bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fractional flow reserve in patients with reduced ejection fraction
Authors: Di Gioia Giuseppe , De Bruyne Bernard , Pellicano Mariano , Bartunek Jozef , Colaiori Iginio , Fiordelisi Antonella , Canciello Grazia , Xaplanteris Panagiotis , Fournier Stephane , Katbeh Asim , Franco Danilo , Kodeboina Monika , Morisco Carmine , Van Praet Frank , Casselman Filip , Degrieck Ivan , Stockman Bernard , Vanderheyden Marc , Barbato Emanuele 
Published: July 2019

Abstract

Aims
Fractional flow reserve (FFR) has never been investigated in patients with reduced ejection fraction and associated coronary artery disease (CAD). We evaluated the impact of FFR on the management strategies of these patients and related outcomes.

Methods and results
From 2002 to 2010, all consecutive patients with left ventricular ejection fraction (LVEF) ≤50% undergoing coronary angiography with ≥1 intermediate coronary stenosis [diameter stenosis (DS)% 50–70%] treated based on angiography (Angiography-guided group) or according to FFR (FFR-guided group) were screened for inclusion. In the FFR-guided group, 433 patients were matched with 866 contemporary patients of the Angiography-guided group. For outcome comparison, 617 control patients with LVEF &gt;50% were included. After FFR, stenotic vessels per patient were significantly downgraded compared with the Angiography-guided group (1.43 ± 0.98 vs. 1.97 ± 0.84; P &lt; 0.001). This was associated with lower revascularization rate (52% vs. 62%; P &lt; 0.001) in the FFR-guided vs. the Angiography-guided group. All-cause death at 5 years of follow-up was significantly lower in the FFR-guided as compared with Angiography-guided group [22% vs. 31%. HR (95% CI) 0.64 (0.51–0.81); P &lt; 0.001]. Similarly, rate of major adverse cardiovascular and cerebrovascular events (MACCE: composite of all-cause death, myocardial infarction, revascularization, and stroke) was significantly lower in the FFR-guided group [40% vs. 46% in the Angiography-guided group. HR (95% CI) 0.81 (0.67–0.97); P = 0.019]. Higher rates of death and MACCE were observed in patients with reduced LVEF compared with the control cohort.

Conclusions
In patients with reduced LVEF and CAD, FFR-guided revascularization was associated with lower rates of death and MACCE at 5 years as compared with the Angiography-guided strategy. This beneficial impact was observed in parallel with less coronary artery bypass grafting and more patients deferred to percutaneous coronary intervention or medical therapy.
A Novel Test for Absolute Fit of Evolutionary Models Provides a Means to Correctly Identify the Substitution Model and the Model Tree
Authors: Goremykin Vadim 
Published: July 2019

Abstract
A novel test is described that visualizes the absolute model-data fit of the substitution and tree components of an evolutionary model. The test utilizes statistics based on counts of character state matches and mismatches in alignments of observed and simulated sequences. This comparison is used to assess model-data fit. In simulations conducted to evaluate the performance of the test, the test estimator was able to identify both the correct tree topology and substitution model under conditions where the Goldman–Cox test—which tests the fit of a substitution model to sequence data and is also based on comparing simulated replicates with observed data—showed high error rates. The novel test was found to identify the correct tree topology within a wide range of DNA substitution model misspecifications, indicating the high discriminatory power of the test. Use of this test provides a practical approach for assessing absolute model-data fit when testing phylogenetic hypotheses.
Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study
Authors: Lam Ming-Tuen , Sing Chor-Wing , Li Gloria H Y , Kung Annie W C , Tan Kathryn C B , Cheung Ching-Lung 
Published: July 2019

Abstract

Background
To evaluate whether the common risk factors and risk scores (FRAX, QFracture, and Garvan) can predict hip fracture in the oldest old (defined as people aged 80 and older) and to develop an oldest-old-specific 10-year hip fracture prediction risk algorithm.

Methods
Subjects aged 80 years and older without history of hip fracture were studied. For the derivation cohort (N = 251, mean age = 83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N = 599, mean age = 85), outpatients were enrolled with a median follow-up of 2.6 years. A five-factor risk score (the Hong Kong Osteoporosis Study [HKOS] score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores.

Results
In the derivation cohort, the C-statistics were .65, .61, .65, .76, and .78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all p &lt; .001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer–Lemeshow test p &lt; .001). In the validation cohort, the HKOS score had a C-statistic of .81 and a considerable agreement between expected and observed fracture risk in calibration.

Conclusion
The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings.
Functional Hearing Loss and Social Engagement Among Medicare Beneficiaries
Authors: Shukla Aishwarya , Cudjoe Thomas K M , Lin Frank R , Reed Nicholas S 
Published: July 2019

Abstract

Objectives
Hearing loss is common in older adults and limits communication. We investigated the independent association between functional hearing loss and social engagement in a nationally representative sample of older adults.

Methods
Using data from the 2015 Medicare Current Beneficiaries Survey, we modeled the cross-sectional association between self-reported hearing ability and limitation in social activity over the past month using multivariable logistic regression.

Results
The majority of the study population was female (54.8%) and non-Hispanic white (74.3%). Participants (40.4%) reported “a little trouble” hearing and 7.4% reported “a lot of trouble” hearing. Those who reported any trouble hearing had higher odds of limited social engagement in the past month. After adjustment for demographic, clinical, and functional covariates, those who reported “a lot of trouble” hearing had 37% higher odds of limited social activity in the past month compared to those with normal hearing.

Discussion
These results suggest that hearing loss may be an important risk factor for limited social engagement and downstream negative health consequences, independent of other disability and health conditions.
“You’ve Got to Be Old to Go There”: Psychosocial Barriers and Facilitators to Social Eating in Older Adults
Authors: Saeed Anisa , Fisher Jenny , Mitchell-Smith Zinnia , Brown Laura J E 
Published: July 2019

Abstract

Background and Objectives
Social eating is associated with a range of physical and mental health benefits for older adults. Previous research has identified some of the practical barriers that may limit social eating, such as cost and access to public transport. However, little is known about the psychosocial issues that can affect older adults’ engagement with social eating. This study examines psychosocial barriers and facilitators to attending community-based social eating opportunities for older adults.

Design and Methods
Forty-two older people aged between 59 and 89 years living in Manchester, UK, participated in semi-structured interviews or focus groups about their experiences and perceptions of social eating opportunities. Interview transcripts were analyzed using inductive thematic analyses. As there are known gender differences in relation to attitudes and behaviors relating to food and social activities, a framework analysis was applied to explore how these themes were differentially expressed by gender.

Results
Four themes were identified that related to the importance of (a) offering more than food; (b) participants’ social identity; (c) taking the first step; and (d) embarrassment and self-consciousness about physical health. Gender differences related to perceptions of the relevance and attractiveness of social eating, and the role of social support.

Discussion and Implications
This study improves our understanding of older adults’ social eating experiences and highlights clear strategies by which social eating opportunities could be made more attractive, accessible, and acceptable to older adults.
Split Injectivity ofA-Theoretic Assembly Maps
Authors: Bunke Ulrich , Kasprowski Daniel , Winges Christoph 
Published: July 2019

AbstractWe construct an equivariant coarse homology theory arising from the algebraic $K$-theory of spherical group rings and use this theory to derive split injectivity results for associated assembly maps. On the way, we prove that the fundamental structural theorems for Waldhausen’s algebraic $K$-theory functor carry over to its nonconnective counterpart defined by Blumberg–Gepner–Tabuada.
Tipping the Scales for Labour in Ireland? Collective Bargaining and the Industrial Relations (Amendment) Act 2015
Authors: Murphy Caroline , Turner Thomas 
Published: July 2019

Abstract
Trade union density in Ireland has followed a similar pattern of decline to that of other Anglo-Saxon economies in recent decades. However, two factors make Ireland distinctive within this classification of countries, firstly the system of national social partnership that prevailed from 1987 to 2008, and secondly, the absence of a statutory route to union recognition. In this paper, we examine the extent to which a new piece of legislation, the Industrial Relations Amendment Act 2015, provides unions with a route to securing bargaining rights for workers and extends collective bargaining rights generally. We conclude that the Act represents a missed opportunity to offer mechanisms to secure rights for unions and their members capable of delivering collective bargaining to the non-union sector. We situate the paper within debates concerning the role of labour law in supporting workers rights to collective bargaining.
Rotating ionized gas ring around the Galactic center IRS13E3
Authors: Tsuboi Masato , Kitamura Yoshimi , Tsutsumi Takahiro , Miyawaki Ryosuke , Miyoshi Makoto , Miyazaki Atsushi 
Published: July 2019

Abstract
We detected a compact ionized gas associated physically with IRS13E3, an intermediate mass black hole (IMBH) candidate in the Galactic center, in the continuum emission at 232 GHz and H30α recombination line using ALMA Cy.5 observation (2017.1.00503.S, P.I. M.Tsuboi). The continuum emission image shows that IRS13E3 is surrounded by an oval-like structure. The angular size is 0${^{\prime\prime}_{.}}$093 ± 0${^{\prime\prime}_{.}}$006 × 0${^{\prime\prime}_{.}}$061 ± 0${^{\prime\prime}_{.}}$004 (1.14 × 1016 cm × 0.74 × 1016 cm). The structure is also identified in the H30α recombination line. This is seen as an inclined linear feature in the position–velocity diagram, which is usually a defining characteristic of a rotating gas ring around a large mass. The gas ring has a rotating velocity of Vrot ≃ 230 km s−1 and an orbit radius of r ≃ 6 × 1015 cm. From these orbit parameters, the enclosed mass is estimated to be $M_{\mathrm{IMBH}}\simeq 2.4\times 10^{4}\, M_{\odot }$. The mass is within the astrometric upper limit mass of the object adjacent to Sgr A*. Considering IRS13E3 has an X-ray counterpart, the large enclosed mass would be supporting evidence that IRS13E3 is an IMBH. Even if a dense cluster corresponds to IRS13E3, the cluster would collapse into an IMBH within τ &lt; 107 yr due to the very high mass density of $\rho \gtrsim 8\times 10^{11}\, M_{\odot }\:$pc−3. Because the orbital period is estimated to be as short as T = 2πr/Vrot ∼ 50–100 yr, the morphology of the observed ionized gas ring is expected to be changed in the next several decades. The mean electron temperature and density of the ionized gas are $\bar{T}_{\mathrm{e}}=6800\pm 700\:$K and $\bar{n}_{\mathrm{e}}=6\times 10^{5}\:$cm−3, respectively. Then the mass of the ionized gas is estimated to be $M_{\mathrm{gas}}=4\times 10^{-4}\, M_{\odot }$.
Blinding Strategies in Dry Needling Trials: Systematic Review and Meta-Analysis
Authors: Braithwaite Felicity A , Walters Julie L , Li Lok Sze Katrina , Moseley G Lorimer , Williams Marie T , McEvoy Maureen P 
Published: July 2019

Abstract

Background
Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling.

Purpose
The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials.

Data Sources
Twelve databases were searched from inception to February 2016.

Study Selection
Trials that compared active dry needling with a sham that simulated dry needling were included.

Data Extraction
The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index).

Data Synthesis
The search identified 4894 individual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding.

Limitations
Trials were clinically and methodologically diverse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial.

Conclusions
Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.
Progression of nailfold capillaroscopic patterns and correlation with organ involvement in systemic sclerosis: a 12 year study
Authors: Sulli A , Paolino S , Pizzorni C , Ferrari G , Pacini G , Pesce G , Carmisciano L , Smith V , Cutolo M 
Published: July 2019

Abstract

Objective
The aim of this observational study was to investigate the evolution of scleroderma microangiopathy throughout different nailfold videocapillaroscopy (NVC) patterns (‘early’, ‘active’, ‘late’) as well as the prevalence of organ involvement in SSc patients during a 12-year follow-up.

Methods
Thirty-four SSc patients showing at baseline (first capillaroscopic analysis) the ‘early’ NVC pattern of microangiopathy were enrolled and followed for 12 years (s.d. 2). Complete NVC analysis and clinical and serological findings were collected. Patients were in a standard therapeutic care setting. Statistical analysis was carried out by non-parametric tests.

Results
After a 12-year follow-up, the ‘early’ NVC pattern changed from baseline in 76% of the patients. The NVC pattern was found to be ‘active’ in 9 patients (26%), ‘late’ in 13 (38%) and characterized by non-specific capillary abnormalities in 4 (12%). In the subgroup whose microangiopathy progressed from the ‘early’ to the ‘late’ NVC pattern, the median time of progression from the ‘early’ to the ‘active’ pattern was significantly shorter (11 months) when compared with patients who progressed from the ‘early’ to the ‘active’ NVC pattern (55 months) (P = 0.002). The median time of progression between NVC patterns was significantly shorter in SSc patients showing either a nucleolar ANA pattern or Scl70 autoantibodies (P = 0.048). Organ involvement was progressively greater in SSc patients with ‘early’, ‘active’ and ‘late’ NVC patterns, respectively.

Conclusions
This longitudinal study confirms over a 12-year follow-up the evolution of specific NVC patterns associated with the progressive severity of organ involvement in SSc patients in a standard clinical care setting.
Long-term use of pitolisant to treat patients with narcolepsy: Harmony III Study
Authors: Dauvilliers Yves , Arnulf Isabelle , Szakacs Zoltan , Leu-Semenescu Smaranda , Lecomte Isabelle , Scart-Gres Catherine , Lecomte Jeanne-Marie , Schwartz Jean-Charles ,   HARMONY III study group, Arnulf Isabelle , Bastuji Hélène , Dauvilliers Yves , Vieccherini Marie Françoise , Pepin Jean Louis , Quera Salva Maria Antonia , Stoll Anne Thibault , Szakacs Zoltan 
Published: July 2019

AbstractStudy ObjectivesTo asses the long-term safety and efficacy of pitolisant, an histamine H3-receptor antagonist, on narcolepsy.MethodsThis open-label, single-arm, pragmatic study, recruited adult patients with narcolepsy and Epworth Sleepiness Scale (ESS) score ≥12. After a titration period, patients were treated for up to 1 year with oral pitolisant once-a-day at up to 40 mg. Concomitant stimulants and anti-cataplectic agents were allowed. The primary endpoint was safety; secondary endpoints included ESS, cataplexy, and other diary parameters.ResultsPatients (n = 102, 75 with cataplexy) received pitolisant, for the first time in 73 of them. Sixty-eight patients (51 with cataplexy) completed the 12-month treatment. Common treatment-emergent adverse events were headache (11.8% of patients), insomnia (8.8%), weight gain (7.8%), anxiety (6.9%), depressive symptoms (4.9%), and nausea (4.9%). Seven patients had a serious adverse effect, unrelated to pitolisant except for a possibly related miscarriage. One-third of patients stopped pitolisant, mostly (19.6%) for insufficient benefit. ESS score decreased by 4.6 ± 0.6. Two-thirds of patients completing the treatment were responders (ESS ≤ 10 or ESS decrease ≥ 3), and one third had normalized ESS (≤10). Complete and partial cataplexy, hallucinations, sleep paralysis, and sleep attacks were reduced by 76%, 65%, 54%, 63%, and 27%, respectively. Pitolisant as monotherapy (43% of patients) was better tolerated and more efficacious on ESS than on add-on, but efficacy was maintained in this last case.ConclusionsLong-term safety and efficacy of pitolisant on daytime sleepiness, cataplexy, hallucinations, and sleep paralysis is confirmed.
A Prospective, Multicenter, Single-Arm Clinical Trial for Treatment of Complex Diabetic Foot Ulcers with Deep Exposure Using Acellular Dermal Matrix
Authors: Cazzell Shawn , Moyer Peter M. , Samsell Brian , Dorsch Kimberly , McLean Julie , Moore Mark A. 
Published: July 2019

ABSTRACT

OBJECTIVE
This prospective, multicenter study evaluated the efficacy and safety of an acellular dermal matrix allograft, DermACELL (D-ADM; LifeNet Health, Virginia Beach, Virginia), in the treatment of large, complex diabetic foot ulcers (DFUs) that probed to tendon or bone.

METHODS
Inclusion criteria were Wagner grade 3 or 4 DFUs between 4 weeks and 1 year in duration. All participants received one application of D-ADM at baseline and could receive one additional application if wound healing arrested. Ulcers were assessed weekly for 16 weeks using a laser measuring device.

RESULTS
Sixty-one participants were enrolled, with an average wound area of 29.0 cm2; 59 of these ulcers showed exposed bone. The entire per-protocol population (n = 47) achieved 100% granulation. The mean time to 100% granulation was 4.0 weeks with an average of 1.2 applications of D-ADM. Mean percent wound area reduction was 80.3% at 16 weeks. Those DFUs 15 cm2 or smaller were substantially more likely to close than DFUs larger than 29 cm2 (P = .0008) over a 16-week duration. No complications were associated with the use of the studied matrix.

CONCLUSIONS
The D-ADM demonstrated the ability to rapidly reduce the size of large, complex DFUs with exposed bone. Some wounds did not completely heal by 16 weeks; however, the significant reduction in size suggests that these large, complex wounds may heal if given more time.
Treatment of urticaria: a clinical and mechanistic approach
Authors: Kaplan Allen P. 
Published: July 2019

Purpose of review
This manuscript describes the recommended therapy of chronic spontaneous urticaria based on our understanding of the pathogenesis of hive formation. Thus, the mechanism of action of each medication is elaborated in addition to a discussion of clinical utility.

Recent findings
The main drugs are antihistamines, omalizumab, and cyclosporine with a success rate of 40–55, 65–80, and 70–80%, respectively. Used in sequence, over 90% of patients can be successfully treated. The addition of omalizumab represents a major advance because of its efficacy, easy utility, and favorable side-effect profile. The interaction with IgE eliminates any reaction with antigens to which it might be directed, down regulates IgE receptors on mast cells and basophils, and leads to down-regulation of mast cell functions with amelioration of hives.

Summary
The use of antihistamines in high dosage (at least four times a day) is effective in close to half the patients with CSU. For antihistamine resistance, the use of omalizumab has revolutionized therapy of antihistamine-resistant cases because of its efficacy and excellent side-effect profile. If the response is insufficient, cyclosporine is the next choice. Patients should be monitored regarding any adverse effects on blood pressure or renal function. All these are far safer than extended use of corticosteroid.