bluuebunny/crossref_metadata_2025_split huggingface dataset:
P279 Standard dose of rivaroxaban in Asian patients with atrial fibrillation: 20ms vs.15mg? Off label dose reduction of rivaroxaban should be avoided
Authors: Jeong H K , Won J M , Lee K H , Yoon N S , Park H W , Cho J G 
Published: January 2020

Abstract

Background
Rivaroxaban emerged as potential alternatives to warfarin for the prevention of thromboembolisim in patients with atrial fibrillation (AF). Because of the concern for the risk of major bleeding with rivaroxaban in Asian patients, off label rivaroxaban dose reduction to15mg is common in Asian real-world practice. We aimed to set standard rivaroxaban dose in Asian patients with AF by comparison between on-label rivaroxaban 20mg and off-label reduced rivaroxaban dose 15mg.

Methods
A total of 2,208 consecutive non-valvular AF patients were enrolled between 2011 and 2017. After propensity score matching, both warfarin (n = 804) and rivaroxaban group (n = 804) had comparable baseline characteristics. Rivaroxaban group was further divided into on-label rivaroxaban 20mg group (n = 390) and off-label reduced rivaroxaban 15mg group (n = 333). Efficacy outcome was stroke/systemic embolism. Safety outcome was major bleeding. Primary net clinical benefit (NCB) was defined as the composite of stroke, systemic embolism, major bleeding and all-cause mortality. Secondary NCB was defined as the composite of stroke, systemic embolism and major bleeding. Patients were followed upto one-year or until the first occurrence of any study outcomes.

Results
Both Rivaroxaban groups had comparable efficacy compared to warfarin. However, both on-label rivaroxaban 20mg (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.18-0.90, p = 0.026) and off-label reduced rivaroxaban 15mg (HR 0.37, 95% CI 0.16-0.88, p = 0.025) significantly reduced major bleeding. There were no differences in efficacy and safety outcomes between on-label rivaroxaban 20mg and off-label reduced rivaroxaban 15mg group. On-label rivaroxaban 20mg significantly reduced primary (HR 0.44, 95% CI 0.25-0.79, p = 0.006) and secondary (HR 0.51, 95% CI 0.27-0.96, p = 0.038) NCBs compared to warfarin. However, off-label reduced rivaroxaban 15mg did not reduce both primary and secondary NCBs.

Conclusion
Off-label rivaroxaban dose reduction to 15mg had no benefit compared to on-label rivaroxaban 20mg. Compared to warfarin, on-label rivaroxaban 20mg significantly improved primary and secondary NCBs, whereas off-label reduced rivaroxaban 15mg did not. Therefore, rivaroxaban 20mg is favorable as standard dose in Asian patients.
Friendships in Old Age: Daily Encounters and Emotional Well-Being
Authors: Ng Yee To , Huo Meng , Gleason Marci E , Neff Lisa A , Charles Susan T , Fingerman Karen L 
Published: January 2020

AbstractObjectivesHaving friends in old age is linked to higher levels of happiness and life satisfaction. Yet, we know little about older adults’ emotional experiences when they encounter friends throughout the day. This study examined whether older adults reported (a) more pleasantness, (b) fewer conversations about stressful experiences, and (c) better mood when they had contact with friends compared to when they had contact with other social partners or were alone throughout the day. We also examined whether these experiences varied by the friendship closeness.MethodAdults aged 65+ (n = 313) from the Daily Experiences and Well-being Study provided background information and listed and described their close social partners. Participants then completed ecological momentary assessment (EMA) surveys every 3 hr for 5 to 6 days where they reported their encounters with social partners, rated the pleasantness and indicated whether they discussed stressful issues during these encounters, and rated positive and negative mood.ResultsMultilevel models revealed that encounters with friends were more pleasant and were associated with fewer discussions about stressful experiences compared to encounters with romantic partners or family members throughout the day. Encounters with friends were also associated with better mood, though this link only held for encounters with friends who were not considered close.DiscussionFindings are discussed in terms of functionalist theory, socioemotional selectivity theory, relationship ambivalence, and the benefits of less close ties. This work facilitates the understanding of how daily contact with friends can promote older adults’ emotional well-being.
Evaluating the Saliva of Burn ICU Patients for Resistant Infections Harbor Metallo-β-Lactamase Genes
Authors: Emami Amir , Pirbonyeh Neda , Keshavarzi Abdolkhalegh , Bazargani Abdollah , Hassanpour Somayeh , Javanmardi Fatemeh 
Published: January 2020

Abstract
Pseudomonas aeruginosa and Acinetobacter baumannii are the bacteria which increasingly account for nosocomial infections. Due to high virulence, the rate of Multi-Drug Resistance (MDR) and limited availability of new agents, these infections create significant clinical burdens, making it important to identify the possible sources of their occurrence. The aim of this study was to assess non-lactose fermenting bacteria and their metallo-β-lactamase (MBLs) genes expression in the Burn Intensive Care Unit (BICU) patients’ saliva samples. This cross-sectional study was conducted from 2017 to 2018 on 124 saliva samples of BICU patients. Identified isolates were evaluated for drug susceptibility by disc diffusion method. MBLs production isolates were detected by Modified Hodge test and Imipenem-EDTA Combined disk. MBLs related genes were evaluated by polymerase chain reaction (PCR). A total of 86 Gram negative non-lactose fermenting bacteria (38; A. baumannii) and (48; P. aeruginosa), were detected. All of the A. baumannii isolates were resistant to Carbapenems, while more than 90% of them were sensitive to Colistin. However, the highest sensitivity in P. aeruginosa isolates was related to Carbapenems and Colistin. More than 95% of A. baumannii and 32% of P. aeruginosa were detected MDR. MBLs production was confirmed in 9 (33.33%) P. aeruginosa and 18 (66.67%) A. baumannii isolates. The blaVIM was the most prevalent gene, while this gene was detected in all of MBLs positive strains. This study confirmed the prevalence of carbapenemase producer Gram-negative bacilli in the saliva of BICU patients. The results of the present study provide a new data set about saliva infection source that could lead to the proper antibiotic regimen and better control of drug resistance.
A Political Economy of Global Security Approach to Migration and Border Control
Authors: Lori Noora , Schilde Kaija 
Published: January 2020

AbstractPopulation movements have causes and consequences for both global security and the economic and security considerations of states. Migration itself is inexorably intertwined with global security outcomes, in the form of instability, state fragility, transnational terrorism and crime, and the radicalization (or perceived radicalization) of migrants and host societies. While modern states may have monopolized the authority over legitimate movement, they have never fully captured the management and enforcement of migration flows. Instead, market actors play key roles in determining migration outcomes—including the scale, direction, and violence associated with migration flows. Migration outcomes are, thus, critically constituted by two key forces—the security priorities of states and the complementary and competing forces of privatization and profit-making. While market forces undermine state control over migration, states have buffered and further consolidated their power over mobility by harnessing private actors and markets toward migration management and border control. We situate migration management and border control as a political economy of security issue, arguing that migration outcomes cannot be explained without examining the interaction between state security imperatives, private actors, and market forces.
A rare case of a closed loop obstruction due to epiploic appendage of the sigmoid colon
Authors: Gosavi Rathin , Ban Ee 
Published: January 2020

Abstract
An internal hernia is a protrusion of viscera through a congenital or acquired defect in the mesentery of peritoneum. They account for &lt;0.9% of all small bowel obstructions [1] and ~4% of obstructions due to hernias [2]. We present a rare case of closed loop obstruction secondary to a band adhesion traversing the lower abdomen from a sigmoid colon appendage epiploicae to the right pelvic wall. A 82-year-old woman presented to the emergency department with nausea, vomiting and worsening right sided abdominal pain for 24 h, on the background of previous pelvic radiation and hysterectomy for uterine cancer. She was subsequently found to have a closed loop obstruction with 30 cm of ischemic bowel strangulated by a band adhesion from a sigmoid colon appendage epiploicae to the right abdominal wall. The patient underwent a successful small bowel resection with primary anastomosis and made an uneventful recovery.
Evolution of the extracytoplasmic function σ factor protein family
Authors: Pinto Daniela , da Fonseca Rute R 
Published: January 2020

AbstractUnderstanding transcription has been a central goal of the scientific community for decades. However, much is still unknown, especially concerning how it is regulated. In bacteria, a single DNA-directed RNA-polymerase performs the whole of transcription. It contains multiple subunits, among which the σ factor that confers promoter specificity. Besides the housekeeping σ factor, bacteria encode several alternative σ factors. The most abundant and diverse family of alternative σ factors, the extracytoplasmic function (ECF) family, regulates transcription of genes associated with stressful scenarios, making them key elements of adaptation to specific environmental changes. Despite this, the evolutionary history of ECF σ factors has never been investigated. Here, we report on our analysis of thousands of members of this family. We show that single events are in the origin of alternative modes of regulation of ECF σ factor activity that require partner proteins, but that multiple events resulted in acquisition of regulatory extensions. Moreover, in Bacteroidetes there is a recent duplication of an ecologically relevant gene cluster that includes an ECF σ factor, whereas in Planctomycetes duplication generates distinct C-terminal extensions after fortuitous insertion of the duplicated σ factor. At last, we also demonstrate horizontal transfer of ECF σ factors between soil bacteria.
Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain
Authors: Whedon James M , Toler Andrew W J , Kazal Louis A , Bezdjian Serena , Goehl Justin M , Greenstein Jay 
Published: January 2020

Abstract

Objective
Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain.

Design and Setting
We employed a retrospective cohort design for analysis of health claims data from three contiguous states for the years 2012–2017.

Subjects
We included adults aged 18–84 years enrolled in a health plan and with office visits to a primary care physician or chiropractor for spinal pain. We identified two cohorts of subjects: Recipients received both primary care and chiropractic care, and nonrecipients received primary care but not chiropractic care.

Methods
We performed adjusted time-to-event analyses to compare recipients and nonrecipients with regard to the risk of filling an opioid prescription. We stratified the recipient populations as: acute (first chiropractic encounter within 30 days of diagnosis) and nonacute (all other patients).

Results
The total number of subjects was 101,221. Overall, between 1.55 and 2.03 times more nonrecipients filled an opioid prescription, as compared with recipients (in Connecticut: hazard ratio [HR] = 1.55, 95% confidence interval [CI] = 1.11–2.17, P = 0.010; in New Hampshire: HR = 2.03, 95% CI = 1.92–2.14, P &lt; 0.0001). Similar differences were observed for the acute groups.

Conclusions
Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription. Among those who saw a chiropractor within 30 days of diagnosis, the reduction in risk was greater as compared with those with their first visit after the acute phase.
Associations between migraine attacks and nightly sleep characteristics among adults with episodic migraine: a prospective cohort study
Authors: Vgontzas Angeliki , Li Wenyuan , Mostofsky Elizabeth , Rueschman Michael , Mittleman Murray A , Bertisch Suzanne M 
Published: January 2020

Abstract

Study Objectives
Given the unknown immediate impact of migraine on nighttime sleep, we prospectively examined whether migraine headaches were associated with subsequent shorter sleep duration, higher fragmentation, and poorer quality in a cohort of 98 adults with episodic migraine.

Methods
Participants completed twice-daily electronic diaries and wore actigraphs continuously for 6 weeks. We examined whether days with headaches were associated with changes in that night’s sleep characteristics compared with headache-free days, using adjusted multivariable linear mixed models with subject-specific intercepts.

Results
Participants were 35 ± 12 years old, 88% women, with an average of five migraine headaches per month. Over 4,406 days, we observed 1,077 headache days, representing 823 discrete headaches. Average nightly objective sleep duration was 7.3 ± 1.2 hr, efficiency 89.5 ± 3.3%, and wake after sleep onset (WASO) 44.8 ± 17.0 min. Objective sleep duration was 7.3 min (95% CI: 1.5, 13.0) longer on nights following a headache day compared with nights on a headache-free day. Objective sleep efficiency, WASO, and reported sleep quality were not significantly different on headache days compared with headache-free days (sleep efficiency: −0.06 min, 95% CI: −0.3, 0.2; WASO 1.5 min, 95% CI: 0.0, 3.0; sleep quality: 1.0, 95% CI: 0.8, 1.3).

Conclusions
Sleep periods immediately following migraine headaches are not associated with shorter duration, higher disruption, or poorer sleep quality in patients with episodic migraine. These results suggest that clinical evaluation of sleep disturbance in patients with episodic migraine should be approached independently of their migraine status.
Endodormancy release in Norway spruce grafts representing trees of different ages
Authors: Partanen Jouni , Häkkinen Risto , Sutinen Sirkka , Viherä-Aarnio Anneli , Zhang Rui , Hänninen Heikki 
Published: January 2020

AbstractStudies addressing endodormancy release in adult trees are usually carried out using twigs detached from the trees in the experiments. Potential problems caused by cutting the root–shoot connection when detaching the twigs can be avoided by using grafts as the experimental material. We studied the effects of chilling on the endodormancy release in Norway spruce (Picea abies (L.) Karst.) grafts where twigs of 16-, 32- and 80-year-old trees were used as the scions. The grafts were first exposed to chilling in natural conditions and then samples of them were transferred at intervals to a regrowth test in forcing conditions in a greenhouse. The bud burst percentage, BB%, in the forcing conditions generally increased from zero to near 100% with increasing previous chilling accumulation from mid-October until mid-November, indicating that endodormancy was released in almost all of the grafts by mid-November. The days to bud burst, DBB, decreased in the forcing conditions with successively later transfers until the next spring. Neither BB% nor DBB was dependent on the age of the scion. However, in the early phase of ecodormancy release, the microscopic internal development of the buds was more advanced in the grafts representing the 16-year-old than in those representing the 32- or 80-year-old trees. In conclusion, our findings suggest that no major change in the environmental regulation of endodormancy release in Norway spruce takes place when the trees get older. Taken together with earlier findings with Norway spruce seedlings, our results suggest that regardless of the seedling or tree age, the chilling requirement of endodormancy release is met in late autumn. The implications of our findings for Norway spruce phenology under climatic warming and the limitations of our novel method of using grafts as a proxy of trees of different ages are discussed.
Intravenous Ibuprofen Reduces Opioid Consumption During the Initial 48 Hours After Injury in Orthopedic Trauma Patients
Authors: Weisz Russell D. , Fokin Alexander A. , Lerner Vivian , Flynt Amy , Macias-Perez Ines , Pavliv Leo , Crawford Maggie , Puente Ivan 
Published: January 2020

Objectives:
To evaluate the efficacy of intravenous (IV) ibuprofen (Caldolor) administration in the management of acute pain in orthopedic trauma patients and to minimize opioid use.

Design:
Randomized controlled trial, double-blind, parallel, placebo-controlled.

Setting:
Level 1 Trauma Center.

Patients:
A total of 99 consecutive orthopedic trauma patients with fractures of the ribs, face, extremities, and/or pelvis were randomized to receive either 800 mg IV ibuprofen (53 patients) or placebo (44 patients) administered every 6 hours for a total of 8 doses within 48 hours of admission and the same PRN medications along with 20-mg IV/PO Pepcid twice a day. To establish pain reduction efficacy, the analysis was consequently performed in the modified intent-to-treat group that included 74 randomized subjects with a baseline pain score greater than 2. The primary outcomes were reduction in opioid consumption and decrease in pain intensity (PI).

Intervention:
Administration of study medications.

Outcome Measurements:
PI measured by Numerical Rating Scale, opioid consumption adjusted to morphine equivalent dose, and time to first narcotic administration.

Results:
The 2 groups had comparable baseline characteristics: age, sex distribution, mechanism of injury, type of injury, injury severity score, and PI. IV ibuprofen statistically significantly reduced opioid consumption compared with placebo during the initial 48-hour period (P = 0.017). PI calculated as PI differences was statistically different only at 8-hour interval after Caldolor administration. Time to first narcotic medication was significantly longer in the Caldolor group (hazard ratio: 1.640; 95% confidence interval, 1.009–2.665; P = 0.046).

Conclusions:
IV ibuprofen provided adequate analgesia, prolonged time to first narcotic administration, and was opioid-sparing for the treatment of pain in orthopedic trauma patients, which makes Caldolor a recommended candidate for managing acute pain in the diverse orthopaedic trauma population.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Human immunodeficiency virus prevention strategies in China
Authors: Wu Zun-You , Scott Sarah Robbins 
Published: January 2020

Abstract
This paper reviews the current epidemics of human immunodeficiency virus (HIV) infection in China, particularly the globally available prevention strategies developed and implemented. This review focuses on HIV prevention measures in general, such as education, testing, and counseling and in specific responses to transmission modes, such as blood safety, harm reduction for people who inject drugs, and condom promotion to reduce sexual transmission. We also assess newly developed prevention measures, such as prevention treatment, pre-exposure prophylaxis, post-exposure prophylaxis, male circumcision, and promising potential future preventions, including microbicides and vaccines. Based on this assessment, we provide recommendations for their implementation in China. We conclude that there is no magic bullet for HIV prevention, particularly sexual transmission of the disease, but only a combination of these prevention strategies can control the HIV epidemic.
Intrascleral hydration for 23-Gauge Pars Plana Vitrectomy Sclerotomy Closure
Authors: Rizzo Stanislao , Pacini Bianca , De Angelis Lorenzo , Barca Francesco , Savastano Alfonso , Giansanti Fabrizio , Caporossi Tomaso 
Published: January 2020

Purpose:
To describe and evaluate the effectiveness of a new technique to close 23-gauge sclerotomies in transconjunctival pars plana vitrectomy.

Materials and Methods:
A prospective, consecutive, interventional study of 90 eyes of 90 patients who underwent 23-gauge pars plana vitrectomy with the introduction of the new sealing technique was conducted. The 23-gauge sclerotomies were hydrated with a 30-gauge needle inserted in the scleral stroma near the scleral opening.

Results:
A total of 90 eyes of 90 patients were recruited in the study. The number of the eyes requiring suture for sclerotomy closure was 3.3% (3 of 90), and the sclerotomies requiring suture were 1.4% (4 of 270). Three eyes had hypotony on Day 1. No statistically significant difference was registered between preoperative intraocular pressure and postoperative intraocular pressure on Days 15 and 30. No leaking of endotamponade bubble filling was noticed on Day 1. No postoperative complications were registered during the follow-up period.

Conclusion:
The intrascleral stroma hydration is a simple and fast technique that does not require extra surgical materials.
Long-Term Incidence of Infectious-Related Hospitalizations of Offspring Born to Mothers With Intrauterine Device
Authors: Tamari Itamar , Wainstock Tamar , Sheiner Eyal , Pariente Gali 
Published: January 2020

Background:
Pregnancy with an Intrauterine device (IUD) is a risk factor for adverse pregnancy outcomes. The purpose of this study was to examine a possible association between presence of IUD during pregnancy and long-term incidence of infectious-related hospitalizations of the offspring.

Methods:
A population-based cohort analysis was performed including all singleton deliveries between 1991 and 2014 at a single tertiary hospital. Primary exposure was defined as delivery of an infant to a mother who conceived with an IUD, that was either removed or retained during pregnancy. Offspring of mothers who conceived without an IUD comprised the comparison group. The main outcome evaluated was infectious-related hospitalizations of the offspring up to the age of 18 years.

Results:
The number of deliveries that met the inclusion criteria was 227,431, of which 209 were to mothers who conceived with an IUD that was removed and 52 were to mothers who retained their device. Long-term incidence of infections-related hospitalizations was compared between the groups (12.5% in the retained IUD, 12.9% in the removed IUD and 11.2% in the No-IUD group, P = 0.638). A Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of infectious-related hospitalizations in offspring of women who conceived with an IUD (log-rank P = 0.340). In a Cox regression model, while controlling for confounders such as maternal age and preterm birth, conceiving with an IUD was not found to be independently associated with long-term incidence of infectious-related hospitalizations of the offspring.

Conclusion:
Offspring of women conceiving with an IUD are not at increased risk for long-term incidence of infectious-related hospitalizations.