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  • 1
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2019
    In:  Infection Control & Hospital Epidemiology Vol. 40, No. 8 ( 2019-08), p. 897-903
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 40, No. 8 ( 2019-08), p. 897-903
    Abstract: To assess the impact of incorporating early rapid influenza diagnosis on antimicrobial usage, nosocomial influenza transmission, length of stay, and occupancy rates among hospitalized patients. Setting: A 1,100 bed tertiary-care hospital in southern Israel. Methods: We implemented early rapid detection of influenza with immediate communication of results. Using Orion methods, we compared the 2017–2018 influenza season to the prior season in our hospital and to the 2017–2018 occupancy rates at other Israeli hospitals. Results: During the intervention season, 5,006 patients were admitted; 1,824 were tested for influenza, of whom 437 (23.9%) were positive. In the previous season, 4,825 patients were admitted; 1,225 were tested and 288 (23.5%) were positive. Time from admission to test report decreased from 35.5 to 18.4 hours ( P 〈 .001). Early discharge rates significantly increased, from 21.5% to 41.6% at 36 hours, from 37.2% to 54.5% at 48 hours, and from 66% to 73.2% at 72 hours. No increase in repeat ER visits, readmission, or mortality rates was observed. Hospital occupancy decreased by 10% compared to the previous year and was 26% lower than the national rate. Hospital-acquired influenza cases were reduced from 37 (11.4%) to 12 (2.7%) ( P 〈 .001). Antibiotic usage was reduced both before and after notification of test results by 16% and 12%, respectively. Conclusions: Implementing this intervention led to earlier discharge of patients, lower occupancy in medical wards, reduced antibiotic administration, and fewer hospital-acquired influenza events. This strategy is useful for optimizing hospital resources, and its implementation should be considered for upcoming influenza seasons.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
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  • 2
    In: Catheterization and Cardiovascular Interventions, Wiley
    Abstract: The safety and efficacy of treatment with P2Y12 adenosine‐diphosphate receptor inhibitors (P2Y12‐RI) before coronary angiography among patients with non‐ST‐segment elevation acute coronary syndromes (NSTEACS) are questionable. Aims To assess the pretreatment rate with P2Y12‐RI and its association with ischemic and bleeding risks among patients with NSTEACS. Methods The study comprised patients with NSTEACS referred for coronary angiography and included in the Acute Coronary Syndrome Israeli Surveys between 2013 and 2021. Patients were divided into two groups according to the timing of P2Y12‐RI loading concerning coronary angiography: pretreatment and posttreatment. The primary endpoints were 30‐day major adverse cardiovascular events (MACE; composite of cardiovascular mortality, myocardial infarction, stroke, stent thrombosis, and urgent revascularization) and 1‐year all‐cause mortality. Results Of 3076 patients, 2423 (78.8%) received pretreatment with a P2Y12‐RI, and 653 (21.2%) received P2Y12‐RI posttreatment. Prasugrel and ticagrelor were used more in the posttreatment group compared to the pretreatment group (16% vs. 6% and 38% vs. 25%, respectively, p   〈  0.001 for both). No difference was observed in the rate of 30‐day MACE comparing pretreatment and posttreatment (5.3% vs. 2.2%, respectively, p  = 0.62). A sensitivity analysis of 30‐day MACE among patients from the 2021 survey demonstrated similar results (2.5% in the posttreatment group vs. 8.0% in the pretreatment group, p  = 0.13). There were no differences in 1‐year all‐cause mortality rates between the pretreatment and posttreatment groups (4.8% vs. 3.8%, p  = 0.31). Conclusions Among patients with NSTEACS referred for an invasive strategy, the P2Y12‐RI posttreatment strategy was associated with similar 30‐day and 1‐year MACE as the pretreatment strategy. These large‐scale, multicenter, real‐world data provide reassurance on the safety and efficacy of delaying P2Y12‐IR until after coronary stratification to improve clinical decision‐making.
    Type of Medium: Online Resource
    ISSN: 1522-1946 , 1522-726X
    Language: English
    Publisher: Wiley
    Publication Date: 2024
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  • 3
    In: Hepatology, Ovid Technologies (Wolters Kluwer Health)
    Abstract: We demonstrated in the randomized 18-month DIRECT PLUS trial (n = 294) that a Mediterranean (MED) diet, supplemented with polyphenol-rich Mankai duckweed, green tea, and walnuts and restricted in red/processed meat, caused substantial intrahepatic fat (IHF%) loss compared with 2 other healthy diets, reducing NAFLD by half, regardless of similar weight loss. Here, we investigated the baseline proteomic profile associated with IHF% and the changes in proteomics associated with IHF% changes induced by lifestyle intervention. Approach and Results: We calculated IHF% by proton magnetic resonance spectroscopy (normal IHF% 〈 5% and abnormal IHF% β‰₯5%). We assayed baseline and 18-month samples for 95 proteomic biomarkers.Participants (age = 51.3 Β± 10.8Β y; 89% men; and body mass index = 31.3 Β± 3.9Β kg/m 2 ) had an 89.8% 18-month retention rate; 83% had eligible follow-up proteomics measurements, and 78% had follow-up proton magnetic resonance spectroscopy. At baseline, 39 candidate proteins were significantly associated with IHF% (false discovery rate 〈 0.05), mostly related to immune function pathways (eg, hydroxyacid oxidase 1). An IHF% prediction based on the DIRECT PLUS by combined model ( R 2 = 0.47, root mean square error = 1.05) successfully predicted IHF% ( R 2 = 0.53) during testing and was stronger than separately inputting proteins/traditional markers ( R 2 = 0.43/0.44). The 18-month lifestyle intervention induced changes in 18 of the 39 candidate proteins, which were significantly associated with IHF% change, with proteins related to metabolism, extracellular matrix remodeling, and immune function pathways. Thrombospondin-2 protein change was higher in the green-MED compared to the MED group, beyond weight and IHF% loss ( p = 0.01). Protein principal component analysis revealed differences in the third principal component time distinct interactions across abnormal/normal IHF% trajectory combinations; p 〈 0.05 for all). Conclusions: Our findings suggest novel proteomic signatures that may indicate MRI-assessed IHF state and changes during lifestyle intervention. Specifically, carbonic anhydrase 5A, hydroxyacid oxidase 1, and thrombospondin-2 protein changes are independently associated with IHF% change, and thrombospondin-2 protein change is greater in the green-MED/high polyphenols diet.
    Type of Medium: Online Resource
    ISSN: 0270-9139
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
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  • 4
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Journal of General Internal Medicine Vol. 36, No. 8 ( 2021-08), p. 2300-2306
    In: Journal of General Internal Medicine, Springer Science and Business Media LLC, Vol. 36, No. 8 ( 2021-08), p. 2300-2306
    Type of Medium: Online Resource
    ISSN: 0884-8734 , 1525-1497
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 5
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 107, No. 2 ( 2022-01-18), p. 336-345
    Abstract: Lower fasting ghrelin levels (FGL) are associated with obesity and metabolic syndrome. Objective We aimed to explore the dynamics of FGL during weight loss and its metabolic and adiposity-related manifestations beyond weight loss. Methods This was a secondary analysis of a clinical trial that randomized participants with abdominal obesity/dyslipidemia to 1 of 3 diets: healthy dietary guidelines (HDG), Mediterranean diet (MED), or green-MED diet, all combined with physical activity (PA). Both MED diets were similarly hypocaloric and included 28 g/day walnuts. The green-MED group further consumed green tea (3-4 cups/day) and a Wolffia globosa (Mankai) plant green shake. We measured FGL and quantified body fat depots by magnetic resonance imaging at baseline and after 18 months. Results Among 294 participants (body mass index = 31.3 kg/m2; FGL = 504 Β± 208 pg/mL; retention rate = 89.8%), lower FGL was associated with unfavorable cardiometabolic parameters such as higher visceral adipose tissue (VAT), intrahepatic fat, leptin, and blood pressure (P & lt; 0.05 for all; multivariate models). The βˆ†FGL18-month differed between men (+7.3 Β± 26.6%) and women (βˆ’9.2% Β± 21.3%; P = 0.001). After 18 months of moderate and similar weight loss among the MED groups, FGL increased by 1.3%, 5.4%, and 10.5% in HDG, MED, and green-MED groups, respectively (P = 0.03 for green-MED vs HDG); sex-stratified analysis revealed similar changes in men only. Among men, FGL18-month elevation was associated with favorable changes in insulin resistance profile and VAT regression, after adjusting for relative weight loss (HbA1c: r = βˆ’0.216; homeostatic model of insulin resistance: r = βˆ’0.154; HDL-c: r = 0.147; VAT: r = βˆ’0.221; P & lt; 0.05 for all). Insulin resistance and VAT remained inversely related with FGL elevation beyond that explained by weight loss (residual regression analyses; P & lt; 0.05). Conclusion Diet-induced FGL elevation may reflect insulin sensitivity recovery and VAT regression beyond weight loss, specifically among men. Green-MED diet is associated with greater FGL elevation.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    RVK:
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2022
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  • 6
    In: Gastroenterology, Elsevier BV, Vol. 160, No. 1 ( 2021-01), p. 158-173.e10
    Type of Medium: Online Resource
    ISSN: 0016-5085
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 80112-4
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2017
    In:  Obesity Surgery Vol. 27, No. 11 ( 2017-11), p. 2785-2791
    In: Obesity Surgery, Springer Science and Business Media LLC, Vol. 27, No. 11 ( 2017-11), p. 2785-2791
    Type of Medium: Online Resource
    ISSN: 0960-8923 , 1708-0428
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 1070827-3
    detail.hit.zdb_id: 2087903-9
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  • 8
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2023-09-25)
    Abstract: Epigenetic age is an estimator of biological age based on DNA methylation; its discrepancy from chronologic age warrants further investigation. We recently reported that greater polyphenol intake benefitted ectopic fats, brain function, and gut microbiota profile, corresponding with elevated urine polyphenols. The effect of polyphenol-rich dietary interventions on biological aging is yet to be determined. Methods We calculated different biological aging epigenetic clocks of different generations (Horvath2013, Hannum2013, Li2018, Horvath skin and blood2018, PhenoAge2018, PCGrimAge2022), their corresponding age and intrinsic age accelerations, and DunedinPACE, all based on DNA methylation (Illumina EPIC array; pre-specified secondary outcome) for 256 participants with abdominal obesity or dyslipidemia, before and after the 18-month DIRECT PLUS randomized controlled trial. Three interventions were assigned: healthy dietary guidelines, a Mediterranean (MED) diet, and a polyphenol-rich, low-red/processed meat Green-MED diet. Both MED groups consumed 28Β g walnuts/day (+ 440Β mg/day polyphenols). The Green-MED group consumed green tea (3–4 cups/day) and Mankai ( Wolffia globosa strain) 500-ml green shake (+ 800Β mg/day polyphenols). Adherence to the Green-MED diet was assessed by questionnaire and urine polyphenols metabolomics (high-performance liquid chromatography quadrupole time of flight). Results Baseline chronological age (51.3 ± 10.6Β years) was significantly correlated with all methylation age (mAge) clocks with correlations ranging from 0.83 to 0.95; p   〈  2.2eβ€‰βˆ’β€‰16 for all. While all interventions did not differ in terms of changes between mAge clocks, greater Green-Med diet adherence was associated with a lower 18-month relative change (i.e., greater mAge attenuation) in Li and Hannum mAge (beta =β€‰β€‰βˆ’β€‰0.41, p  = 0.004 and beta =β€‰β€‰βˆ’β€‰0.38, p  = 0.03, respectively; multivariate models). Greater Li mAge attenuation (multivariate models adjusted for age, sex, baseline mAge, and weight loss)Β was mostly affected by higher intake of Mankai (beta =β€‰β€‰βˆ’β€‰1.8; p  = 0.061) and green tea (beta =β€‰β€‰βˆ’β€‰1.57; p  = 0.0016) and corresponded with elevated urine polyphenols: hydroxytyrosol , tyrosol , and urolithin C ( p   〈  0.05 for all) and urolithin A ( p  = 0.08),Β highly common in green plants. Overall, participants undergoing either MED-style diet had ~ 8.9Β months favorable difference between the observed and expected Li mAge at the end of the intervention ( p  = 0.02). Conclusions This study showed that MED and green-MED diets with increased polyphenols intake,Β such as green tea and Mankai, are inversely associated with biological aging. To the best of our knowledge, this is the first clinical trial to indicate a potential link between polyphenol intake, urine polyphenols, and biological aging. Trial registration ClinicalTrials.gov, NCT03020186.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 9
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2022-09-30)
    Abstract: Mediterranean (MED) diet is a rich source of polyphenols, which benefit adiposity by several mechanisms. We explored the effect of the green-MED diet, twice fortified in dietary polyphenols and lower in red/processed meat, on visceral adipose tissue (VAT). Methods In the 18-month Dietary Intervention Randomized Controlled Trial PoLyphenols UnproceSsed (DIRECT-PLUS) weight-loss trial, 294 participants were randomized to (A) healthy dietary guidelines (HDG), (B) MED, or (C) green-MED diets, all combined with physical activity. Both isocaloric MED groups consumed 28 g/day of walnuts (+ 440 mg/day polyphenols). The green-MED group further consumed green tea (3–4 cups/day) and Wolffia globosa (duckweed strain) plant green shake (100 g frozen cubes/day) (+ 800mg/day polyphenols) and reduced red meat intake. We used magnetic resonance imaging (MRI) to quantify the abdominal adipose tissues. Results Participants (age = 51 years; 88% men; body mass index = 31.2 kg/m 2 ; 29% VAT) had an 89.8% retention rate and 79.3% completed eligible MRIs. While both MED diets reached similar moderate weight (MED: βˆ’β€‰2.7%, green-MED: βˆ’β€‰3.9%) and waist circumference (MED: βˆ’β€‰4.7%, green-MED: βˆ’β€‰5.7%) loss, the green-MED dieters doubled the VAT loss (HDG: βˆ’β€‰4.2%, MED: βˆ’β€‰6.0%, green-MED: βˆ’β€‰14.1%; p 〈 0.05, independent of age, sex, waist circumference, or weight loss). Higher dietary consumption of green tea, walnuts, and Wolffia globosa ; lower red meat intake; higher total plasma polyphenols (mainly hippuric acid ), and elevated urine urolithin A polyphenol were significantly related to greater VAT loss ( p 〈 0.05, multivariate models). Conclusions A green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression. Trial registration ClinicalTrials.gov , NCT03020186
    Type of Medium: Online Resource
    ISSN: 1741-7015
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2131669-7
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  • 10
    In: Heart Rhythm, Elsevier BV, Vol. 21, No. 5 ( 2024-05), p. S416-S417
    Type of Medium: Online Resource
    ISSN: 1547-5271
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2229357-7
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