bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does modifying the timing of meal intake improve cardiovascular risk factors? Protocol of an Australian pilot intervention in night shift workers with abdominal obesity
Authors: Bonham Maxine P , Leung Gloria K W , Davis Rochelle , Sletten Tracey L , Murgia Chiara , Young Morag J , Eikelis Nina , Lambert Elisabeth A , Huggins Catherine E 
Published: March 2018

IntroductionShift work is an independent risk factor for cardiovascular disease (CVD). Shift workers who are awake overnight and sleep during the day are misaligned with their body’s endogenous circadian rhythm. Eating at night contributes to this increased risk of CVD by forcing the body to actively break down and process nutrients at night. This pilot study aims to determine whether altering meal timing overnight, in a shift working population, will impact favourably on modifiable risk factors for CVD (postprandial bplasma lipids and glucose concentration).Methods and analysisA randomised cross-over study with two 4-week test periods, separated by a minimum of a 2-week washout will be undertaken. The effectiveness of redistributing energy intake overnight versusad libitumeating patterns on CVD risk factors will be examined in night shift workers (n=20), using a standard acute test meal challenge protocol. Primary outcomes (postprandial lipids and glucose) will be compared between the two conditions: post-intervention and post-control period using analysis of variance. Potential effect size estimates to inform sample size calculations for a main trial will also be generated.Ethics and disseminationEthics approval has been granted by the Monash University Human Research Ethics Committee (2017-8619-10329). Outcomes from this study will determine whether eliminating food intake for a defined period at night (1–6 am) impacts favourably on metabolic risk factors for CVD in night shift workers. Collective results from this novel trial will be disseminated through peer-reviewed journals, and national and international presentations. The results are essential to inform health promotion policies and guidelines for shift workers, especially those who aim to improve their metabolic health.Trial registration numberACTRN12617000791336; Pre-results.
Pharmacists detecting atrial fibrillation (PDAF) in primary care during the influenza vaccination season: a multisite, cross-sectional screening protocol
Authors: Veale Emma L , Stewart Adrian J , Mathie Alistair , Lall Satvinder K , Rees-Roberts Melanie , Savickas Vilius , Bhamra Sukvinder K , Corlett Sarah A 
Published: March 2018

IntroductionAtrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics.Methods and analysisSeven clinical pharmacists will be trained by a cardiologist to pulse palpate and record single-lead ECGs using the AliveCor Kardia Mobile device. Quantitative analysis will assess the accuracy and ability of the clinical pharmacist to identify pulse irregularities using pulse palpation and to record and interpret a single-lead ECG. The level of agreement of pulse irregularities detected by pulse palpation will be compared with those detected by the single-lead ECG device, as will the level of agreement between the cardiologist and the device’s interpretation of the ECG. The proportion of people identified with AF (confirmed by the cardiologist) will be determined. Additional demographic data will be obtained from all participants through a questionnaire. Qualitative data will be captured from the participants, from the clinical pharmacists and from the general practitioners and practice staff to determine their views on this method of AF screening. We aim to recruit 600 participants across general practices within Kent.Ethics and disseminationThis protocol was approved by the London–Riverside Research Ethics committee. The findings of this study will be disseminated through forums including, but not limited to, peer-reviewed journals, national and international conferences.
Reducing the number of invalid surgical consents in the day surgery unit
Authors: Chong Wesley , Fong Allan Chee Yang , Yeo Yi Lin , Ng Angie Puay Hong , Neo Eileen May Lin , Sam Veronica Li Ee , Ong Jessica Kai Jun , Huey Peng Loh 
Published: March 2018

AimTo reduce the number of invalid surgical consents in the Singapore National Eye Centre Day Surgery Unit over a period of 6 months.MethodologyA multidisciplinary team involving doctors, nurses, day surgery unit, operating theatre, listing and clinical audit staff looked into the listing process and the root causes of the high number of invalid consents. A Pareto chart detailing the top causes of invalid consents was drawn, and with a prioritisation matrix, feasible yet effective changes were identified and effected. Plan-Do-Study-Act (PDSA) cycles included moving consent checks upstream, getting invalid consents amended on the same day, sending emails to raise awareness on invalid consents and posters in clinics to emphasise the correct way to fill up consent forms.ResultThere has been a progressive downtrend in the monthly mean percentage of invalid consents since the introduction of PDSA cycles. There was a significant reduction in the mean rate of rejected consents from the preintervention phase of 15.2% to the postintervention phase of 11.3%, shown with a Z score of 6.56 (P<0.05). Sustainability was also demonstrated with multiple consecutive points below the median of 14.5% on the postimplementation phase of the run chart, with estimated time-efficiency savings of USD$19 738.50 annually.ConclusionErrors in the workplace can be reduced with a concerted effort from multiple stakeholders. It is important to have a thorough look at processes with concerned parties, so that different perspectives and skill sets can be harnessed to determine and implement feasible and effective interventions.
Realist synthesis of intentional rounding in hospital wards: exploring the evidence of what works, for whom, in what circumstances and why
Authors: Sims Sarah , Leamy Mary , Davies Nigel , Schnitzler Katy , Levenson Ros , Mayer Felicity , Grant Robert , Brearley Sally , Gourlay Stephen , Ross Fiona , Harris Ruth 
Published: March 2018

BackgroundIntentional rounding (IR) is a structured process whereby nurses conduct one to two hourly checks with every patient using a standardised protocol.ObjectiveA realist synthesis of the evidence on IR was undertaken to develop IR programme theories of what works, for whom, in what circumstances and why.MethodsA three-stage literature search and a stakeholder consultation event was completed. A variety of sources were searched, including AMED, CINAHL, MEDLINE, PsycINFO, HMIC, Google and Google Scholar, for published and unpublished literature. In line with realist synthesis methodology, each study’s ‘fitness for purpose’ was assessed by considering its relevance and rigour.ResultsA total of 44 papers met the inclusion criteria. To make the programme theories underpinning IR explicit, we identified eight a priori propositions: (1) when implemented in a comprehensive and consistent way, IR improves healthcare quality and satisfaction, and reduces potential harms; (2) embedding IR into daily routine practice gives nurses ‘allocated time to care’; (3) documenting IR checks increases accountability and raises fundamental standards of care; (4) when workload and staffing levels permit, more frequent nurse–patient contact improves relationships and increases awareness of patient comfort and safety needs; (5) increasing time when nurses are in the direct vicinity of patients promotes vigilance, provides reassurance and reduces potential harms; (6) more frequent nurse–patient contact enables nurses to anticipate patient needs and take pre-emptive action; (7) IR documentation facilitates teamwork and communication; and (8) IR empowers patients to ask for what they need to maintain their comfort and well-being. Given the limited evidence base, further research is needed to test and further refine these propositions.ConclusionsDespite widespread use of IR, this paper highlights the paradox that there is ambiguity surrounding its purpose and limited evidence of how it works in practice.
Retention of gait stability improvements over 1.5 years in older adults: effects of perturbation exposure and triceps surae neuromuscular exercise
Authors: Epro G. , Mierau A. , McCrum C. , Leyendecker M. , Brüggemann G.-P. , Karamanidis K. 
Published: March 2018

The plantarflexors play a crucial role in recovery from sudden disturbances to gait. The objective of this study was to investigate whether medium (months)- or long(years)-term exercise-induced enhancement of triceps surae (TS) neuromuscular capacities affects older adults’ ability to retain improvements in reactive gait stability during perturbed walking acquired from perturbation training sessions. Thirty-four adult women (65 ± 7 yr) were recruited to a perturbation training group ( n = 13) or a group that additionally completed 14 wk of TS neuromuscular exercise ( n = 21), 12 of whom continued with the exercise for 1.5 yr. The margin of stability (MoS) was analyzed at touchdown of the perturbed step and the first recovery step following eight separate unexpected trip perturbations during treadmill walking. TS muscle-tendon unit mechanical properties and motor skill performance were assessed with ultrasonography and dynamometry. Two perturbation training sessions (baseline and after 14 wk) caused an improvement in the reactive gait stability to the perturbations (increased MoS) in both groups. The perturbation training group retained the reactive gait stability improvements acquired over 14 wk and over 1.5 yr, with a minor decay over time. Despite the improvements in TS capacities in the additional exercise group, no benefits for the reactive gait stability following perturbations were identified. Therefore, older adults’ neuromotor system shows rapid plasticity to repeated unexpected perturbations and an ability to retain these adaptations in reactive gait stability over a long time period, but an additional exercise-related enhancement of TS capacities seems not to further improve these effects. NEW & NOTEWORTHY Older adults’ neuromotor system shows rapid plasticity to repeated exposure to unexpected perturbations to gait and an ability to retain the majority of these adaptations in reactive recovery responses over a prolonged time period of 1.5 yr. However, an additional exercise-related enhancement of TS neuromuscular capacities is not necessarily transferred to the recovery behavior during unexpected perturbations to gait in older adults.
STAT3/HOTAIR Signaling Axis Regulates HNSCC Growth in an EZH2-dependent Manner
Authors: Sun Shanshan , Wu Yansheng , Guo Wenyu , Yu Feng , Kong Lingping , Ren Yu , Wang Yu , Yao Xiaofeng , Jing Chao , Zhang Chao , Liu Mingyang , Zhang Yuqing , Zhao Minghui , Li Zhaoqing , Wu Chuanqiang , Qiao Yu , Yang Jingxuan , Wang Xudong , Zhang Lun , Li Min , Zhou Xuan 
Published: March 2018

Abstract
Purpose: PI3K and STAT3 are frequently activated in cancer progression. However, little is known about the underlying mechanisms by which PI3K and STAT3 regulate head and neck squamous cell cancer (HNSCC) growth. The lncRNA HOX transcript antisense RNA (HOTAIR) was found to modulate the progression of HNSCC. In this study, we attempted to establish the correlation of PI3K/STAT3/HOTAIR signaling with the progression of HNSCC and its sensitivity toward platinum-based and targeted anti-EGFR combination therapy.
Experimental Design: We first analyzed the STAT3/HOTAIR and PI3K/AKT level in human HNSCC samples. We then activated or suppressed STAT3/HOTAIR and determined the effects on HNSCC cell proliferation in vitro and the growth of UM1 xenograft tumor, an orthotopic model of HNSCC. The sensitivity of HNSCC cells toward cisplatin and cetuximab was determined by in vitro assays.
Results: HNSCC samples showed significantly robust expression/activation of STAT3, HOTAIR, PI3K, and AKT, compared with normal squamous epithelium. STAT3 inhibition with WP1066 decreased HOTAIR level and sensitized HNSCC to cisplatin or cetuximab. STAT3 promoted HOTAIR transcription and its interaction with pEZH2-S21, resulting in enhanced growth of HNSCC cells. In addition, overexpression of HOTAIR promoted the growth of UM1 xenograft tumors in vivo.
Conclusions: Our results suggest that STAT3 signaling promotes HNSCC progression via regulating HOTAIR and pEZH2-S21 in HNSCC with PI3K overexpression/activation. These findings provide a rationale to target the STAT3/HOTAIR/pEZH2-S21 regulatory axis for treating patients with HNSCC. Clin Cancer Res; 24(11); 2665–77. ©2018 AACR.
Survivin Monoclonal Antibodies Detect Survivin Cell Surface Expression and Inhibit Tumor Growth In Vivo
Authors: Fenstermaker Robert A. , Figel Sheila A. , Qiu Jingxin , Barone Tara A. , Dharma Sanam S. , Winograd Evan K. , Galbo Phillip M. , Wiltsie Laura M. , Ciesielski Michael J. 
Published: March 2018

Abstract
Purpose: Survivin is an inhibitor of apoptosis protein (IAP) that is highly expressed in many cancers and represents an attractive molecule for targeted cancer therapy. Although primarily regarded as an intracellular protein with diverse actions, survivin has also been identified in association with circulating tumor exosomes.
Experimental Design: We have reported that active, specific vaccination with a long peptide survivin immunogen leads to the development of survivin-specific CD8-mediated tumor cell lysis and prolongation of survival in tumor-bearing mice. In addition to cellular antitumor responses, circulating anti-survivin antibodies are detected in the serum of mice and human glioblastoma patients following vaccination with the survivin immunogen.
Results: Here we demonstrate that survivin is present on the outer cell membrane of a wide variety of cancer cell types, including both murine and human glioma cells. In addition, antibodies to survivin that are derived from the immunogen display antitumor activity against murine GL261 gliomas in both flank and intracranial tumor models and against B16 melanoma as well.
Conclusions: In addition to immunogen-induced, CD8-mediated tumor cell lysis, antibodies to the survivin immunogen have antitumor activity in vivo. Cell-surface survivin could provide a specific target for antibody-mediated tumor immunotherapeutic approaches. Clin Cancer Res; 24(11); 2642–52. ©2018 AACR.
The Cytochrome P450 3A5 Non-Expressor Kidney Allograft as a Risk Factor for Calcineurin Inhibitor Nephrotoxicity
Authors: Udomkarnjananun Suwasin , Townamchai Natavudh , Chariyavilaskul Pajaree , Iampenkhae Kroonpong , Pongpirul Krit , Sirichindakul Boonchoo , Panumatrassamee Kamol , Vanichanan Jakapat , Avihingsanon Yingyos , Eiam-Ong Somchai , Praditpornsilpa Kearkiat 
Published: March 2018

<b><i>Background:</i></b> Tacrolimus is mainly metabolized by cytochrome P450 3A5 (<i>CYP3A5</i>), which is expressed in the liver. However, <i>CYP3A5</i> is also expressed in the kidney tissue and may contribute to local tacrolimus clearance in the kidney allograft. We aimed to evaluate the association between the allograft <i>CYP3A5</i> genotype and transplant outcomes. <b><i>Methods:</i></b> We conducted a retrospective cohort study at the King Chulalongkorn Memorial Hospital, Thailand, comparing 2 groups of donor and recipient <i>CYP3A5</i> genotypes, the expressor (*1/*1<i></i> and *1/*3) and the non-expressor (*3/*3). The primary outcomes were allograft complications including calcineurin inhibitor (CNI) nephrotoxicity and acute rejection episode. <b><i>Results:</i></b> Of the 50 enrolled patients, 21 donors were expressors and 29 donors were the non-expressors. Tacrolimus trough concentrations were similar between the 2 genotypes. The incidence of CNI nephrotoxicity was higher in recipients with non-expressor donor genotype compared with the expressor donor genotype (72.4 vs. 33.3%, <i>p</i> = 0.006). CNI nephrotoxicity incidence was not different when recipient’s genotypes were compared. Multivariate analysis from Cox-regression showed a hazard ratio of 3.18 (<i>p</i> = 0.026) for CNI nephrotoxicity in the non-expressor compared with the expressor donor. The recipient <i>CYP3A5</i> genotypes did not significantly contribute to CNI nephrotoxicity. Kaplan-Meier analysis demonstrated the lowest CNI nephrotoxicity-free survival in recipients with the expressor genotype who received allograft from the non-expressor donors (<i>p</i> = 0.005). <b><i>Conclusion:</i></b> In conclusion, our results suggest that donor <i>CYP3A5</i> non-expressor genotype (*3/*3) is a risk for CNI nephrotoxicity.
Outcomes After Continuous-Flow Left Ventricular Assist Device Implantation as Destination Therapy at Transplant Versus Nontransplant Centers
Authors: Brinkley D. Marshall , DeNofrio David , Ruthazer Robin , Vest Amanda R. , Kapur Navin K. , Couper Gregory S. , Kiernan Michael S. 
Published: March 2018

Background:
Since Food and Drug Administration’s approval of the HeartMate II left ventricular assist device (LVAD) as destination therapy, the number of hospitals offering LVAD therapy has grown rapidly. A rising number are performed at centers without internal transplant programs. We sought to determine whether outcomes after destination therapy LVAD implantation are similar at transplant and nontransplant centers.

Methods and Results:
Adult recipients of a primary, continuous-flow LVAD as destination therapy between January 2012 and March 2014 from the Interagency Registry for Mechanically Assisted Circulatory Support were included. Subjects were classified by implanting center as transplant (n=3323) or nontransplant (n=260). Center volume before 2012 was categorized as <15 or ≥15 implants. Outcomes included overall survival, freedom from death or major adverse event, rates of individual adverse events, rehospitalization, and health-related quality of life. Patients treated at nontransplant centers were generally less sick, with higher Interagency Registry for Mechanically Assisted Circulatory Support patient profiles and more normal laboratory and hemodynamic values. One-month (94.2% [95% confidence interval {CI}, 95.0–93.4] versus 94.2% [95% CI, 97.1–91.4]) and 12-month (76.4% [95% CI, 77.9–74.8] versus 71.3% [95% CI, 77.4–65.2]) survival were similar at transplant and nontransplant centers, respectively (hazard ratio, 0.88 [95% CI, 0.70–1.12]). Risk remained similar after adjustment for baseline characteristics (hazard ratio, 0.88 [95% CI, 0.69–1.12]). Freedom from death or major adverse event at 12 months (29.0% [95% CI, 30.6–27.3] versus 29.8% [95% CI, 36.0–23.6]) was similar at transplant and nontransplant centers (adjusted hazard ratio, 1.01 [95% CI, 0.87–1.18]). Individual adverse event rates, rehospitalization, and postimplant health-related quality of life were also similar.

Conclusions:
In a large, modern cohort of destination therapy LVAD recipients, outcomes after implantation were similar at transplant and nontransplant centers.
Predictors and Prognostic Value of Worsening Renal Function During Admission in HFpEF Versus HFrEF: Data From the KorAHF (Korean Acute Heart Failure) Registry
Authors: Kang Jeehoon , Park Jin Joo , Cho Young‐Jin , Oh Il‐Young , Park Hyun‐Ah , Lee Sang Eun , Kim Min‐Seok , Cho Hyun‐Jai , Lee Hae‐Young , Choi Jin Oh , Hwang Kyung‐Kuk , Kim Kye Hun , Yoo Byung‐Su , Kang Seok‐Min , Baek Sang Hong , Jeon Eun‐Seok , Kim Jae‐Joong , Cho Myeong‐Chan , Chae Shung Chull , Oh Byung‐Hee , Choi Dong‐Ju 
Published: March 2018

Background

Worsening renal function (
WRF
) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of
WRF
during admission, in patients with preserved ejection fraction (
HF
p
EF
) versus those with reduced ejection fraction (
HF
r
EF
).

Methods and Results

A total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry.
WRF
was defined as an absolute increase in creatinine of ≥0.3 mg/
dL
. Transient
WRF
was defined as recovery of creatinine at discharge, whereas persistent
WRF
was indicated by a nonrecovered creatinine level.
HF
p
EF
and
HF
r
EF
were defined as a left ventricle ejection fraction ≥50% and ≤40%, respectively. Among the total population,
WRF
occurred in 3101 patients (55.1%). By heart failure subgroup,
WRF
occurred more frequently in
HF
r
EF
(57.0% versus 51.3%;
P
<0.001 in
HF
r
EF
and
HF
p
EF
). Prevalence of
WRF
increased as creatinine clearance decreased in both heart failure subgroups. Among various predictors of
WRF
, chronic renal failure was the strongest predictor.
WRF
was an independent predictor of adverse in‐hospital outcomes (
HF
r
EF
: odds ratio; 2.75; 95% confidence interval, 1.50–5.02;
P
=0.001;
HF
p
EF
: odds ratio, 9.48; 95% confidence interval, 1.19–75.89;
P
=0.034) and 1‐year mortality (
HF
r
EF
: hazard ratio, 1.41; 95% confidence interval
,
1.12–1.78;
P
=0.004 versus
HF
p
EF
: hazard ratio, 1.72; 95% confidence interval, 1.23–2.42;
P
=0.002). Transient
WRF
was a risk factor for 1‐year mortality, whereas persistent
WRF
had no additive risk compared to transient
WRF
.

Conclusions

In patients with acute heart failure patients,
WRF
is an independent predictor of adverse in‐hospital and follow‐up outcomes in both
HF
r
EF
and
HF
p
EF
, though with a different effect size.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01389843.
Elevated Circulating Fibrocytes Is a Marker of Left Atrial Fibrosis and Recurrence of Persistent Atrial Fibrillation
Authors: Liu Yang , Niu Xiao‐Hui , Yin Xiaomeng , Liu Yue‐Jian , Han Chao , Yang Jie , Huang Xin , Yu Xiaohong , Gao Lianjun , Yang Yan‐Zong , Xia Yun‐Long , Li Hui‐Hua 
Published: March 2018

Background

In atrial fibrillation (
AF
), a more extensively fibrotic left atrium (
LA
) provides a substrate for arrhythmias and increases risk of relapse following ablation. Fibrocytes are bone marrow–derived circulating mesenchymal progenitors that have been identified in the atrium of patients with AF who have valvular diseases. The present study investigates the associations between circulating fibrocytes and
LA
fibrosis or the prevalence of recurrence after ablation in patients with persistent
AF
.

Methods and Results

We measured the proportion, differentiation, and migration of circulating fibrocytes from patients with persistent
AF
(n=40), those with paroxysmal
AF
(n=30), and sinus rhythm controls (n=30).
LA
low‐voltage (fibrosis) area was identified by an electroanatomic mapping system, and patients were followed up for 1 year after ablation. The relationship between circulating fibrocyte percentage and
LA
low‐voltage area or recurrence was assessed by multivariate regression analysis. Circulating fibrocyte percentage positively associated with
LA
low‐voltage area in the persistent
AF
group, and circulating fibrocyte (≥4.05%) was a significant predictor of 1‐year recurrence after ablation. Cultured fibrocytes exhibited enhanced potential of differentiation in the persistent
AF
group (67.58±1.54%) versus the paroxysmal
AF
group (56.67±1.52%) and sinus rhythm controls (48.43±1.79%). Furthermore, expression of fibroblast activation markers and cell migratory ability were also elevated in differentiated fibrocytes from patients with persistent
AF
. Transforming growth factor β1 and stromal cell–derived factor 1 were elevated in the plasma of patients with persistent AF and were shown to promote fibrocyte differentiation and migration, respectively.

Conclusions

In patients with persistent
AF
, increased circulating fibrocytes served as a marker of
LA
fibrosis and recurrence.