bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knockout of the Circadian Clock Protein PER1 (Period1) Exacerbates Hypertension and Increases Kidney Injury in Dahl Salt-Sensitive Rats
Authors: Zietara Adrian , Spires Denisha R. , Juffre Alexandria , Costello Hannah M. , Crislip G. Ryan , Douma Lauren G. , Levchenko Vladislav , Dissanayake Lashodya V. , Klemens Christine A. , Nikolaienko Oksana , Geurts Aron M. , Gumz Michelle L. , Staruschenko Alexander 
Published: October 2022

Background:

Circadian rhythms play an essential role in physiological function. The molecular clock that underlies circadian physiological function consists of a core group of transcription factors, including the protein PER1 (Period1). Studies in mice show that PER1 plays a role in the regulation of blood pressure and renal sodium handling; however, the results are dependent on the strain being studied. Using male Dahl salt-sensitive (SS) rats with global knockout of PER1 (SS
Per1−/−
), we aim to test the hypothesis that PER1 plays a key role in the regulation of salt-sensitive blood pressure.

Methods:
The model was generated using CRISPR/Cas9 and was characterized using radiotelemetry and measures of renal function and circadian rhythm.

Results:

SS
Per1−/−
rats had similar mean arterial pressure when fed a normal 0.4% NaCl diet but developed augmented hypertension after three weeks on a high-salt (4% NaCl) diet. Despite being maintained on a normal 12:12 light:dark cycle, SS
Per1−/−
rats exhibited desynchrony mean arterial pressure rhythms on a high-salt diet, as evidenced by increased variability in the time of peak mean arterial pressure. SS
Per1−/−
rats excrete less sodium after three weeks on the high-salt diet. Furthermore, SS
Per1−/−
rats exhibited decreased creatinine clearance, a measurement of renal function, as well as increased signs of kidney tissue damage. SS
Per1−/−
rats also exhibited higher plasma aldosterone levels.

Conclusions:
Altogether, our findings demonstrate that loss of PER1 in Dahl SS rats causes an array of deleterious effects, including exacerbation of the development of salt-sensitive hypertension and renal damage.
Impact of Arterial Hypertension and Use of Antihypertensive Pharmacotherapy on Mortality in Patients Hospitalized due to COVID-19: The CRACoV-HHS Study
Authors: Wojciechowska Wiktoria , Terlecki Michał , Klocek Marek , Pac Agnieszka , Olszanecka Agnieszka , Stolarz-Skrzypek Katarzyna , Jastrzębski Marek , Jankowski Piotr , Ostrowska Aleksandra , Drożdż Tomasz , Prejbisz Aleksander , Dobrowolski Piotr , Januszewicz Andrzej , Krzanowski Marcin , Małecki Maciej T. , Grodzicki Tomasz , Kreutz Reinhold , Rajzer Marek ,   CRACoV-HHS Investigators†
Published: October 2022

Background:
Cardiovascular diseases including arterial hypertension are common comorbidities among patients hospitalized due to COVID-19. We assessed the influence of preexisting hypertension and its pharmacological treatment on in-hospital mortality in patients hospitalized with COVID-19.

Methods:
We studied all consecutive patients who were admitted to the University Hospital in Krakow, Poland, due to COVID-19 between March 2020 and May 2021. Data of 5191 patients (mean age 61.9±16.7 years, 45.2% female) were analyzed.

Results:

The median hospitalization time was 14 days, and the mortality rate was 18.4%. About a quarter of patients had an established cardiovascular disease including coronary artery disease (16.6%) or stroke (7.6%). Patients with hypertension (58.3%) were older and had more comorbidities than patients without hypertension. In multivariable logistic regression analysis, age above median (64 years), male gender, history of heart failure or chronic kidney disease, and higher C-reactive protein level, but not preexisting hypertension, were independent risk factors for in-hospital death in the whole study group. Patients with hypertension already treated (n=1723) with any first-line antihypertensive drug (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, or thiazide/thiazide-like diuretics) had a significantly lower risk of in-hospital death (odds ratio, 0.25 [95% CI, 0.2–0.3];
P
<0.001) compared to nontreated hypertensives (n=1305).

Conclusions:
Although the diagnosis of preexisting hypertension per se had no significant impact on in-hospital mortality among patients with COVID-19, treatment with any first-line blood pressure–lowering drug had a profound beneficial effect on survival in patients with hypertension. These data support the need for antihypertensive pharmacological treatment during the COVID-19 pandemic.
Blood Pressure Mediated the Effects of Urinary Uromodulin Levels on Myocardial Infarction: a Mendelian Randomization Study
Authors: Jian Zhongyu , Yuan Chi , Ma Yucheng 
Published: October 2022

Background:
The causal links between urinary uromodulin (uUMOD) and cardiovascular disease (CVD) are still not clarified.

Methods:
We first assessed the relationship between uUMOD and CVD using bidirectional 2-sample Mendelian randomization. Then, multivariable Mendelian randomization and product of the coefficients methods were used to investigate the role of blood pressure in mediating the effect of uUMOD on CVD.

Results:

1-unit higher uUMOD level was associated with a higher risk of myocardial infarction (MI), with an odds ratio of 1.08 ([95% CI, 1.02–1.14];
P
=0.009), while MI was not associated with uUMOD levels in reverse. Our study did not support the causal effects of uUMOD on other CVD outcomes, including coronary artery disease, atrial fibrillation, heart failure, and ischemic stroke. In multivariable Mendelian Randomization, the direct effects of uUMOD on MI were attenuated to null after introducing systolic blood pressure or diastolic blood pressure. Mediation analysis showed that the indirect effect of uUMOD on MI mediated by systolic blood pressure or diastolic blood pressure was 1.05 ([95% CI, 1.04–1.06]; mediation proportion=69%) and 1.07 ([95% CI, 1.05–1.08]; mediation proportion=87%), respectively. Similar results were found in sensitivity analysis based on different sets of genetic instruments.

Conclusions:
Our findings provide evidence for the effect of higher uUMOD on increasing blood pressure, which mediates a consequent effect on MI risk in the general population. Further studies are necessary to verify the associations between uUMOD and other CVD outcomes.
Prognostic Implications of Exercise-Induced Hypertension in Adults With Repaired Coarctation of Aorta
Authors: Egbe Alexander C. , Miranda William R. , Jain C. Charles , Borlaug Barry A. , Connolly Heidi M. 
Published: October 2022

Background:
The purpose of this study was to assess the relationship between exercise-induced hypertension (EIH) and cardiovascular events, and to determine whether exercise blood pressure (BP) improved risk stratification in adults with repaired coarctation of aorta.

Methods:
Retrospective study of patients with repaired coarctation of aorta on antihypertensive therapy that underwent exercise testing and exercise test (2003–2019). BP was measured at rest in 3 different clinical settings and averaged to determine the resting BP. Indices of left ventricular function and afterload were obtained from the echocardiogram. EIH was defined as systolic BP >210 (males) or >190 (females) at peak exercise. Cardiovascular event was defined as atrial fibrillation, ventricular tachycardia, heart failure hospitalization, heart transplant, and cardiovascular death.

Results:

Of 327 patients (age 35±13 years), 116 (35%) had EIH. Although the resting BP was similar between patients with versus without EIH, the EIH group had higher pulsatile arterial load, more advanced left ventricular remodeling, and were less likely to be on angiotensin converting enzyme inhibitor/angiotensin receptor blocker. EIH was associated with cardiovascular events (hazard ratio, 1.06 [95% CI, 1.02–1.08]) independent of resting systolic BP, and improved prognostic accuracy above resting systolic BP (
C
statistic, 0.671 [95% CI, 0.645–0.694] to 0.727 [95% CI, 0.709–0.750];
P
=0.01). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker was associated with a lower risk of cardiovascular events.

Conclusions:
EIH was associated with cardiovascular events independent of resting BP, and patients receiving angiotensin-converting enzyme inhibitor/angiotensin receptor blocker had lower risk of cardiovascular events. These data suggest that exercise BP could be used to assess adequacy of antihypertensive therapy, and to guide titration of antihypertensive therapy.
Immune Checkpoint Inhibitors Do Not Increase Short-Term Risk of Hypertension in Cancer Patients: a Systematic Literature Review and Meta-Analysis
Authors: Minegishi Shintaro , Kinguchi Sho , Horita Nobuyuki , Namkoong Ho , Briasoulis Alexandros , Ishigami Tomoaki , Tamura Kouichi , Nishiyama Akira , Yano Yuichiro ,   Japanese Society of Hypertension working group “Onco-Hypertension”
Published: October 2022

Background:
Immune checkpoint inhibitors (ICIs) are becoming widely used for novel cancer treatments. Immune-related adverse events, including cardiac toxicity, are frequently observed following immune checkpoint inhibitor (ICI) use. However, little is known regarding the association between ICIs initiation and hypertension in cancer patients.

Methods:
A systematic literature search was performed using PubMed, EMBASE, Cochrane Library, and Web of Science Core Collection. The risk of hypertension associated with ICI initiation in randomized controlled trials (RCTs) was evaluated. Hypertension was categorized according to the Common Terminology Criteria for Adverse Events. The odds ratios of grades I to V and grades III to V hypertension were calculated using a random-effects meta-analysis.

Results:

Thirty-two RCTs (n=19 810 cancer patients) were included. At a median follow-up of 36 months, the median overall survival was 15 months in the ICI group. ICI initiation was not significantly associated with hypertension (grades I–V: odds ratio, 1.12 [95% CI, 0.96–1.30]; grades III–V: odds ratio, 0.95 [95% CI, 0.78–1.16]). Additionally, no significant differences in hypertension risk were evident in ICI combination therapies with various drugs, including anti-VEGF (vascular endothelial growth factor) agents. In a subgroup analysis based on clinical setting (placebo RCT versus nonplacebo RCT), there were discrepancies between the results obtained with different methodologies, with patients in the nonplacebo RCTs having higher grades I–V hypertension (I
2
=88.6%,
P
for heterogeneity=0.003).

Conclusions:
ICI initiation was not associated with short-term risk of hypertension in cancer patients, and the association was similar regardless of concomitant treatment with other anticancer drugs.
The Truth in Fake News: How Disinformation Laws Are Reframing the Concepts of Truth and Accuracy on Digital Platforms
Authors: Cavaliere Paolo 
Published: October 2022

Abstract
The European Union’s (EU) strategy to address the spread of disinformation, and most notably the Code of Practice on Disinformation and the forthcoming Digital Services Act, tasks digital platforms with a range of actions to minimise the distribution of issue-based and political adverts that are verifiably false or misleading. This article discusses the implications of the EU’s approach with a focus on its categorical approach, specifically what it means to conceptualise disinformation as a form of advertisement and by what standards digital platforms are expected to assess the truthful or misleading nature of the content that they distribute because of this categorisation. The analysis will show how the emerging EU anti-disinformation framework marks a departure from the European Court of Human Rights’ consolidated standards of review for public interest and commercial speech and the tests utilised to assess their accuracy.
Performance of a vascular anomaly center: a retrospective analysis of 461 cases over seven years
Authors: Strübing Felix , Laurich Annette , Weiss Christel , Schönberg Stefan , Kneser Ulrich , Sadick Maliha 
Published: October 2022

Background Vascular malformations are rare diseases that are best managed in multidisciplinary vascular anomaly centers (VAC). So far, there are few published data on the logistic structure, patient allotment, and internal workflow in an interdisciplinary VAC. Purpose To demonstrate the referral structure and patient allotment in a European VAC. Material and Methods A retrospective cohort study was conducted. All patients treated in the VAC since its establishment in April 2014 until June 2020 were identified. A total of 461 patients were included in this study. Results Most often, a venous malformation was diagnosed (49.9%), followed by arteriovenous malformations (8.7%) and syndromal vascular malformations (8.2%). Only 45.1% of referral diagnoses were correct. Of referrals, 35.1% were internal on-campus references, 28.0% were external references through physicians in private practice, and 19.7% came via external cooperating hospitals. Of the patients, 17.1% were self-admissions without a referral. Conclusion The most important referring clinics are internal medicine, pediatric, and vascular surgery. A substantial proportion of referrals came from private practices. Recruiting these cooperation partners should be considered a high priority when establishing a new VAC. The rate of misdiagnosis is high, and more education of fellow clinicians is urgently needed. Therefore, patients with vascular malformations should be referred to and treated in dedicated centers for vascular anomalies.
Comparison of Different Ultrasound Methods to Assess Changes in Muscle Mass in Critically ill Patients
Authors: Fuest Kristina E. , Lanz Hugo , Schulz Jana , Ulm Bernhard , Bennett Victoria A. , Grunow Julius J. , Weiss Björn , Blobner Manfred , Schaller Stefan J. 
Published: October 2022

Background Muscle ultrasound represents a promising approach to aid diagnoses of neuromuscular diseases in critically ill patients. Unfortunately, standardization of ultrasound measurements in clinical research is lacking, making direct comparisons between studies difficult. Protocols are required to assess qualitative muscle changes during an ICU stay in patients at high risk for the development of neuromuscular acquired weakness (ICUAW). Methods We conducted a retrospective, observational analysis comprised of three prospective observational studies with the aim of diagnosing muscle changes by ultrasound measurement of the quadriceps muscle. Different protocols were used in each of the three studies. In total, 62 surgical, neurocritical care and trauma intensive care patients were serially assessed by different ultrasound protocols during the first week of critical illness. The relative change in ultrasound measurements was calculated for all possible locations, methods and sides. Comparison was obtained using mixed effect models with the location, the height and the side as influencing variables and patients as fixed effect. The relationship between variables and outcomes was assessed by multivariable regression analysis. Results Ultrasound methods and measurement sites of the quadriceps muscles from all protocols were equally effective in detecting muscle changes. During the first week of an ICU stay, two groups were identified: patients with decreased muscle mass on ultrasound (n = 42) and a cohort with enlargement (n = 23). Hospital mortality was significantly increased in the cohort with muscle swelling (8 (19%) versus 12 (52%), p = .013). Conclusions Different approaches of ultrasound measurement during critical-illness are equally able to detect muscle changes. While some patients have a decrease in muscle mass, others show swelling, which may result in a reduced probability of surviving the hospital stay. Causative reasons for these results still remain unclear.
The Specialty Chaplain on the Palliative Care Team: A Narrative Review
Authors: McCann Klug Leah 
Published: October 2022

Background Spiritual care is a vital component of palliative care. Provision of specialty spiritual care is required by the guiding principles of palliative care as expressed in the National Consensus Project guidelines. Objective This review examines the role and duties of the specialty palliative care chaplain in contributing to the overall work of the interdisciplinary palliative care team. Methods The PUBMED, EMBASE, and CINAHL electronic databases were searched using identified key words including studies published between January 2008 and September 2022. Review articles met pre-established selection and exclusion criteria. A thematic approach was used to synthesize and discuss the findings in the form of a narrative review. Results Two main categories of articles were identified: (1) articles explicitly illustrating the tasks or duties of the palliative care chaplain and (2) case study articles including the input of the palliative care chaplain. These duties were comprehensive in nature and support the contributions of the specialty chaplain to the interdisciplinary plan of care. Conclusion The role of the palliative care chaplain has evolved over time as has chaplain training. Current research calls for standardizing inclusion of the palliative care chaplain on the interdisciplinary team to improve care and expand team function. Future research could examine contributions of chaplains to plan of care, the role of the chaplain in supporting the interdisciplinary team, and how the chaplain contributes to ongoing team growth.
The hand grip training device: A new therapeutic option in arteriovenous fistula maturation
Authors: Tapia González Irati , Esteve Simó Vicent , Ibañez Pallarés Sara , Moreno Guzman Fátima , Oleas Vega Diana , Fulquet Nicolás Miquel , Duarte Gallego Verónica , Saurina Solé Anna , Pou Potau Mónica , Yeste Campos Montse , Ramírez de Arellano Serna Manel 
Published: October 2022

Introduction: Postoperative exercise improves arteriovenous fistula maturation for hemodialysis. However, scarce evidence exists about hand grip device on fistula maturation process. Objective: To evaluate the efficacy of a hand grip training program on arteriovenous fistula maturation in population with Chronic Kidney Disease 5-5D. Methodology: Prospective study (15 months). Patients were randomized to handgrip (HG) or control group (CG) postoperatively. HG performed a training program using a hand grip device. CG received conventional care. Upper limb muscle strength (ULMS), Duplex ultrasonography, and clinical arteriovenous fistula maturation were assessed at 4 and 8 weeks postoperatively. Results: At 8 weeks after fistula creation, upper limb muscle strength was increased only in the handgrip group (from 18 ± 6 to 23 ± 9 kg, p = 0.023). Clinical maturation was significantly greater in handgrip group versus control group, both at 4 weeks after intervention (62% vs 23%, p = 0.004) and at 8 weeks (65% vs 27%, p = 0.004). Similarly, the Doppler ultrasonography maturation rates were significantly greater in the HG, both at 4 weeks (HG: 84% vs CG: 47%; p = 0.004) and at 8 weeks (HG: 89% vs CG: 50%; p = 0.002). Conclusions: The hand grip is a useful and safety training device to improve the arteriovenous fistula maturation. This device results a new therapeutic option for maturation in arteriovenous fistula, particularly in distal arteriovenous fistula. Further studies are required to support these results.
Association of Smoking With Graft Rupture After Anterior Cruciate Ligament Reconstruction
Authors: Chan Yat-Chi , Yau W. P. 
Published: October 2022

Background: The effect of smoking on graft rupture after anterior cruciate ligament (ACL) reconstruction is not well understood. Hypothesis: It was hypothesized that there will be no relationship between tobacco use and graft rupture after ACL reconstruction, as reflected by postoperative magnetic resonance imaging (MRI) and arthroscopic examination. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 233 patients who received primary ACL reconstruction with hamstring tendon autograft between January 1, 2013, and December 31, 2019, and who underwent MRI evaluation at 20.2 ± 1.9 months postoperatively. The patients were categorized by smoking history into 2 groups: 39 smokers and 194 nonsmokers. The 2 groups did not differ significantly in age, sex, operative technique, preinjury Tegner score, or mean time until postoperative MRI. The primary outcome was graft rupture rate, with rupture confirmed by either arthroscopic assessment or postoperative MRI diagnosis. The secondary outcome measure was degree of graft ligamentization, evaluated by measuring the signal-to-noise quotient (SNQ) of the graft. Results: The overall ACL graft rupture rate was 6.0%. The rupture rate was significantly higher in smokers than in nonsmokers (12.8% vs 4.6%, respectively; P = .0498). Smokers also had a significantly higher whole-graft SNQ compared with nonsmokers (4.7 ± 4.4 vs 3.3 ± 3.7, respectively; P = .028), suggesting less satisfactory ligamentization in smokers. Conclusion: Smoking was associated with a higher risk of graft rupture of ACL reconstruction and a higher SNQ of the intact graft as shown on postoperative MRI.
Do Practice Policies Limit Distractions and Improve the Quality During an Obstetric Sonogram?
Authors: Lijewski Virginia , Lendrum Taylor , Frey April , Sheeder Jeanelle , Straub Heather 
Published: October 2022

Objective: To assess if distractions alter sonographers’ perceptions of an obstetric sonogram’s (OBS) quality and whether clinic policies mitigate this association. Materials and Methods: Members of the Society of Diagnostic Medical Sonography were surveyed regarding demographics, perceived distractions during OBS, clinic observer and/or recording policies, plus perceptions of OBS quality concerns. Distraction and OBS quality scores were calculated. Chi-squared tests were used for bivariate analysis. Logistic regression identified independent predictors of OBS quality concerns. Results: There were 805 surveys completed. Many respondents (68%) found more than 75% of behaviors distracting, which was associated with increased reports of OBS quality concerns (adjusted odds ratio [aOR] = 3.63, 95% confidence interval [CI]: 2.55, 5.15), despite respondents’ demographics or clinic policies. More distracting behaviors (79%, P < .01) and quality concerns (40%, P = .04) were noted by sonographers who wanted, but did not have, recording policies at their clinic. Increased quality concerns correlated with disagreement concerning current recording policies (aOR = 2.89, 95% CI: 1.11, 8.00) and desired but absent observer policy (aOR = 2.24, 95% CI: 1.09, 4.59), regardless of respondent demographics or distraction score. Conclusion: Increased distraction scores are associated with more sonographer reports of OBS quality concerns. The lack of desired policies was associated with increased distractions and quality concerns. Further work is needed to understand the relationship between clinic policies, perceived distraction, and OBS quality.