bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial: Comparison of Sun Safe Workplaces Policy Intervention to Attention Control
Authors: Buller David B. , Walkosz Barbara J. , Buller Mary Klein , Wallis Allan , Andersen Peter A. , Scott Michael D. , Meenan Richard T. , Cutter Gary R. 
Published: November 2018

Purpose: Implementation of employer sun safety actions was assessed in a 2-year follow-up to an occupational sun protection policy intervention. Design: Two-year follow-up assessment in a randomized pretest–posttest controlled design. Setting: Local government organizations with workers in public safety, public works, and parks and recreation. Participants: Sixty-three local government organizations (participation = 64%) and 330 frontline supervisors and 1454 workers. Intervention: Sun Safe Workplaces (SSW) intervention promoting occupational sun safety policy and education. Measures: Observations of SSW messages and sun safety items and surveys on organizations’ communication and actions on sun safety. Analysis: Comparison between SSW and control groups was conducted using regression models and adjusted for clustering where appropriate, with α criterion set at P = .05 (2-tailed). Results: At intervention worksites, more SSW messages ( P < .001) and sun safety items ( P = .025) were observed; more frontline supervisors reported organizations provided free/reduced price sunscreen ( P = .005) and communicated about sun safety ( P < .001); and more workers recalled receiving sun safety messages ( P < .001) and sun safety training ( P <.001) compared to control organizations. Implementation was greater at larger than smaller intervention organizations for wide-brimmed hats ( P = .009), long work pants ( P = .017), and shade structures ( P = .036). Older workers received the most written messages ( P = .015). Conclusions: Sun Safe Workplaces appeared to produce actions by organizations to support employee sun safety. Large organizations may have processes, communication channels, and slack resources to achieve more implementation.
Human Milk Expression After Domperidone Treatment in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Taylor Alicia , Logan Gabrielle , Twells Laurie , Newhook Leigh Anne 
Published: November 2018

Background: Insufficient milk production is among the most cited reasons by mothers for discontinuing breastfeeding. Medications that can increase milk production, such as domperidone, an off-label galactagogue, are often prescribed. Domperidone is controversial as it is not approved for any purpose in the United States and is approved only for gastrokinetic purposes in Canada and other countries. Research aim: The aim was to update the existing literature on the efficacy of domperidone as a galactagogue compared to placebo when given to mothers with insufficient human milk production. The primary outcome is the change in expressed human milk volume per day from baseline. Methods: The authors independently searched the literature from inception to May 2018. The search included any randomized controlled trials examining the efficacy of domperidone increasing mothers’ expressed human milk, measured via a human milk pump. Both authors independently assessed quality and risk of bias and extracted relevant data. Meta-analysis on expressed human milk volume per day was performed. Results: Seven studies met the inclusion criteria for review; two were excluded from the meta-analysis due to quality grading and insufficient reporting of the outcome of interest. Five studies ( N = 239) were combined in the meta-analysis. The effect size showed an increase in the mean difference of expressed human milk volume in mothers given domperidone, 93.97 mL per day (95% CI [71.12, 116.83 mL]; random effect, T2 0.00, I2 0%). Conclusion: This meta-analysis reports a significant improvement in expressed human milk volume per day with the use of domperidone in mothers experiencing insufficient human milk production.
Implication of Fast Activities of Spectral Analysis in Subjective Sleep Complaints of Elderly Women
Authors: Choi Hayun , Jeong Jahyun , Kim Heejun , Shin Chuljin , Yoon In-Young 
Published: November 2018

Objective: In elderly patients, women have better qualities of sleep than men in objective parameters; however, women subjectively complain more about sleep disturbances than men. We performed visual scoring and spectral analysis of sleep electroencephalograms to explain these gender differences in the degree of arousal, the most representative marker in insomnia. Methods: A total of 354 participants (≥60 years old) were recruited from a Korean community underwent nocturnal polysomnography (NPSG). A Fast Fourier transform was used for the spectral analysis of the NPSG data. Relative power was calculated as absolute power of each band divided by total absolute power. Difference in total sleep time (D_TST) is obtained by subtracting the total sleep time reported in Pittsburgh Sleep Quality Index (PSQI) from the TST measured by the NPSG. Results: A total of 75 participants (women, 51) were finally analyzed. Women had higher PSQI, longer sleep latencies, sleep inefficiencies, and daytime dysfunctions compared to men. The percentage of stage 1 sleep was higher in men versus in women, whereas percentage of stage 3 sleep was higher in women than in men ( P = .001; P = .001). Women had higher relative alpha and beta powers than men during nonrapid eye movement (NREM) sleep ( P = .017; P = .015). During NREM sleep, beta power was negatively correlated with D_TST ( R = −0.250, P = .033), and relative alpha power in stage 3 sleep was positively correlated with sleep latency in PSQI ( R = 0.267, P = .022). Conclusion: Spectral analysis showed that women had more disturbed sleep than men. The result from the spectral analysis may explain hyperarousal in elderly women.
Suicide Among Persons With Dementia, Georgia, 2013 to 2016
Authors: Annor Francis B. , Bayakly Rana A. , Morrison Reynolds A. , Bryan Michael J. , Gilbert Leah K. , Ivey-Stephenson Asha Z. , Holland Kristin M. , Simon Thomas R. 
Published: November 2018

Introduction: Findings from studies examining the relationship between dementia and suicide have been inconsistent. This study examined the characteristics, precipitants, and risk factors for suicide among persons with dementia. Methods: Data from the Georgia Alzheimer’s Disease and Related Dementia registry were linked with 2013 to 2016 data from Georgia Vital Records and Georgia Violent Death Reporting System. Descriptive statistics were calculated and logistic regression was used to examine risk factors for suicide. Results: Ninety-one Georgia residents with dementia who died by suicide were identified. Among decedents with known circumstances, common precipitants included depressed mood (38.7%) and physical health problems (72.6%). Suicide rate among persons with dementia was 9.3 per 100 000 person-years overall and substantially higher among those diagnosed in the past 12 months (424.5/100 000 person-years). Being male, dementia diagnosis before age 65, and a recent diagnosis of dementia independently predicted suicide, but not depression or cardiovascular diseases. Conclusion: Prevention strategies that identify at-risk individuals, provide support, and ensure continuity of care for persons diagnosed with dementia may help reduce suicide in this population.
Preferred Place of Death for Patients With Incurable Cancer and Their Family Caregivers in Egypt
Authors: Alsirafy Samy A. , Hammad Ahmad M. , Ibrahim Noha Y. , Farag Dina E. , Zaki Omar 
Published: November 2018

Background: Little is known about the place of death of patients with cancer in Eastern Mediterranean countries including Egypt, where palliative care is underdeveloped. Identifying the preferred place of death (PPoD) is important for the development of appropriate palliative care models in these countries. Objectives: To know the PPoD of Egyptian patients with incurable cancer and their family caregivers (FCGs) and to determine the factors that may impact their preferences. Methods: An observational cross-sectional study that included 301 dyads of patients with incurable cancer and one of their FCGs. A questionnaire was designed to collect data about the characteristics of patients and FCGs as well as their preferences. Results: The majority of dyads (272/301, 90.4%) answered the PPoD question. Home was the PPoD in 93% of patients and 90.1% of FCGs ( P = .218). The congruence between patients’ and FCGs’ PPoD was 92.7% (κ = 0.526). In multivariate analysis, poorer performance status (Eastern Cooperative Oncology Group 3 or 4) and full employment of FCGs associated significantly with patients’ preference to die in hospital (odds ratio [OR] = 3.015 [95% confidence interval [CI]: 1.004-9.054], P = .049 and OR = 4.402 [95% CI: 1.561-12.417], P = .005, respectively), while poorer performance status and nonreferral to the palliative medicine unit were associated with FCGs’ preference of hospital death (OR = 2.705 [95% CI: 1.105-6.626], P = .029 and OR = 2.537 [95% CI: 1.082-5.948], P = .032, respectively). Conclusions: The results of the current study suggest that home is the PPoD for the vast majority of Egyptian patients with incurable cancer and their FCGs. Palliative care interventions that promote home death of patients with incurable cancer are needed in Egypt.
Pulmonary Function Testing in Elderly Patients Treated for a Myasthenia Gravis Exacerbation
Authors: van Gaal Stephen C. , English Shane W. , Bourque Pierre R. J. , Zwicker Jocelyn C. 
Published: November 2018

Background and Purpose: Pulmonary function testing is a standard part of care for patients admitted to hospital with a myasthenia gravis exacerbation. It may inform clinicians’ decisions to intubate patients. It is known that pulmonary function declines with age in healthy adults. We studied the effect of age on pulmonary function and serious respiratory events, including intubation, in patients admitted to hospital for a myasthenia gravis exacerbation. Methods: Single center, retrospective cohort of consecutive patients treated for a myasthenia gravis exacerbation. Demographics, pulmonary function tests (PFTs), and respiratory events requiring intubation or emergency respiratory therapy were recorded for each encounter. Relationship of PFTs to age was analyzed using age as a continuous and as a dichotomous (cut-value 70 years) variable. Results: Forty-nine encounters from 39 patients were included. Slow vital capacity (SVC) was negatively correlated with age ( R 0.46, P value .002). Maximum inspiratory pressure (MIP) and SVC were significantly reduced in elderly versus nonelderly patients (MIP-20.0 vs −30.0 cm H2O, P value .004; SVC 16.5 vs 23.4 mL/kg, P value .013). The incidence of respiratory events did not significantly differ between elderly and nonelderly patients (χ2 P value .08). Conclusions: In patients treated for a myasthenia gravis exacerbation, pulmonary function values are significantly reduced in elderly patients compared to nonelderly patients. Despite very low SVC and MIP values most elderly patients do not require intubation however they do require intensive monitoring for serious respiratory complications.
Distal Biceps Repair With Flexible Instrumentation and Risk of Posterior Interosseous Nerve Injury: A Cadaveric Analysis
Authors: Tat Jimmy , Hart Adam , Cota Adam , Alsheikh Khalid , Behrends Dominique , Martineau Paul A. 
Published: November 2018

Background: Current repair techniques using cortical button fixation cannot achieve anatomic reconstruction of the distal biceps when performed through a single-incision anterior approach. We recently introduced a single-incision technique that uses flexible guide pins and flexible reamers to allow for an insertion point on the tuberosity that more closely approximates the anatomic footprint of the distal biceps. Purpose: To investigate the safety of this technique with regard to nerve injury by comparing the guide pin position relative to the posterior interosseous nerve in 16 cadaveric elbows through use of a flexible versus rigid reamer. Study Design: Descriptive laboratory study. Methods: A standard single-incision anterior approach was performed in all cadaveric specimens, and the biceps tendon was dissected off the tuberosity. In 8 specimens, a traditional straight guide pin was used with a cortical button repair inserted through the bicipital tuberosity as close to the anatomic tendon footprint as possible. In the remaining 8 specimens, a curved guide was used to insert a flexible guide wire through the tuberosity within the native footprint. Dissection was carried out to measure the distance from the exit point of the guide pin to the posterior interosseous nerve. The 2 groups were compared by use of nonparametric Wilcoxon rank-sum test (significance threshold, P < .05). Results: The mean distance of the guide wire to the posterior interosseous nerve was 11.6 mm (SD, 3.4 mm; range, 6.5-16.9 mm) in the standard rigid instrument group compared with 8.6 mm (SD, 4.2 mm; range, 1.0-13.9 mm) in the flexible instrumentation group; the difference between groups was not statistically different ( P = .19; 95% CI, –1.1 to 7.1). Conclusion: Based on our cadaveric testing, the use of flexible instrumentation in a single-incision repair of the distal biceps presents with no significant difference in risk of damage to the posterior interosseous nerve compared with standard rigid instruments. In view of the relatively small number of specimens, however, some caution should be observed when applying these results clinically. Clinical Relevance: As contemporary techniques in sports medicine strive to re-create each patient’s native anatomic characteristics, the use of flexible instruments allows for a more anatomic repair of the distal biceps, and our study demonstrates that it is a safe option. The next step is to evaluate its safety in vivo.
Low-grade evolution of clay minerals and organic matter in fault zones of the Hikurangi prism (New Zealand)
Authors: Maison Tatiana , Potel Sébastien , Malié Pierre , Ferreiro Mählmann Rafael , Chanier Frank , Mahieux Geoffroy , Bailleul Julien 
Published: November 2018

ABSTRACTClay minerals and organic matter occur frequently in fault zones. Their structural characteristics and their textural evolution are driven by several formation processes: (1) reaction by metasomatism from circulating fluids; (2)in situevolution by diagenesis; and (3) neoformation due to deformation catalysis. Clay-mineral chemistry and precipitated solid organic matter may be used as indicators of fluid circulation in fault zones and to determine the maximum temperatures in these zones. In the present study, clay-mineral and organic-matter analyses of two major fault zones – the Adams-Tinui and Whakataki faults, Wairarapa, North Island, New Zealand – were investigated. The two faults analysed correspond to the soles of large imbricated thrust sheets formed during the onset of subduction beneath the North Island of New Zealand. The mineralogy of both fault zones is composed mainly of quartz, feldspars, calcite, chabazite and clay minerals such as illite-muscovite, kaolinite, chlorite and mixed-layer minerals such as chlorite-smectite and illite-smectite. The diagenesis and very-low-grade metamorphism of the sedimentary rock is determined by gradual changes of clay mineral ‘crystallinity’ (illite, chlorite, kaolinite), the use of a chlorite geothermometer and the reflectance of organic matter. It is concluded here that: (1) the established thermal grade is diagenesis; (2) tectonic strains affect the clay mineral ‘crystallinity’ in the fault zone; (3) there is a strong correlation between temperature determined by chlorite geothermometry and organic-matter reflectance; and (4) the duration and depth of burial as well as the pore-fluid chemistry are important factors affecting clay-mineral formation.
American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism
Authors: Monagle Paul , Cuello Carlos A. , Augustine Caitlin , Bonduel Mariana , Brandão Leonardo R. , Capman Tammy , Chan Anthony K. C. , Hanson Sheila , Male Christoph , Meerpohl Joerg , Newall Fiona , O’Brien Sarah H. , Raffini Leslie , van Ommen Heleen , Wiernikowski John , Williams Suzan , Bhatt Meha , Riva John J. , Roldan Yetiani , Schwab Nicole , Mustafa Reem A. , Vesely Sara K. 
Published: November 2018

Abstract

Background:
Despite an increasing incidence of venous thromboembolism (VTE) in pediatric patients in tertiary care settings, relatively few pediatric physicians have experience with antithrombotic interventions.

Objective:
These guidelines of the American Society of Hematology (ASH), based on the best available evidence, are intended to support patients, clinicians, and other health care professionals in their decisions about management of pediatric VTE.

Methods:
ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including updating or performing systematic evidence reviews (up to April of 2017). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment.

Results:
The panel agreed on 30 recommendations, covering symptomatic and asymptomatic deep vein thrombosis, with specific focus on management of central venous access device–associated VTE. The panel also addressed renal and portal vein thrombosis, cerebral sino venous thrombosis, and homozygous protein C deficiency.

Conclusions:
Although the panel offered many recommendations, additional research is required. Priorities include understanding the natural history of asymptomatic thrombosis, determining subgroup boundaries that enable risk stratification of children for escalation of treatment, and appropriate study of newer anticoagulant agents in children.
American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy
Authors: Bates Shannon M. , Rajasekhar Anita , Middeldorp Saskia , McLintock Claire , Rodger Marc A. , James Andra H. , Vazquez Sara R. , Greer Ian A. , Riva John J. , Bhatt Meha , Schwab Nicole , Barrett Danielle , LaHaye Andrea , Rochwerg Bram 
Published: November 2018

AbstractBackground:Venous thromboembolism (VTE) complicates ∼1.2 of every 1000 deliveries. Despite these low absolute risks, pregnancy-associated VTE is a leading cause of maternal morbidity and mortality.Objective:These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and others in decisions about the prevention and management of pregnancy-associated VTE.Methods:ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations.Results:The panel agreed on 31 recommendations related to the treatment of VTE and superficial vein thrombosis, diagnosis of VTE, and thrombosis prophylaxis.Conclusions:There was a strong recommendation for low-molecular-weight heparin (LWMH) over unfractionated heparin for acute VTE. Most recommendations were conditional, including those for either twice-per-day or once-per-day LMWH dosing for the treatment of acute VTE and initial outpatient therapy over hospital admission with low-risk acute VTE, as well as against routine anti-factor Xa (FXa) monitoring to guide dosing with LMWH for VTE treatment. There was a strong recommendation (low certainty in evidence) for antepartum anticoagulant prophylaxis with a history of unprovoked or hormonally associated VTE and a conditional recommendation against antepartum anticoagulant prophylaxis with prior VTE associated with a resolved nonhormonal provoking risk factor.
American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy
Authors: Witt Daniel M. , Nieuwlaat Robby , Clark Nathan P. , Ansell Jack , Holbrook Anne , Skov Jane , Shehab Nadine , Mock Juliet , Myers Tarra , Dentali Francesco , Crowther Mark A. , Agarwal Arnav , Bhatt Meha , Khatib Rasha , Riva John J. , Zhang Yuan , Guyatt Gordon 
Published: November 2018

Abstract
In July 2022, these guidelines were reviewed by an expert work group convened by ASH. Review included limited searches for new evidence and discussion of the search results. Following this review, the ASH Committee on Quality agreed to continue monitoring the supporting evidence rather than revise or retire these guidelines at this time. Limited searches and expert review will be repeated annually going forward until these guidelines are revised or retired.
Background: Clinicians confront numerous practical issues in optimizing the use of anticoagulants to treat venous thromboembolism (VTE).
Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in their decisions about the use of anticoagulants in the management of VTE. These guidelines assume the choice of anticoagulant has already been made.
Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.
Results: The panel agreed on 25 recommendations and 2 good practice statements to optimize management of patients receiving anticoagulants.
Conclusions: Strong recommendations included using patient self-management of international normalized ratio (INR) with home point-of-care INR monitoring for vitamin K antagonist therapy and against using periprocedural low-molecular-weight heparin (LMWH) bridging therapy. Conditional recommendations included basing treatment dosing of LMWH on actual body weight, not using anti–factor Xa monitoring to guide LMWH dosing, using specialized anticoagulation management services, and resuming anticoagulation after episodes of life-threatening bleeding.