bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevating ATP‐binding cassette transporter G1 improves re‐endothelialization function of endothelial progenitor cells via Lyn/Akt/eNOS in diabetic mice
Authors: Shi Ying , Lv Xue , Liu Yanan , Li Bochuan , Liu Mingming , Yan Meng , Liu Yajin , Li Qi , Zhang Xuejiao , He Shuang , Zhu Mason , He Jinlong , Zhu Yan , Zhu Yi , Ai Ding 
Published: November 2018

ABSTRACTEndothelial progenitor cell (EPC) dysfunction contributes to diabetes‐induced delay in endothelium repair after vessel injury, prominently associated with diabetic cardiovascular complications such as neointima formation. ATP‐binding cassette transporter G1 (ABCG1) promotes cholesterol efflux to HDL, which may favorably affect EPC function. However, whether ABCG1 improves EPC function, especially in diabetes, remains unknown. Here we investigated the role of ABCG1 in EPCs by using Tie2‐mediated ABCG1 transgenic (Tie2‐ABCG1Tg)mice. Mice were injected with streptozotocin to induce diabetes mellitus. As compared with wild‐type (WT) mice, in Tie2‐ABCG1Tg mice, diabetes‐impaired EPC migration and tube formation were reversed. In vitro gain‐of‐function and loss‐of‐function studies further revealed that ABCG1‐overexpressing EPCs showed increased migration and tube formation and differentiation via the Lck/Yes‐related novel protein tyrosine kinase /Akt/endothelial NO synthase pathway by enhancing cellular cholesterol efflux. Finally, type 1 and type 2 diabetic mouse models with arterial injury were intravenously injected with labeled EPCs from WT or Tie2‐ABCG1Tg mice. Re‐endothelialization in diabetic mice was improved to a greater extent by injection of ABCG1‐overexpressing than WT EPCs. Our study demonstrated that ABCG1 in EPCs improved repair after vascular injury in diabetes by increasing EPC function such as migration, tube formation and differentiation, and subsequent re‐endothelialization. ABCG1 might be a promising therapeutic target for diabetes‐associated vascular diseases.—Shi, Y., Lv, X., Liu, Y., Li, B., Liu, M., Yan, M., Liu, Y., Li, Q., Zhang, X., He, S., Zhu, M., He, J., Zhu, Y., Zhu, Y., Ai, D. Elevating ATP‐binding cassette transporter G1 improves re‐endothelialization function of endothelial progenitor cells via Lyn/Akt/eNOS in diabetic mice. FASEB J. 32, 6525–6536 (2018). www.fasebj.org
Overlooked adenocarcinoma of the scalp
Authors: Elefteriou-Kokolis Elena , Danielsen Randy , Kokolis Rodamanthos Nicholas 
Published: November 2018

ABSTRACT
An apocrine adenocarcinoma of the scalp is a rare diagnosis in internal medicine. The article reviews the pathophysiology of the diagnosis and new, nonsurgical treatment options including radiation therapy and topical chemotherapy treatments.
A Road Map for Attending to Medical Students’ Professionalism Lapses
Authors: Mak-van der Vossen Marianne C. , de la Croix Anne , Teherani Arianne , van Mook Walther N.K.A. , Croiset Gerda , Kusurkar Rashmi A. 
Published: November 2018

Purpose
To develop a road map for educators attending to medical students’ professionalism lapses, aiming to offer an empirical base for approaching students who display such lapses.

Method
Between October 2016 and January 2018, 23 in-depth interviews with 19 expert faculty responsible for remediation from 13 U.S. medical schools were conducted about the way they handle students’ professionalism lapses. Three researchers independently completed three rounds of coding. Data collection, coding, and analysis were performed in a constant comparative process. A constructivist grounded theory approach was used to develop an explanatory model for attending to students’ professionalism lapses.

Results
Based on participants’ descriptions, the authors developed a three-phase approach for attending to professionalism lapses. In phase 1, experts enacted the role of concerned teacher, exploring the lapse from the student’s perspective. In phase 2, they functioned as supportive coach, providing feedback on professionalism values, improving skills, creating reflectiveness, and offering support. In phase 3, if the student did not demonstrate reflectiveness and improvement, and especially if (future) patient care was potentially compromised, participants assumed an opposite role: gatekeeper of the profession.

Conclusions
An explanatory model for attending to professionalism lapses that fits in the overarching “communities of practice” framework was created. Whereas phase 1 and 2 aim at keeping students in the medical community, phase 3 aims at guiding students out. These findings provide empirical support to earlier descriptive, opinion-based models and may offer medical educators an empirical base for attending to students who display professionalism lapses.
Impact of In-utero Exposure to Selective Serotonin Reuptake Inhibitors and Opioids on Neonatal Opioid Withdrawal Syndrome
Authors: Bhatt-Mehta Varsha , Richards Jessika , Sturza Julie , Schumacher Robert E. 
Published: November 2018

Objective:
The objective of this study was to compare short-term outcomes of neonatal opioid withdrawal syndrome (NOWS) treatment in infants exposed in-utero to opioids and selective serotonin reuptake inhibitors (SSRIs) or opioids alone.

Methods:
This was a retrospective cohort study of mother-infant dyads, 34 weeks or greater gestation, receiving opioids and/or SSRIs during pregnancy. Intravenous or oral methadone was administered according to a pre-existing protocol for NOWS treatment guided by withdrawal scores. Primary outcome was length of treatment (LOT). Secondary outcomes included length of stay (LOS), total methadone exposure, time to symptom control, need for a second agent, and NOWS medications at discharge.

Results:
Fifty-five mother-infant dyads were included in the study. LOT was longer in the infants in the SSRI plus opioid group but not significantly different [24 ± 23 days (SSRI plus opioid) vs 20 ± 14 days (opioid alone); P = 0.78]. There was a trend towards shorter LOS (30 ± 22 day vs 27 ± 15 days; P = 0.86), lower total methadone exposure (3.2 ± 4.3 mg/kg vs 2.7 ± 5.1 mg/kg; P = 0.66), less time to control symptoms (1 ± 1.7 days vs 0.5 ± 0.36 days; P = 0.31) and less need for a second agent (OR 2.65, 95% CI 0.69–10.5) in the opioid only group, although these observations also did not reach statistical significance.

Conclusions:
This study could not demonstrate a statistically significant difference in short-term NOWS outcome of LOT between the 2 groups. However, there was a trend towards longer LOT and LOS in the SSRI plus opioid group which could be clinically significant. A larger cohort may detect a true significant difference in these short-term outcomes.
Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-analysis
Authors: Gao Burke , Dwivedi Shashank , Milewski Matthew D. , Cruz Aristides I. 
Published: November 2018

Background:
Although sleep has been identified as an important modifiable risk factor for injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied. The objective of this study was to quantitatively and qualitatively review published literature to examine if a lack of sleep is associated with sports injuries in adolescents and to delineate the effects of chronic versus acute lack of sleep.

Methods:
PubMed (includes MEDLINE) and EMBASE databases were systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported statistics regarding the relationship between sleep and sports injury in adolescents aged 19 years or younger published between January 1, 1997 and December 21, 2017. From these included studies, the following information was extracted: bibliographic and demographic information, reported outcomes related to injury and sleep, and definitions of injury and decreased sleep. A random effects model was then created to quantify the odds of injury with decreased sleep in adolescents.

Results:
Of 907 identified articles, 7 met inclusion criteria. Five studies reported that adolescents who chronically slept poorly were at a significantly increased likelihood of experiencing a sports or musculoskeletal injury. Two studies reported on acute sleep behaviors. One reported a significant positive association between acutely poor sleep and injury, whereas the other study reported no significant association. In our random effects model, adolescents who chronically slept poorly were more likely to be injured than those who slept well (OR, 1.58; 95% CI, 1.05-2.37; P=0.03).

Conclusions:
Chronic lack of sleep in adolescents is associated with greater risk of sports and musculoskeletal injuries. Current evidence cannot yet definitively determine the effect of acute lack of sleep on injury rates.

Level of Evidence:
Level IV—systematic review of level II studies and one level IV study.
Impact of Nursing Education on Phlebotomy Blood Loss and Hospital-Acquired Anemia
Authors: Jones Stacy , Spangler Paris , Keiser Megan , Turkelson Carman 
Published: November 2018

Background
Phlebotomy blood loss resulting in hospital-acquired anemia remains a significant problem in the critically ill population. A quality improvement project focused on decreasing phlebotomy blood loss and increasing nursing knowledge regarding blood conservation strategies was undertaken in the intensive care unit of a community hospital.

Methods
The project followed a quasi-experimental design. Data were gathered using electronic chart review and surveys before and after educational sessions. Intensive care unit nurses attended educational sessions focused on increasing knowledge regarding phlebotomy blood loss, hospital-acquired anemia, blood conservation strategies, and utilization of blood conservation devices.

Results
The study showed a statistically significant increase in nursing knowledge regarding hospital-acquired anemia, phlebotomy blood loss, and blood conservation device use (P < .001) and a statistically significant change in blood conservation device application practice in the posteducation period when compared with the preeducation period (P = .016).

Conclusion
The findings of this project support the added value of dedicated blood conservation education to nurses to promote increased knowledge, increased blood conservation device utilization, and decreases in phlebotomy blood loss.
The Effects of Oral Care Protocol on the Incidence of Ventilation-Associated Pneumonia in Selected Intensive Care Units in Jordan
Authors: Alja’afreh Mahmoud A. , Mosleh Sultan M. , Habashneh Sakhaa S. 
Published: November 2018

Purpose
This study aims to evaluate the effects of oral care protocol on the incidence of ventilator-associated pneumonia (VAP) at selected intensive care units (ICUs) in Jordan using clinical pulmonary infection score.

Methods
A quasi-experimental design was used, and 1 large teaching hospital from the Jordanian capital, along with 2 hospitals from the southern region, was selected. A total of 218 patients participated, among which VAP risk in 2 independent groups was evaluated through the Clinical Pulmonary Infection Score sheet.

Results
The VAP incidence rate was significantly lower in the intervention group (n = 102) as compared with control group (n = 116) (21.6 vs 35.3, respectively; P = .018); in addition, ICU stay and intubation period were significantly shorter among the intervention group. A higher risk of VAP was independently predicted by previous lung diseases (odds ratio [OR], 1.441; 95% confidence interval [CI], 1.185-1.88), open suctioning system (OR, 2.536; 95% CI, 1.261-5.101), and duration of intubation (OR, 1.770; 95% CI, 0.845-2.220). The oral care protocol has effectively improved ventilated patients’ oral health, which has statistically reduced the incidence of VAP. It occurred more frequently among patients who have lung disease and those who were intubated for more than 7 days and have an open suctioning system.

Conclusion
Health care teams should ensure that effective care protocol is implemented among patients.
Construct Validity and Responsiveness of the Abdominal Surgery Impact Scale in the Context of Recovery After Colorectal Surgery
Authors: Balvardi Saba , Pecorelli Nicolò , Castelino Tanya , Niculiseanu Petru , Liberman A. Sender , Charlebois Patrick , Stein Barry , Carli Franco , Mayo Nancy E. , Feldman Liane S. , Fiore Julio F. 
Published: November 2018

BACKGROUND:
The Abdominal Surgery Impact Scale is a patient-reported outcome measure that evaluates quality of life after abdominal surgery. Evidence supporting its measurement properties is limited.

OBJECTIVE:
This study aimed to contribute evidence for the construct validity and responsiveness of the Abdominal Surgery Impact Scale as a measure of recovery after colorectal surgery in the context of an enhanced recovery pathway.

DESIGN:
This is an observational validation study designed according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist.

SETTING:
This study was conducted at a university-affiliated tertiary hospital.

PATIENTS:
Included were 100 consecutive patients undergoing colorectal surgery (mean age, 65; 57% male).

INTERVENTION:
There were no interventions.

MAIN OUTCOME MEASURES:
Construct validity was assessed at 2 days and 2 and 4 weeks after surgery by testing the hypotheses that Abdominal Surgery Impact Scale scores were higher 1) in patients without vs with postoperative complications, 2) with higher preoperative physical status vs lower, 3) without vs with postoperative stoma, 4) in men vs women, 5) with shorter time to readiness for discharge (≤4 days) vs longer, and 6) with shorter length of stay (≤4 days) vs longer. To test responsiveness, we hypothesized that scores would be higher 1) preoperatively vs 2 days postoperatively, 2) at 2 weeks vs 2 days postoperatively, and 3) at 4 weeks vs 2 weeks postoperatively.

RESULTS:
The data supported 3 of the 6 hypotheses (hypotheses 1, 5, and 6) tested for construct validity at all time points. Two of the 3 hypotheses tested for responsiveness (hypotheses 1 and 2) were supported.

LIMITATIONS:
This study was limited by the risk of selection bias due to the use of secondary data from a randomized controlled trial.

CONCLUSIONS:
The Abdominal Surgery Impact Scale was responsive to the expected trajectory of recovery up to 2 weeks after surgery, but did not discriminate between all groups expected to have different recovery trajectories. There remains a need for the development of recovery-specific, patient-reported outcome measures with adequate measurement properties. See Video Abstract at http://links.lww.com/DCR/A814.
Randomized Clinical Trial Comparing Laparoscopic Versus Ultrasound-Guided Transversus Abdominis Plane Block in Minimally Invasive Colorectal Surgery
Authors: Zaghiyan Karen N. , Mendelson Brian J. , Eng Matthew R. , Ovsepyan Gayane , Mirocha James M. , Fleshner Phillip 
Published: November 2018

BACKGROUND:Transversus abdominis plane block may improve analgesia after colorectal surgery; however, techniques remain unstandardized and results are conflicting.OBJECTIVE:The purpose of this study was to compare laparoscopic and ultrasound-guided transversus abdominis plane block with no block in minimally invasive colorectal surgery.DESIGN:This was a randomized controlled trial.SETTINGS:The study was conducted at an urban teaching hospital.PATIENTS:Patients undergoing laparoscopic colorectal surgery were included.INTERVENTIONS:The intervention included 2:2:1 randomization to laparoscopic, ultrasound-guided, or no transversus abdominis plane block.MAIN OUTCOME MEASURES:Morphine use in the first 24 hours after surgery was measured.RESULTS:The study cohort included 107 patients randomly assigned to laparoscopic (n = 41), ultrasound-guided (n = 45), or no transversus abdominis plane block (n = 21). Mean age was 50.4 years (SD ± 18 y), and 50 patients (47%) were men. Laparoscopic transversus abdominis plane block was superior to ultrasound-guided (p= 0.007) and no transversus abdominis plane block (p= 0.007), with median (interquartile range) total morphine used in the first 24 hours postoperatively of 17.6 mg (6.6–33.9 mg), 34.0 mg (16.4–44.4 mg), and 31.6 mg (18.4–44.4 mg). At 48 hours, laparoscopic transversus abdominis plane block remained superior to ultrasound-guided (p= 0.03) and no transversus abdominis plane block (p= 0.007) with median (interquartile range) total morphine used at 48 hours postoperatively of 26.8 mg (15.5–45.8 mg), 44.0 mg (27.6–70.0 mg), and 60.8 mg (34.8–78.8 mg). Mean hospital stay was 5.1 ± 3.1 days without any intergroup differences. Overall complications were similar between groups.LIMITATIONS:Treatment teams were not blinded and there was operator dependence of techniques and variable timing of the blocks.CONCLUSIONS:Laparoscopic transversus abdominis plane block is superior to ultrasound-guided and no transversus abdominis plane block in achieving pain control and minimizing opioid use in the first 24 hours after colorectal surgery. A large, multicenter, randomized trial is needed to confirm our findings. SeeVideo Abstractat http://links.lww.com/DCR/A822.
Do Post-breast Cancer Diagnosis Toenail Trace Element Concentrations Reflect Prediagnostic Concentrations?
Authors: O’Brien Katie M. , White Alexandra J. , Sandler Dale P. , Jackson Brian P. , Karagas Margaret R. , Weinberg Clarice R. 
Published: November 2018

Background:
Exposure to trace elements may affect health, including breast cancer risk. Trace element levels in toenails are potentially useful biomarkers of exposure, but their reliability is not established. We assessed the reproducibility of toenail element concentrations over time and whether concentrations change following a breast cancer diagnosis.

Methods:
We assessed trace element levels in toenails collected at two time points from 221 women (111 with and 110 without an intervening breast cancer diagnosis). We measured levels of arsenic, cadmium, chromium, cobalt, copper, iron, mercury, manganese, molybdenum, nickel, lead, antimony, selenium, tin, vanadium, and zinc using inductively coupled plasma mass spectrometry in samples collected at baseline and 4–10 years later. We compared trace element concentrations over time using Spearman’s rank correlation coefficient (R). We used linear models to examine the magnitude and direction of changes and the influence of a breast cancer diagnosis.

Results:
Overall, we observed positive correlations (R = 0.18–0.71) between paired samples for all trace elements. However, nickel (R = −0.02) and antimony (R = 0.12) were not correlated among cases. We observed decreases in cadmium, chromium, mercury, manganese, molybdenum, nickel, and lead between baseline and follow-up, but case status was unrelated to these changes. The declines are consistent with decreases over calendar time rather than age time.

Conclusions:
Toenail trace element concentrations were correlated over time, but many elements showed systematic decreases by calendar year. Aside from nickel and antimony, postdiagnostic toenail levels correlated with prediagnostic levels, providing support for using postdiagnostic toenail samples in retrospective studies.
Diesel Exhaust, Respirable Dust, and Ischemic Heart Disease: An Application of the Parametric g-formula
Authors: Neophytou Andreas M. , Costello Sadie , Picciotto Sally , Brown Daniel M. , Attfield Michael D. , Blair Aaron , Lubin Jay H. , Stewart Patricia A. , Vermeulen Roel , Silverman Debra T. , Eisen Ellen A. 
Published: November 2018

Background:
Although general population studies of air pollution suggest that particulate matter—diesel exhaust emissions in particular—is a potential risk factor for cardiovascular disease, direct evidence from occupational cohorts using quantitative metrics of exposure is limited. In this study, we assess counterfactual risk of ischemic heart disease (IHD) mortality under hypothetical scenarios limiting exposure levels of diesel exhaust and of respirable mine/ore dust in the Diesel Exhaust in Miners Study cohort.

Methods:
We analyzed data on 10,779 male miners from 8 nonmetal, noncoal mines—hired after diesel equipment was introduced in the respective facilities—and followed from 1948 to 1997, with 297 observed IHD deaths in this sample. We applied the parametric g-formula to assess risk under hypothetical scenarios with various limits for respirable elemental carbon (a surrogate for diesel exhaust), and respirable dust, separately and jointly.

Results:
The risk ratio comparing the observed risk to cumulative IHD mortality risk at age 80 under a hypothetical scenario where exposures to elemental carbon and respirable dust are eliminated was 0.79 (95% confidence interval [CI]: 0.64, 0.97). The corresponding risk difference was -3.0% (95% CI: -5.7, -0.3).

Conclusion:
Our findings, based on data from a cohort of nonmetal miners, are consistent with the hypothesis that interventions to eliminate exposures to diesel exhaust and respirable dust would reduce IHD mortality risk.
Drug-induced Sialorrhoea
Authors: Haastrup Maija Bruun , Henriksen Daniel P. , Christensen Mette Marie H. 
Published: November 2018

Summary
Sialorrhoea is a common adverse effect of a range of medicines, primarily clozapine. At least a third of patients treated with clozapine suffer from sialorrhoea, and the consequences of this can be socially stigmatising and lead to non-adherence. The treatment options are limited and primarily centered around muscarinic antagonism. We suggest non-pharmacological interventions followed by locally applied atropine or glycopyrrolate. If systemic treatment is necessary, amisulpride, benztropine, or terazosin may be attempted.
Darunavir Population Pharmacokinetic Model Based on HIV Outpatient Data
Authors: Daskapan Alper , Tran Quynh T.D. , Cattaneo Dario , Gervasoni Cristina , Resnati Chiara , Stienstra Ymkje , Bierman Wouter F.W. , Kosterink Jos G. W. , van der Werf Tjip S. , Proost Johannes H. , Alffenaar Jan-Willem C. , Touw Daniel J. 
Published: November 2018

Background:
Darunavir is a second-generation protease inhibitor and is registered for the treatment of HIV-1 infection. The aim of this study was to develop and validate a darunavir population pharmacokinetic model based on data from daily practice.

Methods:
Data sets were obtained from 2 hospitals: ASST Fatebenefratelli Sacco University Hospital, Italy (hospital A), and University Medical Center Groningen, the Netherlands (hospital B). A pharmacokinetic model was developed using data from the largest data set using the iterative two-stage Bayesian procedure within the MWPharm software package. External validation was conducted using data from the smaller data set with Passing–Bablok regression and Bland–Altman analyses.

Results:
In total, data from 198 patients from hospital A and 170 patients from hospital B were eligible for inclusion. A 1-compartment model with first-order absorption and elimination resulted in the best model. The Passing–Bablok analysis demonstrated a linear correlation between measured concentration and predicted concentration with r2 = 0.97 (P < 0.05). The predicted values correlated well with the measured values as determined by a Bland–Altman analysis and were overestimated by a mean value of 0.12 mg/L (range 0.23–0.94 mg/L). A total of 98.2% of the predicted values were within the limits of agreement.

Conclusions:
A robust population pharmacokinetic model was developed, which can support therapeutic drug monitoring of darunavir in daily outpatient settings.