bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship and Changes of Liver Blood Supply, Portal Pressure Gradient, and Liver Volume following TIPS in Cirrhosis
Authors: He Jinghong , Li Jinyu , Fang Changxing , Qiao Ying , Feng Duiping 
Published: December 2022

Aim. Transjugular intrahepatic portosystemic shunt (TIPS) alters the liver blood supply and reduces portal pressure. This study was to investigate the changes and associations of the hepatic blood flow, liver volume, and portal pressure gradient (PPG) after TIPS in liver cirrhosis. Methods. Twenty-one patients with liver cirrhosis who received TIPS were recruited. The contrast CT images were used to assess the iodine density (ID) of liver parenchymal and liver volume. The ID of the liver parenchyma was used to reflect hepatic blood flow. We used a paired t-test and regression analysis to investigate the effect of TIPS on hepatic blood flow, liver volume, and PPG in individuals with cirrhosis and the factors that affect changes in liver volume. Results. After TIPS, there was a significant improvement in the ID of liver parenchyma at arterial phase (AP) and PPG in individuals with cirrhosis (

P

< 0.05). Each 1 unit increase in the ID change of whole liver parenchyma at the venous phase (VP) was significantly associated with a 269.44 cm3 increase in the liver volume after TIPS (b = 269.44,

P

= 0.012). With an increasing ID change of whole liver parenchyma at VP, the change in liver volume followed an increasing trend (

P

for overall association = 0.005). Conclusions. Our data indicate that there was a significant improvement in hepatic blood flow, especially at AP, after TIPS and the change in hepatic blood supply from the portal vein is positively associated with the change in liver volume after TIPS. Increasing the blood supply to the liver from the portal vein may improve the reduction of liver volume.
Proteasome Inhibitors Silence Oncogenes in Multiple Myeloma through Localized Histone Deacetylase 3 Stabilization and Chromatin Condensation
Authors: Maneix Laure , Iakova Polina , Moree Shannon E. , Hsu Joanne I. , Mistry Ragini M. , Stossi Fabio , Lulla Premal , Sun Zheng , Sahin Ergun , Yellapragada Sarvari V. , Catic André 
Published: December 2022

Proteasome inhibitors have become the standard of care for multiple myeloma. Blocking protein degradation particularly perturbs the homeostasis of short-lived polypeptides such as transcription factors and epigenetic regulators. To determine how proteasome inhibitors directly impact gene regulation, we performed an integrative genomics study in multiple myeloma cells. We discovered that proteasome inhibitors reduce the turnover of DNA-associated proteins and repress genes necessary for proliferation through epigenetic silencing. Specifically, proteasome inhibition results in the localized accumulation of histone deacetylase 3 (HDAC3) at defined genomic sites, which reduces H3K27 acetylation and increases chromatin condensation. The loss of active chromatin at super-enhancers critical for multiple myeloma, including the super-enhancer controlling the proto-oncogene c-MYC, reduces metabolic activity and cancer cell growth. Epigenetic silencing is attenuated by HDAC3 depletion, suggesting a tumor-suppressive element of this deacetylase in the context of proteasome inhibition. In the absence of treatment, HDAC3 is continuously removed from DNA by the ubiquitin ligase Seven in Absentia Homolog 2 (SIAH2). Overexpression of SIAH2 increases H3K27 acetylation at c-MYC–controlled genes, increases metabolic output, and accelerates cancer cell proliferation. Our studies indicate a novel therapeutic function of proteasome inhibitors in multiple myeloma by reshaping the epigenetic landscape in an HDAC3-dependent manner. As a result, blocking the proteasome effectively antagonizes c-MYC and the genes controlled by this proto-oncogene.Significance:Integrative genomics reveals that a key function of proteasome inhibitors involves limiting the activity of MYC and MYC-dependent genes through epigenetic repression.
The Association of Protein Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction
Authors: Takvorian Katherine S. , Wang Dongyu , Courchesne Paul , Vasan Ramachandran S. , Benjamin Emelia J. , Cheng Susan , Larson Martin G. , Levy Daniel , Ho Jennifer E. 
Published: December 2022

Background:
Heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) are distinct clinical entities, yet there is scant evidence for associations of proteomic signatures with future development of HFpEF versus HFrEF.

Methods:
We evaluated the association of 71 protein biomarkers with incident HFpEF versus HFrEF (left ventricular ejection fraction ≥ versus <50%) among Framingham Heart Study participants using multivariable Cox models.

Results:

Among 7038 participants (mean age 49 years; 54% women), 5 biomarkers were associated with increased risk of incident HFpEF (false discovery rate q<0.05): NT-proBNP (N-terminal pro-B-type natriuretic peptide; hazard ratio [HR], 2.13; 95% CI, 1.52–2.99;
P
<0.001), growth differentiation factor-15 (HR, 1.67; 95% CI, 1.32–2.12;
P
<0.001), adrenomedullin (HR, 1.58; 95% CI, 1.23–2.04;
P
<0.001), uncarboxylated matrix Gla protein (HR, 1.55; 95% CI 1.23–1.95;
P
<0.001), and C-reactive protein (HR, 1.46; 95% CI, 1.17–1.83;
P
=0.001). Fourteen biomarkers were associated with incident HFrEF (multivariable
P
<0.001, q<0.05 for all). Of these, 3 biomarkers were associated with both HF subtypes (NT-proBNP, growth differentiation factor-15, and C-reactive protein). When compared directly, myeloperoxidase, resistin, and paraoxanase-1 were more strongly associated with HFrEF than HFpEF.

Conclusions:
We identified 5 protein biomarkers of new-onset HFpEF representing pathways of inflammation, cardiac stress, and vascular stiffness, which partly overlapped with HFrEF. We found 14 biomarkers associated with new-onset HFrEF, with some distinct associations including myeloperoxidase, resistin, and paraoxanase-1. Taken together, these findings provide insights into similarities and differences in the development of HF subtypes.

Registration:

URL:
https://clinicaltrials.gov/ct2/show/NCT00005121
; Unique identifier: NCT0005121.
Homelessness and Crime in Neighborhoods
Authors: Ee Marilyn , Zhang Yan 
Published: December 2022

Objective: Literature on the influence of homelessness on crime is lacking, particularly at the neighborhood level. This study seeks to understand how homelessness affects crime levels in a large city in the United States. Data/Methods: Crime data, homeless count data, and neighborhood characteristics are obtained from three government public data sources. OLS Regression and Geographically Weighted Regression (GWR) are utilized to determine the relationship between homelessness and crime on a global and local level. Results: The analyses revealed that homelessness is significantly, positively associated with crime, even when controlling for macro-level correlates of crime. The effect size of homelessness on crime varies across neighborhoods. Conclusions/Implications: Policy implications based on findings of the current study and future research are discussed.
Deep learning-based noise reduction for coronary CT angiography: using four-dimensional noise-reduction images as the ground truth
Authors: Kobayashi Takuma , Nishii Tatsuya , Umehara Kensuke , Ota Junko , Ohta Yasutoshi , Fukuda Tetsuya , Ishida Takayuki 
Published: December 2022

Background To assess low-contrast areas such as plaque and coronary artery stenosis, coronary computed tomography angiography (CCTA) needs to provide images with lower noise without increasing radiation doses. Purpose To develop a deep learning-based noise-reduction method for CCTA using four-dimensional noise reduction (4DNR) as the ground truth for supervised learning. Material and Methods \We retrospectively collected 100 retrospective ECG-gated CCTAs. We created 4DNR images using non-rigid registration and weighted averaging three timeline CCTA volumetric data with intervals of 50 ms in the mid-diastolic phase. Our method set the original reconstructed image as the input and the 4DNR as the target image and obtained the noise-reduced image via residual learning. We evaluated the objective image quality of the original and deep learning-based noise-reduction (DLNR) images based on the image noise of the aorta and the contrast-to-noise ratio (CNR) of the coronary arteries. Further, a board-certified radiologist evaluated the blurring of several heart structures using a 5-point Likert scale subjectively and assigned a coronary artery disease reporting and data system (CAD-RADS) category independently. Results DLNR CCTAs showed 64.5% lower image noise ( P < 0.001) and achieved a 2.9 times higher CNR of coronary arteries than that in original images, without significant blurring in subjective comparison ( P > 0.1). The intra-observer agreement of CAD-RADS in the DLNR image was excellent (0.87, 95% confidence interval = 0.77–0.99) with original CCTAs. Conclusion Our DLNR method supervised by 4DNR significantly reduced the image noise of CCTAs without affecting the assessment of coronary stenosis.
The effect of manufacturing parameters on various composite plates under ballistic impact
Authors: ARI Ali , KARAHAN Mehmet , KOPAR Mehmet , AHRARI Mazyar 
Published: December 2022

In this study, the usability of several composite plates in level III and level IV body armors were examined, along with the ballistic resistance, protection level, and production parameters of each plate. For level III protection, composite panels are made using the heat pressing method under various pressures, and for level IV composites, ceramic plates of various thicknesses are reinforced on the back with various composite materials. Ballistic tests using the NIJ standards were performed on the created composite panels. There were delaminations between the layers as a result of the ballistic test in the level III protective panels produced at 140 bar pressure, but there was no puncture in the panels produced at 250 bar pressure, and the depth of trauma was reduced to a minimum. These observations were made using samples produced at 90 bar pressure under controlled conditions. Level IV panels were subjected to dry and wet ballistic tests, and the results of these tests showed that K-flex reinforced ceramics were impervious to punctures. It has been found that aramid-reinforced epoxy ceramic panels and UD H62 reinforced ceramics have superior ballistic qualities and are 6% lighter.
Culture of discrimination in healthcare: A grounded theory
Authors: Hosseinabadi-farahani Mohammadjavad , Fallahi-khoshknab Masoud , Arsalani Narges , Hosseini Mohammadali , Mohammadi Eesa 
Published: December 2022

Background Discrimination in health care is an international challenge and a serious obstacle to justice and equality in health. Research objective The purpose of this study was to design a grounded theory of discrimination in health care based on the experiences and perceptions of Iranian healthcare providers and patients. Research design This qualitative study was conducted using by the grounded theory method. Participants and research context Data were collected through semi-structured interviews with 18 healthcare providers including 11 nurses, two physicians, two nurse’s assistants, and three patients in two general hospitals in Tehran, Iran. Participants were selected through purposeful sampling and analyzed simultaneously using the Corbin and Strauss (2015) approach. Ethical considerations The study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Ethics code: IR.USWR.REC.1398.023). Also, after explaining the objectives of the study, all the participants completed and signed the written consent form. Findings The “culture of discrimination” was the study’s core category, reflecting the nature of discrimination in health care. The theory of “culture of discrimination in health care” is the result of five main categories: “individual social stimuli,” “culture of discrimination,” “unintentional discrimination,” “conflict with discrimination,” and “dissatisfaction with discriminatory behavior.” These categories cover the underlying factors, strategies, and outcomes of the discrimination process in health care. Discussion The results of the study showed that nurses and other health care providers experience unintentional discrimination. Unintentional discrimination refers to discriminatory behaviors and practices of health care providers. Conclusion The theory of culture of discrimination in health care can be used as a practical guide to describe and understand the role of health care providers, especially nurses. Further studies with a quantitative approach to applying this theory in medical settings are recommended.
Antioxidant Status in Neonatal Sepsis: A Case Control Study
Authors: Kumar Pankaj , Singh Manoj Kumar , Shukla Avneesh , Kumar Rajesh , Singh Sheo Pratap , Pasupuleti Mukesh 
Published: December 2022

Objective: Assessment of catalase, superoxide dismutase (SOD), and glutathione levels in neonatal sepsis. Methods: This case-control study was conducted from October 2017 to October 2018. All the patients having features suggestive of sepsis were subjected to a sepsis screen and blood culture. SOD, catalase, and glutathione assay was done in study subjects qualifying inclusion and exclusion criteria and in controls by spectrophotometric assay. Results: This study consisted of 58 cases and 46 controls. Out of 58 cases, 36 (62.07%) were male, 45 (77.59%) were term, and 23 (39.66%) cases were of normal birth weight. The levels of catalase ( P value = .0037) and glutathione ( P value = .0009) were lower, while SOD was higher ( P value = .0122) among cases with neonatal sepsis than controls. Conclusion: This study helps us in understanding antioxidant status in neonatal sepsis. However, studies with a larger sample size are needed to further understand inflammatory and antioxidant cascade.
The Safety of Direct Oral Anticoagulants Compared to Warfarin in Patients Hospitalized With Acute Kidney Injury
Authors: Harrsch Felicia A. , Walls Jennifer L. , Makkar Kathleen M. 
Published: December 2022

Background: Direct oral anticoagulants (DOACs) are preferred over warfarin for many indications, though their safety has not been well established in patients with acute renal impairment. Objective: The purpose of this study was to evaluate the frequency of bleeding complications associated with DOACs compared with warfarin in patients admitted to the hospital with acute kidney injury (AKI). Methods: This was a retrospective cohort study evaluating patients admitted to the Penn Medicine Lancaster General Hospital with a diagnosis of AKI from October 2017 through September 2021 and receiving therapy with oral anticoagulants. Comparing DOACs with warfarin, the primary endpoint was the percent frequency of composite major and minor bleeding during the admission and within 30 days of discharge. Results: There were 112 hospitalization encounters included in the study. Of these, 42 (37.5%) patients were receiving warfarin and 70 (62.5%) patients were receiving DOAC therapy before admission. There was a higher frequency of the primary endpoint of bleeding in patients receiving DOACs as compared with warfarin, though this was not statistically significant (18.5% vs. 11.9%, respectively, P = 0.432). There were no differences between groups in the frequency of major bleeding, minor bleeding, or transfusions. Patients receiving DOAC therapy were more likely to experience anticoagulation-related readmissions or emergency department visits compared with patients on warfarin therapy (11.4% vs. 0%, P = 0.024). Conclusion and Relevance: Direct oral anticoagulants and warfarin were associated with statistically similar rates of bleeding in patients presenting with AKI. Further research is necessary to elucidate if DOACs are safer than warfarin in this patient population.
Clinical differences in enterococcal bacteriuria compared with other bacteriuria in cats
Authors: Seidel Emily J , Hess Rebecka S , Cole Stephen J , McClosky Megan E 
Published: December 2022

Objectives The clinical differences between Enterococcus species bacteriuria compared with other bacteria has been reported in a small number of cats. The objective of this study was to compare a large number of cats with Enterococcus species bacteriuria to cats with other bacteriuria and determine the clinical differences. It was hypothesized that enterococcal bacteriuria would be associated with subclinical bacteriuria and polymicrobial infections more than other bacteriuria, and that when local or systemic comorbidities were present, enterococcal bacteriuria would be more common. Methods This retrospective case-control study compared case cats with enterococcal bacteriuria to control cats with other bacteriuria. Cats with enterococcal bacteriuria were age, year and weight matched with 1–2 control cats with any other bacteriuria. Results Lower urinary tract clinical signs were statistically significantly more common in controls (n = 38/77 [49%]) compared with Enterococcus cases (n = 12/47 [25%]; P = 0.01). Specifically, control cats (n = 20/77 [26%]) were statistically significantly more likely to have gross hematuria compared with Enterococcus case cats (n = 3/47 [6%]; P = 0.01). Enterococcus cases were statistically significantly more likely to have a polymicrobial infection compared with controls (odds ratio 5.84, 95% confidence interval 1.33–34.70; P = 0.01). Conclusions and relevance Enterococcus species are associated with subclinical bacteriuria and polymicrobial urinary tract infections in cats vs other bacteriuria.
Perceptions of pharmacy technician students of the CARD (Comfort Ask Relax Distract) e-module introduced as part of vaccine injection training
Authors: Taddio Anna , Gerges Sandra , Rocchi Marie , Gudzak Victoria , Ilersich Angelo L. 
Published: December 2022

Introduction: The scope of practice for pharmacy technicians is expanding to include vaccine administration in some provinces. Vaccine training courses and programs currently do not include education about mitigating immunization stress-related responses (ISRR) and improving the vaccination experience. We obtained feedback from pharmacy technician students about a new e-module that addresses this identified knowledge gap, whereby learners are educated about CARD (Comfort Ask Relax Distract), a vaccine delivery framework that reduces ISRR and improves the vaccination experience. Methods: Mixed-methods design including second-year pharmacy technician students who elected to take an accredited vaccine injection training program. Students were given access to the CARD e-module after completing mandatory vaccine education components. Eight students answered a quantitative survey and 4 (50%) additionally participated in a focus group. Qualitative data were analyzed deductively using the Consolidated Framework for Implementation Research (CFIR). Results: The study was conducted between April 28 and June 12, 2022. Students reported positive attitudes about the CARD e-module across quantitative and qualitative measures. Qualitative feedback spanned 4 CFIR constructs: intervention characteristics, outer setting, inner setting and individual characteristics. Students reported the e-module was well designed and that the content was relevant. They believed CARD facilitated provision of vaccinations using a person-centred approach that promotes vaccination. They felt that CARD could potentially add time to the vaccination appointment and that it would need to be acceptable to pharmacy leaders because of implications for training and vaccination delivery. They suggested that CARD education should be mandatory. CARD improved their confidence in delivering vaccinations, and they planned to integrate CARD into their practice. Conclusion: The CARD e-module was well received by pharmacy technician students when coupled with usual vaccine injection training.
A Machine Learning Model for Prediction of Amputation in Diabetics
Authors: Stefanopoulos Stavros , Qiu Qiong , Ren Gang , Ahmed Ayman , Osman Mohamed , Brunicardi F. Charles , Nazzal Munier 
Published: December 2022

Background: Diabetic foot ulcer (DFU) and the resulting lower extremity amputation are associated with a poor survival prognosis. The objective of this study is to generate a model for predicting the probability of major amputation in hospitalized patients with DFU. Methods: The National Inpatient Sample (NIS) database from 2008 to 2014 was used to select patients with DFU, who were then further divided by major amputation status. International Classification of Diseases, Ninth Edition, Clinical Modification ( ICD-9-CM) and Agency for Healthcare Research and Quality (AHRQ) comorbidity codes were used to compare patient characteristics. For the descriptive statistics, the Student t test, the χ2 test, and the Spearman correlation were utilized. The five most predictive variables were identified. A decision tree model (CTREE) based on conditional inference framework algorithm and a random forest model were used to develop the algorithm. Results: A total of 326 853 inpatients with DFU were identified, and 5.9% underwent major amputation. The top five contributory variables (all with P < .001) were gangrene (odds ratio [OR] = 11.8, 95% confidence interval [CI] = 11.5-12.2), peripheral vascular disease (OR = 2.9, 95% CI = 2.8-3.0), weight loss (OR = 2.6, 95% CI = 2.5-2.8), systemic infection (OR = 2.5, 95% CI = 2.4-2.53), and osteomyelitis (OR = 1.7, 95% CI = 1.6-1.73). The model performance of the training data was 77.7% (76.1% sensitivity and 79.3% specificity) and of the testing data was 77.8% (76.2% sensitivity and 79.4% specificity). The model was further validated with boosting and random forest models which demonstrated similar performance and area under the curve (AUC) (0.84, 95% CI = 0.83-0.85). Conclusion: Utilizing machine learning methods, we have developed a clinical algorithm that predicts the risk of major lower extremity amputation for inpatients with diabetes with 77.8% accuracy.
The burden of surgical site infections and related antibiotic resistance in two geographic regions of Sierra Leone: a prospective study
Authors: Lakoh Sulaiman , Yi Le , Russell James B.W. , Zhang Juling , Sevalie Stephen , Zhao Yongkun , Kanu Joseph Sam , Liu Peng , Conteh Sarah K. , Williams Christine Ellen Elleanor , Barrie Umu , Sheku Mohamed Gbessay , Jalloh Mohamed Boie , Adekanmbi Olukemi , Jiba Darlinda F. , Kamara Matilda N. , Deen Gibrilla F. , Okeibunor Joseph Chukwudi , Yendewa George A. , Guo Xuejun , Firima Emmanuel 
Published: December 2022

Introduction: Despite the prolongation of hospitalization, increase in morbidity, mortality and cost of care associated with both surgical site infections (SSIs) and antibiotic resistance, there are limited data on SSIs and antibiotic resistance to guide prevention strategies in Sierra Leone. Methods: This study assessed the burden of SSIs and related antibiotic resistance in the 34 Military Hospital (MH) and Makeni Government Hospital (MGH) located in two geographic regions of Sierra Leone using a prospective study design to collect data from adults aged 18 years or older. Results: Of the 417 patients, 233 (55.9%) were enrolled in MGH. Most were women 294 (70.5%). The incidence rate of SSI was 5.5 per 1000 patient-days, and the cumulative incidence of SSI was 8.2%. Common bacteria isolated in MH were Escherichia coli (6,33.3%) and Pseudomonas aeruginosa (3,16.7%) and in MGH were P. aeruginosa (3,42.9%) and Proteus mirabilis (2,28.9%). Of the gram-negative bacteria, 40% were Extended-spectrum beta-lactamase-producing Enterobacteriaceae, 33% were Carbapenem-resistant P. aeruginosa and 10% were carbapenem-resistant Enterobacteriaceae. Conclusion: Although the incidence of SSIs in our study is lower than previously reported, the rate of antibiotic resistance reported in this study is high. Urgent action is needed to invest in the microbiology infrastructure to support SSI surveillance and prevention strategies.