bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to goal-directed therapy for patients with cirrhosis hospitalized with spontaneous bacterial peritonitis
Authors: Eberhard Chrysten M , Davis Kyle A , Nisly Sarah A 
Published: February 2022

Abstract

Purpose
The American Association for the Study of Liver Diseases has developed a standard of care for the treatment of patients with spontaneous bacterial peritonitis (SBP). Evidence examining the adherence rate to these guideline recommendations is limited. This study aimed to determine the adherence rate to guideline-directed therapy for patients with cirrhosis hospitalized with SBP.

Methods
This institutional review board–approved retrospective cohort study conducted at a large academic hospital evaluated the adherence rate to guideline-directed therapy in adult patients with cirrhosis hospitalized with SBP. Included hospitalized patients had a documented diagnosis of cirrhosis and acute SBP. The adherence rate to guideline-directed therapy was determined by receipt of paracentesis within 24 hours of admission, request of Gram stain and culture tests, avoidance of fresh frozen plasma, receipt of albumin on days 1 and 3, receipt of empiric antibiotics within 6 hours, receipt of SBP prophylaxis, receipt of deep vein thrombosis prophylaxis, and offer of pneumococcal vaccination.

Results
A total of 110 patients were included. Provider adherence to goal-directed therapy was poor, with criteria met for only 10 (9.1%) patients. The therapies with the lowest adherence rates included SBP prophylaxis on discharge (54.5%), receipt of albumin on day 3 (42.7%), and offer of pneumococcal vaccination during admission (43.6%). Patients with a gastrointestinal consult were more likely than those without a consult to obtain albumin on day 1 (69.4% vs 36.8%, P = 0.001) and albumin on day 3 (52.8% vs 23.7%, P = 0.004).

Conclusion
This study demonstrated a lack of adherence to guideline-directed therapy for the management of SBP.
Retrospective evaluation of a delirium order set utilizing nonpharmacologic and pharmacologic interventions for the treatment of delirium in medical intensive care unit patients
Authors: Taylor Alex D , Chen Alyssa , Reddy Anita J , Lewandowski Adriane , Torbic Heather 
Published: February 2022

Abstract

Purpose
To describe the use of a medical intensive care unit (MICU) delirium order set pilot and its associated impact on utilization of nonpharmacologic and pharmacologic interventions, pharmacologic continuation at transitions of care, and resolution of ICU delirium.

Methods
This was a retrospective cohort analysis of MICU patients who received delirium management using an order set pilot compared to standard care. Patients 18 years of age or older admitted to the MICU between May 2019 and January 2020 who received an antipsychotic or valproic acid for the treatment of delirium were included.

Results
Pharmacologic treatment continuation past ICU discharge occurred in 30% of patients in the pilot cohort (n = 50) compared to 54% of patients receiving standard care (n = 50; P = 0.027). On treatment days 1 through 7, utilization of deliriogenic medications was significantly lower in the pilot cohort (78% vs 96%, P = 0.007). No differences were observed between the groups in delirium resolution, delirium recurrence, hospital and ICU length of stay, or mortality.

Conclusion
A MICU order set prioritizing nonpharmacologic management and limiting the duration of pharmacologic agents for delirium may aid providers in the management of ICU delirium and reduce exposure to pharmacologic interventions.
Physiological Demands of Common Occupational Tasks among Australian Police Officers: A Descriptive Analysis
Authors: Decker Amy , Hilton Benjamin , Dawes Jay , Lockie Robert , Orr Robin M 
Published: February 2022

Abstract

Objectives
The aim of this study was to investigate the physiological demands placed on Australian police officers carrying out common operational tasks.

Methods
Forty participants (n = 40) from an Australian police force (mean age = 33.58 ± 7.78 years, mean height = 177.70 ± 7.28 cm, mean weight = 85.68 ± 14.52 kg, mean years of service: 6.74 ± 6.29 years) were recruited through preidentified local area commands. Spanning nine police stations from the same Australian state, volunteers wore monitoring devices to collect physiological measures (heart rate, respiratory rate, and skin temperature) throughout the course of four consecutive shifts (two day shifts and two night shifts). Descriptive data were recorded and analyzed by task and changes in physiological measures.

Results
Of the 345 duty calls attended by participants, the four most commonly reported tasks were as follows: ‘check bona fides’ (n = 76; 22%), ‘driving urgently’ (n = 45; 13%), ‘attending a domestic incident’ (n = 37; 10%), and ‘attending a concern for welfare’ (n = 30; 8%). Mean percentages of maximum heart rates (%HRmax) were considered of very light exercise intensity and ranged from 47.11 (± 7.18) to 50.15 (± 9.35) % for checking bona fides through to driving urgently respectively. Fifteen percent of tasks attended had officers exceed 100 %HRmax (near maximal to maximal exercise intensity). Mean skin temperatures varied little (36.02–36.27°C) between tasks, while mean respiratory rates were lowest when attending a domestic incident and highest when driving urgently (22.56 ± 3.83 and 24.72 ± 6.12 breaths/min, respectively).

Conclusion
Police officers experienced numerous physiological challenges ranging from an intensity of very light exercise through to near maximal and maximal exercise throughout their working day with occasions where their heart rates exceeded 100 %HRmax. These findings highlight the physiological stress associated with common occupational policing tasks, highlighting the importance of cardiovascular health in police officers and the need for cardiovascular monitoring and conditioning.
Psychological First Aid Intervention after Exposure to a Traumatic Event at Work among Emergency Medical Services Workers
Authors: Tessier Marine , Lamothe Josianne , Geoffrion Steve 
Published: February 2022

Abstract
Psychological First Aid (PFA) is a promising early intervention for managing mental health symptoms and providing psychosocial support after exposure to a traumatic event (TE) among high-risk organizations such as Emergency Medical Service (EMS). However, recipients’ experience with PFA remains understudied. This study aimed to explore the perception of EMS workers (n = 13) who received PFA administered by a peer helper using a qualitative inductive approach. Findings from a thematic analysis indicated that the PFA intervention addresses EMS workers’ immediate needs in congruence with Hobfoll’s five essential principles to enhance coping and recovery after a TE. Specific components of the intervention, such as its time-sensitive nature and the closeness with peers, were especially appreciated by EMS workers. The PFA intervention appeared to have a beneficial impact on recipients, regarding the reduction of stigma, the increase of help-seeking behaviors, and the decrease of organizational difficulties. In conclusion, the PFA intervention offered by peer helpers is appreciated by recipients and is a beneficial first step toward supporting EMS workers in the aftermath of workplace trauma. These qualitative findings contribute to the current literature by informing further research about PFA intervention in other high-risk organizations and quantitative studies aiming to test PFA’s efficacy in such settings.
Ice crystal recrystallization inhibition of type I antifreeze protein, type III antifreeze protein, and antifreeze glycoprotein: effects of AF(G)Ps concentration and heat treatment
Authors: Ma Qingbao , Shibata Mario , Hagiwara Tomoaki 
Published: February 2022

ABSTRACT
This study compared ice recrystallization behaviors of frozen dessert model systems containing type I antifreeze protein (AFP I), type III antifreeze protein (AFP III), and antifreeze glycoprotein (AFGP) at −10 °C. Specifically, effects of AF(G)P concentration and heat treatment (95 °C for 10 min) were examined. The concentration dependence of the ice recrystallization rate constant reasonably well fit a sigmoidal function: the fitting procedure was proposed, along with cooperative coefficient α, and a new index of AF(G)P ice recrystallization inhibition (IRI) activity (C50). After 95 °C heat treatment for 10 min, AFP III lost its ice crystal recrystallization inhibitory activity the most: AFP I was less affected; AFGP was almost entirely unaffected. These different thermal treatment effects might reflect a lower degree of protein aggregation because of hydrophobic interaction after heat treatment or might reflect the simplicity and flexibility of the higher order structures of AFP I and AFGP.
The Effect of Preanalytical and Physiological Variables on Cell-Free DNA Fragmentation
Authors: van der Pol Ymke , Moldovan Norbert , Verkuijlen Sandra , Ramaker Jip , Boers Dries , Onstenk Wendy , de Rooij Johan , Bahce Idris , Pegtel D Michiel , Mouliere Florent 
Published: February 2022

AbstractBackgroundAssays that account for the biological properties and fragmentation of cell-free DNA (cfDNA) can improve the performance of liquid biopsy. However, preanalytic and physiological differences between individuals on fragmentomic analysis are poorly defined.MethodsWe analyzed the impact of collection tube, plasma processing time, and physiology on the size distribution of cfDNA, their genome-wide representation, and sequence diversity at the cfDNA fragment ends using shallow whole-genome sequencing.ResultsNeither different stabilizing collection tubes nor processing times affected the cfDNA fragment sizes, but could impact the genome-wide fragmentation patterns and fragment-end sequences of cfDNA. In addition, beyond differences depending on the gender, the physiological conditions tested between 63 individuals (age, body mass index, use of medication, and chronic conditions) minimally influenced the outcome of fragmentomic methods.ConclusionsFragmentomic approaches have potential for implementation in the clinic, pending clear traceability of analytical and physiological factors.
Systematic Review With Meta-analysis: Safety and Effectiveness of Combining Biologics and Small Molecules in Inflammatory Bowel Disease
Authors: Alayo Quazim A , Fenster Marc , Altayar Osama , Glassner Kerri L , Llano Ernesto , Clark-Snustad Kindra , Patel Anish , Kwapisz Lukasz , Yarur Andres J , Cohen Benjamin L , Ciorba Matthew A , Thomas Deborah , Lee Scott D , Loftus Edward V , Fudman David I , Abraham Bincy P , Colombel Jean-Frederic , Deepak Parakkal 
Published: February 2022

Abstract

Background
Combining biologics and small molecules could potentially overcome the plateau of drug efficacy in inflammatory bowel disease (IBD). We conducted a systematic review and meta-analysis to assess the safety and effectiveness of dual biologic therapy (DBT), or small molecule combined with a biologic therapy (SBT) in IBD patients.

Methods
We searched MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Clinical trials.gov until November 3, 2020, including studies with 2 or more IBD patients on DBT or SBT. Main outcome was safety assessed as pooled rates of adverse events (AEs) and serious AEs (SAEs) for each combination. Effectiveness was reported as pooled rates of clinical, endoscopic, and/or radiographic response and remission. The certainty of evidence was rated according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework.

Results
Of the 3688 publications identified, 13 studies (1 clinical trial, 12 observational studies) involving 266 patients on 7 different combinations were included. Median number of prior biologics ranged from 0 to 4, and median duration of follow-up was 16–68 weeks. Most common DBT and SBT were vedolizumab (VDZ) with anti-tumor necrosis factor (aTNF, n = 56) or tofacitinib (Tofa, n = 57), respectively. Pooled rates of SAE for these were 9.6% (95% confidence interval [CI], 1.5–21.4) for VDZ-aTNF and 1.0% (95% CI, 0.0–7.6) for Tofa-VDZ. The overall certainty of evidence was very low due to the observational nature of the studies, and very serious imprecision and inconsistency.

Conclusions
DBT or SBT appears to be generally safe and may be effective in IBD patients, but the evidence is very uncertain.
Effects of early myocardial reperfusion and perfusion on myocardial necrosis/dysfunction and inflammation in patients with ST-segment and non-ST-segment elevation acute coronary syndrome: results from the PLATelet inhibition and patients Outcomes (PLATO) trial
Authors: Batra Gorav , Renlund Henrik , Kunadian Vijay , James Stefan K , Storey Robert F , Steg P Gabriel , Katus Hugo A , Harrington Robert A , Gibson C Michael , Budaj Andrzej , Siegbahn Agneta , Wallentin Lars 
Published: February 2022

Abstract

Aims
Restoration of myocardial blood flow and perfusion during percutaneous coronary intervention (PCI) measured using Thrombolysis in Myocardial Infarction (TIMI) flow grade (TFG) and perfusion grade (TMPG) is associated with improved outcomes in acute coronary syndrome (ACS). Associations between TFG/TMPG and changes in biomarkers reflecting myocardial damage/dysfunction and inflammation is unknown.

Methods and results
Among 2606 patients included, TFG was evaluated in 2198 and TMPG in 1874 with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment ACS (NSTE-ACS). Biomarkers reflecting myocardial necrosis [troponin T (TnT)], myocardial dysfunction [N-terminal prohormone brain natriuretic peptide (NT-proBNP)], inflammation [interleukin-6 (IL-6) and C-reactive protein (CRP)], and oxidative stress/ageing/inflammation [growth differentiation factor-15 (GDF-15)] were measured at baseline, discharge, and 1- and 6-month post-randomization. Associations between TFG/TMPG and changes in biomarker levels were evaluated using the Mann–Whitney–Wilcoxon signed test. In total, 1423 (54.6%) patients had STEMI and 1183 (45.4%) NSTE-ACS. Complete reperfusion after PCI with TFG = 3 was achieved in 1110 (85.3%) with STEMI and in 793 (88.5%) with NSTE-ACS. Normal myocardial perfusion with TMPG = 3 was achieved in 475 (41.6%) with STEMI and in 396 (54.0%) with NSTE-ACS. Levels of TnT, NT-proBNP, IL-6, CRP, and GDF-15 were substantially lower at discharge in patients with complete vs. incomplete TFG and STEMI (P &lt; 0.01). This pattern was not observed for patients with NSTE-ACS. Patients with normal vs. abnormal TMPG and NSTE-ACS had lower levels of NT-proBNP at discharge (P = 0.01).

Conclusions
Successful restoration of epicardial blood flow in STEMI was associated with less myocardial necrosis/dysfunction and inflammation. Attainment of normal myocardial perfusion was associated with less myocardial dysfunction in NSTE-ACS.
Speckle tracking echocardiography (STE) in patients with primary hyperoxularia type 1 (PH1)
Authors: Bruin De- Bon H , Garrelfs SF , Kuiper IM , Hulton S , Bouma BJ , Oosterveld MJS , Groothoff JW , Chikermane A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Primary Hyperoxaluria type 1 (PH1) is a rare, inherited metabolic disorder of glyoxylate metabolism characterized by oxalate overproduction, leading to end-stage kidney disease (ESKD) in more than half of all patients. As renal function deteriorates the ability of the kidneys to excrete the excess of oxalate is increasingly compromised resulting in elevated concentrations of oxalate in the blood and progressive systemic deposition of calcium-oxalate crystals in virtually all tissues, a situation referred to as systemic oxalosis. A wide spectrum of cardiac abnormalities are reported in PH1 patients, including presymptomatic myocardial disease early in the disease course. We aimed to further determine cardiac manifestations in a heterogenous cohort of PH1 patients by conventional and speckle tracking echocardiography (STE).

Methods
Data from 38 genetically confirmed PH1 patients were included in this two-centre study and compared to age- and sex-matched controls. Comprehensive echocardiographic analysis (including STE) was performed. PH1 patients were subdivided in three groups based on stage of chronic kidney disease (CKD) and transplantation status (CKD1-4 (n = 24), CKD5 (n = 7) and post-liver transplantation (n = 7)).

Results
Left-ventricle ejection fraction (LV EF) was preserved in all subjects. PH1 patients had a decreased global longitudinal strain compared to healthy controls, with a mean difference of -2.28 (p &lt; 0.001). In patients with CKD1-4 decreased LS values were solely found in all apical segments, with a mean difference of -5.3 (p &lt; 0.001) as compared to healthy controls. In patients whom already progressed to end-stage kidney disease (ESKD, defined as CKD5) diastolic dysfunction is noted, with preserved systolic function.

Conclusion
Pre-symptomatic myocardial dysfunction is present in PH1 patients with mild renal impairment and relatively normal plasma oxalate values. This indicates that cardiac screening is warranted in all PH1 patients, irrespective of renal function.
How myocardial work could be relevant in patients with an aortic valve stenosis?
Authors: Taconne M , Le Rolle V , Panis V , Hubert A , Auffret V , Galli E , Hernandez A , Donal E 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Speckle tracking based myocardial work calculation is an attractive method to assess left ventricular (LV) myocardial function. In case of aortic stenosis (AS), assessment of work indices is challenging because it requires an accurate evaluation of LV-pressure curves. Therefore, we sought to evaluate the performances of two distinct methods for the estimation of myocardial work indices and to provide a quantitative comparison with invasively measured data.

Methods
Model-based and template-based methods were defined and applied for the evaluation of LV pressures on 67 AS patients. Global Constructive (GCW), Wasted (GWW), Positive (GPW), Negative (GNW) myocardial work and Global Work Efficiency (GWE) and Index (GWI) parameters were calculated using the available software computing the indices using brachial blood pressure and trans-aortic mean pressure gradient for estimating the LV pressures versus using a model-based and homemade software. A complete comparison was performed with invasive measurements.

Results
Patients were characterized by mean pressure gradient of 49.8 ± 14.8 mmHg, LV ejection fraction of 59 ± 8%, the global longitudinal strain was -15.0 ± 4.04%, GCW was 2107 ± 800mmHg.% (model-based method) and 2483 ± 1068mmHg.% (template-based method). The root mean square error (RMSE) and correlation were calculated for each patient and for each pressure estimation methods. The mean RMSE are 33.9mmHg and 40.4mmHg and the mean correlation coefficients are 0.81 and 0.72 for the model-based and template-based methods respectively. Correlation coefficient and Bland-Altman analysis were performed for the six work indices. The two methods present correlation coefficient r2 &gt; 0.75 for almost all the indices.

Conclusion
The two non-invasive methods of LV pressure estimation and the work indices computation correlate with invasive measurements and computations for AS patients. Although the model-based approach requires less information and is associated with slightly better performances, the implementation of template-based method is easier and seems more appropriate in a clinical practice. Abstract Figure. SUMMARY
A new approach to artefact detection and its effect on the normal range of segmental strain and strain rate values
Authors: Kornev M , Rosner A , Caglayan HA 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Helse Nord HNF1458-19

Background
Definition of normal ranges of myocardial segmental deformation are important in clinical studies and routine echocardiographic practice. It is known that artefacts hamper segmental strain and strain rate (S/SR) analysis.

Purpose
This study is based on a new approach for artefact detection. We intended to investigate to what degree different types of artefacts and their localization bias the result of measurements and to establish corrected normal ranges for segmental S/SR parameters.

Methods
The study is based on a collaboration project between the Russian cross-sectional study "Know your heart" and the Norwegian "Tromso-7" study. From 2207 participants we identified 840 individuals (511 females and 329 males, age range 40-79) with normal cardiac function by excluding left ventricular ejection fraction &lt;50%, moderate or severe valvular heart disease, LV- dilatation, pulmonary hypertension, Q-waves and bundle branch block signs on ECG, high blood pressure, history of heart attack, use of antihypertensive drugs or high level of NT-proBNP. End-systolic longitudinal epi- myo- and endocardial strain and peak systolic SR and diastolic SR E and SR A were assessed for the calculation of segmental normal ranges.
In addition to noise and foreshortening artefacts, we introduced a concept of "curve artefact" which can be defined as unphysiological strain curve shapes. Panel A of the figure shows examples of these curve artefacts, A: diastolic mismatch B: blunted curve, and C: floating curve. All strain curves were assessed for the presence of one of these unphysiological shapes and 2D images were visually assessed for the presence of noise, reverberations, or missing parts of the myocardium.

Results
The bar-chart for segmental strain demonstrates significantly reduced strain values at the presence of curve artefacts and increased strain at the presence of foreshortening. Normal ranges for basal septal, basal, medial, and apical segments excluding segments with artefacts and foreshortening are displayed in the table. The presence of curve artefacts matched the presence of noise or other 2D image artefacts in 88% of cases.

Conclusions
Strain artefacts result in systematically reduced peak-strain values. Thus, the detection and exclusion of curve artefacts seem to be an important measure for the correct interpretation of strain curves for a definition of normalcy and pathology. The selection of artefact-free strain curves reveals high strain and SR gradients increasing from epi to endocardial position and basal-septal towards apical segments. Abstract Figure. normal range Abstract Figure. artefacts