bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the adjusted global antiphospholipid syndrome score in systemic lupus erythematosus patients in Argentina
Authors: Garcia Lucila , Velloso Maria S , Martire Maria V , Savy Florencia , Arizpe Fernando , Garcia Nadia , Testi Adriana , Pena Claudia , Costi Ana C , Isnardi Carolina , Capelusnik Dafne , Mazza Susana , Curi Yessika Soria , Collado Victoria , Rodriguez Maria F , Scarafia Santiago , Pisoni Cecilia , de la Torre Maria , Seewald Adriana , Riva Maria E , Garcia Mercedes 
Published: October 2020

Introduction Assessment of risk both for pregnancy morbidity and thrombosis in the presence of anti-phospholipid antibodies (aPL) is still a challenge in Systemic Lupus Erythematosus (SLE) patients. The Global Antiphospholipid Syndrome Score (GAPSS) takes into account the aPL profile (criteria and non-criteria aPL), the conventional cardiovascular risk factors and the autoimmune antibody profile. An adjusted model of the score (aGAPSS) excluding anti-phosphatidylserine/Prothrombin (aPS/PT), suggests that the score is able to stratify patients for their rate of events making it widely applicable in daily clinical practice. Objective To validate the aGAPSS in a multicentric cohort of SLE patients in Argentina. Patients and methods consecutive SLE patients with and with andwithout thrombotic events from seven Rheumatologist centers were included. Traditional cardiovascular risk factors, aPL antibodies and medications received (aspirin, hydroxychloroquine and anticoagulation) were collected. The score aGAPSS was calculated for each patient at the last visit by adding together the points corresponding to the risk factors: 1 for hypertension, 3 for dyslipidemia, 4 for LA and B2GPI (IgM or IgG) antibodies and 5 for aCL (IgM or IgG) antibodies. The discriminative ability of the aGAPSS was calculated by measuring the area under the receiver operating characteristic curve (AUC). Multivariate logistic regression analysis was performed to examine the impact of multiple cardiovascular risk factors and laboratory parameters on the occurrence of thrombosis. Results Two hundred and ninety-six SLE patients were included. One-hundred and twenty-one patients (40.9%) presented thrombotic and/or pregnancy complications. Median aGAPSS was significantly higher in patients who experienced an event (thrombosis and/or pregnancy morbidity) compared with those without [4 (IQR 1–9) versus 1 (IQR 0–5); p < 0.001]. The best cut off point for the diagnosis of thrombosis and/or pregnancy complications was aGAPSS ≥4. Multivariate logistic regression analysis showed that aCL antibodies [OR 2.1 (95% CI 1.16–3.90); p = 0.015] were an independent risk factors for thrombotic events. Conclusions This score is a simple tool, easy to apply to SLE patients in daily practice. The use of the aGAPSS could change the non-pharmacologic and pharmacologic treatment in higher risk patients to improve their survival.
Improving Access to Palliative Care at a VHA Hospital
Authors: Cromwell Carrie A. , Edwards Beatrice , March Alice L. 
Published: October 2020

Objective: Explore veteran-specific factors impacting the acceptance of palliative care services at a Veterans Health Administration hospital. Methods: Prospective, focused one-on-one interviews were conducted with 18 inpatient veterans with an initial consult to receive palliative care services. Domains impacting reception of outpatient palliative care management were evaluated including knowledge deficit, emotional barriers, physical barriers, psychosocial barriers, and physical support. Themes and trends from interview responses were analyzed using a qualitative directed content analysis approach. Results: The following themes were discovered to influence veteran participation in outpatient palliative care: Knowledge Deficit, Environmental Factors, Positive Patient Satisfaction, Openness to Technology, and Resiliency. Characteristics of veterans interviewed included an average age of 71 with an average distance from the hospital of 59 miles. Conclusion: The identification of factors impacting veteran access to palliative care will be used to guide interventions and improve receipt of services. Care of seriously ill veterans may be substantially improved by facilitating access to palliative care.
Biomechanical Comparison of All-Soft Suture Anchor Single-Row vs Double-Row Bridging Construct for Insertional Achilles Tendinopathy
Authors: Lakey Eric , Kumparatana Pam , Moon Daniel K. , Morales Joseph , Anderson Sophia Elizabeth , Baldini Todd , Pereira Hélder , Hunt Kenneth J. 
Published: October 2020

Background: Two common operative fixation techniques for insertional Achilles tendinopathy are the use of all-soft suture anchors vs synthetic anchors with a suture bridge. Despite increasing emphasis on early postoperative mobilization, the biomechanical profile of these repairs is not currently known. We hypothesized that the biomechanical profiles of single-row all-soft suture anchor repairs would differ when compared to double-row suture bridge repairs. Methods: Achilles tendons were detached from their calcaneal insertions on 6 matched-pair, fresh-frozen cadaver through-knee amputation specimens. Group 1 underwent a single-row repair with all-soft suture anchors. Group 2 was repaired with a double-row bridging suture bridge construct. Achilles-calcaneal displacement was tracked while specimens were cyclically loaded from 10 to 100 N for 2000 cycles and then loaded to failure. Linear mixed models were used to analyze the independent effects of age, body mass index, tendon morphology, repair construct, and footprint size on clinical and ultimate failure loads, Achilles-calcaneal displacement, and mode of failure. Results: The suture bridge group was independently associated with an approximately 50-N increase in the load to clinical failure (defined as more than 5 mm tendon displacement). There was no difference in ultimate load to failure or tendon/anchor displacement between the 2 groups. Conclusion: This cadaveric study found that a double-row synthetic bridge construct had less displacement during cyclic loading but was not able to carry more load before clinical failure when compared to a single-row suture anchor construct for the operative repair of insertional Achilles tendinopathy. Clinical Relevance: Our data suggest that double-row suture bridge constructs increase the load to clinical failure for operative repairs of insertional Achilles tendinopathy. It must be noted that these loads are well below what occurs during gait and the repair must be protected postoperatively without early mobilization. This study also identified several clinical factors that may help predict repair strength and inform further research.
Comparative Anticoagulant and Thrombin Generation Inhibitory Profile of Heparin, Sulodexide and Its Components
Authors: Siddiqui Fakiha , Hoppensteadt Debra , Bontekoe Emily , Farooqui Ambar , Jeske Walter , Fareed Jawed 
Published: October 2020

Introduction: Sulodexide represents a mixture of fast-moving heparin (FMH) and dermatan sulfate (DS) and has been used for the management of venous diseases such as DVT and related disorders. The purpose of this study is to compare sulodexide and its components with unfractionated heparin (UFH) to determine its suitability for the indications in which UFH is used. Materials and Method: Active pharmaceutical ingredients (API) versions of sulodexide, FMH and DS were obtained from Alfasigma. API versions of UFH were obtained from Medefil Inc. Normal human citrated plasma was obtained from blood bank of the Loyola University Medical Center. Each of the individual agents were supplemented in plasma at a graded concentration of 0.0-10 µg/mL. Clotting assays (PiCT, aPTT, PT and TT), anti-Xa and anti-IIa and thrombin generation studies were carried out. Results were compiled as mean ± SD of 3 individual determination. Result: In the clot based (PiCT, aPTT and TT), anti-Xa and IIa assays, both the UFH and FMH produced stronger activities in these assays followed by sulodexide. DS did not show any anticoagulant activity. In the thrombin generation assay, FMH and UFH produced comparable inhibition of thrombin generation as measured by various parameters. Sulodexide was slightly weaker in this assay, whereas DS produced relatively weaker effects. Conclusion: In comparison to sulodexide, both UFH and FMH exhibit comparable anticoagulant activity despite differences in their molecular weight. These results suggest that sulodexide can be developed as a parenteral anticoagulant for indications in which UFH is used.
The rise of a lingua franca: The case of Russian in Dagestan
Authors: Dobrushina Nina , Kultepina Olga 
Published: October 2020

Aims and objectives: In Dagestan, Russian is the language of education, urban way of life, and upward social mobility, and the means of communication between speakers of different languages. This is a result of a quick and drastic change. At the end of the 19th century, Russian was spoken by less than 1% of the population. The aim of this paper is to understand how such rapid spread of Russian as an L2 became possible. Approach: The study uses quantitative data on Dagestanians’ language repertoires. We relate the command of Russian to certain facts from people’s biographies, such as the level of education, migration, warfare and military service, and other professional experience, and run regression analysis. Data and analysis: The data were collected by the method of retrospective family interviews during numerous field trips to highland Dagestan. We use information on 3519 individuals collected in 27 villages. Findings/conclusions: We conclude that the compulsory school education introduced in Dagestan in the 1930s is the social mechanism that resulted in the spread of Russian and its later development into a lingua franca. Russian was imposed from above and supported by the ideology that associated it with future and progress. Originality: This is the first attempt to apply quantitative methods to a large collection of field data to reveal social mechanisms underlying the spread of a single L2 instead of local bilingualism. Significance/implications: The spread of one lingua franca across a large territory is attested in many areas. We suppose that lingua francas of different origin result from different constellations of social factors and show that in Dagestan lingua franca was imposed by the authorities via a systematic educational campaign. We also suggest it was the extreme linguistic diversity of Dagestan that brought Russian from a widely known L2 to a lingua franca.
Management of distal aneurysm of the superior mesenteric artery by percutaneous ultrasound-guided Onyx injection: A case report
Authors: Simoncini Fabio , Mastrorilli Davide , Mezzetto Luca , Angrisano Alessandro , Scorsone Lorenzo , Bergamaschi Gastone , Veraldi Gian Franco 
Published: October 2020

Objectives The aim of this article is to report an alternative approach for the management of a distal aneurysm of superior mesenteric artery using direct percutaneous ultrasound-guided Onyx injection. Methods We report a rare case of symptomatic superior mesenteric artery aneurysm. A 78-year-old man presents with pain and pulsating mass in the right umbilical region of the abdomen. The patient was treated by percutaneous ultrasound-guided Onyx injection after several failing transarterial embolization attempts. Results The procedure was successful without any complication, and the patient wasdischarged to home the day after procedure. Follow-up at 60 months confirmed the complete thrombosis of the aneurysm sac. Ultrasound-guided Onyx injection for distal superior mesenteric artery aneurysm could provide an alternative to transcatheter arterial embolization or open surgery. Anatomical assessment of collaterals and knowledge of abdomen anatomy could play important roles in preventing bowel ischemia and minimizing the risk of procedural complication. Conclusion Ultrasound-guided Onyx injection of superior mesenteric artery aneurysm is a feasible, effective, and cost-saving technique that can be used when endovascular approach is not possible or has failed.
Urinary incontinence and associated factors among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia
Authors: Berhe Arsema , Alamer Abayneh , Negash Kiflom , Assefa Belete 
Published: October 2020

Background: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. Objective: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. Methodology: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. Results: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87–49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48–27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15–18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12–21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05–19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51–22.67), 95% confidence interval). Conclusion: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence.
Pregnancy outcomes after exposure to interferon beta: a register-based cohort study among women with MS in Finland and Sweden
Authors: Hakkarainen Katja Marja , Juuti Rosa , Burkill Sarah , Geissbühler Yvonne , Sabidó Meritxell , Popescu Catrinel , Suzart-Woischnik Kiliana , Hillert Jan , Artama Miia , Verkkoniemi-Ahola Auli , Myhr Kjell-Morten , Mehtälä Juha , Bahmanyar Shahram , Montgomery Scott , Korhonen Pasi , Adamo Alessandra , Wicklein Eva-Maria , Akbaba Metin , Borghesi Gustavo , Köfüncü Evra , Everage Nicholas , Pandhi Avni , Naylor Maria , Ly Anh , Jack Dominic , Todorovic Milorad , Issard Delphine , Macklin Alexandra , Primatesta Paola , Weitzman Richard , Klement Riho , Vehkala Minna , Vattulainen Pia , Korjagina Marta , Gyllensten Hanna 
Published: October 2020

Background Our aim was to estimate and compare the prevalence of adverse pregnancy outcomes among pregnant women with multiple sclerosis (MS) exposed to interferon beta (IFNB) and among women with MS unexposed to any MS disease-modifying drug (MSDMD). Methods This cohort study used Finnish (1996–2014) and Swedish (2005–2014) national register data. Women with MS having IFNB dispensed 6 months before or during pregnancy as the only medication were considered as IFNB exposed (only IFNB-exposed), whereas women with MS unexposed to any MSDMD were considered unexposed (MSDMD-unexposed). Prevalence was described and compared using log-binomial or logistic regression and adjusted for potential confounders including maternal age and comorbidity. Results Among 2831 pregnancies, 2.2% of the only IFNB-exposed and 4.0% of the MSDMD-unexposed women had serious adverse pregnancy outcomes [elective termination of pregnancy due to foetal anomaly (TOPFA), major congenital anomaly (MCA) in live, or stillbirth]. After adjustments, the prevalence of serious adverse pregnancy outcomes was lower among the only IFNB-exposed compared with the MSDMD-unexposed [relative risk 0.55, 95% confidence interval (CI) 0.31–0.96]. The prevalence of individual outcomes, including MCA, spontaneous abortions, and stillbirths was not increased with IFNB exposure. Women with MS exposed to IFNB appeared more likely to terminate their pregnancy for reasons other than foetal anomaly, compared with MSDMD-unexposed pregnant MS patients (odds ratio 1.71, 95% CI 1.06–2.78). Conclusion In this large cohort study, no increase in the prevalence of adverse pregnancy outcomes was observed in women with MS exposed to IFNB compared with MS patients unexposed to any MSDMDs. This study together with other evidence led to a change in the labels of the IFNB products in September 2019 in the European Union, and IFNB use today may be considered during pregnancy, if clinically needed.
Computer-Aided Fracture Size Measurement in Orbital Fractures—An Alternative to Manual Evaluation
Authors: Saloniemi Mikko , Lehtinen Valtteri , Snäll Johanna 
Published: October 2020

Objective: We aimed to present a novel semiautomated tool for orbital fracture size measurement and to compare the variability of the proposed method with traditional manual measurements. Methods: Maximal anteroposterior (AP) and mediolateral (ML) dimensions of orbital fractures from computed tomography images were measured for 15 patients with unilateral orbital fractures by 2 surgeons manually and with a semiautomatic software. Variability was assessed with Bland-Altman limits of agreement plots and intra-class correlation coefficients (ICCs). Results: The intra-observer ICCs in manual and automatic measurements were high, >0.9. The inter-observer ICCs in manual measurements were 0.926 (AP) and 0.631 (ML) and in automatic measurements 0.989 (AP) and 0.989 (ML). The ICCs for manual and semiautomated variability were 0.899 (AP) and 0.669 (ML). The differences were thus particularly pronounced in the ML dimensions. In addition, with the semiautomated technique, a total fracture area could be measured and compared with the total area of the bony orbit and a 3-dimensional reformatted image could be generated. Conclusions: Intra- and inter-observer variability proved to be very low for measuring fracture maximal AP length and ML width, making both the manual and the semiautomatic methods feasible clinically. The semiautomatic fracture size analysis allows better observer-independent repeatability for fracture size measurements and provides the possibility for total fracture area measurements at any orbital bony site, even in challenging nonplanar topography.
Association of plasma adiponectin with pulmonary hypertension, mortality and heart failure in African Americans: Jackson Heart Study
Authors: Lakshmanan Suvasini , Jankowich Matthew , Wu Wen‐Chih , Abbasi Siddique , Morrison Alan R , Choudhary Gaurav 
Published: October 2020

BackgroundAdiponectin is a polypeptide hormone related to obesity, and a known modulator of pulmonary vascular remodeling. Association between plasma adiponectin levels and pulmonary hypertension (PH) has not been studied in African Americans (AAs) who are disproportionately affected by obesity. The relationship between adiponectin and heart failure (HF) and mortality, outcomes associated with PH, is unclear.MethodsWe performed cross‐sectional and longitudinal analysis to examine if there is an association between plasma adiponectin and PH and associated clinical outcomes, in participants of Jackson Heart Study (JHS). JHS is a prospective observational cohort study of heart disease in AAs from Jackson, Mississippi.ResultsOf the 3161 participants included in the study, mean age (SD) was 56.38 (12.61) years, 1028 were men (32.5%), and mean (SD) BMI was 31.42 (7.05) kg/m2. Median (IQR) adiponectin was 4516.82 (2799.32–7065.85) ng/mL. After adjusting for potential confounders including BMI, higher adiponectin levels were associated with increased odds of PH (adjusted odds ratio per log increment in adiponectin, (1.81; 95% CI, 1.41–2.32). High adiponectin levels were also associated with associated HF admissions (adjusted hazard ratio [HR] per log increment in adiponectin, 1.63, 95% CI, 1.24–2.14) and mortality (adjusted HR per log increment in adiponectin, 1.20; 95% CI 1.02–1.41).ConclusionsElevated plasma adiponectin levels are associated with PH, HF admissions and mortality risk in AAs. High adiponectin levels may help identify an at‐risk population that could be evaluated for targeted prevention and management strategies in future studies
Mental and self-rated health of bakery workers in Lebanon: A national study
Authors: Habib Rima R , El-Haddad Nataly W , Elzein Kareem , Hojeij Safa 
Published: October 2020

Objectives: The relationship between poverty and health has been well addressed in public health research. The health effects of social and economic inequalities on working groups have also drawn the attention of occupational health scholars. Research addressing workers in low-paying jobs showed increased risks for poor health. This research examined the psychosocial factors associated with poor mental health and self-rated health among low-income bakery workers performing demanding tasks. Methods: Face-to-face interviews in 504 randomly selected bakeries in Lebanon provided data on socio-demographics, perception of the workplace environment, job security, job satisfaction, general health, and mental health. Results: In total, 16.5% of bakery workers reported poor self-rated health, and 45% reported poor mental health. Workers with a chronic illness were almost three times more likely to report poor self-rated health (OR = 2.86; 95% CI = 1.44–5.67), and those with musculoskeletal pain reported poor self-rated health five times as often (OR = 5.34; 95% CI = 2.9–9.80). Those with a chronic illness and musculoskeletal pain were twice as likely to report poor mental health (OR = 1.94; 95% CI = 1.07–3.50 and OR = 2.07; 95% CI = 1.32–3.23, respectively); and those dissatisfied with their job reported poorer self-rated health (OR = 2.18; 95% CI = 1.12–4.23) and mental health (OR = 2.57; 95% CI = 1.54–4.26). In addition, workers reporting job insecurity had poor mental health twice as often (OR = 1.93; 95% CI = 1.24–2.99). Low socioeconomic indicators showed a gradient association with both poor self-rated health and mental health. Conclusion: Reporting job dissatisfaction and insecurity, musculoskeletal pain, and chronic illness were associated with poor mental and self-rated health among bakery workers. Interventions to improve the working conditions of bakery workers are timely and essential. This research provided evidence for policy to guide occupational health practice and safeguard the health of bakery workers.