bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Pediatric PROMIS CATs in Children With Upper Extremity Fractures
Authors: Gerull William D. , Okoroafor Ugochi C. , Guattery Jason , Goldfarb Charles A. , Wall Lindley B. , Calfee Ryan P.
Published: August 2018

Background: This study was designed to quantify the performance of the pediatric Patient-Reported Outcome Measurement Information System (PROMIS) when delivered as part of routine care to children with upper extremity (UE) fractures. Methods: This cross-sectional study analyzed 964 new pediatric patients presenting with an UE fracture. All patients completed PROMIS computer adaptive tests for pain interference, peer relationships, UE function, and mobility domains at clinic registration. PROMIS was completed by parent-proxy (n = 418) for 5- to 7-year-olds and self-reported by 8- to 10-year-olds (n = 546). PROMIS score distributions were defined, and Pearson correlations assessed the interrelation between PROMIS domains. Student’s t tests compared mean PROMIS scores between parent-proxy and self-completion groups. Results: UE scores indicated the greatest average impairment of all PROMIS domains. However, 13% of patients reached the UE score ceiling indicating maximal UE function. UE scores and mobility scores had a strong positive correlation while UE scores had a moderate negative correlation with pain interference. In all patients, peer relationships were, at most, very weakly correlated with any other PROMIS domain. After grouping by fracture type, parent-proxy completion estimated worse UE function, more pain interference, and worse peer relationship. Conclusions: Pediatric PROMIS UE function scores capture impairment from UE fractures but do have a strong positive correlation with pediatric PROMIS Mobility, which assesses lower extremity function. Among children with UE fractures, parent-proxy completion of pediatric PROMIS appears associated with worse scores on most PROMIS domains.
Numerical analysis of convective heat transfer coefficient for building facades
Authors: Kahsay Meseret T , Bitsuamlak Girma , Tariku Fitsum
Published: August 2018

The latest architectural trends demand an extensive use of glazed curtain walls running from building floor to ceiling. While glazing poorly controls the heat flow, it is important for viewing, daylighting, and solar design features. In order to evaluate building energy consumption accurately, knowledge of convective heat transfer coefficient (CHTC) distribution over the façade of the building is important. In this article, high-resolution numerical simulations that use three-dimensional steady Reynolds-averaged Navier–Stokes and energy equations are performed. Convective heat transfer coefficient values at the windward facade of five buildings, with rectangular floor plans, and heights of 3, 10, 15, 20–30 stories, have been produced. The influence of building height on CHTC distribution is investigated at Reynolds numbers ranging from 0.7 × 106 to 33 × 106, and a correlation equation as a function of building height and a reference wind velocity is developed. For example, as the height increases from 10.1 to 101 m in the study cases, the surface-averaged convective heat transfer coefficient on the windward façade increases by 55%. The high-resolution spatial distribution of convective heat transfer coefficient over façade of the tallest building indicates that the top-corner zone convective heat transfer coefficient values are higher by 24% and the base-center zone values are lower by 27% compared to the average CHTC value, implying the necessity for zonal treatment.
Future models of general practice
Authors: Holmes Mike , Lanaghan Sophie , Nolan Tom
Published: August 2018

The partnership model has been at the heart of UK general practice since the beginning of the NHS. In recent years new models of care have emerged that both challenge and complement the partnership model. These include: Federations; Super-partnerships; Accountable Care Organisations; and Multispecialty Community Providers. Many are questioning whether the partnership model can survive, and whether small independent practices will become a thing of the past. This article examines what these new models of care are, where they have come from, and looks at the future of the partnership model.
The surge in biosimilars: considerations for effective pharmacovigilance and EU regulation
Authors: Calvo Begoña , Martinez-Gorostiaga Javier , Echevarria Enrique
Published: August 2018

The development of biosimilars is growing rapidly, especially in Europe. They are a cost-effective alternative to original biological medicines and can help improve patient access to these therapies.

The European Medicines Agency (EMA) has been the first to issue scientific guidelines related to regulatory requirements for the approval of biosimilars. These guidelines have been being updated in line with advances in analytical techniques and growing experience in the clinical use of these drugs.

Given the complex nature of biological medicines, they pose a greater potential risk of immunogenicity than nonbiological medicines, and hence warrant special consideration. The risk management plan for biopharmaceuticals (innovator and biosimilar drugs) should be based on strengthening ongoing pharmacovigilance activities, especially in the post-approval period.

This paper addresses regulatory issues related to the approval of biosimilars in Europe associated with safety considerations linked to the development and use of these medicines. We also discuss the issues of immunogenicity, interchangeability and traceability of biological medicines.
Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event
Authors: Salzwedel Annett , Heidler Maria-Dorothea , Meng Karin , Schikora Martin , Wegscheider Karl , Reibis Rona , Völler Heinz
Published: August 2018

Background

Although associations between cardiovascular diseases and cognitive impairment are well known, the impact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far.

Design

Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation.

Method

At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.5 ± 6.3 years, 80% men) following an acute coronary syndrome and/or coronary artery bypass graft was tested using the Montreal Cognitive Assessment. Patients’ disease-related knowledge was determined using a quiz (22 items for medical knowledge and 12 items for healthy lifestyle and behaviour) at both times and at follow-up. The change in knowledge after cardiac rehabilitation was analysed in multivariable regression models. Potentially influencing parameters (e.g. level of education, medication, cardiovascular risk factors, coronary artery bypass graft, comorbidities, exercise capacity) were considered.

Results

During cardiac rehabilitation, disease-related knowledge was significantly enhanced in both scales. At follow-up, the average level of medical knowledge was significantly reduced, while lifestyle knowledge remained at a stable level. The maintenance of knowledge after cardiac rehabilitation was predominantly predicted by prior knowledge, cognitive performance at discharge from cardiac rehabilitation and, in the case of medical knowledge, by coronary artery bypass graft.

Conclusion

Patient education in cardiac rehabilitation led to enhanced disease-related knowledge, but the maintenance of this essentially depended on patients’ cognitive performance, especially after coronary artery bypass graft. Therefore, patient education concepts in cardiac rehabilitation should be reconsidered and adjusted as needed.
Understanding Asian American Student Achievement
Authors: Kim Jungnam , Bryan Julia , Choi Younyoung , Kim Ji Hyun
Published: August 2018

This study investigated the relationships of parent networks and parent empowerment to the academic performance of the children of Asian immigrant parents in U.S. schools. It also examined the role of parent networks in explaining the association between parent empowerment and children’s academic performance. We conducted multinomial logistic regression and path analysis on responses of 317 Asian immigrant parents from the Parent and Family Involvement Survey of the National Household Education Survey, 2007. Parent networks and some parent empowerment components (i.e., competence, parent contact with the school counselor) were significantly related to academic performance. Findings suggest the importance of school counselors utilizing empowerment strategies to help those Asian immigrant parents who need support with their children’s education.
Compassionate Coverage: A Patient Access Linen System
Authors: Rabin Jill Maura , Farner Katherine C , Brody Alice H , Peyser Alexandra , Kline Myriam
Published: August 2018

Background:

Patient attire is paramount to patient’s dignity and overall experience. In this pilot study and in concert with a designer and clinician, we developed, patented, tested, and evaluated patient and provider preference and experience with a novel patient gowning system. Our objective was to survey obstetrics and gynecology hospital inpatients’ and providers’ experience with a novel hospital attire system; the patient access linen system (PALS).

Methods:

Patients were provided a PALS item at the beginning of a provider’s shift or at the start of an outpatient visit. Following their use of the PALS item, the patients and providers completed a separate multiple-choice and free-response question survey. Surveys were completed by patients each time a PALS item was returned to the provider for processing.

Results:

Patients and providers had a significantly positive experience with the PALS. The majority of patients had positive responses to each question about comfort and function of the PALS system, showed consistent preference for the PALS in comparison to a traditional hospital gown and demonstrated that comfort of hospital clothing is a priority for patients. The majority of providers found PALS easy to use when compared to the traditional gown with regard to clinical examinations.

Conclusion:

Patients in our pilot prioritized hospital attire as a key element in their overall hospital experience, and both patients and providers preferred the PALS system over the traditional hospital gown. Further study is needed on patient attire and evaluation of the potential clinical impact of the PALS.
Symbolic Violence and Misrecognition: Scripting Gender among Middle-class Women, India
Authors: Bhattacharyya Rituparna
Published: August 2018

Postcolonial India is a complex and paradoxical mix of sociocultural practices and modernity. This tension is especially apparent and holds particular significance, with respect to women’s changing roles. Driving this research is a concern to probe the position of women, pursuing higher education, as daughters/daughter(s)-in-law and wife within the family. The article focuses on the specific case of Assam, located in the northeastern region of India and, within it, a sub-population of young, middle-class Assamese women. The research considers the notions of Pierre Bourdieu’s ‘symbolic violence’ and ‘misrecognition’ as well as feminist literature to examine how unequal gender relations in Assamese society are reproduced and sustained. It draws upon in-depth interviews conducted with a sample of students pursuing higher education in five different educational institutions of Assam. The narrative analysis reveals the conflicting but often-contradictory process of women’s changing roles, particularly of those women who are married and play simultaneously the roles of daughter(s)-in-law and wives. The findings demonstrate that the subtle process of socialisation (and cultural values) that stem from patriarchal power relations are so deeply entrenched within the Assamese society that these highly educated middle-class women continue to be subjected to symbolic power maintained by misrecognition.
First Metatarsophalangeal Joint Arthrodesis
Authors: Filomeno Paola , López Julio
Published: August 2018

Background:

First metatarsophalangeal (MTP) joint arthrodesis can be fixed using either a dorsal plate or crossed screws. However, there is considerable difference in the cost of these implants, and it is not known if there is sufficient difference in outcome that might justify this cost difference. Our aim was to compare the functional results and patient satisfaction rates after first MTP joint arthrodesis in a group of patients using the same surgical technique except for the fixation devices.

Methods:

A prospective cohort of 27 patients who underwent first MTP joint fusion by the same surgeon using 2 crossed screws or a single screw with a dorsal plate was recruited over a 3-year period. Demographic information, patient satisfaction rates, complications, and union rates were evaluated. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scoring systems were used pre- and postoperatively to compare the functional outcomes. Thirty consecutive procedures (screws, n = 15; plate, n = 15) were performed. Age (55.8 ± 11.1 vs 63.3 ± 12.4 years for screws and plate respectively; P = .091) and female gender percentages (80% and 73%, P = .666) were similar between groups.

Results:

The overall union rate was 93% with no differences between groups. AOFAS and VAS scores improved significantly postoperatively for each technique, and no differences were found between the two in the improvement in AOFAS (42.4 ± 8.0 vs 44.3 ± 8.2, screws and plate respectively; P = .520) and VAS scores (66.0 ± 5.4 vs 69.0 ± 6.9; P = .195). The implant cost for screws was $40 and for dorsal plate, $328.

Conclusions:

First MTP joint fusion using either screws or plate fixation results in an improvement in AOFAS and VAS scores. Functional improvement and patient satisfaction did not differ between the 2 techniques, despite a considerable difference in cost between the two methods of fixation.

Level of Evidence:

Level III, prospective comparative study.
Congenital Dislocation of the Fifth Metatarsophalangeal Joint in Adults
Authors: Jaffe David E. , Brodsky James W.
Published: August 2018

Congenital dislocation of the fifth metatarsophalangeal (MTP) joint can cause significant limitations in a patient’s ability to wear a closed shoe. Historic treatment has involved amputation of the digit or attempts at reconstruction. These techniques have had limited success with unreliable correction and/or unacceptable cosmesis. The authors present a detailed, methodical approach to reconstruction of this deformity with a stepwise algorithm that addresses both the bony and soft tissue components of the deformity. With this modern technique, reliable and satisfactory results can be expected.
The Evaluation and Treatment of Diabetic Foot Ulcers and Diabetic Foot Infections
Authors: Del Core Michael A. , Ahn Junho , Lewis Robert B. , Raspovic Katherine M. , Lalli Trapper A. J. , Wukich Dane K.
Published: August 2018

Diabetic foot ulcers and infections are common complications of diabetic foot disease. Additionally, these complications are a common cause of morbidity and impose a substantial burden to the patient and society. It is imperative to understand the major contributing factors, namely, diabetic neuropathy, peripheral arterial disease, and immune system dysfunction in order to guide treatment. Management of diabetic foot disease begins with a detailed history and thorough physical examination. This examination should focus on the manifestations of diabetic neuropathy and peripheral arterial disease, and, in particular, any evidence of diabetic foot ulcers or infection. Prevention strategies should include a multi-disciplinary approach centered on patient education.
The Influence of Project Risk Management Maturity and Organizational Learning on the Success of Power Plant Construction Projects
Authors: Heravi Gholamreza , Gholami Ashkan
Published: August 2018

Project risk management maturity measures how effective risk management processes are implemented by performing organizations aimed at meeting project objectives. Organizational learning from repetitive projects may assist performing organizations deliver successful projects. The purpose of this research is to measure the influence of project risk management maturity and organizational learning on the cost, time, and quality of a power plant construction project. In the studied projects, improving organizational learning led to enhancement of all success criteria, especially the cost and quality criteria. Success criteria trends have shown that the influence of organizational learning on improving project performance is more than the influence of the level of project risk management maturity.
The Concept of Negative Symptoms
Authors: Wing J.K.
Published: August 2018

In a recent edition of the Schizophrenia Bulletin devoted to negative symptoms, the editor suggested at the beginning of his preface that what he called the “positive–negative symptom distinction” had been introduced into psychiatry only a decade previously (Levine, 1985). Many authors in the same volume seemed to agree with him; at least they did not emphasise any continuity with earlier work. There were a few notable exceptions. Since, for more than 30 years, I have seen the relationship between psychological deficit (cognitive defect, negative syndrome) and the productive (florid, positive) symptoms as lying at the heart of the mystery of schizophrenia, it seemed possible that some account of how that interest arose and developed might still be timely. This is part of the history of the Social Psychiatry Research Unit of the Medical Research Council.
The Antidepressant Effects of 5-HT Uptake Inhibitors
Authors: Åberg-Wistedt Anna
Published: August 2018

The functional roles of monaminergic transmitters in depression have been widely studied during the past decade. Data from that research suggest that lower levels of the 5-HT metabolite, 5-HIAA, in the cerebrospinal fluid; 5-HT uptake in human platelets; and platelets [3H]-imipramine binding sites occur in depressed patients. In recent years several potent and selective 5-HT uptake inhibitors have become available for clinical studies. The first shown to have antidepressant effects, zimelidine, was followed by similar compounds such as femoxetine, fluvoxamine, Citalopram, indalpine, fluoxetine, paroxetine, and sertraline. The effectiveness of serotonin inhibitors in treating other disorders, such as obsessive–compulsive disorder, anxiety, and panic disorder, has also been demonstrated. This review reports the data from clinical studies with these agents. The 5-HT uptake inhibitors are devoid of anticholinergic properties and have not produced weight gain or sedative side-effects, but may have another profile of side-effects. Headache, nausea, and vomiting have been reported, however.
Psychology and Psychopathology in Women – A Psychoanalytic Perspective
Authors: Welldon Estela V.
Published: August 2018

Aspects of the normal psychology and psychopathology of women are discussed in relation to adolescence, young womanhood and motherhood. Perversions of motherhood exist, although they are largely denied by a society which idealises being a mother. This denial may be caused by society's inability to see a woman as a complete human being. The aetiology of perversions in women is both psychobiological and social and it is bound up with the politics of power. Perverse motherhood can be seen as the product of the emotional instability and inadequate individuation brought about by a process involving at least three generations.
Schizophrenia and City Residence
Authors: Freeman Hugh
Published: August 2018

It has long been thought that rates of mental illness are higher in cities than elsewhere, because of crowding and resultant stress. In the case of schizophrenia, there are some marked exceptions to generally higher prevalence rates in industrialised cities. Factors such as migration, culture, infectious disease, demographic rates, and other social processes may affect geographical differences in rates. The excess of schizophrenia in central city areas has been given two opposing explanations – the ‘breeder’ hypothesis and ‘social drift’. Data on incidence from three cities are compared, but do not reveal a clear common picture. Environmental factors connected with urban living are of two main types – social and non-social – which are not mutually exclusive; ‘urban’ may also have a variety of meanings. Rather than ‘urbanicity’ being an independent aetiological factor in schizophrenia, its effect may be largely explained in terms of migration and social class.
Prevalence and recognition of anxiety syndromes in five European primary care settings
Authors: Weiller E. , Bisserbe J.-C. , Maier W. , Lecrubier Y.
Published: August 2018

Background This study explored the prevalence, socio-demographic characteristics and severity of different anxiety syndromes in five European primary care settings, as well as medical help-seeking, recognition by general practitioners (GPs) and treatment prescribed.

Method The data were collected as part of the WHO study on Psychological Problems in General Health Care. Among 9714 consecutive primary care patients, 1973 were interviewed using the Composite International Diagnostic Interview. Reason for contact, ICD–10 diagnoses, severity and disability were assessed. Recognition rates and treatment prescribed were obtained from the GPs.

Results Anxiety syndromes, whether corresponding to well-defined disorders or to subthreshold conditions, are frequent in primary care and are associated with a clinically significant degree of severity and substantial psychosocial disability. Their recognition by GPs as well as the proportion treated are low.

Conclusions Since people with subthreshold anxiety show a substantial degree of disability and suffering, GPs may consider diagnostic criteria to be insufficient. However, their awareness of specific definitions and treatment patterns for anxiety disorders still needs a lot of improvement both for patients' well-being and for the cost resulting from non-treatment.
Abecarnil, a new beta-carboline, in the treatment of anxiety disorders
Authors: Aufdembrinke B.
Published: August 2018

Background Abecarnil, a novel anxiolytic beta-carboline, was investigated in five four-week double-blind, European multicentre studies. Overall, 451 patients with generalised anxiety disorder were randomised to abecarnil, 461 to placebo and 464 to active controls.

Method Data includes inferential statistics based on individual studies and descriptive analysis of 323 patients in open-label abecarnil longterm continuation up to 52 weeks.

Results Abecarnil was safe, the most frequent adverse event being drowsiness. Onset of effect was at week I. At week 4 the Hamilton Anxiety Scale score had improved by 12–13 points on average. Due to notably large and variable placebo effects abecarnil was not consistently superior to placebo. No rebound or withdrawal symptoms were observed after fast-tapered discontinuation. Safety, extent of efficacy and incidence of rebound or withdrawal did not change during longterm treatment.

Conclusions Abecarnil is safe and effective. Further research into its therapeutic potential seems warranted.
The Dynamics of Complex Biological-Psychosocial Systems
Authors: Ciompi Luc
Published: August 2018

The scope of this introductory contribution is to present some general facts and ideas which could enhance our understanding of this enigmatic illness. By ‘mediating processes’ (or ‘mediators’) I mean mechanisms providing bridges between different aspects of knowledge of the schizophrenia-puzzle which, so far, have not been linked together in a satisfactory way: one of the central problems is the identification of mediators between psychosocial factors on the one hand, and biological factors on the other. If we do not succeed in building up conceptually valid bridges between these two aspects, which are testable for hypothesis-orientated research, a disastrous splitting of our understanding and treatment of schizophrenia into either biological or psychosocial reductionism is likely.
Delusional Belief Systems and Meaning in Life: A Preferred Reality?
Authors: Roberts Glenn
Published: August 2018

“Extreme psychotic states offer a human parable … patients see into the depths which do not belong so much to their illness as themselves as individuals with their own historical truth … in psychotic reality we find an abundance of content representing fundamental problems in philosophy …. The philosopher in us cannot but be fascinated by this extraordinary reality and to feel its challenge.” (Jaspers, 1963)
General Pharmacology of Clozapine
Authors: Coward D. M.
Published: August 2018

Clozapine shows neuroleptic-like inhibition of locomotor activity and conditioned avoidance responding in rodents, although tolerance develops on repeated treatment. EEG-based studies show strong arousal-inhibiting activity of clozapine as well as neuroleptic-like effects on both caudate spindle duration and rat sleep-waking patterns. Effects such as apomorphine blockade, catalepsy and strong increases of plasma prolactin levels are not seen, however, and chronic treatment does not lead to dopamine D2 receptor supersensitivity. Binding studies show clozapine's highest affinities to be for dopamine D4, 5-HT1c, 5-HT2, α1, muscarinic and histamine H1 receptors, but moderate affinity is also seen for many other receptor subtypes. Microdialysis studies indicate a preferential interaction with striatal D1 receptors, whereas autoradiographical studies indicate upregulation of D1 and downregulation of 5-HT2 receptors after chronic clozapine. Clarification of the mechanisms underlying clozapine's special attributes is often hampered by a failure to examine compounds which show a close chemical relationship to clozapine, but which produce extrapyramidal side-effects in man, such as clothiapine, loxapine and amoxapine.
Clinical Management of Clozapine Patients in Relation to Efficacy and Side-Effects
Authors: Naber D. , Holzbach R. , Perro C. , Hippius H.
Published: August 2018

Medical charts of 480 schizophrenic in-patients (581 treatments) were analysed to evaluate the efficacy and side-effects of clozapine. Clozapine treatment lasted for mean 49 (s.d. 38) days. Of the sample, 11.0% showed worsening or no change, 31.5% slight improvement, 53.0% marked improvement and 4.5% almost total reduction of symptoms. At least one major side-effect occurred in 68.0% of patients. A combination of clozapine with classical neuroleptics, antidepressants, benzodiazepines or lithium is tolerated by most patients, but increases the incidence of some side-effects. Clozapine treatment had to be discontinued because of severe side-effects in 8.6% of patients. In 81 schizophrenic out-patients, clozapine significantly reduced the days of in-patient treatment and number of hospital readmissions. Two patients developed leucopenia but had no complications after clozapine withdrawal. This study indicates a satisfactory benefit/risk ratio and compliance in most of the patients.
A European Study of Views on the Use of Monoamine Oxidase Inhibitors
Authors: Paykel E.S. , White J.L.
Published: August 2018

A total of 1269 psychiatrists, from 15 European countries, completed a questionnaire assessing treatment choice in depressive and anxiety disorders, with particular focus on diagnostic and other factors determining use of monoamine oxidase inhibitors (MAOIs). Tricyclic and similar antidepressants were used most commonly — MAOIs were used as first-choice therapy for depressive or anxiety disorders only by a minority but were commonly a second-choice treatment for atypical depressives. Use was inhibited by interactions and side-effects rather than by perceived ineffectiveness. Cross-national differences in treatment were considerable but diagnostic differences in case history vignettes were much smaller.
Research and treatment strategies in first-episode psychoses: The Pittsburgh experience
Authors: Keshavan M. S. , Schooler N. R. , Sweeney J. A. , Haas G. L. , Pettegrew J. W.
Published: August 2018

Background Studies of first-episode patients allow investigation of the biological basis of psychotic disorders without the potential confounds of prior treatment and illness chronicity. Prospective studies of this population can clarify the impact of illness course and treatment on neurobiology.

Method We summarise preliminary findings from our ongoing magnetic resonance imaging and spectroscopy studies of first-episode schizophrenia patients being conducted prospectively from index evaluations through a period of two years; during this period, patients were treated with either a conventional antipsychotic such as haloperidol, or the atypical risperidone.

Results Baseline neurobiological evaluations in first-episode schizophrenia patients have revealed evidence for structural and functional brain abnormalities consistent with a neurodevelopmental model of this illness. Our preliminary data support the value of risperidone as an antipsychotic drug of first choice among patients with early schizophrenic illness.

Conclusions Focused studies of first-episode patients have the potential to unravel pathophysiology of schizophrenic illness. Such knowledge is critical for more effective early detection, intervention and even prevention of this enigmatic disorder.
Familial Hypercholesterolemia and Risk of Peripheral Arterial Disease and Chronic Kidney Disease
Authors: Emanuelsson Frida , Nordestgaard Børge G , Benn Marianne
Published: August 2018

Context

Individuals with familial hypercholesterolemia (FH) have a high risk of coronary artery disease, but their risk of peripheral arterial disease (PAD) and chronic kidney disease (CKD) is unknown.

Objective

In individuals with clinical FH, we tested the hypotheses (1) that the risks of PAD and CKD are elevated and (2) that low ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR) are associated with a high risk of myocardial infarction.

Design and Setting

Prospective cohort study of the general population.

Participants

A total of 106,172 individuals, of whom 7109 were diagnosed with FH.

Main Outcome Measures

PAD, CKD, and myocardial infarction.

Results

Compared with individuals with unlikely FH, multivariable adjusted ORs (95% CIs) of PAD were 1.84 (1.70 to 2.00) in those with possible FH and 1.36 (1.00 to 1.84) in individuals with probable/definite FH. For CKD, the corresponding ORs (95% CIs) were 1.92 (1.78 to 2.07) and 2.42 (1.86 to 3.26). Compared with individuals with unlikely FH and ABI >0.9, the multivariable adjusted hazard ratio (95% CI) of myocardial infarction was 4.60 (2.36 to 8.97) in those with possible/probable/definite FH and ABI ≤0.9. Compared with individuals with unlikely FH and eGFR ≥60 mL/min/1.73 m2, the corresponding value was 2.19 (1.71 to 2.82) in those with possible/probable/definite FH and eGFR <60 mL/min/1.73 m2.

Conclusions

Individuals with clinical FH have increased risks of PAD and CKD, and low ABI and eGFR are associated with high risk of myocardial infarction. Consequently, individuals with FH should be screened for PAD and CKD, and ABI and eGFR may be used as prognostic tools in the management and treatment of FH to identify those at very high risk of myocardial infarction.
Preventive Therapy of Migraine
Authors: Schwedt Todd J.
Published: August 2018

PURPOSE OF REVIEW

This article reviews the preventive therapy of migraine, including indications, strategies for use, and available treatments.

RECENT FINDINGS

Lifestyle modifications and migraine trigger avoidance are recommended as preventive measures for all individuals with migraine. The decision to recommend additional migraine preventive therapy should consider the frequency of migraine attacks and headaches, extent of migraine-associated disability, frequency of using acute migraine treatments and the responsiveness to such treatments, and patient preferences. Additional therapies include prescription medications, nutraceuticals, neurostimulation, and behavioral therapy. Considering evidence for efficacy and the risk of potential side effects and adverse events, treatments with the most favorable profiles include (in alphabetical order): amitriptyline, beta-blockers (several), biofeedback, candesartan, coenzyme Q10, cognitive-behavioral therapy, magnesium citrate, onabotulinumtoxinA (for chronic migraine only), relaxation therapy, riboflavin, and topiramate. In addition, erenumab, a calcitonin gene-related peptide (CGRP) receptor monoclonal antibody, received approval from the US Food and Drug Administration (FDA) for the prevention of migraine in May 2018.

Successful migraine preventive therapy reduces the frequency and burden of attacks while causing limited side effects. Individual treatment recommendations are determined based upon evidence for efficacy, side effect and adverse event profiles, medication interactions, patient comorbidity, costs, and patient preferences. Patients must be counseled on reasonable expectations for their preventive therapy and the importance of adhering to the recommended treatment plan for a period of time that is sufficient to determine outcomes.
Spinal Cord Stimulation as Treatment for Truncal Chronic Regional Pain Syndrome After Cardiac Surgery: A Case Report
Authors: Poe Lauren M. , Sobey Christopher M.
Published: August 2018

A 59-year-old man presented 7 months after coronary artery bypass with continued bilateral axillary pain. His symptoms progressed over a period of months to allodynia, edema, erythema, decreased range of motion, and skin changes consistent with complex regional pain syndrome type I. After failing multiple treatment options, the patient underwent a trial of spinal cord stimulation. Leads positioned in the posterior epidural space from the seventh cervical to the third thoracic vertebral levels resulted in complete paresthesia coverage of his truncal chronic regional pain syndrome (CRPS) and the stimulation was associated with almost complete resolution of CRPS. This case report suggests that spinal cord stimulation may provide effective treatment for truncal CRPS after coronary artery bypass graft surgery.
The Environmentalitarian Situation
Authors: Hörl Erich
Published: August 2018

This contribution outlines several modes of becoming-environmental that characterize the development thanks to which environmentality [Umweltlichkeit] has become our condition today: the becoming-environmental of media, of power, of subjectivity, of world, of capital and of thinking. The process of cybernetization initiated around 1900—and the process of computerization since 1950 in particular—culminating in the becoming-environmental of computation, is to be understood as a time of environmentalization, that forces us into the new power/knowledge complex of Environmentality [Environmentalität] and that obliges us, as a line of flight, to rethink environmentality as such beyond its restricted actual forms. Accordingly, the key challenge for a general ecology of media and technology is to advance the critique of Environmentalization by developing an analysis of its restricted forms, first of all of the environmentalitarian Capital-Form, and to break through toward a speculative thinking of the environment and a new environmental image of thought.
Post-Postracial America
Authors: Landsberg Alison
Published: August 2018

A seismic shift in the racial landscape of the United States occurred in 2016. The prevailing discourse about a “postracial America,” though always, in the words of Catherine Squires a “mystique,” was firmly and finally extinguished with the election of Donald J. Trump. Race, in the form of racial prejudice, erupted in Trump’s political rhetoric and in the rhetoric of his supporters. At the same time, the continued significance and consequences of racial division in America were also being asserted for politically progressive ends by the increasingly prominent #blacklivesmatter movement and by the newly opened National Museum of African American History and Culture on the National Mall in Washington, DC, not far from the White House. This article tracks the resurgence of race in the US cultural landscape against the racially depoliticized myth of the “postracial” by focusing first on the HBO television series Westworld, which epitomizes that logic. The museum, which opened its doors against the backdrop of the presidential campaign, lodges a scathing critique of the very notion of the postracial; in fact, it signals the return of race as an urgent topic of national discussion. Part of the work of the museum is to materialize race, to move race and white supremacy to the center of the American national narrative. This article points to the way the museum creates what Jacques Rancière calls “dissensus,” and thus becomes a site of possibility for politics. The museum, in its very presence on the Mall, its provocative display strategies, and its narrative that highlights profound contradictions in the very meaning of America, intervenes in what Rancière calls “the distribution of the sensible” and thus creates the conditions for reconfiguring the social order. In part, it achieves this by racializing white visitors, forcing them to feel their own race in uncomfortable ways. The article suggests that this museum, and the broader emerging discourse about race in both film and television, offers new ways to think about the political work of culture.
Contribution to the knowledge of the geology of Attica. The Peninsula of Lomvarda (Zostir)
Authors: ΑΛΕΞΟΠΟΥΛΟΣ Α. , ΜΩΡΑΪΤΗ Ε.
Published: August 2018

In deposits of coherent, foliaceous marls, in Lomvarda's Peninsula (Attica), the biozones NN15 (Reticulofenestra Pseudoumbilica zone) till NN19 (Pseudoemiliania lacunosa zone) were determined, based on a rich calcareous nannoplankton fauna. These deposits are part of irregular alternations of reefal limestones, conglomerates, marls, and red sandstones. After the upper Pleistocene, an extensional faulting took place, created small grabbens and horsts. These events follow a compressional stage, which gave up mesoscopic folds. A numerous discontinuous (bedding planes, joins and faults) controls the shape of the coast. These discontinuities in combination with the different weathering degree of the various lithological units are responsible for the fallings rocks which take place along the steepness coast.
Revision of the geological map and 3D modelling of the geological structure of the Samaria Gorge Region, W. Crete
Authors: ΜΑΝΟΥΤΣΟΓΛΟΥ Ε. , ΣΠΥΡΙΔΩΝΟΣ Ε. , SOUJON Α. , JACOBSHAGEN V.
Published: August 2018

The island of Crete is situated near the front of an active plate margin. Therefore, it is of great interest in the framework of the International Continental Drilling Project (I.C.D.P.). A short review of the digital modelling methods, their applications in the geosciences and the associated advantages is also presented. The digital 3-dimensional geometric model of the geological structure of the Samaria Gorge region is based on the study of the stratigraphy and the tectonic evolution of the metamorphic rocks of the Plattenkalk group in SW Crete. Data from the geological map of Greece (Vatolakkos sheet, 1:50.000) and from the literature have been supplemented by geological mapping and structural analyses. In our study we applied interactive 3D CAD methods implemented in the integrated software package SURPAC2000. The surface geology has been draped over a digital elevation model of the topography in order to model the geometry of the subsurface structures. Two hypotheses about the geological structure of the region are examined: a) the one given by the existing geological map, which proposes a syncline structure and b) the one resulting from the combination of existing data, corrections carried out through repeated 3D simulations and new field observations. After distinguishing in the S of the study area the Trypali union, overthrusted on the Plattenkalk group, we propose an anticline structure with a NNE/SSW striking axis dipping to the NE.
The occurrence of the Internal Hellenides on Parnon mountain range, Centraleastern Peloponnesus
Authors: ΣΚΟΥΡΤΣΟΣ Ε. , ΑΛΕΞΟΠΟΥΛΟΣ Α. , ΖΑΜΠΕΤΑΚΗ-ΛΕΚΚΑ Α. , ΛΕΚΚΑΣ Σ.
Published: August 2018

Detailed mapping of the Parnon mountain range (centraleastern Peloponnesus) showed that over the already well-identified alpine units, which consist the principal mass of Peloponnesus, lies a clastic flysch-type formation, named by the authors as Glypia unit (nappe). This unit encounters in the broader area of Paleochori-Ag. Vasilios, west to the town of Leonidio. The northern margin of the exposure overlies tectonically the Upper Cretaceous limestones of Pindos unit whereas at the eastern, southern and western margins it overlies the Upper Cretaceous - Eocene limestones and the transitional to flysch formation of Tripolis unit through an normal fault. The principal flysch mass is consisted of reddish to brownish and greenish alterations of pelitic horizons, yellowish marly limestones and greenish coarse-grained sandstones. The grains of the latter have been derived from the erosion of a metamorphic exposure, most probably corresponding to 'Pelagonian' zone. After fossil determination, which took place on some of the horizons of the marly limestones, they turn out to be of Danian age. The occurrence of exotic blocks within the flysch matrix of the Glypia unit is quite often. They have derived from carbonate formations of Upper Cretaceous age with either pelagic or neritic character, carbonate formations of Permian age with a neritic character, dolomitic breccias, radiolarites, basaltic lavas along with reddish or greenish pelites and microbrecciated limestones of Upper Creataceous age and, coming to the end, serpentinites along with greenish pelites, sandstones and microbrecciated limestones of unknown age. The study of the tectonic fabric of the Glypia unit reveals an early compressional tectonic event, which has been overprinted by an intense extensional episode of NE-SW orientation. The latter has caused a significant thinning of the unit. The combination of the above mentioned data provides strong evidence, which integrates to the conclusion that the Glypia unit represents a similar unit either to the Ermioni complex in Argolis or to the nappe of Arvi and Miamou in Crete.
Asymmetric development of drainage networks as a factor for the recognition of neotectonic block rotation. The case of Stournarorema and Belesitsas basins (Fokida prefecture, Greece)
Authors: ΦΟΥΝΤΟΥΛΗΣ Ι. , ΦΟΥΜΕΛΗΣ Μ.
Published: August 2018

The aim of the present study is to ditect large scale neotectonic deformation in the wider area of Eratini (South Sterea region), by examining its drainage network, the planation surfaces and the structural contour map of the contact between Bardousia and Pindos geotectonic units. In particular we examined the asymmetry of Stournarorema and Belesitsas (tributary of Mornos river) basins. The main interest of this attempt was to reveal systematic orientation of the Tranverse Topographic Symmetry Vector 'T' as will as its geographic distribution. Thus we estimated the above asymmetry factor for the 3rd order streams of both basins and taking in consideration the influence of the tectonic structure and the lithology of the area to the estimated asymmetry values, we suggest a possible counterbalancing rotation of these basins along a horizontal axis of NE-SW direction
A study of the active tectonics and deformation in the Mygdonia basin (N. Greece) using seismological and neotectonic data
Authors: PAPAZACHOS C. B. , VAMVAKARIS D. A. , VARGEMEZIS G. N. , AIDONA E. V.
Published: August 2018

In the present work we study the active tectonics setting and related deformation scheme in the Mygdonia basin, on the basis of the joint interpretation of seismological and neotectonic data. For this reason, the stress field derived from fault plane solutions of small-magnitude events from a local seismological experiment, as well as neotectonic observations are studied in order to determine its spatial distribution. The results show an almost identical spatial variation of the stress field determined from the two independent data sets, which also exhibits a very good correlation with the geomorphological changes in the Mygdonia basin. Moreover, the average stress field is almost identical to the corresponding stress pattern determined from the 3 largest events in the study area for which reliable fault plane solutions are available. Using the combined stress pattern and the corresponding moment-rate tensors derived from both data sets, the active crustal deformation is studied for the most active sections of the Mygdonia basin system. The results show a N-S extension at an average rate of 3mm/ yr for the central part of the Mygdonia system, in very good agreement with the available geodetic results.
Arhaeological evidence for seismic activity in Butrinti (SW Albania)and neotectonics of the area
Authors: PAVLIDES S. , KOCIU S. , MUKELLI P. , HYSENl A. , ZOUROS N.
Published: August 2018

This is a preliminary study of the neotectonics and the historical seismic destruction imprinted on the archaeological site of Butrinti (SW Albania). Two fault sets surround and intersect both the limestone hill with the archaeological site and the area around it. A normal N-S trending fault is located along the NW of Butrinti hill with an observable length of 1 km and a maximum vertical displacement of 3-4m. The southern part of the hill is confined by a steep tectonic scarp, trending E-W to NE-SW, which represent the continuity of the transcurrent (right-lateral strike-slip) fault of Northern Corfu. Fault planes parallel to this fault have been observed inside the archaeological site. The continuous subsidence of part the ancient city, the presence of evaporates diapirs and their continuous vertical movement allows us to conclude that these faults are still active. Cracks crossing special foundation stone elements of archaeological buildings and other types of dislocation were the main criteria to evident seismic damage in this study. The catastrophes of the Hellenistic-Roman theatre of Butrinti and the surrounding monuments dated to the 3rd-4th century AD should be attributed to the seismic activity triggered by the reactivation of these faults during late Roman-early Byzantine time (358 AD). Another seismic event affecting Byzantine monuments is also probable (1153).
Structure and deformation history of Astypalea island, Aegean Sea
Authors: RING U.
Published: August 2018

Astypalea Island lies south of the Late Cretaceous to Eocene high-pressure belt of the Cyclades and north of the Miocene high-pressure belt of the External Hellenides. The rocks of the island belong to the Tripolitza unit. The latter unit occupies a critical tectonic position in Astypalea between the unmetamorphosed Tripolitza rocks in Crete and the high-pressure Basal unit, which is correlated to the Tripolitza unit, in the Cyclades. We have subdivided the deformation history of Astypalea Island into four events, D; through D4. The problem with interpreting the structural data is that the Di and D2 events cannot unequivocally be ascribed to horizontal crustal contraction or crustal shortening. In our interpretation, Dt caused top-S internal imbrication within the Tripolitza unit as a result of crustal shortening. We envision that this event occurred when the Phyllite-Quartzite and Plattenkalk units were underthrust beneath the Tripolitza unit in the Oligocene. D was probably associated with top-N extension and may be related to large-scale crustal extension across the Cretan detachment in the Early Miocene. D3 caused high-angle faulting due to E-W contraction and D4 was due to N-S extension.