bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Assisted Compression in Screening Mammography: Patient Experience and Image Quality
Authors: Dontchos Brian N , Edmonds Christine E , Mercaldo Sarah F , Miles Randy C , Chu Katrina F , Lehman Constance D
Published: August 2019

Objective

Screening mammography is critical to reduce breast cancer mortality, yet many women cite pain from compression as a reason they avoid this test. We evaluated patient experience and image quality in screening patients opting for a handheld patient-assisted compression (PAC) device.

Methods

After institutional review board approval, women screened between February and July 2018 with a synthetic 2D/tomosynthesis mammography unit were offered use of a handheld PAC device. Patient experience through survey, image quality, compression thickness, compression force, and average glandular dose were evaluated and compared between women opting for PAC and women opting for technologist-controlled compression (TC). Multivariable ordinal logistic and linear regression models were estimated to control for age and breast density. In addition, for women opting for PAC, image quality obtained with their current PAC mammogram was compared with that obtained with their prior TC mammogram, by using Wilcoxon/Pearson tests.

Results

Seventy-three percent of women preferred their mammogram experience with PAC compared with their prior mammogram without PAC. Women using PAC reported decreased anxiety compared with those using TC, after controlling for age and breast density (adjusted odds ratio [aOR] 0.22 [95% confidence interval (CI): 0.09–0.49]). There were no significant differences in image quality, compression thickness, or average glandular dose in exams for women using PAC compared with exams for women using TC. Women using PAC had significantly more compression force than women using TC had (P = 0.012).

Conclusions

Mammography with PAC improves patient experience and results in similar image quality compared with mammography with TC.
Breast Imaging Fellowship Match: Program Directors’ Perspectives in Year Two
Authors: Katzen Janine T , Gotian Ruth , Brem Rachel F
Published: August 2019

Objective

The purpose of this study was to summarize the results of a survey distributed by the Society of Breast Imaging to assess Breast Imaging programs’ experience with the second year of the Breast Imaging Fellowship Match process.

Methods

In July 2018, the Society of Breast Imaging sent out an anonymous 11-question survey to all Breast Imaging programs in attempts to gauge their experience with the previous Match cycle. The survey included dichotomous questions and Likert-scaled questions. Follow-up to several questions allowed for unstructured free text responses. In this institutional review board–exempt study, responses were then summarized and categorized into appropriate categories.

Results

The survey was sent to 88 program coordinators and 90 program directors of the 89 existing programs. In total, 66 responses from program directors were received, representing 74.2% of the existing programs. The majority (68%) of programs reported a positive experience with participation in the Match (at least 4/5 stars). The most commonly cited issues with the Match were interview dates/timeline, programs participating outside of the Match, and need for a universal application. Eighty-four percent of programs stated that they were planning on participating in the Match for the upcoming application cycle, with 11% undecided and 5% stating they were not planning on participating.

Conclusions

Despite recognized areas for improvement, the great majority of programs felt that the Match is an improvement over the prior application process and that it significantly improved the experience for the applicants.
Evaluation of Shimming Techniques on MRI Breast Image Quality at 1.5T
Authors: Zhou Wei , Favazza Christopher P , Axmacher Jessica A , Trzasko Joshua D , Geske Jennifer R , Lee Christine U
Published: August 2019

Objective

The quality of all clinical MRI is dependent on B0 homogeneity, which is optimized during the shimming part of a prescan or preparatory phase before image acquisition. The purpose of this study was to assess shimming techniques clinically employed for breast MRI across our practice, and to determine factors that correlate with higher image quality for contrast-enhanced breast MRI at 1.5T.

Methods

One hundred consecutive female patients were retrospectively collected with Institutional Review Board approval. Shimming-related parameters, including shim-box placement and shimming gradient offsets were extracted from prior contrast-enhanced 3D fat-suppressed T1-weighted gradient echo image acquisitions. Three breast radiologists evaluated these images for fat saturation, breast density, overall image quality, and artifacts. Technologist experience was also evaluated for variability of shimming. Generalized linear mixed models were used to compare acquisition parameters between fat saturation. P < 0.05 was considered as statistical significance.

Results

The percentage of soft tissue inside the field of view (FOV) (ie, Tissue/FOV) in the good fat-saturation group (0.37 ± 0.06) was significantly lower (P < 0.01) than that in the poor fat-saturation group (0.39 ± 0.06). Other shimming-related parameters were found not significantly affecting the fat-saturation outcomes. Technologists with more experience tended to have less variable shimming performance than junior technologists did.

Conclusions

The quality of clinical MRI and especially breast MRI is highly dependent on shimming. Decreasing Tissue/FOV was associated with good image quality (good fat saturation). Optimization of shimming may require manual shimming or higher-order field-correction strategies.
The Introduction of Academy Schools to England's Education
Authors: Eyles Andrew , Machin Stephen
Published: August 2019

This paper studies the origins of what has become one of the most radical and encompassing programmes of school reform seen in the recent past in advanced countries—the introduction of academy schools to English education. Academies are independent state funded schools that are allowed to run in an autonomous manner outside of local authority control. Almost all academies are conversions from already existent state schools and so are school takeovers that enable more autonomy in operation than was permitted in their predecessor state. Studying the first round of conversions that took place in the 2000s, where poorly performing schools were converted to academies, a focus is placed on legacy enrolled pupils who were already attending the school prior to conversion. The impact on end of secondary school pupil performance is shown to be positive and significant. Performance improvements are stronger for pupils in urban academies and for those converting from schools that gained relatively more autonomy as a result of conversion.
The Commitment Role of Equity Financing
Authors: Fahn Matthias , Merlo Valeria , Wamser Georg
Published: August 2019

Existing theories of a firm’s optimal capital structure seem to fail in explaining why many healthy and profitable firms rely heavily on equity financing, even though benefits associated with debt (like tax shields) appear to be high and the bankruptcy risk low. This holds in particular for firms that show a strong commitment toward their workforce and are popular among employees. We demonstrate that such financing behavior may be driven by implicit arrangements made between a firm and its managers/employees. Equity financing generally strengthens a firm’s credibility to honor implicit promises. Debt, however, has an adverse effect on the enforceability of these arrangements because too much debt increases the firm’s reneging temptation, as some of the negative consequences of breaking implicit promises can be shifted to creditors. Our analysis provides an explanation for why some firms only use little debt financing. Predictions made by our theory are in line with a number of empirical results, which seem to stay in contrast to existing theories on capital structure.
Preemptive angioplasty for contralateral leg stenosis following EXCLUDER Iliac Branch Endoprosthesis implantation
Authors: Takagaki Masami , Midorikawa Hirofumi , Yamaguchi Hiroki , Nakamura Hiromasa , Mitsuyama Shinichi , Kadowaki Tasuku , Ueno Yousuke , Kataoka Hiroshi , Uchida Takaki , Aoki Tomoyuki
Published: August 2019

The GORE EXCLUDER Iliac Branch Endoprosthesis (IBE) device is designed to seal off a common iliac artery (CIA) aneurysm, preserving the internal iliac artery during endovascular aortic repair. We report the case of an 84-year-old man with isolated saccular right CIA aneurysm (35 mm) and a relatively small terminal aorta (24 mm). The IBE device was successfully placed, and intraoperative angiography revealed no leakage or delay. However, postoperative computed tomography revealed marked compression of the contralateral leg by a bridging component. Although his ankle–brachial index was preserved, its acute occlusion was judged highly possible; we decided to perform preemptive angioplasty. The angiography revealed the stenosis only in the left anterior oblique view, and angioplasty was uneventfully performed. The leg was successfully patent at 1-year follow-up. When compression by IBE and bridging component in the terminal aorta is expected, caution should be preserved at intraoperative angiography following the device deployment.
Why do Orchestral and Band Musicians in Exile Matter? A Case Study from Spain
Authors: RodrÍguez Eva Moreda
Published: August 2019

Even though scholarship on music and exile under Franco has grown steadily for the past three decades, little attention has been paid thus far to exiled performers who were active primarily as members of orchestras and bands. This article makes an initial contribution to this field by focusing on the Banda Madrid as a case study. The Banda Madrid was founded in the spring of 1939 in the internment camp of Le Barcarès (France) by Rafael Oropesa. Its members went into exile in Mexico City and became a fixture of the Spanish exile community until 1947. I discuss how the Banda Madrid and the stories of some of its individual members expand our understanding of politics and modernity in the Spanish Republican exile. In order to do this, I follow the trajectories of Banda Madrid musicians before, during, and after the Civil War, and contrast them with those of left-wing composers in exile.
Human mitochondrial DNA is extensively methylated in a non-CpG context
Authors: Patil Vibha , Cuenin Cyrille , Chung Felicia , Aguilera Jesus R Rodriguez , Fernandez-Jimenez Nora , Romero-Garmendia Irati , Bilbao Jose Ramon , Cahais Vincent , Rothwell Joseph , Herceg Zdenko
Published: August 2019

Mitochondrial dysfunction plays critical roles in cancer development and related therapeutic response; however, exact molecular mechanisms remain unclear. Recently, alongside the discovery of mitochondrial-specific DNA methyltransferases, global and site-specific methylation of the mitochondrial genome has been described. Investigation of any functional consequences however remains unclear and debated due to insufficient evidence of the quantitative degree and frequency of mitochondrial DNA (mtDNA) methylation. This study uses WGBS to provide the first quantitative report of mtDNA methylation at single base pair resolution. The data show that mitochondrial genomes are extensively methylated predominantly at non-CpG sites. Importantly, these methylation patterns display notable differences between normal and cancer cells. Furthermore, knockdown of DNA methyltransferase enzymes resulted in a marked global reduction of mtDNA methylation levels, indicating these enzymes may be associated with the establishment and/or maintenance of mtDNA methylation. DNMT3B knockdown cells displayed a comparatively pronounced global reduction in mtDNA methylation with concomitant increases in gene expression, suggesting a potential functional link between methylation and gene expression. Together these results demonstrate reproducible, non-random methylation patterns of mtDNA and challenge the notion that mtDNA is lowly methylated. This study discusses key differences in methodology that suggest future investigations must allow for techniques that assess both CpG and non-CpG methylation.
The National Audit Office and the Select Committee System 1979–2019
Authors: Midgley Henry
Published: August 2019

This is the first account of the relationship between select committees and the National Audit Office (NAO). The relationship has been often dismissed, but this article argues that it has been vital for the success of the committee system. Initially, both the committees and the audit office were established to strengthen the scrutiny of public administration. Despite the intentions of the early reformers, they did not initially collaborate. In the 1990s and 2000s, early reluctance gave way to enthusiastic collaboration between the two institutions. Initially, this collaboration focussed on financial and environmental scrutiny, but it has since expanded as the auditors have gained more confidence and the committees more familiarity with their work. Now the NAO advises committees on subjects such as European Union exit, which it would have never discussed with them only 40 years previously. This article provides both an account of that collaboration and an explanation for why the NAO and the committees have become so closely associated.
For Wales, Do Not See England? An Analysis of the 2017 General Election
Authors: McAllister Laura , Awan-Scully Roger
Published: August 2019

This article analyses the 2017 UK General Election from the perspective of the campaign and results in Wales, a nation which had the most interesting election campaign of all the different nations. The election saw a stark contrast between the way the two principal UK-wide parties fought their campaigns and how the campaign impacted on results. Drawing on data from a post-election survey conducted in June 2017, we consider factors that shape voter choice, which affected the outcome of the election in Wales. We argue that the election internalised and reflected a new pattern of party politics that is likely to stimulate differential election outcomes across the UK; this requires a different approach to understanding election campaigns, one that differentiates between the nations and how every political party operates in each territory. This will help distinguish different political and electoral fault lines, as well as constructing a more granular analysis of the campaign’s impact on electoral outcomes. We conclude first that, to better and more comprehensively explain UK-wide elections, there is a need to provide distinctive national and regional analyses, and secondly, it is mistaken to assume that the same electoral patterns will always exist in Wales as in England.
Collaboration Risk and the Choice to Consolidate Local Government Services
Authors: Hansen Katy , Mullin Megan , Riggs Erin K
Published: August 2019

Collaboration among local governments occurs through a range of mechanisms, which vary in degree of formality from contracts and ad hoc agreements to full consolidation. Prior work indicates that local decision makers favor formal mechanisms when expected gains from less formal collaboration may not be realized. This article explicates the concept of collaboration risk, treating it as a product of the likelihood that collaboration fails and the severity of consequences should failure occur. We examine how characteristics of a local service contribute to collaboration risk and thereby influence the choice to consolidate service delivery. Focusing on the case of drinking water provision, we identify physical and financial features of service delivery that contribute to the likelihood and severity of collaboration failure. Drawing on seven case studies of water system consolidation, we then analyze the importance of these service characteristics in the choice to enter into consolidation agreements.
Super heat kernel and one-loop divergence of super Yang–Mills theory in conformal supergravity
Authors: Leung Ka-Hei
Published: August 2019

We consider super Yang–Mills (SYM) theory in $N=1$ conformal supergravity. Using the background field method and the Faddeev–Popov procedure, the quantized action of the theory is presented. Its one-loop effective action is studied using the heat kernel method. We shall develop a non-iterative scheme, generalizing the non-supersymmetric case, to obtain the super heat kernel coefficients. In particular, the first three coefficients, which govern the one-loop divergence, will be calculated. We shall also demonstrate how to schematically derive the higher-order coefficients. The method presented here can be readily applied to various quantum theories. We shall, as an application, derive the full one-loop divergence of SYM in conformal supergravity.
Heroines of the Ballot: The Gender Gap and the Costs of Voting
Authors: Santana Andrés , Aguilar Susana
Published: August 2019

We focus on the effect of gender upon the costs of voting (C). With the aid of the Making Electoral Democracy Work dataset, we unveil a systematic gender gap whereby women always perceive higher C than men. This gap holds for the whole sample and each of the countries, remains after controlling for a wealth of factors, and is robust to changes in the specification of the models. The gender gap is attenuated only by education and widens with the presence of children and political interest. Important normative questions related to the principle of political equality arise from this gap.
19Digital Humanities
Authors: Mandal Anthony
Published: August 2019

This chapter examines material published in the field of the digital humanities (DH) in 2018, all of which explores the relationship between the digitalized present and its pre-digital past(s). In one publication, Friending the Past: The Sense of History in the Digital Age, Alan Liu notes: ‘The signal sense of history […] is not just like a plot on a radar scope. It is like the unfolding epic plot of Tolstoy’s War and Peace’ (p. 157). As political scandals over the use of social media and the role of cyber-targeting to influence electoral outcomes continue to dominate the news, it is becoming increasingly evident that not only are social media ushering in an era in which we are alienated from our personal data, but that today’s digitalized world builds on and replicates pre-digital hegemonic structures. Books by Andrew Piper and Alan Liu discuss ways in which scholars can approach the complexities and challenges of literary tradition and historical transmutation through the application of computational methods and digital tools. Discussion then turns to the ways in which digital practices have converged with wider cultural and political developments since the second half of the twentieth century. Lee Humphreys examines this transformation through the traces that we leave as the record of our daily lives while on social media, while Felix Stalder considers how such practices have wider ramifications as symptoms of a ‘digital condition’, for good and ill. Exploring the pressure points of the digital condition more closely, Safiya Umoja Noble scrutinizes the ways in which algorithmic processes, notably those that drive Google’s search engine, are shaped by and sustain discriminatory regimes at the expense of vulnerable minorities. Finally, Roopika Risam’s critique interrogates the field of the digital humanities itself, which—notwithstanding good intentions—remains dominated by the Global North and is at risk of perpetuating the very power structures that it seeks to dismantle.
Cocrystal structure of meningococcal factor H binding protein variant 3 reveals a new crossprotective epitope recognized by human mAb 1E6
Authors: Bianchi Federica , Veggi Daniele , Santini Laura , Buricchi Francesca , Bartolini Erika , Surdo Paola Lo , Martinelli Manuele , Finco Oretta , Masignani Vega , Bottomley Matthew J. , Maione Domenico , Cozzi Roberta
Published: August 2019

The 4 component meningococcus B vaccine (4CMenB) vaccine is the first vaccine containing recombinant proteins licensed for the prevention of invasive meningococcal disease caused by meningococcal serogroup B strains. 4CMenB contains 3 main recombinant proteins, including the Neisseria meningitidis factor H binding protein (fHbp), a lipoprotein able to bind the human factor H. To date, over 1000 aa sequences of fHbp have been identified, and they can be divided into variant groups 1, 2, and 3, which are usually not crossprotective. Nevertheless, previous characterizations of a small set (n = 10) of mAbs generated in humans after 4CMenB immunization revealed 2 human Fabs (huFabs) (1A12, 1G3) with some crossreactivity for variants 1, 2, and 3. This unexpected result prompted us to examine a much larger set of human mAbs (n = 110), with the aim of better understanding the extent and nature of crossreactive anti‐fHbp antibodies. In this study, we report an analysis of the human antibody response to fHbp, by the characterization of 110 huFabs collected from 3 adult vaccinees during a 6‐mo study. Although the 4CMenB vaccine contains fHbp variant 1, 13 huFabs were also found to be crossreactive with variants 2 and 3. The crystal structure of the crossreactive huFab 1E6 in complex with fHbp variant 3 was determined, revealing a novel, highly conserved epitope distinct from the epitopes recognized by 1A12 or 1G3. Further, functional characterization shows that human mAb 1E6 is able to elicit rabbit, but not human, complement‐mediated bactericidal activity against meningococci displaying fHbp from any of the 3 different variant groups. This functional and structural information about the human antibody response upon 4CMenB immunization contributes to further unraveling the immunogenic properties of fHbp. Knowledge gained about the epitope profile recognized by the human antibody repertoire could guide future vaccine design.—Bianchi, F., Veggi, D., Santini, L., Buricchi, F., Bartolini, E., Lo Surdo, P., Martinelli, M., Finco, O., Masignani, V., Bottomley, M. J., Maione, D., Cozzi, R. Cocrystal structure of meningococcal factor H binding protein variant 3 reveals a new crossprotective epitope recognized by human mAb 1E6. FASEB J. 33, 12099‐12111 (2019). www.fasebj.org
Prospective Observational Investigation of Capnography and Pulse Oximetry Monitoring After Cesarean Delivery With Intrathecal Morphine
Authors: Weiniger C.F. , Akdagli S. , Turvall E. , Deutsch L. , Carvalho B.
Published: August 2019

(Anesth Analg. 2019;128:513–522)

Neuraxial morphine in low dosages is commonly used to provide high-quality analgesia to women after cesarean delivery. However, postoperative respiratory depression remains a concern, with reported incidences ranging from 0 to 32%. Inadequacy of ventilation and apneas can reliably be detected via capnography but current monitoring relies predominantly on pulse oximetry. No study has evaluated capnography use in women after cesarean delivery. Therefore, in the present study, the authors used capnography to estimate the number of “apnea alert events” (AAEs) in women who underwent cesarean delivery with spinal anesthesia that included 150 µg of intrathecal morphine.
Increasing the Participation of Pregnant Women in Clinical Trials
Authors: Heyrana K. , Byers H.M. , Stratton P.
Published: August 2019

(JAMA. 2018;320:Number 20)

Pregnant women are considered a “vulnerable” population in research and are often excluded from trials by institutional review boards and study investigators even when they may benefit from study interventions. This has led to >80% of pregnant patients routinely prescribed medications that have not been studied in pregnancy. It is mostly unknown which medications could cause harm, which interventions are effective, or whether treatment can safely be delayed until after pregnancy. The authors argue to improve the health of pregnant women and their fetuses, they need to be appropriately enrolled in clinical research so that decisions can be based on evidence-based medicine.
Preeclampsia and Risk of Dementia Later in Life: A Nationwide Cohort Study
Authors: Basit S. , Wohlfahrt J. , Boyd H.A.
Published: August 2019

(BMJ. 2018;363:k4109)

Vascular dysfunction plays an important role in the pathophysiology of preeclampsia, and women with a history of preeclampsia face an increased risk of other cardiovascular disorders after pregnancy, including hypertension and stroke. Given these associations, women with preeclampsia might also be at increased risk of developing dementia. Previous studies that have investigated the association between hypertensive disorders of pregnancy and dementia later in life have had limitations such as being underpowered and dependent on self-reported information. This current study used a large register-based national cohort to compare the risk of dementia between women with and without a history of preeclampsia.
Term Pregnant Patients have Similar Gastric Volume to Nonpregnant Females: A Single-Center Cohort Study
Authors: Van de Putte P. , Vernieuwe L. , Perlas A.
Published: August 2019

(Br J Anaesth. 2019;122(1):79–85. Doi: 10.1016/j.bja.2018.07.025)

Current studies suggest that gastric emptying time is not prolonged in pregnancy. However, these data come from small samples. Pulmonary aspiration of gastric contents during obstetric anesthesia remains a concern. In the present study, authors assessed the range of gastric fluid volume in fasted nonlaboring term pregnant patients and fasted nonpregnant female patients scheduled for surgery.
Neuroinflammation in the Developing Brain: Risk Factors, Involvement of Microglial Cells, and Implication for Early Anesthesia
Authors: Baud O. , Saint-Faust M.
Published: August 2019

(Anesth Analg. 2019;128(4):718–725. Doi:10.1213/ANE.0000000000004032)

Microglia, permanent macrophages in the central nervous system, play a neuroprotective role but also a neurotoxic role when a developing brain is exposed to abnormal perinatal events, such as general anesthesia, surgery or analgesic drugs. These events may have adverse effects on maturation and plasticity. In order to better understand the underlying mechanisms of the potential adverse effects of microglial functions, the regulation of microglial activation in the brain and anesthetic interactions should be further investigated. This article reviewed the most common situations associated with neuroinflammation and exacerbated systemic inflammation in infants along with the dual role of microglia in the resulting brain damage.
Nocturnal Desaturation Early After Delivery: Impact of Delivery Type and the Beneficial Effects of Fowler’s Position
Authors: Fujita N. , Grabitz S.D. , Shin C.H. , Hess P.E. , Eikermann M.
Published: August 2019

(Br J Anaesth. 2019;122:e64–e66)

The authors of the present study previously reported that 20% of women experience obstructive sleep apnea episodes in the immediate postpartum period. They have also found that women sleeping in a 45-degree elevated upper body position, rather than supine, may have significantly reduced apnea-hypopnea indices. Subsequently, in this article, the authors reported on their continuing investigation, which evaluates the impact of delivery type on nocturnal oxygenation and the potential influence of elevated upper body position.
Risk of Repeat Cesarean Delivery in Women Undergoing Trial of Labor: A Population-based Cohort Study
Authors: Wollmann C.L. , Ahlberg M. , Saltvedt S. , Johansson K. , Elvander C. , Stephansson O.
Published: August 2019

(Acta Obstet Gynecol Scand. 2018;97:1524–1529)

As the rate of cesarean delivery (CD) has increased worldwide, trial of labor after one cesarean delivery (TOLAC) is often recommended for limiting the incidence of CD. Both elective repeat cesarean delivery (ERCD) and TOLAC carry maternal and neonatal risks. Compared with ERCD, cesarean delivery following TOLAC is associated with increased risks of blood transfusion, hysterectomy, and endometritis. TOLAC itself is associated with a low but increased risk of uterine rupture. Previous studies have estimated the likelihood of successful VBAC after TOLAC in relation to maternal characteristics. These studies, though, have yielded contradictory results and study sizes have been limited. This study aimed to investigate the risk of TOLAC resulting in CD based on cervical dilation during labor for the first CD as well as the indication for the first CD.
Prepregnancy and Early Pregnancy Calcium Supplementation Among Women at High Risk of Preeclampsia: A Multicenter, Double-blind, Randomized, Placebo-controlled Trial
Authors: Hofmeyr G.J. , Betrán A.P. , Singata-Madliki M. , Cormick G. , Munjanja S.P. , Fawcus S. , Mose S. , Hall D. , Ciganda A. , Seuc A.H. , Lawrie T.A. , Bergel E. , Roberts J.M. , von Dadelszen P. , Belizán J.M.
Published: August 2019

(Lancet. 2019;393:330–339)

Approximately 14% of maternal deaths worldwide are directly caused by hypertensive disorders of pregnancy, including preeclampsia. On the basis of surprisingly low rates of preeclampsia in low-income countries with high-calcium diets, it has been suggested that calcium deficiency may be linked to preeclampsia and several randomized controlled trials (RCTs) have tested the hypothesis that calcium supplementation may prevent preeclampsia. One study found reductions in the severity of preeclampsia, maternal morbidity and mortality and neonatal mortality, but no significant effect on preeclampsia prevalence. A meta-analysis of 13 RCTs found that calcium supplementation decreased preeclampsia rates by approximately half, but one limitation was small sample sizes of the studies included. This current study aimed to determine whether calcium supplementation before pregnancy and during the first half of pregnancy would reduce the development of preeclampsia in women who experienced preeclampsia or eclampsia in a previous pregnancy.
Pharmacokinetics of Amlodipine Besylate at Delivery and During Lactation
Authors: Morgan J.L. , Kogutt B.K. , Meek C. , Stehel E.K. , McIntire D.D. , Sheffield J.S. , Roberts S.W.
Published: August 2019

(Pregnancy Hypertens. 2018;11:77–80. Doi:10.1016/j.preghy.2018.01.002)

The management of chronic hypertension, which affects ~5% of all US pregnancies, requires careful balance. While many drugs used to treat hypertension have been well-studied, there is a lack of options that have been adequately studied during pregnancy and lactation. Amlodipine is an ideal option for use in pregnancy due to its long half-life, infrequent dosing, low cost and positive side-effect profile, but more data are needed on its use in pregnant and lactating patients and whether it crosses the placenta. This study aimed to evaluate the pharmacokinetics of amlodipine besylate in a population of pregnant women during delivery and postpartum lactation.
Insertion of an Intrathecal Catheter Following a Recognized Accidental Dural Puncture Reduces the Need for an Epidural Blood Patch in Parturients: An Australian Retrospective Study
Authors: Rana K. , Jenkins S. , Rana M.
Published: August 2019

(Int J Obstet Anesth. 2018;36:11–16)

Postdural puncture headache (PDPH) is one of the most common complications associated with obstetric epidural analgesia, It can be particularly debilitating for new mothers who have to deal with the responsibilities of a newborn and can lead to longer hospital stays after delivery. In addition, some studies have reported that approximately one quarter of parturients who have a PDPH ultimately develop chronic headaches. While some have proposed inserting an intrathecal catheter (ITC) at the time of an accidental dural puncture (ADP) as a means of preventing PDPH and the need for an epidural blood patch (EBP), the efficacy of this management strategy remains unclear. There have been studies reporting a reduction in PDPH and EBP but others have not found these beneficial effects. This study aimed to investigate whether the insertion of an ITC after ADP reduced the rate of PDPH and need for EBP in obstetric patients. They also evaluated whether the length of time the ITC was in place (<24 or >24 h) affected the efficacy of the treatment.
Livebirth After Uterus Transplantation From a Deceased Donor in a Recipient With Uterine Infertility
Authors: Ejzenberg D. , Andraus W. , Carelli Mendes L.R.B. , Ducatti L. , Song A. , Tanigawa R. , Rocha-Santos V. , Arantes R.M. , Soares J.M. , Serafini P.C. , de Paiva Haddad L.B. , Francisco R.P. , D’Albuquerque L.A. , Baracat E.C.
Published: August 2019

(Lancet. 2018;392:2697–2704)

The first reported successful childbirths after uterus transplant occurred in Sweden in 2013. Since then, only 2 centers (1 in the US and 1 in Sweden) have published reports of livebirths from uterus transplants, with all using live donors. While the use of deceased donors could increase the availability of uterus transplants, one previous transplant from a deceased donor in Turkey resulted in a pregnancy that ended in miscarriage. This report detailed the first reported case of a successful livebirth following a uterus transplant from a deceased donor.
Implantable Cardioverter Defibrillator Shocks and Psychological Distress
Authors: Lee Kyoung Suk , Kim Jun Hyung , Kang Ki-Woon , Miller Jennifer , McEvedy Samantha M. , Hwang Seon Young , Moser Debra K.
Published: August 2019

Background:

Although the implantable cardioverter defibrillator (ICD) has a survival benefit for the prevention of sudden cardiac death, ICD recipients commonly experience emotional distress as a consequence of ICD shocks.

Objective:

The aim of this study was to examine whether the association between ICD shocks and psychological distress (anxiety and depressive symptoms) is mediated by ICD-related concerns and perceived control among ICD recipients.

Methods:

This was a multinational cross-sectional observational study of 334 ICD recipients. Patients reported the number of shocks received since ICD implantation and completed questionnaires to assess anxiety, depressive symptoms, ICD-related concerns, and perceived control. A path analysis was conducted to explore the relationship of receiving ICD shocks with anxiety and depressive symptoms and the mediating effects of ICD-related concerns and perceived control.

Results:

Of the 334 ICD recipients, 39.2% experienced ICD shocks at least once since implantation. There was no direct effect of ICD shocks on anxiety and depressive symptoms. Experiencing ICD shocks was indirectly associated with an increased likelihood of anxiety and depressive symptoms via the pathways of ICD-related concerns and perceived control (indirect effects on anxiety = 0.060, 0.043; indirect effect on depressive symptoms = 0.025, 0.073).

Conclusion:

Experiencing defibrillator shocks was associated with psychological distress in ICD recipients; the relationship was fully mediated by ICD-related concerns and perceived control. These results suggest that clinicians should routinely assess ICD-related concerns and perceived control in patients with ICD. Research is needed to develop and test interventions to decrease emotional distress related to the ICD shock experience.
Epithelioid hemangioendothelioma arising from the kidney
Authors: Liu Yuhui , Liu Ailian , Wu Jingjun , Liu Tieli
Published: August 2019

Rationale:

Primary renal epithelioid hemangioendothelioma (EH) is a rare vascular tumor with intermediate biologic behavior and metastatic potential, and it is extremely rare and has only 4 cases in the current literatures.

Patient concerns:

We reported a 30-year-old woman who had a 3-month history of gross hematuria and aggravated for half a month. The imaging examination showed a cystic lesion in the mid pole of the left kidney pelvicaliceal.

Diagnoses:

The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as EH.

Interventions:

The patient underwent ureteroscopy and partial left nephrectomy.

Outcomes:

Her postoperative condition was good without complications. No clinical evidence of local recurrence or metastatic disease was found during 6 months of follow-up clinical and ultrasound examinations. In addition, laboratory tests, including a urine examination, were normal.

Lessons:

Renal EH is a rare low-grade malignant tumor with characteristic histological structure. Locally excision has been considered as the optimal treatment and regular follow-up is necessary. Our present study reviewed the clinical and biological information of previous cases which were diagnosed as renal EH and we supplemented more data for further study.
Evaluation of nutritional status and prognostic impact assessed by the prognostic nutritional index in children with chronic kidney disease
Authors: Zhang Hui , Tao Yuhong , Wang Zheng , Lu Jing
Published: August 2019

To evaluate the nutritional status of children with chronic kidney disease (CKD) before dialysis via a series of indexes, and investigate the prognostic impact of nutritional status in these patients assessed by the Prognostic Nutritional Index (PNI).

Fifty-four children with CKD before dialysis were enrolled in this study. The nutritional status was evaluated by different indexes, including dietary intake, anthropometry data and biochemical parameters. Additionally, PNI is calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (/mm3). Glomerular filtration rate (GFR) of patients with different PNI scores was followed up.

Thirty-four patients (63.0%) experienced unreasonable dietary intake, and the patients with CKD stage 4 were characterized by lower energy intake. The height was the most affected anthropometry parameter. Additionally, 46 patients (85.2%) suffered from anemia. The serum albumin of 42 patients (77.8%) was <35 g/L, while 34 cases (63.0%) had increased cholesterol and triglyceride. According to the PNI scores, the patients were divided into 3 groups: high-PNI (PNI ≥ 38), middle-PNI (35 ≤ PNI < 38), and low-PNI (PNI < 35). Of the 54 patients, the PNI was <35 in 29 (53.7%) and ≥38 in 13 (24.1%). The patients with CKD stage 4 were belonged to the low-PNI group. At follow-up, GFR decreased significantly in patients with low-PNI scores compared with the high-PNI group (P < .05).

Malnutrition, as a common complication of CKD, has a prognostic impact in children with CKD before dialysis, as assessed by the PNI score.
The predictive role of monocyte-to-lymphocyte ratio in osteoporosis patient
Authors: Gao Kun , Zhu Wenxiu , Liu Weidong , Ma Dujun , Li Heng , Yu Weiji , Li Quan , Cao Yafei
Published: August 2019

Osteoporosis is a chronic, progressive disease in which early diagnosis is very important. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been reported as new predictors in inflammatory and immune diseases including osteoporosis. No studies have reported the relationship between monocyte-to-lymphocyte ratio (MLR) and osteoporosis patients.

To investigated the ability of MLR to predict osteoporosis.

Three hundred sixteen osteoporosis patients and 111 healthy control subjects were enrolled. Patients’ laboratory and clinical characteristics were recorded. MLR, NLR, and PLR levels were calculated. The differences were compared and the diagnostic values of MLR were analyzed.

There were 76 male and 105 female patients included, with a mean age of 56.57 ± 9.95 years. The levels of MLR, NLR, and PLR in osteoporosis patients were all higher than those in healthy control subjects. The area under the curve of MLR was higher than those of NLR and PLR. Multivariate linear regression analysis showed that T-score was affected by age and MLR. MLR was positively correlated with C-reactive protein, erythrocyte sedimentation rate, red blood cell distribution width, age, sex, and inversely with hemoglobin. MLR and PLR levels were significantly higher in osteoporosis patients than in osteopenia patients (P < .05).

The present study shows that MLR had a higher diagnostic value for osteoporosis. MLR may be a reliable, inexpensive, and novel potential predictor of osteoporosis.
Efficacy of oxycodone in intravenous patient-controlled analgesia with different infusion modes after laparoscopic radical surgery of cervical cancer a prospective, randomized, double-blind study
Authors: Zhu Yejing , Xie Kangjie , Yuan Junbo , Gu Bin , Lian Yanhong , Zhou Huidan , Fang Jun
Published: August 2019

Backgroud:

The aim of this study was to compare the analgesic and adverse effects of oxycodone with 3 different infusion modes on postoperative pain after laparoscopic radical surgery of cervical cancer.

Methods:

Ninety patients undergoing laparoscopic radical surgery of cervical cancer were randomly divided into 3 groups: Group A (continuous infusion with 0.01 mg/kg/h and a bolus dose with 0.03 mg/kg), Group B (a bolus dose with 0.03 mg/kg) and Group C (PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass). A blinded observer recorded Visual Analogue Scale (VAS), Ramsay sedation score (RSS), infused cumulative dose of oxycodone and side effects at 1, 6, 12, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours.

Results:

There were significant differences in the VAS pain score when resting or coughing among 3 groups at 1, 6 and 48 hours postoperatively (P<.05). VAS was significantly higher in Group B than in Group A and C until postoperative 1, 6, and 48 hours (P<.05). There were significant differences in cumulative PCA dose among the 3 groups at 1 and 48 hours postoperatively (P<.05). Group C showed significantly less amount of cumulative PCA dose compared to other 2 groups at 1 hour, whereas cumulative PCA dose of Group A at 48 hours was significantly more than other 2 groups (P<.05). There were no significant differences in postoperative nausea and vomiting, FAS, muscle chilling score and RSS among 3 groups at 1, 6, 12, 24 and 48 hours postoperatively. In addition, there was no difference in overall satisfaction during 48 hours postoperatively among 3 groups.

Conclusions:

Oxycodone provides significant analgesic effect in 3 different infusion modes over 48 hours after laparoscopic radical surgery of cervical cancer, and a time-scheduled decremental continuous infusion of oxycodone can become a better choice for patients after surgery of cervical cancer.
Factors influencing erythrocyte sedimentation rate in adults
Authors: Alende-Castro Vanessa , Alonso-Sampedro Manuela , Vazquez-Temprano Nuria , Tuñez Carmen , Rey Daniel , García-Iglesias Carmen , Sopeña Bernardo , Gude Francisco , Gonzalez-Quintela Arturo
Published: August 2019

The erythrocyte sedimentation rate (ESR) is a routine test for inflammation. Few studies have investigated the potential influence of lifestyle factors and common metabolic abnormalities on the ESR. This study investigates the influence of demographic factors, alcohol consumption, smoking, physical activity, obesity, and metabolic syndrome on the ESR in adults.

This cross-sectional study covered 1472 individuals (44.5% males; age range, 18–91 years) randomly selected from the population of a Spanish municipality. The ESR was measured using a standardized method. We assessed habitual alcohol consumption in standard drinking units, along with tobacco smoking, regular physical exercise (by questionnaire), body mass index, and variables defining metabolic syndrome. Multivariate analyses were performed, including mean corpuscular volume and hemoglobin concentration in the models.

The ESR was higher in females than in males, and increased steadily with age. Median ESR of females was 2-fold higher than that of males, and median ESR of individuals aged >65 years was 2-fold higher than that of individuals in the youngest category (ages 18–35 years). Body mass index, presence of metabolic syndrome, and smoking were independently and positively associated with higher ESR values. Light alcohol drinkers and individuals with high regular physical activity displayed lower ESR values than did alcohol abstainers and individuals with low physical activity, respectively.

ESR varies greatly with age and sex, and corresponding reference values are proposed. Lifestyle factors (physical activity, smoking, and alcohol consumption) and common metabolic abnormalities (obesity and related metabolic syndrome) may also influence ESR values.
Acupuncture for diminished ovarian reserve
Authors: Ma Ruihong , Song Jiayi , Si Jinhua , Liu Yan , Li Xinyun , Cheng Rui , Hu Zuxian , Xia Tian , Zhai Jingbo
Published: August 2019

Background:

The choice of treatments for diminished ovarian reserve (DOR) still remains a challenging clinical problem in reproductive medicine. Acupuncture could be beneficial for patients with DOR. This study aims to systematically investigate the efficacy and safety of the acupuncture for women with DOR.

Methods:

We will search electronic databases including PubMed (1946 to present), EMBASE (1974 to present), Cochrane Central Register of Controlled Trials (CENTRAL, all years), Web of Science (1900 to present), Chinese Biomedical Literatures Database (CBM, 1978 to present), China National Knowledge Infrastructure (CNKI, 1979 to present), WANFANG Data (from 2000 to present) to identify potentially eligible studies. Only randomized controlled trials (RCTs) will be included. Experimental interventions include traditional or contemporary acupuncture. Control interventions include no treatment, sham acupuncture, placebo acupuncture, or another active therapy. The primary outcomes include ongoing pregnancy rate and serum anti-Müllerian hormone level. A meta-analysis will be used to estimate a pooled intervention effect if possible.

Results:

The results will be published in a peer-reviewed journal.

Conclusion:

The findings will provide further evidence for the management of DOR.

PROSPERO registration number:

CRD42018114385.
Antiplatelet therapy and coronary artery bypass grafting
Authors: Gupta Saurabh , Belley-Côté Emilie P. , Rochwerg Bram , Bozzo Anthony , Panchal Puru , Pandey Arjun , Mbuagbaw Lawrence , Mehta Shamir , Schwalm J-D. , Whitlock Richard P.
Published: August 2019

Introduction:

Saphenous vein graft (SVG) is the most common conduit used for coronary artery bypass grafting (CABG) surgery. Unfortunately, SVG are associated with poor long-term patency rates; a significant predictor of re-operation rates and survival. As such, medical therapy to prevent SVG narrowing or occlusion is of paramount importance. Aspirin (ASA) monotherapy is the standard of care after CABG, to improve long-term major adverse cardiovascular events (MACE) and graft patency. Benefits of dual antiplatelet therapy (DAPT) have not been well established in all CABG patients. We present a protocol for a network meta-analysis (NMA) comparing the effects of various antiplatelet therapy regimens on SVG patency, mortality, and bleeding among adult patients following CABG.

Methods:

We will search CENTRAL, MEDLINE, EMBASE, CINAHL ACPJC, and grey literature sources (AHA, ACC, ESC, and CCC conference proceedings, ISRCTN Register, and WHO ICTRP) for randomized controlled trials (RCTs) which fit our criteria. RCTs that evaluate different antiplatelet regimens at least 3-months after CABG and have any of SVG patency, mortality, MACE, and major bleeding as outcomes will be selected. We will perform title and abstract screening, full-text screening, and data extraction independently and in duplicate. Two independent reviewers will also assess risk of bias (ROB) for each study, as well as evaluate quality of evidence using the GRADE framework. We will use R to perform the NMA and use low-dose ASA as reference within our network. We will report results as odds ratios with confidence intervals for direct comparisons, and credible intervals for indirect or mixed comparisons. We will use the surface under the cumulative ranking curve (SUCRA) to estimate the ranking of interventions.

Discussion:

Given the limited direct comparison of various antiplatelet regimens, a network approach is ideal to clarify the optimum antiplatelet therapy after CABG. We hope that our NMA will be the largest quantitative synthesis evaluating antiplatelet regimens among patients requiring CABG. It should inform clinicians and guideline developers in selecting the most effective and safest antiplatelet regimen.

Systematic Review registration: International Prospective Register for Systematic Reviews (PROSPERO)—CRD42019127695.