali F. , Hatch Sarah , Smith Carl , Mathias Jordan , Thomson Kathryn , Eberl Matthias 
Published: June 2021

Abstract‘Superbugs: A Pop-up Science Shop’ was a public engagement event in the school summer holidays of 2019, organised by members of Cardiff University’s School of Medicine. We transformed an empty retail unit in the centre of Wales’ largest shopping centre into an interactive and immersive microbiology experience. We aimed to facilitate opportunities for two-way dialogue to impart positive impact on the awareness of antibiotic resistance, whilst concurrently evaluating the efficacy of an engagement strategy focused on the utilisation of public spaces to attract public demographics diverse to those who would normally engage with STEM outreach.Over the course of 14 days, we welcomed 6,566 visitors, with 67% attending as part of the natural footfall of the shopping centre. We created 1,625 young Antibiotic Resistance Champions, located in over 200 schools. Through a multi-lateral evaluation strategy, we were able to collect quantitative and qualitative feedback on the success of our delivery model, and the impact on our stakeholders. Herein, we will discuss the evolution of ‘Superbugs’ from concept, planning and design, to the logistics of delivering an engagement event of this scale. We will focus in particular on the learning outcomes of the project, and how this will shape the future of our ‘Superbugs’ project, and engagement events beyond.Key MessagesCreating a multi-disciplinary core team is essential to the success of large-scale engagement events as well as the support and development of large numbers of colleagues/volunteersUtilising themes of exhibition and gameplay alongside strong fear-empowerment messages is an impactful way to confer positive influence and behaviour around antimicrobial resistance (AMR) and the use of antibiotics‘Pop-up shop’ is an effective mode of delivery to capture diverse public demographics far beyond those who would traditionally engage with scientific outreach and science engagement.