bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Dose Tirofiban Treatment Improves Neurological Deterioration Outcome After Intravenous Thrombolysis
Authors: Wu Chuanjie , Sun Chenghe , Wang Lijun , Lian Yajun , Xie Nanchang , Huang Shengming , Zhao Wenbo , Ren Ming , Wu Di , Ding Jianping , Song Haiqing , Wang Yuping , Ma Qingfeng , Ji Xunming 
Published: October 2019

Background and Purpose—
Early use of antiplatelet drugs within 24 hours after intravenous thrombolysis (IVT) has always been a confusing clinical problem. The purpose of this study was to assess the safety and efficacy of early low-dose tirofiban treatment in patients with early neurological deterioration (END) within the first 24 hours after IVT.

Methods—
This was a retrospective analysis of prospectively collected data of 1764 consecutive patients with acute ischemic stroke treated with IVT between January 2017 and September 2018. Patients with early neurological deterioration within the first 24 hours after IVT were treated with or without tirofiban. The safety outcomes included symptomatic intracranial hemorrhage, any ICH, severe systemic bleeding, and mortality. Efficacy outcomes included excellent (modified Rankin scale scores 0–1) and favorable (modified Rankin scale scores 0–2) 3-month functional outcomes.

Results—

Early neurological deterioration occurred in 278 (15.8%) patients. Of the 187 eligible patients, 121 (64.7%) were treated with tirofiban within the first 24 hours after IVT. Adjusted multivariate analysis showed that early tirofiban use was not associated with symptomatic intracranial hemorrhage (adjusted odds ratio [aOR], 1.05; 95% CI, 0.088–11.02;
P
=1.000), ICH (aOR, 1.13; 95% CI, 0.45–4.25;
P
=0.512), and mortality (aOR, 0.77; 95% CI, 0.19–2.27;
P
=0.875) but was significantly associated with excellent (aOR, 2.24; 95% CI, 1.16–3.94;
P
=0.027) and favorable (aOR, 2.31; 95% CI, 1.48–3.99;
P
=0.011) functional outcomes. Subgroup analyses suggested that early tirofiban-use efficacy is time dependent, being more effective in patients receiving tirofiban treatment earlier.

Conclusions—
Low-dose tirofiban use in patients with early neurological deterioration within the first 24 hours after IVT did not increase the risk of symptomatic intracranial hemorrhage, ICH, and mortality, it seems associated with neurological improvement at 3 months. Future randomized clinical trials will be needed to validate these results.
Occluded Histories: Philippine Labor after EDSA
Authors: Moratilla Noel Christian A. 
Published: October 2019

Abstract
The uprising alternately called EDSA Revolution or People Power Revolution or EDSA People Power Revolt, which led to the downfall of Filipino dictator Ferdinand Marcos in 1986, supposedly ushered in the formal restoration of civil freedoms that had been snatched away by Marcos’ martial law. In the aftermath of the uprising, formal democratic institutions and civil rights were returned, including the right to free elections and the right to peaceful assembly. But as this article seeks to show, the administrations after EDSA have been marred by the neglect of workers’ welfare and the failure to address old labor concerns such as inadequate wages, job precarity, and contractualization. Given the shortage of employment opportunities in the Philippines, the administrations after EDSA have also promoted migration as its de facto job-generating mechanism. But the export of human resources is not without its ugly consequences, such as making overseas Filipino workers (OFWs) susceptible to abuse and exploitation. Deploying the notion of counter-history and using various materials from both government and non-government organizations, this article undertakes to critically assess the labor conditions during the historical period after the fabled EDSA People Power Revolt, and concludes that no notable changes have taken place.
The Role for Imaging in the Investigation of Isolated Objective Vestibular Weakness
Authors: Gigliotti Deanna , Blakley Brian , Moore Paige , Hochman Jordan 
Published: October 2019

ObjectiveUnilateral vestibular weakness has considerable potential etiologies. One source is a vestibular schwannoma. This article evaluates, in the absence of other symptoms and signs, if unilateral vestibular weakness is an analogue to asymmetric sensorineural hearing loss and serves as an indication for lateral skull base imaging.Study DesignRetrospective chart review.SettingAcademic tertiary center.Subjects and MethodsAll patients undergoing caloric assessment between January 1, 2012, and June 30, 2018, were investigated. Patients with unilateral vestibular weakness (a left‐right difference >25% on electronystagmography) were included in the study. A provincial encompassing image library was surveyed for potential adequate imaging (computed tomography internal auditory canal infused, magnetic resonance imaging [MRI] brain, MRI internal auditory canal) of the target population within the preceding 5 years. Presence/absence of vestibular schwannoma on imaging was determined.ResultsOf the 3531 electronystagmography reports reviewed during the period, 864 patients were identified with unilateral vestibular weakness. Of these, 542 had sufficient imaging, and 14 vestibular schwannomas were identified. Only 1 individual had a vestibular weakness in isolation, while the remaining 13 patients also suffered from documented sensorineural hearing loss that would have mandated MRI scanning.ConclusionThe results of our study suggest that, in isolation, vestibular weakness is an insufficient indicator for lateral skull base imaging.
Workload-indexed blood pressure response is superior to peak systolic blood pressure in predicting all-cause mortality
Authors: Hedman Kristofer , Cauwenberghs Nicholas , Christle Jeffrey W , Kuznetsova Tatiana , Haddad Francois , Myers Jonathan 
Published: October 2019

Aims The association between peak systolic blood pressure (SBP) during exercise testing and outcome remains controversial, possibly due to the confounding effect of external workload (metabolic equivalents of task (METs)) on peak SBP as well as on survival. Indexing the increase in SBP to the increase in workload (SBP/MET-slope) could provide a more clinically relevant measure of the SBP response to exercise. We aimed to characterize the SBP/MET-slope in a large cohort referred for clinical exercise testing and to determine its relation to all-cause mortality. Methods and results Survival status for male Veterans who underwent a maximal treadmill exercise test between the years 1987 and 2007 were retrieved in 2018. We defined a subgroup of non-smoking 10-year survivors with fewer risk factors as a lower-risk reference group. Survival analyses for all-cause mortality were performed using Kaplan–Meier curves and Cox proportional hazard ratios (HRs (95% confidence interval)) adjusted for baseline age, test year, cardiovascular risk factors, medications and comorbidities. A total of 7542 subjects were followed over 18.4 (interquartile range 16.3) years. In lower-risk subjects ( n = 709), the median (95th percentile) of the SBP/MET-slope was 4.9 (10.0) mmHg/MET. Lower peak SBP (<210 mmHg) and higher SBP/MET-slope (>10 mmHg/MET) were both associated with 20% higher mortality (adjusted HRs 1.20 (1.08–1.32) and 1.20 (1.10–1.31), respectively). In subjects with high fitness, a SBP/MET-slope > 6.2 mmHg/MET was associated with a 27% higher risk of mortality (adjusted HR 1.27 (1.12–1.45)). Conclusion In contrast to peak SBP, having a higher SBP/MET-slope was associated with increased risk of mortality. This simple, novel metric can be considered in clinical exercise testing reports.
Mixture risks threaten water quality: the European Collaborative Project SOLUTIONS recommends changes to the WFD and better coordination across all pieces of European chemicals legislation to improve protection from exposure of the aquatic environment to multiple pollutants
Authors: Kortenkamp Andreas , Faust Michael , Backhaus Thomas , Altenburger Rolf , Scholze Martin , Müller Christin , Ermler Sibylle , Posthuma Leo , Brack Werner 
Published: October 2019

Abstract
Evidence is mounting that chemicals can produce joint toxicity even when combined at levels that singly do not pose risks. Environmental Quality Standards (EQS) defined for single pollutants under the Water Framework Directive (WFD) do not protect from mixture risks, nor do they enable prioritization of management options. Despite some provisions for mixtures of specific groups of chemicals, the WFD is not fit for purpose for protecting against or managing the effects of coincidental mixtures of water-borne pollutants. The conceptual tools for conducting mixture risk assessment are available and ready for use in regulatory and risk assessment practice. Extension towards impact assessment using cumulative toxic unit and mixture toxic pressure analysis based on chemical monitoring data or modelling has been suggested by the SOLUTIONS project. Problems exist in the availability of the data necessary for mixture risk assessments. Mixture risk assessments cannot be conducted without essential input data about exposures to chemicals and their toxicity. If data are missing, mixture risk assessments will be biassed towards underestimating risks. The WFD itself is not intended to provide toxicity data. Data gaps can only be closed if proper feedback links between the WFD and other EU regulations for industrial chemicals (REACH), pesticides (PPPR), biocides (BPR) and pharmaceuticals are implemented. Changes of the WFD alone cannot meet these requirements. Effect-based monitoring programmes developed by SOLUTIONS should be implemented as they can capture the toxicity of complex mixtures and provide leads for new candidate chemicals that require attention in mixture risk assessment. Efforts of modelling pollutant levels and their anticipated mixture effects in surface water can also generate such leads. New pollutant prioritization schemes conceived by SOLUTIONS, applied in the context of site prioritization, will help to focus mixture risk assessments on those chemicals and sites that make substantial contributions to mixture risks.
Seasonal distribution, gas–particle partitioning and inhalation exposure of brominated flame retardants (BFRs) in gas and particle phases
Authors: Meng Yuan , Zhang Hongli , Qiu Yanling , Du Xinyu , Niu Dong , Lu Zhibo , Zhu Zhiliang , Zhao Jianfu , Yin Daqiang 
Published: October 2019

Abstract

Background
Atmosphere is one of the sources and sinks to gas- and particle-bound brominated flame retardants (BFRs). Therefore, BFRs can enter human body via inhalation. In the present study, 79 of gas- and particle-phase samples (TSP, PM10 and PM2.5) were collected during 2015–2016 in urban area of Shanghai, China to investigate the occurrence of 25 polybrominated diphenyl ether (PBDEs) congeners, hexabromobenzene (HBB) and 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE).

Results
The total concentrations of BFRs ranged from 0.66 to 13.7 pg/m3, 25.82 to 376.27 pg/m3, 14.58 to 365.49 pg/m3 and 15.17 to 304.89 pg/m3 in gas, TSP, PM10 and PM2.5, respectively. HBB was the main compound in gas phase; while BDE-209 was the dominant congener in particle phase. Atmospheric BFRs in winter was much lower than in summer, while particle phase showed opposite seasonal tendency.

Conclusions
Clausius–Clapeyron equation suggested that BTBPE, BDE-28, -66, -99, -100, and -154 were more driven by temperature and evaporated from local contamination. Higher-brominated congeners tended to be absorbed in particle phase, while low-brominated compounds partitioned in both gas and particle phases. Gas/particle partitioning results showed that absorption into the aerosol organic matter was the dominant process for BFRs. The inhalation health risk assessment demonstrated that the hazard quotient (HQs) for most PBDEs in winter was higher than in summer.
The number of acute cerebrovascular events in Israel: a forecast until 2040
Authors: Ben Shoham Assaf , Liberant-Taub Sigal , Sharon Mor , Zucker Inbar 
Published: October 2019

Abstract

Background
Acute cerebrovascular event is one of the leading causes of death in Israel and is the primary cause of neurological disability in adults. Although some evidence indicates that the incidence rate of acute cerebrovascular events in developed countries is stable or has been decreasing over the past decades, the number of events is expected to increase in these countries due to projected changes in size and composition of the population. The purpose of this study was to provide a forecast of the number of acute cerebrovascular events in Israel for the coming decades.

Methods
We used data from the National Stroke Registry at the Israel Center for Disease Control and data from the long-term population forecasts of the Israeli Central Bureau of Statistics. We generated forecasts of the annual number of acute cerebrovascular events based on the mean annual incidence rates during 2014–2016 within population subgroups defined by gender, age, and ethnicity, and on the projected population size of these subgroups for 2015–2040. The forecasts were generated for various assumptions as to trends in the incidence rate and for alternatives as to the projected population growth.

Results
Based on the intermediate population growth alternative, the annual number of acute cerebrovascular events is expected to increase from 18,400 to 38,500, 34,800 or 26,400 events, assuming constant annual incidence rates, decreasing annual incidence rates at a rate of 2% every 5 years, or decreasing annual incidence rates at a rate of 7.25% every 5 years, respectively. Whereas, presently, events affecting Arab patients account for 15% of acute cerebrovascular events and events affecting patients over 80 account for 33% of acute cerebrovascular events, by 2040 events affecting Arab patients will account for more than 21% of the events and events affecting patients over 80 will account for 42% of the events.

Conclusions
In view of the expected increase in the number of acute cerebrovascular events and the changes in the demographic composition of adults suffering from such events, and in order to allow for optimal care and equity, it is imperative to evaluate the preparedness of care provision and the geographical deployment of treatment services in the short and long term.
On effect of surface tension in the Rayleigh–Taylor problem of stratified viscoelastic fluids
Authors: Ma Xingrui , Xiong Xianzhu 
Published: October 2019

AbstractIn this article, we investigate the effect of surface tension in the Rayleigh–Taylor (RT) problem of stratified incompressible viscoelastic fluids. We prove that there exists an unstable solution to the linearized stratified RT problem with a largest growth rateΛunder the instability condition (i.e., the surface tension coefficientϑis less than a threshold$\vartheta _{c}$ϑc). Moreover, for this instability condition, the largest growth rate$\varLambda _{\vartheta }$Λϑdecreases from a positive constant to 0, whenϑincreases from 0 to$\vartheta _{c}$ϑc, which mathematically verifies that the internal surface tension can constrain the growth of the RT instability during the linear stage.
A longitudinal assessment of retinal function and structure in the APP/PS1 transgenic mouse model of Alzheimer’s disease
Authors: Georgevsky Dana , Retsas Stephanie , Raoufi Newsha , Shimoni Olga , Golzan S. Mojtaba 
Published: October 2019

Abstract

Background
A great body of evidence suggests that there are retinal functional and structural changes that occur in Alzheimer’s disease (AD). However, whether such changes are primary or secondary remains to be elucidated. We studied a range of retinal functional and structural parameters in association with AD- specific pathophysiological markers in the double transgenic APP/PS1 and control mice across age.

Methods
Electroretinogram (ERG) and optical coherence tomography (OCT) was performed in APP/PS1 and wild type (WT) control mice every 3 months from 3 to 12 months of age. For functional assessment, the a- and b-wave of the ERG, amplitude of oscillatory potentials (OP) and the positive scotopic threshold response (pSTR) were quantified at each time point. For structural assessment, the inner and outer retinal thickness was segmented and measured from OCT scans. Episodic memory was evaluated at 6, 9 and 12 months of age using the novel object recognition test. Amyloid beta (Aβ) distribution in the hippocampus and the retina were visualised at 3, 6 and 12 months of age. Inter- and intra- group analysis was performed to study rate of change for each parameter between the two groups.

Results
Inter-group analysis revealed a significant difference in b-wave and OPs of APP/PS1 compared to WT controls starting from 3 months (p < 0.001). There was also a significant difference in the amplitude of pSTR between the two groups starting from 6 months (p < 0.001). Furthermore, a significant difference in the inner retinal thickness, between the two groups, was observed starting from 9 months (p < 0.001).

Conclusions
We observed an age-related decline in retinal functional and structural parameters in both APP/PS1 and WT controls, however, inter-group analysis revealed that inner retinal functional and structural decline is exacerbated in APP/PS1 mice, and that retinal functional changes precede structural changes in this strain. Further studies are required to confirm whether such phenomenon occurs in humans and if studying retinal functional changes can aid-in early assessment of AD.
Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis
Authors: Dasa Tamirat Tesfaye , Kassie Teshager Worku , Roba Aklilu Abrham , Wakwoya Elias Bekele , Kelel Henna Umer 
Published: October 2019

Abstract

Background
Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia.

Methods
The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5.

Results
Women’s inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P = 0.02], women’s age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P = 0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P < 0.0001] and women from rural area [OR = 0.65;95% CI:0.50, 0.81, P = 0.0009] were less likely associated in the use of long-acting family planning services. The odds of utilizing long acting family planning methods were high among non-government- employed women and husband [OR, 1.77; 95% CI: 1.29, 2.43, P = 0.0004], [OR, 1.69; 95% CI: 1.33, 2.15, P < 0.0001] respectively. Having no previous exposure to any modern family planning method [OR = 2.29; 95%CI: 1.83, 2.86, P < 0.00001] and women having no discussion with husband [OR = 1.92 (95%CI: 1.50, 2.45) P < 0.00001] were more likely associated in the utilization of long-acting family planning services.

Conclusion
Lack of information and knowledge, having discussion with husband, being women of younger age, having less than five living children, being government-employed women and husband, not having electronic media, and being residents in rural area were significant barriers for underutilization of long acting family planning methods in Ethiopia. Hence, the investigators suggest that key stakeholders should design interventions strategies to avert attitudinal, cultural and informational barriers towards long-acting family planning methods.

Systematic review registration
PROSPERO: 2018: CRD42018096373.
Application of botulinum toxin in maxillofacial field: part I. Bruxism and square jaw
Authors: Kwon Kyung-Hwan , Shin Kyung Su , Yeon Sung Hee , Kwon Dae Gun 
Published: October 2019

AbstractThe application of botulinum in oral and maxillofacial surgery begins in 1982, where Jan Carruthers started using it for reducing the muscle mass and smoothing the skin, and since then it has been used for cosmetic purposes. In Korea, it is already being used by various specialties including dentistry (oral and maxillofacial surgery, oral medicine), plastic surgery, dermatology, ophthalmology, general surgery, and orthopedic surgery, etc. Each specialty approaches to Botox with its own medical indications. In this article, we will discuss the maxillofacial application of botulinum toxin, which includes theoretical and practical aspects of such as bruxism and square jaw.
Hepatic resection in children: highlighted and revisited steps
Authors: Abdelkader Hesham Mohammed , Abdel-Latif Mohamed , Abdelsattar Mohamed , Youssef Ahmed Abdelhaseeb 
Published: October 2019

AbstractBackgroundHepatectomy in children deserves exhaustive preoperative and intraoperative tools to define the anatomy, minimize blood loss, and confirm adequacy of liver tissue left. The aim of this study is to report our experience in surgical management of liver tumors.ResultsAll liver resections performed in Ain-Shams University Hospital, by the same team, between July 2013 and June 2018 were retrospectively reviewed. Data related to basic demographics, indication for resection, methods of parenchymal resection, blood loss, hospital stay, morbidity, and mortality was collected. The study included 27 patients who underwent different types of hepatectomies. There was a male predominance. Age ranged from 6 months to 13 years. Weight ranged from 5.7 to 33.7 kg. Total operative time ranged from 68 to 322 min, while resection time ranged from 34 to 144 min. Blood loss ranged from 53 to 259 ml. Surgical morbidities included five patients with minor biliary leak, three patients had surgical site infection, and one patient had torsion of the remnant liver necessitating repositioning. Recurrence of the mass was faced in three patients with hepatoblastoma. There were two mortalities; one occurred as a sequela of massive intraoperative bleeding and the other took place due to postoperative hepatic insufficiency.ConclusionFor a safe hepatectomy, thorough familiarity of the hepatic segmental anatomy together with the various techniques for parenchymal resection and vascular control is fundamental. Complications such as biliary leak and torsion of remnant can be easily avoided by simple measures.