bluuebunny/crossref_metadata_2025_split huggingface dataset:
Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker
Authors: Jun Hye-Ran , Kim Hyunah , Lee Seung-Hwan , Cho Jae Hyoung , Lee Hyunyong , Yim Hyeon Woo , Yoon Kun-Ho , Kim Hun-Sung 
Published: March 2021

Introduction. In spite of the established importance of detecting angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker- (ARB-) induced hyperkalemia, there have not been many studies on the time of its occurrence. Methods. We retrospectively analyzed electronic medical records to determine the onset time and incidence rate of hyperkalemia (

serum

potassium
>
5.5

mEq
/
L

or 6.0 mEq/L) among hospitalized patients newly started on a 15-day ACEI or ARB therapy. Results. Among 3101 hospitalized patients, hyperkalemia incidence was 0.5%–0.9% and 0.8%–2.1% in the ACEI and ARB groups, respectively. However, it was not significantly different among different ARB types. Hyperkalemia’s onset was distributed throughout 15 days, without any trend. Hyperkalemia incidence was 7.3 and 35.1 times higher at 5.5 mEq/L (

hazard

ratio

HR

=
7.31

,

95
%
confidence

interval

CI

=
4.19
–
12.76

,

p
<
0.001

) and 6.0 mEq/L (

HR
=
35.11

,

95
%
CI
=
8.25
–
149.52

,

p
<
0.001

), respectively, than the baseline creatinine level. Hyperkalemia incidence in patients with chronic renal failure was 5.7 and 9.2 times higher at 5.5 mEq/L (

HR
=
5.72

,

95
%
CI
=
3.24
–
10.12

,

p
<
0.001

) and 6.0 mEq/L (

HR
=
9.16

,

95
%
CI
=
4.02
–
20.88

,

p
<
0.001

), respectively. Conclusions. It is unlikely that it is necessary to monitor hyperkalemia immediately after administration of ACEI or ARB. However, when prescribed for patients with abnormal kidney function, clinicians should always consider the possibility of developing hyperkalemia.
Human Engineered Heart Tissue Patches Remuscularize the Injured Heart in a Dose-Dependent Manner
Authors: Querdel Eva , Reinsch Marina , Castro Liesa , Köse Deniz , Bähr Andrea , Reich Svenja , Geertz Birgit , Ulmer Bärbel , Schulze Mirja , Lemoine Marc D. , Krause Tobias , Lemme Marta , Sani Jascha , Shibamiya Aya , Stüdemann Tim , Köhne Maria , Bibra Constantin von , Hornaschewitz Nadja , Pecha Simon , Nejahsie Yusuf , Mannhardt Ingra , Christ Torsten , Reichenspurner Hermann , Hansen Arne , Klymiuk Nikolai , Krane M. , Kupatt C. , Eschenhagen Thomas , Weinberger Florian 
Published: March 2021

Background:
Human engineered heart tissue (EHT) transplantation represents a potential regenerative strategy for patients with heart failure and has been successful in preclinical models. Clinical application requires upscaling, adaptation to good manufacturing practices, and determination of the effective dose.

Methods:
Cardiomyocytes were differentiated from 3 different human induced pluripotent stem cell lines including one reprogrammed under good manufacturing practice conditions. Protocols for human induced pluripotent stem cell expansion, cardiomyocyte differentiation, and EHT generation were adapted to substances available in good manufacturing practice quality. EHT geometry was modified to generate patches suitable for transplantation in a small-animal model and perspectively humans. Repair efficacy was evaluated at 3 doses in a cryo-injury guinea pig model. Human-scale patches were epicardially transplanted onto healthy hearts in pigs to assess technical feasibility.

Results:

We created mesh-structured tissue patches for transplantation in guinea pigs (1.5×2.5 cm, 9–15×10
6
cardiomyocytes) and pigs (5×7 cm, 450×10
6
cardiomyocytes). EHT patches coherently beat in culture and developed high force (mean 4.6 mN). Cardiomyocytes matured, aligned along the force lines, and demonstrated advanced sarcomeric structure and action potential characteristics closely resembling human ventricular tissue. EHT patches containing ≈4.5, 8.5, 12×10
6
, or no cells were transplanted 7 days after cryo-injury (n=18–19 per group). EHT transplantation resulted in a dose-dependent remuscularization (graft size: 0%–12% of the scar). Only high-dose patches improved left ventricular function (+8% absolute, +24% relative increase). The grafts showed time-dependent cardiomyocyte proliferation. Although standard EHT patches did not withstand transplantation in pigs, the human-scale patch enabled successful patch transplantation.

Conclusions:
EHT patch transplantation resulted in a partial remuscularization of the injured heart and improved left ventricular function in a dose-dependent manner in a guinea pig injury model. Human-scale patches were successfully transplanted in pigs in a proof-of-principle study.
Making Sense of the Political Question Doctrine: The Case of Kosovo
Authors: Beširević Violeta 
Published: March 2021

Abstract
Ever since it was announced in Madison v. Marbury, and articulated in Baker v. Carr, the political question doctrine that tends to exclude ‘mega politics’ from judicial check has been a controversial tool of judicial abstention. Not only that it is not universally applied, but it seems also to be losing significance even in countries of its usual influence due to extensive judicialization of ‘mega politics,’ which implies that there is no claim which the courts will not hear. Based on the judicialization of the Kosovo conflict, this paper shows why the doctrine deserves to be revived and even transplanted in jurisdictions outside its usual reach, particularly in disputes regarding real-life unilateral secession.
15. Libya
Authors: Richter Carola 
Published: March 2021

“From house to house, from apartment to apartment, from alley to alley” he would “cleanse Libya of dirt and filth.” With this statement, Mu’ammar Al-Qadhafi threatened the rebels during the “Arab Spring” in a thunderous speech on February 22, 2011 on Libyan state television. As he had so often done, he tried to use “his” medium to explain, justify, and mobilize. The media – and television in particular – were understood by the self-proclaimed “Brother Leader” to be a direct channel to the masses since he had come to power in 1969.
William Rugh (1987) classified the Libyan media system as a mobilization system. Mobilization media intend to shake people up, at best educate them, and make them good citizens. In practice, however, this approach meant the dissemination of regime propaganda through media, which, in a simple sender–receiver model, were assumed to have immediate effects on the audience. This understanding of the media as instruments for the dissemination of ideology to a supposedly receptive audience is still prevalent in the Libyan media system today even after the fall of the Qadhafi regime.
16. Tunisia
Authors: Miladi Noureddine 
Published: March 2021

The media landscape in Tunisia has witnessed significant transformations since the revolution of 14 January 2011. After decades of direct control and tight monitoring by the dictatorial regimes of Bourguiba and Ben Ali, the country has shifted to a new era of a diverse media market. Public service media have been consolidated and made independent from government interference. Also, newly set up TV and radio channels have been thriving and stand in competition with the public service broadcasters. This diversity in the media market has also been accompanied by regulatory frameworks which guarantee free speech and the independence of journalists. In spite of its slow development, the independent TV and radio regulator, Haute Autorité Indépendante de la Communication Audiovisuelle (High Independent Authority of the Audiovisual Commission) (HAICA), has been considered decisive in transforming the nature of the audio-visual market to meet international standards.
However, despite the abovementioned substantial strides, I argue in this chapter that, similar to any other transitional democracy, in the case of Tunisia, ideological forces, the power of business magnates, and overseas influences remain key factors which affect the operation and effects of various media outlets.
Pyriform Aperture Enlargement for Internal Nasal Valve Obstruction in Adults: Systematic Review and Surgical Classification
Authors: Hajem Humoud , Botter Charles , Al Omani Mohammad , Sounthakith Vincent , de Bressieux Eléonore , Benkhatar Hakim 
Published: March 2021

ObjectivePyriform aperture enlargement or “pyriplasty” is an uncommonly used procedure for internal nasal valve obstruction in adults besides functional rhinoplasty, inferior turbinate reduction, and septoplasty. A systematic review of the literature was performed to analyze current surgical techniques, their suggested indications, and their related outcome in terms of success and complications.Data SourcesThe search was performed on PubMed, EMBASE, SCOPUS, and Cochrane databases.Review MethodsThe systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Studies on congenital, traumatic, tumoral, or infectious internal nasal valve obstruction were excluded.ResultsEight articles were finally included. Three types of pyriplasty have been described according to the level of bone resection: low‐level pyriplasty through the sublabial approach, mid‐level pyriplasty through endonasal approach, and extended pyriplasty through either approach. Indications included (1) clinically or radiologically narrow pyriform aperture, (2) previously unsuccessful internal nasal valve surgery, (3) lateral nasal wall collapse, and (4) inferior turbinate’s head hypertrophy. Subjective improvement of nasal obstruction was reported in these 4 indications. No major complication was encountered.ConclusionPyriplasty for nasal obstruction is a simple and safe procedure that could be effective in selected cases. However, level of evidence is currently low, and success rate may vary with indications and pyriplasty techniques. Moreover, there is no clear definition of normal pyriform aperture dimensions to date. Further prospective studies are thereby necessary and should include radiological analysis of pyriform aperture and validated nasal obstruction measurement tools.
What defines the comprehensive assessment of needs in palliative care? An integrative systematic review
Authors: Goni-Fuste Blanca , Crespo Iris , Monforte-Royo Cristina , Porta-Sales Josep , Balaguer Albert , Pergolizzi Denise 
Published: March 2021

Background: The comprehensive assessment of needs in palliative care identifies where patients most want attention to guide clinical decisions that tailor care provision from their first encounters. Aim: To define how and what needs are identified by the comprehensive assessment of needs in the original peer-reviewed articles in the field of palliative care. Design: An integrative systematic review as outlined by Whittemore and Knafl. Quality appraisal performed using the Mixed Methods Appraisal Tool. Data sources: PubMed, CINAHL, PsycINFO, Web of Science databases searched through May 2019 and updated in July 2020. Results: Forty-nine articles met inclusion criteria for original articles in English or Spanish reporting comprehensive assessment of needs of adult patients receiving palliative care. The majority (41/49) of studies were moderate to high quality. Two themes were identified: (1) How a comprehensive assessment of needs should be carried out in palliative care, which reflected a preference to develop structured tools for assessment; (2) What needs of patients should be assessed in the comprehensive assessment of needs in palliative care, which conveyed a trend to assess beyond core domains – physical, psychological, social, spiritual – with information and practical most prevalent, but with substantial variation in specifying and classifying needs into domains. Conclusions: The assessment of needs in palliative care is comprehensive but lacks consensus on the needs and domains that should be assessed by the palliative care team. Future studies should better define what needs can be standardized into the assessment to improve process of care and patient satisfaction.
The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center
Authors: Bohn Brian C. , Neuner Elizabeth A. , Athans Vasilios , Rivard Kaitlyn R. , Riffle Allison R. , Richter Sandra S. , Fraser Thomas G. , Gordon Steven M. 
Published: March 2021

Background: In September 2018, pharmacy antimicrobial stewardship (AMS) services were expanded to include weekends at this academic medical center. Activities performed by AMS pharmacists on the weekends include blood culture rapid diagnostic (RDT) review, antiretroviral therapy (ART) review, prospective audit and feedback (PAF) utilizing clinical decision support, vancomycin dosing, and operational support. The purpose of this study was to assess the operational and clinical impact of these expanded AMS services. Methods: This single-center, quasi-experimental study included data from weekends before (9/2017–11/2017) and after (9/2018–11/2018) implementation. The descriptive primary outcome was the number of activities completed for each AMS activity type in the post-implementation group only. Secondary outcomes were time to AMS opportunity resolution, time to escalation or de-escalation following PAF or RDT alert, time to resolution of miscellaneous AMS related opportunities, length of stay (LOS), and antimicrobial use outcomes. Results: During the post-implementation period 1258 activities were completed, averaging 97/weekend. Inclusion criteria for time to resolution outcomes were met by 72 patients pre-implementation and 59 patients post. The median (IQR) time to AMS opportunity resolution decreased from 18.5 hours pre-intervention (7.7-35.7) to 8.5 hours post-intervention (IQR 1.8-14.0), p < 0.01. Time to escalation was 11.6 hours compared to 1.7 hours (p = 0.1), de-escalation 16.7 hours compared to 10.8 hours (p = 0.03), and miscellaneous opportunity 40.8 hours compared to 13.2 hours (p = 0.01). No differences were observed in LOS or antimicrobial use outcomes. Conclusion: Presence of pharmacist-driven weekend AMS services significantly reduced time to resolution of AMS opportunities. These data support the value of weekend AMS services.
Anterior Plate-Screws and Lower Postoperative T1 Slope Affect Cervical Allospacer Failures in Multi-Level ACDF Surgery: Anterior Versus Posterior Fixation
Authors: Suk Kyung-Soo , Jimenez Kathryn Anne , Jo Je Hyung , Kim Hak-Sun , Lee Hwan-Mo , Moon Seong-Hwan , Lee Byung Ho 
Published: March 2021

Study Design: Prospective observational study. Objective: In ACDF, graft failure and subsidence are common complications of surgery. Depending on the cervical fixation, different biomechanical characteristics are applied on the grafts. This aims to describe the incidence of cervical spacer failure in patients with cervical degenerative condition according to the cervical fixation method and sagittal balance. Method: From November 2011 to December 2015, 262 patients who underwent cervical spine surgery were enrolled prospectively. Patients were divided into 3 groups based on fixation method: anterior plate/screw (APS), posterior lateral mass screw (LMS), pedicle screw (PPS) groups. Serial X-rays and CT scans were utilized to evaluate radiologic outcomes. Results: Mean patient ages were 56.1 years in the APS group, 61.5 years in the LMS group, and 57.6 years in the PPS group ( P = 0.002). Allospacer failure was most common in the APS group, compared to the LMS and PPS groups (chi-square, P = 0.038). Longer fusion level was associated with greater allospacer failure (Baseline 2 level surgery; Odds ratio (OR) 3.4 in 3 level, 15.2 in 4 level, P = 0.036,0.013). Higher T1 slope was correlated with less allospacer failure (OR 0.875, P = 0.001). ORs of allospacer failure in the LMS and PPS groups were 0.04 and 0.02, respectively, ( P = 0.01, 0.01), compared with the APS group. Conclusion: This study was able to show that allospacer failure in multi-level ACDF surgery is more common with a longer fusion length, less postoperative T1 slope, and an anterior plate-screws technique. Pedicle screws provided the best biomechanical stability among the 3 constructs.
End-of-treatment PET/CT predicts PFS and OS in DLBCL after first-line treatment: results from GOYA
Authors: Kostakoglu Lale , Martelli Maurizio , Sehn Laurie H. , Belada David , Carella Angelo-Michele , Chua Neil , Gonzalez-Barca Eva , Hong Xiaonan , Pinto Antonio , Shi Yuankai , Tatsumi Yoichi , Knapp Andrea , Mattiello Federico , Nielsen Tina , Sahin Deniz , Sellam Gila , Oestergaard Mikkel Z. , Vitolo Umberto , Trněný Marek 
Published: March 2021

AbstractGOYA was a randomized phase 3 study comparing obinutuzumab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) vs standard-of-care rituximab plus CHOP in patients with previously untreated diffuse large B-cell lymphoma (DLBCL). This retrospective analysis of GOYA aimed to assess the association between progression-free survival (PFS) and overall survival (OS) with positron emission tomography (PET)–based complete response (CR) status. Overall, 1418 patients were randomly assigned to receive 8 21-day cycles of obinutuzumab (n = 706) or rituximab (n = 712) plus 6 or 8 cycles of CHOP. Patients received a mandatory fluoro-2-deoxy-d-glucose–PET/computed tomography scan at baseline and end of treatment. After a median follow-up of 29 months, the numbers of independent review committee–assessed PFS and OS events in the entire cohort were 416 (29.3%) and 252 (17.8%), respectively. End-of-treatment PET CR was highly prognostic for PFS and OS according to Lugano 2014 criteria (PFS: hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.19-0.38; P &lt; .0001; OS: HR, 0.12; 95% CI, 0.08-0.17; P &lt; .0001), irrespective of international prognostic index score and cell of origin. In conclusion, the results from this prospectively acquired large cohort corroborated previously published data from smaller sample sizes showing that end-of-treatment PET CR is an independent predictor of PFS and OS and a promising prognostic marker in DLBCL. Long-term survival analysis confirmed the robustness of these data over time. Additional meta-analyses including other prospective studies are necessary to support the substitution of PET CR for PFS as an effective and practical surrogate end point. This trial was registered at www.clinicaltrials.gov as #NCT01287741.
Disruption of CSF-1R signaling inhibits growth of AML with inv(16)
Authors: Simonis Alexander , Russkamp Norman F. , Mueller Jan , Wilk C. Matthias , Wildschut Mattheus H. E. , Myburgh Renier , Wildner-Verhey van Wijk Nicole , Mueller Rouven , Balabanov Stefan , Valk Peter J. M. , Theocharides Alexandre P. A. , Manz Markus G. 
Published: March 2021

Key Points
Human inv(16) AML cells express CSF-1R and are exposed to CSF-1 in vivo. Inhibition of CSF-1R signaling reduces viability of inv(16) AML cells in vitro and in therapeutic settings in humanized mice in vivo.
A machine learning-based gene signature of response to the novel alkylating agent LP-184 distinguishes its potential tumor indications
Authors: Kathad Umesh , Kulkarni Aditya , McDermott Joseph Ryan , Wegner Jordan , Carr Peter , Biyani Neha , Modali Rama , Richard Jean-Philippe , Sharma Panna , Bhatia Kishor 
Published: March 2021

AbstractBackgroundNon-targeted cytotoxics with anticancer activity are often developed through preclinical stages using response criteria observed in cell lines and xenografts. A panel of the NCI-60 cell lines is frequently the first line to define tumor types that are optimally responsive. Open data on the gene expression of the NCI-60 cell lines, provides a unique opportunity to add another dimension to the preclinical development of such drugs by interrogating correlations with gene expression patterns. Machine learning can be used to reduce the complexity of whole genome gene expression patterns to derive manageable signatures of response. Application of machine learning in early phases of preclinical development is likely to allow a better positioning and ultimate clinical success of molecules. LP-184 is a highly potent novel alkylating agent where the preclinical development is being guided by a dedicated machine learning-derived response signature. We show the feasibility and the accuracy of such a signature of response by accurately predicting the response to LP-184 validated using wet lab derived IC50s on a panel of cell lines.ResultsWe applied our proprietary RADR® platform to an NCI-60 discovery dataset encompassing LP-184 IC50s and publicly available gene expression data. We used multiple feature selection layers followed by the XGBoost regression model and reduced the complexity of 20,000 gene expression values to generate a 16-gene signature leading to the identification of a set of predictive candidate biomarkers which form an LP-184 response gene signature. We further validated this signature and predicted response to an additional panel of cell lines. Considering fold change differences and correlation between actual and predicted LP-184 IC50 values as validation performance measures, we obtained 86% accuracy at four-fold cut-off, and a strong (r = 0.70) and significant (p value 1.36e−06) correlation between actual and predicted LP-184 sensitivity. In agreement with the perceived mechanism of action of LP-184, PTGR1 emerged as the top weighted gene.ConclusionIntegration of a machine learning-derived signature of response with in vitro assessment of LP-184 efficacy facilitated the derivation of manageable yet robust biomarkers which can be used to predict drug sensitivity with high accuracy and clinical value.
Women’s perception of continuity of team midwifery care in Iran: a qualitative content analysis
Authors: Shahinfar Sholeh , Abedi Parvin , Najafian Mahin , Abbaspoor Zahra , Mohammadi Eesa , Alianmoghaddam Narges 
Published: March 2021

Abstract
Background
Understanding the pregnant women’s perception of continuity of team midwifery care is necessary for introducing and implementing this model of midwife-led care in the Iranian maternity services. This qualitative study aims to explore women’s perception of continuity of team midwifery care in Iran.

Methods
This research is a qualitative study conducted in Iran to explore women’s perception of continuity of team midwifery care during pregnancy, birth and postpartum from October 2019 to August 2020. Fifteen semi-structured interviews were conducted with women individually in private midwifery clinic through a purposive sampling method. Interviews were digitally recorded and transcribed verbatim in Persian and analyzed using conventional content analysis.

Results
From the data analysis, two themes, four main categories, and nine subcategories emerged. The themes were “Maternal empowerment” and “Mother’s satisfaction during the transition from pregnancy to motherhood”. The first theme included two categories of improving self-efficacy during antenatal education classes and the effective midwife-mother interaction. The second theme composed of two categories of satisfaction with the process of pregnancy, childbirth and postpartum as well as satisfaction with motherhood.

Conclusion
Findings of this qualitative study highlight the effectiveness of continuity of team midwifery model of care for promoting empowerment and satisfaction in women during pregnancy, birth and postpartum. The results of this study could pave the way for developing, introducing and implementing the midwife-led continuity models of care in Iran.