bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Project ECHO on Patient and Community Health Outcomes: A Scoping Review
Authors: Osei-Twum Jo-Ann , Wiles Brittany , Killackey Tieghan , Mahood Quenby , Lalloo Chitra , Stinson Jennifer N. 
Published: May 2022

Purpose
Project Extension for Community Healthcare Outcomes (ECHO) is a hub-and-spoke tele-education model that aims to increase health care providers’ access to evidence-based guidelines and enhance their capacity to care for complex patients in rural, remote, and underserved communities. The purpose of this scoping review was to examine evidence of the impact of Project ECHO programs on patient and community health outcomes.

Method
The authors used Arksey and O’Malley’s framework and subsequent revisions proposed by Levac and colleagues to guide their review. They searched MEDLINE, EMBASE, CINAHL Plus, and Web of Science for English-language, peer-reviewed articles published between January 2003 and June 2020. Included studies focused on Project ECHO programs and reported either patient or community health outcomes. The authors used a standardized data extraction form to document bibliographical information and study characteristics, including health outcome level(s), as articulated by Moore’s evaluation framework for continuing medical education.

Results
Of the 597 search results, the authors identified 15 studies describing Project ECHO programs. These programs were implemented in the United States and Australia and facilitated education sessions with health care providers caring for adult patients living with 1 of 7 medical conditions. Included study findings suggest Project ECHO programs significantly changed patient-level outcomes (n = 15) and to a lesser extent changed community-level outcomes (n = 1). Changes in care were observed at the individual patient level, at the practice level, and in objective clinical measures, including sustained virologic response and HbA1c.

Conclusions
This review identified emerging evidence of the effectiveness of Project ECHO as a tele-education model that improves patient health outcomes and has the potential to positively impact community health. The small number of included studies suggests that additional evidence of patient- and community-level impact is required to support the continued adoption and implementation of this model.
Clinical trials of cell therapy for heart failure: recent results warrant continued research
Authors: Bolli Roberto , Tang Xian-Liang 
Published: May 2022

Purpose of review
Clinical trials of adult cell therapy for chronic heart failure are often misrepresented in an unfairly negative light. Results are claimed to be ’negative’, ’incremental’, or ’modest’. This common misconception is detrimental to medical progress and needs to be dispelled.

Recent findings
Contrary to the false narrative of scientific and lay media, the outcome of recent trials of cell therapy for heart failure has been encouraging and even exciting. Specifically, with the exception of ALLSTAR, in the past 2 years several Phase II–III double-blind, randomized trials have yielded impressive results, demonstrating not just safety but also salubrious effects on cardiac function (MSC-HF) or clinical events (MSC-HF, CONCERT-HF, and DREAM-HF) for at least 1 year after a single administration of cells. Such outcomes were neither incremental nor minor, nor achievable with one dose of any other nondevice therapy for heart failure.

Summary
The oft-repeated assertion that cell therapy does not benefit patients with chronic heart failure is based on a misrepresentation of the literature and is contrary to the available scientific evidence. Although the mechanism of action of cell therapy is unclear, research on its use in heart failure should continue, as only rigorous, well designed, Phase III trials can definitely confirm or refute its efficacy.
The role of multimodality imaging in patients with heart failure with reduced and preserved ejection fraction
Authors: Hassan Ossama K. Abou , Higgins Andrew R. 
Published: May 2022

Purpose of review
The burden of clinical heart failure, both heart failure with a reduced ejection fraction (HFrEF) and with a preserved ejection fraction (HFpEF), continues to increase both nationally and globally. This review summarizes the expanding role of multimodality imaging techniques in the evaluation and management these patients.

Recent findings
Echocardiographic assessment for heart failure continues to expand and should include a robust hemodynamic and strain assessment. Nuclear techniques have also continued to evolve and advances including computed tomography attenuation correction for single photon emission-computed tomography positron-emission tomography increase diagnostic accuracy as well as provide information such as myocardial blood flow and viability assessment. Computed tomography imaging, already well established in the assessment of coronary and valvular disease, has increasing utility in the characterization of myopathy, and cardiac magnetic resonance imaging (MRI) continues to expand its role in tissue characterization to a wider breadth of diseases, including right ventricular cardiomyopathy and left ventricle noncompaction.

Summary
Although heart failure remains a clinical diagnosis based on history and examination, early imaging is critical for further assessment. Due to its widespread availability, affordability, and safety, transthoracic echocardiography has long been the mainstay tool for both initial evaluation as well as for periodic surveillance of heart failure patients, but advances in multimodality imaging are occurring at a rapid pace and promise to provide an increasing wealth of data to help manage such patients.
Novel devices for managing heart failure
Authors: Howard Travis , Spilias Nikolaos , Bhattacharya Sanjeeb , Harb Serge , Puri Rishi 
Published: May 2022

Purpose of review
Despite advances in heart failure (HF) therapies, the associated morbidity, mortality, hospitalization rates, and healthcare expenditures remain high. A significant proportion of patients with HF remain symptomatic despite receiving optimal medical therapy. Consequently, there exists a large unmet clinical need for novel therapies for treating acute and chronic HF. With the exponential growth of transcatheter interventions in structural heart disease, novel applications of minimally invasive, device-based therapies have been sought in an effort to bridge this treatment gap. The rationale, development, and current data underscoring these therapies will be summarized in this review.

Recent findings
Recent studies have demonstrated the safety and efficacy of devices that alter left ventricular geometry (i.e., ventriculoplasty), create anatomic shunts to decompress the left atrium, and modulate vena caval and renal blood flow. However pivotal large trials evaluating clinical outcomes are ongoing.

Summary
Innovative device-based therapies may expand our armamentarium against the growing heterogeneous and morbid HF syndrome.
Role of medical management of cardiogenic shock in the era of mechanical circulatory support
Authors: Blumer Vanessa , Marbach Jeffrey , Veasey Tara , Kanwar Manreet 
Published: May 2022

Purpose of review
The goal of this review is to summarize the current knowledge on the role of medical management of cardiogenic shock in the era of mechanical circulatory support based on important lessons from clinical trials and routine clinical practice, with a focus on providing practical recommendations that can improve contemporary in-hospital management.

Recent findings
Despite an increasing number of invasive therapies being used to manage cardiogenic shock, evidence-based treatment regimens known to improve outcomes are limited. Medical management of cardiogenic shock includes pharmacological interventions aimed at optimizing determinants of cardiac output–contractility, preload, afterload, and heart rate. In this regard, inotropes and vasopressors remain cornerstone therapies for the management of cardiogenic shock. Norepinephrine has shown potential vasopressor advantage with compared with dopamine, and although milrinone and dobutamine are both considered appropriate first-line inotropes, there is limited data to guide selection, and a recent randomized clinical trial found no significant differences in the treatment of cardiogenic shock.

Summary
In the absence of an evidence-based management approach to cardiogenic shock, clinical guidelines are based on expert opinion and routine clinical practice patterns. Further studies focusing on clinical outcomes among specific cardiogenic shock phenotypes are needed to better assess the clinical efficacy of these agents.
The use of multidisciplinary teams, electronic health records tools, and technology to optimize heart failure population health
Authors: Martyn Trejeeve , Montgomery Robert A. , Estep Jerry D. 
Published: May 2022

Purpose of review
Given the limited population level, adoption of optimal therapy that has been shown in recent clinical trials and heart failure registries, efforts to rapidly and safely improve adoption of guideline-directed medical therapy for heart failure should be prioritized. Opportunities to leverage remote monitoring technology, the electronic health record (EHR), and multidisciplinary teams to improve heart failure care merit review.

Recent findings
Dedicated multidisciplinary teams employing algorithmic medication titration schema have shown better efficacy than clinician alerts or quality initiatives that focus on education and audit-feedback processes alone. Technology that enables invasive pressure monitoring and wearable devices that transmit physiologic data have the potential to predict decompensation and allow for early intervention by alerting clinicians to signs of congestion/clinical worsening but further real-world data is needed to prove efficacy and develop effective treatment protocols.

Summary
The combination of technology, multidisciplinary teams, and identification of populations for intervention using the EHR will be central to impactful innovation in heart failure population health and prevention of avoidable morbidity. Novel approaches to study implementation efforts including cluster randomized trials are needed.
Excretion of Pu-238 during Long-term Chelation Therapy by Repeated DTPA Inhalation
Authors: Grémy Olivier , Blanchin Nicolas , Miccoli Laurent 
Published: May 2022

Abstract
An individual underwent an extensive diethylenetriaminepentaacetate (DTPA) chelation therapy that started several months after plutonium incorporation, most likely by inhalation of a soluble compound. After receiving multiple intravenous infusions of DTPA, the patient continued the treatment by pulmonary delivery of aerosolized DTPA. The purpose of the present work is to provide and discuss the bioassay data obtained during the DTPA aerosol therapy and compare them with those under the DTPA infusion therapy that have been largely interpreted elsewhere. As with DTPA given intravenously, each delayed DTPA inhalation increased the clearance of plutonium not only in urine but also in feces, thus demonstrating the ability to remove plutonium retained by extrapulmonary tissues. Also, the slow decline of increased plutonium urinary elimination together with enhanced fecal excretion are two features coherent with the contribution of intracellular chelation to overall decorporation. The therapeutic benefit of DTPA inhalation appeared lower than with DTPA infusion, most likely due to a lower amount of DTPA reaching the systemic compartments where plutonium chelation predominates. The results suggest that DTPA administration through aerosol could be an alternative to the invasive procedure using a needle, i.e., intravenous injection/infusion, when protracted decorporation therapy is needed following transuranic internalization. Indeed, the patient may be more inclined to undergo a chelation treatment for a longer period because taking DTPA by inhalation may make it less cumbersome and painful.
Satisfaction With a Virtual Learning Collaborative Aimed at Implementing Treat-to-Target in Rheumatoid Arthritis
Authors: Ellrodt Jack , Pincus Theodore , Shadick Nancy A. , Stratton Jacklyn , Santacroce Leah , Katz Jeffrey N. , Smolen Josef , Solomon Daniel H. ,   For the TRACTION Virtual Learning Collaborative
Published: May 2022

Objective
Limited information is available concerning experiences of participants in a virtual learning collaborative (LC), and little qualitative data or participant feedback on how this format can be improved. One prior in-person LC in rheumatology successfully improved adherence with treat-to-target (TTT) for RA. We conducted a virtual LC on TTT and herein report on participant satisfaction.

Methods
We conducted a virtual LC with 18 rheumatology practices from across the United States during 2020 to 2021. The LC included a virtual kickoff meeting and monthly videoconferences, accompanied by data submission and feedback. At the conclusion of the LC, we surveyed the 45 LC participants concerning individual experience and satisfaction.

Results
All sites and 78% of participants responded to the surveys. The LC included small and large practices, 14 academic and 4 nonacademic, and respondents ranged in their roles: 24 physicians, 5 nurses or nurse practitioners, 3 administrators, and 3 other roles. Overall, 94% of respondents indicated they were either somewhat or very satisfied with the LC, and 94% said they would recommend a similar LC to a colleague. Aspects of the LC described as “very useful” included a kickoff meeting, intersite discussion, and monthly speakers; however, digital tools such as the Web site and meeting recordings were not found useful.

Conclusions
Virtual LCs are feasible, and participants reported strong satisfaction. Virtual LCs were highly valued by rheumatologists, trainees, and their practice staffs. Potential topics were identified for future LCs that could improve the quality of care delivered to rheumatology patients.
How Do Mexican Patients With Rheumatoid Arthritis Define Sexual and Reproductive Health? A Content Analysis Study
Authors: Ledón-LLanes Loraine Aitana , Contreras-Yáñez Irazú , Guaracha-Basáñez Guillermo Arturo , Valverde-Hernández Salvador Saúl , González-Marín Anayanci , Ballinas-Sánchez Ángel de Jesús , Durand Marta , Pascual-Ramos Virginia 
Published: May 2022

Background
A patient-centered approach is essential for promoting sexual health (SH) and reproductive health (RH) in rheumatoid arthritis patients. The study aimed to describe and interpret Mexican rheumatoid arthritis outpatients' testimonies of their SH and RH definitions.

Methods
Qualitative and quantitative content analysis was conducted on free-text comments from 219 and 223 descriptions of patients' SH and RH definitions, respectively. A comprehensive system of major themes, categories, and subcategories was structured for each definition. The representational foundations of these categories and the context of their production were analyzed. Integration of quantitative and qualitative content analysis was used to comprehend patients' definitions of SH and RH. Internal review board approved the study.

Results
Ten major themes emerged for each definition, and their assigned frequencies differed between SH and RH definitions, and between groups of patients integrated according to age, education level, and sex. Both definitions had similar contents, expressed in the shared major themes and categories, and in managing at the same time SH- and RH-related contents within each definition. The “overall prevention-patient oriented care” major theme defined a common core for both definitions' contents. Meanwhile, a diversity of meanings was also evident particularly at the subcategory level.

Conclusions
In our population, SH content was distinguished by related diseases and their consequences, individual actions directed to prevention, and couple mentions. Meanwhile, RH was distinguished by a primarily biological perspective of the reproductive function, which was required at a particular life stage to concrete a family project.
Phosphoproteomic mapping reveals distinct signaling actions and activation of protein synthesis and muscle hypertrophy by Isthmin-1
Authors: Zhao Meng , Danneskiold-Samsøe Niels Banhos , Ulicna Livia , Nguyen Quennie , Voilquin Laetitia , Lee David E. , White James P. , Jiang Zewen , Cuthbert Nickeisha , Paramasivam Shrika , Bielczyk-Maczynska Ewa , Van Rechem Capucine , Svensson Katrin J. 
Published: May 2022

AbstractThe secreted protein Isthmin-1 (Ism1) mitigates diabetes by increasing adipocyte and skeletal muscle glucose uptake by activating the PI3K-Akt pathway. However, while both Ism1 and insulin converge on these common targets, Ism1 has distinct cellular actions suggesting divergence in downstream intracellular signaling pathways. To understand the biological complexity of Ism1 signaling, we performed phosphoproteomic analysis after acute exposure, revealing overlapping and distinct pathways of Ism1 and insulin. We identify a 53 % overlap between Ism1 and insulin signaling and Ism1-mediated phosphoproteome-wide alterations in ∼ 450 proteins that are not shared with insulin. Interestingly, we find several unknown phosphorylation sites on proteins related to protein translation, mTOR pathway and, unexpectedly, muscle function in the Ism1 signaling network. Physiologically, Ism1 ablation in mice results in altered proteostasis, including lower muscle protein levels under fed and fasted conditions, reduced amino acid incorporation into proteins, and reduced phosphorylation of the key protein synthesis effectors Akt and downstream mTORC1 targets. As metabolic disorders such as diabetes are associated with accelerated loss of skeletal muscle protein content, these studies define a non-canonical mechanism by which this anti-diabetic circulating protein controls muscle biology.
Sustained pigmentation causes DNA damage and invokes translesion polymerase Pol κ for repair in melanocytes
Authors: Khanna Shivangi , Ghazi Madeeha , Subramanian Yogaspoorthi , Sultan Farina , Gupta Iti , Sharma Kanupriya , Chandna Sudhir , Gokhale Rajesh S , Natarajan Vivek T 
Published: May 2022

AbstractThe pigment melanin protects skin cells from ultraviolet (UV) radiation induced DNA damage. However, intermediates of eumelanin are highly reactive quinones that are potentially genotoxic. In this study, we systematically investigate the effect of sustained elevation of melanogenesis and map the consequent cellular repair response of melanocytes. Pigmentation increases DNA damage, causes cell cycle arrest, and invokes translesion polymerase Pol κ for DNA repair in primary human melanocytes, as well as mouse melanoma cells. Confirming the causal link, CRISPR-based genetic ablation of tyrosinase, the key melanin synthesizing enzyme results in depigmented cells with low Pol κ levels. However, silencing of Pol κ in pigmenting cells results in unchecked proliferation despite the presence of damaged DNA, that could potentially lead to genome instability. Thereby, our results indicate Pol κ to be a necessary evil to resolve melanin induced damage. Error-prone repair by Pol κ in part explains the mutational landscape observed in human melanoma. Thus, our study illuminates a hitherto unknown dark side of melanin and identifies (eu)melanogenesis as a key missing link between tanning response and mutagenesis mediatedviathe Pol κ-based low fidelity DNA repair response of melanocytes.Key HighlightsSustained melanogenesis causes DNA damage in melanocytesMelanogenesis elicits replication stress and translesion repair by Pol κPol κ resolves melanin-induced DNA damage and suppresses genome instabilityExpression of Pol κ correlates with mutational load in human melanoma
Aspergillus fumigatus FhdA transcription factor is important for mitochondrial activity and codon usage regulation during the caspofungin paradoxical effect
Authors: Colabardini Ana Cristina , Van Rhijn Norman , LaBella Abigail L. , Valero Clara , Wang Fang , Dineen Lauren , Bromley Michael J. , Rokas Antonis , Goldman Gustavo H. 
Published: May 2022

ABSTRACTAspergillus fumigatus is the main etiological agent of aspergillosis. The antifungal drug caspofungin (CSP) can be used against A. fumigatus and CSP tolerance is observed. Here, we show that the transcription factor FhdA is important for mitochondrial activity and regulates genes transcribed by RNA polymerase II and III. FhdA influences the expression of tRNAs that are important for mitochondrial function upon CSP. Our results show a completely novel mechanism that is impacted by CSP.
Reduced Neutralization of SARS-CoV-2 Omicron Variant in Sera from SARS-CoV-1 Survivors after 3-dose of Vaccination
Authors: Zhao Xuesen , Chen Danying , Hao Xiaohua , Qiu Yaruo , Du Juan , Zhang Yuanyuan , Xiao Fan , Li Xinglin , Song Yanjun , Song Rui , Wang Xi , Jin Ronghua 
Published: May 2022

ABSTRACTRecent studies found that Omicron variant escapes vaccine-elicited immunity. Interestingly, potent cross-clade pan-sarbecovirus neutralizing antibodies were found in survivors of the infection by SARS-CoV-1 after BNT162b2 mRNA vaccination (N Engl J Med. 2021 Oct 7;385(15):1401-1406). These pan-sarbecovirus neutralizing antibodies were observed to efficiently neutralize the infection driven by the S protein from both SARS-CoV and multiple SARS-CoV-2 variants of concern (VOC) including B.1.1.7 (Alpha), B.1.351 (Beta), and B.1.617.2 (Delta). However, whether these cross-reactive antibodies could neutralize the Omicron variant is still unknown. Based on the data collected from a cohort of SARS-CoV-1 survivors received 3-dose of immunization, our studies reported herein showed that a high level of neutralizing antibodies against both SARS-CoV-1 and SARS-CoV-2 were elicited by a 3rd-dose of booster vaccination of protein subunit vaccine ZF2001. However, a dramatically reduced neutralization of SARS-CoV-2 Omicron Variant (B.1.1.529) is observed in sera from these SARS-CoV-1 survivors received 3-dose of Vaccination. Our results indicates that the rapid development of pan-variant adapted vaccines is warranted.
SARS-CoV-2 Booster Effect and Waning Immunity in Hemodialysis Patients
Authors: Goggins Eibhlin , Sharma Binu , Ma Jennie Z. , Gautam Jitendra , Bowman Brendan 
Published: May 2022

AbstractBackgroundDialysis patients are extremely vulnerable to SARS-CoV-2 infection. We recently reported the results of a prospective cohort study measuring serial monthly semi quantitative IgG antibody levels to the SARS-CoV-2 spike protein receptor binding domain in fully vaccinated in-center hemodialysis patients after receiving the BNT162b2 (Pfizer-BioNTech) mRNA vaccination.MethodsProspective cohort study measuring the serologic response of hemodialysis patients to a booster dose of BNT162b2 vaccine at an average of 2, 6 and 11 weeks post vaccination.ResultsOf 35 hemodialysis patients in the original cohort, 27 (77.1%) received a third dose of BNT162b2. Antibody level significantly increased from pre-booster to 2 weeks post-booster (median (25th, 75th percentile) from 59.94 (29.69, 177.8) to 6216 (3806, 11730)), an average increase of 112 fold. Antibody levels dropped to a median of 2654 BAU/mL (1650, 8340) 6 weeks post-booster and to a median of 1444 BAU/mL (1102, 2020) between weeks 6 and 11 post-booster. Antibody levels at 11 weeks remained an average of 40 fold higher than pre-booster levels. Overall, antibody levels declined 47% month to month post-booster. Nine (33%) patients had negative or borderline detectable antibody levels pre-booster and 8 of 9 developed positive (>35.2 BAU/mL) antibody levels post-booster. Those with prior infection had a lower proportional increase in antibody level (51 fold) compared with the median change in COVID naïve patients (144 fold) from pre-booster to 2 weeks post-booster.ConclusionsOur data demonstrates that hemodialysis patients obtain a robust humoral response from a third dose of the BNT162b2 vaccine although antibody levels wane over time.