bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bivalirudin versus heparin monotherapy in non-ST-segment elevation myocardial infarction
Authors: Erlinge David , Koul Sasha , Omerovic Elmir , Fröbert Ole , Linder Rikard , Danielewicz Mikael , Hamid Mehmet , Venetsanos Dimitrios , Henareh Loghman , Pettersson Björn , Wagner Henrik , Grimfjärd Per , Jensen Jens , Hofmann Robin , Ulvenstam Anders , Völz Sebastian , Petursson Petur , Östlund Ollie , Sarno Giovanna , Wallentin Lars , Scherstén Fredrik , Eriksson Peter , James Stefan 
Published: October 2018

Background: The optimal anti-coagulation strategy for patients with non-ST-elevation myocardial infarction treated with percutaneous coronary intervention is unclear in contemporary clinical practice of radial access and potent P2Y12-inhibitors. The aim of this study was to investigate whether bivalirudin was superior to heparin monotherapy in patients with non-ST-elevation myocardial infarction without routine glycoprotein IIb/IIIa inhibitor use. Methods: In a large pre-specified subgroup of the multicentre, prospective, randomised, registry-based, open-label clinical VALIDATE-SWEDEHEART trial we randomised patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention, treated with ticagrelor or prasugrel, to bivalirudin or heparin monotherapy with no planned use of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention. The primary endpoint was the rate of a composite of all-cause death, myocardial infarction or major bleeding within 180 days. Results: A total of 3001 patients with non-ST-elevation myocardial infarction, were enrolled. The primary endpoint occurred in 12.1% (182 of 1503) and 12.5% (187 of 1498) of patients in the bivalirudin and heparin groups, respectively (hazard ratio of bivalirudin compared to heparin treatment 0.96, 95% confidence interval 0.78–1.18, p=0.69). The results were consistent in all major subgroups. All-cause death occurred in 2.0% versus 1.7% (hazard ratio 1.15, 0.68–1.94, p=0.61), myocardial infarction in 2.3% versus 2.5% (hazard ratio 0.91, 0.58–1.45, p=0.70), major bleeding in 8.9% versus 9.1% (hazard ratio 0.97, 0.77–1.24, p=0.82) and definite stent thrombosis in 0.3% versus 0.2% (hazard ratio 1.33, 0.30–5.93, p=0.82). Conclusion: Bivalirudin as compared to heparin during percutaneous coronary intervention for non-ST-elevation myocardial infarction did not reduce the composite of all-cause death, myocardial infarction or major bleeding in non-ST-elevation myocardial infarction patients receiving current recommended treatments with modern P2Y12-inhibitors and predominantly radial access.
Pomalidomide, cyclophosphamide, and dexamethasone for relapsed multiple myeloma
Authors: Garderet Laurent , Kuhnowski Frederique , Berge Benoit , Roussel Murielle , Escoffre-Barbe Martine , Lafon Ingrid , Facon Thierry , Leleu Xavier , Karlin Lionel , Perrot Aurore , Moreau Philippe , Marit Gerald , Stoppa Anne-Marie , Royer Bruno , Chaleteix Carine , Tiab Mourad , Araujo Carla , Lenain Pascal , Macro Margaret , Voog Eric , Benboubker Lofti , Allangba Olivier , Jourdan Eric , Orsini-Piocelle Frederique , Brechignac Sabine , Eveillard Jean-Richard , Belhadj Karim , Wetterwald Marc , Pegourie Brigitte , Jaccard Arnaud , Eisenmann Jean-Claude , Glaisner Sylvie , Mohty Mohamad , Hulin Cyrille , Loiseau Herve Avet , Mathiot Claire , Attal Michel 
Published: October 2018

Abstract
It is important to have an effective therapy for patients with multiple myeloma (MM) at first relapse, particularly if an autologous stem cell transplant (ASCT) is considered at this stage. This multicenter, phase 2 trial evaluated the efficacy and safety of weekly oral pomalidomide-cyclophosphamide-dexamethasone (PCD) in patients with MM in first relapse after treatment with lenalidomide-bortezomib-dexamethasone (RVD). All patients had received RVD as induction and consolidation therapy, plus lenalidomide maintenance for 1 year (arm A). Half had also received an ASCT after induction (arm B). At MM relapse, all patients received 4 oral cycles of pomalidomide 4 mg (days 1-21), cyclophosphamide 300 mg (days 1, 8, 15, and 22), and dexamethasone 40 mg (days 1-4 and days 15-18 of a 28-day cycle; PCD). Responding patients in arm A underwent ASCT and received 2 additional cycles of PCD, whereas those in arm B received 5 cycles of PCD. All patients received pomalidomide-dexamethasone maintenance until disease progression. Primary end point was partial remission or better after the initial 4 cycles of PCD. Responses were obtained in 82/97 (85%) patients evaluated: complete remission (n = 1; 1%), very good partial remission (n = 32; 33%), and partial remission (n = 49; 51%). Three patients (3%) had stable disease, and 6 (6%) had disease progression (6 response failures). Forty-five (94%) of the 48 patients in arm A underwent planned ASCT. PCD was effective therapy after first relapse with RVD. After 4 cycles, the rate of partial remission or better was 85%, and 94% of planned ASCTs were performed. Toxicity was mostly hematologic and manageable. This trial was registered at www.clinicaltrials.gov as #NCT02244125.
Salivary Cortisone to Estimate Cortisol Exposure and Sampling Frequency Required Based on Serum Cortisol Measurements
Authors: Harrison Robert F , Debono Miguel , Whitaker Martin J , Keevil Brian G , Newell-Price John , Ross Richard J 
Published: October 2018

Abstract

Context
Population studies frequently measure cortisol as a marker of stress, and excess cortisol is associated with increased mortality. Cortisol has a circadian rhythm, and frequent blood sampling is impractical to assess cortisol exposure. We investigated measuring salivary cortisone and examined the sampling frequency required to determine cortisol exposure.

Methods
Serum and saliva with cortisol and cortisone were measured by liquid chromatography–tandem mass spectrometry in independent cohorts. The relationship between serum cortisol and salivary cortisone was analyzed in cohort 1 using a linear mixed effects model. The resulting fixed effects component was applied to cohort 2. Saliva cannot easily be collected when a patient is sleeping, so we determined the minimum sampling required to estimate cortisol exposure [estimated area under the curve (eAUC)] using 24-hour cortisol profiles (AUC24) and calculated the relative error (RE) for eAUC.

Results
More than 90% of variability in salivary cortisone could be accounted for by change in serum cortisol. A single serum cortisol measurement was a poor estimate of AUC24, especially in the morning or last thing at night (RE &gt;68%); however, three equally spaced samples gave a median RE of 0% (interquartile range, −15.6% to 15.1%). In patients with adrenal incidentalomas, eAUC based on three serum cortisol samples showed a difference between those with autonomous cortisol secretion and those without (P = 0.03).

Interpretation
Accepting that most people sleep 7 to 8 hours, ∼8-hourly salivary cortisone measurements provide a noninvasive method of estimating 24-hour cortisol exposure for population studies.
Resident Competency and Proficiency in Combined Spinal–Epidural Catheter Placement Is Improved Using a Computer-Enhanced Visual Learning Program: A Randomized Controlled Trial
Authors: Nixon Heather C. , Stariha Jillian , Farrer Jason , Wong Cynthia A. , Maisels Max , Toledo Paloma 
Published: October 2018

BACKGROUND:
Physician educators must balance the need for resident procedural education with clinical time pressures as well as patient safety and comfort. Alternative educational strategies, including e-learning tools, may be beneficial to orient novice learners to new procedures and speed proficiency. We created an e-learning tool (computer-enhanced visual learning [CEVL] neuraxial) to enhance trainee proficiency in combined spinal–epidural catheter placement in obstetric patients and performed a randomized controlled 2-center trial to test the hypothesis that use of the tool improved the initial procedure performed by the anesthesiology residents.

METHODS:
Anesthesiology residents completing their first obstetric anesthesiology rotation were randomized to receive online access to the neuraxial module (CEVL group) or no access (control) 2 weeks before the rotation. On the first day of the rotation, residents completed a neuraxial procedure self-confidence scale and an open-ended medical knowledge test. Blinded raters observed residents performing combined spinal–epidural catheter techniques in laboring parturients using a procedural checklist (0–49 pts); the time required to perform the procedure was recorded. The primary outcome was the duration of the procedure.

RESULTS:
The CEVL group had significantly shorter mean (±standard deviation) procedure time compared to the control group 22.5 ± 4.9 vs 39.5 ± 7.1 minutes (P < .001) and had higher scores on the overall performance checklist 36.4 ± 6.6 vs 28.8 ± 7.1 (P = .012). The intervention group also had higher scores on the open-ended medical knowledge test (27.83 ± 3.07 vs 22.25 ± 4.67; P = .002), but self-confidence scores were not different between groups (P = .64).

CONCLUSIONS:
CEVL neuraxial is a novel prerotation teaching tool that may enhance the traditional initial teaching of combined spinal–epidural procedures in obstetric anesthesiology. Future research should examine whether the use of web-based learning tools impacts long-term provider performance or patient outcomes.
Predicting the Depth of the Lumbar Plexus in Pediatric Patients: A Retrospective Magnetic Resonance Imaging Study
Authors: Jang Young-Eun , Lee Joon-Hee , Yoon Hee-Chul , Kim Eun-Hee , Lee Ji-Hyun , Kim Hee-Soo , Kim Jin-Tae 
Published: October 2018

BACKGROUND:
The lumbar plexus (LP) block is commonly used for analgesia for lower extremities. If the depth of the LP (LPD) can be predicted, the performance time and procedure-related complications could be reduced.

METHODS:
Three hundred sixty-one magnetic resonance images of pediatric patients (<18 years of age) were analyzed. Simple linear regression and multiple linear regression analyses were performed to predict the LPD using patient age, weight, height, and the distance between the midline and posterior superior iliac spine (midline-PSIS). The ratio of the distance between the midline and the most lateral aspect of the LP (midline-LP) to midline-PSIS (midline-LP/midline-PSIS ratio) was calculated to suggest a needle insertion point at the L4/L5 intervertebral level. The presence of the kidney at the L4 level and the L4/L5 intervertebral level was determined.

RESULTS:
The LPD at the L4/L5 intervertebral levels was predicted using the equation LPD = 0.844 × weight (kg) + 25.8 (mm) in pediatric patients <18 years of age (r
2 = 0.791; 95% confidence interval [CI] of r
2, 0.753–0.829). The overall midline-LP/midline-PSIS ratio was 0.87 (95% CI, 0.86–0.89), and the ratio was higher in neonates and infants (0.98 [95% CI, 0.95–1.02]) than in the other age groups. The presence of the lower kidney pole at the L4 level was common in pediatric patients (43.7% of neonates and infants and 13.7% of toddlers and preschool-aged children). The lower kidney pole was observed at the L4/L5 level in 6 patients (1.7%).

CONCLUSIONS:
When LP block is performed in pediatric patients, the LPD and risk of renal injury should be considered for successful and safe analgesic block.
#TurbanteoConsciente
Authors: Serrano-Abreu María Beatriz 
Published: October 2018

Abstract
Turbanteo Consciente, literally “consciousness headwrap wearing,” is the term facilitators, participants, and collaborators have coined to name the process of thinking, creating, and promoting the headwrap workshops, a self-developed project that has been going on for more than a year in Puerto Rico. Through the lens of Welmo E. Romero Joseph and Gloribel Delgado Esquilín, this photo essay highlights some of the faces and moments that happen commonly during the process of a headwrap workshop. Our purpose as facilitators is to utilize the headwrap as a strategic hook to address three main subjects: the presence of racism in Puerto Rico and its connections to colonialism, a proposal to subvert patriarchal forms that dictate relationships between women, and an invitation to embrace our Afro-Caribbean identity as a manifestation of cultural resistance.
Panther Teacher
Authors: New Michael J. 
Published: October 2018

AbstractSarah Webster Fabio taught some of the earliest Black studies courses at Merritt College and the University of California, Berkeley, where founding members of the Black Panther Party and other activist organizations took her classes. In the mid-1960s she earned an international reputation as an essential voice within the Black Arts Movement. She was an early theorist of Black Vernacular English and later extended her work with multimedia by performing with musical accompaniment. In the 1970s she recorded four albums of poetry and music for Folkways Records and published a seven-volume series of chapbooks entitled Rainbow Signs. Yet Webster Fabio’s contributions to the Black Student, Black Power, and Black Arts movements have been largely forgotten by most who aren’t themselves veterans of these struggles. This essay recovers Webster Fabio’s life story and literary art in order to resituate women at the center of revolutionary Black art and activism.
New academic year, new challenges: Tips for student midwives to maintain momentum and motivation
Authors: Power Alison , Coiffait Sarah 
Published: October 2018

At the start of the academic year, the physical signs of progression from one year to the next for student midwives include an additional stripe on an epaulette, a different coloured badge or perhaps a change of uniform. But what about emotional progression? If we think of learning as a continuum, a lifelong process of developing skills and knowledge, then the transition from one year to the next should be seamless. However, in the context of the pre-registration midwifery programme, each academic year places more complex demands on students in both theory and practice as they progress from concentrating on normality in year one, to altered health in year two, to leadership, consolidation of practice and preparation for qualification in year three. The Nursing and Midwifery Council (NMC) Code requires midwives to be ‘lifelong learners’, basing their practice on the best available evidence—an ethos that should be embedded from day one of midwifery training. After a summer break, returning to studies and the physical and emotional demands of the pre-registration midwifery programme can be daunting; this article will provide tips for students to maintain momentum and motivation as they progress to the next year of their studies.
Intra-operative imaging in trauma surgery
Authors: Keil Holger , Beisemann Nils , Swartman Benedict , Vetter Sven Yves , Grützner Paul Alfred , Franke Jochen 
Published: October 2018

The reconstruction of anatomical joint surfaces, limb alignment and rotational orientation are crucial in the treatment of fractures in terms of preservation of function and range of motion. To assess reduction and implant position intra-operatively, mobile C-arms are mandatory to immediately and continuously control these parameters. Usually, these devices are operated by OR staff or radiology technicians and assessed by the surgeon who is performing the procedure. Moreover, due to special objectives in the intra-operative setting, the situation cannot be compared with standard radiological image acquisition. Thus, surgeons need to be trained and educated to ensure correct technical conduct and interpretation of radiographs. It is essential to know the standard views of the joints and long bones and how to position the patient and C-arm in order to acquire these views. Additionally, the operating field must remain sterile, and the radiation exposure of the patient and staff must be kept as low as possible. In some situations, especially when reconstructing complex joint fractures or spinal injuries, complete evaluation of critical aspects of the surgical results is limited in two-dimensional views and fluoroscopy. Intra-operative three-dimensional imaging using special C-arms offers a valuable opportunity to improve intra-operative assessment and thus patient outcome. In this article, common fracture situations in trauma surgery as well as special circumstances that the surgeon may encounter are addressed. Cite this article: EFORT Open Rev 2018;3:541-549. DOI: 10.1302/2058-5241.3.170074
Sustainable Management of Acromyrmex octospinosus (Reich): How Botanical Insecticides and Fungicides Should Promote an Ecofriendly Control Strategy.
Authors: Boulogne Isabelle , Desfontaine Lucienne , Ozier-Lafontaine Harry , Loranger-Merciris Gladys 
Published: October 2018

The leaf-cutting ant Acromyrmex octospinosus (Reich) causes serious damage to crops and protected areas due to its foraging activity. The main method of control of this species consists of the use of synthetic insecticides that can lead to environmental damage and negative side effects on human health. Consequently, alternative strategies, such as biopesticides, are needed. Insecticide evaluation by ingestion assays was performed using A. octospinosus in vitro bioassay and laboratory nests. Chemical analyses were also performed to know the contents of plant extracts. This study showed that Mammea americana L. is the most promising insecticidal plant extract in the control of A. octospinosus. Indeed, the lethal concentrations (LC50 and LC99) an the lethal dose (LD99) of the M. americana extract (51.31 mg.mL-1, 131.92 mg.mL-1, and 17.36 mg/g of ant respectively) were the closest to those of Fipronil, 0.03 g/kg, the commercial insecticide used as positive control.
Magnitude and risk factors for hypertension among public servants in Tigray, Ethiopia: A cross-sectional study
Authors: Bayray Alemayehu , Meles Kidanu Gebremariam , Sibhatu Yosef 
Published: October 2018

Background
Hypertension is a globally recognized threat to social and economic development with premature morbidity and mortality. In middle and low-income countries hypertension appears to be increasing. However, sufficient data on this silent-killer is not available in Ethiopia. Therefore, this study examined the magnitude and risk factors for hypertension among public servants in Tigray, Ethiopia.

Methods
We used a cross-sectional survey from May-June 2016 among 1525 public servants in Tigray region. Field workers collected data using a pre-tested, standardized questionnaire. A multivariate logistic regression analysis conducted to identify risk factors for hypertension. Statistical significance was declared using a p-value<0.05 and 95% of confidence interval (CI) for an adjusted odds ratio (AOR).

Results
The overall prevalence of hypertension was 16% (95% CI: 13.10–21.9) and the proportion of awareness (96.7%), treatment (31.3%) and control of hypertension (40.1%) among employees. Being male [AOR = 2.06, 95%CI:1.49, 2.84], ages groups of 30–49 years [AOR = 2.21, 95%CI:1.25, 3.89] and >50years [AOR = 3.61, 95% CI:1.93, 6.69], Body Mass Index(BMI); underweight [AOR = 0.40, 95% CI; 0.20, 0.78], overweight [AOR = 1.70, 95%CI; 1.22, 2.33] and obesity [AOR = 3.20, 95% CI; 1.78, 5.78] were determinants for hypertension.

Conclusion
The prevalence of hypertension is relatively high in Mekelle city compared with previous reports. This study revealed that male sex, age-group, and BMI were evidenced as risk factors for hypertension. Policy makers need to consider sector wise integrating prevention and control of hypertension. Skilled based information, education and communication strategies should be designed and implemented to avoid unhealthy lifestyles, investing in workforces to eliminate the modifiable risk factors for non-communicable diseases and promote healthy practices.
Advances in the Treatment of Hemophilia: Implications for Laboratory Testing
Authors: Tripodi Armando , Chantarangkul Veena , Novembrino Cristina , Peyvandi Flora 
Published: October 2018

Abstract

BACKGROUND
Until recently, clinical laboratories have monitored hemophilia treatment by measuring coagulation factors before/after infusion of human-derived or recombinant factors. Substantial changes are expected in the near future based on new therapeutic approaches that have been or are being developed.

CONTENT
Hemophilia treatment includes replacement therapy with human-derived/recombinant factors or treatment with bypassing agents for patients without or with inhibitors, respectively. Accordingly, laboratory methods for monitoring include one-stage clotting or chromogenic assays meant to measure either factor VIII/IX or global coagulation tests to measure the effect of bypassing agents. Recently, modified long-acting coagulation factors have been introduced for which discrepant results may be expected when measurement is performed with one-stage clotting or chromogenic assays. Currently, novel drugs not based on coagulation factors are under development and are being tested in clinical studies. These drugs do require new methods and therefore laboratory evaluation of hemophilia will undergo dramatic changes in the near future.

SUMMARY
From the analysis of the current practice and literature, we draw the following conclusions: (a) Thrombin generation or thromboelastometry are the logical candidate assays to monitor bypassing agents. (b) Considerable differences are expected when measuring modified long-acting coagulation factors, depending on whether one-stage or chromogenic assays are used. Although no definitive conclusions can presently be drawn, chromogenic assays are probably more suitable than one-stage clotting. (c) Novel drugs not based on coagulation factors such as emicizumab, fitusiran, or concizumab that are entering the market do require alternative methods that are not yet well established.
Serum IGF-1 and short stature in adolescents with beta-thalassemia major
Authors: Elizabeth Monalisa , Fadlyana Eddy , Reniarti Lelani , Faisal Faisal , Sukandar Hadyana , Rusmil Kusnandi 
Published: October 2018

Background The prevalence of short stature in thalassemia patients ranges from 39.3 to 65%. The cause of short stature is complex and still up for debate. In Indonesia, data on the prevalence and risk factors of short stature in adolescents with thalassemia have been limited.
Objective To assess for the prevalence and risk factors of short stature in adolescents with beta-thalassemia major.
Methods This cross-sectional study was done from February to March 2017 at the Thalassemia Clinic at Dr. Hasan Sadikin General Hospital, Bandung. The baseline characteristics data of 80 adolescents with thalassemia aged 10-14 years were recorded. Short stature was assessed by height-for-age, (Z-score <-2SD) based on the 2007 WHO Reference Growth Chart. Mid-upper arm circumference was scored according to age and sex and serum IGF-1 was measured by ELISA method. Data analyses used were Chi-square, Fisher’s, and Mann-Whitney tests. Logistic regression model was used to further analyze for risk factors of short stature.
Results Subjects were 40 males and 40 females, 81.2% of whom had short stature. The mean serum IGF-1 level was 32.2 (SD 26.38) ng/mL. The IGF-1 cut-off point by ROC curve was £38.51 ng/mL, with sensitivity of 64.4% and specificity of 86.7%. The risk factors of short stature were IGF-1 level £38.51 ng/mL (PR 40.66; 95%CI 4.37 to 377.58; P<0.001) and low family income (PR 19.76; 95%CI: 1.152 to 256.08; P=0.022).
Conclusion IGF-1 level may be useful as a predictor of short stature in adolescent beta-thalassemia major patients.