bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Early‐Onset Ischemic Stroke: A Case‐Control Study
Authors: Kivioja Reetta , Pietilä Arto , Martinez‐Majander Nicolas , Gordin Daniel , Havulinna Aki S. , Salomaa Veikko , Aarnio Karoliina , Curtze Sami , Leiviskä Jaana , Rodríguez‐Pardo Jorge , Surakka Ida , Kaste Markku , Tatlisumak Turgut , Putaala Jukka 
Published: October 2018

Background

Recent studies have shown an increasing prevalence of vascular risk factors in young adults with ischemic stroke (
IS
). However, the strength of the association between all vascular risk factors and early‐onset
IS
has not been fully established.

Methods and Results

We compared 961 patients with a first‐ever
IS
at 25 to 49 years to 1403 frequency‐matched stroke‐free controls from a population‐based cohort study (
FINRISK
). Assessed risk factors included an active malignancy, atrial fibrillation, cardiovascular disease, current smoking status, a family history of stroke, high low‐density lipoprotein cholesterol, high triglycerides, low high‐density lipoprotein cholesterol, hypertension, and type 1 and type 2 diabetes mellitus. We performed subgroup analyses based on age, sex, and
IS
etiology. In a fully adjusted multivariable logistic regression analysis, significant risk factors for
IS
consisted of atrial fibrillation (odds ratio [OR], 10.43; 95% confidence interval [
CI
], 2.33–46.77], cardiovascular disease (OR, 8.01; 95%
CI
, 3.09–20.78), type 1 diabetes mellitus (OR, 6.72; 95%
CI
, 3.15–14.33), type 2 diabetes mellitus (OR, 2.31; 95%
CI
, 1.35–3.95), low high‐density lipoprotein cholesterol (OR, 1.81; 95%
CI
, 1.37–2.40), current smoking status (OR, 1.81; 95%
CI
, 1.50–2.17), hypertension (OR, 1.43; 95%
CI
, 1.17–1.75), and a family history of stroke (OR, 1.37; 95%
CI
, 1.04–1.82). High low‐density lipoprotein cholesterol exhibited an inverse association with
IS
. In the subgroup analyses, the most consistent associations appeared for current smoking status and type 1 diabetes mellitus.

Conclusions

Our study establishes the associations between 11 vascular risk factors and early‐onset
IS
, among which atrial fibrillation, cardiovascular disease, and both type 1 and 2 diabetes mellitus in particular showed strong associations.
Association of Blood Pressure and Arterial Stiffness With Cognition in 2 Population‐Based Child and Adult Cohorts
Authors: Lamballais Sander , Sajjad Ayesha , Leening Maarten J. G. , Gaillard Romy , Franco Oscar H. , Mattace‐Raso Francesco U. S. , Jaddoe Vincent W. V. , Roza Sabine J. , Tiemeier Henning , Ikram M. Arfan 
Published: October 2018

Background
High blood pressure levels and higher arterial stiffness have been shown to be associated with lower cognition during adulthood, possibly by accumulative changes over time. However, vascular factors may already affect the brain during early life.

Methods and Results
We examined the relation between cognition and vascular factors within 5853 children from the Generation R Study (mean age 6.2 years) and 5187 adults from the Rotterdam Study (mean age 61.8 years). Diastolic and systolic blood pressure and arterial stiffness were assessed, the latter by measuring pulse‐wave velocity and pulse pressure. For cognition, the Generation R Study relied on nonverbal intelligence, whereas the Rotterdam Study relied on a cognitive test battery to calculate the g‐factor, a measure of global cognition. In the Generation R Study, standardized diastolic blood pressure showed a significant association with standardized nonverbal intelligence (β=−0.030, 95% confidence interval=[−0.054; −0.005]) after full adjustment. This association held up after excluding the top diastolic blood pressure decile (β=−0.042 [−0.075; −0.009]), suggesting that the relation holds in normotensives. Within the Rotterdam Study, standardized cognition associated linearly with standardized systolic blood pressure (β=−0.036 [−0.060; −0.012]), standardized pulse‐wave velocity (β=−0.064 [−0.095; −0.033]), and standardized pulse pressure (β=−0.044 [−0.069; −0.020], and nonlinearly with standardized diastolic blood pressure (quadratic term β=−0.032 [−0.049; −0.015]) after full adjustment.

Conclusions
Blood pressure and cognition may already be related in the general population during early childhood, albeit differently than during adulthood.
The Metaphysical, Epistemological, and Mystical Aspects of Happiness in the Treatise on Ultimate Happiness Attributed to Moses Maimonides
Authors: Elqayam Avi 
Published: October 2018

Abstract
This article explores the metaphysical, epistemological, and mystical aspects of happiness in the Judeo-Arabic Treatise on Ultimate Happiness (Kitāb as-Saʿāda al-Ākhira), of which only two chapters have survived from what is thought to have been a more comprehensive text. Although the treatise is attributed to Moses Maimonides, the conception of happiness (saʿāda) it presents is clearly that of the Pietists (Ḥasīdīm), the Jewish-Sufi circle of thirteenth-century Egypt. The discussion of happiness in this short treatise constitutes an important chapter in the philosophical and mystical discourse about happiness in medieval Jewish-Islamic thought, especially within the Jewish-Sufi mystical stream led by Maimonides’s descendants.
Prevalence of Minor Larynx Structural Alterations: Influence on the Concept of a Normal Vocal Fold
Authors: Moraes Bruno Teixeira , De Biase Noemi Grigoletto 
Published: October 2018

ObjectiveTo determine the prevalence of minor structural alterations (MSA) in the vocal fold cover in a population submitted to extralaryngeal site surgery and to characterize them according to morphological and epidemiological parameters.Study DesignThis was a cross‐sectional and observational study.SettingTertiary referral medical center.Subjects and MethodsA total of 147 patients underwent general anesthesia for extralaryngeal site surgery indicated for a procedure extraneous to the study and irrespective of the presence of vocal complaint. Next, detection and morphological characterization of MSAs in the vocal fold cover were performed by means of suspension microlaryngoscopy with laryngeal inspection and palpation without surgical intervention related to this procedure. The laryngeal findings were compared with variables from a clinical and demographic characteristics questionnaire given to these individuals.ResultsA 21.1% prevalence of MSAs was identified in the sample, which included a majority of individuals without vocal complaint (95.9%). Of these, 5.4% of individuals had laryngeal microdiaphragms, 16.3% sulcus vocalis, and 4.1% epidermoid cysts. No pouch sulcus or mucosal bridges were found. The identification of these alterations occurred mainly after 10 years of age, without effects of sex, vocal abuse, or upper airway conditions. The most common combination of MSAs was bilateral sulcus vocalis.ConclusionsThe prevalence of MSAs in laryngeal coverage in this predominantly vocally asymptomatic population was 21.1%, with identification of sulcus vocalis, epidermoid cyst, and laryngeal microdiaphragm. Age was the only clinical or demographic characteristic associated with these alterations.
Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review
Authors: Casazza Geoffrey , Graham M. Elise , Nelson Douglas , Chaulk David , Sandweiss David , Meier Jeremy 
Published: October 2018

ObjectiveTo review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis.Study DesignCase series with literature review.SettingTertiary children's hospital and available literature.Subjects and MethodsCase series of children with bacterial tracheitis retrospectively reviewed at a tertiary children's hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded.ResultsThirty‐six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin‐sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation.ConclusionBacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time.
Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography
Authors: Weinberg Aaron S. , Chang William , Ih Grace , Waxman Alan , Tapson Victor F. 
Published: October 2018

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.
Growing international evidence for urinary biomarker panels identifying lupus nephritis in children – verification within the South African Paediatric Lupus Cohort
Authors: Smith E M D , Lewandowski L B , Jorgensen A L , Phuti A , Nourse P , Scott C , Beresford M W 
Published: October 2018

Background A urinary biomarker panel including alpha-1-acid-glycoprotein (AGP), lipocalin-like-prostaglandin-D-synthase (LPGDS), transferrin and ceruloplasmin demonstrates an ‘excellent’ ability for identifying active lupus nephritis in UK/US children. This study aimed to assess whether this panel identifies active lupus nephritis within the South African Paediatric Lupus Cohort. Methods Juvenile-onset-systemic lupus erythematosus (JSLE) patients aged < 19 years at diagnosis and healthy controls were recruited. Patients were categorized as having active lupus nephritis (renal BILAG score; A/B and previous histological confirmation) or inactive lupus nephritis (renal BILAG score: D/E). Urinary biomarkers were quantified by ELISA. Mann–Whitney U-test compared biomarker levels between groups. Binary logistic regression and receiver operating curve analysis assessed biomarker combinations. Results Twenty-three juvenile-onset-systemic lupus erythematosus patients were recruited with a median age of 13.5 years (interquartile range (IQR) 12.7–14.9) and disease duration of 2.6 years (IQR 1.8–4.0). Eighteen healthy controls had a median age of 11.0 years (IQR 10.0–12.0). AGP, LPGDS, transferrin, ceruloplasmin and VCAM-1 were significantly higher in active than in inactive lupus nephritis patients (corrected p-values, all pc < 0.05), with no difference between inactive lupus nephritis patients and healthy controls (all pc = 1.0). The optimal biomarker combination included AGP, ceruloplasmin, LPGDS and transferrin (area under the curve = 1.0). Conclusions A urinary biomarker panel comprising AGP, ceruloplasmin, LPGDS and transferrin previously validated within UK/US cohorts also performed excellently within a racially distinct South African cohort which displayed more severe lupus nephritis.
Estimation of annual probabilities of changing disability levels in Australians with relapsing-remitting multiple sclerosis
Authors: Ahmad Hasnat , van der Mei Ingrid , Taylor Bruce V , Lucas Robyn M , Ponsonby Anne-Louise , Lechner-Scott Jeannette , Dear Keith , Valery Patricia , Clarke Philip M , Simpson Steve , Palmer Andrew J 
Published: October 2018

Background: Transition probabilities are the engine within many health economics decision models. However, the probabilities of progression of disability due to multiple sclerosis (MS) have not previously been estimated in Australia. Objectives: To estimate annual probabilities of changing disability levels in Australians with relapsing-remitting MS (RRMS). Methods: Combining data from Ausimmune/Ausimmune Longitudinal (2003–2011) and Tasmanian MS Longitudinal (2002–2005) studies ( n = 330), annual transition probabilities were obtained between no/mild (Expanded Disability Status Scale (EDSS) levels 0–3.5), moderate (EDSS 4–6.0) and severe (EDSS 6.5–9.5) disability. Results: From no/mild disability, 6.4% (95% confidence interval (CI): 4.7–8.4) and 0.1% (0.0–0.2) progressed to moderate and severe disability annually, respectively. From moderate disability, 6.9% (1.0–11.4) improved (to no/mild state) and 2.6% (1.1–4.5) worsened. From severe disability, 0.0% improved to moderate and no/mild disability. Male sex, age at onset, longer disease duration, not using immunotherapies greater than 3 months and a history of relapse were related to higher probabilities of worsening. Conclusion: We have estimated probabilities of changing disability levels in Australians with RRMS. Probabilities differed between various subgroups, but due to small sample sizes, results should be interpreted with caution. Our findings will be helpful in predicting long-term disease outcomes and in health economic evaluations of MS.
Apoptotic PET Imaging of Rat Pulmonary Fibrosis With [18F]ML-8
Authors: Xiong Ying , Nie Dahong , Liu Shaoyu , Ma Hui , Su Shu , Sun Aixia , Zhao Jing , Zhang Zhanwen , Xiang Xianhong , Tang Ganghua 
Published: October 2018

Objective: To investigate the value of 2-(3-[18F]fluoropropyl)-2-methyl-malonic acid ([18F]ML-8) positron emission tomography (PET) imaging of rat pulmonary fibrosis. Methods: Male Sprague-Dawley rats were divided into 2 groups, including pulmonary fibrosis model group and control group. The rat model was established by an intratracheal instillation of bleomycin (BLM). Control rats were treated with saline. Positron emission tomography/computed tomography (CT) with [18F]ML-8 or 18F-fluorodeoxyglucose ([18F]FDG) was performed on 2 groups. After PET/CT imaging, lung tissues were collected for histologic examination. Data were analyzed and comparisons between 2 groups were performed using Student t test. Results: Bleomycin-treated rats showed a higher lung uptake of [18F]ML-8 than control rats ( P < .05). In BLM-treated rats, the lung to muscle relative uptake ratio of [18F]ML-8 was also higher than that of [18F]FDG ( P < .05). Pathological examination showed overproliferation of fibroblasts and deposition of collagen in lungs from BLM-treated rats. Compared to control rats, BLM-treated rats had higher lung hydroxyproline content ( P < .05). Immunofluorescence staining indicated more apoptotic cells in BLM-treated rats than those in control rats. Moreover, the apoptosis rate of lung tissues obtained from BLM-treated rats was higher than that from control rats ( P < .05). Conclusions: 2-(3-[18F]fluoropropyl)-2-methyl-malonic acid PET/CT could be used for noninvasive diagnosis of pulmonary fibrosis in a rat model.
Enlivening a Community of Authentic Scholarship
Authors: West Christina H. , Rieger Kendra L. , Chooniedass Rishma , Adekoya Adebusola A. , Isse Anisa A. R. , Karpa Jane V. , Waldman Celeste , Peters-Watral Brenda , Chernomas Wanda M. , Scruby Lynn S. , Martin Donna E. 
Published: October 2018

Background: Critical and engaged qualitative scholarship depends on high-quality graduate training. The need to reexamine graduate student mentorship has become particularly pressing, given the high level of mental health distress experienced by students. It is unclear whether mentorship emerging within the student–advisor relationship is sufficient to ensure comprehensive mentorship. Innovative, experiential pedagogical approaches that integrate emotional and intellectual aspects are limited but may play a vital role in mentorship. There is a critical need to develop and study creative mentorship initiatives for emerging qualitative scholars. Methods: This study used interpretive description methodology and a community of practice theoretical framework to describe a faculty-mentored experience for graduate nursing students at the 2016 Qualitative Health Research Conference (FM-QHR) hosted by the International Institute for Qualitative Methodology. Participants completed written journals elucidating their experiences throughout FM-QHR. The textual data were analyzed using a constant comparative group analysis process, leading to the development of salient and interconnected themes. Results: Six graduate students and four faculty mentors submitted journals. Three interrelated themes articulate how this FM-QHR initiative enlivened a community of authentic scholarship: Questioning the Academic Self: Unvoiced Experiences of Angst, Uncertainty, and Fear; Cocreating Authentic Community through Shared Vulnerability; and Generative and Emergent Empowerment. Conclusion: These findings provide compelling insights into the importance of assisting students to navigate the emotional experiences that are a part of qualitative graduate training. Relational, mentorship initiatives hold potential to not only alleviate emotional distress but also support student empowerment, socialization, and entrance into a community of international qualitative researchers.
Sex-related response to bivalirudin and unfractionated heparin in patients with acute myocardial infarction undergoing percutaneous coronary intervention: A subgroup analysis of the VALIDATE-SWEDEHEART trial
Authors: Venetsanos D , Sederholm Lawesson S , Fröbert O , Omerovic E , Henareh L , Robertsson L , Linder R , Götberg M , James S , Alfredsson J , Erlinge D , Swahn E 
Published: October 2018

Aims: Our aim was to study the impact of sex on anticoagulant treatment outcomes during percutaneous coronary intervention in acute myocardial infarction patients. Methods: This study was a prespecified analysis of the Bivalirudin versus Heparin in ST-Segment and Non ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated according to Recommended Therapies Registry Trial (VALIDATE-SWEDEHEART) trial, in which patients with myocardial infarction were randomised to bivalirudin or unfractionated heparin during percutaneous coronary intervention. The primary outcome was the composite of death, myocardial infarction or major bleeding at 180 days. Results: There was a lower risk of the primary outcome in women assigned to bivalirudin than to unfractionated heparin (13.6% vs 17.1%, hazard ratio 0.78, 95% confidence interval (0.60–1.00)) with no significant difference in men (11.8% vs 11.2%, hazard ratio 1.06 (0.89–1.26), p for interaction 0.05). The observed difference was primarily due to lower risk of major bleeding (Bleeding Academic Research Consortium definition 2, 3 or 5) associated with bivalirudin in women (8.9% vs 11.8%, hazard ratio 0.74 (0.54–1.01)) but not in men (8.5% vs 7.3%, hazard ratio 1.16 (0.94–1.43) in men, p for interaction 0.02). Conversely, no significant difference in the risk of Bleeding Academic Research Consortium 3 or 5 bleeding, associated with bivalirudin, was found in women 4.5% vs 5.4% (hazard ratio 0.84 (0.54–1.31)) or men 2.9% vs 2.1% (hazard ratio 1.36 (0.93–1.99)). Bleeding Academic Research Consortium 2 bleeding occurred significantly less often in women assigned to bivalirudin than to unfractionated heparin. The risk of death or myocardial infarction did not significantly differ between randomised treatments in men or women. Conclusion: In women, bivalirudin was associated with a lower risk of adverse outcomes, compared to unfractionated heparin, primarily due to a significant reduction in Bleeding Academic Research Consortium 2 bleeds.
Comparison of early postoperative pain after partial tumour nephrectomy by flank, transabdominal or laparoscopic access
Authors: Hager Boris , Herzog Sereina A , Hager Barbara , Sandner-Kiesling Andreas , Zigeuner Richard , Pummer Karl 
Published: October 2018

Aim:To explore whether the total pain experience differs after (partial) kidney tumour nephrectomies via flank, transabdominal or laparoscopic access.Materials and methods:We analyzed retrospectively 107 patients with flank, 12 with transabdominal and 21 with laparoscopic interventions. For pain treatment, conventional analgesics (A) or intravenous patient-controlled analgesia (PCIA) or thoracic peridural analgesia (tPDA) were used. Self-reported pain was measured with a Visual Analogue Scale three times daily. The area under the curve (AUC) at rest (R) and during a standardized body movement (M) were calculated from the intervention till the end of the second T(0–2) and seventh postoperative day T(0–7), respectively.Results:The median AUC for T(0–2) at R was more intense for laparoscopy (13) than for flank incision (A, 9) and approximately the same during M. For flank incisions (A), the median AUC at R rises from 9 for T(0–2) to 22 for T(0–7) and at M the median AUC increases from 18 to 37. In contrast, laparoscopy did not cause further pain after the second postoperative day. Furthermore, with flank incision for T(0–2), at R, tPDA was superior to A (median AUC: 5 versus 9, p = 0.02) and at M again tPDA (median AUC: 12) had a better pain-control as A (18) or even as PCIA (19, p = 0.005).Conclusion:Laparoscopic nephrectomies cause a relatively intense mean cumulative pain for T(0–2) and a subsequent absence of pain. However, flank incisions went on to increased pain levels until the seventh postoperative day with tPDA as most effective therapy.