bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early or Late Pregnancy Loss and Development of Clinical Cardiovascular Disease Risk Factors: A Prospective Cohort Study
Authors: Horn J. , Tanz L.J. , Stuart J.J. , Markovitz A.R. , Skurnik G. , Rimm E.B. , Missmer S.A. , Rich-Edwards J.W. 
Published: November 2019

(BJOG. 2019;126:33–42)
Certain pregnancy complications, including preterm birth, preeclampsia and gestational hypertension, are female-specific risk factors for cardiovascular disease (CVD), the leading cause of death for both men and women. Pregnancy loss has been suggested as a possible risk factor for CVD. Although stillbirth and spontaneous abortion have been associated with an increased risk of stroke and ischemic heart disease, there is a lack of information regarding increased risk of CVD in women with a history of spontaneous pregnancy loss. This study aimed to assess the associations of pregnancy loss and risk of hypertension, type 2 diabetes (T2D), and hypercholesterolemia.
Development and Pilot Testing of a Context-Relevant Safe Anesthesia Checklist for Cesarean Delivery in East Africa
Authors: Alexander L.A. , Newton M.W. , McEvoy K.G. , Newton M.J. , Mungai M. , DiMiceli-Zsigmond M. , Sileshi B. , Watkins S.C. , McEvoy M.D. 
Published: November 2019

(Anesth Analg. 2019;128(5):993–998)
Maternal mortality rates in low and middle-income countries are 20 times higher than in developed countries, at a rate of 239 deaths per 100,000 live births. Sub-Saharan Africa in particular is reported by the World Health Organization (WHO) to be the most dangerous place in the world for a woman to bear a child. This study developed a context-sensitive obstetric anesthesia checklist for cesarean delivery (CD) in East Africa, with the hypothesis that such a list would improve adherence to best practice guidelines in the management of anesthesia for elective and emergent CD in low and middle-income countries.
Ephedrine Versus Phenylephrine as a Vasopressor for Spinal Anaesthesia-induced Hypotension in Parturients Undergoing High-risk Caesarean Section: Meta-analysis, Meta-regression, and Trial Sequential Analysis
Authors: Heesen M. , Rijs K. , Hilber N. , Ngan Kee W.D. , Rossaint R. , van der Marel C. , Klimek M. 
Published: November 2019

(Int J Obstet Anesth. 2019;37:16–28)
Hypotension is a common adverse effect of spinal anesthesia for cesarean section. In this setting, phenylephrine is the preferred vasopressor for the treatment of spinal-induced hypotension because it has been associated with a lower rate of fetal acidosis compared with ephedrine. However, this conclusion was based on studies performed in low-risk healthy parturients. Some studies in high-risk parturients undergoing spinal anesthesia for cesarean section, have since been performed. They have not found a difference in umbilical artery pH when ephedrine as compared with phenylephrine was used to treat hypotension. However, the retrospective design of some of these studies is prone to bias. Therefore, the current investigators decided to conduct a meta-analysis of prospective, randomized controlled trials comparing ephedrine versus phenylephrine for the treatment or prevention of spinal-induced hypotension during high-risk cesarean sections.
Plantar Cutaneous Sensory Stimulation Improves Foot Sensibility and Gait Speed in Older Adults With Diabetes: A Clinical Trial
Authors: Navarro-Peternella Fabiana Magalhães , Teston Elen Ferraz , dos Santos Santiago Ribeiro Beatriz Maria , Marcon Sonia Silva 
Published: November 2019

ABSTRACT

OBJECTIVE
To determine the effect of an intervention involving muscular ankle strengthening and feet sensory stimuli to improve gait speed and balance in older adults with diabetes mellitus type 2 (DM2).

DESIGN
A clinical trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

PARTICIPANTS
The trial enrolled 66 people 60 years or older with DM2 who were physically independent (did not require assistance with activities of daily living).

INTERVENTION
The experimental group performed 12 weeks of plantiflexor and dorsiflexor muscle strengthening exercises with resistance bands, proprioceptive exercises on balance boards and a buoy, and plantar sensory stimulation with bristle brushes and cloths, as well as general foot care instructions. The control group received foot care instructions only.

OUTCOME MEASURES
The primary outcome was plantar cutaneous sensibility as measured with Semmes-Weinstein monofilaments. Secondary outcomes included muscular strength (plantar flexion and dorsiflexion torque as measured with an isokinetic dynamometer), gait speed, and balance (total displacement area, mediolateral displacement, anteroposterior displacement, mediolateral displacement speed, and anteroposterior displacement speed) on right and left bipedal and unipedal supports.

RESULTS
In comparison with the control group, the experimental group demonstrated improved plantar cutaneous sensibility on the right foot (3.46 points; 95% confidence interval [CI], 3.85–9.80), left foot (3.46 points; 95% CI, 4.06–9.76), and an increase in gait speed (0.15 m/s; 95% CI 0.12–0.42). There were no meaningful changes in participants’ ankle muscle strength or balance.

CONCLUSIONS
This study showed that plantar cutaneous sensory stimulation can improve foot sensibility and increase the gait speed of older adults with DM2. However, there were no meaningful dorsiflexor or plantiflexor gains after 12 weeks.
New Drug Targets Key Genetic Driver of Cancer
Authors: Aschenbrenner Diane S. 
Published: November 2019

Entrectinib (Rozlytrek) has been approved by the Food and Drug Administration to treat adolescent and adult patients whose solid tumor cancers are related to a specific genetic defect known as neurotrophic tyrosine receptor kinase gene fusion, and for whom there are no effective treatments.Several warnings and precautions are listed on entrectinib's labeling, including congestive heart failure, central nervous system effects, skeletal fractures, hepatotoxicity, hyperuricemia, QT interval prolongation, vision disorders, and embryo–fetal toxicity.
CE: Hematologic Childhood Cancers: An Evidence-Based Review
Authors: Spruit Jessica Lynne 
Published: November 2019

ABSTRACT:
Every year in the United States, thousands of children and adolescents are diagnosed with a hematologic cancer. That diagnosis and the prescribed course of treatment profoundly affect both the child and the family. This article provides a brief overview of the therapies used to treat such cancers, describes the presentations and diagnoses of the various hematologic cancers, and explains the treatments specific to each. Nursing care of the child and family is discussed, with an emphasis on education and supportive care.
Alpha Omega Alpha Honor Medical Society: A Commitment to Inclusion, Diversity, Equity, and Service in the Profession of Medicine
Authors: Byyny Richard L. , Martinez Dee , Cleary Lynn , Ballard Billy , Barth Bradley E. , Christensen Sean , Eidson-Ton Wetona , Estevez-Ordonez Dagoberto , Fuhrer Jack , Kinzie J. Mark , Lee Amy L. , Lynch Catherine , Pfeil Sheryl , Schoenbaum Ellie 
Published: November 2019

With a motto of “Be Worthy to Serve the Suffering,” Alpha Omega Alpha Honor Medical Society (AΩA) supports the importance, inclusion, and development of a culturally and ethnically diverse medical profession with equitable access for all. The underrepresentation of minorities in medical schools and medicine continues to be a challenge for the medical profession, medical education, and AΩA. AΩA has worked, and continues to work, to ensure the development of diverse leaders, fostering within them the objectivity and equity to be inclusive servant leaders who understand and embrace diversity in all its forms.
Inclusion of talented individuals from different backgrounds benefits patient care, population health, education, and scientific discovery. AΩA values an inclusive, diverse, fair, and equitable work and learning environment for all and supports the medical profession in its work to achieve a welcoming, inclusive environment in teaching, learning, caring for patients, and collaboration.
The diversity of medical schools is changing and will continue to change. AΩA is committed to continuing to work with its members, medical school deans, and AΩA chapters to assure that AΩA elections are unbiased and based on the values of AΩA and the profession of medicine in service to patients and the profession.
Progress toward diversity, inclusion, and equity is more than simply checking off a box or responding to criticism—it is about being and developing diverse excellent physicians. AΩA and all those in the medical profession must continue to guide medicine to be unbiased, open, accepting, inclusive, and culturally aware in order to “Be Worthy to Serve the Suffering.”
The Triceps Traction Test: A Decision Tool for the Choice of Stabilizing Flap After In Situ Decompression of the Ulnar Nerve
Authors: Curran Matthew W.T. , Power Hollie A. , Chan K. Ming , Morhart Michael J. 
Published: November 2019

Purpose:
Recent evidence demonstrates that in situ decompression has comparable outcomes to other surgical techniques for cubital tunnel syndrome. However, this technique does not address the instability of the ulnar nerve, a common indication to transpose the ulnar nerve. Transposition of the ulnar nerve can potentially devascularize the ulnar nerve, stabilizing flaps block subluxation of the ulnar nerve and thereby negate the need for transposition. Flaps originating from the triceps and the flexor-pronator fascia could be used to stabilize the ulnar nerve. Herein, we present a novel intraoperative test, the “triceps traction test” and our algorithm for choosing a stabilizing flap when ulnar nerve instability is encountered after in situ decompression.
Cardiac complications in systemic sclerosis: early diagnosis and treatment
Authors: Nie Liu-Yan , Wang Xiao-Dong , Zhang Ting , Xue Jing 
Published: November 2019

Abstract

Objective:
Systemic sclerosis (SSc) is a remarkably systemic heterogeneous connective tissue disease with many organs involved. The heart is one of the major organs involved, carrying the threat of sudden cardiac death, especially in diffuse cutaneous SSc. This review summarizes the pathophysiology, types, new diagnostic approaches, and imaging and novel therapies of primary cardiac complications while underlining the effects of recently developed non-contrast cardiovascular magnetic resonance (CMR) in early diagnosis.

Data sources:
Medline and Embase were searched for articles published up to July 2019. A combination of Medical Subject Headings (MeSH) terms and keywords pertaining to SSc (“Scleroderma, Systemic” OR “Systemic sclerosis” OR" SSc”), AND cardiology (“cardiology” OR “heart” OR “cardiac”) were applied to the search strategies.

Study selection:
Literature was mainly printed in English and Chinese about cardiac complications in systemic sclerosis. After selected simply on the title and abstract, the articles were included for the full text. Article type was not limited.

Results:
Relevant cardiac manifestations are complex, including arrhythmias, pericardial effusion, myocardial dysfunction, and valvular diseases. Even though the symptoms of cardiac complications are well known, unfortunately, they appear to be poor prognostic factors. As systemic sclerosis with cardiac complications has a high mortality rate and patients might have a poor quality of life, it is essential to promote early diagnosis and treatment. With the advent of non-invasive imaging techniques, such as CMR, early diagnosis of cardiac complications in SSc is becoming more effective.

Conclusions:
Cardiac complications play an essential role in SSc and carry the threat of sudden cardiac death. More basic and clinical studies are warranted to develop better management of cardiac involvement in patients with SSc.
Significance of alternative splicing in cancer cells
Authors: Qi Fei , Li Yong , Yang Xue , Wu Yan-Ping , Lin Lian-Jun , Liu Xin-Min 
Published: November 2019

Abstract

Objective
Alternative splicing can generate various structural and functional protein isoforms. Recently, accumulating evidence shows a relationship between alternative splicing and cancer. Cancer is a complex and chronic disease that involves malignant transformation. In this review, we consider alternative splicing events in relation to the hallmarks of cancer cells, and discuss current therapies to treat cancer-related to alternative splicing.

Data sources
Data cited in this article are from the PubMed and Embase database, primarily focusing on research published from 2000 to 2018.

Study selection
Articles were selected with the search terms “alternative splicing,” “cancer cell,” “tumor microenvironment,” and “therapy.”

Results
Alternative splicing plays an important role in tumorigenesis, development, and escape from cell death. Taking this trait of cancer cells into consideration will allow more definite diagnoses of cancer, and allow the development of more effective medicines to intervene in cancer that could focus on controlling alternative splicing or competitively binding to the final products.

Conclusions
Alternative splicing is common in cancer cells. Consideration of alternative splicing may allow different strategies for cancer therapy or the identification of novel biomarkers for cancer diagnosis.
Mohs Surgery for Periocular Tumors
Authors: Monheit Gary , Hrynewycz Katherine 
Published: November 2019

BACKGROUND
Skin cancers of the periorbital area present unique challenges to Mohs surgeons.

OBJECTIVE
The need for precise and high-quality Mohs micrographic surgery (MMS) is paramount because of the complex anatomy, vital structures, and potential threat to vision.

METHODS
A thorough comprehension of anatomy is essential to help predict tumor behavior and ensure successful outcomes for patients.

RESULTS
Tumors occurring at the medial and lateral canthi are of greatest concern for deeper orbital penetration.

CONCLUSION
In this study, we present our experience with MMS of periorbital tumors, including clinical pearls and techniques to aid the Mohs surgeon.
Considering Breast Reconstruction after Mastectomy: A Patient Decision Aid Video and Workbook
Authors: Hoffman Aubri S. , Cantor Scott B. , Fingeret Michelle C. , Housten Ashley J. , Hanson Summer E. , McGee Jennifer H. , Pietz Jordan T. , Bennett Alina , Volk Robert J. , Reece Gregory P. 
Published: November 2019

Background:
Women report difficulty understanding and personalizing breast reconstruction information during the complex and time-limited period of cancer treatment planning. Patient decision aids can help patients become well informed, form realistic expectations, prepare to communicate with the surgical team, and be more satisfied with their decision-making process.

Methods:
We engaged patients, providers, and stakeholders in a user-centered design process to develop an online patient decision aid video and interactive workbook for breast reconstruction after mastectomy. The video and workbook introduce breast reconstruction and compare the risks and benefits of 3 key decisions: reconstruction versus no reconstruction, immediate versus delayed, and tissue- versus implant based. Pilot testing using cognitive interviews and pre-/postdecision aid questionnaires assessed acceptability, knowledge, and decision-making values.

Results:
After viewing the decision aid, patients (n = 20) scored 97.5% correct on a knowledge test; however, the factors driving their decisions were varied. All (n = 40) patients and providers/stakeholders provided over 80% positive acceptability ratings. 97.5% said they would recommend the video and workbook to other women with breast cancer.

Conclusions:
The Considering Breast Reconstruction after Mastectomy patient decision aid video and workbook show potential for improving informed decision-making. Delivery before the initial plastic surgery consultation was well supported as a way to give women time to process the information and prepare to talk with the surgical team about their options. The Personal Decision Worksheet shows potential for assessing patients’ knowledge and the factors driving their personal decision-making process.
A Cost and Efficiency Analysis of the WALANT Technique for the Management of Trigger Finger in a Procedure Room of a Major City Hospital
Authors: Maliha Samantha G. , Cohen Oriana , Jacoby Adam , Sharma Sheel 
Published: November 2019

Background:
The “Wide Awake Local Anesthesia No Tourniquet” (WALANT) technique is gaining popularity in hand surgery owing to its benefits of reduced cost, shorter hospital stay, improved safety, and the ability to perform active intraoperative examinations. The aim of this study is to analyze the cost savings and efficiency of performing A1 pulley release for treatment of trigger finger using the WALANT technique in a major city hospital procedure room (PR) as compared with the standard tourniquet, operating room (OR) approach.

Methods:
Patients who underwent trigger finger release between 2012 and 2017 were identified. Demographic and procedural information were obtained. Patients were followed for an average of 82 and 242 days in the PR and OR groups, respectively.

Results:
Thirty-nine PR and 37 OR patients were identified. Case length and turnover time were shorter in the PR group [21.4 ± 7 versus 23.5 ± 14.3 min (P = 0.942) and 31.1 ± 11.1 and 65.3 ± 17.7 min (P < 0.001), respectively). The cost of the instrument tray utilized was calculated as $3,304.25 in the main OR and $993.79 in the PR. Cost per minute for all personal services in the OR was calculated to be $44/min, a cost that was virtually absent in the PR. Complication rates did not differ between both groups.

Conclusion:
Performing A1 pulley release for treatment of trigger finger using the WALANT technique is both cost effective and time efficient compared to performing the same procedure in the main OR of a major city public hospital.
Weight gain and blood pressure
Authors: Sundström Johan , Lind Lars , Lampa Erik , Angerås Oskar , Bachus Erasmus , Bergström Göran , Carlberg Bo , Engström Gunnar , Engvall Jan E. , Eriksson Mats , Gigante Bruna , Hagström Emil , Hjelmgren Ola , Jansson Jan-Håkan , Jernberg Tomas , Mannila Maria , Nyström Fredrik H. , Oldgren Jonas , Persson Margaretha , Sandström Anette , Swahn Eva , Söderberg Stefan , Torén Kjell , Östgren Carl Johan , Rosengren Annika 
Published: November 2019

Objective:
Although the causality of the obesity--hypertension association is established, the potential for prevention is not. We hypothesized that weight gain between early adulthood and mid-life is associated with higher mid-life blood pressure.

Methods:
We investigated the hypothesis using a large contemporaneous population-based mid-life cohort of men and women aged 50–64 years. Recalled body weight at age 20 years was self-reported, and mid-life body weight and office blood pressures were measured in accordance with a detailed protocol.

Results:
On average, men had gained 14.9 (95% CI 14.6–15.2) kg of weight, and women 14.6 (95% CI 14.4–14.9) kg, between age 20 years and the mid-life examination, corresponding to 0.40 (95% CI 0.39–0.41) kg/year for men and women. Both weight at age 20 years and weight at the mid-life examination were associated with mid-life blood pressures. On average, a 10 kg weight increase between age 20 years and mid-life was associated with 2.2 (95% CI 0.9–3.5) mmHg higher systolic and 1.7 (95% CI 0.9–2.5) mmHg higher diastolic mid-life blood pressure in men, and 3.2 (2.5–4.0) mmHg higher systolic and 2.4 (1.9–2.9) mmHg higher diastolic mid-life blood pressure in women. Mid-life weight was more closely associated than weight at age 20 years with mid-life blood pressure. For a given mid-life weight, blood pressure was higher in persons with higher weight gain from age 20 years.

Conclusion:
In sum, weight gain between early adulthood and mid-life was associated with higher mid-life blood pressure. The magnitude of the association indicates a potentially great public health impact of strategies to prevent weight gain throughout adulthood.
Objectively measured physical activity relates to night-time blood pressure in older adults: cross-sectional analysis in the HEIJO-KYO cohort
Authors: Yamagami Yuki , Saeki Keigo , Tai Yoshiaki , Maegawa Taeko , Iwamoto Junko , Kataoka Hiroshi , Kurumatani Norio , Obayashi Kenji 
Published: November 2019

Objectives:
Prognostically, night-time blood pressure (BP) is more important than other BP parameters. Previous physiological studies suggested physical exercise continuously decreases subsequent BP levels, although the association between daytime physical activity and night-time BP has not been evaluated in large populations.

Methods:
This cross-sectional study of 1111 older adults (mean age, 71.8 years) measured physical activity using actigraphy and ambulatory BP parameters.

Results:
The mean night-time SBP and DBP were 115.9 mmHg (SD, 16.2) and 67 mmHg (8.6), respectively, and the mean average daytime physical activity was 299.2 counts/min (104.3). A multivariable linear regression analysis, adjusted for potential confounders, suggested greater average daytime physical activity was significantly associated with lower night-time SBP (regression coefficient per 100 counts/min increment, −1.18; 95% CI −2.10 to −0.26), and DBP (−0.69; 95% CI −1.17 to −0.17). Significant associations between time above activity thresholds and night-time SBP were consistently observed (≥500 counts/min: regression coefficient per log min increment, −1.61, 95% CI −3.14 to −0.08; ≥1000 counts/min: −1.00, 95% CI −1.97 to −0.03; ≥1500 counts/min: −1.13, 95% CI −2.11 to −0.14). A subgroup analysis without antihypertensive medications (n = 619) strongly associated time above activity thresholds with night-time SBP (≥500 counts/min: −2.94; 95% CI −5.20 to −0.68). These results were consistent in the analysis using dipping as a dependent variable.

Conclusion:
Objectively measured daytime physical activity was significantly and inversely associated with night-time BP in older adults. Further longitudinal studies would ascertain effects of physical activity on night-time BP.
A 15-YEAR-OLD BOY WITH PROTRACTED VISION LOSS FROM ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY
Authors: Sulewski Michael E. , Kolomeyer Anton M. , Saran Bruce R. , Brucker Alexander J. 
Published: November 2019

Purpose:
To present an atypical case of acute posterior multifocal placoid pigment epitheliopathy in a 15 year old treated with immunosuppressive therapy.

Methods:
Interventional case report.

Results:
On initial presentation, the vision was 20/200 in the right eye and 20/300 in the left eye. The posterior poles of both eyes showed numerous creamy-white placoid lesions. Fundus autofluorescence demonstrated hypoautofluorescence lesions with hyperautofluorescence rims, while fluorescein angiography showed early blockage followed by late staining. These findings were consistent with a diagnosis of acute posterior multifocal placoid pigment epitheliopathy. Optical coherence tomography demonstrated outer retinal disruptions and thinning. Due to the severity of his disease, the patient was treated first with oral prednisone and later transitioned to mycophenolate mofetil by 2 months. His poor vision persisted beyond a 5-month follow-up visit despite fading of the lesions and reconstitution of the outer retinal layers and thickness on optical coherence tomography. By 8 months of follow-up, the visual acuity returned to 20/20 bilaterally without any further recurrences.

Conclusion:
Although most patients with acute posterior multifocal placoid pigment epitheliopathy have a relatively short course and recover vision quickly, the use of steroids and immunosuppression may be of benefit for those patients with severe and prolonged visual loss.