bluuebunny/crossref_metadata_2025_split huggingface dataset:
Southern France
Authors: Garcia Dominique 
Published: June 2018

Abstract
A distinct material culture, economy, and society developed in the south of France during the Iron Age. This phenomenon was related to the way in which local communities were situated between the traditional Celtic societies of temperate Europe, and Mediterranean communities such as the Phoenicians, Etruscans, Greeks, and Romans. This chapter examines the changing nature of settlement types (architecture, urbanization, material culture, topography) and territorial organization during the first millennium BC. From the eighth century BC, local forms of production (agriculture, crafts, trade) were confronted with market activity that greatly expanded after the foundation of Massalia in 600 BC, and towns began to develop soon after. The distinctive monuments and sculpture, public buildings, and burial grounds of the region provide a wealth of insight into religious and funerary practices. The place of different ethnic groups in the regional history is also considered.
The Eastern Baltic
Authors: Lang Valter 
Published: June 2018

Abstract
This chapter examines Iron Age funerary and domestic archaeological sites, and economic and cultural developments from c.500 BC–AD 550/600, in the east Baltic region (present day Estonia, Latvia, and Lithuania). While the early pre-Roman Iron Age was to some extent a continuation of the late Bronze Age in material culture terms, many changes took place in the late pre-Roman Iron Age. At the change of era, new cultural trends spread over the east Baltic region, from the south-eastern shore of the Baltic to south-west Finland, which produced a remarkable unification of material culture over this entire region up to the Migration period. Differences in burial practices and ceramics, however, indicate the existence of two distinct ethnic groups, Proto-Finnic in the northern part of the region and Proto-Baltic to the south. Subsistence was based principally on agriculture and stock rearing, with minor variations in the economic orientation of different areas.
The Carpathian and Danubian area
Authors: Rustoiu Aurel 
Published: June 2018

Abstract
This chapter provides an overview of Iron Age societies in the eastern Carpathian basin and lower Danube region, from the Great Hungarian Plain to the Black Sea, drawing on funerary and settlement data from the different regions. The first iron objects occur in Transylvania in the late Bronze Age, but ironworking only developed fully in the early first millennium BC. Throughout the period, the area was open to contacts with central Europe, as well as the Mediterranean and Black Sea regions. The so-called Scythian and Celtic horizons in the Carpathian basin were both associated with newcomers, although the nature and extent of population movement remains open to discussion. In the north Balkans, a series of opulent graves and fortified settlements attests to the development of an aristocracy with strong ties to the Greek world, followed in the late Iron Age by the rise of the impressive but short-lived Dacian kingdom.
Newton on Body
Authors: Brading Katherine 
Published: June 2018

Abstract
This article argues for Newton’s concept of body as a powerful tool of analysis in examining his natural philosophy, including his matter theory, metaphysics, epistemology, and methodology. Newton certainly had views on matter theory, but the methodology he developed transformed the relationship between matter theory and the theory of bodies, enabling him to arrive at results concerning bodies while remaining largely silent about matter theory. Topics covered include the mathematical and physical treatment of bodies; condensation and rarefaction; cohesion; the law-constitutive approach to bodies; and the qualities of bodies. The article shows that the bodies of our experience are Newton’s primary explanatory target, connecting his views on such quintessential Newtonian topics as atomism, inertia, force, gravity, space, and motion.
Defining an Intraoperative Hypotension Threshold in Association with Stroke in Cardiac Surgery
Authors: Sun Louise Y. , Chung Amy M. , Farkouh Michael E. , van Diepen Sean , Weinberger Jesse , Bourke Michael , Ruel Marc 
Published: June 2018

Abstract

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Stroke is a leading cause of morbidity, mortality, and disability in patients undergoing cardiac surgery. Identifying modifiable perioperative stroke risk factors may lead to improved patient outcomes. The association between the severity and duration of intraoperative hypotension and postoperative stroke in patients undergoing cardiac surgery was evaluated.

Methods
A retrospective cohort study was conducted of adult patients who underwent cardiac surgery requiring cardiopulmonary bypass at a tertiary center between November 1, 2009, and March 31, 2015. The primary outcome was postoperative ischemic stroke. Intraoperative hypotension was defined as the number of minutes spent within mean arterial pressure bands of less than 55, 55 to 64, and 65 to 74 mmHg before, during, and after cardiopulmonary bypass. The association between stroke and hypotension was examined by using logistic regression with propensity score adjustment.

Results
Among the 7,457 patients included in this analysis, 111 (1.5%) had a confirmed postoperative diagnosis of stroke. Stroke was strongly associated with sustained mean arterial pressure of less than 64 mmHg during cardiopulmonary bypass (adjusted odds ratio 1.13; 95% CI, 1.05 to 1.21 for every 10 min of mean arterial pressure between 55 and 64 mmHg; adjusted odds ratio 1.16; 95% CI, 1.08 to 1.23 for every 10 min of mean arterial pressure less than 55 mmHg). Other factors that were independently associated with stroke were older age, hypertension, combined coronary artery bypass graft/valve surgery, emergent operative status, prolonged cardiopulmonary bypass duration, and postoperative new-onset atrial fibrillation.

Conclusions
Hypotension is a potentially modifiable risk factor for perioperative stroke. The study’s findings suggest that mean arterial pressure may be an important intraoperative therapeutic hemodynamic target to reduce the incidence of stroke in patients undergoing cardiopulmonary bypass.
Osteomyelitis Risk Factors Related to Combat Trauma Open Tibia Fractures: A Case–Control Analysis
Authors: Tribble David R. , Lewandowski Louis R. , Potter Benjamin K. , Petfield Joseph L. , Stinner Daniel J. , Ganesan Anuradha , Krauss Margot , Murray Clinton K. ,   the Trauma Infectious Disease Outcomes Study Group
Published: June 2018

Objectives:
We assessed osteomyelitis risk factors in US military personnel with combat-related open tibia fractures (2003–2009).

Methods:
Patients with open tibia fractures who met the diagnostic criteria of osteomyelitis were identified as cases using Military Health System data and verified through medical record review. Controls were patients with open tibia fractures who did not meet osteomyelitis criteria. The Gustilo–Andersen fracture classification scheme was modified to include transtibial amputations (TTAs) as the most severe level. Logistic regression multivariable odds ratios [ORs; 95% confidence intervals (CI)] were assessed.

Results:
A total of 130 tibia osteomyelitis cases and 85 controls were identified. Excluding patients with TTAs, osteomyelitis cases had significantly longer time to radiographic union compared with controls (median: 210 vs. 165 days). Blast injuries, antibiotic bead utilization, ≥ Gustilo–Andersen-IIIb fractures [highest risk with TTA (OR: 15.10; CI: 3.22–71.07)], and foreign body at the fracture site were significantly associated with developing osteomyelitis. In a separate model, the Orthopaedic Trauma Association Open Fracture Classification muscle variable was significant with increasing risk from muscle loss (OR: 5.62; CI: 2.21–14.25) to dead muscle (OR: 8.46; CI: 3.31–21.64). When TTAs were excluded, significant risk factors were similar and included sustaining an injury between 2003 and 2006.

Conclusions:
Patients with severe blast trauma resulting in significant muscle damage are at the highest risk for osteomyelitis. The period association coincides with a time frame when several trauma system practice changes were initiated (eg, increased negative pressure wound therapy, decreased high-pressure irrigation, and reduced crystalloid use).

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Drug Monitoring to Assess Drug Adherence in Assumed Resistant Hypertension: A Comparison With Directly Observed Therapy in 3 Nonadherent Patients
Authors: Feyz Lida , Bahmany Soma , Daemen Joost , van den Meiracker Anton H. , Koch Birgit C. P. , van Gelder Teun , Versmissen Jorie 
Published: June 2018

Abstract:
Resistant hypertension is a common health problem leading to suboptimal cardiovascular prevention. A large number of patients with resistant hypertension have poor medication adherence explaining their assumed resistance to therapy. We combined directly observed therapy (DOT) with therapeutic drug monitoring (TDM) in 3 patients at several time points to enable an extensive feedback on blood pressure (BP) and drug levels. BP was measured with an automatic oscillatory device at regular intervals of 5 minutes (directly before and after drug intake) and at 30-minute intervals (at night) during admission. Blood samples were obtained at different time points (t = in hours; t = 0, 2, 4, 6, 12, and 24 hours after drug intake). DOT was performed under supervision of the physician. In 2 of the 3 patients, automated BP decreased directly after DOT, −10/0 and −5/−5 mm Hg, respectively. Plasma drug levels for several drugs or active metabolites were 0 at t = 0, whereas plasma levels were positive at t = 24 hours after observed intake. We recommend a more frequent use of TDM combined with repeated BP measurements in clinical practice because this is a convenient, objective method of measurement and to ensure that actual drug levels reflect the BP at the time of measurement.
Clinical Profile of a Nonselected Population Treated With Sacubitril/Valsartan Is Different From PARADIGM-HF Trial
Authors: Vicent Lourdes , Esteban-Fernández Alberto , Gómez-Bueno Manuel , De-Juan Javier , Díez-Villanueva Pablo , Iniesta Ángel Manuel , Ayesta Ana , González-Saldívar Hugo , Rojas-González Antonio , Bover-Freire Ramón , Iglesias Diego , García-Aguado Marcos , Perea-Egido Jesús A. , Martínez-Sellés Manuel 
Published: June 2018

Abstract:
Our aim is to describe the characteristics of the patients receiving sacubitril/valsartan (SV) in daily clinical practice. This is a prospective registry in 10 hospitals including all patients who started SV in everyday clinical practice. From October 2016 to March 2017, 427 patients started treatment with SV. The mean age was 68.1 ± 12.4 years, and 30.5% were women (22.0% in PARADIGM-HF, P < 0.001). Comparing our cohort with patients included in PARADIGM-HF, baseline treatment was different, with a lower ratio of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (2.7 vs. 3.5, P < 0.001), and a higher proportion of patients with implantable cardioverter defibrillator (53.8% vs. 15%, P < 0.001), and cardiac resynchronization therapy (25.8% vs. 5%, P < 0.001). Treatment with mineralocorticoid receptor antagonists was more frequent (76.7% vs. 60.0%, P < 0.001), and the use of beta-blockers was similar (94.6% vs. 93.0%, P = 0.43). We observed more patients in functional class III-IV (30.4 vs. 24.8, P = 0.015), higher levels of Nt pro-BNP [3421 (904–4161) vs. 1631 (885–3154) pg/mL] and worse renal function (creatinine level 1.3 ± 0.7 vs. 1.1 ± 0.3 mg/dL, P < 0.001). In real life, patients receiving SV have a higher risk profile than in the pivotal trial, poorer functional class, higher levels of natriuretic peptides, and worse renal function.
Into the void: a review of postoperative urinary retention after minimally invasive gynecologic surgery
Authors: Wong Marron C. , Isaacson Keith , Morris Stephanie 
Published: June 2018

Purpose of review
Postoperative urinary retention (POUR) is a common occurrence after minimally invasive gynecologic surgery (MIGS). This review discusses the definition, incidence, evaluation, diagnosis, and treatment of POUR after MIGS.

Recent findings
Reported incidence of POUR after MIGS ranges from 0.5 to 21%. Active void trials or awaiting spontaneous void after surgery are both viable options for diagnosing POUR, but active void trials appear to be more accurate, quicker, and preferred by patients. The use of enhanced recovery after surgery pathways and minimizing postoperative opioids can help reduce POUR.

Summary
It is important to evaluate postoperative patients for POUR after MIGS. Standard guidelines are lacking for the evaluation and treatment of patients with POUR.
Sclerocornea–Microphthalmia–Aphakia Complex: Description of Two Additional Cases Associated With Novel FOXE3 Mutations and Review of the Literature
Authors: Quiroz-Casian Natalia , Chacon-Camacho Oscar F. , Barragan-Arevalo Tania , Nava-Valdez Jessica , Lieberman Esther , Salgado-Medina Acatzin , Navas Alejandro , Graue-Hernandez Enrique O. , Zenteno Juan C. 
Published: June 2018

Purpose:
To describe 2 sporadic Mexican patients having congenital bilateral, total sclerocornea, aphakia, and microphthalmia associated with novel mutations in the FOXE3 gene.

Methods:
Two affected individuals with congenital bilateral, total sclerocornea, aphakia, and microphthalmia underwent detailed examinations including slit-lamp examination, visual acuity, and intraocular pressure measurements. Ocular ultrasonography and ultrasound biomicroscopy were performed. Genomic DNA was isolated from blood leukocytes in each subject, and molecular analysis of the FOXE3 gene was performed. For cosegregation analysis, presumable pathogenic variants were tested by Sanger sequencing in parental DNA.

Results:
Molecular screening of FOXE3 was performed in 2 cases with congenital bilateral, total sclerocornea, aphakia, and microphthalmia. In patient 1, genetic analysis demonstrated a novel homozygous c.291C>G (p.Ile97Met) FOXE3 pathogenic variant. In patient 2, compound heterozygosity for the novel c.387C>G (p.Phe129Leu) transversion and for the previously reported c.244A>G (p.Met82Val) transition, was recognized.

Conclusions:
The sclerocornea–microphthalmia–aphakia complex is a severe malformative ocular phenotype resulting from mutations in the FOXE3 transcription factor. To date, patients from at least 14 families with this uncommon ocular disorder have been described. The identification of 2 novel pathogenic variants in our patients expands the mutational spectrum in FOXE3-related congenital eye disorders. In addition, we performed a review of the clinical and genotypic characteristics of all published patients carrying biallelic FOXE3 mutations.
Effects of the use of neuromuscular blocking agents on acute respiratory distress syndrome outcomes: A systematic review
Authors: Paramore Samantha 
Published: June 2018

ABSTRACT

Background and purpose:
Acute respiratory distress syndrome (ARDS) is a high-mortality disease with limited treatment options. Optimization of gas exchange while limiting damage to the lungs is key. The use of neuromuscular blocking agents may limit hypoxemia while preventing ventilator-induced lung injury.

Methods:
A literature search was conducted using Ovid Medline and the exploded MeSH terms ARDS, acute respiratory distress syndrome, neuromuscular blockade, neuromuscular blocking agents, and paralytics. With limitations applied, three original randomized controlled trials investigating the use of neuromuscular blocking agents (NMBAs) in severe ARDS were identified and reviewed.

Conclusions:
Two of the three trials demonstrated improved primary outcomes with the use of NMBA. The third trial was underpowered (due to unanticipated low mortality in the control group) and did not show a statistically significant improvement in the primary outcome. As all the original research was conducted by the same group, further investigation is necessary to assess generalizability and confirm results. Currently, additional research is underway, focusing on early enrollment and narrow inclusion criteria.

Implications for practice:
Secondary analysis from two separate groups concluded the improved outcomes, with no evidence of increased risk of critical illness polyneuropathy or myopathy, suggest that the use of NMBAs in severe ARDS is appropriate.
Food and Drug Administration upscheduling of hydrocodone and the effects on nurse practitioner pain management practices
Authors: Mack Rachel 
Published: June 2018

ABSTRACT

Background and purpose:
In 2013, the Advisory Committee of the Food and Drug Administration determined hydrocodone combination medications (HCMs) needed tighter regulation due to high abuse potential; they recommended upscheduling HCMs from Schedule III to II. The purpose of this study was to examine the effect of upscheduling of HCMs on pain management practices of advanced practiced registered nurses (APRNs) in Oklahoma.

Methods:
In this qualitative study, 25 participants described their primary care experiences after the upscheduling. A thematic analysis was used to understand the effects on APRN pain management practices.

Conclusions:
The upscheduling of HCMs has greatly affected the pain management practices of APRNs in a state where Schedule II narcotic prescribing is forbidden. Findings will assist APRNs with improving patient access to care, implementing practice regulations, and exploring options for alternative pain therapies in primary care.

Implications for practice:
Upscheduling of HCMs has had a severe impact on APRNs, affecting their prescribing practices and leading to increased referrals. They noted limited treatment options, increased health care costs, and decreased access to care. The APRNs understand the problem of prescription opioid abuse, diversion, and misuse. A consensus model could standardize the regulatory process for APRNs, increase interstate mobility for practice, and increase access to APRN care nationwide.
Towards more specific treatment for diabetic dyslipidemia
Authors: Rodriguez Valentina , Newman Jonathan D. , Schwartzbard Arthur Z. 
Published: June 2018

Purpose of review
Treatment of diabetic dyslipidemia is necessary because of its impact on cardiovascular disease, which is the leading cause of death in patients with diabetes. In the past, standard treatment of diabetic dyslipidemia focused only on correcting lipids. Although this remains the mainstay of treatment, because new antihyperglycemic treatments reduce cardiovascular events with minimal effect on dyslipidemia, a new approach is both timely and relevant.

Recent findings
LDL-lowering remains the focus of treatment for diabetic dyslipidemia, especially in patients with both diabetes and cardiovascular disease (CVD). Higher intensity statin therapy or lower LDL cholesterol goals are recommended in these patients. Combination therapy, especially with ezetimibe, fibrates, bile acid sequestrants, PCSK9 inhibitors and omega 3 fatty acids should be considered along with selected new agents to reduce glycemia.

Summary
As diabetic dyslipidemia plays a key role in CVD, aggressive treatment is indicated. New research targets include apo-CIII and lipoprotein(a) [Lp(a)]. In addition, new antihyperglycemic therapy is changing diabetes care and altering treatment guidelines. The most recent American Diabetes Association Standards of Care has expanded its recommendations for people with CVD and diabetes, suggesting that medications validated to improve cardiac health should be strongly considered.
Metformin, lipids and atherosclerosis prevention
Authors: Jenkins Alicia J. , Welsh Paul , Petrie John R. 
Published: June 2018

Purpose of review
We provide an overview of recent publications that extend clinically relevant knowledge relating to metformin's effects on lipids and atherosclerotic vascular disease and/or provide insights into the drug's mechanisms of action on the heart and vasculature.

Recent findings
We focus on original research in humans or in human tissues. Several recently completed randomized clinical trials have reported effects of metformin on surrogate measures of atherosclerotic vascular disease, including carotid–intima media thickness, vascular reactivity and calcification in people with Type 1 (T1D) and Type 2 (T2D) diabetes as well as nondiabetic dysglycaemia. In addition, observational studies have provided novel insights into the mechanisms of metformin's effects on carotid plaque, monocytes/macrophages, vascular smooth muscle and endothelial cells, including via 5’-adenosine monophosphate-activated protein kinase (AMPK) activation.

Summary
Recent trials based on surrogate outcome measures have provided further data suggesting protective effects of metformin against vascular disease in youth and adults with Type 1 diabetes, as well as in adults with prediabetes and Type 2 diabetes. In parallel, human tissue and cell studies have provided new insights into pleiotropic effects of metformin and suggest novel drug targets. As metformin is an inexpensive agent with an established safety profile, larger scale clinical trials based on hard clinical outcomes [cardiovascular disease (CVD) events] are now indicated.
Defining kidney allograft benefit from successful pancreas transplant: separating fact from fiction
Authors: Wiseman Alexander C. , Stites Erik , Kennealey Peter 
Published: June 2018

Purpose of review
To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival.

Recent findings
A postulated benefit of simultaneous pancreas kidney transplant is that, unlike kidney transplant alone, euglycemia from the added pancreas allograft may confer a nephroprotective benefit and prevent recurrent diabetic nephropathy in the renal allograft. Recent large database analyses and long-term histological assessments have been published that assist in quantifying the problem of recurrent diabetic nephropathy and answering the question of the potential benefits of euglycemia. Further data may be extrapolated from larger single-center series that follow the prognosis of early posttransplant diabetes mellitus as another barometer of risk from diabetic nephropathy and graft loss.

Summary
Recurrent diabetic nephropathy following kidney transplant is a relatively rare, late occurrence and its clinical significance is significantly diminished by the competing risks of death and chronic alloimmune injury. Although there are hints of a protective effect upon kidney graft survival with pancreas transplant, these improvements are small and may take decades to appreciate. Clinical decision-making regarding pancreas transplant solely based upon nephroprotective effects of the kidney allograft should be avoided.