bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-Sectional Survey of Views on COVID-19 and Its Vaccines Among Pregnant Women
Authors: Li Yan Yu , Lok Wing Yi , Poon Liona C. , Kong Choi Wah , To William W.K. 
Published: August 2022

Abstract

Objective
The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study.

Methods
This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong, China. Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021. Apart from basic demographic data, the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19. Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables, whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate. A P value of <0.05 was considered to be statistically significant.

Results
A total of 816 completed questionnaires were included for analysis. Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816, 48.2% vs. 518/623, 83.1%, P<0.001). Fewer pregnant women believed that pregnancy were more susceptible to contract SARS-CoV-2 as compared to the last survey (265/816, 32.5% vs. 261/623, 41.9%, P<0.001). They have significant knowledge gap and concerns about COVID-19 vaccines. Nearly half of the participants believed that pregnant women cannot have COVID-19 vaccination (402/816, 49.3%) and it is unsafe to fetus (365/816, 44.7%). Around a third of women perceived that they were more prone to the side effects and complications of COVID-19 vaccines than the general population (312/816, 38.2%) and did not recognize that maternal COVID-19 vaccination could effect transferral of antibodies to the fetus to promote postnatal passive immunity (295/816, 36.2%). Most of them had not been vaccinated (715/816, 87.6%) and only (12/715) 1.7% of them would consider vaccination during pregnancy.

Conclusion
Despite the local and international recommendations for pregnant women to be vaccinated, the uptake of COVID-19 vaccines during pregnancy remained extremely low. Efforts should be made to effectively provide information about the safety and benefits of COVID-19 vaccines during pregnancy. There is an urgent need to booster vaccination rates in pregnant women to avoid excessive adverse pregnancy outcomes related to COVID-19.
Hypertension and clinical outcomes in patients with familial hypercholesterolemia
Authors: Liu Ming-Ming , Peng Jia , Xu Rui-Xia , Guo Yuan-Lin , Zhu Cheng-Gang , Wu Na-Qiong , Li Jian-Jun 
Published: August 2022

Background:
Hypertension is a known risk factor for cardiovascular disease; however, its impact on clinical outcomes in patients with heterozygous familial hypercholesterolemia (HeFH) is unclear. Hence, we aimed to investigate the effects of hypertension on severity of coronary artery atherosclerosis and cardiovascular outcomes in patients with HeFH.

Methods:
A total of 480 patients with clinical or molecular diagnosis of definite or probable familial hypercholesterolemia according to Dutch Lipid Clinic Network criteria (DLCN score ≥6) were included in the study. They were divided into the two groups according to their blood pressure status: hypertension group and normotension group. The severity of coronary stenosis was assessed by a number of diseased vessels, Gensini, Syntax, and Jeopardy scores. All individuals were followed up for cardiovascular events (CVEs) and cox proportion hazard models were used to evaluate the association of hypertension with cardiovascular outcomes.

Results:
Patients with hypertension had more severe coronary stenosis and a higher incidence of CVEs compared with the ones with normotension (log-rank P < 0.001). After multivariable adjustment, there was a 2.1-fold increased risk of CVEs among patients with hypertension compared with patients with normotension (adjusted hazard ratio 2.06, 95% confidential interval 1.17–3.65, P < 0.01). Hypertension control status was also associated with CVEs even after adjustment of multiple variables. However, no combined effect on increased cardiovascular risks was detected in this HeFH cohort.

Conclusion:
In patients with HeFH, hypertension is an independent risk factor for cardiovascular events. Moreover, blood pressure control status in patients with hypertension is associated with the worse outcomes.
The impact of Sacubitril/Valsartan on cardiac fibrosis early after myocardial infarction in hypertensive rats
Authors: Liu Yihai , Zhong Chongxia , Si Jiayi , Chen Shan , Kang Lina , Xu Biao 
Published: August 2022

Background:
Sacubitril/Valsartan, a dual inhibitor of the neprilysin and angiotensin receptor, exerts cardioprotective effects in heart failure. Little is known on the impact of Sacubitril/Valsartan in hypertensive patients early post myocardial infarction.

Methods:
Spontaneously hypertensive rats (SHR) were pretreated by daily angiotensin receptor blocker (ARB; 30 mg/kg intraperitoneally), Sacubitril/Valsartan (ARNI; 60 mg/kg intraperitoneally) or the same dosage of physiological saline for 1 week. Then each group underwent myocardial infarction induction and received the same treatment for another week. The blood pressure and cardiac function were evaluated prior to sacrifice. We performed histological and molecular evaluation of fibrosis in vivo and in vitro.

Results:
The blood pressure was comparable between three groups both 1 week prior to and post myocardial infarction. ARNI and ARB restore the decreased ejection fraction (57.3 ± 7.6 vs. 42.9 ± 5.2%, P < 0.05; 54.3 ± 6.9 vs. 42.9 ± 5.2%, P < 0.01, respectively) and fractional shortening (31.6 ± 5.4 vs. 22.1 ± 3.1%, P < 0.05; 29.4 ± 4.5 vs. 22.1 ± 3.1%, P < 0.05, respectively) post myocardial infarction. The infarct size and collagen deposition were also significantly mitigated in ARNI and ARB groups. In addition, ARNI and ARB treatment reduced the expression of cardiac remodeling-related factors, such as Bnp, α-SMA, Vimentin, and Col1a1 (all P < 0.05 vs. MI group). Finally, ARNI and ARB decreased the expression of α-SMA in cardiac fibroblasts treated with Ang II.

Conclusion:
In conclusion, pretreatment with ARNI maintained cardiac function and reduced myocardial fibrosis in myocardial infarction, probably prior to any anti-hypertensive effect.
MANAGEMENT OF RETINAL DETACHMENT ASSOCIATED WITH MORNING GLORY SYNDROME USING THE HUMAN AMNIOTIC MEMBRANE
Authors: Caporossi Tomaso , Ferrara Silvia , Savastano Alfonso , Gambini Gloria , De Vico Umberto , Savastano Maria Cristina , Rizzo Stanislao 
Published: August 2022

Purpose:
This case report describes an innovative procedure for addressing retinal detachment in patients with morning glory syndrome.

Methods:
An 18-year-old woman with unilateral morning glory syndrome complicated by macula-off retinal detachment without any visible peripheral retinal breaks underwent three corrective surgeries. In the first surgery, a 25-gauge pars plana vitrectomy with a 3-mm human amniotic membrane patch positioned on the optic disc and gas endotamponade was performed. When the gas reabsorbed, inferior retinal detachment recurred, and a second vitrectomy with silicone oil endotamponade was conducted. At three months, the retina was still attached under the silicone oil, so the oil was removed. At the second follow-up, retinal detachment had recurred, and a third vitrectomy with a larger amniotic patch and silicone oil endotamponade was performed.

Results:
Three months following the last surgery, the subretinal fluid had totally reabsorbed, and the retina was completely attached. The best-corrected visual acuity was 20/100.

Conclusion:
To the best of our knowledge, the first description of a human amniotic patch associated with vitrectomy in morning glory syndrome complicated with retinal detachment is described. Using human amniotic membranes, positioned onto the optic nerve, and silicone oil endotamponade could be useful for morning glory syndrome complicated by retinal detachment.
Workload and Mental Well-Being of Homeworkers
Authors: Zappalà Salvatore , Swanzy Erasmus Keli , Toscano Ferdinando 
Published: August 2022

ObjectiveBased on the Conservation of Resources theory, this cross-sectional study investigates the relationship between workload experienced by employees when working at home and their mental well-being. Work-family conflict, sleeping problems, and work engagement are proposed as mediators.MethodsA sample of 11,501 homeworkers was drawn from the sixth wave of the European Working Condition Survey data set.ResultsUnlike the expected, the higher the workload, the higher the mental well-being of employees. However, as expected, high workload was correlated with lower well-being when indirect effects through work-family conflict, sleep problems, and work engagement were considered. Similarly, the total effect of workload on mental well-being was negative.ConclusionsThe study suggests that organizations should pay more attention to the amount of workload experienced by their homeworkers because it may be harmful to their health and well-being.
Productivity Loss, Healthcare Costs, and Habitual Physical Activity Among Adults With Cardiovascular Diseases
Authors: Araujo Monique Yndawe Castanho , de Barros Mauro Virgilio Gomes , Ricardo Suelen Jane , Mantovani Alessandra Madia , Turi-Lynch Bruna Camilo , Codogno Jamile Sanches 
Published: August 2022

Objectives
The aims of the study are to quantify the relationship between productivity loss and healthcare costs among adults with cardiovascular diseases and also to verify whether habitual physical activity (HPA) modulates this relationship.

Methods
Information was obtained about healthcare costs, productivity loss, and HPA.

Results
The sample consisted of 278 adults. Active workers who reported presenteeism and absenteeism due to cardiovascular diseases had higher direct costs (P < 0.05) than those who reported other reasons. Those who reported absenteeism spent US $187.33 more on healthcare services annually than those who did not miss work because of health reasons. However, an annual savings of US $53.00 was observed for each increase in the score of HPA.

Conclusions
There was a positive correlation between absenteeism and direct healthcare costs among adults with cardiovascular diseases, and HPA positively affected this relationship.
Alternatives to glucocorticoid monotherapy in the treatment of polymyalgia rheumatica
Authors: Walz Kirsten , Elliott Lydia , Pearson Tamera 
Published: August 2022

ABSTRACT

Background:
Treatment of polymyalgia rheumatica (PMR) can be challenging. The most efficacious and cost-effective treatment of PMR is some type of glucocorticoid (GC), with necessary treatment duration typically one year or longer. This duration of GC use is often associated with significant morbidity. Numerous studies have been and are being conducted that focus on alternative treatment modalities.

Objectives:
This literature review explores alternatives to glucocorticoid monotherapy in the treatment of PMR.

Data Sources:
An integrative literature review was conducted to evaluate peer-reviewed literature on the topic. An electronic literature search was performed in the Cochrane Database of Systematic Reviews, and an EBSCO search identified relevant articles in the following databases: MEDLINE Complete, Academic Search Premier, Cumulative Index of Nursing and Allied Health (CINAHL) Plus, PsycInfo, Education Source, SocINDEX, the CDC, and PubMed.

Conclusions:
Agents such as methotrexate and tocilizumab have been used successfully in conjunction with oral glucocorticoids and have demonstrated steroid-sparing effects. A promising adjunctive treatment is the monoclonal antibody, tocilizumab, which has been studied as both adjuvant and monotherapy. Further research in the efficacy, safety, and affordability of these agents is warranted.

Implications for Practice:
Because PMR is commonly diagnosed and managed in primary care, providers should keep abreast of the most current recommendations concerning optimal treatment options and carefully weigh the risks versus benefits of long-term GC use. This expanding area of research may assist primary care providers to better treat and manage PMR as well as reduce long-term treatment risk by minimizing corticosteroid use when possible.
Prognostic significance of thrombus burden on short- and long-term clinical outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention
Authors: Köktürk Uğur , Somuncu Mustafa Umut , Uygur Begüm , Akgül Özgür , Püşüroğlu Hamdi 
Published: August 2022

Objective
Large thrombus burden (LTB) observed during ST-segment elevation myocardial infarction (STEMI) may end up with worse clinical outcomes. The relationship between LTB and long-term mortality and major adverse cardiac events (MACE) in STEMI patients undergoing percutaneous coronary intervention (PCI) is unclear. In this study, we aimed to investigate the relationship of LTB with short- and long-term mortality and MACE in STEMI patients undergoing PCI.

Methods
Thrombus burden (TB) was evaluated in STEMI patients who underwent PCI between December 2010 and April 2012. After infarct-related arterial flow was restored, TB was reclassified. LTB was defined as thrombus with the largest dimension of at least two vessel diameters. Patients were evaluated for 1-month, 1-year, and 10-year follow-ups in terms of MACE and mortality.

Results
Four hundred ninety-nine patients with clinical information and TB classification were analyzed. Three hundred sixty-six patients (73.3%) were in the small TB (STB) group, and 133 patients (26.7%) were in the LTB group. No-reflow (10.6% vs. 5.2%; P = 0.033) and stent thrombosis (7.5% vs. 3.3%; P = 0.042) were observed at a higher rate in the LTB group compared with the STB group. Thirty-day mortality (9.8% vs. 3.8%; P = 0.009) and MACE (16.5% vs. 9.6%; P = 0.030) were higher in the LTB group than in the STB group. Although 10-year MACE (56.4% vs. 46.2%; P = 0.044) was observed higher in the LTB group, no significant difference was observed between the two groups in terms of 10-year mortality (35.3% vs. 32.8%; P = 0.589). LTB was found to be an independent predictor for 10-year MACE (OR, 1.62; 95% CI, 1.01–2.61; P = 0.045).

Conclusion
LTB was associated with short- and long-term clinical events in STEMI patients undergoing PCI, but the mortality effect disappeared at the end of 1 year. Nevertheless, hospitalizations due to heart failure became significant in 10-year follow-up.
Antibiotics: it is all about timing, isn’t it?
Authors: Klompas Michael , Rhee Chanu 
Published: August 2022

Purpose of review
Sepsis guidelines and quality measures set aggressive deadlines for administering antibiotics to patients with possible sepsis or septic shock. However, the diagnosis of sepsis is often uncertain, particularly upon initial presentation, and pressure to treat more rapidly may harm some patients by exposing them to unnecessary or inappropriate broad-spectrum antibiotics.

Recent findings
Observational studies that report that each hour until antibiotics increases mortality often fail to adequately adjust for comorbidities and severity of illness, fail to account for antibiotics given to uninfected patients, and inappropriately blend the effects of long delays with short delays. Accounting for these factors weakens or eliminates the association between time-to-antibiotics and mortality, especially for patients without shock. These findings are underscored by analyses of the Centers for Medicaid and Medicare Services SEP-1 measure: it has increased sepsis diagnoses and broad-spectrum antibiotic use but has not improved outcomes.

Summary
Clinicians are advised to tailor the urgency of antibiotics to their certainty of infection and patients’ severity of illness. Immediate antibiotics are warranted for patients with possible septic shock or high likelihood of infection. Antibiotics can safely be withheld to allow for more investigation, however, in most patients with less severe illnesses if the diagnosis of infection is uncertain.
Opportunities in digital health and electronic health records for acute kidney injury care
Authors: Selby Nicholas M. , Pannu Neesh 
Published: August 2022

Purpose of review
The field of digital health is evolving rapidly with applications relevant to the prediction, detection and management of acute kidney injury (AKI). This review will summarize recent publications in these areas.

Recent findings
Machine learning (ML) approaches have been applied predominantly for AKI prediction, but also to identify patients with AKI at higher risk of adverse outcomes, and to discriminate different subgroups (subphenotypes) of AKI. There have been multiple publications in this area, but a smaller number of ML models have robust external validation or the ability to run in real-time in clinical systems. Recent studies of AKI alerting systems and clinical decision support systems continue to demonstrate variable results, which is likely to result from differences in local context and implementation strategies. In the design of AKI alerting systems, choice of baseline creatinine has a strong effect on performance of AKI detection algorithms.

Summary
Further research is required to overcome barriers to the validation and implementation of ML models for AKI care. Simpler electronic systems within the electronic medical record can lead to improved care in some but not all settings, and careful consideration of local context and implementation strategy is recommended.
Endocarditis in the intensive care unit: an update
Authors: Lakbar Ines , Delamarre Louis , Einav Sharon , Leone Marc 
Published: August 2022

Purpose of review
The incidence of infective endocarditis (IE) is increasing worldwide, resulting in a higher number of patients with IE being admitted to intensive care units (ICU). Nearly half of patients with IE develop a complication during their clinical course. However, few well conducted studies or reviews are devoted to critically ill IE patients. This review discusses the contemporary perioperative and intensive care literature.

Recent findings
IE epidemiology is changing towards elderly and frail patients. ICU patients are at risk of risk of developing IE because they are often in a pro-inflammatory state and many also have several indwelling catheters, which favors infection. Increased performance and recent advances in cardiac imaging allow for easier diagnosis of EI, but the applicability of these techniques to ICU patients is still relatively limited. New developments in antibiotic treatment and adjunctive therapies are explored further in this review.

Summary
The lack of evidence on ICU patients with IE highlights the critical importance of multidisciplinary decision-making and the need for further research.
Dietary nitrate, aging and brain health: the latest evidence
Authors: Shannon Oliver M. , Gregory Sarah , Siervo Mario 
Published: August 2022

Purpose of review
With an increasing population age, cognitive decline and age-associated neurodegenerative diseases are becoming increasingly prevalent and burdensome in society. Dietary supplementation with inorganic nitrate, which serves as a nitric oxide precursor, has been suggested as a potential nutritional strategy to improve brain health in older adults. In this review, we discuss recent findings in this area.

Recent findings
A number of studies have emerged in the past 12–18 months exploring the effects of dietary nitrate supplementation on cognitive function, with typically (although not exclusively) null findings emerging. This research is characterized by small, acute/short-term studies, although observational studies and longer-duration randomised controlled trials are beginning to emerge. From the limited research reporting benefits of nitrate supplementation on cognitive function, one important discovery has been the identification of a potential pathway through which nitrate could impact cognitive health, involving modulation of the oral microbiome, which warrants further investigation.

Summary
Despite some promising early findings, there is currently insufficient evidence to recommend increased dietary nitrate intake for the purpose of improving brain health. However, longer-term, larger-scale trials in potentially responsive groups are warranted to provide definitive evidence in this area.
Peripheral polyneuropathy and acute psychosis from chronic nitrous oxide poisoning: A case report with literature review
Authors: Sood Radhika , Parent Thibault 
Published: August 2022

Rationale:
Nitrous oxide (NO) is a commonly used drug in medical practice, restoration, and the automobile industry. Recreational abuse is an emerging public health problem owing to its accessibility and drug properties.

Patient concerns:
A 25-year-old male was hospitalized with acute psychosis and lower-extremity sensorimotor proprioceptive ataxia due to nitrous oxide abuse.

Diagnosis:
Laboratory studies confirmed a vitamin B12 deficiency. Magnetic resonance imaging of the spinal cord showed normal findings. Electrophysiological testing confirmed length-dependent sensorimotor polyneuropathy, with a predominant motor component and axonal degeneration.

Intervention and outcomes:
Abstinence from toxic substances was suggested, and vitamin B12 substitution was introduced. The patient was lost to follow up.

Lessons:
Nitrous oxide toxicity is multisystemic and is thought to result from vitamin B12 inactivation. Recent case reports postulated direct paranodal lesions resulting from nitrous oxide consumption. Neurological, neuropsychiatric, and hematological toxicities are among those explored in this case report. Correction of the functional vitamin B12 status and nitrous oxide abstinence are essential in the treatment process.