Thrombectomy With the pRESET vs Solitaire Stent Retrievers as First-Line Large Vessel Occlusion Stroke Treatment: A Randomized Clinical Trial.

Importance: Stent retriever-based thrombectomy is highly beneficial in large vessel occlusion (LVO) strokes. Many stent retriever designs are currently available, but comparison of these technologies in well-conducted studies is lacking.

Objective: To determine whether thrombectomy for LVO stroke with the pRESET stent retriever is noninferior to treatment with the Solitaire stent retriever.

How Does an Artisan Cooperative Impact Food Perception and Consumer Behaviors? A Rapid Rural Appraisal of Women in East Africa.

We examined the impact of artisan cooperatives on East African women related to changes in consumer perception and food choice. We sought to understand how artisan cooperatives were impacting women's food security, diet, and nutrition. To comprehend the lived experiences of women, a qualitative, phenomenological study was conducted within three purposively selected cooperatives in Rwanda and Kenya.

Isolation and sequencing of the spoilage yeast .

New sequencing workflows can enable the genomics of microbes isolated from craft beverages. Here, we use hybrid, short, and long-read sequencing to assemble the genome of a yeast isolated from cider, NCC-J. The genus has few genomes available; thus, this contributes to yeast genomics.

Period-Prevalence and Risk Factors for Delirium in a Tertiary Referral ICU: A prospective cohort study.

Background: Delirium is common in intensive care and leads to increases in morbidity, mortality, Intensive Care Unit (ICU) length of stay, and hospital length of stay. Certain risk factors predict the appearance of delirium.

Study Objectives: To determine the rates of delirium, the rate of risk factors, and their relationship to the occurrence of delirium in an adult ICU.

Impact of Daily Electronic Laboratory Alerting on Early Detection and Clinical Documentation of Acute Kidney Injury in Hospital Settings.

Acute kidney injury, especially early-stage disease, is a common hospital comorbidity requiring timely recognition and treatment. We investigated the effect of daily laboratory alerting of patients at risk for acute kidney injury as measured by documented diagnoses. A quasi-experimental study was conducted at 8 New York hospitals between January 1, 2014, and June 30, 2017.

A Serological Diagnosis of Coeliac Disease Is Associated with Osteoporosis in Older Australian Adults.

Previously thought to be mainly a disorder of childhood and early adult life, coeliac disease (CeD) is increasingly diagnosed in older adults. This may be important given the association between CeD and osteoporosis. The primary aim of this study was to determine the seroprevalence of undiagnosed CeD (‘at-risk serology’) in an older Australian community and relate this to a diagnosis of osteoporosis and fractures during a follow-up period of 12 years.

Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome.

Background: We examined the prevalence of undiagnosed diabetes or prediabetes and associations with ischemic outcomes among non-ST-segment elevation acute coronary syndrome (ACS) patients.

Methods: We categorized 8795 EARLY ACS trial patients into one of the following groups: "known diabetes" (n = 2860 [32.5%]; reported on the case report form), "undiagnosed diabetes" (n = 1069 [12.

Age, treatment, and outcomes in high-risk non-ST-segment elevation acute coronary syndrome patients: insights from the EARLY ACS trial.

Background: Elderly patients with acute coronary syndromes (ACS) are at high risk for death and recurrent thrombotic events. We evaluated the efficacy and safety of intensive treatment with glycoprotein IIb/IIIa inhibitors in an elderly population, and the relationships between age, timing of administration, and clinical outcomes.

Methods: We used data from high-risk non-ST-segment elevation ACS patients randomized to early eptifibatide vs.

Acute coronary syndromes: from the emergency department to the catheterization laboratory-integrating evidence from recent ACS/NSTEMI trials into clinical practice: an evidence-based review of recent clinical trial results and report on a roundtable discussion.

Over the past 2 years, multiple clinical trials have reported results that will influence the treatment of patients with non-ST-segment elevation acute coronary syndromes (ACS) for many years to come. However, large-scale clinical trials take years to complete, during which time the underlying landscape may shift. Thus, while clinical trials provide baseline information to help physicians make evidence-based decisions regarding patient care, trials must be interpreted in the context of current treatment guidelines and practices.

ED to catheterization laboratory: a roundtable integrating trials with practice.

Background: Clinical trials are the foundation underlying clinical decision-making. However, stringent inclusion and exclusion criteria may reduce the generalizability of their results, especially for patients seen in the emergency department (ED). Guideline recommendations, based on clinical trials and pertinent registries, apply to broad populations, but not all patients cared for at the bedside fit the predefined categories that make guidelines practical.

Safety and efficacy of bivalirudin in high-risk patients admitted through the emergency department.

Objectives: The objective was to assess the safety and efficacy of bivalirudin monotherapy in patients with high-risk acute coronary syndrome (ACS) presenting to the emergency department (ED).

Methods: Data from the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial were used to conduct a post hoc subgroup analysis of high-risk ACS patients (cardiac biomarker elevation or ST-segment deviation) who initially presented to the ED. The ACUITY trial randomized patients to receive heparin (unfractionated [UFH] or enoxaparin) plus glycoprotein IIb/IIIa inhibition (GPI), bivalirudin plus GPI, or bivalirudin monotherapy.

EMS in Mauritius.

Mauritius lies in the southwest Indian Ocean about 1250 miles from the African coast and 500 miles from Madagascar. Mauritius (estimated population 1,230,602) became independent from the United Kingdom in 1968 and has one of the highest GDP per capita in Africa. Within Mauritius there is a well established EMS system with a single 999 national dispatch system.

Insurance coverage and care of patients with non-ST-segment elevation acute coronary syndromes.

Background: The impact of insurance coverage on the care of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) is unclear.

Objective: To compare NSTE ACS care patterns by insurance type.

Design: Comparison of Medicaid patients younger than 65 years of age and Medicare patients 65 years of age or older with patients of similar age who have health maintenance organization (HMO) or private insurance coverage.

The impact of emergency department structure and care processes in delivering care for non-ST-segment elevation acute coronary syndromes.

Background: We sought to assess the influence of emergency department (ED) structure and care processes on adherence to practice guidelines for the treatment of patients with non-ST-segment elevation acute coronary syndromes.

Methods: We surveyed emergency physicians and nurses from 316 hospitals participating in the CRUSADE Quality Improvement Initiative and used multivariable modeling to correlate ED-specific characteristics with guidelines adherence.

Results: Factors that were significantly associated with improved guidelines adherence included collaboration between emergency physicians and hospital administration, northeast region, adequate nursing support, use of locum tenens physicians, an independent ED (not a division of another clinical department), and use of a care algorithm for acute coronary syndromes.

Treatment disparities in the care of patients with and without diabetes presenting with non-ST-segment elevation acute coronary syndromes.

Objective: The objective of this study was to characterize treatment patterns among patients with diabetes presenting with non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs).

Research Design And Methods: We compared adherence to treatment recommendations from the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for NSTE ACS among 46,410 patients from 413 U.S.

Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative.

Objectives: We hypothesized that significant disparities in gender exist in the management of patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS).

Background: Gender-related differences in the diagnosis and treatment of ACS have important healthcare implications. No large-scale examination of these disparities has been completed since the publication of the revised American College of Cardiology/American Heart Association guidelines for management of patients with NSTE ACS.

Update on acute coronary syndromes and implications for therapy.

Our understanding of the pathophysiology of acute coronary syndromes (ACS), including acute ST elevation myocardial infarction, unstable angina and non-ST-segment elevation (NSTE) myocardial infarction, has evolved considerably over the years, with atherothrombosis playing a pivotal role. This review will discuss the recent advances/recommendations for drug therapy based on this enhanced understanding of the pathophysiology of thrombosis. More recently developed agents, such as low-molecular-weight heparins (LMWHs), glycoprotein (GP) IIb-IIIa inhibitors, direct thrombin inhibitors, Factor Xa inhibitors and thienopyridines, offer several potential advantages, either as an alternative to unfractionated heparin (i.