bluuebunny/crossref_metadata_2025 huggingface dataset:
Words, Wounds, and Relationships: Why Social Ties Matter to Free Speech in High-Conflict Protests
Authors: Fuller P. Brooks
Published: August 2019

Under settled First Amendment doctrine, true threats and incitement to violence fall clearly outside the protection of the United States Constitution. However, the line between violent speech and protected political hyperbole is exceedingly blurry, especially in high-conflict protest environments. This study complements doctrinal analysis with an ethnographic field study of abortion clinic protests in the Southern United States to test assumptions about speech, harm, and political discourse. It recommends that courts modify the analytical frameworks for true threats and incitement to better capture the layers of social and historical context that create social and rhetorical meaning amid political conflict.
New Technique for Preconditioning of the Spinal Cord Before Endovascular Repair of Descending Thoracic and Thoracoabdominal Aortic Aneurysms
Authors: Sonesson Björn , Dias Nuno V. , Resch Timothy A.
Published: August 2019

Purpose: To propose a new simplified technique to occlude multiple segmental arteries for staging and preconditioning of the spinal cord to decrease the potential for spinal cord ischemia after thoracic and thoracoabdominal aortic aneurysm repair. Technique: A thoracic stent-graft that flares out to a maximum of 51 mm is deployed in a standard fashion covering all segmental arteries where graft-wall apposition occurs in the first ~20 cm of the aneurysm. The segmental arteries are always closed at their ostia in contrast to selective coil embolization, where there is a risk of more peripheral closure. Follow-up imaging shows thrombus lining the stent-graft–covered portion of the aneurysm and secondary proximal segmental artery occlusion. Conclusion: A new and fast way of staging and preconditioning the spinal cord using a modified stent-graft prior to definitive repair might be an alternative to segmental artery embolization.
A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease
Authors: Spiliopoulos Stavros , Tsochatzis Athanasios , Festas Georgios , Reppas Lazaros , Christidi Foteini , Palialexis Konstantinos , Brountzos Elias
Published: August 2019

Purpose: To investigate the bleeding complications associated with endovascular therapy (EVT) for peripheral artery disease (PAD) and develop a dedicated peripheral bleeding score (PBS). Materials and Methods: This prospective, single-center study enrolled 530 patients (mean age 67.6±9.8 years; 396 men) undergoing endovascular procedures between August 2016 and July 2018 for chronic PAD. Primary endpoints were the incidence of 30-day bleeding complications [minor and major (prolonging hospitalization, causing permanent sequelae, or resulting in death)], the identification of factors associated with bleeding events, and the development of a dedicated PBS based on univariate and multivariate analysis. Hazard ratios (HR) and 95% confidence intervals (CI) are reported. The HAS-BLED score was compared with the PBS. Results: The overall peripheral bleeding complication rate was 3.8% (20/530), of which 3.2% (17/530) were major and included 4 (0.7%) active retroperitoneal bleeding events and 13 (2.4%) pseudoaneurysms. The annualized incidences of overall bleeding and major bleeding complications were 1.9% and 1.6%, respectively. Multivariable regression analysis identified age ≥75 as a correlate of significantly increased bleeding risk (HR 3.32, 95% CI 1.12 to 9.80, p<0.02). Male gender (HR 0.193, 95% CI 0.49 to 0.75, p<0.001) and statin therapy (HR 0.245, 95% CI 0.08 to 0.71, p=0.01) were correlated with a significantly decreased bleeding risk. Based on the regression analysis findings an 8-point PBS was developed, demonstrating 75.0% sensitivity and 78.4% specificity in detecting bleeding complications. The HAS-BLED score failed to identify 30-day bleeding events. Conclusion: The annualized incidence of bleeding complications associated with peripheral EVT was low. Advanced age and female sex were correlated with increased bleeding risk. The PBS demonstrated satisfactory statistical performance and could be considered for inclusion in the preprocedural endovascular checklist to help optimize intra- and postprocedural care.
Performance of BeGraft and BeGraft+ Stent-Grafts as Bridging Devices for Fenestrated Endovascular Aneurysm Repair: An In Vitro Study
Authors: Torsello Giovanni Federico , Herten Monika , Frank André , Müller Markus , Jung Susanne , Torsello Giovanni B. , Austermann Martin
Published: August 2019

Purpose: To investigate 2 generations of balloon-expandable covered stents as potential bridging devices using an in vitro model of stent-graft fenestrations. Materials and Methods: Twenty BeGraft and 20 BeGraft+ cobalt-chromium stents covered in expanded polytetrafluoroethylene (ePTFE) in 6- and 8-mm diameters were tested in sheets mimicking stent-graft fenestrations. Microscopy and radiography were employed to evaluate stent morphology after flaring. In vitro bench tests measured maximum pullout (perpendicular displacement) and the shear stress (axial displacement) forces needed to dislocate the stents. Results: No alteration of ePTFE coverage was detected in the flared stents. Digital radiography and computed tomography showed marked alteration of the stent geometry, which was more pronounced in the BeGraft group. No fractures were detected. Median (minimum–maximum) pullout forces for the 6-mm stent-grafts were 17.1 N (15.8–19.6) for the BeGraft device and 30.4 N (20.2–31.9) for the BeGraft+ device (p=0.006). Median (minimum–maximum) pullout forces for the 8-mm stent-grafts were 11.3 N (11–12.1) for the BeGraft device and 21.8 N (18.2–25.5) for the BeGraft+ device (p<0.001). The shear stress test showed median forces of 10.5 vs 15.28 N at 150% of the stent diameter for the 6-mm BeGraft and BeGraft+ stent-grafts, respectively, and 15.23 vs 20.72 N at 150% stent diameter for the 8-mm models (p=0.016 and 0.017, respectively). Conclusion: Flaring changed the stent geometry but did not provoke stent fractures. The BeGraft+ is superior to the BeGraft in terms of pullout and shear stress forces, demonstrating greater resilience.
Researchers’ Perspectives on Informed Consent and Ethical Review of Biobank Research in South Africa: A Cross-Sectional Study
Authors: Mwaka Erisa , Horn Lyn
Published: August 2019

There is limited literature on the opinions and perspectives of researchers on the ethical issues in biobank research in South Africa. This study aimed to explore researchers’ perspectives on informed consent and ethical review of biobank research in South Africa. An online survey was conducted among researchers and scientists at Stellenbosch University and the University of Kwazulu-Natal. The majority of researchers opined that broad consent is appropriate for biobank research. However, there was no consensus on the necessity for re-consent. Researchers were also in agreement that issues concerning informed consent and future use of samples require thorough discussions during the ethical review process. Overall, the attitude of researchers on informed consent and ethical review of biobank research was positive and ethically informed.
An Innovative Three-Step Method for Identifying Exemplars
Authors: Etz Rebecca S. , Gonzalez Martha M. , Crabtree Benjamin F. , Reves Sarah R. , Stange Kurt C.
Published: August 2019

Purpose:

To improve practices in rapidly changing environments, it is helpful to learn from relevant innovators. This article describes a well-defined and adaptable method for discovering innovative cases that inform best practices or positive/negative deviant research.

Methods:

As part of a national study of innovation in primary care settings, we developed a three-step method for identifying exemplar practices and applied that method to finding a sample of relevant innovators for in-depth case studies from which to draw transportable lessons about improving primary care practice.

Results:

Relevant, information-rich cases are uncovered using cycles of identification, sampling, and assessment. This cycle is repeated at each step of the defined three-step method. Step 1, a scan of the published literature, assesses both the state-of-the-art and the baseline characteristics of relevant cases; Step 2, a scan of practice settings, draws upon the expert knowledge of key informants to identify additional potentially relevant cases; and Step 3, sample refinement, evaluates potential cases for eligibility, purposeful diversity, and information-rich expressions of defined key domains. Using this three-step method, we identified a national cohort of primary care practice innovators. We found the method to be feasible, practical, and highly successful at identifying information-rich practices from which to draw transportable lessons about practice innovation.

Conclusions:

The three-step method outlines an effective sampling strategy for identifying innovation exemplars and information-rich cases that exceed measures of central tendency. By leveraging the collective knowledge of innovators, this method can support dynamic research and foster rapid cycle learning.
miR-142-3p as a novel biomarker for predicting poor prognosis in renal cell carcinoma patients after surgery
Authors: Peng Xiqi , Pan Xiang , Liu Kaihao , Zhang Chunduo , Zhao Liwen , Li Hang , Guan Xin , Xu Weijie , Xu Jinling , Zhang Fangting , Lai Yongqing
Published: August 2019

Background:

miR-142-3p has proved to be involved in tumorigenesis and the development of renal cell carcinoma. The present study aimed to explore the prognostic value of miR-142-3p.

Methods:

Total RNA was extracted from renal cell carcinoma specimens and the expression level of miR-142-3p was measured. Pearson Chi-square test, Kaplan–Meier analysis, as well as univariate and multivariate regression analysis were performed to determine the correlation between miR-142-3p and the prognosis of renal cell carcinoma patients. Receiver operating characteristic curves were constructed to evaluate the predictive efficiency of miR-142-3p for the prognosis of renal cell carcinoma patients. Data from The Cancer Genome Atlas (TCGA) were utilized to validate our findings.

Results:

Our results demonstrated that upregulation of miR-142-3p was correlated with shorter overall survival (P=0.002) and was, in the meantime, an independent prognostic factor for renal cell carcinoma patients (P=0.002). The receiver operating characteristic curve combining miR-142-3p expression with tumor stage showed an area under the curve of 0.633 (95% confidence interval 0.563, 0.702). The result of TCGA data was consistent with our findings.

Conclusions:

Our results suggest miR-142-3p expression is correlated with poor prognosis of renal cell carcinoma patients and may serve as a prognostic biomarker in the future.
Adjustable compliance soft gripper system
Authors: Sârbu F , Deaconescu A , Deaconescu T
Published: August 2019

This article proposes a novel, innovative, soft gripper system developed for the manipulation of objects of unknown or unspecified shape and consistence. This could be achieved by the utilization of a linear pneumatic muscle benefitting from an inherently compliant behaviour. A gripper system of this type does not require the presence of sensors or complex controllers, as it is the mechanical system itself that provides the required adaptive behaviour. The compliance of the system is ensured by the variations of the air pressure fed to the pneumatic muscle, monitored and controlled in a closed loop by means of proportional pressure regulator.
Benefit of Digital Tools Used for Integrated Personalized Diabetes Management: Results From the PDM-ProValue Study Program
Authors: Heinemann Lutz , Schramm Wendelin , Koenig Helena , Moritz Annette , Vesper Iris , Weissmann Joerg , Kulzer Bernhard
Published: August 2019

Background:

Integrated personalized diabetes management (iPDM) is a digitally supported therapeutic concept to improve patient-physician interaction to overcome the aspects of clinical inertia. Integrated personalized diabetes management can support decision making and improve therapeutic outcomes of suboptimally controlled persons with insulin-treated type 2 diabetes (T2D). In this paper, we report the results of an analysis of the PDM-ProValue study program on the effectiveness and perceived benefit of this approach, with a focus on how physicians used and assessed the digital tools provided for the iPDM process.

Materials and Methods:

The study program included two 12-month, prospective, controlled, cluster-randomized multicenter trials. A total of 101 practices participated with 907 patients. Practices were cluster-randomized to an intervention group and a control group. Digital tools for data visualization and analysis applied were used. HCP were asked to assess the use, relevance, and usefulness of the tools.

Results:

A clear preference was stated for the visual overview over more statistically complex analyses. A total of 83% of the participants rated a high relevance of the “daily profile,” 81% of the “total profile,” and 68% the “risk illustrated by traffic light symbols” for the therapy decision. The overall iPDM process was very favorably rated with respect to structuredness and potential for personalized treatment and well accepted among health care professionals (HCP).

Conclusions:

Embedding digital tools in a structured process (iPDM) were proved to provide a benefit for insulin-treated T2D patients and their physicians. These results offer insight for further development and improvement of the tools and add information on how to overcome clinical inertia.
Enhancing the out-of-plane behaviour of unreinforced masonry walls under impact loading through the use of partially bonded layers of engineered cementitious composite
Authors: Pourfalah Saeed , Cotsovos Demetrios M
Published: August 2019

Published experimental work reveals that the out-of-plane behaviour of unreinforced masonry walls under impact loading can be significantly enhanced through the use of engineered cementitious composite layers fully bonded to the surface of the masonry. The disadvantage of this method is associated with the localised cracking exhibited by the engineered cementitious composite layer close to the joints forming between bricks. This cracking is associated with the bond developing between the masonry and the engineered cementitious composite layer and does not allow the latter layer to achieve its full potential, thus resulting in its premature failure. In an attempt to address this problem, a series of drop-weight tests were carried on masonry prismatic specimens strengthened with a layer of engineered cementitious composite partially bonded to the surface of the masonry acting in tension. The latter prismatic specimens consist of a stack of bricks connected with mortar joints. The specimens are considered to provide a simplistic representation of a vertical strip of a masonry wall subjected to out-of-plane actions associated with impact or blast loading. Analysis of the test data reveals that under impact loading, the specimens retrofitted with partially bonded engineered cementitious composite layers can exhibit a more ductile performance compared to that exhibited by the same specimens when strengthened with fully bonded layers of engineered cementitious composite. This is attributed to the fact that along its unbonded length, the engineered cementitious composite layer is subjected to purely uniaxial tension (free from any interaction with the surface of the masonry), allowing for the development of multiple uniformly distributed fine cracks.
Cutaneous Crohn’s disease of the vulva after a total colectomy and without gastrointestinal manifestations: A case report
Authors: Bohdanowicz Michal , Ghazarian Danny , Rosen Cheryl F.
Published: August 2019

Crohn’s disease has many cutaneous manifestations. We report a case of a 54-year-old woman, who had non-contiguous vulvar Crohn’s disease despite a total colectomy and the absence of gastrointestinal Crohn’s disease on ileoscopy.
Effect of Muscle Quality on Operative and Nonoperative Treatment of Rotator Cuff Tears
Authors: Naimark Micah , Trinh Thai , Robbins Christopher , Rodoni Bridger , Carpenter James , Bedi Asheesh , Miller Bruce
Published: August 2019

Background:

Rotator cuff muscle atrophy and fatty infiltration are predictors of negative outcomes after rotator cuff repair. However, the impact of muscle degeneration on nonsurgical treatment is unknown.

Hypothesis:

Rotator cuff muscle atrophy and fatty infiltration will reduce the outcomes of operative repair while having a minimal effect on nonsurgical treatment. Additionally, in the setting of atrophy and fatty infiltration, surgical and nonsurgical treatment will produce equivalent outcomes.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients undergoing operative and nonoperative treatment of full-thickness rotator cuff tears were prospectively enrolled into a nonrandomized cohort study. Muscle quality was assessed on magnetic resonance imaging by use of the supraspinatus tangent sign, Warner atrophy, and Goutallier fatty infiltration classifications. Grading was performed by 2 independent observers who were blinded to patient treatment and outcomes. Normalized Western Ontario Rotator Cuff (WORC) index was the primary patient-reported outcome. Multivariate linear regression analysis was used to determine the impact of muscle quality on treatment outcomes.

Results:

The cohort consisted of 157 patients, 89 (57%) surgical and 68 (43%) nonsurgical, with a mean follow-up of 2.4 years (range, 1-5 years). Tangent sign had the best inter- and intrarater reliability, with kappa statistics of 0.81 and 0.86, respectively. Reliability for Warner atrophy was 0.69 to 0.76 and for Goutallier classification was 0.54 to 0.64. Overall, improvement in WORC scores was higher in the surgical group than the nonsurgical group (39.3 vs 21.2; P < .001). A positive tangent sign was the only independent predictor ( P < .01) of worse outcomes in the surgical group, accounting for an estimated 22-point lower improvement in WORC scores.

Conclusion:

A positive tangent sign was predictive of worse operative outcomes, resulting in equivalent improvements between surgical and nonsurgical treatment. The tangent sign is a reliable, prognostic indicator that clinicians can use when counseling patients on the optimal treatment of rotator cuff tears.
Globalisation, Economic Growth, and Spillovers: A Spatial Analysis
Authors: Ahmad Mahyudin
Published: August 2019

This article seeks to deepen our understanding of the globalisation–growth nexus as it extends the investigation to using a spatial econometric approach, hitherto rarely used in the globalisation literature. The objective of the article is to uncover not only the significant growth effects of globalisation but also its possible spillover effects onto neighbouring countries. Using a panel data set of 83 countries across a 30-year period and via a spatial autoregressive panel data method, this article estimates a standard growth model augmented with a parameter to capture the countries’ spatial dependence, whilst controlling for globalisation indices. The findings indicate a positive effect of economic globalisation, which is dependent upon the political settings in the countries under study. The spillover effects of globalisation across neighbouring countries are shown, both in geographical and institutional spheres. The article concludes with some policy recommendations.

JEL: F63, C31
Training to Proficiency in the WHO Hand Hygiene Technique
Authors: Lacey Gerard , Showstark Mary , Van Rhee James
Published: August 2019

Objectives:

Hand hygiene is critical to patient safety, but low performance in terms of the quantity and quality of hand hygiene is often reported. Training-to-proficiency is common for other clinical skills, but no proficiency-based training program for hand hygiene has been reported in the literature. This study developed a proficiency-based training program to improve hand hygiene quality in line with World Health Organization (WHO) guidelines and assessed the amount of training required to reach proficiency. The training was delivered as part of a 5-day induction for students on the Physician Assistant online program.

Methods:

A total of 42 students used a simulator to objectively measure hand hygiene technique over a 5-day period. Proficiency was achieved when students demonstrated all 6 steps of the WHO technique in less than 42 seconds. The students also completed a postintervention questionnaire.

Results:

The average training episode lasted 2.5 minutes and consisted of 4.5 hand hygiene exercises. The average student completed 5 training episodes (1 per day) taking a total of 17 minutes. A total of 40% (17) of the students achieved proficiency within the 5 days. Proficiency was strongly correlated with the number of training exercises completed ( r = 0.79, P < .001) and the total time spent training ( r = 0.75, P < .001). Linear regression predicted that the 32 hand hygiene exercises or a total of 23-minute training were required to achieve proficiency.

Conclusions:

This is the first study to develop a train-to-proficiency program for hand hygiene quality and estimate the amount of training required. Given the importance of hand hygiene quality to preventing health care–associated infections (HAIs), medical education programs should consider using proficiency-based training in hand hygiene technique.
Fiscal principles for self-organizing cities
Authors: Minola Luca A , Foldvary Fred E , Andersson David E
Published: August 2019

In ‘ Self-organizing’ cities, decisions are based on the unhampered, peaceful, and honest choices of individuals, and governance, aside from penalizing coercive harm, is based on voluntary agreements. Self-organization has become an increasingly important topic in planning theory, as such processes enable urban systems to more effectively adapt to various stimuli and contextual needs over time. Self-organization may lead to emergent spatial configurations that are more in tune with individuals’ values and preferences than the prevailing top-down approaches. The purpose of this article is to analyse how current tax systems impede emergent spatial configurations and, additionally, to explore what kind of fiscal rules and instruments are more supportive of creative (i.e. dynamically productive) processes of self-organization. The main finding is that the use of behavioural rules (such as contractual covenants and easements) and principles of taxation that do not distort the decentralized creation of value, such as user fees, congestion charges, and repayment of rental value received such as land value taxation, are superior to currently dominant approaches.
Climate-smart Agriculture, Productivity and Food Security in India
Authors: Ghosh Madhusudan
Published: August 2019

This article evaluates the importance of climate-smart agriculture (CSA) in promoting sustainable agricultural development and ensuring food security and mitigating the negative impacts of climatic changes on agricultural productivity in India. A range of CSA technologies, practices and services have been initiated in climate-smart villages as adaptation strategies for coping with climate risks to ensure stability and sustainability in agricultural production. The farmers using CSA adaptation strategies were found to have achieved higher output, yield and return compared to those who did not. There are exciting opportunities for scaling out and immense potentials of these strategies for enhancing crop yields and farm incomes and reducing greenhouse gas emissions. Strengthening agricultural extension service and agricultural finance to achieve smart farming practices/technologies by linking climate finance to traditional agricultural finance could play a significant role in scaling out the CSA practices and technologies to make agriculture more sustainable and climate-resilient and a viable source of livelihood and food security for millions of farmers in the country. Zero budget natural farming as a climate-resilient farming system can enhance food and nutritional security, enabling farmers to improve soil fertility and yields through lower costs, risk and irrigation requirements, thus protecting the ecosystem by improving soil organic matter, water retention and biodiversity and reducing air and water pollution as well as greenhouse gas emissions.
Cost‐effectiveness of Preoperative Staphylococcus aureus Screening and Decolonization in Cochlear Implantation
Authors: Kirchner Gregory J. , Ghazaryan Hovhannes , Lieber Alexander M. , Sunkerneni Anisha Reddy , McKinnon Brian J.
Published: August 2019

Objective

Infection following cochlear implantation is medically and economically devastating. The cost‐effectiveness (CE) of colonization screening and decolonization for infection prophylaxis in cochlear implantation has not been examined.

Study Design

An analytic observational study of data collected from purchasing records and the literature.

Methods

Costs of Staphylococcus aureus colonization screening and decolonization were acquired from purchasing records and the literature. Infection rates after cochlear implantation and average total costs for evaluation and treatment were obtained from a review of the literature. A break‐even analysis was performed to determine the required absolute risk reduction (ARR) in infection rate to make colonization screening or decolonization CE.

Results

Nasal screening ($144.07) is CE if the initial infection rate (1.7%) had an ARR of 0.60%. Decolonization with 2% intranasal mupirocin ointment ($5.09) was CE (ARR, 0.02%). A combined decolonization technique (2% intranasal mupirocin ointment, chlorhexidine wipes, chlorhexidine shower, and prophylactic vancomycin: $37.57) was CE (ARR, 0.16%). Varying infection rate as high as 15% demonstrated that CE did not change by maintaining an ARR of 0.16%. CE of the most expensive decolonization protocol was enhanced as the cost of infection treatment increased, with an ARR of 0.03% at $125,000.

Conclusions

Prophylactic S aureus decolonization techniques can be CE for preventing infection following cochlear implantation. Decolonization with mupirocin is economically justified if it prevents at least 1 infection out of 5000 implants. S aureus colonization screening needed high reductions in infection rate to be CE.
PHF19 promotes multiple myeloma tumorigenicity through PRC2 activation and broad H3K27me3 domain formation
Authors: Ren Zhihong , Ahn Jeong Hyun , Liu Hequn , Tsai Yi-Hsuan , Bhanu Natarajan V. , Koss Brian , Allison David F. , Ma Anqi , Storey Aaron J. , Wang Ping , Mackintosh Samuel G. , Edmondson Ricky D. , Groen Richard W. J. , Martens Anton C. , Garcia Benjamin A. , Tackett Alan J. , Jin Jian , Cai Ling , Zheng Deyou , Wang Gang Greg
Published: August 2019

Polycomb repressive complex 2 (PRC2) dysregulation is associated with proliferation of hematological malignancies. Ren et al elucidate the mechanisms of PRC2 in multiple myeloma (MM), demonstrating that malignant progression of MM is associated with overexpression of PHF19, a PRC2-associated factor that enhances its gene-regulatory function.
A case report of a primary lymphoma of the tongue presenting as trigeminal neuralgia
Authors: Arifin Andrew J. , Lam Selay , MacNeil S. Danielle
Published: August 2019

Background

Primary lymphoma of the oral cavity is a rare phenomenon. Herein we describe a unique presentation of lymphoma of the tongue which initially manifested as trigeminal neuralgia.

Case presentation

A 63-year-old female experienced a 10-month history of paresthesia and neuropathic pain involving the left tongue and mandibular area of her face. Investigations including imaging and biopsy revealed primary lymphoma of the tongue with extensive perineural spread. The patient underwent standard chemotherapy with complete radiological response, but minimal recovery of the affected neurological functions.

Conclusion

This case highlights an unusual presentation of a rare disease leading to a delay in diagnosis and the importance of a complete workup for trigeminal neuropathy.
Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Clinical Practice Guideline Update
Authors: Key Nigel S. , Khorana Alok A. , Kuderer Nicole M. , Bohlke Kari , Lee Agnes Y.Y. , Arcelus Juan I. , Wong Sandra L. , Balaban Edward P. , Flowers Christopher R. , Francis Charles W. , Gates Leigh E. , Kakkar Ajay K. , Levine Mark N. , Liebman Howard A. , Tempero Margaret A. , Lyman Gary H. , Falanga Anna
Published: August 2019

PURPOSE

To provide updated recommendations about prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer.

METHODS

PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs published from August 1, 2014, through December 4, 2018. ASCO convened an Expert Panel to review the evidence and revise previous recommendations as needed.

RESULTS

The systematic review included 35 publications on VTE prophylaxis and treatment and 18 publications on VTE risk assessment. Two RCTs of direct oral anticoagulants (DOACs) for the treatment of VTE in patients with cancer reported that edoxaban and rivaroxaban are effective but are linked with a higher risk of bleeding compared with low-molecular-weight heparin (LMWH) in patients with GI and potentially genitourinary cancers. Two additional RCTs reported on DOACs for thromboprophylaxis in ambulatory patients with cancer at increased risk of VTE.

RECOMMENDATIONS

Changes to previous recommendations: Clinicians may offer thromboprophylaxis with apixaban, rivaroxaban, or LMWH to selected high-risk outpatients with cancer; rivaroxaban and edoxaban have been added as options for VTE treatment; patients with brain metastases are now addressed in the VTE treatment section; and the recommendation regarding long-term postoperative LMWH has been expanded. Re-affirmed recommendations: Most hospitalized patients with cancer and an acute medical condition require thromboprophylaxis throughout hospitalization. Thromboprophylaxis is not routinely recommended for all outpatients with cancer. Patients undergoing major cancer surgery should receive prophylaxis starting before surgery and continuing for at least 7 to 10 days. Patients with cancer should be periodically assessed for VTE risk, and oncology professionals should provide patient education about the signs and symptoms of VTE. Additional information is available at www.asco.org/supportive-care-guidelines .
Single-Lumen Endotracheal Tube and Bronchial Blocker for Airway Management During Tracheobronchoplasty for Tracheobronchomalacia: A Case Report
Authors: Lui Natalie S. , Guo Haiwei Henry , Sung Arthur W. , Peterson Ashley , Kulkarni Vivekanand N.
Published: August 2019

We present a case of a 69-year-old man who underwent tracheobronchoplasty for tracheobronchomalacia using a single-lumen endotracheal tube and a Y-shaped bronchial blocker for airway management. Tracheobronchoplasty is performed by sewing mesh to plicate the posterior, membranous wall of the distal trachea and main bronchi through a right posterolateral thoracotomy. The goals of airway management include continuous left-lung ventilation and lung protection from aspiration. Ideally, only conventional airway management tools are used. This case demonstrates that a single-lumen endotracheal tube with a bronchial blocker can be a straightforward strategy for airway management during tracheobronchoplasty.
Wishful Landscapes
Authors: Shaindlinger Noa
Published: August 2019

The article, based on two years of fieldwork, examines the meaning of displacement for Palestinian citizens of Israel who live in Jaffa. Specifically, it focuses on one key site, the Clock Tower Square, historically a hub of Palestinian urban economy. The discussion follows a group of local Palestinian activists who consciously chose the square to stage protests, thus reclaiming Arab Jaffa's material heritage and directly challenging recent histories of spatial expropriation by the Israeli state, the Tel Aviv municipality, and real estate developers. The analysis below also proposes a multiscalar understanding of these protests as a reclamation of Jaffa's Arab heritage as well as an act of remapping the nation and its colonized homeland. In this sense, the Clock Tower Square activists produce “wishful landscapes” that work to undermine the colonizer's project of normalizing occupation.
Legal History between the Humanities and Social Sciences
Authors: Stephens Julia
Published: August 2019

This Kitabkhana contribution situates Beshara Doumani's Family Life in the Ottoman Mediterranean: A Social History within recent trends in the field of legal history. Doumani's hybrid method, which combines quantitative analysis with qualitative case studies, presents a particularly fruitful model for new work in the field.
Sharia and Kinship in the Ottoman Eastern Mediterranean
Authors: Moumtaz Nada
Published: August 2019

This essay engages Beshara Doumani's Family Life in the Ottoman Mediterranean. It highlights Doumani's significant deconstruction of the culturalist assumptions of the category of the Arabor Muslim family. Based on the wealth of the archive uncovered by Doumani, the essay calls for further engagement with the Islamic legal tradition in the analysis of sharia court records in order to better understand the relation between state, law, and community. Finally, it elaborates on Doumani's important contributions to the anthropology of kinship.
Interactions among ryanodine receptor isotypes contribute to muscle fiber type development and function
Authors: Chagovetz Alexis A. , Klatt Shaw Dana , Ritchie Erin , Hoshijima Kazuyuki , Grunwald David J.
Published: August 2019

Mutations affecting ryanodine receptor (RyR) calcium release channels commonly underlie congenital myopathies. Although these channels are known principally for their essential roles in muscle contractility, mutations in the human RYR1 gene result in a broad spectrum of phenotypes, including muscle weakness, altered proportions of fiber types, anomalous muscle fibers with cores or centrally placed nuclei, and dysmorphic craniofacial features. Currently, it is unknown which phenotypes directly reflect requirements for RyRs and which result secondarily to aberrant muscle function. To identify biological processes requiring RyR function, skeletal muscle development was analyzed in zebrafish embryos harboring protein-null mutations. RyR channels contribute to both muscle fiber development and function. Loss of some RyRs had modest effects, altering muscle fiber-type specification in the embryo without compromising viability. In addition, each RyR-encoding gene contributed to normal swimming behavior and muscle function. The RyR channels do not function in a simple additive manner. For example, although isoform RyR1a is sufficient for muscle contraction in the absence of RyR1b, RyR1a normally attenuates the activity of the co-expressed RyR1b channel in slow muscle. RyR3 also acts to modify the functions of other RyR channels. Furthermore, diminished RyR-dependent contractility affects both muscle fiber maturation and craniofacial development. These findings help to explain some of the heterogeneity of phenotypes that accompany RyR1 mutations in humans.
Mast cells enhance sterile inflammation in chronic nonbacterial osteomyelitis
Authors: Young Stephanie , Sharma Namit , Lee Jae Hoon , Chitu Violeta , Neumeister Volker , Sohr Elisabeth , Stanley E. Richard , Hedrich Christian M. , Craig Andrew W. B.
Published: August 2019

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease, and patients with active or recurrent bone inflammation at multiple sites are diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). The Chronic multifocal osteomyelitis (CMO) mouse model develops IL-1β-driven sterile bone lesions reminiscent of severe CRMO. The goal of this study was to evaluate the potential involvement of mast cells in CMO/CRMO. Here, we show that mast cells accumulate in inflamed tissues from CMO mice and that mast cell protease Mcpt1 can be detected in the peripheral blood. A transgenic model of connective tissue mast cell depletion (Mcpt5-Cre:Rosa26-Stopfl/fl-DTa) was crossed with CMO mice and the resulting mice (referred to as CMO/MC–) showed a significant delay in disease onset compared with age-matched CMO mice. At 5-6 months of age, CMO/MC– mice had fewer bone lesions and immune infiltration in the popliteal lymph nodes that drain the affected tissues. In bone marrow-derived mast cell cultures from CMO mice, cytokine production in response to the alarmin IL-33 was elevated compared with wild-type cultures. To test the relevance of mast cells to human CRMO, we tested serum samples from a cohort of healthy controls and from CRMO patients at diagnosis. Interestingly, mast cell chymase was elevated in CRMO patients as well as in patients with oligoarticular juvenile arthritis. Tryptase-positive mast cells were also detected in bone lesions from CRMO patients and patients with bacterial osteomyelitis. Together, our results identify mast cells as cellular contributors to bone inflammation in CMO/CRMO and provide rationale for further study of mast cells as therapeutic targets.
Vascular regression precedes motor neuron loss in the FUS (1-359) ALS mouse model
Authors: Crivello Martin , Hogg Marion C. , Jirström Elisabeth , Halang Luise , Woods Ina , Rayner Megan , Coughlan Karen S. , Lewandowski Sebastian A. , Prehn Jochen H. M.
Published: August 2019

Amyotrophic lateral sclerosis (ALS) presents a poorly understood pathogenesis. Evidence from patients and mutant SOD1 mouse models suggests vascular damage may precede or aggravate motor dysfunction in ALS. We have previously shown angiogenin (ANG) treatment enhances motor neuron survival, delays motor dysfunction and prevents vascular regression in the SOD1G93A ALS model. However, the existence of vascular defects at different stages of disease progression remains to be established in other ALS models. Here, we assessed vascular integrity in vivo throughout different disease stages, and investigated whether ANG treatment reverses vascular regression and prolongs motor neuron survival in the FUS (1-359) mouse model of ALS. Lumbar spinal cord tissue was collected from FUS (1-359) and non-transgenic control mice at postnatal day (P)50, P90 and P120. We found a significant decrease in vascular network density in lumbar spinal cords from FUS (1-359) mice by day 90, at which point motor neuron numbers were unaffected. ANG treatment did not affect survival or counter vascular regression. Endogenous Ang1 and Vegf expression were unchanged at P50 and P90; however, we found a significant decrease in miRNA 126 at P50, indicating vascular integrity in FUS mice may be compromised via an alternative pathway. Our study demonstrates that vascular regression occurs before motor neuron degeneration in FUS (1-359) mice, and highlights that heterogeneity in responses to novel ALS therapeutics can already be detected in preclinical mouse models of ALS.

This article has an associated First Person interview with the joint first authors of the paper.
Assessment of adeno-associated virus gene therapies efficacy on acid alpha-glucosidase restoration and glycogen
storage correction in cardiac muscle of Pompe disease mice using synchrotron infrared and ultraviolet
microspectroscopies
Authors: Dubreil Laurence , Lagalice Lydie , Deniaud Johan , Sabourin Antoine , Lovo Claire , Bey Karim , Hordeaux Juliette , Thorin Chantal , Sandt Christophe , Jamme Frédéric , Colle Marie-Anne
Published: August 2019

Pompe disease (glycogen storage disease type II) is a lysosomal storage disorder due to a mutation in the gene
that encodes acid alpha-glucosidase (GAA). GAA deficiency causes the excessive storage of lysosomal glycogen in
many cell types, leading to cell and, subsequently, tissue dysfunction. Cardiac, respiratory and skeletal muscles are the
most severely affected. Enzyme replacement therapy (ERT) with recombinant human GAA (rhGAA, Myozyme®, Genzyme,
Cambridge) is the only approved treatment for Pompe disease. A new therapeutic strategy was developed consisting of
delivering adeno-associated virus serotype 9 (AAV9) and serotype 10 (AAV10) vectors expressing human GAA into
cerebrospinal fluid of GAA-KO 6neo/6neo Pompe mice. The purpose of this work was to investigate synchrotron Fourier
transform infrared (sFT-IR) and deep ultraviolet (sDUV) microspectroscopies to detect new biomarkers of the disease and
the AAV gene therapy in the cardiac muscle, one of the most affected organs in Pompe disease. Multivariate statistics
applied to sFT-IR spectra between 4000 cm–1 and 950 cm–1 highlighted the potential of sFT-IR to discriminate Pompe (-/-),
Wild type and AAV-treated animals from C–H stretching vibrations of CH3, from C–O, C–N and C–C stretching vibrations of
amide I, II, III bands and from specific IR signature of the glycogen. Investigations performed by sDUV microscopy showed
a significant increase of the tryptophan autofluorescent signal in the right ventricle for the AAV9-treated Pompe mice. The
high-resolution sDUV microspectroscopy experiments suggested a correlation between the tryptophan-rich area and the
GAA-rich area. These unprecedented results demonstrate that high-resolution UV microspectroscopy can be a
complementary innovative approach to monitor the chemical change in label-free cardiac muscle section. Moreover, this
non-destructive technology can be applied to a small amount of tissue allowing therapeutic assessment from biopsy of
human patients.
Identification of a noncanonical RNA binding domain in the U2 snRNP protein SF3A1
Authors: Martelly William , Fellows Bernice , Senior Kristen , Marlowe Tim , Sharma Shalini
Published: August 2019

During splicing of pre-mRNA, 5′ and 3′ splice sites are brought within proximity by interactions between the pre-mRNA bound U1 and U2 snRNPs, followed by recruitment of the tri-snRNP for assembly of the mature spliceosome. Previously, we identified an interaction between the U2 snRNP-specific protein SF3A1 and the stem–loop 4 (SL4) of the U1 snRNA that occurs during the early steps of spliceosome assembly. Although harboring many annotated domains, SF3A1 lacks a canonical RNA binding domain. To identify the U1-SL4 binding region in SF3A1, we expressed amino- and carboxy-terminal deletion constructs using a HeLa cell-based cell free expression system. UV-crosslinking of the truncated proteins with 32P-U1-SL4 RNA identified the carboxy-terminal ubiquitin-like (UBL) domain of SF3A1 as the RNA binding region. Characterization of the interaction between SF3A1-UBL and U1-SL4 by electrophoretic mobility shift assay and surface plasmon resonance determined high binding affinity (KD = ∼97 nM), and revealed the double-stranded G-C rich stem of U1-SL4 as an important feature for binding to the UBL domain. Further, mutations of two conserved tyrosine residues, Y772 and Y773, were found to cause a two- and fivefold decrease in the binding affinity for U1-SL4, respectively. Finally, we found that SF3A1-UBL can specifically pull down the U1 snRNP from HeLa nuclear extract, demonstrating its capacity to bind U1-SL4 in the context of the intact snRNP. Thus, the data show that the UBL domain of SF3A1 can function as an RNA binding domain and that mutations in this region may interfere with U1-SL4 binding.
Oral labetalol versus oral nifedipine for the management of postpartum hypertension a randomized control trial
Authors: Ainuddin Jahanara , Javed Fariha , Kazi Sarah
Published: August 2019

Objective: To compare the efficacy of oral Labetalol versus oral Nifedipine for the treatment of postpartum hypertension.

Methods: A prospective randomized controlled trial with parallel assignment was conducted in the department of Obstetrics and Gynecology, Dow University of Health Sciences Karachi, Pakistan, 124 patients with post partum hypertension were selected and randomized into two groups with 62 patients receiving Labetalol and 62 receiving long acting nifedipine. Initial blood pressures were recorded, and the respective drug was administered. Dose adjustments were performed in the initial 24 hours. The outcome was measured in the form of drug efficacy by lowering of systolic blood pressure less than 140mm of Hg and diastolic less than 90mm of Hg up to 48 hours after starting treatment. Data was entered and analyzed through SPSS version 20.

Results: Our study randomized 62 women to oral labetalol and 62 women to oral long acting nifedipine. The time required to achieve blood pressure control was 35.6±2.8 hours in labetalol group and 30.4±1.9 hours in nifedipine group (p=0.04).length of hospital stay, need of additional antihypertensive medications were same in both groups. Minor side effects were observed more in nifedipine group.

Conclusion: We conclude that both oral labetalol and oral long acting nifedipine are effective and well tolerated interventions for the management of post-partum hypertension. However we found Nifidipine more effective in the management of postpartum hypertension.

doi: https://doi.org/10.12669/pjms.35.5.812

How to cite this:Ainuddin J, Javed F, Kazi S. Oral labetalol versus oral nifedipine for the management of postpartum hypertension a randomized control trial. Pak J Med Sci. 2019;35(5):1428-1433. doi: https://doi.org/10.12669/pjms.35.5.812

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
On the evaluation of research software: the CDUR procedure
Authors: Gomez-Diaz Teresa , Recio Tomas
Published: August 2019

Background:Evaluation of the quality of research software is a challenging and relevant issue, still not sufficiently addressed by the scientific community.

Methods:Our contribution begins by defining, precisely but widely enough, the notions of research software and of its authors followed by a study of the evaluation issues, as the basis for the proposition of a sound assessment protocol: the CDUR procedure.

Results:CDUR comprises four steps introduced as follows:Citation, to deal with correct RS identification,Dissemination, to measure good dissemination practices,Use, devoted to the evaluation of usability aspects, andResearch, to assess the impact of the scientific work.

Conclusions:Some conclusions and recommendations are finally included. The evaluation of research is the keystone to boost the evolution of the Open Science policies and practices.  It is as well our belief that research software evaluation is a fundamental step to induce better research software practices and, thus, a step towards more efficient science.
Reducing Capital Market Anomaly: The Role of Information Technology Using an Information Uncertainty Lens
Authors: Jia Ning , Rai Arun , Xu Sean Xin
Published: August 2019

We investigate how firms use information technology (IT) implementation to mitigate an anomaly in capital markets: investors underreacting to new public information. The theory of information uncertainty (IU) suggests that the anomaly is amplified with IU; that is, with ambiguity in information about firm value. We theorize that a firm’s IT in general—and enterprise systems (ES) in particular—can mitigate IU, thus reducing the IU-induced underreaction anomaly. Based on a difference-in-differences analysis of a sample of 572 ES implementations, our main finding is that ES implementation does reduce IU-induced underreaction anomaly. This is achieved through a reduction in the firm’s fundamentals volatility and an improvement in information quality. We also find that firms with greater IT capability are better positioned to realize the anomaly-reducing benefits of ES implementation and that ES’s anomaly-reducing effect is most pronounced when high levels of both functional and operational ES modules are implemented. We obtain remarkably consistent results when using alternate empirical design, samples, and measures of news. Such IT impacts are economically highly consequential because they improve capital market efficiency.

This paper was accepted by Anandhi Bharadwaj, information systems.