bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgeons’ Perspective of Decision Making in Recurrent Diverticulitis
Authors: Hawkins Alexander T. , Rothman Russell L. , Geiger Timothy M. , Bonnet Kemberlee R. , Mutch Matthew G. , Regenbogen Scott E. , Schlundt David G. , Penson David F. 
Published: May 2022

Objective:
This study employs qualitative methodology to assess surgeons’ perspective on decision making in management of recurrent diverticulitis to improve patient-centered decision making.

Background:
The decision to pursue colectomy for patients with recurrent diverticulitis is nuanced. Strategies to enact broad acceptance of guidelines for surgery are hindered because of a knowledge gap in understanding surgeons’ current attitudes and opinions.

Methods:
We performed semistructured interviews with board-certified North American general and colorectal surgeons who manage recurrent diverticulitis. We purposely sampled specialists by both surgeon and practice factors. An iterative inductive/deductive strategy was used to code and analyze the interviews and create a conceptual framework.

Results:
Twenty-five surgeons were enrolled over a 9-month period. There was diversity in surgeons’ gender, age, experience, training, specialty (colorectal vs general surgery), and geography. Surgeons described the difficult process to determine who receives an operation. We identified 7 major themes as well as 20 subthemes of the decision-making process. These were organized into a conceptual model. Across the spectrum of interviews, it was notable that there was a move over time from decisions based on counting episodes of diverticulitis to a focus on improving quality of life. Surgeons also felt that quality of life was more dependent on psychosocial factors than the degree of physiological dysfunction.

Conclusions:
Surgeons mostly have discarded older dogma in recommending colectomy for recurrent diverticulitis based on number and severity of episodes. Instead, decision making in recurrent diverticulitis is complex, involving multiple surgeon and patient factors and evolving over time. Surgeons struggle with this decision and education- or communication-based interventions that focus on shared decision-making warrant development.
How Are the Sleep Problems of Children in the US Foster Care System Addressed?
Authors: Alfano Candice A. , Valentine Madeline , Nogales Josefina Muñoz , Kim Jinu , Kim Josephine S. , Rigos Priscilla , McGlinchey Eleanor L. , Ripple Carol H. , Wolfson Amy R. 
Published: May 2022

Abstract:

Objective:
Evidence of poor sleep health among children in foster care continues to mount, but information about whether and how sleep problems are addressed is unavailable. The goal of this study was to begin to fill these significant knowledge gaps.

Methods:
Four hundred eighty-five foster caregivers from across the United States completed a survey focused on the sleep health of one child, 4 to 11 years (M = 6.4; SD = 2.2) currently in their care. Caregivers provided quantitative and qualitative responses to questions regarding training, information, and services received in relation to their child's sleep. Caregivers also reported on the factors and strategies they perceived as most important for helping children in their care sleep well.

Results:
Only 13% of caregivers reported receiving any information/education about sleep from agencies or case workers, whereas 55% had sought help from a health provider related to their child's sleep. Nearly half of all caregivers (46%) reported giving their child melatonin. Caregivers reported that a bedtime routine/consistency, reassurance of safety/love, and a calming environment were most important for helping their child sleep well. A recurrent theme in qualitative responses was a need to mitigate child fear/anxiety at night.

Conclusion:
Children in foster care face a range of risk factors that increase the likelihood of poor/insufficient sleep, but these findings suggest this critical aspect of health requires greater clinical and research attention. As these data were collected during the initial months of the COVID-19 pandemic, replication studies are necessary.
Clinical variables accompanying salt-sensitive essential hypertension in ethnic Kashmiri population
Authors: Chachoo Javaid , Mushtaq Nausheen , Jan Sami , Majid Sabhiya , Mohammad Iqbal 
Published: May 2022

Background:
Salt sensitivity is actually a measure of an individual's blood pressure response to salt intake. It has been reported that people who are salt sensitive have high prevalence of hypertension and target organ damage. The link between dietary salt intake and hypertension is well established, and a reduction in salt intake has been shown to lower blood pressure.

Scope:
In Kashmir, this achieves significance because of a high incidence of hypertension along with a high salt intake among ethnic Kashmiris.

Design and methods:
We analysed clinical variables accompanying salt sensitive hypertension among Kashmiri population in our on-going salt sensitivity study on 770 Kashmiri patients (250 men, 520 women) of age group 18years and above from March 2020 to June 2021. We studied the clinical variables accompanying salt sensitivity and the difference in their blood pressure on. a low salt diet (mean = 2 g/day) vs. their usual salt intake (mean = 11 g/day). To document compliance of salt-restricted diet, we used 24-h urinary NaCl estimation as a surrogate marker for salt intake estimation.

Results:
We observed, a huge drop in SBP (−28.9 mmHg), DBP (−17.6 mmHg) and mean arterial pressure (−21.3mmHg) in this cohort of 770 ethnic Kashmiris on a strict salt restricted diet. And that women, urban inhabitants, and nonsmokers are more prone to the risk of developing salt sensitive hypertension. Physical activity had no effect on salt sensitivity.

Conclusion:
As per our study, salt restriction has a major role in treatment of Hypertension in Kashmiri Population. More studies need to be focused on this vital area.
The correlation between VitD3 levels and the disease activity of childhood-onset systemic lupus erythematosus
Authors: Cheng Kan-Hung , Tsai Ming-Chin , Fu Lin-Shien 
Published: May 2022

Background:
There is growing evidence linking low levels of vitamin D3 to an increased risk of many autoimmune diseases. Compared to the general population, hypovitaminosis D is more prevalent among children with systemic lupus erythematosus (SLE), which can be associated with sun exposure avoidance, long-term corticosteroid treatment, and renal disease. Therefore, we launched this study to assess the correlation between 25 (OH) D3 (VitD3) levels and the disease activity of children with SLE (cSLE) in Taiwan.

Methods:
From September to December 2018, we recruited 31 cSLE patients from the Pediatric Out-patient Department of Taichung Veterans General Hospital. Their basic data, including SLE disease index 2000 (SLEDAI-2K) score, laboratory values, prescribed drugs and VitD3 levels were collected and analyzed statistically.

Results:
The mean serum VitD3 concentration was 19.7 ± 7.9 ng/mL and SLEDAI-2K 6.2 ± 5.0. Those patients (N = 16) with an SLEDAI-2K≦4 had higher VitD3 levels when compared to those (N = 15) with an SLEDAI-2K>4 (22.9 ± 7.7 vs 16.3 ± 6.7 points, p = 0.020). Five patients not taking systemic corticosteroids (SCS) had significantly higher VitD3 levels and lower SLEDAI-2K than those who took SCS (N = 26). Additionally, we found VitD3 levels to be negatively correlated to SLEDAI-2K (rs = −0.55, p = 0.001) and daily SCS dosages (rs = −0.49, p = 0.005).

Conclusion:
This study shows that VitD3 deficiency is common in patients with cSLE. It was also noted that serum VitD3 levels negatively correlate to SLEDAI-2K, which can be partially explained by less usage of SCS.
Dynamic changes in signal-averaged P wave after catheter ablation of atrial fibrillation
Authors: Yugo Dony , Kuo Ming-Jen , Hu Yu-Feng , Liu Chih-Min , Lin Yenn-Jiang , Chang Shih-Lin , Lo Li-Wei , Chao Tze-Fan , Chung Fa-Po , Liao Jo-Nan , Chang Ting-Yung , Lin Chin-Yu , Tuan Ta-Chuan , Kuo Ling , Liu Shin-Huei , Ton An Nu- Khanh , Chhay Chheng , Elimam Ahmed , Chen Shih-Ann 
Published: May 2022

Background:
The comprehensive surveillance for interval changes in signal-averaged P-wave (SAPW) after pulmonary vein isolation (PVI) remains lacking. We aimed to analyze the SAPW parameters before and after PVI and explored their link to the left atrial electrical properties.

Methods:
Eighteen patients with paroxysmal atrial fibrillation receiving primary catheter ablation were enrolled. SAPW parameters, including root mean square voltages in the last 40, 30, and 20 ms (RMS40, RMS30, and RMS20, respectively), the total P-wave (RMSt), the integral of P-wave potentials (Int-p), and P-wave duration (fPWD), were measured before and after PVI and correlated to the left atrial activation time (LAT) and mean left atrial voltage (LAV) from electro-anatomical mapping.

Results:
Compared with the SAPW before PVI, fPWD (before vs after PVI: 144.1 ± 5.2 vs 135.1 ± 11.9 ms, p = 0.02), Int-p (687.4 ± 173.1 vs 559 ± 202.5 mVms, p = 0.01), and RMSt (6.44 ± 1.3 vs 5.44 ± 2.0 mV, p = 0.04) all decreased after PVI. RMS20, RMS30, and RMS40 showed no significant difference. Similarly, LAT (97.5 ± 9.3 vs 90.5 ± 9.3 ms, p = 0.008) and LAV (1.37 ± 0.27 vs 0.96 ± 0.31 mV, p = 0.001) decreased after PVI. Although consistent changes after PVI were observed between SAPW parameters and LAT or LAV, no linear correlation was observed among them.

Conclusion:
The consistent changes in SAPW and left atrial electrical properties after PVI suggest that SAPW may be used as a noninvasive tool to monitor the responses to PVI.
Comparison of prognoses between cirrhotic and noncirrhotic patients with hepatocellular carcinoma and esophageal varices undergoing surgical resection
Authors: Chen Yu-Jen , Su Chien-Wei , Wei Cheng-Yi , Chau Gar-Yang , Chen Ping-Hsien , Chao Yee , Huang Yi-Hsiang , Wu Jaw-Ching , Yang Tsung-Chieh , Lee Pei-Chang , Hou Ming-Chih 
Published: May 2022

Background:
Esophageal varices (EV) is common and is a poor prognostic factor for patients with hepatocellular carcinoma (HCC). However, the outcomes between cirrhotic and noncirrhotic HCC patients with EV is not well studied. The present study aimed to investigate the clinical manifestations and prognoses of HCC patients after surgical resection stratified by the cirrhosis status.

Methods:
A total of 111 patients with HCC and EV, who underwent surgical resection, were retrospectively enrolled between July 2003 and July 2019. The diagnosis of liver cirrhosis was established using the Ishak fibrosis score F5 or F6 in the nontumor part of liver specimens. Prognostic factors were analyzed using the Cox proportional hazards model.

Results:
There were 85 (76.6%) and 26 (23.4%) patients with and without cirrhosis, respectively. Compared with those without cirrhosis, there were more females, less seropositive rate of hepatitis B surface antigen (HBsAg), more seropositive rate of antibody against to hepatitis C virus (HCV), less albumin-bilirubin (ALBI) grade 1, lower platelet count, and more had tumor burden within the Milan criteria in cirrhotic patients. Cirrhotic patients had a higher risk of posthepatectomy decompensation compared to noncirrhotic patients (hazard ratio 9.577, p = 0.017). No difference was observed in overall survival and recurrence-free survival between patients with or without cirrhosis.

Conclusion:
Compared with patients without cirrhosis, cirrhotic patients with HCC and EV are vulnerable to posthepatectomy decompensation. However, cirrhosis is not a poor prognostic factor of overall survival and recurrence for HCC patients after surgical resection.
Factors Related to Patients' Self-care and Self-care Confidence in Korean Patients With Heart Failure and Their Caregivers
Authors: Heo Seongkum , Shin Mi-Seung , Lee Mee Ok , Kim Sangsuk , Kim Sun Hwa , Randolph Justus , Jun Se-Ran , An Minjeong , Ounpraseuth Songthip , Kim JinShil 
Published: May 2022

Background
The relationships of patient factors and caregiver contribution to patients' self-care to different types of self-care have been rarely examined in Korean patients with heart failure.

Objective
The aim of this study was to examine patient (ie, age, depressive symptoms, and self-care confidence) and caregiver (ie, caregiver contribution to self-care maintenance and self-care management, and caregiver confidence in contributing to self-care) factors related to different types of self-care (ie, self-care maintenance, symptom perception, and self-care management) and self-care confidence in Korean patients with heart failure.

Methods
In this cross-sectional, correlational study, data from 41 pairs of patients (mean age, 68.0 years) and caregivers (mean age, 54.1 years) were collected and analyzed using multiple regression.

Results
Higher levels of self-care confidence in patients were related to higher levels of self-care maintenance in patients. Higher levels of self-care confidence in patients were related to higher levels of symptom perception. Higher levels of self-care confidence in patients and caregiver contribution to self-care maintenance were related to higher levels of self-care management. Less severe depressive symptoms in patients and higher levels of caregiver confidence in contributing to self-care were related to higher levels of self-care confidence.

Conclusion
Different patient and caregiver factors were related to different types of self-care and self-care confidence in Korean patients, but patients' self-care confidence was related to all types of self-care. Clinicians and researchers need to develop and deliver effective interventions to both patients and their caregivers to improve patients' self-care confidence and, in turn, self-care, considering different factors associated with each type of self-care.
Evaluation of the 18F-FDG-PET/CT uptake association with pathological and immunohistochemistry features in esophagogastric adenocarcinoma
Authors: Simionato Perrotta Fernando , Ribeiro Ulysses , Mester Marcelo , Sobroza de Mello Evandro , Sado Heitor Naoki , Bezerra Pinheiro Rafaela Brito , Tustumi Francisco , Buchpiguel Carlos Alberto , Zilberstein Bruno , Sallum Rubens Antonio Aissar , Ceconello Ivan 
Published: May 2022

Background
The present study aimed to analyze the association between 18F-fluorodeoxyglucose (FDG) uptake and histologic panel in esophagogastric adenocarcinoma.

Methods
We retrospectively enrolled 26 patients with histologically confirmed esophageal, gastroesophageal junction and gastric adenocarcinoma that have been submitted to pretreatment FDG-PET/CT. We collected the cancer tissue sample of each patient and performed immunohistochemical analyses of the glucose transport protein 1 (GLUT-1), Ki-67, cysteine aspartate-specific proteinases (Caspase)-3 and hexokinase-1, and evaluated the association of these parameters with FDG uptake. The FDG uptake was measured by tumor standardized uptake value (SUV), metabolic tumor volume (MTV), and Total Lesion Glycolysis (TLG). Besides, we analyzed the association of FDG uptake and tumor location, Lauren’s histologic subtype, grade of cellular differentiation and intratumoral inflammatory infiltrate.

Results
We found a positive association between GLUT-1 with SUV and TLG, Caspase-3 and SUV and inflammation grade with SUV.

Conclusion
Tumor inflammation infiltrate, GLUT-1 and Caspase-3 correlated with 18F-FDG uptake in PET/CT in esophagogastric adenocarcinoma. These findings may help understand the pathologic PET/CT significance in cancer. Understanding the meaning of the 18F-FDG uptake in the field of tumor histologic and immunohistochemistry features is essential to allow the evolution of PET/CT application in esophageal and gastric carcinomas.
The effect of coronavirus disease 2019 pneumonia on myocardial ischemia detected by single-photon emission computed tomography myocardial perfusion imaging
Authors: Bilge Önder , Kömek Halil , Kepenek Ferat , Taştan Ercan , Gündoğan Cihan , Tatli İsmail , Öztürk Cansu , Akin Halil , Işik Ferhat , Kavak Şeyhmus , Aslan Burhan , Akyüz Abdurrahman , Kanbal Çap Neşe , Erdoğan Emrah 
Published: May 2022

Objective
We aimed to examine the effects of COVID-19 pneumonia on cardiac ischemia detected by myocardial perfusion imaging with single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients presenting with chest pain and shortness of breath after recovery from COVID-19.

Materials and method
Patients with a history of COVID-19 confirmed by reverse transcriptase-PCR test who underwent SPECT-MPI for the evaluation of ischemia with the complaints of chest pain and shortness of breath were screened for this study. Patients who underwent thorax CT during the acute period of the COVID-19 were included. Patients with and without pneumonia were determined based on computed tomographic criteria. The patients with a summed stress score of at least 4 on SPECT-MPI were considered to have abnormal MPI in terms of ischemia.

Results
A total of 266 patients were included in the study. Sixty-five (24%) patients had ischemia findings on SPECT-MPI. Thorax CT showed pneumonia in 152 (57%) patients, and the patients were divided into two groups as pneumonia and nonpneumonia. Abnormal SPECT-MPI scores, which represented myocardial ischemia, were higher in the pneumonia group. Multivariate logistic regression analyses showed that the presence of hyperlipidemia and pneumonia on CT increased the risk of ischemia on SPECT-MPI (OR, 2.08; 95% CI, 1.08–3.99; P-value = 0.029; and OR, 2.90; 95% Cl, 1.52–5.54; P-value = 0.001, respectively).

Conclusion
COVID-19 pneumonia was identified as an independent predictor of ischemia on SPECT-MPI. Symptoms including chest pain and shortness of breath in patients who have had COVID-19 pneumonia may be attributed to coronary ischemia.
Favorable tumor uptake and nuclear transport of Auger electrons by nuclear targeting with 111In-trastuzumab in an intraperitoneal tumor mouse model
Authors: Keiko Li Huizi , Hasegawa Sumitaka 
Published: May 2022

Objectives
The 111In-labeled anti-HER2 antibody trastuzumab modified with a nuclear-localizing sequence (NLS) peptide (111In-trastuzumab-NLS) is a radiopharmaceutical candidate for Auger electron radioimmunotherapy (AE-RIT). However, in-vivo action of 111In-trastuzumab-NLS is poorly understood in intraperitoneal tumors. We aimed to elucidate the nuclear targeting activity of 111In-trastuzumab-NLS in a mouse model of intraperitoneal tumors.

Methods
Trastuzumab, trastuzumab-NLS-S with shorter NLS peptides, and trastuzumab-NLS-L with longer NLS peptides were tested in an intraperitoneal tumor xenograft. The AE-emitting radionuclide 111In was labeled with these antibodies. The cell-binding activity, nuclear importation, and cytotoxicity of those radiolabeled antibodies were examined in human cancer cell lines. Analyses of the biodistribution and in-vivo nuclear importation of 111In were conducted in a mouse model.

Results
The two111In-trastuzumab-NLS variants delivered the radionuclide into the nucleus more efficiently and had a comparable cytotoxicity to 111In-trastuzumab against human gastric cancer cells, although had a lower cell binding affinity. 111In-trastuzumab-NLS-L exhibited both a superior tumor uptake and in vivo nuclear transportation of the radionuclide than 111In-trastuzumab.

Conclusion
Nuclear targeting using 111In-trastuzumab-NLS promotes a more efficient tumor cell uptake and subsequent nuclear translocation of the 111In AE-emitting radionuclide in vivo. This radio-immunoconjugate will likely be an effective agent for HER2-targeting by AE-RIT.
The role of volumetric and textural analysis of pretreatment 18F-fluorodeoxyglucose PET/computerized tomography images in predicting complete response to transarterial radioembolization in hepatocellular cancer
Authors: Karahan Şen Nazli Pinar , Alataş Özkan , Gülcü Aytaç , Özdoğan Özhan , Derebek Erkan , Çapa Kaya Gamze 
Published: May 2022

Objective
This study evaluates the role of pretreatment 18F-FDG PET/CT in predicting the response to treatment in patients with hepatocellular cancer (HCC) who applied transarterial radioembolization (TARE) via the volumetric and texture features extracted from 18F-FDG PET/CT images.

Methods
Thirty-three patients with HCC who had applied TARE [lobar (LT) or superselective (ST)] after 18F-FDG PET/CT were included in the study. Response to the treatment was evaluated from posttherapy magnetic resonance (MR). Patients were divided into two groups: the responder group (RG) (complete responders) and non-RG (NRG) (including partial response, stabile, and progressive). Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) and texture features were extracted from PET/CT images. The differences among MTV, TLG, and texture features between response groups were analyzed with the Mann–Whitney U test. ROC analysis was performed for features with P < 0.05. Spearman correlation analysis was used, and features with correlation coefficient < 0.8 were evaluated with the logistic regression analysis.

Results
Significant differences were detected in TLG, MTV, SHAPE_compacity, GLCM_correlation, GLRLM_GLNU, GLRLM_RLNU, NGLDM_coarseness, NGLDM_busyness, GLZLM_LZHGE, GLZLM_GLNU, and GLZLM_ZLNU between RG and NRG. Multivariate analysis demonstrated that MTV was the only meaningful parameter with an AUC of 0.827 (P = 0.002; 95% CI, 0.688–0.966). The best cutoff value was determined as 74.11 ml with 78.9% sensitivity and 78.6% specificity in discriminating nonresponders.

Conclusion
In predicting the curative effect of TARE, multivariate analysis results demonstrated that MTV was the only independent predictor, and MTV higher than 74.11 ml were determined the best predictor of nonresponders.
PET/CT features of a novel gallium-68 labelled hypoxia seeking agent in patients diagnosed with tuberculosis: a proof-of-concept study
Authors: Bresser Philippa L. , Sathekge Mike M. , Vorster Mariza 
Published: May 2022

Introduction
Positron emission tomography/computed tomography (PET/CT) in infection and inflammation has yielded promising results across a range of radiopharmaceuticals. In particular, PET/CT imaging of tuberculosis (TB) allows for a better understanding of this complex disease by providing insights into molecular processes within the TB microenvironment. TB lesions are hypoxic with research primarily focussed on cellular processes occurring under hypoxic stress. With the development of hypoxia seeking PET/CT radiopharmaceuticals, that can be labelled in-house using a germanium-68/gallium-68 (68Ge/68Ga) generator, a proof-of-concept for imaging hypoxia in TB is presented.

Methods
Ten patients diagnosed with TB underwent whole-body PET/CT imaging, 60–90 min after intravenous administration of 74–185 MBq (2–5 mCi) 68Ga-nitroimidazole. No oral or intravenous contrast was administered. Images were visually and semiquantitatively assessed for abnormal 68Ga-uptake in the lungs.

Results
A total of 28 lesions demonstrating hypoxic uptake were identified. Low- to moderate-uptake was seen in nodules, areas of consolidation and cavitation as well as effusions. The mean standard uptake value (SUVmean) of the lesions was 0.47 (IQR, 0.32–0.82) and SUVmax was 0.71 (IQR, 0.41–1.11). The lesion to muscle ratio (median, 1.70; IQR, 1.15–2.31) was higher than both the left ventricular and the aorta lesion to blood ratios.

Conclusion
Moving towards the development of unique host-directed therapies (HDT), modulation of oxygen levels may improve therapeutic outcome by reprogramming TB lesions to overcome hypoxia. This proof-of-concept study suggests that hypoxia in TB lesions can be imaged and quantified using 68Ga-nitroimidazole PET/CT. Subsequently, hypoxic load can be estimated to inform personalised treatment plans of patients diagnosed with TB.