bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortened acquisition time in simultaneous 99mTc-tetrofosmin and 123I-β-methyl-p-iodophenyl pentadecanoic acid dual-tracer imaging with cadmium–zinc–telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction
Authors: Yamada Yoshihiro , Nakano Shintaro , Gatate Yodo , Sugi Keiki , Okano Nanami , Muramatsu Toshihiro , Nishimura Shigeyuki , Kuji Ichiei , Fukushima Kenji , Matsunari Ichiro 
Published: September 2019

Objective
The use of cadmium–zinc–telluride-based scanners may increase the clinical feasibility of simultaneous dual-isotope imaging. In the current study, we sought to investigate a potential acquisition time in simultaneous 99mTc-tetrofosmin/123I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging using a Discovery NM/CT 670 cadmium–zinc–telluride.

Methods
Simultaneous 99mTc-tetrofosmin/123I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging was performed in 29 patients who had undergone primary percutaneous coronary intervention for acute myocardial infarction. Referenced images with an acquisition time of 65 s/view (16.25 min) were reframed to produce images with acquisition times of 33, 16, and 8 s/view. The values for the quantitative-gated single-photon emission computed tomography (SPECT) and the quantitative perfusion SPECT were compared.

Results
The quantitative-gated SPECT values for images with 33, 16, and 8 s/views showed good consistency with those for 65 s/view (the lower 95% confidence intervals for the intraclass correlation were ≥0.80). The quantitative perfusion SPECT values for 99mTc-tetrofosmin images with 33, 16, and 8 s/views also showed good consistency with those for 65 s/view; however, the quantitative perfusion SPECT values for 123I-β-methyl-p-iodophenyl pentadecanoic acid images with an acquisition time of 8 s/view were not consistent with the reference acquisition time of 65 s/view.

Conclusions
The quantitative-gated SPECT and quantitative perfusion SPECT values obtained from images with shorter acquisition times correlated with the values obtained from images with a reference acquisition time of 65 s/view; however, tracer-specific predisposition should be considered. These findings suggest that it is possible to reduce acquisition time when performing simultaneous 99mTc-tetrofosmin/123I-β-methyl-p-iodophenyl pentadecanoic acid dual-tracer imaging with the novel cadmium–zinc–telluride scanner.
Diabetes Distress, Depressive Symptoms, and Cardiovascular Health in Adults With Type 1 Diabetes
Authors: McCarthy Margaret M. , Whittemore Robin , Gholson Georica , Grey Margaret 
Published: September 2019

Background
The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health.

Objectives
The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors.

Methods
This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores.

Results
Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c.

Discussion
This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.
Decreasing Barriers to Research Utilization Among Labor and Delivery Nurses
Authors: Heelan-Fancher Lisa , Edmonds Joyce K. , Jones Emily J. 
Published: September 2019

Background
Intermittent fetal monitoring (IFM) is a recommended strategy for intrapartum fetal heart rate assessment in low-risk pregnancies; however, this “high touch, low tech” approach is underutilized.

Objective
The aim of the study was to examine the relationships between labor and delivery nurses’ intellectual capital and their perceptions of barriers to research utilization in the work setting.

Methods
A cross-sectional correlational design using data derived from a larger study of labor and delivery nurses (N = 248) was used. Covell’s theory of nursing intellectual capital was used as the conceptual and analytic framework to examine labor and delivery nurses’ intellectual capital and their perceived barriers to research utilization.

Results
Nurses who receive paid time off from their employer to attend conferences (p < .01) and nurses who do not report nurse-to-patient ratios as a problem in providing IFM (p < .01) perceive fewer barriers to research utilization.

Discussion
Time, especially available time, has an effect on labor and delivery nurses’ attitude toward IFM and their perceptions of barriers to research utilization.
Surrogacy and Pregnancy
Authors: Phillips Amy M. , Magann Everett F. , Whittington Julie R. , Whitcombe Dayna D. , Sandlin Adam T. 
Published: September 2019

Importance
Surrogacy allows for parenthood when it is otherwise impossible or exceedingly difficult; however, the risks of surrogate pregnancy for the gestational surrogate and the fetus are not well defined.

Objective
The aim of this study was to review the literature to examine the prevalence and requirements of surrogate pregnancy and maternal and perinatal outcomes.

Evidence Acquisition
A CINAHL and 2 PubMed searches were undertaken using the terms “surrogate mothers” OR “(surrogate or surrogacy)” AND “(mothers OR pregnancy OR pregnant).” The second search used these terms and pregnancy outcomes. The search was limited to the English language, but the years searched were unlimited.

Results
The search identified 153 articles, 36 of which are the basis for this review. The number of surrogate pregnancies is increasing in the United States. Fetal risks associated with surrogacy include low birth weight, increased risk of multiple gestation, and preterm birth. Maternal complications associated with surrogate pregnancy include hypertensive disorders of pregnancy, postpartum hemorrhage, and gestational diabetes.

Conclusions and Relevance
Surrogacy is a route to parenting that is not without risk to the surrogate or the fetus, and surrogate pregnancy is increasing in frequency in the United States.

Target Audience
Obstetricians and gynecologists, family physician.

Learning Objectives
After completing this activity, the learner should be better able to identify candidates for surrogacy; describe the effects of obesity on surrogacy; and explain the maternal and perinatal complications associated with surrogate pregnancy.
Syphilis in Pregnancy
Authors: Tsai Shelun , Sun Michael Y. , Kuller Jeffrey A. , Rhee Eleanor H. J. , Dotters-Katz Sarah 
Published: September 2019

Importance
Since 2013, the United States has seen a rise in cases of congenital syphilis, culminating in a relative increase of 153% from 2013 to 2017 and 918 reported cases in 2017. In all, 50% to 80% of pregnant women with syphilis experience an adverse pregnancy outcome including stillbirth or spontaneous abortion.

Objective
This article aims to review the current evidence and recommendations for management of syphilis in pregnancy.

Evidence Acquisition
Original research articles, review articles, and guidelines on syphilis were reviewed.

Results
In pregnancy, routine screening for syphilis is recommended on initiation of prenatal care. In high-risk populations, repeat testing is recommended in the early third trimester and at delivery. Penicillin remains the recommended treatment in pregnancy. After treatment, nontreponemal titers should be repeated at minimum during the early third trimester and at delivery to assess for serologic response. In high-risk populations, titers should be repeated monthly.

Conclusion and Relevance
Routine screening in pregnancy is essential for identification of syphilis infection and prevention of congenital syphilis. Subsequent adequate treatment with penicillin therapy more than 30 days before delivery and at the correct dosages depending on the stage of infection should be incorporated into clinical practice.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completion of this educational activity, the obstetrician/gynecologist should be better able to summarize current knowledge of how syphilis impacts maternal and neonatal outcomes; describe the recommended screening and diagnostic tests for syphilis; and outline the treatment regimens and follow-up recommendations for management of syphilis in pregnancy.
Electronic Interventions for Changing Knowledge, Attitudes or Practices Regarding Contraception: A Systematic Review
Authors: Dewart Courtney M. , Serpico Jaclyn , Steiner Markus J. , Gallo Maria F. 
Published: September 2019

(Abstracted from Contraception, https://doi.org/10.1016/j.contraception.2019.04.004)
Globally, nearly half of pregnancies are unintended. Sociodemographic factors associated with unintended pregnancy include age, parity, education, and economic status.
In Search of Mobile Applications for Patients With Pelvic Floor Disorders
Authors: Sudol Neha T. , Adams-Piper Emily , Perry Rachel , Lane Felicia , Chen Katherine T. 
Published: September 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25: 252–256)
Multiple medical societies have issued guidelines emphasizing the importance of patient education, behavioral therapy, and/or exercise regimens in the initial treatment and management of women with pelvic floor disorders. Even with these well-established recommendations, however, it is often difficult to engage patients and maintain adherence to treatment plans.
Time From Neuraxial Anesthesia Placement to Delivery Is Inversely Proportional to Umbilical Arterial Cord pH at Scheduled Cesarean Delivery
Authors: Rimsza Rebecca R. , Perez William M. , Babbar Shilpa , O'Brien Megan , Vricella Laura K. 
Published: September 2019

(Abstracted from Am J Obstet Gynecol 2019;220:389.e1–389.e9)
Risks to the fetus during cesarean delivery, although rare, can include neonatal depression and hypoxic ischemic encephalopathy during nonemergent cesarean delivery. It is known that neuraxial anesthesia–related hypotension can contribute to uterine hypoperfusion and decreased umbilical arterial pH at cesarean delivery.
Dual Trigger With Gonadotropin Releasing Hormone Agonist and Human Chorionic Gonadotropin Significantly Improves Live Birth Rate for Women With Diminished Ovarian Reserve
Authors: Lin Ming-Huei , Wu Frank Shao-Ying , Hwu Yuh-Ming , Lee Robert Kuo-Kuang , Li Ryh-Sheng , Li Sheng-Hsiang 
Published: September 2019

(Abstracted from Reprod Biol Endocrinol 2019;17:7)
As the prevalence of fertility treatment increases, research into managing “diminished ovarian reserve” (DOR) remains a challenge. A “dual trigger” consisting of a gonadotropin hormone–releasing hormone agonist (GnRH-a) in combination with a reduced dose of human chorionic gonadotropin (hCG) showed robust evidence of increased pregnancy and live birth rate without ovarian hyperstimulation in in vitro fertilization (IVF) cycles for high responders.
Active Seizures in Children Are Often Subtle and Unrecognized by Prehospital Providers
Authors: Rose Emily , Abramson Tiffany M. , Kearl Yvette L. , Loza-Gomez Angelica 
Published: September 2019

Abstract
Early recognition and treatment of seizures is essential for optimal patient outcomes. Seizure activity, particularly in young children, can be subtle and often go unrecognized by providers. This case series retrospectively identified 7 cases of pediatric patients (14 years and younger) who presented to the emergency department with active seizure activity that was unrecognized by the prehospital care providers. The presentation of these patients, their clinical signs of seizure, and emergency department disposition are highlighted in this series.
Facial Artery Pseudoaneurysm in a Child Diagnosed With Point-of-Care Ultrasound
Authors: Abulfaraj Maher M. , Deanehan J. Kate 
Published: September 2019

Abstract
This case describes a 3-year-old boy who was brought to the pediatric emergency department for evaluation of facial swelling. The patient's history was remarkable for a deep facial laceration 5 days prior that required surgical repair in the operating room. On the day of presentation, he was noted to have mild swelling and tenderness to palpation of the left jaw below the mandible, in the same location as his recent laceration repair. Point-of-care ultrasound (POCUS) revealed a pseudoaneurysm with an arterial feeding vessel. This was confirmed by radiology-performed ultrasound, and the patient underwent a coil embolization procedure. To our knowledge, this is the first reported case of a pseudoaneurysm being diagnosed by POCUS in a pediatric patient. This case demonstrates the utility of POCUS in facilitating the timely recognition of vascular mass lesions and guiding management in the emergency department to avoid complications.
The Value of Serum Amyloid A Levels in Familial Mediterranean Fever to Identify Occult Inflammation During Asymptomatic Periods
Authors: Çakan Mustafa , Karadağ Şerife Gül , Tanatar Ayşe , Sönmez Hafize Emine , Ayaz Nuray Aktay 
Published: September 2019

Objective
The aim of this observational study was to evaluate whether there was any correlation between the acute phase reactants in children with familial Mediterranean fever (FMF) during attack and attack-free periods.

Methods
The study was conducted between June 2016 and January 2018. Clinical features and laboratory parameters of children with FMF during attack and attack-free periods were recorded longitudinally.

Results
The cohort consisted of 168 children with FMF (84 boys, 84 girls). Median values of acute phase reactants during FMF attacks were 433.5 mg/L (34.0–1780.0 mg/L) for serum amyloid A (SAA), 56.7 mg/L (7.6–379.0 mg/L) for C-reactive protein (CRP), and 37.5 mm/h (5–100 mm/h) for erythrocyte sedimentation rate (ESR). Median values for the same tests in attack-free periods were 3.2 mg/L (0.1–25.0 mg/L), 1.7 mg/L (0.1–12.7 mg/L), and 8 mm/h (1–30 mm/h), respectively. Correlation analyses showed that SAA and CRP were highly correlated in FMF attack (r = 0.67, p < 0.01), but no correlation was found between SAA and ESR levels. C-reactive protein was elevated in 13.6%, ESR in 20.8%, and SAA in 28.5% of the patients during attack-free period. Age at onset, sex of the patients, and characteristics of attacks were found to be not associated with elevated SAA in attack-free period. On the other hand, having homozygous exon 10 mutation and having elevated CRP were found to be associated with high SAA in attack-free period.

Conclusions
C-reactive protein and SAA correlate well with FMF attacks. Therefore, checking for SAA during a FMF attack is not required. However, SAA seems to be the most sensitive method for demonstrating subclinical inflammation in attack-free period. Thus, checking SAA levels might be a valuable tool in selected FMF patients.
The Relationship Between Autonomic Dysfunction of the Gastrointestinal Tract and Emotional Distress in Patients With Systemic Sclerosis
Authors: DiRenzo Dana , Russell James , Bingham Clifton O. , McMahan Zsuzsanna 
Published: September 2019

Background/Objectives
We hypothesized that emotional distress in systemic sclerosis (SSc) patients with moderate to severe gastrointestinal (GI) dysfunction is associated with dysautonomia. We sought to determine (1) the clinical characteristics associated with emotional distress in SSc, (2) the odds of having dysautonomia in those with emotional distress, and (3) whether GI dysautonomia, as measured by the Survey of Autonomic Symptoms (SAS), correlates with GI dysautonomia on the Composite Autonomic Symptom Score-31 (COMPASS-31).

Methods
Clinical and demographic features from our prospective cohort study were compared among SSc patients with and without GI-associated emotional distress (University of California at Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 well-being subscale >0.5 or ≤0.5) in cross-sectional analysis. Covariates/confounders independently associated with emotional distress were used to construct multivariable logistic regression models. The COMPASS-31 and SAS GI subdomains were compared with Spearman correlation.

Results
Forty-six patients with SSc were enrolled in the study. In univariate analyses, age (odds ratio [OR], 1.06; p = 0.026), severity of GI dysautonomia (COMPASS-31: OR, 1.41; p = 0.003), anti–centromere (A/B) antibodies (OR, 3.60; p = 0.044), and anti–PM-Scl (75/100) antibodies (OR, 0.15; p = 0.035) were associated with emotional distress. In the adjusted model, those with more severe GI dysautonomia remained more likely to have emotional distress (OR, 1.85; p = 0.026); those with anti–PM-Scl (75/100) antibodies were less likely to have emotional distress (OR, 0.03; p = 0.031). The SAS and COMPASS-31 GI subdomains moderately correlated (ρ = 0.68, p < 0.001).

Conclusions
In SSc, increased symptom burden related to GI dysautonomia is associated with emotional distress. Multidisciplinary approaches addressing both the physical and emotional needs of the SSc patient may be warranted to optimize patient care.
Spectral Photon-Counting Computed Tomography for Coronary Stent Imaging
Authors: Bratke Grischa , Hickethier Tilman , Bar-Ness Daniel , Bunck Alexander Christian , Maintz David , Pahn Gregor , Coulon Philippe , Si-Mohamed Salim , Douek Philippe , Sigovan Monica 
Published: September 2019

Objectives
In-stent restenosis (ISR) is one of the main long-term complications after coronary stent placement, and the ability to evaluate ISR noninvasively using coronary computed tomography (CT) angiography remains challenging. For this application, spectral photon-counting CT (SPCCT) has the potential to increase image quality and reduce artifacts due to its advanced detector technology.
Our study aimed to verify the technical and clinical potential of a novel SPCCT prototype using an ISR phantom setup.

Materials and Methods
Soft plaque-like restenosis (45 HU; approximately 50% of the stent lumen) were inserted into 10 different coronary stents (3 mm diameter), which were placed in a vessel phantom and filled with a contrast agent (400 HU). A research prototype SPCCT and a clinical dual-layer CT (DLCT; IQon; Philips) with comparable acquisition and reconstruction parameters were used to scan the phantoms. Conventional polyenergetic (PolyE) and monoenergetic (MonoE) images with 4 different energy levels (40, 60, 90, 120 keV) were reconstructed. Qualitative (delineation of the stenosis and adjacent residual lumen using a 5-point Likert scale) and quantitative (image noise, visible lumen diameter, lumen diameter adjacent to the stenosis, contrast-to-noise ratio of the restenosis) parameters were evaluated for both systems.

Results
The qualitative results averaged over all reconstructions were significantly superior for SPCCT compared with DLCT (eg, subjective rating of the best reconstruction of each scanner: DLCT PolyE: 2.80 ± 0.42 vs SPCCT MonoE 40 keV: 4.25 ± 1.03). Stenosis could be clearly detected in 9 and suspected in 10 of the 10 stents with both SPCCT and DLCT. The residual lumen next to the stenosis was clearly delineable in 7 of 10 stents (0.64 ± 0.11 mm or 34.97% of the measured stent lumen) with SPCCT, while it was not possible to delineate the residual lumen for all stents using DLCT. The measured diameter of the lumen within the stent was significantly higher for SPCCT compared with DLCT in all reconstructions with the best results for the MonoE 40 keV images (SPCCT: 1.80 ± 0.17 mm; DLCT: 1.50 ± 0.31 mm). The image noise and the contrast-to-noise ratio were better for DLCT than for SPCCT (contrast-to-noise ratio: DLCT MonoE 40: 31.58 ± 12.54; SPCCT MonoE 40: 4.64 ± 1.30).

Conclusions
Spectral photon-counting CT allowed for the noninvasive evaluation of ISR with reliable results regarding the residual lumen for most tested stents and the clear identification or suspicion of stenosis for all stents. In contrast, the residual lumen could not be detected for a single stent using DLCT.
Risk of Hypersensitivity Reactions to Iopromide After Intra-Arterial Versus Intravenous Administration
Authors: Endrikat Jan , Michel Alexander , Kölbach Ralf , Lengsfeld Philipp , Vogtländer Kai 
Published: September 2019

Objective
The aim of this study was to compare the risk of hypersensitivity reactions to iopromide after intra-arterial (IA) administration and intravenous (IV) administration.

Materials and Methods
Four observational studies were pooled. Almost half of the study population (48.1%) was from Europe, and one quarter each from China (27.6%) and other Asia countries (24.1%). All patients received iopromide either intra-arterially or intravenously for angiographic procedures (mostly cardio-angiography) or contrast-enhanced computed tomography. A nested case-control analysis, including a multivariable logistic regression model, was performed. Cases were defined by patients with a typical and unequivocal hypersensitivity (assumed non–IgE-mediated) reaction; controls were patients without any recorded reaction. The primary target variable is the odds ratio of having a hypersensitivity reaction after IA versus IV administration.

Results
A total of 133,331 patients met the inclusion criteria, 105,460 and 27,871 patients received iopromide IV or IA, respectively. Hypersensitivity reactions were recorded for 822 patients, and 132,509 patients served as controls.
Major risk factors for hypersensitivity reactions were method of injection (IV vs IA), age (18 to <50 years vs ≥65 years), history of allergy or previous contrast media reaction (all P < 0.001), and asthma (P = 0.005).
A total of 766 patients (0.7%) and 56 patients (0.2%) were recorded with hypersensitivity reactions after IV or IA administration, respectively (P < 0.0001).
Adjusted odds ratio (IA vs IV) was 0.23 (95% confidence interval, 0.16–0.32) for all countries together: for China only, 0.22 (0.11–0.44); for all countries without China, 0.36 (0.25–0.53).
Most frequent reactions were erythema/urticaria/rash, pruritus, and cough/sneezing.

Conclusions
Hypersensitivity reactions to iopromide were significantly less frequently recorded after IA administrations. This could be related to the delayed and diluted arrival of iopromide to the lungs.