bluuebunny/crossref_metadata_2025 huggingface dataset:
Mutational status and thromboembolic risk in lung, gastrointestinal and breast cancer patients.
Authors: Platania Marco , Nichetti Federico , De Braud Filippo G.
Published: May 2019

e23147

Background: Cancer-Associated Thrombosis (CAT) is one of the most threatening complications of cancer. Recent evidences suggested a link between the molecular profile of solid tumors and the incidence of CAT. The aim of this study was to explore the relationship between the mutational status of breast, lung and gastrointestinal cancer patients and the risk of CAT. Methods: We retrospectively evaluated the molecular profile, analysed as per clinical practice, of all consecutive patients hospitalized at the National Cancer Institute’s Department in Milan from October 2017 to November 2018. Patients with previous thromboembolic events and patients under anticoagulant therapy at cancer diagnosis were excluded. Due to death as competing risk, the Fine and Gray proportional regression model was used to detect statistical association and estimate relative risk. Results: The resulting cohort consisted of 484 patients, of whom 47% had gastrointestinal cancers, 18% had lung cancer and 15% had breast cancer. Molecular investigations were available for 375 (77%) patients; in particular, a 50-gene Next Generation Sequencing (NGS) panel was performed on 148 (31%) patients. After a median follow up of 17 months, 118 patients (24%) exhibited clinical manifestations of thrombosis (i.e. deep vein thrombosis, pulmonary thromboembolism, splanchnic thrombosis, disseminated intravascular coagulation, arterial thrombosis) and 117 (24%) patients deceased without thrombotic events. A statistically significant association was observed between incidence of CAT and presence of TP53 (HR 0.50, p = 0.04), c-KIT (HR 4.30, p = 0.041), and SMAD4 (HR 3.19, p = 0.029) mutations. No significant association was detected for KRAS and MET gene mutations, even if HRs were >2. Conclusions: In this study, the mutational status of TP53, SMAD4 and c-KIT genes was statistically associated to the risk of thrombosis. Due to methodological limits and low prevalence of mutations, large prospective studies are warranted, with the aim of better defining the role of oncogenes in CAT risk.
A double-blind, placebo-controlled randomized phase II study: Evaluating the effect of curcumin for treatment of cancer anorexia-cachexia syndrome in solid cancer patients.
Authors: Prasongsook Naiyarat , Sitalarom Kasarn , Saichaemchan Siriwimon , Peechatanan Khunthong , Chaiworramukkul Aornchuma
Published: May 2019

e23151

Background: Cancer anorexia–cachexia syndrome (CACS) is common among patients with advanced solid cancer and associated with poor prognosis. CACS is a hypercatabolic state, which comprises adipose tissue and skeletal muscle loss, which is characterized by negative protein and energy balance, loss of lean body mass and adipose tissue. Also, CACS increase systemic inflammation. The treatment of CACS is still unclear. Curcumin has been shown anti-cancer and anti-inflammatory effects, including attenuation of CACS in animal models. Therefore, clinical study of curcumin for CACS is required. Methods: This is randomized, double-blind, placebo-controlled phase ll study, 52 patients with CACS in solid malignancy were enrolled and randomized in 1:1 to receive oral curcumin (at a dose of 400 mg twice daily) or placebo for 8 weeks. The primary end point was body tissue composition and the secondary end points were body weight and body mass index, Hand grip muscle strengthening, safety and toxicity. Results: All parameters of body compositions were not statistically significant different between two groups: curcumin group and placebo group, which were consist body fat mass -0.9, SEM = 0.94 versus –1.65, SEM = 1 ( p-value = 0.58), skeletal muscle mass -0.17, SEM = 0.49 versus +0.4, SEM = 0.52 ( p-value = 0.42) and percent body fat –1.0, SEM = 0.65 versus -0.1, SEM = 0.68 ( p-value = 0.3) including with basal metabolic rate -5.3, SEM = 18 versus +18.3, SEM = 19 ( p-value = 0.37). The average of weight loss was also not statistically significant different between two groups, -1.04, SEM = 0.63 in curcumin group versus –1.15, SEM = 0.61 in placebo group, ( p-value = 0.9). Notably, patient with curcumin had less reduction of hand-grip muscle strength on both hands [right hand: -2.09 in curcumin versus -3.68 in placebo; p = 0.46], [left hand: -1.24 versus -5.04; p-value = 0.12], and basal metabolic rate than placebo group. Most adverse events were grade 1 on both groups similarly. Conclusions: Curcumin was not shown to be superior to placebo with regard to increasing the body composition in cancer patients with CACS. However, curcumin might show some clinical benefits, including slow progression of hand-grip muscle strength loss and basal metabolic rate. Further investigations should be explored.
Non-invasive assessment of chemotherapy-induced peripheral neuropathy using neuromuscular ultrasound in breast cancer patients.
Authors: Lycan Thomas , Thomas Alexandra , Hsu Fang-Chi , Cartwright Michael Stephen , Walker Francis O , Ahn Christine , Sangueza Omar P , Shiozawa Yusuke , Park Sun Hee , Peters Christopher Michael , Romero-Sandoval Edgar Alfonso , Melin Susan Anitra , Sorscher Steven , Ansley Katherine Cox , Lesser Glenn Jay , Strowd Roy E.
Published: May 2019

e23152

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity for breast cancer patients that leads to early treatment discontinuation and worse outcomes. Neuromuscular ultrasound (NMUS) is a non-invasive assessment of peripheral nerves that has not been studied in taxane CIPN. Methods: This cross-sectional study enrolled breast cancer patients with subjective complaints of CIPN symptoms during or after taxane chemotherapy and compared nerve cross-sectional area (CSA) by NMUS with historical values in 120 healthy adults. Findings were correlated with self-reported symptom scale (EORTC-QLQ CIPN20, range 0-72, higher more severe); nerve conduction studies; and skin biopsies for intraepidermal nerve fiber density (IENF). Results: We evaluated 20 participants (mean 55.4 ± 10.5 yrs) with NMUS at 74 nerve sites after median 3.7 months (IQR 1.0-6.1) since last taxane (paclitaxel 10, docetaxel 8, nab-paclitaxel 2). Participants reported moderate-to-severe CIPN symptoms which were predominantly sensory (19.1 ±4.9, max 32) as opposed to motor (15.6 ±5.8, max 32) or autonomic (3.3 ±1.6, max 8). Sural sensory nerve CSA was 1.2 mm2 smaller than in historical controls (4.1 vs. 5.3 mm2, 2-sample t-test p = 0.005) and decreased with more days from last taxane (Spearman’s r -0.46, p = 0.04). Tibial motor nerve was not significantly different from controls (p = 0.35). Median nerve CSA was enlarged at the distal wrist crease entrapment site (12.5 vs 10.1, p = 0.03). Older age was associated with smaller sural CSA (r = -0.72, p < 0.001). When controlling for age and days from last taxane, for each 1mm2 decrease in sural CSA, distal IENF reduced by 2.1 nerve/mm2 (p = 0.04, R2 = 0.30). Conclusions: NMUS showed expected sensory predominant distal axonopathy in taxane CIPN. Evaluation of nerve CSA by non-invasive NMUS may serve as an objective point-of-care assessment to risk-stratify women with taxane CIPN prior to the development of debilitating symptoms. Clinical trial information: NCT03139435. [Table: see text]
Direct oral factor Xa inhibitors for the treatment of acute cancer-associated venous thromboembolism: A systematic review and network meta-analysis.
Authors: Fuentes Harry E , McBane Robert , Wysokinski Waldemar , Tafur Alfonso Javier , Loprinzi Charles L. , Murad M. Hassan , Riaz Irbaz Bin
Published: May 2019

e23156

Background: A direct meta-analysis was performed to explore the efficacy and safety of direct oral factor Xa inhibitors with dalteparin in patients with cancer associated acute venous thromboembolism (VTE). Also, the comparative efficacy and safety of apixaban, rivaroxaban, and edoxaban was assessed with a network meta-analysis. Methods: MEDLINE, CENTRAL, and EMBASE were searched for trials comparing direct oral anticoagulants (DOACs) to dalteparin for the management of cancer associated acute VTE. A network meta-analysis using both frequentist and Bayesian methods was performed to analyze VTE recurrence, major and clinically relevant non-major bleeding (CRNMB). Results: Three randomized control trials, at low risk of bias, enrolled 1,739 patients with cancer associated VTE. Direct comparison showed a lower rate of VTE recurrence in DOAC compared to dalteparin groups (odds Ratio [OR]:0.48, 95% Confidence interval [CI]:0.24-0.96; I2:46%). Indirect comparison suggested that apixaban had greater reduction in VTE recurrence compared to dalteparin (OR: 0.10; 95% CI: 0.01–0.82), but not rivaroxaban or edoxaban. Apixaban also had the highest probability of being ranked most effective. By direct comparisons, there was an increased likelihood of major bleeding in the DOAC group compared to dalteparin (OR: 1.70; 95% CI: 1.04–2.78). CRNMB did not differ. Indirect estimates were imprecise. Subgroup analyses in gastrointestinal cancers suggested that dalteparin may have the lowest risk of bleeding whereas estimates in urothelial cancer were imprecise. Conclusions: DOACs appear to lower the risk of VTE recurrence compared to daltaparin while increasing major bleeding. Apixaban may be associated with the lowest risk of VTE recurrence compared to the other DOACs.
Phase 2 study of brigatinib in patients (pts) with anaplastic lymphoma kinase (ALK)−positive, advanced non–small cell lung cancer (NSCLC) that progressed on alectinib or ceritinib.
Authors: Kim Edward S. , Ou Sai-Hong Ignatius , Barlesi Fabrice , Mok Tony S. K. , Ahn Myung-Ju , Bunn Veronica , Zhang Pingkuan
Published: May 2019

TPS9115

Background: Second-generation ALK tyrosine kinase inhibitors (TKIs) alectinib and ceritinib have demonstrated efficacy and acceptable safety in ALK TKI-pretreated and TKI-naive NSCLC. However, as with crizotinib, resistance to alectinib and ceritinib eventually develops, with secondary resistance mutations detected in approximately 50% of pts. Brigatinib is a next-generation ALK TKI designed to have potent and broad activity against ALK mutants. Post-crizotinib, brigatinib demonstrated high systemic and CNS objective response rates (ORR) and the longest reported median progression-free survival (PFS) of any ALK inhibitor in this setting (16.3–16.7 mo) (Huber. J Clin Oncol 2018;36; Bazhenova. Ann Oncol 2017;28); efficacy was demonstrated regardless of mutations. Based on nonclinical and clinical data, brigatinib may show efficacy in ALK+ NSCLC that has developed resistance or failed to respond to alectinib/ceritinib. This trial was designed to assess efficacy and safety of brigatinib in pts with ALK+ NSCLC that has progressed on alectinib or ceritinib. Methods: This is a phase 2, open-label, single-arm, multicenter, international trial (NCT03535740) in pts (≥18 y) with locally advanced/metastatic NSCLC and disease progression on alectinib or ceritinib (± prior crizotinib; ≤3 different systemic regimens for locally advanced/metastatic disease). Pts receive oral brigatinib 180 mg QD with 7-day lead-in at 90 mg QD. Treatment beyond progression or escalation to brigatinib 240 mg QD is permitted. Primary endpoint: independent review committee (IRC)−assessed confirmed ORR (cORR) per RECIST v1.1. Secondary endpoints: investigator (INV)-assessed cORR, duration of response (INV- and IRC-assessed), PFS, disease control rate, and time to response; in pts with baseline brain metastases: IRC-assessed intracranial cORR, duration of intracranial response, and intracranial PFS; OS; safety/tolerability; and HRQoL. Exploratory endpoints include biomarker analyses. The study was initiated in Dec 2018 at 78 sites (North America, Europe, Asia), with a planned sample size of 103 pts. Accrual is ongoing. Clinical trial information: NCT03535740.
A multicenter, open label, randomized phase II study of osimertinib plus ramucirumab versus osimertinib alone as initial chemotherapy for EGFR mutation-positive non-squamous non-small cell lung cancer: TORG1833.
Authors: Nakahara Yoshiro , Kato Terufumi , Isomura Reiko , Seki Nobuhiko , Furuya Naoki , Naoki Katsuhiko , Yamanaka Takeharu , Okamoto Hiroaki
Published: May 2019

TPS9120

Background: Vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) pathways are shown to be interrelated in several preclinical studies. Furthermore, recent clinical studies have shown the adding effect of an anti VEGF monoclonal antibody with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for the non-small-cell lung cancer (NSCLC) patients with EGFR mutation. Thus, osimertinib plus ramucirumab would be the promising candidate for the new standard treatment in EGFR mutation positive NSCLC. Methods: This study is an investigator initiated trial. Previously untreated EGFR mutation positive advanced non squamous NSCLC patients aged 20 years or older with a performance status of 0 or 1 are randomized at a 1:1 ratio to receive osimertinib (80mg) every day either without or with ramucirumab (10mg/kg) every 2 weeks until evidence of disease progression or development of unacceptable toxicity. The primary endpoint of the study is progression free survival (PFS) assessed by the central image reviewer. Secondly endpoints include PFS (assessed by an attending physician), objective response rate (ORR), disease control rate (DCR), duration of response (DOR), overall survival (OS), safety and toxicity profile. Stratification factors are gender and the type of EGFR mutation (exon 19 deletion, Leu858Arg point mutation in exon 21). We determined that, with a sample size of 120 patients (60 in each arm), the trial will have 80% power to show a hazard ratio for disease progression or death of 0.667 at a one-sided alpha level of 0.2 (as calculated on the basis of 80 such events) for comparison between the two arms with 1.5-year accrual and 2-year follow-up periods. Study enrollment began in November 2018 and is continued for 3.5 years among 20 sites of Thoracic Oncology Research Group (TORG). Seven patients were enrolled at time of submission. Clinical trial information: 184146.
Large ants don't carry their fair share: Maximal load carrying performance of leaf-cutter ants (Atta cephalotes)
Authors: Segre P. S. , Taylor E. D.
Published: May 2019

Although ants are lauded for their strength, little is known about the limits of their load carrying abilities. We determined the maximal load carrying capacity of leaf-cutter ants by incrementally adding mass to the leaves they carried. Maximal load carrying ability scaled isometrically with body size, indicating that larger ants had the capacity to lift the same proportion of their body mass as smaller ants (8.78 * body mass). However, larger ants were captured carrying leaf fragments that represented a lower proportion of their body mass compared to their smaller counterparts. Therefore, when selecting leaves, larger ants retained a higher proportion of their load carrying capacity in reserve. This suggests that either larger ants require greater power reserves to overcome challenges they encounter along the trail, or leaf-cutter ants do not select loads that maximize the overall leaf transport rate of the colony.
Division of labor in honey bees is associated with transcriptional regulatory plasticity in the brain
Authors: Hamilton Adam R. , Traniello Ian M. , Ray Allyson M. , Caldwell Arminius S. , Wickline Samuel A. , Robinson Gene E.
Published: May 2019

Studies in evolutionary and developmental biology show that relationships between transcription factors (TFs) and their target genes can be altered to result in novel regulatory relationships that generate phenotypic plasticity. We hypothesized that context-dependent shifts in the nervous system associated with behavior may also be linked to changes in TF-target relationships over physiological timescales. We tested this hypothesis using honey bee (Apis mellifera) division of labor as a model system by performing bioinformatic analyses of previously published brain transcriptomic profiles together with new RNAi and behavioral experiments. The bioinformatic analyses identified five TFs that exhibited strong signatures of regulatory plasticity as a function of division of labor. RNAi targeting one of these TFs (broad complex) and a related TF that did not exhibit plasticity (fushi-tarazu transcription factor 1) was administered in conjunction with automated analyses of foraging behavior in the field, laboratory assays of aggression and brood care behavior, and endocrine treatments. Results showed that changes in regulatory relationships of these TFs were associated with behavioral state, social context and endocrine state. These findings provide the first empirical evidence that TF-target relationships in the brain are altered in conjunction with behavior and social context. They also suggest that one mechanism for this plasticity involves pleiotropic TFs high in regulatory hierarchies producing behavior-specific transcriptional responses by activating different downstream TFs, to induce discrete context-dependent transcriptional cascades. These findings provide new insights into the dynamic nature of the transcriptional regulatory architecture underlying behavior in the brain.
Debt Traps? Market Vendors and Moneylender Debt in India and the Philippines
Authors: Karlan Dean , Mullainathan Sendhil , Roth Benjamin N.
Published: May 2019

A debt trap occurs when someone takes on a high-interest-rate loan and is barely able to pay back the interest, and thus perpetually finds themselves in debt (often by refinancing). Studying such practices is important for understanding financial decision-making of households in dire circumstances, and also for setting appropriate consumer protection policies. We conduct a simple experiment in three sites in which we paid off high-interest moneylender debt of individuals. Most borrowers returned to debt within six weeks. One to two years after intervention, treatment individuals were borrowing at the same rate as control households. (JEL D14, D18, D91)
The Violent Consequences of Trade-Induced Worker Displacement in Mexico
Authors: Dell Melissa , Feigenberg Benjamin , Teshima Kensuke
Published: May 2019

Mexican manufacturing job loss induced by competition with China increases cocaine trafficking and violence, particularly in municipalities with transnational criminal organizations. When it becomes more lucrative to traffic drugs because changes in local labor markets lower the opportunity cost of criminal employment, criminal organizations plausibly fight to gain control. The evidence supports a Becker-style model in which the elasticity between legitimate and criminal employment is particularly high where criminal organizations lower illicit job search costs, where the drug trade implies higher pecuniary returns to violent crime, and where unemployment disproportionately affects low-skilled men. (JEL F16, J24, J64, K42, L60, O15, R23)
Analyzing Cultural Artifacts for the Introduction, Perpetuation, or Reinforcement of Moral Ideals
Authors: Williams Jennifer
Published: May 2019

The development and socialization of morals is a complex concept for students studying ethics. To help students understand the role social learning theory plays in the development of morality, an activity was created focusing on cultural artifacts and their introduction, perpetuation, and/or reinforcement of morality. The aim of this assignment is for students to see “the dialogue between cognitive structure and the complexity presented by the environment” (Kohlberg & Hersh, 1977, p. 57). Results for this assignment not only showed improved conceptualization of moral development by students, but also engaged their higher-order thinking skills.
What Brings People to Leadership Roles: A Phenomenological Study of Beef Industry Leaders
Authors: Gordon B. Lynn , Ellis Jason D.
Published: May 2019

Leadership has been deeply studied in the literature; however, little research exists studying the role of volunteer peer leaders in non-formalized leadership roles in membership-based organizations. This phenomenological study was designed to explore the experience of beef industry leaders in leadership roles. Twelve active beef industry volunteer leaders were interviewed and described their experience as leaders. Industry leadership was defined from study themes as a role fulfilled by someone who is willing to serve their industry, with the best of the industry in mind and taking on the responsibility and challenges that come along with making decisions to serve and speak for their peers with integrity. Seven themes identified the central phenomenon and seven traits of beef industry leaders were identified. This study offers significance to the field of leadership; to the beef industry; and to agricultural organizations that may guide developing future leaders.
Social Media Tools in the Leadership Classroom: Students’ Perceptions of Use
Authors: Odom Summer F. , Jarvis Holly D. , Sandlin M’Randa R. , Peek Cassidy
Published: May 2019

Social media is becoming more prevalent in the higher education classroom. As part of an ongoing study, the Department of Agricultural Leadership, Education, and Communications at Texas A&M University surveyed leadership students about their perceptions of their level of comfort and frequency of use of social media tools and the advantages and disadvantages that these students perceived when social media was used in the leadership classroom. A total of 79 students were surveyed in two upper level leadership courses. Facebook was the social media tool students were most comfortable with and used most frequently. Advantages included social media helping increase quality and efficiency of communication between students and the instructor, social media as a technological norm, access to class information, ease of collaboration, and stronger social connections between classmates. Disadvantages revolved around issues of use of and access to social media.
Socially Responsible or Just Plain Social?
Authors: Mills Katie Elizabeth , Bruce Jacklyn
Published: May 2019

This study seeks to understand one facet of leadership development among the newest members of a Greek Letter community at a southern university. New Members (NMs) of the Greek Community at North Carolina State University were administered the Socially Responsible Leadership Survey (SRLS Guidebook, 2005) during the Fall, 2011. Results indicate this population perceived themselves as open to and able to commit to organizations while not being as comfortable with the idea of change. However, it should be noted that none of the constructs measured in the neutral or negative range. Results of this study could be used to assist in driving the mandatory programming provided by North Carolina State University’s Administration and Greek Life staff in an effort to create more purposeful and directed programming.
Informal Learning in Academic Student Organizations: An Exploratory Examination of Student-Faculty Interactions and the Relationship to Leadership
Authors: Holzweiss Peggy C. , Parrott Kelli Peck , Cole Bryan R.
Published: May 2019

This exploratory study examined informal learning opportunities that exist within student organizations. The researchers specifically isolated academic organizations and the interactions between students and faculty that may occur in this context. Findings indicate that 81% of participants experienced interactions with faculty within the context of their academic organizations and students who hold leadership positions are more likely to experience interactions with faculty compared to general members. The results suggest that informal learning opportunities do exist and can be identified by using the Informal and Incidental Learning Model (Marsick & Watkins, 2001). By identifying these opportunities leadership educators can design purposeful activities within student organizations to better promote development and growth.
ACTION LEARNING IN A GRADUATE ONLINE COURSE
Authors: Goertzen Brent J.
Published: May 2019

Today’s organizations often face complex problems that do not have readily identifiable solutions. Leadership educators are called upon to implement innovative pedagogical practices to teach students to address such complex problems. Inspired by action learning principles, this application brief describes a group-oriented assignment in an online graduate course on leadership development. Practitioner and student reflections are offered as well as an analysis of student learning. Recommendations from these experiences offer ways to refine this pedagogical practice.
IS IT WORTH IT? A CASE STUDY EXPLORING VOLUNTEERS’ PERCEPTIONS OF LEADERSHIP TRAINING
Authors: Morrison Carley C. , Greenhaw Laura L.
Published: May 2019

Volunteer-based organizations are dependent on volunteers to meet the goals of the organization. Identifying and training volunteers as leaders of the organization is one way to increase positive social change in their community. However, there is limited literature investigating the outcomes of providing leadership training to volunteers. This case study determined participants’ perceptions of a volunteer leadership training experience compared to observations of the actual leadership training. A focus group revealed three themes that were both supported and refuted by observations of the training: (a) the need for refreshers and follow-up trainings, a disconnect between understanding leadership concepts and applying them in the volunteer scenario, and the transfer of for-profit skills and experience to the non-profit setting.
Debt Heterogeneity and Covenants
Authors: Lou Yun , Otto Clemens A.
Published: May 2019

Coordination failure among owners of heterogeneous debt types increases distress costs. Covenants reduce expected distress costs by lowering the probability of liquidity shortages, increasing liquidation values, and incentivizing creditor monitoring. We predict and find that new debt contracts include more covenants when borrowers’ existing debt structures are more heterogeneous. Our findings suggest that covenants are not only used to address creditor–shareholder conflicts but also to reduce the expected costs of coordination failure among creditors. Furthermore, our results indicate a dynamic component missing from static debt structure models: Debt heterogeneity entails additional covenants (i.e., constraints) when raising future debt.

This paper was accepted by Lauren Cohen, finance.
Coordination Is Hard: Electronic Auction Mechanisms for Increased Efficiency in Transportation Logistics
Authors: Karaenke Paul , Bichler Martin , Minner Stefan
Published: May 2019

The lack of coordination among carriers leads to substantial inefficiencies in logistics. Such coordination problems constitute fundamental problems in supply chain management for their computational and strategic complexity. We consider the problem of slot booking by independent carriers at several warehouses and investigate recent developments in the design of electronic market mechanisms promising to address both types of complexity. Relax-and-round mechanisms describe a class of approximation mechanisms that is truthful in expectation and runs in polynomial time. Whereas the solution quality of these mechanisms is low, we introduce a variant able to solve real-world problem sizes with high solution quality while still being incentive compatible. We compare these mechanisms to core-selecting auctions, which are not incentive compatible but provide stable outcomes with respect to the bids. In addition to a theoretical analysis we report results from extensive numerical experiments based on field data. The experimental results yield a clear ranking of the mechanisms in terms of waiting time reductions and computation times.

This paper was accepted by Anandhi Bharadwaj, information systems.
How to prepare and manage a systematic review and meta-analysis of clinical studies
Authors: Berstock James R. , Whitehouse Michael R.
Published: May 2019

Use the PICO framework to formulate a specific clinical question. Formulate a search strategy. Prospectively register the review protocol. Execute the literature search. Apply eligibility criteria to exclude irrelevant studies. Extract data and appraise each study for risk of bias and external validity. Provide a narrative review. If appropriate data are available, perform a meta-analysis. Report the review findings in the context of the risk of bias assessment, any sensitivity analyses and the analysis of risk of publication bias. Useful resources include the Cochrane Handbook, PROSPERO, GRADE and PRISMA.

Cite this article: EFORT Open Rev 2019;4:213-220. DOI: 10.1302/2058-5241.4.180049
Dairy Intake and Body Composition and Cardiometabolic Traits among Adults: Mendelian Randomization Analysis of 182041 Individuals from 18 Studies
Authors:   Mendelian Randomization of Dairy Consumption Working Group,   the CHARGE consortium, Huang Tao , Sun Dianjianyi , Heianza Yoriko , Bergholdt Helle K M , Gao Meng , Fang Zhe , Ding Ming , Frazier-Wood Alexis C , North Kari E , Marouli Eirini , Graff Mariaelisa , Smith Caren E , Varbo Anette , Lemaitre Rozenn N , Corella Dolores , Wang Carol A , Tjønneland Anne , Overvad Kim , Sørensen Thorkild I A , Feitosa Mary F , Wojczynski Mary K , Kähönen Mika , Mikkilä Vera , Bartz Traci M , Psaty Bruce M , Siscovick David S , Danning Rebecca D , Dedoussis George , Pedersen Oluf , Hansen Torben , Havulinna Aki S , Männistö Satu , Rotter Jerome I , Sares-Jäske Laura , Allison Mathew A , Rich Stephen S , Sorlí Jose V , Coltell Oscar , Pennell Craig E , Eastwood Peter , Ridker Paul M , Viikari Jorma , Raitakari Olli , Lehtimäki Terho , Helminen Mika , Wang Yujie , Deloukas Panagiotis , Knekt Paul , Kanerva Noora , Kilpeläinen Tuomas O , Province Michael A , Mozaffarian Dariush , Chasman Daniel I , Nordestgaard Børge G , Ellervik Christina , Qi Lu
Published: May 2019

BACKGROUND

Associations between dairy intake and body composition and cardiometabolic traits have been inconsistently observed in epidemiological studies, and the causal relationship remains ill-defined.

METHODS

We performed Mendelian randomization analysis using an established genetic variant located upstream of the lactase gene (LCT-13910 C/T, rs4988235) associated with dairy intake as an instrumental variable (IV). The causal effects of dairy intake on body composition and cardiometabolic traits (lipids, glycemic traits, and inflammatory factors) were quantified by IV estimators among 182041 participants from 18 studies.

RESULTS

Each 1 serving/day higher dairy intake was associated with higher lean mass [β (SE) = 0.117 kg (0.035); P = 0.001], higher hemoglobin A1c [0.009% (0.002); P < 0.001], lower LDL [−0.014 mmol/L (0.006); P = 0.013], total cholesterol (TC) [−0.012 mmol/L (0.005); P = 0.023], and non-HDL [−0.012 mmol/L (0.005); P = 0.028]. The LCT-13910 C/T CT + TT genotype was associated with 0.214 more dairy servings/day (SE = 0.047; P < 0.001), 0.284 cm higher waist circumference (SE = 0.118; P = 0.017), 0.112 kg higher lean mass (SE = 0.027; P = 3.8 × 10−5), 0.032 mmol/L lower LDL (SE = 0.009; P = 0.001), and 0.032 mmol/L lower TC (SE = 0.010; P = 0.001). Genetically higher dairy intake was associated with increased lean mass [0.523 kg per serving/day (0.170); P = 0.002] after correction for multiple testing (0.05/18). However, we find that genetically higher dairy intake was not associated with lipids and glycemic traits.

CONCLUSIONS

The present study provides evidence to support a potential causal effect of higher dairy intake on increased lean mass among adults. Our findings suggest that the observational associations of dairy intake with lipids and glycemic traits may be the result of confounding.
Поиск многомерной связи категориальных признаков: сравнение CHAID, логлинейного анализа и множественного анализа соответствий
Authors: Жучкова Светлана Васильевна , Ротмистров Алексей Николаевич
Published: May 2019

В работе затрагивается проблема отсутствия разработанных концепций анализа многомерных связей между категориальными признаками при том, что такие признаки и многомерные связи между ними довольно распространены в социологических исследованиях. Об этом свидетельствует ряд методологических работ, в которых делается вывод о необходимости анализа многомерных связей, а не только парных, поскольку многомерные связи не сводятся к набору парных связей. Тем не менее опыт изучения многомерных связей между категориальными признаками в социологии остается довольно ограничен и практически отсутствует его теоретическое обобщение. Настоящим исследованием авторы попытались восполнить этот пробел через сравнение трех методов, подходящих для поиска многомерной связи между категориальными признаками: дерева решений CHAID, логлинейного анализа и множественного анализа соответствий. Сравнение методов происходило на теоретическом и эмпирическом уровнях. Содержательной задачей эмпирического этапа выступило составление портрета типичного представителя электората различных российских политических партий на основе базы восьмой волны Европейского социального исследования, проведенного в 2016 г., и социологического теоретико-методологического подхода к изучению электорального поведения. Результаты применения этих методов приведены к форме комбинаций категорий; введены числовые критерии сравнения, благодаря чему выделен наиболее эффективный метод в двух типах аналитических задач: описании и прогнозировании. Согласно результатам исследования, в описательных задачах наиболее эффективен множественный анализ соответствий, а в задачах прогноза — логлинейный анализ. Последний вывод противоречит сложившемуся мнению о преимуществе CHAID в случаях наличия в данных какого-либо целевого признака и в связи с этим обладает высокой практической значимостью для дальнейшего развития идеи построения высокоточных прогностических моделей в социологических исследованиях.
Благодарность. Публикация подготовлена в ходе проведения исследования «Обоснование преимуществ поиска эффектов взаимодействия и их учета в социологических регрессионных моделях» (№18-05-0031) в рамках Программы «Научный фонд Национального исследовательского университета «Высшая школа экономики» (НИУ ВШЭ)» в 2018 г. и в рамках государственной поддержки ведущих университетов Российской Федерации «5-100».
Переезд из Таджикистана в Россию: мифы и реальность
Authors: Лисицын Павел Петрович , Степанов Александр Михайлович
Published: May 2019

В статье представлены результаты  исследования, проведенного в России и Таджикистане в 2017—2018 гг. Целью исследования было сопоставление ожиданий мигрантов с реальностью принимающей стороны. Метод исследования — глубинное интервью с четырьмя группами информантов: трудовыми мигрантами (N=40, Самара, Иваново, Москва) и посредниками, обеспечивающими их официальными документами и работой на территории России (N=12, Самара, Иваново, Москва), готовящимися к отъезду в Россию гражданами Таджикистана (N=20, Душанбе) и представителями профсоюзов и работодателей Таджикистана (N=4, Душанбе, Худжанд, Бохтар (Курган-Тюбе)).

Благодарность. Статья подготовлена при поддержке Российского научного фонда, проект № 17-78-20107.
Блокчейн для науки: революционные возможности, перспективы внедрения, потенциальные проблемы
Authors: Космарский Артем Анатольевич
Published: May 2019

В статье рассматриваются перспективы применения технологии блокчейна (распределенного реестра) в сфере науки. Объясняется, чем ключевые свойства технологии (децентрализация, гарантия неизменности данных, доверие среди не доверяющих друг другу субъектов) могут быть полезны в организации науки. Подробно рассказывается о том, насколько реально работающие проекты в Европе, США и России смогли воплотить в жизнь обещания новой технологии. Описываются четыре области, где применение блокчейна идет наиболее активно: работа с первичными данными и выход из кризиса воспроизводимости исследований; оптимизация издательских процессов и рецензирования; снижение пристрастности, коррумпированности и бюрократизма в экспертизе и финансировании науки; выстраивание более комплексной, гибкой и «низовой» наукометрии. Наконец, автор обсуждает главные сложности и проблемы, возникающие при интеграции блокчейна в повседневные практики ученых: конфликт между демократическим потенциалом новой технологии и ее использованием в новых инструментах отчетности и контроля над исследователями; опасность исключительно денежной мотивации для ученых (токенизация); плюсы и минусы анархической, коммерческой и государственной «блокчейнизации» науки.

Благодарность. Статья подготовлена при финансовой поддержке Российского фонда фундаментальных исследований (РФФИ) в рамках научного проекта «Сетевые договоры (смарт-контракты) как способ регулирования и организации научной деятельности» (№ 18-29-16184).

Автор выражает благодарность Ивану Тарханову (ГАУГН) за ценные советы, высказанные при обсуждении рукописи статьи.
НЕМОСКВА: практики управления на основе социологических данных в регионах. По материалам секции на IХ Грушинской социологической конференции
Authors: Петрова Лариса Евгеньевна , Бурлуцкая Мария Георгиевна
Published: May 2019

Материал не аннотирован.

Благодарность. Авторы выражают благодарность Программному комитету IX Грушинской социологической конференции и лично Наталье Седовой, руководителю Департамента науки и образования ВЦИОМ, заместителю председателя Программного комитета, за внимание к проблеме и предоставленную возможность обсудить ее на конференции.
Aplikasi klinis Continous Interscalene Block
Authors: Basuki Djujuk R
Published: May 2019

Blok pleksus brakialis dimulai oleh Ansbro pada tahun 1946. Pada tahun 1999, Boezaart mempublikasi tehnik baru yaitu continuous interscalene block. Sebagian besar metode  ini memiliki kendala pada penempatan kateter yang tidak akurat atau dislokasi kateter. Continous Interscalene Block (CISB) adalah blok plexus brachial proximal di leher yang dapat dilakukan melalui pendekatan anterior atau posterior. Pendekatan anterior disebut juga True Continous Interscalene Block dan pendekatan posterior dikenal sebagai continous Cervikal Paravertebral Block. CISB diindikasikan untuk setelah pembedahan mayor bahu, clavicula lateral, acromiocalvicular join dan proksimal humerus serta  juga dapat digunakan untuk terapi nyeri kronik ekstremitas atas. Komplikasi Continous Interscalene Block (CISB) mirip dengan single ISB injeksi, meskipun insiden paralisis diafragma akibat blok nervus frenicus telah dilaporkan secara signikan berkurang.Dalam praktik rutin, interscalene blok dapat menggunakan bolus awal 10-15 ml obat anastesi lokal seperti rovipacaine 0,2-0,75 %.  Konsentrasi yang digunakan  tergantung pada faktor pasien, tujuan blok (analgesia atau anestesia), dan ada tidanya kateter. Jika terdapat kateter, dosis bolus awal bisa dikurangi dan anastesi lokal tambahan bisa disuntikkan melalui kateter. Infus kontinyu rovipacaine 0,2 % 4-10 ml/ jam dapat digunakan untuk analgesia pasca operasi. Penggunaan infus kontinyu bupivacaine 0,125 % dengan kecepatan 0,125 ml/kg per jam juga dapat mengatasi nyeri secara efisien.  Dibandingkan dengan teknik kontinyu, teknik PCRA (Patient control regional analgesia) dengan infus basal rendah 5 ml/jam bupivacaine ditambah dengan bolus kecil PCA 2,5 ml/30 menit dapat memberikan kontrol nyeri yang efisien, tetapi konsumsi lokal anastesi berkurang 37 % dan efek sampingnya rendah.
Preoksigenasi pada Anestesi Umum
Authors: Malawat Faizal Rahmat , Cahyadi Bondan Irtani
Published: May 2019

Latar Belakang: Pemantauan saturasi hemoglobin selama tatalaksana jalan napas penting untuk keselamatan pasien. Desaturasi di bawah 70% menghantarkan  pasien pada risiko mengalami disritmia, dekompensasi hemodinamik, kerusakan otak akibat hipoksia dan kematian. Tantangan untuk dokter emergensi adalah dapat melakukan intubasi endotrakeal secara cepat tanpa hipoksia atau aspirasi. Preoksigenasi dengan 100% oksigen sebelum induksi anestesi, merupakan manuver yang diterima secara luas yang dapat meningkatkan penyimpanan oksigen tubuh, sehingga menunda onset desaturasi selama periode apnea setelah induksi anestesi dan muscle relaksan.Tujuan: Tujuan preoksigenasi adalah mengganti nitrogen di FRC dengan oksigen; yang disebut proses denitrogenasi. Hal ini memiliki dampak pada penyimpanan oksigen tubuh dan meningkatkan toleransi terhadap apneu secara substansial. Preoksigenasi efektif menghasilkan batas aman untuk intubasi darurat dan memperpanjang durasi dari apnea tanpa desaturasi.Metode: Preoksigenasi di dalam kamar operasi biasanya menggunakan sirkuit yang terpasang pada mesin anestesi, yang akan memberikan FiO2 yang tinggi. Kemudian, keberhasilan dari preoksigenasi dapat terus dinilai dengan memperkirakan derajat denitrogenasi menggunakan penganalisa gas untuk menentukan konsentrasi fraksi oksigen yang dihembuskan (FeO2). Untuk operasi pasien dengan risiko aspirasi yang tinggi, anestesi mengembangkan induksi dengan sekuens cepat dengan cara pemberian sedatif dan paralitik tanpa ventilasi secara simultan sembari menunggu paralitik berefek, sehingga dapat mengurangi risiko aspirasi. Posisi supine tidak ideal untuk mencapai preoksigenasi optimal, karena menjadi lebih sulit untuk mengambil napas penuh dan lebih banyak bagian paru posterior yang menjadi prone sampai kolaps. Sebaliknya posisi trendelenburg akan meningkatkan preoksigenasi dan mungkin berguna pada pasien yang diimobilisasi karena kemungkinan spinal injury.Simpulan: Dalam keadaan apneu, faktor yang memiliki efek terbesar pada waktu tercapainya hipoksia kritis adalah FRC, konsentrasi oksigen alveoli, dan kecepatan metabolisme. Konsentrasi hemoglobin dan derajat shunting sirkulasi kurang penting dibandingkan faktor-faktor diatas. Ahli anestesi dapat menghindari hipoksia dengan preoksigenasi. Sampai kontrol definitif jalan napas dapat dicapai, ahli anestesi dapat memberikan oksigen 100% sehingga memungkinkan masuknya oksigen ke paru dan membantu mencegah terjadinya hipoksia.
Perbedaan Pengaruh Parasetamol dan Parecoxib Terhadap Aktivitas Agregasi Trombosit pada Pasien SIRS atau Sepsis
Authors: Wibowo Admaji , Purwoko Purwoko , Suradi Suradi
Published: May 2019

Latar Belakang: Parasetamol dan parecoxib adalah Obat Anti Inflamasi Non Steroid (OAINS) yang paling banyak digunakan pada pasien yang dirawat dengan SIRS atau sepsis di ICU sebagai antipiretik dan anti inflamasi. Kedua obat tersebut dapat mempengaruhi agregasi trombosit yang dapat kita nilai melalui tes agregasi trombosit.Tujuan: Mengetahui perbedaan pengaruh pemberian parasetamol dan parecoxib terhadap aktivitas agregasi trombosit pada pasien SIRS atau sepsis.Metode: Penelitian ini merupakan penelitian experimental dengan pendekatan uji klinis dengan rancangan penelitian pre dan post. Terdapat 34 subjek penelitian pasien SIRS atau sepsis yang dirawat di ICU dengan umur antara 17 - 65 tahun. Distribusi sampel meliputi 17 subjek dengan pemberian parasetamol dan 17 subjek dengan pemberian parecoxib. Setelah dilakukan pengacakan dilakukan pemeriksaan agregasi trombosit sebelum perlakuan dan 120 menit sesudah perlakuan dengan menggunakan induktor 10 µM ADP.Hasil: Berdasarkan hasil uji beda Mann Whitney pada kelompok tidak berpasangan mendapatkan nilai p=0,310, yang berarti bahwa tidak ada perbedaan yang signifikan dalam hal agregasi trombosit antara kelompok parasetamol dan parecoxib sebelum perlakuan dan nilai p=0,013 (p<0,05), yang berarti bahwa terdapat perbedaan yang signifikan antara kelompok parasetamol dan parecoxib setelah perlakuan. Analisa selanjutnya berdasarkan hasil uji beda Wilcoxon pada kelompok berpasangan mendapat nilai p=0,020 (p<0,05) yang berarti bahwa terdapat perbedaan yang signifikan antara sebelum dan sesudah pemberian parasetamol.Kesimpulan: Penggunaan parasetamol akan berdampak pada penurunan agregasi trombosit secara signifikan secara statistik dibandingkan dengan parecoxib (p=0,013).
Analisis Anesthesia Ready Time Dalam Pelayanan Anestesi untuk Pembedahan Darurat di Kamar Operasi IGD RSUD Dr. Soetomo Surabaya Tahun 2018
Authors: Prabowo Yudha Adi , Basoeki April Poerwanto , Sylvaranto Teguh , Edwar Pesta Maurid
Published: May 2019

Latar Belakang: Pelayanan anestesi untuk operasi darurat bertujuan memberikan kedalaman anestesi secara cepat dan adekuat untuk dilakukan pembedahan. Survei pendahuluan di kamar operasi elektif RSUD Dr. Soetomo pada Oktober hinggaDesember 2017 menunjukkan bahwa pada lebih dari 30% pasien, waktu sejak masuk kamar operasi hingga manipulasi pembedahanmencapai lebih dari 60 menit, sedangkan waktu benchmark internasional adalah kurang dari 45 menit. Tujuan: Untuk menganalisis Anesthesia Ready Time (ART) dalam pelayanan anestesi di kamar operasi darurat IGD RSUD Dr. Soetomo, Surabaya.Metode: 254 subyek dengan Pasien Status (PS) ASA 1-4 yang menjalani operasi darurat di RSUD Dr. Soetomo selama April 2018 yang terlibat dalam penelitian ini. Waktu dicatat sejak pemasangan monitor, waktu induksi anestesi, waktu pemasangan prosedur invasif, dan deklarasi pasien siap dilakukan manipulasi bedah. Kesulitan dan kendala yang terjadi dari pemasangan monitor hingga deklarasi siap operasi juga dicatat.Hasil: ART di kamar operasi darurat IGD RSUD Dr. Soetomo 24,00 menit untuk PS ASA 1;22,08 menit untuk PS ASA 2;29,03 menit untuk PS ASA 3;25,00 menit untuk PS ASA 4;23,34 menit untuk Sub Arachnoid Block (SAB); 36,67 menit untuk epidural; 21,71 menit untuk pemasangan ABP ; dan 21,25 menit untuk pemasangan Central Venous Catheter (CVC). Faktor yang mempengaruhi lamanya ART adalah menunggu kedatangan operator (42,5%), pemasangan prosedur invasif anestesi (7,3%), dan menunggu kedatangan PPDS anestesi yang lebih senior untuk mendampingi proses induksi anestesi (5,2%).Kesimpulan: ART di kamar operasi darurat IGD RSUD Dr. Soetomo sudah mendekati benchmark internasional.
Perioperatif Early Goal Directed Theraphy Pada Bedah Jantung
Authors: Raharjo Langgeng , Syamsu Zuswahyudha
Published: May 2019

Perawatan paska bedah jantung dapat meningkatkan morbiditas dan mortalitas apabila terjadi ketidakstabilan hemodinamik. Pasien yang berhasil baik, didapatkan nilai cardiac output dan delivery oxygen yang lebih tinggi. Dengan mengenali dan mengelola lebih awal terjadinya cardiac output yang rendah, dapat menghindari kejadian hipoksia jaringan. Dengan metode Early Goal Directed Therapy, mengatur jumlah cairan dan inotropik, pengelolaan preload, afterload, dan kontraktilitas jantung dapat mempertahankan kecukupan hemodinamik.
Manajemen Anestesi Prosedur Fontan
Authors: Ridconi Akhmad , Nugroho Budi
Published: May 2019

PendahuluanSingle ventricle merupakan kelainan jantung kongenital kompleks, dan seseorang yang hidup dengan kelainan ini akan disertai dengan sejumlah keterbatasan. Tanpa terapi bedah, univentrikel akan menjadi malapetaka. Prosedur Fontan merupakan teknik pembedahan terpilih yang dapat diterapkan pada pasien dengan single ventricle. Hasil prosedur Fontan dipengaruhi oleh beberapa faktor termasuk faktor, prosedur, pengelolaan, dan tekanan vena sisi kanan berangsur-angsur akan meningkat. Seiring dengan berjalannya waktu gagal jantung kanan akan mengalami penurunan fungsi sistem, meliputi peningkatan resistensi pembuluh darah pulmoner (PVR), peningkatan tekanan vena sistemik (SVR), low-cardiac output kronis, disfungsi ventrikel kanan, dan kegagalan prosedur perbaikan single ventricle. Presentasi KasusWanita 19 tahun dengan Double Outlet Right Ventricle, Ventricular Septal Defect, Pulmonal Stenosis, Patent Ductus Arteriosus, Bilateral Superior Vena Cava yang akan menjalani prosedur Fontan. KesimpulanProsedur Fontan akan meningkatkan usia harapan hidup pasien. Keberhasilan jangka panjang ditentukan oleh banyaknya komplikasi. Dalam kondisi tidak adanya ketaatan.