bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prehospital opioid dose and myocardial injury in patients with ST elevation myocardial infarction
Authors: Fernando Himawan , Nehme Ziad , Peter Karlheinz , Bernard Stephen , Stephenson Michael , Bray Janet , Cameron Peter , Ellims Andris , Taylor Andrew , Kaye David M , Smith Karen , Stub Dion 
Published: July 2020

ObjectiveTo characterise the relationship between opioid dose and myocardial infarct size in patients with ST elevation myocardial infarction (STEMI).MethodsPatients given opioid treatment by emergency medical services with confirmed STEMI were included in this secondary, retrospective cohort analysis of the Air versus Oxygen in Myocardial Infarction (AVOID) study. Patients with cardiogenic shock were excluded. The primary endpoint was comparison of cardiac biomarkers as a measure of infarct size based on opioid dose (low ≤8.75 mg, intermediate 8.76–15 mg and high >15 mg of intravenous morphine equivalent dose).Results422 patients were included in the analysis. There was a significantly higher proportion of patients with Thrombolysis in Myocardial Infarction (TIMI) 0 or 1 flow pre-percutaneous coronary intervention (PCI) (94% vs 81%, p=0.005) and greater use of thrombus aspiration catheters (59% vs 30%, p<0.001) in the high compared with low-dose opioid group. After adjustment for potential confounders, every 1 mg of intravenous morphine equivalent dose was associated with a 1.4% (95% CI 0.2%, 2.7%, p=0.028) increase in peak creatine kinase; however, this was no longer significant after adjustment for TIMI flow pre-PCI.ConclusionsOur study suggests no benefit of higher opioid dose and a dose-dependent signal between opioid dose and increased myocardial infarct size. Prospective randomised controlled trials are required to establish causality given that this may also be explained by patients with a greater ischaemic burden requiring higher opioid doses due to more severe pain. Future research also needs to focus on strategies to mitigate the opioid–P2Y12 inhibitor interaction and non-opioid analgesia to treat ischaemic chest pain.
Whey protein supplementation and its potentially adverse effects on health: a systematic review
Authors: Vasconcelos Quezia Damaris Jones Severino , Bachur Tatiana Paschoalette Rodrigues , Aragão Gislei Frota 
Published: July 2020

Whey protein comprises soluble whey proteins and its benefits are well described in the literature. However, there are not many studies investigating the potential adverse effect of a diet with indiscriminate use of this supplement. The aim of this study was to perform a systematic review of papers that addressed this theme. A search was conducted in Medline, LILACS, TOXNET, Web of science, and Scopus electronic databases. In the end, 11 documents comprised this review. The majority of the papers associated the damaging effect with the chronic and abusive use of whey protein, with the kidneys and liver being the main organs affected. The other studies related whey protein to aggravation of aggression, presence of acne, and modification of the microbiota. Therefore, excessive consumption over a long period of protein supplementation may have some adverse effects on the body, which is aggravated when associated with sedentary lifestyle. PROSPERO registration no.: CRD42020140466. Novelty: A systematic review of experimental and randomized studies about the use of whey proteins supplements and its impact on physical health. Analysis revealed that chronic and without professional guidance use of whey protein supplementation may cause some adverse effects specially on kidney and liver function. Presented data support a need for future studies co-relating the use of different types of whey protein with and without exercise to better see the impact on human physical health.
The role of spin–orbit effects in the mobility of N+ ions moving in a helium gas at low temperature
Authors: Aïssaoui Lamia , Knowles Peter J. , Bouledroua Moncef 
Published: July 2020

Abstract

The mobility of N+ ions in ground-state helium gas at very low temperature is examined with explicit inclusion of spin–orbit coupling effects. The ionic kinetics is treated theoretically with the three-temperature model. The N+–He interaction potentials, including spin–orbit coupling, are determined using high-level ab initio calculations. Then, the classical and quantal transport cross sections, both needed in the computation of the mobility coefficients, are calculated in terms of the collisional energy of the N+–He system. The numerical results, at temperature 4.3 K, show the spin–orbit interactions have negligible effect on the mobility coefficients.

Graphical abstract
Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death
Authors: Everett Brendan M. , Moorthy M.V. , Tikkanen Jani T. , Cook Nancy R. , Albert Christine M. 
Published: July 2020

Background:
The majority of sudden cardiac deaths (SCDs) occur in low-risk populations often as the first manifestation of cardiovascular disease (CVD). Biomarkers are screening tools that may identify subclinical cardiovascular disease and those at elevated risk for SCD. We aimed to determine whether the total to high-density lipoprotein cholesterol ratio, high-sensitivity cardiac troponin I, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or high-sensitivity C-reactive protein individually or in combination could identify individuals at higher SCD risk in large, free-living populations with and without cardiovascular disease.

Methods:
We performed a nested case-control study within 6 prospective cohort studies using 565 SCD cases matched to 1090 controls (1:2) by age, sex, ethnicity, smoking status, and presence of cardiovascular disease.

Results:
The median study follow-up time until SCD was 11.3 years. When examined as quartiles or continuous variables in conditional logistic regression models, each of the biomarkers was significantly and independently associated with SCD risk after mutually controlling for cardiac risk factors and other biomarkers. The mutually adjusted odds ratios for the top compared with the bottom quartile were 1.90 (95% CI, 1.30–2.76) for total to high-density lipoprotein cholesterol ratio, 2.59 (95% CI, 1.76–3.83) for high-sensitivity cardiac troponin I, 1.65 (95% CI, 1.12–2.44) for NT-proBNP, and 1.65 (95% CI, 1.13–2.41) for high-sensitivity C-reactive protein. A biomarker score that awarded 1 point when the concentration of any of those 4 biomarkers was in the top quartile (score range, 0–4) was strongly associated with SCD, with an adjusted odds ratio of 1.56 (95% CI, 1.37–1.77) per 1-unit increase in the score.

Conclusions:
Widely available measures of lipids, subclinical myocardial injury, myocardial strain, and vascular inflammation show significant independent associations with SCD risk in apparently low-risk populations. In combination, these measures may have utility to identify individuals at risk for SCD.
Possible Link Between the ABO Blood Group of Bioprosthesis Recipients and Specific Types of Structural Degeneration
Authors: Schussler Olivier , Lila Nermine , Grau Juan , Ruel Marc , Lecarpentier Yves , Carpentier Alain 
Published: July 2020

Background
Pigs/bovines share common antigens with humans: α‐Gal, present in all pigs/bovines close to the human B‐antigen; and AH‐histo‐blood‐group antigen, identical to human AH‐antigen and present only in some animals. We investigate the possible impact of patients’ ABO blood group on bioprosthesis structural valve degeneration (SVD) through calcification/pannus/tears/perforations for patients ≤60 years at implantation.

Methods and Results

This was a single‐center study (Paris, France) that included all degenerative bioprostheses explanted between 1985 and 1998, mostly porcine bioprostheses (Carpentier‐Edwards second/third porcine bioprostheses) and some bovine bioprostheses. For the period 1998 to 2014, only porcine bioprostheses with longevity ≥13 years were included (total follow‐up ≥29 years). Except for blood groups, important predictive factors for SVD were prospectively collected (age at implantation/longevity/number/site/sex/SVD types) and analyzed using logistic regression. All variables were available for 500 explanted porcine bioprostheses. By multivariate analyses, the A group was associated with an increased risk of: tears (odds ratio[OR], 1.61;
P
=0.026); pannus (OR, 1.5;
P
=0.054), pannus with tears (OR, 1.73;
P
=0.037), and tendency for lower risk of: calcifications (OR, 0.63;
P
=0.087) or isolated calcification (OR, 0.67;
P
=0.17). A‐antigen was associated with lower risk of perforations (OR 0.56;
P
=0.087). B‐group patients had an increased risk of: perforations (OR, 1.73;
P
=0.043); having a pannus that was calcified (OR, 3.0,
P
=0.025). B‐antigen was associated with a propensity for calcifications in general (OR, 1.34;
P
=0.25).

Conclusions
Patient’s ABO blood group is associated with specific SVD types. We hypothesize that carbohydrate antigens, which may or may not be common to patient and animal bioprosthetic tissue, will determine a patient’s specific immunoreactivity with respect to xenograft tissue and thus bioprosthesis outcome in terms of SVD.
Right‐Sided Infective Endocarditis 2020: Challenges and Updates in Diagnosis and Treatment
Authors: Shmueli Hezzy , Thomas Felix , Flint Nir , Setia Gayatri , Janjic Aleksandar , Siegel Robert J. 
Published: July 2020

Abstract

Compared with the extensive data on left‐sided infective endocarditis (
IE
), there is much less published information on the features and management of right‐sided
IE
. Right‐sided
IE
accounts for 5% to 10% of all
IE
cases, and compared with left‐sided
IE
, it is more often associated with intravenous drug use, intracardiac devices, and central venous catheters, all of which has become more prevalent over the past 20 years. In this manuscript on right‐sided
IE
we provide an up‐to‐date overview on the epidemiology, etiology, microbiology, potential locations of infection in the right heart, diagnosis, imaging, common complications, management, and prognosis. We present updated information on the treatment of pacemaker and device infections, infected fibrin sheaths that appear to be an easily missed source of infection after central line as well as pacemaker removal. We review current data on the AngioVac percutaneous aspiration device, which can obviate the need for surgery in patients with infected pacemaker leads and fibrin sheaths. We also focused on advanced diagnostic modalities, such as positron emission tomography/computed tomography. All of these are supported by specific case examples with detailed echocardiographic imaging from our experience.
Abraham Unbound: The Prefiguration of the Unconscious in the First Generation of the Musar and Hasidic Movements
Authors: Boulouque Clémence 
Published: July 2020

Abstract
This study examines the respective theological assumptions of two major forces in nineteenth-century Judaism—the Musar and the early Hasidic movements, and the way in which the budding concept of the unconscious illuminates both. Often translated as an ethical approach, the Musar movement originated from Lithuania and focused on Torah study as it deemed Talmud insufficient to create a deep, emotional attachment to Judaism; yet, despite their shared emphasis on emotions and their criticism of talmudic studies, the Musar movement was at odds with Hasidism, the mystical Jewish current that swept Eastern Europe from the eighteenth century onward. Through an examination of the biblical motif of the binding of Isaac, and the reaction of Abraham, this article will probe both movements’ analysis of the patriarch’s psychological make up. Such a comparison of their understanding of the pre-conscious psychic states will illustrate the nature of their theological opposition.
Ostmann’s Fat Pad—Does it Really Matter?
Authors: Biadsee Ameen , Fanadka Feda , Dagan Or , Firas Kassem , Nageris Benny 
Published: July 2020

Objective: To compare the size of Ostmann’s fat pad (OFP) between healthy ears and ears with chronic otitis media with cholestatoma (COMwC) using magnetic resonance imaging (MRI). Methods: Twenty-six patients with unilateral COMwC underwent mastoidectomy. Pre-operative MRI records were reviewed retrospectively. The healthy ears served as the control group. OFP is represented by the maximum diameter of the high intensity area medial to the tensor veli palatini muscle (TVP); M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle; M2. Values of M1, M2 and the ratio of M1:M2 was compared between the healthy and pathological ear in each patient. Results: All 26 patients (16 females,10 males) had unilateral cholestatoma. Mean age was 37.6 years (range 19-83). In the healthy (H) ears group, mean M1H was 2.04 ± 0.53 mm, mean M2H was 9.57 ± 2.57 mm. In the pathological (P) ears group; mean M1P was 2.03 ± 0.55 mm, mean M2P was 9.86 ± 2.37 mm. A comparison of M1 and M2 values between the healthy and pathological ear groups was not statistically significant ( P = .853 and P = .509, respectively). Mean M1H:M2H ratio in the healthy ears group was 0.22 ± 0.05, mean M1P:M2P ratio in the pathological ear group was 0.21 ± 0.06. A comparison between these ratios found no significant statistical correlation ( P = .607). Conclusion: The size of Ostmann’s fat pad does not affect the development of chronic otitis media with cholestatoma in adults.
The effect of childhood trauma on age of onset in patients with schizophrenia
Authors: İngeç Cem , Evren Kılıçaslan Esin 
Published: July 2020

Purpose: Childhood trauma (CT) has been shown to affect the etiology and clinical features of schizophrenia. In this study, it was aimed to investigate the effects of CT on the age of onset (AoO) and clinical features of the disease by considering factors such as family history, head trauma, birth trauma, alcohol and substance abuse that may affect AoO of the disease. Methods: The sample comprising 200 patients admitted to the outpatient and inpatient care at the Izmir Katip Çelebi University, Atatürk Education and Research Hospital psychiatry clinic, were included in the study. Socio-demographic information form, Positive and Negative Syndrome Scale (PANSS), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and subscale of Mini-International Neuropsychiatric Interview (MINI) were applied. Results: All types of trauma, except physical abuse, were found related to the disease onset age earlier. It was also detected that the factors of head trauma, birth complication, presence of an individual diagnosed with schizophrenia in the family and migration history were not related to AoO of the disease. On the other hand, it was found that physical, emotional and sexual abuses lead to more positive psychotic symptoms, and all types of CT increase the severity of disease and the risk of suicide. Conclusion: This study draws attention to the etiological importance of CT in schizophrenia as an environmental factor by showing that it affects AoO of the disease along with symptomatology. Future studies should focus on the pathogenesis of CT in schizophrenia and the interaction between CT and biological and genetic predisposition.
Pediatric to Adult Transitions of Ketogenic Dietary Therapy for Epilepsy
Authors: Seaborg Kristin , Wang Xing , Olson Clara , Felton Elizabeth A. 
Published: July 2020

Ketogenic therapy is now an accepted treatment for pediatric and adult patients with medically refractory epilepsy.1-3 However, young adults treated with a ketogenic diet face unique challenges when transitioning to adult neurology providers.4 The variable acceptance of dietary therapy, paucity of nutritionists and adult neurology providers educated in dietary therapy, and lack of insurance coverage for dietary education may interfere with transition to adult care. In addition, patients in this life stage may just begin to independently seek medical care, cook meals, and manage medications, making strict dietary limitations difficult.4 In this worldwide study, we surveyed 191 pediatric and adult neurology providers who prescribe ketogenic dietary therapy for epilepsy. Our response rate was 39% with a total of 74 valid surveys received. Our goal was to identify perceived barriers that inhibit effective transition and successful continuation of dietary therapy during transition to adult care. We found that dietary therapy is a more accepted treatment of intractable epilepsy in children (84%) than adults (17%) in all geographic areas. Although half of pediatric neurology providers (50%) transition their young adult patients on dietary therapy to adult providers, only 23% have a documented transition plan or a formal transition protocol. Most (87%) pediatric providers who prescribe the ketogenic diet feel the lack of sufficient adult providers who prescribe dietary therapy as a barrier to transitioning adolescent and young adult patients.
The National Patient Notification Exercise: How well did local breast screening services cope with the additional workload?
Authors: Zelenyanszki Christiane , McAvinchey Rita , Hudson Sue 
Published: July 2020

Objective To describe how three English breast screening services responded to the 2018 Patient Notification Exercise, a national intervention whereby women who had potentially missed their final screening invitation were offered new appointments. To compare key performance indicators for women thus invited with key performance indicators for women invited routinely in the same period. Methods Uptake, assessment and cancer detection for 9439 women aged over 70 in the Patient Notification Exercise were compared with key performance indicators for 14,824 women, of similar age, who were routinely invited in the same period, using chi squared ( χ2) tests. Invitation cancellation and attendance levels were also compared. Results Uptake was significantly lower among Patient Notification Exercise women sent a new, timed appointment than for women who were routinely invited (67.3% and 70.8%, respectively, p = 0.001). Assessment rates were higher for Patient Notification Exercise women (5.2% vs. 4.4%, p = 0.192) as were cancer detection rates (1.87% vs. 1.28%, p = 0.080). Services achieved national round-length standards for routine invitations during and after the Patient Notification Exercise but screen-to-assessment standards were breached (80%) in the smallest service. More Patient Notification Exercise women than routinely invited women rebooked appointments (43.6% and 33.2%, respectively); they were also slightly more likely to miss their appointments (24.5% vs. 21.2%). Conclusions Screening invitation performance can be maintained whilst responding to an additional demand of ∼5%. Larger services that cover a compact geographical area may find it easier to respond. Women affected by the incident are not more likely to attend but may require relatively more assessment capacity in incidents where invitations have been delayed.
A Systematic Review on the Use of Sacubitril/Valsartan Initiated Prior to Discharge in Hospitalized Patients With Heart Failure
Authors: Thornby Krisy-Ann , Maksutovic Nicole M. 
Published: July 2020

Objective Systematically review the evidence of sacubitril/valsartan initiated in the hospital setting prior to discharge in patients with acute decompensated heart failure (HF). Data Sources A literature search using keywords related to sacubitril/valsartan, HF, and inpatient use was performed using MEDLINE, CINAHL, and Google Scholar from inception through May 8, 2020. Study Selection and Data Extraction Eligible studies included patients initiated on sacubitril/valsartan while inpatient and reported efficacy and safety outcomes. Data Synthesis A total of 10 articles were included for study review, of which 9 were full text and 1 was a conference poster. Key outcomes of interest were related to tolerability, N-terminal proB-type natriuretic peptide (NT-proBNP), functional capacity, target dose attainment, or rehospitalization rates. NT-proBNP levels were improved in 4 trials, and the results of functional capacity were mixed based on 2 studies. Rehospitalization rates were reported as secondary outcomes, and only 1 large study showed numerical and statistical improvement. The most frequent dose initiated prior to discharge was sacubitril/valsartan 24/26 mg twice daily. Hypotension was the most commonly reported adverse drug reaction and was commonly cited as a reason for not tolerating inpatient initiation with sacubitril/valsartan therapy. Relevance to Patient Care and Clinical Practice Inpatient initiation of sacubitril/valsartan may improve surrogate and clinical outcomes after hemodynamic stabilization. Clinicians should consider patient-specific factors to ensure that benefits outweigh the risks and monitor for hypotension when initiated prior to hospital discharge. Conclusion Initiating inpatient treatment with sacubitril/valsartan after hemodynamic stabilization is reasonable based on available evidence.
Three-Dimensional Biometrics to Correlate Hindfoot and Knee Coronal Alignments Using Modern Weightbearing Imaging
Authors: Dagneaux Louis , Dufrenot Maryama , Bernasconi Alessio , Bedard Nicholas A. , de Cesar Netto Cesar , Lintz François 
Published: July 2020

Background: Previous studies focusing on the effects of knee surgery on hindfoot alignment have suggested some degree of compensation between the knee and the hindfoot. However, these studies did not investigate a preoperative relationship in patients without end-stage knee osteoarthritis using 3-dimensional (3D) biometrics. The purpose of this study was to investigate the relationship between knee and hindfoot alignment using 3D weightbearing imaging. Methods: This retrospective comparative study included 95 lower limbs with weightbearing computed tomography and low-dose biplanar radiograph investigations. Cases with a history that may have caused a change in lower limb alignment were excluded. Hindfoot and knee alignments were measured using foot ankle offset (FAO) and hip-knee-ankle (HKA) angle, respectively. Patients were separated into 3 groups according to the knee deformity to investigate the distribution of FAO in each group. Results: The mean (SD) FAO was 2% (7%) for the knee varus group, 1% (6%) for the neutral knee group, and 4% (5%) for the valgus knee group ( P = .12). Fifty-three percent of patients with knee valgus showed a pathological hindfoot valgus ( P = .04). We found a positive but moderate correlation between hindfoot valgus and HKA (ρ = 0.53; P = .01). Female sex was associated with higher FAO (3% ± 4% vs 0.6% ± 6%; P = .009). Conclusion: This feasibility study suggests a new opportunity using 3D biometrics to understand the relationship between knee and hindfoot alignment and to highlight different patterns of combined deformities in further investigations. Level of Evidence: Level III, comparative study.