bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prasugrel versus ticagrelor in patients with myocardial infarction undergoing percutaneous coronary intervention
Authors: Venetsanos Dimitrios , Träff Erik , Erlinge David , Hagström Emil , Nilsson Johan , Desta Liyew , Lindahl Bertil , Mellbin Linda , Omerovic Elmir , Szummer Karolina Elisabeth , Zwackman Sammy , Jernberg Tomas , Alfredsson Joakim 
Published: March 2021

ObjectiveThe comparative efficacy and safety of prasugrel and ticagrelor in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) remain unclear. We aimed to investigate the association of treatment with clinical outcomes.MethodsIn the SWEDEHEART (Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies) registry, all patients with MI treated with PCI and discharged on prasugrel or ticagrelor from 2010 to 2016 were included. Outcomes were 1-year major adverse cardiac and cerebrovascular events (MACCE, death, MI or stroke), individual components and bleeding. Multivariable adjustment, inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for confounders.ResultsWe included 37 990 patients, 2073 in the prasugrel group and 35 917 in the ticagrelor group. Patients in the prasugrel group were younger, more often admitted with ST elevation MI and more likely to have diabetes. Six to twelve months after discharge, 20% of patients in each group discontinued the P2Y12 receptor inhibitor they received at discharge. The risk for MACCE did not significantly differ between prasugrel-treated and ticagrelor-treated patients (adjusted HR 1.03, 95% CI 0.86 to 1.24). We found no significant difference in the adjusted risk for death, recurrent MI or stroke alone between the two treatments. There was no significant difference in the risk for bleeding with prasugrel versus ticagrelor (2.5% vs 3.2%, adjusted HR 0.92, 95% CI 0.69 to 1.22). IPTW and PSM analyses confirmed the results.ConclusionIn patients with MI treated with PCI, prasugrel and ticagrelor were associated with similar efficacy and safety during 1-year follow-up.
Evaluation of an intervention to reduce child injury in Bedouin communities in Southern Israel
Authors: Myers Vicki , Malkin Gali , Nir Natalie , Orr Daniella , Baron-Epel Orna 
Published: March 2021

BackgroundChild injury is particularly prevalent in low socioeconomic populations and minorities. In Israel, Bedouin children exhibit high rates of injuries and death. A multifaceted community intervention to reduce injury in children in and around the home was run in nine Bedouin communities in Southern Israel during 2014–2018. The aim of the study was to evaluate the effect of the intervention on injuries among children aged 0–4 by comparing emergency room (ER) visits and hospitalisations before and after the intervention.MethodsChild injury data (ages 0–4, 5–17) for 2013–2018 were obtained from Soroka Medical Center, including ER visits and hospitalisations. Further data on reason for hospitalisation and injury severity score (ISS) were obtained from the National Centre for Trauma Research for 2011–2018. Reach was assessed by calculating the per cent of participants from the total relevant population in each town. Poisson regression was used to assess change over time, from preintervention (2013) to postintervention (2018).ResultsA high proportion of educational institutions took part in the intervention, and around 20% of relevant households received a home visit (n=6334). There was a significant reduction in ER visits (7.6%) in children aged 0–4 in 2018 compared with 2013. Hospitalisations did not decrease significantly, although the number of admissions for burns and falls was reduced significantly at follow-up.ConclusionsThis multifaceted intervention programme resulted in reduced injury in children aged 0–4 years in the Bedouin community. The use of simultaneous multiple intervention methods was effective in increasing child safety.
Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach
Authors: Hagaman Ashley , LeMasters Katherine , Zivich Paul N. , Sikander Siham , Bates Lisa M. , Bhalotra Sonia , Chung Esther O. , Zaidi Ahmed , Maselko Joanna 
Published: March 2021

BackgroundDepression in the perinatal period, during pregnancy or within 1 year of childbirth, imposes a high burden on women with rippling effects through her and her child’s life course. Social support may be an important protective factor, but the complex bidirectional relationship with depression, alongside a paucity of longitudinal explorations, leaves much unknown about critical windows of social support exposure across the perinatal period and causal impacts on future depressive episodes.MethodsThis study leverages marginal structural models to evaluate associations between longitudinal patterns of perinatal social support and subsequent maternal depression at 6 and 12 months postpartum. In a cohort of women in rural Pakistan (n=780), recruited in the third trimester of pregnancy and followed up at 3, 6 and 12 months postpartum, we assessed social support using two well-validated measures: the Multidimensional Scale of Perceived Social Support (MSPSS) and the Maternal Social Support Index (MSSI). Major depressive disorder was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM IV).ResultsHigh and sustained scores on the MSPSS through the perinatal period were associated with a decreased risk of depression at 12 months postpartum (0.35, 95% CI: 0.19 to 0.63). Evidence suggests the recency of support also matters, but estimates are imprecise. We did not find evidence of a protective effect for support based on the MSSI.ConclusionsThis study highlights the protective effect of sustained social support, particularly emotional support, on perinatal depression. Interventions targeting, leveraging and maintaining this type of support may be particularly important for reducing postpartum depression.
Impact of previous disease-modifying treatment on effectiveness and safety outcomes, among patients with multiple sclerosis treated with alemtuzumab
Authors: Pfeuffer Steffen , Ruck Tobias , Pul Refik , Rolfes Leoni , Korsukewitz Catharina , Pawlitzki Marc , Wildemann Brigitte , Klotz Luisa , Kleinschnitz Christoph , Scalfari Antonio , Wiendl Heinz , Meuth Sven G 
Published: March 2021

ObjectivesAlemtuzumab is effective in patients with active multiple sclerosis but has a complex safety profile, including the development of secondary autoimmunity. Most of patients enrolled in randomised clinical trials with alemtuzumab were either treatment naïve or pretreated with injectable substances. Other previous disease-modifying treatments (DMTs) were not used in the study cohorts, and therefore, associated risks might yet remain unidentified.MethodsWe retrospectively evaluated a prospective dual-centre alemtuzumab cohort of 170 patients. We examined the baseline characteristics as well as safety and effectiveness outcomes, including the time to first relapse, the time to 3 months confirmed disability worsening and the time to secondary autoimmunity.ResultsThe regression analysis showed that, among all previously used DMTs, the pretreatment with fingolimod (n=33 HRs for the time to first relapse (HR 5.420, 95% CI 2.520 to 11.660; p<0.001)) and for the time to worsening of disability (HR 7.676, 95% CI 2.870 to 20.534; p<0.001). Additionally, patients pretreated with fingolimod were more likely to experience spinal relapses (55% vs 10% among previously naïve patients; p<0.001) and had an increased risk of secondary autoimmunity (HR 5.875, 95% CI 2.126 to 16.27; p<0.001).ConclusionIn the real-world setting, we demonstrated suboptimal disease control and increased risk of secondary autoimmunity following alemtuzumab, among patients previously treated with fingolimod. These data can provide guidance for improving MS therapeutic management.
Prevalence and determinants of hypertension control among almost 100 000 treated adults in the UK
Authors: Tapela Neo , Collister Jennifer , Clifton Lei , Turnbull Iain , Rahimi Kazem , Hunter David J 
Published: March 2021

ObjectiveTo identify factors associated with hypertension control among treated middle-aged UK adults.MethodsA cross-sectional population-based study including 99 468 previously diagnosed, treated hypertensives enrolled in the UK Biobank. Hypertension control was defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg.ResultsMedian age was 62.3 years (IQR 57.3 to 66.0), 45.9% female, 92.0% white, 40.1% obese, 9.3% current smokers and 19.4% had prior cardiovascular disease. 38.1% (95% CI 37.8% to 38.4%) were controlled. In multivariable logistic regression, associations with lack of hypertension control included: older age (OR 0.61, 95% CI 0.58 to 0.64 for 60–69 years compared with age 40–50 years), higher alcohol use (OR 0.61, 95% CI 0.58 to 0.64, for consuming >30 units per week compared with none), black ethnicity (OR 0.73, 95% CI 0.65 to 0.82 compared with white), obesity (OR 0.73, 95% CI 0.71 to 0.76 compared with normal body mass index). The strongest positive association with control was having ≥3 comorbidities (OR 2.09, 95% CI 1.95 to 2.23). Comorbidities associated with control included cardiovascular disease (OR 2.11, 95% CI 2.04 to 2.19), migraines (OR 1.68, 95% CI 1.56 to 1.81), diabetes (OR 1.32, 95% CI 1.27 to 1.36) and depression (OR 1.27, 95% CI 1.20 to 1.34).ConclusionsIn one of the largest population-based analyses of middle-aged adults with measured blood pressure, the majority of treated hypertensives were uncontrolled. Risk factors for hypertension were associated with a lower probability of control. Having a comorbidity was associated with higher probability of control, possibly due to more frequent interaction with the healthcare system and/or appropriate management of those at greater cardiovascular risk.
Five-year outcome of respiratory muscle weakness at intensive care unit discharge: secondary analysis of a prospective cohort study
Authors: Van Aerde Nathalie , Meersseman Philippe , Debaveye Yves , Wilmer Alexander , Gunst Jan , Casaer Michael P , Wauters Joost , Wouters Pieter J , Gosselink Rik , Van den Berghe Greet , Hermans Greet 
Published: March 2021

Purpose
To assess the association between respiratory muscle weakness (RMW) at intensive care unit (ICU) discharge and 5-year mortality and morbidity, independent from confounders including peripheral muscle strength.

Methods

Secondary analysis of the prospective 5-year follow-up of the EPaNIC cohort (ClinicalTrials.gov:
NCT00512122
), limited to 366 patients screened for respiratory and peripheral muscle strength in the ICU with maximal inspiratory pressure (MIP) after removal of the artificial airway, and the Medical Research Council sum score. RMW was defined as an absolute value of MIP <30 cmH
2
O. Associations between RMW at (or closest to) ICU discharge and all-cause 5-year mortality, and key measures of 5-year physical function, comprising respiratory muscle strength (MIP), hand-grip strength (HGF), 6 min walk distance (6MWD) and physical function of the SF-36 quality-of-life questionnaire (PF-SF-36), were assessed with Cox proportional hazards and linear regression models, adjusted for confounders including peripheral muscle strength.

Results

RMW was present in 136/366 (37.2%) patients at ICU discharge. RMW was not independently associated with 5-year mortality (HR with 95% CI 1.273 (0.751 to 1.943), p=0.352). Among 156five-year survivors, those with, as compared with those without RMW demonstrated worse physical function (MIP (absolute value, cmH
2
O): 62(42–77) vs 94(78–109), p<0.001; HGF (%pred): 67(44–87) vs 96(68–110), p<0.001; 6MWD (%pred): 87(74–102) vs 99 (80–111), p=0.009; PF-SF-36 (score): 55 (30–80) vs 80 (55–95), p<0.001). Associations between RMW and morbidity endpoints remained significant after adjustment for confounders (effect size with 95% CI: MIP: −23.858 (−32.097 to −15.027), p=0.001; HGF: −18.591 (−30.941 to −5.744), p=0.001; 6MWD (transformed): −1587.007 (−3073.763 to −179.253), p=0.034; PF-SF-36 (transformed): 1.176 (0.144–2.270), p=0.036).

Conclusions
RMW at ICU discharge is independently associated with 5-year morbidity but not 5-year mortality.
Design and analysis of a waterproof capacitive touch key sensor interface circuit
Authors: Chen Yanbo , Dong Changchun , Wu Bo , He Guokun , Li Yunjie 
Published: March 2021

Traditional mechanical keys are gradually replaced with touch keys. Capacitive touch keys have advantages in achieving higher sensitivity with a longer service life and lower cost. Hence, the capacitive touch key technology is widely used in consumer electronic products. In use of household electric appliances, such as electric kettle, induction cooker and exhaust hood, sometimes the water vapor would condense into visible moisture or even the water would splash out of the pot when overheated, which may lead to a falsely trigger of touch key. So, waterproof becomes a big challenge in household electric appliances. This paper analyzes how water affects capacitive touch key and proposes a waterproof capacitive touch key sensor interface circuit to overcome the challenge. Sensing of touch key capacitor would be influenced only when water covers more than two touch keys. Compensating channels working in certain strategy are used to decrease the influence of water. For the same water capacitor, the bigger threshold voltage, the bigger change of the counting number. A much smaller threshold voltage is better to further weak the effect of water. The circuit is implemented in a standard 110 nm CMOS process. The measured results show that the touch Signal to Noise and Water Disturb Ration (SNWDR) is 20.7 dB which proves that the proposed waterproof capacitive touch key sensor interface circuit is effective against water splash.
FDA Approval Summary: Selumetinib for Plexiform Neurofibroma
Authors: Casey Denise , Demko Suzanne , Sinha Arup , Mishra-Kalyani Pallavi S. , Shen Yuan-li , Khasar Sachia , Goheer M. Anwar , Helms Whitney S. , Pan Lili , Xu Yuan , Fan Jianghong , Leong Ruby , Liu Jiang , Yang Yuching , Windsor Katherine , Ou Mei , Stephens Olen , Oh Byeongtaek , Reaman Gregory H. , Nair Abhilasha , Shord Stacy S. , Bhatnagar Vishal , Daniels Selena R. , Sickafuse Sharon , Goldberg Kirsten B. , Theoret Marc R. , Pazdur Richard , Singh Harpreet 
Published: March 2021

Abstract
On April 10, 2020, the FDA approved selumetinib (KOSELUGO, AstraZeneca) for the treatment of pediatric patients 2 years of age and older with neurofibromatosis type 1 who have symptomatic, inoperable plexiform neurofibromas. Approval was based on demonstration of a durable overall response rate per Response Evaluation in Neurofibromatosis and Schwannomatosis criteria and supported by observed clinical improvements in plexiform neurofibroma–related symptoms and functional impairments in 50 pediatric patients with inoperable plexiform neurofibromas in a single-arm, multicenter trial. The overall reponse rate per NCI investigator assessment was 66% (95% confidence interval, 51–79) with at least 12 months of follow-up. The median duration of response was not reached, and 82% of responding patients experienced duration of response ≥12 months. Clinical outcome assessment endpoints provided supportive efficacy data. Risks of selumetinib are consistent with MAPK (MEK) inhibitor class effects, including ocular, cardiac, musculoskeletal, gastrointestinal, and dermatologic toxicities. Safety was assessed across a pooled database of 74 pediatric patients with plexiform neurofibromas and supported by adult and pediatric selumetinib clinical trial data in cancer indications. The benefit–risk assessment for selumetinib in patients with inoperable plexiform neurofibromas was considered favorable.
Interim Singapore guidelines for basic and advanced life support for paediatric patients with suspected or confirmed COVID-19
Authors: Ong Gene Yong-Kwang , Zhi Ng Beatrice Hui , Mok Yee Hui , Ong Jacqueline SM , Ngiam Nicola , Tan Josephine , Lim Swee Han , Ng Kee Chong 
Published: March 2021

Abstract
The COVID-19 pandemic has resulted in significant challenges for the resuscitation of paediatric patients, especially for infants and children who are suspected or confirmed to be infected. Thus, the paediatric subcommittee of the Singapore Resuscitation and First Aid Council developed interim modifications to the current Singapore paediatric guidelines using extrapolated data from the available literature, local multidisciplinary expert consensus and institutional best practices. It is hoped that this it will provide a framework during the pandemic for improved outcomes in paediatric cardiac arrest patients in the local context, while taking into consideration the safety of all community first responders, medical frontline providers and healthcare workers.
Epidemiology of pelvic and acetabular fractures in a tertiary hospital in Singapore
Authors: Singh Amritpal , Lim Amaris Shu Min , Lau Bernard Puang Huh , O’Neill Gavin 
Published: March 2021

Abstract

Introduction:
Pelvic and acetabular fractures (PAFs) usually result from high-energy, potentially life-threatening accidents. They are one of the major injuries that lead to death in patients involved in such accidents. We studied the recent epidemiology of these injuries in Singapore.

Methods:
This is a retrospective data analysis of all trauma patients who underwent surgery for PAFs from 2008 to 2016 in a tertiary trauma centre in Singapore. Data including patient demographics, mechanism of injury and associated injuries was collected.

Results:
A total of 169 patients were admitted for PAFs over the eight-year period. The majority (79.3%) were male. The mean age was 41 (range 13–79) years. Most patients (51.5%) were Chinese. The most common mechanisms of injury were road traffic accidents (53.8%), falls (33.1%) and crush injuries (13.0%). 46.2% sustained acetabular fractures, while 44.4% sustained pelvic fractures. PAFs were most commonly associated with upper and lower limb injuries, followed by spinal and thoracic injuries. Average of length of stay in hospital was 24 (range 2–375) days.

Conclusion:
PAF predominantly affects young working males. Compared to previously published local data, there has been a significant reduction in the incidence of PAFs, likely due to improved road and work safety. The demographics of PAFs have changed, with fewer injuries in females (20.7% vs. 33.3%), a reduction in the proportion of injuries in the Chinese (51.5% vs. 70.1%). While road traffic accidents remain the most common cause, crush injuries are now more prevalent (13.0%).
Theory of planned behaviour approach to understand pro-environmental behaviour among young green consumers in Malaysia
Authors: Ogiemwonyi Osarodion , Harun Amran Bin 
Published: March 2021

Abstract
The depletion of the natural environment and earth-wide natural resources have led to the increasing demand for green products. This has made young consumers carry on the green, and as a result, it affects the organization’s bottom line in building a positive image and goodwill message. This research explored the facet to investigate while applying some constructs from the Ajzen’s existing theory of planned behaviour (TPB) model with additional construct. 250 viable responses were applied and path modelling using SmartPLS 3.0 analyses was used to establish the model proposed. The results indicate that among the TPB constructs, perceived behavioural control (PBC), green perceived attitude (GPA), and other contextual constructs influence pro-environmental behaviour (PEB) positively. Looking at the relative importance of constructs, perceived green culture (PGC) followed by (GPA) had a stronger impact on PEB. The study provides evidence that young green consumers exhibit great concern towards environment, through model supportability and the inclusion of additional constructs which was supported in the TPB providing insight, and holding a sense of responsibility in the consumption pattern for a peaceful future. The obtained results can promote scientific progress in the respective research area and policy implications.
The Role of Transaminases in Predicting Choledocholithiasis. A Novel Predictive Composite Score Development in a Cohort of 1089 Patients Undergoing Laparoscopic Cholecystectomy
Authors: Kokoroskos Nikolaos , Peponis Thomas , Lee Jae Moo , El Hechi Majed , Naar Leon , Nederpelt Charlie , Gaitanidis Apostolos , Mendoza April E. , Saillant Noelle , Kaafarani Haytham , King David , Velmahos George , Fagenholz Peter 
Published: March 2021

Background Optimal use of interventional procedures and diagnostic tests for patients with suspected choledocholithiasis depends on accurate pretest risk estimation. We sought to define sensitivity/specificity of transaminases in identifying choledocholithiasis and to incorporate them into a biochemical marker composite score that could accurately predict choledocholithiasis. Methods All adult patients who underwent laparoscopic cholecystectomy by our Emergency Surgery Service between 2010 and 2018 were reviewed. Admission total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) was captured. Choledocholithiasis was confirmed via intraoperative cholangiogram, endoscopic retrograde cholangiopancreatography, or magnetic resonance cholangiopancreatography. Area under receiver operating characteristic curve (AUC) or C-statistic for AST, ALT, ALP, and TB as a measure of detecting choledocholithiasis was calculated. For score development, our database was randomly dichotomized to derivation and validation cohort and a score was derived. The score was validated by calculating its C-statistic. Results 1089 patients were included; 210 (20.3%) had confirmed choledocholithiasis. The AUC was .78 for TB, .77 for ALP and AST, and .76 for ALT. 545 and 544 patients were included in the derivation and the validation cohort, respectively. The elements of the derived score were TB, AST, and ALP. The score ranged from 0 to 4. The AUC was .82 in the derivation and .77 in the validation cohort. The probability of choledocholithiasis increased from 8% to 89% at scores 0 to 4, respectively. Conclusions Aspartate aminotransferase predicted choledocholithiasis adequately and should be featured in choledocholithiasis screening algorithms. We developed a biochemical composite score, shown to be accurate in preoperative choledocholithiasis risk assessment in an emergency surgery setting.