bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Profile of Acute Myocardial Infarction Patients Included in the Hospital Readmissions Reduction Program
Authors: Martin Lila M. , Januzzi James L. , Thompson Ryan W. , Ferris Timothy G. , Singh Jagmeet P. , Bhambhani Vijeta , Wasfy Jason H. 
Published: September 2018

Background
Medicare's Hospital Readmissions Reduction Program assesses financial penalties to hospitals based on risk‐standardized readmission rates after specific episodes of care, including acute myocardial infarction. Detailed information about the type of patients included in the penalty is unknown.

Methods and Results

Starting with administrative data from Medicare, we conducted physician‐adjudicated chart reviews of all patients considered 30‐day readmissions after acute myocardial infarction from July 2012 to June 2015. Of 197 readmissions, 68 (34.5%) received percutaneous coronary intervention and 18 (9.1%) underwent coronary artery bypass grafting on index hospitalization. The remaining 111 patients did not receive any intervention. Of the 197 patients, 56 patients (28.4%) were considered too high risk for invasive management, 23 (11.7%) had nonobstructive coronary artery disease on diagnostic catheterization and therefore no indication for revascularization, 19 patients had a type
II
myocardial infarction (9.6%) for which noninvasive, outpatient workup was recommended, and 13 (6.6%) declined further care. The most common readmission diagnoses were cardiac causes and noncardiac chest discomfort, infection, and gastrointestinal bleeding.

Conclusions

Our results demonstrate that more than a quarter of the patients included in the penalty do not receive revascularization either because of provider assessment of risk or patient preference, and nearly one tenth have type
II
myocardial infarction. As such, administrative codes for prohibitive procedural risk, patient‐initiated “do not resuscitate” status, or type
II
myocardial infarction may improve the risk‐adjustment of the metric. Furthermore, provider organizations seeking to reduce readmission rates should focus resources on the needs of these patients, such as care coordination, hospice services when requested by patients, and treatment of noncardiac conditions.
Genetic and Phenotypic Characterization of Community Hospital Patients With QT Prolongation
Authors: Gibbs Charlotte , Thalamus Jacob , Tveten Kristian , Busk Øyvind L. , Hysing Jan , Haugaa Kristina H. , Holla Øystein L. 
Published: September 2018

Background

Congenital long‐
QT
syndrome (
LQTS
) is a genetic disorder characterized by prolongation of the corrected
QT
interval (
QT
c) on an
ECG
. The aim of the present study was to estimate the prevalence of pathogenic and likely pathogenic sequence variants in patients who had at least 1
ECG
with a
QT
c ≥500 ms.

Methods and Results

Telemark Hospital Trust is a community hospital within the Norwegian national health system, serving ≈173 000 inhabitants. We searched the
ECG
database at Telemark Hospital Trust, Norway, from January 2004 to December 2014, and identified 1531 patients with at least 1
ECG
with a
QT
c ≥500 ms. At the time of inclusion in this study (2015), 766 patients were alive. A total of 733 patients were invited to participate, and 475 accepted. The 17 genes that have been reported to cause monogenic LQTS were sequenced among the patients. Pro‐
QT
c score was calculated for each patient. A molecular genetic cause of
LQTS
was detected in 31 (6.5%) of 475 patients. These patients had a lower pro‐
QT
c score than those without pathogenic or likely pathogenic variants (1.7±1.0 versus 2.8±1.6;
P
<0.001).

Conclusions

Compared with the general population, hospitalized patients with a
QT
c ≥500 ms in at least 1
ECG
recording had an increased likelihood for pathogenic and likely pathogenic variants in
LQTS
genes. We recommend increased awareness of the possibility of
LQTS
in patients with at least 1
ECG
with a
QT
c ≥500 ms.
Property and Social Relations in Mughal India: Litigations and Disputes at the Qazi’s Court in Urban Localities, 17th-18th Centuries
Authors: Hasan Farhat 
Published: September 2018

AbstractCritiquing the commodity-centered frames of reference, this paper looks at property not within an economic logic, but as a set of practices that served to structure and reconfigure social relations. Based on a study of property documents and court papers, the essay argues that property was not simply an index of wealth, but a medium through which social relations were affirmed, reproduced and contested. Owing to the identification of property with the honor of families and caste groups, transactions in property were socially regulated activities that bore the imprint of local power relations. Property documents were imbued with a plethora of meanings, and this was because the scribal-literate tradition in Mughal India co-existed with an oral-performative culture. Writing was used by social actors in a wide variety of ways, and for different sets of objectives, sometimes to reinforce the social order, on other occasions to disrupt it.
Simulated Dust Aerosol Impacts on Western Sahelian Rainfall: Importance of Ocean Coupling
Authors: Jordan Asha K. , Gnanadesikan Anand , Zaitchik Benjamin 
Published: September 2018

AbstractNorth Africa is the world’s largest source of mineral dust, and this dust has potentially significant impacts on precipitation. Yet there is no consensus in published studies regarding the sign or magnitude of dust impacts on rainfall in either the highly climate-sensitive Sahel region of North Africa or the neighboring tropical Atlantic Ocean. Here the Geophysical Fluid Dynamics Laboratory (GFDL) Climate Model 2 (GFDL CM2.0) with Modular Ocean Model, version 4.1 (MOM4.1), run at coarse resolution (CM2Mc) is applied to investigate one poorly characterized aspect of dust–precipitation dynamics: the importance of sea surface temperature (SST) changes in mediating the atmospheric response to dust. Two model experiments were performed: one comparing Dust-On to Dust-Off simulations in the absence of ocean–atmosphere coupling, and the second comparing Dust-On to Dust-Off with the ocean fully coupled. Results indicate that SST changes in the coupled experiment reduce the magnitude of dust impacts on Sahel rainfall and flip the sign of the precipitation response over the nearby ocean. Over the Sahel, CM2Mc simulates a net positive impact of dust on monsoon season rainfall, but ocean–atmosphere coupling in the presence of dust decreases the inflow of water vapor, reducing the amount by which dust enhances rainfall. Over the tropical Atlantic Ocean, dust leads to SST cooling in the coupled experiment, resulting in increased static stability that overrides the warming-induced increase in convection observed in the uncoupled experiment and yields a net negative impact of dust on precipitation. These model results highlight the potential importance of SST changes in dust–precipitation dynamics in North Africa and neighboring regions.
A Decade of Ocean Changes Impacting the Ice Shelf of Petermann Gletscher, Greenland
Authors: Washam P. , Münchow A. , Nicholls K. W. 
Published: September 2018

AbstractHydrographic data collected during five summer surveys between 2002 and 2015 reveal that the subsurface ocean near Petermann Gletscher, Greenland, warmed by 0.015° ± 0.013°C yr−1. New 2015–16 mooring data from beneath Petermann Gletscher’s ice shelf imply a continued warming of 0.025° ± 0.013°C yr−1 with a modest seasonal signal. In 2015, we measured ocean temperatures of 0.28°C near the grounding line of Petermann Gletscher’s ice shelf, which drove submarine melting along the base of the glacier. The resultant meltwater contributed to ocean stratification, which forced a stronger geostrophic circulation at the ice shelf terminus compared with previous years. This increased both the freshwater flux away from the sub–ice shelf cavity and the heat flux into it. Net summertime geostrophic heat flux estimates into the sub–ice shelf cavity exceed the requirement for steady-state melting of Petermann Gletscher’s ice shelf. Likewise, freshwater fluxes away from the glacier exceed the expected steady-state meltwater discharge. These results suggest that the warmer, more active ocean surrounding Petermann Gletscher forces “non steady state” melting of its ice shelf. When sustained, such melting thins the ice shelf.
Multiple Personality Disorder and Criminal Responsibility: Critique of a Paper by Elyn Saks
Authors: Piper August 
Published: September 2018

This article critiques a recent essay that argues that patients who have multiple personality disorder (MPD) are not legally responsible for any crimes they commit: the simple finding that the accused has MPD is sufficient to exonerate him or her. The present article makes the following points: first, the cause of MPD is unknown, despite claims to the contrary made by the disorder's proponents. Second, the central features of MPD are ill-defined: for example, the definition of the word “personality” is ambiguous and unsatisfactory. Third, this vagueness makes it impossible to differentiate MPD from numerous other psychiatric conditions; this inability is probably responsible for the epidemic of MPD cases currently seen in the United States. Such imprecision also makes it impossible to distinguish between true and false MPD cases, raising concern that accused individuals will malinger MPD in an effort to avoid criminal responsibility. Fourth, good evidence exists that MPD patients have control over at least some manifestations of the disorder, such as personality switching. The article concludes that adopting the position taken in the essay would have serious adverse consequences for both the law and psychiatry.
Retractors of false memories: The evolution of pseudo-memories
Authors: Lief Harold I. , Fetkewicz Janet 
Published: September 2018

The formation of pseudomemories and the subsequent methods used by subjects to eventually distinguish between true and false memories are the primary foci of this study. A survey instrument was distributed to 100 “retractors” after an initial telephone interview with False Memory Syndrome Foundation (FMSF) staff. Forty respondents (40% of the subjects) who returned the questionnaire comprise our study population. The survey inquired about personal and family information, events surrounding the subject's accusations of sexual abuse, childhood history, and the subject's reflections on his or her experience. The process of the development of pseudomemories is highlighted. Subjects also described their feelings and experiences in open-ended questions, including their subjective experience as memories evolved, factors influencing thoughts, feelings and doubts, the process of questioning memories, the process of restoring relationships with family members, and uncertainties about views of memories currently held. We focus on the evolution of pseudomemories, especially the influence of the therapist; we explore the nature of therapy, one that makes an ill patient much worse and that eventually becomes so onerous that patients who still have some remaining reality-testing flee from therapy.
Increased circulating levels of tumor necrosis factor-like cytokine 1A and decoy receptor 3 correlate with SYNTAX score in patients undergoing coronary surgery
Authors: Li Xin-Ya , Hou Hai-Tao , Chen Huan-Xin , Wang Zheng-Qing , He Guo-Wei 
Published: September 2018

Objective Chronic inflammation of the arteries is a critical mechanism responsible for coronary atherosclerosis. We aimed to determine if tumor necrosis factor (TNF)-like cytokine 1A (TL1A) and decoy receptor 3 (DcR3) were involved in promoting atherosclerosis. Methods We compared plasma levels of TL1A and DcR3 in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (n=40) and patients without CAD group (n=37, normal coronary artery angiogram) by enzyme-linked immunosorbent assay. We also analyzed the correlation between CAD and SYNTAX scores. Results Plasma levels of TL1A and DcR3 were significantly higher in the CAD compared with the no-CAD group. Multivariate analysis showed that TL1A and DcR3 were significantly correlated with the presence of CAD, and receiver operating characteristic curve analysis indicated that both TL1A and DcR3 showed high sensitivity and specificity for diagnosing CAD. Furthermore, TL1A was positively and significantly correlated with SYNTAX score in CAD patients. Conclusions CAD patients requiring coronary artery bypass grafting have high circulating levels of both TL1A and DcR3, which may thus be useful biomarkers for diagnosing severe CAD. Furthermore, plasma levels of TL1A correlate with SYNTAX score, supporting its potential use as an indicator of the severity of CAD.
Ectopic transglutaminase 1 and 3 expression accelerating keratinization in oral lichen planus
Authors: Shimada Katsumitsu , Ochiai Takanaga , Hasegawa Hiromasa 
Published: September 2018

Objective Oral lichen planus (OLP) characterized by interface mucositis frequently shows hyper-keratinization. To clarify mechanisms of excess keratinization, we investigated key molecules for cornified cell envelope (CE). Methods Involucrin (IVL), loricrin (LOR), transglutaminase 1 (TGase 1) and transglutaminase 3 (TGase 3) were immunohistochemically examined in 20 specimens of OLP; five specimens of buccal mucosa served as controls. Subsequently, the data were statistically analyzed. Results IVL in OLP was localized in the cell membrane, in contrast to its localization in the cytoplasm in controls. No positive reaction indicative of LOR was noted in any specimens. Although the TGase 1 localization in controls was restricted to the upper three-quarters of the membrane, the localization in OLP was in both membrane and in the cytoplasm of full thickness mucosal layers. The TGase 3 localization pattern was dramatically altered from cytoplasmic to membranous in OLP. Conclusion Our data suggest that aberrant TGase 1 and TGase 3 localization and distribution are closely related to hyper-keratinization in OLP. This is the first report of ectopic transglutaminase localization in OLP.
Facial solitary morphea profunda presenting with painful trigeminal neuropathy: A case report
Authors: Moreno-Ajona David , Moreno-Artero Ester , García de Eulate María Reyes , Irimia Pablo , España Agustín 
Published: September 2018

Background Localized facial scleroderma usually presents as frontal linear morphea or progressive hemifacial atrophy. Only isolated cases of trigeminal painful neuropathy have been described. Case report A 43-year-old woman developed an oval lesion on the right cheek. After 1 year, she noticed constant “pulling” pain and episodes of lancinating pain, both spontaneous and triggered by chewing and cold drinks. She was diagnosed with solitary morphea profunda and CT scan, ultrasonography, cranial MRI and biopsy were completed. Methylprednisolone (1 gr/day for 3 days) was prescribed. For pain, gabapentin, oxcarbazepine, amitryptiline, pregabalin and eslicarbacepine were all ineffective. A capsaicin patch was placed with prolonged benefit. Later on, the pain slightly worsened; occipital blockade was effective and methotrexate was recommended. Conclusion This is the first case of solitary morphea profunda associated with painful trigeminal neuropathy. Treatment should include immunosuppressants and treatment of neuropathic pain, in which local therapies seem particularly beneficial.
Synovial Mesenchymal Stem Cells Derived From the Cotyloid Fossa Synovium Have Higher Self-renewal and Differentiation Potential Than Those From the Paralabral Synovium in the Hip Joint
Authors: Murata Yoichi , Uchida Soshi , Utsunomiya Hajime , Hatakeyama Akihisa , Nakashima Hirotaka , Chang Angela , Sekiya Ichiro , Sakai Akinori 
Published: September 2018

Background: Several studies have shown the relationship between poorer clinical outcomes of arthroscopic femoroacetabular impingement syndrome surgery and focal chondral defects or global chondromalacia/osteoarthritis. Although recent studies described good outcomes after the conjunctive application of synovial mesenchymal stem cells (MSCs), none demonstrated the application of synovial MSCs for cartilaginous hip injuries. Purpose: To compare the characteristics of MSCs derived from the paralabral synovium and the cotyloid fossa synovium and determine which is the better source. Study Design: Controlled laboratory study. Methods: Synovium was harvested from 2 locations of the hip—paralabral and cotyloid fossa—from 18 donors. The number of cells, colony-forming units, viability, and differentiation capacities of adipose, bone, and cartilage were collected and compared between groups. In addition, real-time polymerase chain reaction was used to assess the differentiation capacity of adipose, bone, and cartilage tissue from both samples. Results: The number of colonies and yield obtained at passage 0 of synovium from the cotyloid fossa was significantly higher than that of the paralabral synovium ( P < .01). In adipogenesis experiments, the frequency of detecting oil red O–positive colonies was significantly higher in the cotyloid fossa than in the paralabral synovium ( P < .05). In osteogenesis experiments, the frequency of von Kossa and alkaline phosphatase positive colonies was higher in the cotyloid fossa synovium than in the paralabral synovium ( P < .05). In chondrogenic experiments, the chondrogenic pellet culture and the gene expressions of COL2a1 and SOX9 were higher in the cotyloid fossa synovium than in the paralabral synovium ( P < .05). Conclusion: MSCs from the cotyloid fossa synovium have higher proliferation and differentiation potential than do those from the paralabral synovium and are therefore a better source. Clinical Relevance: Synovial cells from the cotyloid fossa synovium of patients with femoroacetabular impingement syndrome are more robust in vitro, suggesting that MSCs from this source may be strongly considered for stem cell therapy.
Changes in Throwing Arm Mechanics at Increased Throwing Distances During Structured Long-Toss
Authors: Dowling Brittany , McNally Michael P. , Laughlin Walter A. , Onate James A. 
Published: September 2018

Background: Elbow injuries among adolescent baseball players have been outpacing those of college and professional players. In attempts to prevent injuries and maximize return-to-play potential following injury, attention has been focused on “return to throw” programs, which include long-toss throws. Because the few studies that were conducted on long-toss throwing focused primarily on college-aged athletes, it is not known what type of load is incurred at the elbow during interval throwing progression among high school baseball players. Purpose: To quantify the change in arm slot, arm speed, shoulder external rotation, and elbow varus torque across increasing throwing distances within a given athlete. Study Design: Descriptive laboratory study. Methods: Ninety-five high school baseball players performed a long-toss protocol while wearing an inertial sensor and sleeve. Each participant was tested for 5 throws at distances of 9 m, 18 m, 27 m, 37 m, and 46 m. Linear mixed-effects models and likelihood ratio tests were used to estimate the within-participant relationship between throw distance and arm slot, arm speed, shoulder external rotation, and elbow varus torque. Results: Arm slot ( P < .01), arm speed ( P < .01), shoulder external rotation ( P < .01), and elbow varus torque ( P < .01) were significantly associated with long-toss throw distance. As the throw distance increased, there was an increase in arm speed and shoulder external rotation and a decrease in arm slot for each distance. However, elbow varus torque increased with each distance up to 37 m and then remained the same at 46 m. Conclusion: The use of longer distances for conditioning and rehabilitation may be beneficial in increasing shoulder range of motion and arm speed; however, precaution needs to be taken, as throwing longer distances are accompanied by an increase in arm rotation, arm speed, and elbow torque, with a decrease in arm slot. Clinical Relevance: Return-to-throw programs have been utilized by sports medicine clinicians and coaches to help guide a player during rehabilitation. These programs involve throwing at increased efforts through increased distances with no immediate feedback on elbow stress. This investigation describes arm biomechanical changes during submaximum interval throwing and demonstrates a tool that can be utilized to measure arm stress in real time for clinicians and athletes progressing through an interval throwing program.
Implementation of a Direct Oral Anticoagulation Screening Service at a Large Academic Medical Center Provided by a Pharmacist-managed Antithrombosis Clinic as a Method to Expand Antithrombotic Stewardship Efforts
Authors: Uppuluri Ellen M. , McComb Meghan N. , Shapiro Nancy L. 
Published: September 2018

Background: How and when to monitor direct oral anticoagulants (DOACs) for safety and efficacy is a question many anticoagulation clinics are trying to answer. A pharmacist-led antithrombosis clinic (ATC) initiated a clinical service to provide oversight for all prescribed DOACs. Objective: Describe the implementation and outcomes of a DOAC screening service. Methods: The service was initiated utilizing a daily electronic prescribing report of DOAC prescriptions. Prescriptions were reviewed by clinical pharmacists to assess patient insurance, eligibility, and accuracy of prescribed doses. Results: In the first year since service implementation in April 2016, 317 new prescriptions and 595 refill prescriptions were reviewed. A DOAC service pharmacist was able to reach 125 (39.4%) of 317 patients about their new prescription and 59 (9.9%) of 595 refill patients to provide education and follow-up on management as needed. Interventions were performed for 79 (28%) of 317 new prescriptions and 86 (14.5%) of 595 refill prescriptions. Common interventions with new prescriptions include contacting the prescriber for a medication or dose change (25.4%), assistance with medication access (21.5%), and coordinating appropriate lab and provider follow up (21.5%). Common interventions with refill prescriptions include recommending appropriate follow-up (50%) and contacting the prescriber for medication or dosage change (24.4%). Conclusion: Implementation of a DOAC screening service identified and resolved dosing errors, improved medication access, provided patient education, and improved follow-up.