bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular- and Bleeding-Related Hospitalization Rates With Edoxaban Versus Warfarin in Patients With Atrial Fibrillation Based on Results of the ENGAGE AF–TIMI 48 Trial
Authors: Vilain Katherine , Li Haiyan , Kwong Wingham J. , Antman Elliott M. , Ruff Christian T. , Braunwald Eugene , Cohen David J. , Giugliano Robert P. , Magnuson Elizabeth A. ,   on behalf of the ENGAGE AF-TIMI 48 Trial Investigators
Published: November 2020

Background
The ENGAGE AF–TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation–Thrombolysis in Myocardial Infarction 48) demonstrated noninferiority of once-daily 60 mg (30 mg dose-reduced) edoxaban compared with warfarin for prevention of stroke/systemic embolism in patients with atrial fibrillation. No previous analysis has explored the impact of treatment with edoxaban versus warfarin on rates of hospitalizations.

Methods
Detailed healthcare resource utilization data from ENGAGE AF–TIMI 48 for the 14 024 randomized patients who received at least one dose of study drug were used to compare the rates of bleeding- and cardiovascular-related hospitalizations for edoxaban versus warfarin. Hospitalization rates were calculated for each treatment group, and relative rates were estimated using Poisson regression. The influence of patient characteristics on the impact of edoxaban versus warfarin was evaluated through the inclusion of interaction terms.

Results

The overall rate of cardiovascular- or bleeding-related hospitalization was significantly lower for edoxaban than warfarin (relative rate [RR], 0.91 [95% CI, 0.85–0.97],
P
=0.003). Rates of hospitalizations for cardiovascular reasons (RR, 0.91 [95% CI, 0.85–0.97],
P
=0.004), stroke (RR, 0.80 [95% CI, 0.72–0.88],
P
<0.0001), and for each stroke subtype (ischemic: RR, 0.89 [95% CI, 0.81–0.99],
P
=0.03; hemorrhagic: RR, 0.60 [95% CI, 0.54–0.68],
P
<0.0001) were also lower for edoxaban. Notably, significantly greater reductions with edoxaban versus warfarin were seen for ischemic stroke–related hospitalizations in vitamin K antagonist naive patients and patients with CHADS
2
scores 4 to 6, previous stroke or transient ischemic attack, age ≥75, and no previous coronary artery disease. For nonstroke bleeding–related hospitalizations, greater reductions with edoxaban were seen in vitamin K antagonist naive patients, patients with CHADS
2
scores 4 to 6, and patients with moderate renal dysfunction.

Conclusions
Edoxaban 60 mg (30 mg dose-reduced) was associated with a significantly lower overall rate of cardiovascular- or bleeding-related hospitalization and significant reductions in the subcategories of cardiovascular-related, stroke-related, bleed-related, and nonstroke cardiovascular–related hospitalizations, when compared with warfarin. These results suggest the potential for cost offsets with edoxaban, with even greater reductions in higher-risk patients.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00781391
Reduction in Revascularization With Icosapent Ethyl
Authors: Peterson Benjamin E. , Bhatt Deepak L. , Steg Ph. Gabriel , Miller Michael , Brinton Eliot A. , Jacobson Terry A. , Ketchum Steven B. , Juliano Rebecca A. , Jiao Lixia , Doyle Ralph T. , Granowitz Craig , Gibson C. Michael , Pinto Duane , Giugliano Robert P. , Budoff Matthew J. , Tardif Jean-Claude , Verma Subodh , Ballantyne Christie M. ,   On behalf of the REDUCE-IT Investigators
Published: November 2020

Background:
Patients with elevated triglycerides despite statin therapy have increased risk for ischemic events, including coronary revascularizations.

Methods:
REDUCE-IT (The Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial), a multicenter, double-blind, placebo-controlled trial, randomly assigned statin-treated patients with elevated triglycerides (135–499 mg/dL), controlled low-density lipoprotein (41–100 mg/dL), and either established cardiovascular disease or diabetes plus other risk factors to receive icosapent ethyl 4 g/d or placebo. The primary and key secondary composite end points were significantly reduced. Prespecified analyses examined all coronary revascularizations, recurrent revascularizations, and revascularization subtypes.

Results:

A total of 8179 randomly assigned patients were followed for 4.9 years (median). First revascularizations were reduced to 9.2% (22.5/1000 patient-years) with icosapent ethyl versus 13.3% (33.7/1000 patient-years) with placebo (hazard ratio, 0.66 [95% CI, 0.58–0.76];
P
<0.0001; number needed to treat for 4.9 years=24); similar reductions were observed in total (first and subsequent) revascularizations (negative binomial rate ratio, 0.64 [95% CI, 0.56–0.74];
P
<0.0001), and across elective, urgent, and emergent revascularizations. Icosapent ethyl significantly reduced percutaneous coronary intervention (hazard ratio, 0.68 [95% CI, 0.59–0.79];
P
<0.0001) and coronary artery bypass grafting (hazard ratio, 0.61 [95% CI, 0.45–0.81];
P
=0.0005).

Conclusions:
Icosapent ethyl reduced the need for first and subsequent coronary revascularizations in statin-treated patients with elevated triglycerides and increased cardiovascular risk. To our knowledge, icosapent ethyl is the first non–low-density lipoprotein–lowering treatment that has been shown to reduce coronary artery bypass grafting in a blinded, randomized trial.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01492361.
Drinking Patterns and Risk of Ischemic Stroke in Middle-Aged Adults
Authors: Yang Wookjin , Kang Dong-Wan , Ha Sue Young , Lee Seung-Hoon 
Published: November 2020

Background and Purpose:
Although it has been reported that the amount of alcohol consumption has a J-shaped association with ischemic stroke, it is unclear whether differences in drinking patterns affect this relationship. We aimed to clarify the impact of drinking patterns on ischemic stroke in midlife.

Methods:
We used data from the National Health Insurance Service-National Sample Cohort, which is a large-sized, standardized population cohort in Korea. Five different drinking patterns were defined by combining the frequency of alcohol consumption and quantity of alcohol consumed per occasion, that is, abstainers, not drinking alcohol; drinker group I, ≤30 g/d and <5 d/wk; drinker group II, ≤30 g/d and ≥5 d/wk; drinker group III, >30 g/d and <5 d/wk; and drinker group IV, >30 g/d and ≥5 d/wk. The association between the drinking patterns and ischemic stroke occurrence was analyzed using the Cox proportional hazard model.

Results:
A total of 152 469 middle-aged participants (mean age, 50.2 years; 72 285 men [47.4%]) were eligible for the analyses. The median follow-up time was 9.0 years. Compared with abstainers, those who drank <5 d/wk (drinker groups I and III) had a significantly lower risk of ischemic stroke (group I hazard ratio, 0.71 [95% CI, 0.59–0.85]; group III hazard ratio, 0.80 [95% CI, 0.68–0.93]) during the first 7 years from the baseline, while other drinker groups showed no such differences. However, the effect of drinking patterns on ischemic stroke risk was attenuated after the first 7 years.

Conclusions:
Reduced risk of ischemic stroke was observed in middle-aged participants with specific drinking patterns, but it was limited to the earlier period. Physicians should be cautious in educating patients on alcohol consumption, considering the long-term association between drinking patterns and ischemic stroke.
Introduction
Authors: Dahlgren Susanne , Lindbekk Monika 
Published: November 2020

Abstract
This article focuses on adjudication of Muslim family law in countries that range from the Middle East and North Africa to South-East Asia. It begins by shortly summarizing the development of shari‘a in pre-modern times, up until the 19th century. We discuss the basic features of marriage among classical jurists and argue that the close connection known today between the family and Islamic law can be traced to the emergence of modern nation states and centralizing state structures. We then provide a description of important personal status reforms during the 20th and 21st centuries and consider the growing body of scholarship that engages with adjudication of Muslim family law in action and in context. Finally, we consider the contribution that the articles contained in the special double issue make to the field of research, including the questions of gender and judicial authority, religion-based judicial activism, and the courts’ involvement in larger socio-political processes.
“I’ll Dance for You, I’ll Dance for Me, I’ll Dance for the Sake of Dancingˮ
Authors: Gottesfeld Dorit 
Published: November 2020

Abstract
This article examines ʿAtaba thaqīlat al-rūḥ (“Threshold of heavy spirit,” 2011), a novel by the new generation West Bank writer Māyā Abū l-Ḥayāt, who is considered one of the prominent new generation Palestinian West Bank writers, in which diverse and unique use of a dance motif is found. The article reviews the history of dance in Arab society and the meanings that it had in the past and currently has in Arab society and culture. It illustrates how Abū l-Ḥayāt uses each of these meanings throughout her novel in order to reveal the female soul and the status of women in Arab society. The article shows how Abū l-Ḥayāt incorporates this motif into her novel in a unique and original way, thus exposing woman’s yearning for freedom, creating a new feminine language and undermining accepted norms.
Cross Scripts: Inscribing Hebrew into Jewish American Literature
Authors: Wirth-Nesher Hana 
Published: November 2020

Abstract
Most Jewish immigrants to America during the early 20th century arrived speaking Yiddish or Ladino and using Hebrew and Aramaic for liturgical purposes. When subsequent generations abandoned the first two languages, Hebrew and Aramaic were retained, used primarily for liturgy and rites of passage. Jewish American writers have often inserted Hebrew into their English texts by either reproducing the original alphabet or transliterating into Latin letters. This essay focuses on diverse strategies for representing liturgical Hebrew with an emphasis on the poetic, thematic, and sociolinguistic aspects of these expressions of both home and the foreign. Hebrew transliteration is discussed for its literary (rather than phonetic) rendering, for its multilingual creative contact with the other languages and cultures of each narrative. Among the authors whose works are discussed are Philip Roth, Michael Chabon, Nathan Englander, Joshua Cohen, Achy Obejas, and Gary Shteyngart.
Analysis of Debris Signature Characteristics and Evolution in the 24 May 2016 Dodge City, Kansas, Tornadoes
Authors: Wienhoff Zachary B. , Bluestein Howard B. , Reif Dylan W. , Wakimoto Roger M. , Wicker Louis J. , Kurdzo James M. 
Published: November 2020

AbstractOn 24 May 2016, a supercell that produced 13 tornadoes near Dodge City, Kansas, was documented by a rapid-scanning, X-band, polarimetric, Doppler radar (RaXPol). The anomalous nature of this storm, particularly the significant deviations in storm motion from the mean flow and number of tornadoes produced, is examined and discussed. RaXPol observed nine tornadoes with peak radar-derived intensities (ΔVmax) and durations ranging from weak (~60 m s−1) and short lived (<30 s) to intense (>150 m s−1) and long lived (>25 min). This case builds on previous studies of tornado debris signature (TDS) evolution with continuous near-surface sampling of multiple strong tornadoes. The TDS sizes increased as the tornadoes intensified but lacked direct correspondence to tornado intensity otherwise. The most significant growth of the TDS in both cases was linked to two substantial rear-flank-downdraft surges and subsequent debris ejections, resulting in growth of the TDSs to more than 3 times their original sizes. The TDS was also observed to continue its growth as the tornadoes decayed and lofted debris fell back to the surface. The TDS size and polarimetric composition were also found to correspond closely to the underlying surface cover, which resulted in reductions in ZDR in wheat fields and growth of the TDS in terraced dirt fields as a result of ground scouring. TDS growth with respect to tornado vortex tilt is also discussed.
Parenting a Child With Autism Spectrum Disorder: Perspective of Jordanian Mothers
Authors: Shattnawi Khulood Kayed , Bani, Saeed Wafa’a M. , Al-Natour Ahlam , Al-Hammouri Mohammed M. , Al-Azzam Manar , Joseph Rachel A. 
Published: November 2020

Introduction: Parenting a child diagnosed with autism spectrum disorder (ASD) is challenging for mothers because of concerns related to behavior, difficulties in accessing specialized care, and lack of community acceptance, yet their stories in Jordanian context are still unknown. Common challenges in Jordan include financial burdens, lack of public awareness, and lack of specialized knowledge even among health care providers, which may lead to delays in obtaining the diagnosis and interventions for ASD. Method: A phenomenological descriptive approach was used to explore and understand the mothers’ everyday lived experiences of raising a child with ASD. Semistructured interviews were conducted with 14 mothers to identify their challenges so that nurses can identify gaps in services, empower families, and facilitate optimum care to these Jordanian families. Findings: The main themes that emerged were (1) mothers’ journeys with the diagnosis, in which mothers recognized the abnormalities of their children, reported delays in getting the diagnosis and initiation of treatment, and described a wide range of reactions to the diagnosis from grief and guilt to a blessing from God; (2) the burden of care, by which mothers reported physical and emotional exhaustion, financial burdens, and concerns about the quality of available services; and (3) the consequences and the hurdle of having a child with ASD, which affected the family relationships and social life. Discussion: Jordanian mothers caring for children with ASD face several challenges, including physical, psychological, financial, and social challenges, in addition to limited specialized services. Identifying their unique challenges and needs are essential to support them, provide appropriate services and resources, and develop policies and guidelines for culturally competent quality services.
Economic Burden of Osteoporosis-Related Fractures in the US Medicare Population
Authors: Williams Setareh A. , Daigle Shanette G. , Weiss Richard , Wang Yamei , Arora Tarun , Curtis Jeffrey R. 
Published: November 2020

Background Osteoporosis-related fractures are an important public health burden. Objective To examine health care costs in Medicare patients with an osteoporosis-related fracture. Methods Medicare fee-for-service members with an osteoporosis-related fracture between January 1, 2010, to September 30, 2014 were included. A nonfracture comparator group was selected by propensity score matching. Generalized linear models using a gamma distribution were used to compare costs between fracture and nonfracture cohorts. Results A total of 885 676 Medicare beneficiaries had fracture(s) and met inclusion criteria. Average age was 80.5 (±8.4) years; 91% were White, and 94% female. Mean all-cause costs were greater in the fracture vs nonfracture cohort ($47 163.25 vs $16 034.61) overall and for men ($52 273.79 vs $17 352.68). The highest mean costs were for skilled nursing facility ($29 216), inpatient costs ($24 190.19), and hospice care ($20 996.83). The highest incremental costs versus the nonfracture cohort were for hip ($71 057.83 vs $16 807.74), spine ($37 543.87 vs $16 860.49), and radius/ulna ($24 505.27 vs $14 673.86). Total medical and pharmacy costs for patients who experienced a second fracture were higher compared with those who did not ($78 137.59 vs $44 467.47). Proportionally more patients in the fracture versus nonfracture cohort died (18% vs 9.3%), with higher death rates among men (20% vs 11%). Conclusion and Relevance The current findings suggest a significant economic burden associated with fractures. Early identification and treatment of patients at high risk for fractures is of paramount importance for secondary prevention and reduced mortality.
A Pharmacokinetic-Pharmacodynamic Analysis to Dose Optimize Daptomycin in Vancomycin-Resistant Enterococcus faecium: Is the Answer Fixed Dosing or Lowering Breakpoints?
Authors: Butterfield-Cowper Jill M. 
Published: November 2020

Background: The optimal daptomycin dose for vancomycin-resistant Enterococcus faecium remains unclear. Dosing of 8 to 12 mg/kg/d has been recommended to improve outcomes, but literature suggests fixed dosing may improve methicillin-resistant Staphylococcus aureus bacteremia pharmacodynamic (PD) targets. Objective: This study sought to evaluate weight-based versus fixed dosing of daptomycin based on pharmacokinetic and PD (PK-PD) targets in vancomycin-resistant E faecium bacteremia. Methods: PK-PD analyses were conducted using previously published PK models for daptomycin. Probability of target attainment (PTA) was assessed for 8 to 12 mg/kg/d and various fixed doses. The percentage of simulated participants who achieved a free area under the concentration-time curve from 0 to 24 hours to minimum inhibitory concentration ratio ( fAUC0-24/MIC) >27.43 for susceptible dose-dependent (SDD) MICs and the probability of a minimum concentration ( Cmin) > 24.3 mg/L were calculated. Results: At MICs ≤2 mg/L, fixed doses had the best overall PTA. At the SDD breakpoint of 4 mg/L, all weight-based doses had <60% PTA. A fixed dose of 1500 mg/d was necessary for >/= 90% PTA at higher MICs considered SDD; however, this dose had elevated risks of Cmin ≥24.3 mg/L. Conclusion and Relevance: Fixed doses were more likely to achieve a fAUC/MIC of 27.43 than weight-based doses up to 12 mg/kg/d. However, fixed doses necessary for 90% PTA against SDD isolates with higher MICs were associated with elevated risks of toxicity. A reevaluation of Clinical Laboratory Standards Institute breakpoints may need to be considered, with an emphasis on lowering the SDD breakpoint to 1 mg/L.
Well Homes Initiative: A Home-Based Intervention to Address Housing-Related Ill Health
Authors: Pierse Nevil , White Maddie , Ombler Jenny , Davis Cheryl , Chisholm Elinor , Baker Michael , Howden-Chapman Philippa 
Published: November 2020

Background Six thousand children are hospitalized each year in New Zealand with housing sensitive conditions, and 86.2% of these children are rehospitalized during childhood. The Healthy Homes Initiative, set up by the Ministry of Health, and implemented in Wellington through Well Homes, carries out housing assessments and delivers a range of housing interventions. Method Housing assessments were carried out by trained community workers. Philanthropic funding was received for the interventions through a local charitable trust. Results Well Homes saw 895 families. Mold in the home was the most commonly recorded area of poor housing quality, in 836 homes (93%). Partial or complete lack of insulation was also common, with 452 records (51%) having a documented need for further assessment and either an upgrade or full installation. Eighty-three percent of homes had insufficient sources of heating. A total of 5,537 interventions were delivered. Bedding, heaters, and draft stopping were delivered over 90% of the time. In contrast, insulation and carpets were only delivered 40% of the time. Interventions were least likely to be delivered in private rental housing. Discussion Targeted interventions using social partnerships can deliver housing improvements for relatively little health spending. Well Homes provides immediate and practical interventions, education, connection with social agencies, and advocacy for more substantial structural home improvements to help families keep their home warmer, drier, and healthier. This approach will be strengthened when combined with a new regulatory framework to raise the standards of private rental housing.
Public Housing and Well-Being: Evaluation Frameworks to Influence Policy
Authors: Rangiwhetu Lara , Pierse Nevil , Chisholm Elinor , Howden-Chapman Philippa 
Published: November 2020

Background A robust evidence base is needed to develop sustainable cross-party solutions for public housing to promote well-being. The provision of public housing is politically contentious in New Zealand, as in many liberal democracies. Depending on the government, policies oscillate between encouraging sales of public housing stock and reducing investment and maintenance, and large-scale investment, provision, and regeneration of public housing. Aim We aimed to develop frameworks to evaluate the impact of public housing regeneration on tenant well-being at the apartment, complex, and community levels, and to inform future policies. Method Based on a systems approach and theory of change models, we developed a mixed methods quasi-experimental before-and-after outcomes evaluation frameworks, with control groups, for three public housing sites. This evaluation design had flexibility to accommodate real-world complexities, inherent in evaluating large-scale public health interventions, while maintaining scientific rigor to realize the full effects of interventions. Results Three evaluation frameworks for housing were developed. The evaluation at the apartment level confirmed proof of concept and viability of the framework and approach. This also showed that minor draught-stopping measures had a relatively big impact on indoor temperature and thermal comfort, which subsequently informed healthy housing standards. The complex and community-level evaluations are ongoing due to longer regeneration timeframes. Conclusion Public housing is one of central government’s larger social sector interventions, with Kāinga Ora – Homes and Communities the largest Crown entity. Evaluating public housing policies is important to develop an evidence base to inform best practice, rational, decision-making policy for the public as well as the private sector.
Comparative analysis of ocular redness score evaluated automatically in glaucoma patients under different topical medications
Authors: Giannaccare Giuseppe , Pellegrini Marco , Bernabei Federico , Senni Carlotta , Aloi Maria , Scalzo Giovanna Carnovale , Ceravolo Domenico , Iovino Claudio , Scorcia Vincenzo 
Published: November 2020

Purpose: To compare ocular redness score calculated automatically between glaucoma patients and healthy controls, and to assess the associations between this score and both demographical and clinical characteristics. Methods: Glaucoma patients under different topical medications and matched controls were enrolled in this observational cross-sectional study. The Keratograph 5M (Oculus Optikgeräte GmbH) was used to automatically measure 5 redness scores: global; nasal bulbar; temporal bulbar; nasal limbal; temporal limbal. The Student t and ANOVA tests were used to compare continuous variables between groups. A multiple linear regression analysis was performed to evaluate the associations between redness scores and the use of different active principles. Results: One hundred two glaucoma patients and 32 controls were included. Ocular redness scores were significantly higher in glaucoma patients compared to controls (always p < 0.001). The number of active principles was significantly associated with all the redness scores (always p < 0.05). The use of carbonic anhydrase inhibitors (CAIs) was the strongest predictor of overall redness, followed by prostaglandin analogs (PAs) and alpha-adrenergic agonists (AAAs) (respectively, β = 0.400, p = 0.002; β = 0.330, p = 0.013; β = 0.311, p = 0.044). The post hoc analysis measuring the effect of different PAs on redness scores showed that overall redness and bulbar nasal redness scores were significantly lower in patients using tafluprost and latanoprost compared to those using travoprost and bimatoprost 0.01% (respectively, p = 0.025 and p = 0.024). Conclusion: Ocular redness was significantly higher in patients with glaucoma compared to control subjects. The number of active principles and the use of PAs, CAIs and AAAs were associated with higher redness scores.