bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beginning to Understand the Cost-effectiveness of Andexxa
Authors: Haque Marina , Gratson Michael , Woerle Jodi , Tavernier Jr Fitz 
Published: April 2021

Introduction: Tens of thousands of patients die of major life-threatening bleeds every year while taking direct factor Xa inhibitors, a class of anticoagulant medications that until now had no reversal agent. In May 2018, the US Food and Drug Administration approved andexanet alfa (Andexxa), the first known reversal agent for a subset of direct factor Xa inhibitors. It has been reported to substantially reduce mortality rates for patients who experience a major bleed while taking rivaroxaban or apixaban. Andexxa is costly, however, ranging between US $24,750 and $49,500 for treatment. Methods: To explore the cost-effectiveness of Andexxa, a Markov model was generated using existing Andexxa trial data and related literature. Multiple 1-way and 2-way sensitivity analyses were also constructed to delineate the impact Andexxa would need to have on mortality rates and health-related quality of life to meet the willingness-to-pay thresholds ranging between $50,000 and $150,000. The model included a hypothetical cohort of patients aged 65 years at an increased risk of stroke due to nonvalvular atrial fibrillation and with no contraindication to anticoagulation. Results: The Markov model showed that the incremental cost-effectiveness ratio of Andexxa over the standard of care is $211,056 for an intracranial hemorrhage and $40,718 for a gastrointestinal bleed. Sensitivity analyses further indicated that while Andexxa may be cost-effective to treat gastrointestinal bleeds, medication trial data will likely need to show significant impact on a patient’s quality of life and relative risk of death following an intracranial bleed to be cost-effective. Discussion: Although the application of these findings is restricted due to limited trial data, beginning to understand the cost-effectiveness of Andexxa provides policymakers important insight into the economic value of the intervention.
TINGKAT STRES DAN KUALITAS TIDUR DENGAN KADAR GULA DARAH KLIEN DIABETES MELITUS DI RUMAH SAKIT MUHAMMADIYAH PALEMBANG
Authors: Suratun Suratun 
Published: April 2021

Pendahuluan: Diabetes melitus merupakan penyakit gangguan metabolisme kronis yang ditandai peningkatan kadar gula dalam darah (hiperglikemia). Salah satu faktor pemicu yang berpotensi mempengaruhi kadar gula dalam darah adalah stres. Stres memicu reaksi biokimia tubuh melalui neural dan neuroendokrin. Stres juga merupakan salah satu faktor yang mempengaruhi tidur. Pola tidur yang tidak teratur menjadi salah satu pemicu perubahan kadar gula darah. Tidur yang berkualitas dan cukup dapat membantu menstabilkan kadar gula darah. Tujuan penelitian: untuk mengetahui hubungan tingkat stres pendekatan cros sectdan kualitas tidur dengan kadar gula darah klien diabetes melitus di rumah sakit muhammadiyah palembang. Metode Penelitian: ini menggunakan desain deskritif analitik yang dilakukan dengan pendekatan cross sectional. Sampel penelitian: klien diabetes melitus, teknik pengambilan sampel dengan cara accidental sampling, jumlah responden sebanyak 65 klien diabetes melitus. Instrumen dalam penelitian ini menggunakan kuesioner. Uji statistik yang akan digunakan adalah Chi Square. Hasil penelitian menunjukkan bahwa sebagian besar responden memiliki tingkat stres sedang 69,2%, memiliki kualitas tidur buruk 55,4% dan dengan kadar gula darah tinggi 63,1%, terdapat hubungan antara tingkat stres dengan kadar gula darah dengan pvalue 0,047, ada hubungan antara kualitas tidur dengan kadar gula darah dengan p-value 0,05.

Introduction: Diabetes mellitus is a chronic metabolic disorder characterized by an increase in blood sugar levels (hyperglycemia). One trigger factor that has the potential to influence blood sugar levels is stress. Stress triggers the body's biochemical reactions through neural and neuroendocrine. Stress is also one of the factors that influence sleep. Irregular sleep patterns become one of the triggers for changes in blood sugar levels. Good quality sleep can help stabilize blood sugar levels. The purpose of this study: to determine the relationship between the stress level of the cross sect approach and the quality of sleep with the blood sugar levels of diabetes mellitus clients in Palembang Muhammadiyah Hospital. Research Methods: This uses an analytical descriptive design that is carried outwith a cross sectional approach. Study sample: diabetes mellitus clients, sampling techniques by accidental sampling, the number of respondents was 65 diabetes mellitus clients. The instrument in this study used a questionnaire. The statistical test that will be used is Chi Square. The results showed that most respondents had moderate stress levels of 69.2%, had poor sleep quality of 55.4% and with high blood sugar levels 63.1%, there was a relationship between stress levels and blood sugar levels with a p-value of 0.047, there is a relationship between sleep quality with blood sugar levels with a p-value of 0.05.
VIOLÊNCIA CONJUGAL E PRÁTICA ASSISTENCIAL POR NÍVEIS DE ATENÇÃO À SAÚDE: DISCURSO DE ENFERMEIRAS
Authors: Sousa Anderson Reis de , Estrela Fernanda Matheus , Silva Andrey Ferreira da , Magalhães Júlia Renata Fernandes de , Oliveira Milena Arão Da Silva , Loureiro Adriana Karlla Neves da Silva , Gomes Valquíria Rodrigues 
Published: April 2021

Objetivo: descrever a prática assistencial da enfermeira frente aos casos de violência conjugal nos três níveis de atenção à saúde.Método: estudo qualitativo realizado com 47 enfermeiras atuantes em uma grande cidade do Nordeste brasileiro. Os dados foram coletados entre setembro e novembro de 2018, sistematizados através do software NVIVO11®, e analisados por meio do Discurso do Sujeito Coletivo.Resultados: a pesquisa despontou que, na identificação dos casos de violência, há necessidade de investigação do cotidiano conjugal e estabelecimento de vínculo com a usuária. No que tange aos encaminhamentos, é necessária articulação com outros profissionais.Considerações finais: a pesquisa oferece subsídios para nortear o cuidado às mulheres em situação de violência conjugal nos três níveis de atenção.
Pain among patients with substance use disorders and non-pharmacological options: An integrative review
Authors: Redd Mishiko , Goldstein Nancy 
Published: April 2021

Background: An increased incidence of chronic pain is growing worldwide. Typical treatment of chronic pain often involves a medication regimen. Opioids are the most highly prescribed class of medications for chronic pain by providers. The liberal use of opioids to help relieve chronic pain has led to other undesirable effects such as addiction, morbidity and mortality.Methods: A literature search was conducted using the key search concepts: pain AND physical therapy AND substance use. Results: A total of 5 articles met inclusion criteria out of 331 articles considered.Conclusions: The focus on alternative approaches to treatment of chronic pain/back pain for the SUD population is limited in the literature. Training for non-pharmacological options is needed for the NP and other practitioners to treat chronic back pain in the SUD population.
Comparative Studies of the Shear Strength Property of Two Members of the Fabaceae Family with Respect to Their Fibres
Authors: Nweze A. E. , Ojua E. O. , Ajuziogu G. C. , Ngele I. E. 
Published: April 2021

Aim: The shear strength of wood is a very significant parameter required in describing the potential of woods in making wooden structure. This study is aimed at comparing the shear strength of Pentaclethra macrophylla and Erythrophleum suaveolens with respect to their fibre. This is to determine the suitability of including Erythrophleum suaveolens in making traditional motars in order to reduce the demand load on Pentaclethra macrophylla.
Methods: The heartwood samples of Pentaclethra macrophylla and Erythrophleum suaveolens for maceration were fixed in specimen bottles containing formalin-acetic-alcohol (FAA) in the ratio 90:5:5 to prevent fungal growth. The preparations involved cutting small clear samples of the heartwood of the two timber species of fabaceae family. The shear strength parallel to the grain test was conducted using a Hounsfield Tensometer.
Results: Significant differences were recorded across the fibre characteristics of the two plant species. The share strength of the 25 wood samples from the two plants each fluctuate around 100 to 200 N/mm2. On the average, P. macrophylla recorded higher shear strength as compared to

suaveolens however no significant difference was recorded between the means when tested for significant differences using independent sample t-test.

Conclusion: Since the shear strength of E. suaveolens is comparable to that of P. macrophylla, it is therefore recommended its substitute for the manufacturing of wood based products where P. macrophylla has been in continual usage in order to relieve the pressure and demand on P. macrophylla.
Diagnosis and management of malignant germ cell ovarian tumors in young females
Authors: Zalel Y. , Piura B. , Elchalal U. , Czernobilsky B. , Antebi S. , Dgani R. 
Published: July 2002

AbstractGerm cell tumors (GCT) compose most of the preadolescent malignant ovarian tumors; dysgerminoma being the most common (48%), followed by endodermal sinus tumor, immature teratoma, mixed GCT and embryonal carcinoma. The percentage of malignant epithelial ovarian tumors rises with increasing age, while that of the GCT tumors declines. Of all tumor markers discussed, only AFP ang hCG are being routinely monitored. Their most effective use is in monitoring response to therapy and detecting recurrences early. The current therapeutic regimens are presented, among them bleomycin, etoposide and platinol (BEP) and other new regimens; their influence on the patients' fertility is discussed. Further improvement in the prognosis of these young patients will hopefully follow development of new surgical and chemotherapeutic approaches.
A POTENT INHIBITOR OF NEURITE OUTGROWTH THAT PREDOMINATES IN THE EXTRACELLULAR MATRIX OF REACTIVE ASTROCYTES
Authors: Canning David R. , Höke Ahmet , Malemud Charles J. , Silver Jerry 
Published: July 2002

AbstractIn a model of astrogliosis in vitro, cultured cortical astrocytes were triggered into a functionally reactive state by an immobilized fragment of the β‐amyloid peptide. Induced astrocytes produced an extracellular matrix that inhibited the outgrowth of embryonic CNS axons. Within the extracellular matrix deposited by reactive astrocytes, we found an overall increase in the deposition of chondroitin sulphate that accounted for the inhibition. Specifically, we have detected an increased biosynthesis of a small chondroitin/heparan sulphate proteoglycan that is a potent inhibitor of axon outgrowth. We further suggest that this proteoglycan, or related molecules yet to be discovered, may play a role in gliosis‐mediated regenerative failure of CNS axons.
Prenatal strategies for reducing severe thalassemia in pregnancy
Authors: Wanapirak C , Tongsong T , Sirivatanapa P , Sa‐nguansermsri T , Sekararithi R , Tuggapichitti A 
Published: July 2002

AbstractObjective: To describe the prenatal strategy in reducing new cases of severe thalassemia at Maharaj Nakorn Chiang Mai Hospital. The study design involved a prospective descriptive analysis set in Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University. Subjects: Pregnant women attending antenatal clinic. Methods: The strategy included: (1) carrier identification by retrospective (history review) and prospective screening program; (2) the couples at risk were counseled and offered cordocentesis; (3) analysis of fetal blood with high performance liquid chromatography (HPLC) or electrophoresis; and (4) counseling for termination of pregnancy in case of affected fetus. The prospective screening consisted of testing for a carrier by a simple erythrocyte osmotic fragility test (EOFT) in women with no risk and testing the husbands of the women with abnormal tests. A pregnancy in which both of the couple were carriers was considered a risk. Results: Cordocentesis was performed in 554 pregnancies at risk, 252 and 302 from retrospective and prospective screening, respectively. Sixty of 252 of the first group had severe thalassemia. In the prospective screening program of 12 680 women, 459 risk couples were identified, 302 pregnancies underwent cordocentesis and 53 (17.5%) had severe thalassemia. This strategy enabled us to identify 113 cases of severe thalassemia (Hb Bart's; 60, β‐thal entities; 53) from 554 cases at risk. Conclusion: The strategy proves valuable in the control of severe thalassemia. This extensive experience suggests the strategy be considered an effective way in the control of severe thalassemia in high prevalence areas.
Erythropoietin in amniotic fluid as a marker of chronic fetal hypoxia
Authors: Buescher U , Hertwig K , Wolf C , Dudenhausen J.W 
Published: July 2002

AbstractObjective: To determinate the erythropoietin concentration in amniotic fluid in normal pregnancies and pregnancies with suspected hypoxia. Method: The erythropoietin concentration of 164 samples of amniotic fluid was determined by ELISA. The samples were taken by amniotomy during birth, as well as amniocentesis conducted during prenatal care. Results: A distribution of 1.07–7.29 U/l (10th–90th percentile) within the normal group (n=106) was determined. Significantly elevated erythropoietin levels in amniotic fluid were determined in maternal hypertension (P=0.039) and low birth‐weight children (P=0.0032). A correlation with the child's sex could be excluded. Conclusion: Elevated erythropoietin levels in amniotic fluid indicated chronic fetal hypoxia.
Medical versus surgical abortion
Authors: Cabezas E 
Published: July 2002

AbstractObjective: To evaluate the safety, efficacy, and acceptability of an oral drug regimen of medical abortion compared with surgical abortion. Materials and methods: 500 women with amenorrhea <56 days chose either surgical abortion or 600 mg of mifepristone (RU‐486) followed by 400 μg of misoprostol after 48 h. Results: Medical regimen had more side effects than surgical abortion, including bleeding, cramping, nausea and vomiting. Only fever was more frequent in the surgical method. The failure rates for medical abortion exceeded those for surgical abortion, 16.0% vs. 4.0%. The adolescents' failure rate in the medical regimen group was only 1.7%. Several failures on medical abortion were not true drug failures, but surgical interventions not medically necessary (misdiagnosis). Women were satisfied with either method, but more preferred medical abortion. Conclusion: Medical methods are safe, effective, simpler and potentially allow greater privacy than surgical abortion methods. Therefore, medical methods could be the method of choice for abortion, particularly for adolescents.
Lead exposure alters Egr‐1 DNA‐binding in the neonatal rat brain
Authors: Reddy G.R. , Zawia N.H. 
Published: July 2002

AbstractZinc finger proteins (ZFP) contain a structural motif (Cys‐2 His‐2) found in a large family of eukaryotic transcriptional regulatory proteins, such as Spl. Previous studies have shown that Sp1 DNA‐binding was disrupted by exposure to lead (Pb), due to action on its zinc finger domain. In this paper, we discuss the results of studies with another ZFP, Egr‐1, an early growth response gene, which is functionally involved in cell proliferation and differentiation. Egr‐1 DNA‐binding was studied by gel shift mobility assays in several brain regions of developing rat pups. We observed a distinct developmental profile of Egr‐1 DNA‐binding with a gradual increase from the early to late postnatal days in all the brain regions examined. Lactational exposure to Pb resulted in a modulation of Egr‐1 DNA binding manifested by premature peaks in DNA‐binding reminiscent of the in vivo changes previously reported for Spl. These data are consistent with earlier findings that exposure to Pb both in vivo and in vitro causes a modulation in the DNA‐binding of ZFP such as Sp1, Egr‐1 and TFIIIA. The commonality by which Pb exposure alters the DNA‐binding patterns of ZFP suggests that divalent Pb may be interacting directly with the Zn moiety of these proteins.
First report of mirtazapine-induced arthralgia
Authors: Jolliet P. , Veyrac G. , Bourin M. 
Published: July 2002

SummaryObjective.The aim of our work is to describe the first two cases of arthralgia associated with the antidepressant drug mirtazapine.Method.Descriptive analysis of two iatrogenic cases. The review of the literature was achieved by the traditional electronic methods. The French database of iatrogenic cases was consulted.Results.A 53-year-old man presented with gonalgia after some weeks of mirtazapine treatment. The intensity of the arthralgia was correlated with the dosage and the adverse effect rapidly disappeared after the antidepressant therapy was stopped. A 38-year-old woman received mirtazapine for 3 months and complained of arthralgia and myalgia. This clinical picture was suspended as the drug was stopped and a positive reintroduction was observed. No other cause was found in these two patients.Discussion.No similar case has been reported in the international literature, but several observations of arthralgia with mianserin are mentioned. As mirtazapine is the 6-aza derivative of the tetracyclic antidepressant mianserin, the similarities of their chemical structures begs the responsibility of mirtazapine for arthralgia.
Follow-up studies of schizophrenia I: Natural history and non-psychopathological predictors of outcome
Authors: van Os J , Wright P , Murray RM 
Published: July 2002

SummaryTreatment-resistant schizophrenia does not exist as a discrete entity, so separating patients who will fail to respond to traditional antipsychotics from those who will respond is impossible with 100% accuracy. However, several predictors of poor clinical outcome have emerged from recent research and knowledge of the processes that lead to poor outcome has become increasingly important with the advent of atypical antipsychotics that may be used in patients with treatment-resistant illness. Much of the variation in outcome can be understood in terms of differences in sample selection, outcome definition and stringency of the diagnostic criteria used. Failure to appreciate these mechanisms may lead to over- or underestimation of the proportion of patients with poor treatment response in clinical and research settings. The importance of factors that predict poor outcome should be judged in terms of their effect size and the degree to which alternative explanations for the association with outcome have been excluded. Although much current research is being focused on specific biological predictors, baseline demographic and illness-related factors, such as ethnic group, sex, social class, type of onset, age of onset and concurrent misuse of alcohol or drugs, have large effects on outcome. Although duration of untreated psychosis before first contact with services may independently predict poor outcome, confounding by variables that are associated with both pathways to care and clinical outcome has not been excluded.
The effects of enalapril‐digoxin‐diuretic combination therapy on nutritional and anthropometric indices in chronic congestive heart failure: preliminary findings in cardiac cachexia
Authors: Adigun A.Q. , Ajayi A.A. Leslie 
Published: July 2002

AbstractBackground:Body wasting is a clinical feature of a variety of chronic illnesses including congestive heart failure. The wasting associated with chronic congestive heart failure (cardiac cachexia) has recently been shown to portend a worse prognosis, and it is an independent predictor of mortality. The mechanisms underlying cardiac cachexia are multi‐factorial, including metabolic, nutritional, neuroendocrine and immunological aberrations. There is, however, no direct evidence that current medical treatment reverses cachexia in chronic heart failure.Methods:The effect of enalapril, digoxin and frusemide combination on clinical, biochemical and anthropometric indices were determined in eight cachectic Nigerians with chronic congestive heart failure [body mass index (BMI) 20.80 ± 2.7 kg/m2, left ventricular ejection fraction 29 ± 4% and LV mass index 161 + 37 g/m2] at baseline, and again after 3 and 6 months of therapy. Ten age‐ and sex‐matched healthy volunteers whose anthropometric data were concurrently measured served as controls.Results:The anthropometric and clinical measurements were significantly (P < 0.001) reduced in heart failure compared to the healthy controls. Congestive hepatomegaly significantly regressed from 161 ± 20 mm to 123 ± 13 mm after 6 months therapy (P < 0.001 ANOVA). There was a significant increase in the sum of four skin fold thickness from 27.6 ± 3.3 mm to 30.1 ± 3.9 mm at 6 months (P < 0.001 ANOVA) 95% confidence intervals for the difference being 1.42 to 3.4 mm. There was a significant increase in the mid‐upper arm circumference (P < 0.001 ANOVA) with a 95% confidence interval of 0.87 – 2.1 cm, and a similar trend for increased mid‐thigh circumference (95% confidence limits 0.93 – 5.30 cm) was apparent. Plasma albumin and sodium increased significantly (P < 0.05) from 30.1 ± 3.8 g/l and 136 ± 5.9 mmol/l to 32.9 ± 2.5 g/l and 139 ± 3.9 mmol/l, respectively. There was a positive and significant correlation between the treatment induced increases in plasma albumin and the increase in mid‐upper arm circumference (y ‐ 0.25x + 0.8, r ‐ 0.76, P ‐ 0.03 ANOVA) but not with the change in skin fold thickness.Conclusion:The preliminary results demonstrate increased subcutaneous fat (increased skin fold thickness), greater muscle bulk (increased mid‐upper arm and thigh circumferences) together with a significant elevation in plasma albumin and the hematocrit, which reflect the anabolic state in patients treated with ACE inhibitor–digoxin–diuretic with congestive heart failure.
Chiral Photodetector Based on GaAsN
Authors: Joshya Rajagopal Shyamala , Carrère Hélène , Ibarra‐Sierra Victor Guadalupe , Sandoval‐Santana Juan Carlos , Kalevich Vladimir K. , Ivchenko Eugeniyus L. , Marie Xavier , Amand Thierry , Kunold Alejandro , Balocchi Andrea 
Published: April 2021

AbstractThe detection of light helicity is key for various applications, from drug production to optical communications. However, the light helicity direct measurement is inherently impossible with conventional photodetectors based on III–V or IV–VI non‐chiral semiconductors. The prior polarization analysis by often moving optical elements is necessary before light is sent to the detector. A method is here presented to effectively give the conventional dilute nitride GaAs‐based semiconductor epilayer a chiral photoconductivity. The detection scheme relies on the giant spin‐dependent recombination of conduction electrons and the accompanying spin polarization of the engineered defects to control the conduction band. As the conduction electron spin polarization is, in turn, intimately linked to the excitation light polarization, the light polarization state and intensity can be determined by a simple conductivity measurement. This approach, removing the need for any optical elements in front of a non‐chiral detector, could offer easier integration and miniaturization. This new chiral photodetector could potentially operate in a spectral range from the visible to the infra‐red using (InGaAl)AsN alloys or ion‐implanted nitrogen‐free III–V compounds.