bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of the RADPAD Protection Drape in Reducing Operators’ Radiation Exposure in the Catheterization Laboratory
Authors: Vlastra Wieneke , Delewi Ronak , Sjauw Krischan D. , Beijk Marcel A. , Claessen Bimmer E. , Streekstra Geert J. , Bekker Robbert J. , van Hattum Juliette C. , Wykrzykowska Joanna J. , Vis Marije M. , Koch Karel T. , de Winter Robbert J. , Piek Jan J. , Henriques José P.S. 
Published: November 2017

Background—
Interventional cardiologists are increasingly exposed to radiation-induced diseases like cataract and the stochastic risk of left-sided brain tumors. The RADPAD is a sterile, disposable, lead-free shield placed on the patient with the aim to minimize operator-received scatter radiation. The objective of the trial was to examine the RADPAD’s efficacy in a real-world situation.

Methods and Results—

In the current, double-blind, sham-controlled, all-comer trial, patients undergoing diagnostic catheterization or percutaneous coronary interventions were randomized in a 1:1:1 ratio to a radiation absorbing shield (RADPAD), standard treatment (NOPAD), or a sham shield (SHAMPAD). The sham shield allowed testing for shield-induced radiation behavior. The primary outcome was the difference in relative exposure of the primary operator between the RADPAD and NOPAD arms and was defined as the ratio between operator’s exposure (E in µSv) and patient exposure (dose area product in mGy·cm
2
), measured per procedure. A total of 766 consecutive coronary procedures were randomized to the use of RADPAD (N=255), NOPAD (N=255), or SHAMPAD (N=256). The use of RADPAD was associated with a 20% reduction in relative operator exposure compared with that of NOPAD (
P
=0.01) and a 44% relative exposure reduction compared with the use of a SHAMPAD (
P
<0.001). Use of the SHAMPAD was associated with a 43% higher relative radiation exposure than procedures with NOPAD (
P
=0.009).

Conclusions—
In clinical daily practice, the standard use of the RADPAD radiation shield reduced operator radiation exposure compared with procedures with NOPAD or SHAMPAD. This study supports the routine use of RADPAD in the catheterization laboratory.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT03139968.
Left Atrial Volume and Mortality in Patients With Aortic Stenosis
Authors: Rusinaru Dan , Bohbot Yohann , Kowalski Cédric , Ringle Anne , Maréchaux Sylvestre , Tribouilloy Christophe 
Published: November 2017

Background

Left atrium (
LA
) enlargement is common in patients with aortic stenosis (
AS
), yet its prognostic implications are unclear. This study investigates the value of left atrial volume (
LAV
) and
LAV
normalized to body size for predicting mortality in
AS
.

Methods and Results

We included 1351 patients with
AS
in sinus rhythm at diagnosis and analyzed the occurrence of all‐cause death during follow‐up with medical and surgical management. Five parameters of
LA
enlargement were tested: nonindexed
LAV
and normalized
LAV
by ratiometric (
LAV
/body surface area [
BSA
] and
LAV
/height) and allometric (
LAV
/
BSA
1.7
and
LAV
/height
2.0
) scaling. For each parameter, patients in the highest quartile were at high risk of death, whereas outcome was better and similar for the other quartiles. Five‐year survival was lower for patients with
LAV
>95 mL and
LAV
/
BSA
>50 mL/m
2
compared with those with no or mild
LA
enlargement (both
P
<0.001). After adjustment for established outcome predictors, including surgery, high risk of death was observed with
LAV
>95 mL (adjusted hazard ratio, 1.40 [95% confidence interval, 1.06–1.88]) and
LAV
/
BSA
>50 mL/m
2
(adjusted hazard ratio, 1.42 [95% confidence interval, 1.08–1.91]).
LAV
/
BSA
and LAV showed good and similar predictive performance, whereas other scaling methods did not show better outcome prediction. In patients with severe
AS
at baseline, preserved (≥50%) ejection fraction, and no or minimal symptoms,
LA
enlargement was significantly associated with mortality (adjusted hazard ratio, 1.87 [95% confidence interval, 1.02–3.44] for
LAV
>95 mL, and adjusted hazard ratio, 1.90 [95% confidence interval, 1.03–3.56] for
LAV
/
BSA
>50 mL/m
2
).

Conclusions

LA
enlargement is an important predictor of mortality in
AS
, incrementally to known predictors of outcome.
LAV
and
LAV
/
BSA
have comparable predictive performance and should be assessed in clinical practice for risk stratification.
Impact of Diabetes Mellitus on the Evaluation of Stable Chest Pain Patients: Insights From the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) Trial
Authors: Sharma Abhinav , Sekaran Nishant K. , Coles Adrian , Pagidipati Neha J. , Hoffmann Udo , Mark Daniel B. , Lee Kerry L. , Al‐Khalidi Hussein R. , Lu Michael T. , Pellikka Patricia A. , Truong Quynh A. , Douglas Pamela S. 
Published: November 2017

Background

The impact of diabetes mellitus on the clinical presentation and noninvasive test (
NIT
) results among stable outpatients presenting with symptoms suggestive of coronary artery disease (
CAD
) has not been well described.

Methods and Results

The PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial enrolled 10 003 patients with known diabetic status, of whom 8966 were tested as randomized and had interpretable
NIT
results (1908 with diabetes mellitus, 21%). Differences in symptoms and
NIT
results were evaluated using logistic regression. Patients with diabetes mellitus (versus without) were similar in age (median 61 versus 60 years) and sex (female 54% versus 52%), had a greater burden of cardiovascular comorbidities, and had a similar likelihood of nonchest pain symptoms (29% versus 27%). The Diamond‐Forrester/Coronary Artery Surgery Study score predicted that patients with diabetes mellitus (versus without) had similar likelihood of obstructive
CAD
(low 1.8% versus 2.7%; intermediate 92.3% versus 92.6%; high 5.9% versus 4.7%). Physicians estimated patients with diabetes mellitus to have a higher likelihood of obstructive
CAD
(low to very low: 28.3% versus 40.1%; intermediate 63.9% versus 55.9%; high to very high 7.8% versus 4.0%). Patients with diabetes mellitus (versus without) were more likely to have a positive
NIT
result (15% versus 11%; adjusted odds ratio, 1.23;
P
=0.01).

Conclusions

Stable chest pain patients with and without diabetes mellitus have similar presentation and pretest likelihood of obstructive
CAD
; however, physicians perceive that patients with diabetes mellitus have a higher pretest likelihood of obstructive
CAD
, an assessment supported by increased risk of a positive
NIT
. Further evaluation of diabetes mellitus's influence on
CAD
assessment is required.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01174550.
Strength Training and All‐Cause, Cardiovascular Disease, and Cancer Mortality in Older Women: A Cohort Study
Authors: Kamada Masamitsu , Shiroma Eric J. , Buring Julie E. , Miyachi Motohiko , Lee I‐Min 
Published: November 2017

Background
Few data exist on the association between strength training and mortality rates. We sought to examine the association between strength training and all‐cause, cardiovascular disease, and cancer mortality.

Methods and Results

Beginning in 2001 to 2005, 28 879 women throughout the United States (average baseline age, 62.2 years) from the Women's Health Study who were free of cardiovascular disease, diabetes mellitus, and cancer reported their physical activities, including strength training. During follow‐up (average, 12.0 years) through 2015, investigators documented 3055 deaths (411 from cardiovascular disease and 748 from cancer). After adjusting for covariables, including aerobic activity, time in strength training showed a quadratic association with all‐cause mortality (
P
=0.36 for linear trend;
P
<0.001 for quadratic trend); hazard ratios across 5 categories of strength training (0, 1–19, 20–59, 60–149, and ≥150 min/wk) were 1.0 (referent), 0.73 (95% confidence interval, 0.65–0.82), 0.71 (0.62–0.82), 0.81 (0.67–0.97), and 1.10 (0.77–1.56), respectively. A significant quadratic association was also observed for cardiovascular disease death (
P
=0.007) but not cancer death (
P
=0.41). Spline models also indicated a J‐shaped nonlinear association for all‐cause mortality (
P
=0.020); the point estimates of hazard ratios were <1.00 for 1 to 145 min/wk of strength training, compared with 0 min/wk, whereas hazard ratios were >1.00 for ≥146 min/wk of strength training. However, confidence intervals were wide at higher levels of strength training.

Conclusions
Time in strength training showed a J‐shaped association with all‐cause mortality in older women. A moderate amount of time in strength training seemed beneficial for longevity, independent of aerobic activity; however, any potential risk with more time (≈≥150 min/wk) should be further investigated.
Konothrips polychaeta sp.n. from Delaware, North America, with a key to the three species of this genus
Authors: GOLDARAZENA ARTURO , MITCHELL ADAM , HANCE THIERRY 
Published: November 2017

The genus Konothrips was erected by Bhatti (1990) for a single species, tuttlei, that was described from Arizona in the genus Chirothrips by zur Strassen (1967). The new genus was distinguished by the longitudinally orientated sculpture on the abdominal terga and sterna, the fore wing costa with only a single seta, and the ovipositor lacking teeth (Bhatti 1990). Subsequently, Nakahara and Foottit (2012) described in Konothrips a second species, colei, from Texas. However, those authors indicated that there is variation in these characters, with colei intermediate in structure between tuttlei and members of Arorathrips. In the new species described below, the abdominal tergal and sternal sculpture is weakly developed, transverse medially with some reticles in the pleurotergites slightly orientated longitudinally, the ovipositor is reduced and smooth, and costal setae are present on the fore wing. This new species is described in Konothrips because antennal segment I is enlarged (more than 3 times wider than base of segment II), antennal segment II is strongly produced laterally, and the mesosternal furcal invaginations are widely separated. These characters are also shared with the species of Arorathrips, and distinguish this pair of genera from Chirothrips. However, the new species, together with tuttlei and colei, is distinguished from species placed in Arorathrips by the presence of more than 6 stout conical setae on the median area of the mesonotum, and the anterior abdominal tergites with D1 and D2 setae spine-like (conical and stout).
An Exploratory Electromyography-Based Coactivation Index for the Cervical Spine
Authors: Le Peter , Aurand Alexander , Best Thomas M. , Khan Safdar N. , Mendel Ehud , Marras William S. 
Published: November 2017

Objective Develop a coactivation index for the neck and test its effectiveness with complex dynamic head motions. Background Studies describing coactivation for the cervical spine are sparse in the literature. Of those in existence, they were either limited to a priori definitions of agonist/antagonist activity that limited the testing to sagittal and lateral planes or consisted of isometric exertions. Multiplanar movements would allow for a more realistic understanding of naturalistic movements in the cervical spine and propensity for neck pain. However, a gap in the literature exists in which a method to describe coactivation during complex dynamic motions does not exist for the cervical spine. Methods An electromyography-based coactivation index was developed for the cervical spine based on previously tested methodology used on the lumbar spine without a high-end model and tested using a series of different postures and speeds. Results Complex motions involving twisting (i.e., flexion and twisting) and higher speed had higher magnitudes of coactivation than uniplanar motions in the sagittal or lateral plane, which was expected. The coupled motion of flexion and twisting showed four to five times higher coactivation than uniplanar (sagittal or lateral) movements. Conclusion The coactivation index developed accommodates multiplanar, naturalistic movements. Testing of the index showed that motions requiring higher degrees of head control had higher effort due to coactivation, which was expected. Application Overall, this coactivation index may be utilized to understand the neuromuscular effort of various tasks in the cervical spine.
Patients’ preferences for new versus old anticoagulants: a mixed-method vignette-based study
Authors: Bajorek Beata , Saxton Brooke , Anderson Elizabeth , Chow Clara K 
Published: November 2017

Background: For both patients and clinicians, differences between older and new anticoagulants have major implications for treatment selection, day-to-day management of therapy and adherence. Aims: To explore patients’ preferences for warfarin versus direct oral anticoagulant (DOAC) therapy. Methods: Mixed-method study involving anticoagulated older patients admitted to hospital. Part A comprised a vignette-based questionnaire; patients were asked whether they preferred Medicine A (warfarin) or Medicine B (DOAC). Part B interviews explored patients’ satisfaction with their current anticoagulant. Responses were thematically analysed. Results: Forty patients participated: 23 warfarin-treated, 17 DOAC-treated. Collectively, Parts A and B identified that most patients were satisfied with their current therapy (warfarin or DOAC), expressing reluctance to change to alternatives. Among patients who were able to numerically rate their satisfaction with therapy, most were ‘satisfied’ with their current anticoagulant, although warfarin-treated patients were slightly less ‘satisfied’ (median score 3.5) than those on DOACs (median score 5.0). Despite this, warfarin-treated patients still preferred their current therapy (over DOACs) due to familiarity and the security of regular international normalised ratio (INR) monitoring; those who preferred DOACs cited previous warfarin-related bleeding and unstable INRs as key reasons. DOAC-treated patients who preferred warfarin perceived regular monitoring as a major advantage; only those having had negative experiences with warfarin clearly preferred DOACs. Conclusion: Most patients accepted their currently prescribed anticoagulant, be it warfarin or DOACs. Features of specific anticoagulants, such as regular monitoring with warfarin, were perceived variably – some patients cited them as advantages and others as disadvantages. The clearest preference identified was for the agent already being taken.
Youth Baseball Pitching Mechanics: A Systematic Review
Authors: Thompson Samuel F. , Guess Trent M. , Plackis Andreas C. , Sherman Seth L. , Gray Aaron D. 
Published: November 2017

Context: Pitching injuries in youth baseball are increasing in incidence. Poor pitching mechanics in young throwers have not been sufficiently evaluated due to the lack of a basic biomechanical understanding of the “normal” youth pitching motion. Objective: To provide a greater understanding of the kinetics and kinematics of the youth baseball pitching motion. Data Sources: PubMed, MEDLINE, and SPORTDiscus databases were searched from database inception through February 2017. Study Selection: A total of 10 biomechanical studies describing youth pitching mechanics were included. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Manual extraction and compilation of demographic, methodology, kinetic, and kinematic variables from the included studies were completed. Results: In studies of healthy youth baseball pitchers, progressive external rotation of the shoulder occurs throughout the start of the pitching motion, reaching a maximum of 166° to 178.2°, before internally rotating throughout the remainder of the cycle, reaching a minimum of 13.2° to 17°. Elbow valgus torque reaches the highest level (18 ± 4 N·m) just prior to maximum shoulder external rotation and decreases throughout the remainder of the pitch cycle. Stride length is 66% to 85% of pitcher height. In comparison with a fastball, a curveball demonstrates less elbow varus torque (31.6 ± 15.3 vs 34.8 ± 15.4 N·m). Conclusion: Multiple studies show that maximum elbow valgus torque occurs just prior to maximum shoulder external rotation. Forces on the elbow and shoulder are greater for the fastball than the curveball.
Operating room central serous chorioretinopathy
Authors: Mansour Ahmad M , Hamam Rola 
Published: November 2017

Objectives: The operating room is a place of surgical intervention with its accompanying bodily and cognitive strain on the performers. Stress in the operating room may lead to the onset of central serous chorioretinopathy as reported hereby in a retina surgeon and is labeled as operating room central serous chorioretinopathy. Methods: The same operator performed the optical coherence tomography scans on one retina surgeon. A masked observer estimated the maximal height of the subretinal fluid. Results: Central serous chorioretinopathy recurred four times over a 1-year period 1 -2 days after a stressful day in the operating room, especially when cases were done under topical or subtenon anesthesia for cataract surgery, vitreous surgery or combined surgeries with complex ocular and medical problems and inability for anesthesia team to intervene. Stress management allowed resolution of subretinal fluid between 3 and 4 weeks. Adopting this strategy, no further attacks were documented by optical coherence tomography for 5 years. Conclusions: (1) This is one of a few optical coherence tomography documentation of resolution of central serous chorioretinopathy within 3-4 weeks of its occurrence and its recurrence induced by stress in the operating room; (2) Unassisted topical anesthesia required in patients with complex medical and ocular problems causes more cognitive stress than when surgery is carried under assisted local or general anesthesia (partly due to unexpected ocular or bodily movements); and (3) the available evidence suggests that those overcommitted surgeons (type A personality) may very well be most susceptible to burnout and central serous chorioretinopathy.
Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series
Authors: Cai Cindy X. , Linz Marguerite O. , Scott Adrienne W. 
Published: November 2017

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.
Schizophrenia — an anxiety disorder?
Authors: Hall Jeremy 
Published: November 2017

SummaryAnxiety and affective symptoms are prominent features of schizophrenia which are often present in the prodromal phase of the illness and preceding psychotic relapses. A number of studies suggest that genetic risk for the disorder may be associated with increased anxiety long before the onset of psychotic symptoms. Targeting anxiety symptoms may represent an important strategy for primary and secondary prevention in schizophrenia.
Bortezomib Prescription Pattern for the Treatment of Multiple Myeloma by Hematologists in Nigeria
Authors: Korubo Kaladada I. , Madu Anazoeze J. , Okoye Helen C. , Nwogoh Benedict 
Published: November 2017

Purpose Novel therapy has dramatically changed the outcome of patients with myeloma. Current National Comprehensive Cancer Network guidelines give bortezomib-based combinations a central role in the management of multiple myeloma (MM). The aim of this survey is to assess the use of bortezomib for the treatment of MM by hematologists practicing in Nigeria. Materials and Methods This is a cross-sectional observational survey. A structured, prevalidated questionnaire was self-administered to different cadres of hematologists. Data collected were analyzed using SPSS software version 21 (IBM, Chicago, IL). Results There were 54 respondents from 24 centers across the country. The most frequently used drugs for first-line therapy were thalidomide (66.7%), dexamethasone (54.2%), and bortezomib (48%), and a combination of bortezomib, thalidomide, and dexamethasone (16.7%) was the most frequently used first-line regimen. Of the 54 hematologists, 39 (72.2%) had prescribed bortezomib previously; no one had used bortezomib as monotherapy. Drug unavailability (86.7%) and cost (46.7%) were the major reasons for those who had not prescribed bortezomib. Approximately 56.4% of responders had patients who had experienced adverse effects, of which neuropathy was the most common (86.3%). Conclusion Bortezomib, thalidomide, and dexamethasone was the most frequently used first-line regimen to treat myelomatosis. Thalidomide and dexamethasone were the most frequently used drugs in myeloma treatment. Despite poor access to health care, coupled with the high cost and poor availability of bortezomib in our low- or middle-income country, those who prescribed bortezomib did so frequently (in more than half of their patients).
Weibel−Palade bodies at a glance
Authors: McCormack Jessica J. , Lopes da Silva Mafalda , Ferraro Francesco , Patella Francesca , Cutler Daniel F. 
Published: November 2017

ABSTRACT
The vascular environment can rapidly alter, and the speed with which responses to both physiological and pathological changes are required necessitates the existence of a highly responsive system. The endothelium can quickly deliver bioactive molecules by regulated exocytosis of its secretory granules, the Weibel−Palade bodies (WPBs). WPBs include proteins that initiate both haemostasis and inflammation, as well those that modulate blood pressure and angiogenesis. WPB formation is driven by von Willebrand factor, their most abundant protein, which controls both shape and size of WPBs. WPB are generated in a range of sizes, with the largest granules over ten times the size of the smallest. In this Cell Science at a Glance and the accompanying poster, we discuss the emerging mechanisms by which WPB size is controlled and how this affects the ability of this organelle to modulate haemostasis. We will also outline the different modes of exocytosis and their polarity that are currently being explored, and illustrate that these large secretory organelles provide a model for how elements of secretory granule biogenesis and exocytosis cooperate to support a complex and diverse set of functions.