bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeting Obesity to Optimize Weight Loss in Cardiac Rehabilitation
Authors: Brinkley Tina E. , Hsu Fang-Chi , Bowman Benita M. , Addison Theresa , Kitzman Dalane W. , Houston Denise K. 
Published: November 2022

Purpose:
Cardiac rehabilitation (CR) programs are integral in the treatment of coronary heart disease (CHD). However, most programs do not incorporate structured, evidence-based obesity treatment, potentially limiting efficacy for the large number of CHD patients with overweight/obesity. This pilot study determined the feasibility of adding a behavioral weight loss intervention during standard CR.

Methods:
Adults aged ≥40 yr with CHD and overweight/obesity were randomized to 6 mo of CR alone or CR plus a behavioral weight loss program incorporating meal replacements and individual dietary counseling (CR + WL). Body weight, adiposity, cardiometabolic risk factors, self-efficacy for eating, and stages and processes of change for weight management (S-Weight, P-Weight) were assessed at baseline and during follow-up.

Results:
Thirty-eight participants (64.5 ± 7.9 yr, 24% female, 16% Black/Hispanic) were enrolled over 18 mo. Retention was high, with 95% of participants completing the 6-mo follow-up visit. Participants attended ∼58% of the prescribed exercise sessions, and those in the CR + WL group attended 98% of the prescribed weight loss sessions. The CR + WL group lost significantly more weight than the CR group (6.4 ± 4.7% vs 1.2 ± 3.0%, P = .001), and there were significant treatment effects for total/regional adiposity, eating self-efficacy, and P-weight scores (all P values < .05). Overall, greater weight loss was associated with improvements in self-efficacy (P = .014) and P-weight scores for weight consequences evaluation (P = .007) and weight management actions (P = .04).

Conclusions:
A behavioral weight loss intervention during CR is feasible and safe, leading to greater weight and fat loss and related improvements in weight maintenance behaviors in overweight/obese adults with CHD.
Accelerated vascular age in adolescents with primary hypertension
Authors: Obrycki Łukasz , Sarnecki Jędrzej , Pac Michał , Dereziński Tadeusz , Lewandowska Weronika , Feber Janusz , Litwin Mieczysław 
Published: November 2022

Background:
Primary hypertension may lead to early vascular ageing. We aimed to evaluate differences between expected vascular age based on pulse wave velocity (PWV)/carotid intima-media thickness (cIMT) and actual chronological age (CHA) in adolescents with primary hypertension.

Methods:
Three hundred and fifty-two children (median age of 15.5 years) with office hypertension and 64 normotensive healthy children of the same age underwent anthropometry, office and ambulatory blood pressure (BP), left ventricular mass index, cIMT, PWV, pulse wave analysis and biochemistry measurements. Vascular age was calculated using pooled pediatric and adult normative PWV and cIMT data. The difference between vascular age and CHA was calculated in relation to the 90th percentile for PWV (PWVAgeDiff90) and the 95th percentile for cIMT (cIMTAgeDiff95).

Results:
One hundred and sixty-six patients had white-coat hypertension (WCH), 32 had ambulatory prehypertension (AmbPreHT), 55 had isolated systolic hypertension with normal central SBP (ISH+cSBPn), 99 had elevated office, ambulatory and cSBP (true hypertension, tHT). The differences between vascular age (both PWV and cIMT based) and CHA were significantly higher in AmbPreHT and tHT compared with normotension, WCH and ISH+cSBPn. Median PWVAgeDidff90 was −3.2, −1.2, −2.1, +0.8 and +0.3 years in normotension, WCH, ISH+cSBPn, AmbPreHT and tHT, respectively. Median cIMTAgeDiff95 was −8.0, −6.3, −6.8, −3.8 and −4.3 years in normotension, WCH, ISH+cSBPn, AmbPreHT and tHT, respectively. Significant predictors of PWVAge90Diff were the DBP and serum cholesterol, whereas cSBP and augmentation index were significant predictors of cIMTAgeDiff95.

Conclusion:
Children with AmbPreHT and tHT show accelerated vascular age compared with their normotensive peers.
Impact of Wire Sensor Location on Coronary Physiological Measurement
Authors: Lotfi Amir , Haider Ali , Pervaiz Abdullah , Kadado Anis John , Bachman Marcos , Rodriguez-Arciniega Jose A. , Visintainer Paul 
Published: November 2022

Background:
The location of the wire sensor to measure fractional flow reserve (FFR) and diastolic pressure ratio (dPR) has not been systematically studied. Therefore, we hypothesize that the coronary physiological measurements will vary with the location of the sensor.

Methods:
Fifty-four patients were screened, and 30 consecutive patients were enrolled. The OptoWire 2 or 3 generation fiberoptic pressure wire was used to assess whole cycle pressure distal/pressure aorta, dPR, and FFR. Our primary goal is to test if those measurements vary with the wire sensor placed at 10 mm (proximal), 35–45 mm (mid), and greater than or equal to 60–70 mm (distal) distal to the target lesion, respectively. We used a multilevel linear regression approach.

Results:
Of 30 patients enrolled, 23 (76.6%) were males, mean age was 64.7 years (± 11.0 years), and mean stenosis was 61.6% (±13.4%). Adjusting for age, gender, and severity of stenosis, results showed that for all 3 measures (whole cycle pressure distal/pressure aorta, dPR, and FFR), pressure decreased in a linear fashion the further the sensor was from the target lesion (P < 0.001). Further, pairwise comparisons of the measurements at adjacent locations similarly showed significant declines in pressure (P < 0.001).

Conclusions:
This is the first study to demonstrate that the location of the pressure wire can impact the results of both resting and hyperemic pressures, which can cause a false-negative result. This is especially important where the values are near the cutoff.
Value of 99mTc-MIBI SPECT/CT in the localization of recurrent lesions in patients with suspected recurrent parathyroid carcinoma
Authors: Guo Yue-Hong , Huang Jing-Wei , Wang Ying , Lu Ruigang , Yang Min-Fu 
Published: November 2022

Purpose
Accurate preoperative localization of tumor-bearing lesions is crucial for the successful surgical management of suspected recurrent parathyroid carcinoma. The purpose of this study was to evaluate the diagnostic value of 99m-technetium-labeled methoxyisobutylisonitrile (99mTc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) and cervical ultrasound, individually and in combination, for preoperative localization of recurrent/metastatic lesions. We also analyzed the value of 99mTc-MIBI SPECT/CT in detecting ectopic lesions in patients with suspected recurrent parathyroid carcinoma.

Methods
Twenty-nine patients with suspected recurrent parathyroid carcinoma were included in this retrospective cohort study. Patients underwent preoperative 99mTc-MIBI SPECT/CT and cervical ultrasound. The reference standard was postsurgical histopathology. The sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy of the two diagnostic modalities alone and in combination were analyzed.

Results
Of the 29 patients, histopathological results revealed 48 metastases/recurrent lesions in 26 patients. The diagnostic value of 99mTc-MIBI SPECT/CT, cervical ultrasound, and the two modalities in combination were compared for the 27 patients who underwent new cervical surgery. Patient-level analysis of the combined use of 99mTc-MIBI SPECT/CT and cervical ultrasound had the highest sensitivity (100.00%) and accuracy (96.30%). At the lesion level, 99mTc-MIBI SPECT/CT had the highest specificity and PPV, at 100.00% respectively, whereas the combined use of 99mTc-MIBI SPECT/CT and cervical ultrasound had the highest sensitivity, at 97.62%. Moreover, 99mTc-MIBI SPECT/CT detected six ectopic lesions, and five of them showed increased 99mTc-MIBI uptake.

Conclusions
The combined use of 99mTc-MIBI SPECT/CT and cervical ultrasound is the most efficient strategy in the diagnosis of parathyroid carcinoma relapse, whereas 99mTc-MIBI SPECT/CT is the preferred method for localizing and analyzing cervical and extra-cervical lesions before the new surgery.
45 Is the new 50: improving colon cancer screening rates
Authors: Levy Benjamin H. , Thelin Camille , Da Silva Juliana 
Published: November 2022

Purpose of review
The colonoscopy guidelines recently changed to begin screening at age 45. This review discusses the reasons for lowering the age, adenomatous polyp detection rates for patients 45–49, and to discover innovative health education campaigns aimed at younger patients.

Recent findings
There are currently approximately 20 million Americans between the age of 45–49 who will need to be screened by gastroenterologists. The prevalence of overall and advanced colorectal neoplasia on screening colonoscopy for average-risk individuals younger than 50 years is 14% and 2%. An important 2022 study using the GI Quality Improvement Consortium Registry demonstrated that patients aged 45–49 had an overall adenoma detection rate of >25%.

Summary
Health education campaigns need to immediately target 20 million Americans to begin colorectal cancer screening. Additional research should focus on whether there are sex differences for adenoma detection rates among patients aged 46–49. Innovative health education campaigns such as “Tune It Up: A Concert To Raise Colorectal Cancer” organized by the American College of Gastroenterology are educating younger patients to begin colorectal screening by combining concerts and health communication.
Characteristics of Pediatric Patient Transfers From General Emergency Departments in California From 2005 to 2018
Authors: Lee Moon O. , Wall Jessica , Saynina Olga , Camargo Carlos A. , Wang N. Ewen 
Published: November 2022

Objective
Each year, approximately 300,000 pediatric patients are transferred out of emergency departments (EDs). Emergency department transfers may not only provide a higher level of care but also incur increased resource use and cost. Our objective was to identify hospital characteristics and patient demographics and conditions associated with ED transfer as well as the trend of transfers over time.

Methods
This was a retrospective cohort study of pediatric visits to EDs in California using the California Office of Statewide Health Planning and Development ED data set (2005–2018). Hospitals were categorized based on inpatient pediatric capabilities. Patients were characterized by demographics and Clinical Classifications Software diagnostic categories. Regression models were created to analyze likelihood of outcome of transfer compared with admission.

Results
Over the 14-year period, there were 38,117,422 pediatric visits to 364 EDs in California with a transfer rate of 1% to 2%. During this time, the overall proportion of pediatric transfers increased, whereas pediatric admissions decreased for all hospital types. Transfers were more likely in general hospitals without licensed pediatric beds (odds ratio [OR], 16.26; 95% confidence interval [CI], 15.87–16.67) and in general hospitals with licensed pediatric beds (OR, 3.54; 95% CI, 3.46–3.62) than in general hospitals with pediatric intensive care unit beds. Mental illness (OR, 61.00; 95% CI, 57.90–63.20), poisoning (OR, 11.78; 95% CI, 11.30–12.30), diseases of the circulatory system (OR, 6.13; 95% CI, 5.84–6.43), diseases of the nervous system (OR, 4.61; 95% CI, 4.46–4.76), and diseases of the blood and blood-forming organs (OR, 3.21; 95% CI, 3.62; 95% CI, 3.45–3.79) had increased odds of transfer.

Conclusion
Emergency departments in general hospitals without pediatric intensive care units and patients' Clinical Classifications Software category were associated with increased likelihood of transfer. A higher proportion of patients with complex conditions are transferred than those with common conditions. General EDs may benefit from developing transfer processes and protocols for patients with complex medical conditions.
Childhood Lead Poisoning 1970-2022: Charting Progress and Needed Reforms
Authors: Jacobs David E. , Brown Mary Jean 
Published: November 2022

Context:
Childhood lead poisoning prevention in the United States was marked by a largely failed medical approach from 1971 to 1990; an emergent (but small) healthy housing primary prevention strategy from 1991 to 2015; and implementation of large-scale proven interventions since then.

Program:
Childhood Lead Poisoning Prevention & Healthy Housing.

Methods:
Historic and recent health and housing data from the National Health and Nutrition Examination Survey (NHANES) and the American Healthy Homes Survey (AHHS) were retrieved to analyze trends and associated policy gaps.

Evaluation:
Approximately 590 000 US children aged 1 through 5 years had elevated blood lead levels of 3.5 μg/dL and greater in 2016, and 4.3 million children resided in homes with lead paint in 2019. Despite large improvements, racial and other disparities remain stubbornly and statistically significant. The NHANES and the AHHS require larger sample sizes. The Centers for Disease Control and Prevention has not published children's blood lead surveillance and NHANES data in several years; the Department of Housing and Urban Development (HUD) has no analogous housing surveillance system; and the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) have not updated training, Superfund, and occupational standards in decades.

Discussion:
The nation has been without a plan and an associated budget for more than 2 decades. Congress has not reformed the nation's main lead poisoning prevention laws in more than 30 years. Such reforms include stopping US companies from producing new residential lead paint in other countries; enabling the disclosure law to identify all residential lead hazards; closing loopholes in federally assisted housing regulations and mortgage insurance standards; harnessing tax policy to help homeowners mitigate lead hazards; streamlining training requirements; increasing the size of health and housing surveys and surveillance systems; and updating housing codes, medical guidance, dust lead standards, training, Superfund, and worker exposure limits. Congress and the president should reauthorize a cabinet-level task force (dormant since 2010) to develop a new strategic plan with an interagency budget to implement it. These reforms will scale and optimize markets, subsidies, enforcement, and other proven interventions to end ineffective, costly, harmful, and irrational cost shifting that threatens children, workers, and affordable housing.
Brief Report: Refusal of Daily Oral PrEP: Implementation Considerations and Reported Likelihood of Using Various HIV Prophylaxis Products in a Diverse Sample of MSM
Authors: Mansergh Gordon , Kota Krishna Kiran , Carnes Neal , Gelaude Deborah 
Published: November 2022

Background:
An important subgroup of gay, bisexual, and other men who have sex with men (MSM) with behavioral indications refuse daily oral pre-exposure prophylaxis (PrEP) when recommended by a provider. Emerging HIV prophylaxis products (eg, injectable, event-driven) offer more options to MSM who refuse daily PrEP. In this article, we assess reasons for refusal and likelihood to use various products among MSM who refused PrEP.

Methods:
MSM who reported anal sex without condoms or PrEP and refused daily oral PrEP in the past 6 months were recruited through clinics, community venues, and online in Atlanta, Chicago, and Raleigh-Durham. Men were asked their main reason for recently refusing daily PrEP and likelihood of using various PrEP options in the future. Bivariate and multivariable regression models were used to estimate associations.

Results:
MSM (n = 93; 70% Black, 48% age 18–29 years) reported their main reason for refusing daily PrEP were potential side effects (35%), a daily pill regimen (22%), and not having enough information (18%). Reported likelihood of using PrEP products was 58% for penile gel, 54% for event-driven oral, 52% for injectable, and 50% for daily PrEP. MSM who reported daily regimen as the main reason for refusing PrEP had greater odds of likelihood to use an injectable [adjusted odds ratio (AOR) = 5.21, 95% confidence interval (CI): 1.32 to 20.52]. Younger men (18–29 vs 30+ years) had greater odds of likelihood to use condoms (AOR = 3.40, 95% CI: 1.15 to 10.04) and daily PrEP (AOR = 2.76, 95% CI: 1.06 to 7.16); there were no product preference differences by race.

Conclusion:
Most men who refused daily PrEP indicated likelihood of using some form of PrEP in the future.
Obstetric Ultrasonography in Postgraduate Radiology Training
Authors: Emekli Emre , Coşkun Özlem , Budakoğlu Işil İrem , Cerit Mahi Nur 
Published: November 2022

Abstract
There is no study in the literature that reveals the adequacy of obstetric ultrasonography (US) training in Turkey. We aimed to evaluate the adequacy of obstetric US training radiologists had received during their residency and determine how competent they considered themselves to be in this regard.
A survey (27 items for residents, 21 items for specialists) was sent to all the radiology residents and specialists in Turkey through the mail list of the Turkish Society of Radiology.
Ninety-one residents and 217 specialists participated in our study. Sixteen residents (17.6%) had received theoretical courses, 21 residents (23.1%) and 59 specialists (27.2%) had attended in-house obstetric US rotations, and 5 residents (5.5%) and 23 specialists (10.6%) had attended obstetric US rotations in another institution. When questioned separately for each trimester, only 11% to 36.3% of the residents stated that they took care of a sufficient number of patients. In general, 62.6% of the residents and 25.3% of the specialists did not consider themselves to be absolutely competent in obstetric US. The competency sources were specified as residency training by 44 residents (48.6%) and 55 specialists (25.3%), postgraduate training by 2 residents (2.2%) and 78 specialist (35.9%).
In Turkey, current obstetric US training does not provide the experience that will allow physicians with radiology training to easily perform and interpret obstetric US. The main reasons for this situation include the limited number of patients the physicians took care of as a resident, insufficient rotation time, and lack of theoretical courses they attended.
A Study on the Expression of Messenger RNAs and Long Noncoding RNA in Keloid Fibroblasts Based on Gene Expression Omnibus Microarray Data Mining
Authors: Su Zhicheng , Liu Xiangxia , Liu Zheng , Deng Yu , Han Bing , Zhang Yujing , Zhu Zhaowei , Xu Yangbin , Xu Shuqia 
Published: November 2022

Objective:The purpose of this study was to find the coding RNA [messenger RNA (mRNA)] and long noncoding RNA (lncRNA) expressed in keloid through the analysis of Gene Expression Omnibus microarray chip of keloid fibroblasts.Materials and Methods:Gene Expression Omnibus database GSE7890 database was downloaded with selection of keloids and normal scar group data. The data were analyzed by R language combined with online database. The log2FC>1,Pvalue <0.01 was chosen as screening criteria, and the differentially expressed mRNAs were screened for GO and KEGG function analysis.Results:One hundred fifty-five mRNA expression in the keloid group was significantly different from that in the normal group, including 31 groups with upregulated mRNA expression and 124 groups with down-regulated mRNA expression. Meanwhile, 8 lncRNAs were changed in the keloid group, including 3 upregulated (Rp11-420a23.1, Rp11-522b15.3, and Rp11-706j10.1) and 5 down-regulated (LINC00511, LINC00327, Hoxb-as3, Rp11-385n17.1, and Rp3-428l16.2). Quantitative polymerase chain reaction analysis of DElncRNAs in keloid fibroblasts showed that the expression of all DElncRNAs except for RP11-385N17.1 was increased in the keloid group compared with the control group. Moreover, the differences in LINC00511 and RP11-706J10.1 were statistically significant.Conclusion:The noncoding RNA information of Gene Expression Omnibus chip data can be deeply mined through bioinformatics, and the potential epigenomic mechanism affecting keloid formation can be found from the existing database.
Re-emergence of cholera in Haiti linked to environmentalV. choleraeO1 Ogawa strains
Authors: Mavian Carla N. , Tagliamonte Massimiliano S. , Alam Meer T. , Sakib S. Nazmus , Cash Melanie N. , Riva Alberto , De Rochars V. Madsen Beau , Rouzier Vanessa , Pape Jean William , Morris J. Glenn , Salemi Marco , Ali Afsar 
Published: November 2022

AbstractBACKGROUNDOn September 25th, 2022, cholera re-emerged in Haiti.OBJECTIVES/METHODSToxigenicVibrio choleraeO1 Ogawa were isolated on October 3rd& 4th, 2022, from cholera case patients in Port-au-Prince. The two new genomes were compared with genomes from 2,129V. choleraeO1 isolated worldwide, including 292 Haitian strains from 2010-2018.RESULTSPhylogenies conclusively show the 2022 strains clustering within the Haitian monophyletic clade dating back to the 2010 outbreak. Strains shared a most recent common ancestor with a 2018 Haitian Ogawa strain isolated from the aquatic ecosystem, and cluster with the Ogawa clade that was circulating in 2015-2016.CONCLUSIONSRe-emergence of cholera in Haiti is the likely result of a spill-over event at the aquatic-human interface related to persistence ofV. choleraeO1 in the environment.One-Sentence SummaryWe analyzed the full genome of twoV. choleraestrains isolated from Haitian patients infected during the early days of the current 2022 epidemic, with data indicating that they originated from strains that have been circulating undetected at sub-epidemic levels in the aquatic environment.
Implementation of flash glucose monitoring in four paediatric diabetes clinics – controlled before and after study to produce real world evidence of patient benefit. Statistical and health economic analysis plan
Authors: Kandiyali R. , Taylor H. 
Published: November 2022

AbstractThis study seeks to answer two key questions:Does flash glucose monitoring improve outcomes in children with Type 1 diabetes compared to finger prick testing?What are the healthcare implications associated with flash monitoring when compared to finger prick testing in terms of staff time, experience and healthcare costs?We report our combined Statistical and Health Economic Plan (SHEAP) for a controlled before and after study using routinely collected health record data on children who are eligible for flash glucose monitoring (Abbott FreeStyle Libre™) and a control population of children who continue to finger prick test in South West England. Our main analysis includes comparison of glucose control in terms of glycated haemoglobin (HbA1c) and UK health service costs relating to prescribing and loss of control (via record of diabetes related complications).
Monoclonal antibody levels and protection from COVID-19
Authors: Stadler Eva , Burgess Martin T , Schlub Timothy E , Chai Khai Li , McQuilten Zoe K , Wood Erica M , Polizzotto Mark N , Kent Stephen J , Cromer Deborah , Davenport Miles P , Khoury David S 
Published: November 2022

AbstractMultiple monoclonal antibodies have been shown to be effective for both prophylaxis and therapy for SARS-CoV-2 infection. Here we aggregate data from randomized controlled trials assessing the use of monoclonal antibodies in preventing symptomatic SARS-CoV-2 infection. We use data on changes in thein vivoconcentration of monoclonal antibodies, and the associated protection from COVID-19, over time to model the dose-response relationship of monoclonal antibodies for prophylaxis. We estimate that 50% protection from COVID-19 is achieved with a monoclonal antibody concentration of 54-fold of thein vitroIC50 (95% CI: 16 – 183). This relationship provides a quantitative tool allowing prediction of the prophylactic efficacy and duration of protection for new monoclonal antibodies administered at different doses and against different SARS-CoV-2 variants.Finally, we compare the relationship between neutralization titer and protection from COVID-19 after either monoclonal antibody treatment or vaccination. We find no evidence for a difference between the 50% protective titer for monoclonal antibodies and vaccination.