bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Score to Predict Need for Intensive Care in Initially Hemodynamically Stable Adults With Non–ST‐Segment–Elevation Myocardial Infarction
Authors: Fanaroff Alexander C. , Chen Anita Y. , Thomas Laine E. , Pieper Karen S. , Garratt Kirk N. , Peterson Eric D. , Newby L. Kristin , de Lemos James A. , Kosiborod Mikhail N. , Amsterdam Ezra A. , Wang Tracy Y. 
Published: May 2018

Background

Intensive care unit (
ICU
) use for initially stable patients presenting with non–ST‐segment–elevation myocardial infarction (
NSTEMI
) varies widely across hospitals and minimally correlates with severity of illness. We aimed to develop a bedside risk score to assist in identifying high‐risk patients with
NSTEMI
for
ICU
admission.

Methods and Results

Using the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry linked to Medicare data, we identified patients with
NSTEMI
aged ≥65 years without cardiogenic shock or cardiac arrest on presentation. Complications requiring
ICU
care were defined as subsequent development of cardiac arrest, shock, high‐grade atrioventricular block, respiratory failure, stroke, or death during the index hospitalization. We developed and validated a model and integer risk score (Acute Coronary Treatment and Intervention Outcomes Network (ACTION)
ICU
risk score) that uses variables present at hospital admission to predict requirement for
ICU
care. Of 29 973 patients with
NSTEMI
, 4282 (14%) developed a complication requiring
ICU
‐level care, yet 12 879 (43%) received care in an
ICU
. Signs or symptoms of heart failure, initial heart rate, initial systolic blood pressure, initial troponin, initial serum creatinine, prior revascularization, chronic lung disease,
ST
‐segment depression, and age had statistically significant associations with requirement for
ICU
care after adjusting for other risk factors. The ACTION
ICU
risk score had a C‐statistic of 0.72. It identified 11% of patients as having very high risk (>30%) of developing complications requiring
ICU
care and 49% as having low likelihood (<10%) of requiring an
ICU
.

Conclusions

The ACTION
ICU
risk score quantifies the risk of initially stable patients with
NSTEMI
developing a complication requiring
ICU
care, and could be used to more effectively allocate limited
ICU
resources.
Aristotle on the Structure of Akratic Action
Authors: Cagnoli Fiecconi Elena 
Published: May 2018

AbstractI argue that, for Aristotle, akratic actions are against one’s general commitment to act in accordance with one’s correct conception of one’s ends overall. Only some akratic actions are also against one’s correct decision to perform a particular action. This thesis explains Aristotle’s views on impetuousakrasia, weakakrasia, stubborn opinionated action and inverseakrasia. In addition, it sheds light on Aristotle’s account of practical rationality. Rational actions are coherent primarily with one’s commitments to one’s conception of the good and only secondarily with one’s decisions to perform a particular action.
Where does the modality of Ancient Greek modal verbs come from?
Authors: Danesi Serena , Johnson  , Barðdal Jóhanna 
Published: May 2018

Abstract
Modality can be expressed through a variety of different linguistic means within and across languages, of which one manifestation is through noncanonical case marking of the subject. In Ancient Greek several predicates show a systematic alternation between constructions with nominative and oblique subjects, which coincides with a difference in meaning, yielding a modal meaning in the latter case. We show how this modal meaning cannot be derived from the meaning of the individual parts of the construction, neither from the lexical material nor from the relevant grammatical elements. Instead, the data call for a constructional analysis of a modal subconstruction of the oblique subject construction, for which the modality must be attributed to the construction itself. We argue that this can be viewed through the lens of subjectification in the sense of Traugott (2003), here demonstrating that the semantic relation holding between the subject referent and the oblique case marking selected by the verb has been extended to the empathic relation holding between the speaker and his/her attitude towards the proposition uttered (Barðdal 2004). This, we believe, is how the concept of modality came to be associated with oblique case marking of subjects.
Venous leg symptoms in patients with varicocele: A multicenter assessment study (VEIN-TURKEY study)
Authors: Ozturk Selcuk , Akbaba Kaan Turker , Kılıc Suleyman , Cıcek Tufan , Peskırcıoglu Levent , Tandogan Izzet , Gurlek Ahmet , Aydemır Ozbay , Ilerı Mehmet , Yetkın Ertan 
Published: May 2018

Objective The aim of this study is to evaluate chronic venous disease symptoms by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in varicocele patients. Material and methods The study was designed as a prospective, case controlled study and conducted in four hospitals from Turkey. A total of 600 patients who admitted to urology outpatient clinic were enrolled to the study. After the exclusion of 44 patients who do not match the inclusion criteria, the remaining 556 patients were examined for the presence and grade of varicocele and subsequently examined clinically for the presence of chronic venous disease findings. Finally, patients were asked to answer the VEINES-Sym questionnaire consisting of 10 items. All patients’ demographic parameters, cardiovascular risk factors, other co-morbid diseases and drug usage were noted. Results Patients were classified into two groups: varicocele (+) group ( n = 269) and varicocele (−) group ( n = 287). VEINES-Sym scores of varicocele patients were lower compared to patients without varicocele (41.41 ± 5.21, 43.19 ± 3.22, respectively, p < 0.001). Grades of varicocele significantly but inversely correlated with VEINES-Sym score ( r = 0, −206, p = 0.001). Logistic regression analysis revealed that presence of varicocele irrespective of grading significantly and independently associated with the presence of aching (odds ratio: 2.054, 95% confidence interval: 1.265–3.338, p = 0.004) and throbbing (odds ratio: 2.586, 95% confidence interval: 1.353–4.943, p = 0.004). Conclusion Varicocele patients have lower VEINES-Sym scores compared to patients without varicocele and this finding is inversely correlated with the degree of the varicocele. This association supports the hypothesis that there may be a systemic vessel wall abnormality in venous disease patients. Patients with symptoms related to vascular dilatation in any territory may deserve to be assessed systematically with the support of further clinical studies.
Career Length and Performance Among Professional Baseball Players Returning to Play After Hip Arthroscopy
Authors: Frangiamore Salvatore J. , Mannava Sandeep , Briggs Karen K. , McNamara Shannen , Philippon Marc J. 
Published: May 2018

Background:Hip arthroscopy has been shown to be effective for management of symptomatic femoroacetabular impingement (FAI) in professional athletes; however, it is unclear how hip arthroscopy affects career length and performance when professional baseball players return to play.Purpose:To determine the career length, performance, and return-to-play rates of professional baseball players after undergoing arthroscopy for symptomatic FAI.Study Design:Case series; Level of evidence, 4.Methods:Forty-four professional baseball players (51 hips) underwent hip arthroscopy for FAI between 2000 and 2015 by a single surgeon. Data were retrieved for each player from MLB.com , MiLB.com , Baseballreference.com , and individual team websites. Age, surgical procedure, and intraoperative findings were also used in analysis. Return to play was defined as playing in a preseason or regular season major or minor league game after arthroscopy. Career length was measured as total years played before and after arthroscopy. Performance measures included earned run average for pitchers, batting average for position players, and games played for all players.Results:Of the 44 players, there were 21 pitchers and 23 position players. Ninety-five percent (n = 42) were able to return to professional baseball after hip arthroscopy. The mean career length for all players was 9.5 years. The mean career length after return to play was 3.6 seasons (range, 1-14 seasons). Pitchers had a mean career length of 8.7 years (3.3 after surgery), and position players averaged a career length of 10 years (3.9 after surgery). There were no differences in performance measures between preinjury and postoperative values.Conclusion:Professional baseball players undergoing hip arthroscopy for FAI returned to sport and had similar performance as they did before injury. The average career length was 9.5 years. In our study cohort, more pitchers than position players underwent hip arthroscopy. Hip arthroscopy appears to be an effective surgical intervention, allowing for return to play after complete recovery.
The role of workplace social capital, compassion satisfaction and secondary traumatic stress in affective organisational commitment of a sample of Iranian nurses
Authors: Vagharseyyedin Seyyed Abolfazl , Zarei Bahare , Hosseini Mahdi 
Published: May 2018

Background Affective organisational commitment (AOC) refers to employees’ emotional attachment to the organisation and identification with it. It is vital that nurses explore contributors to their AOC because they stand as the largest group of employees in healthcare organisations. Aim This cross-sectional, analytical study explored the role of workplace social capital (WSC), compassion satisfaction (CS), and secondary traumatic stress (STS) in AOC in a sample of Iranian nurses. Method The study sample consisted of 250 nurses working in eight hospitals affiliated with Birjand University of Medical Sciences, eastern Iran. Participants’ WSC was measured using the Social Capital at Work Scale developed by Kouvonen et al. (2006). CS and STS were measured using CS and STS dimensions of the Professional Quality of Life measure (Version 5) developed by Stamm (2010). Results Significant positive associations were found between WSC and AOC ( p < 0.001), between the cognitive dimension of WSC and AOC ( p < 0.001), between the structural dimension of WSC and AOC ( p < 0.001), and between CS and AOC ( p < 0.001). The correlation between STS and AOC ( p < 0.001) was negatively significant. Conclusion Effort to promote WSC and CS on the one hand and prevention and early recognition of STS on the other hand can enhance nurses’ AOC.
Analysis of IL-6 and IL-1β release in cryopreserved pooled human whole blood stimulated with endotoxin
Authors: He Qing , Gao Hua , Xu Li-ming , Lu Yan , Wang Chong , Rui Jing , Fan Hua , Wang Xiu-ying , Wang Jun-zhi 
Published: May 2018

To overcome the lack of availability of fresh human whole blood for pyrogen detection, we explored the feasibility of utilizing cryopreserved pooled human blood to detect the responses of the pro-inflammatory cytokines IL-6 and IL-1β to LPS. Whole blood was obtained from five donors and incubated with LPS. The quantities of pro-inflammatory cytokines were measured using ELISA, and the results were compared among the samples. After the blood was cryopreserved with Dimethyl sulfoxide (DMSO) (10% v/v) and stored for 4 mo at –196℃, the detection limits of the IL-6/IL-1β responses to LPS were 0.2/0.4 endotoxin units (EU)/ml, respectively, and IL-6/IL-1β release increased in response to LPS in a dose-dependent manner. When these experiments were performed in three separate laboratories, the within-laboratory reproducibility of the IL-6/IL-1β responses was 100%/86.7%, 93.3%/100%, and 86.7%/80%, and the inter-laboratory reproducibility was 92.9%/85.7%, 64.3%/63.6%, and 57.1%/66.7%, respectively. The sensitivity (the probability of correctly classifying positive samples) and specificity (the probability of correctly classifying negative samples) of the IL-6/IL-1β tests were 81.7%/82.5% and 100%/100%, respectively. The results of this study suggest that cryopreserved pooled blood is a convenient and viable alternative for evaluating in vitro pyrogenicity. Additionally, maintaining cryopreserved pooled blood promotes safety for the user because it is released only after pretesting for infection parameters and has lower variation than fresh donations from a variety of donors.
Relapse Rate and MRI Activity in Young Adult Patients With Multiple Sclerosis: A Post Hoc Analysis of Phase 3 Fingolimod Trials
Authors: Gärtner Jutta , Chitnis Tanuja , Ghezzi Angelo , Pohl Daniela , Brück Wolfgang , Häring Dieter Adrian , Karlsson Goeril , Putzki Norman 
Published: May 2018

Background Disease activity differs in young patients with multiple sclerosis (MS) compared with the overall adult MS population. Objective The objective of this paper is to evaluate the effect of fingolimod 0.5 mg on disease activity in young adults with MS from three randomized, double-blind Phase 3 trials. Methods Annualized relapse rate (ARR), number of new/newly enlarging T2 lesions (neT2), and no evidence of disease activity (NEDA-3) were estimated in the intent-to-treat population at age 20 (youngest) and 30 (young) and compared to the overall population. Models used included a negative binomial regression (ARR/neT2) and a logistic regression (NEDA), with age at baseline as a continuous covariate. Results ARRs were higher in younger patients (all p < 0.05), and significantly reduced with fingolimod versus placebo or interferon beta-1a (IFN β-1a), with the percentage reduction inversely proportional to age. Fingolimod was significantly associated with a lower number of neT2 lesions versus placebo/IFN in all age groups except versus IFN in the youngest patients. Regardless of age, fingolimod-treated patients were more likely to achieve NEDA-3 versus placebo/IFN β-1a, with strongest benefits in the youngest patients (all p < 0.05). Conclusions Young adults show higher levels of MS disease activity, and may particularly benefit from fingolimod treatment compared with the overall study population.
Infection and Rerupture After Surgical Repair of Achilles Tendons
Authors: Jildeh Toufic R. , Okoroha Kelechi R. , Marshall Nathan E. , Abdul-Hak Abraham , Zeni Ferras , Moutzouros Vasilios 
Published: May 2018

Background: Surgical repair of an Achilles tendon rupture has been shown to decrease rerupture rates. However, surgery also increases the risk of complications, including infection. Purpose: To determine the risk factors for infection and rerupture after primary repair of Achilles tendon ruptures. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was performed on 423 patients who underwent operative treatment of Achilles tendon ruptures between the years 2008 and 2014. The primary outcome of interest was the total rate of infection, and the secondary outcome of interest was the incidence of rerupture within 2 years of operation. Results: A total of 423 patients were analyzed, with a mean age of 46 years (range, 16-83 years) and a mean body mass index of 31.4 kg/m2 (range, 17-55 kg/m2). The overall infection rate was 2.8%, and the rerupture rate was 1%. The median time between surgery and superficial surgical site infection was 30 days, and the median time between surgery and rerupture was 38 days. Longer tourniquet times (100.3 ± 34.7 minutes vs 69.9 ± 21.4 minutes; P = .04) and greater estimated blood loss (15.0 ± 9.1 mL vs 5.1 ± 12.0 mL; P = .01) were associated with an increased rate of deep surgical site infections. Patients who had longer operation and tourniquet times trended toward higher rerupture rates ( P = .06 and .08, respectively). When compared with nonsmokers, current and previous smokers had an increased incidence of superficial or deep surgical site infections (6.25% vs 1.42%; P = .02). Age, sex, race, body mass index, alcohol use, diabetes, past steroid injections, and mechanism of injury did not contribute to complication rates. Conclusion: Achilles tendon repairs were associated with a low risk of infection and rerupture. Patients with longer tourniquet times, higher estimated blood loss, and a history of smoking were at increased risk for surgical site infections. Patients with longer operative times had increased rates of rerupture.
Performance of the PROMIS in Patients After Anterior Cruciate Ligament Reconstruction
Authors: Scott Elizabeth J. , Westermann Robert , Glass Nathalie A. , Hettrich Carolyn , Wolf Brian R. , Bollier Matthew J. 
Published: May 2018

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is designed to advance patient-reported outcome (PRO) instruments by utilizing question banks for major health domains. Purpose: To compare the responsiveness and construct validity of the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments for patients before and up to 2 years after anterior cruciate ligament (ACL) reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Initially, 157 patients completed the PROMIS PF CAT, Short Form–36 Health Survey (SF-36 physical function [PF] and general health [GH]), Marx Activity Rating Scale (MARS), Knee injury and Osteoarthritis Outcome Score (KOOS activities of daily living [ADL], sport, and quality of life [QOL]), and EuroQol–5 dimensions questionnaire (EQ-5D) at 6 weeks, 6 months, and 2 years after ACL reconstruction. Correlations between instruments, ceiling and floor effects, effect sizes (Cohen d), and standardized response means to describe responsiveness were evaluated. Subgroup analyses compared participants with and without additional arthroscopic procedures using linear mixed models. Results: At baseline, 6 weeks, and 6 months, the PROMIS PF CAT showed excellent or excellent-good correlations with the SF-36 PF ( r = 0.75-0.80, P < .01), KOOS-ADL ( r = 0.63-0.70, P < .01), and KOOS-sport ( r = 0.32-0.69, P < .01); excellent-good correlation with the EQ-5D ( r = 0.60-0.71, P < .01); and good correlation with the KOOS-QOL ( r = 0.52-0.58, P < .01). As expected, there were poor correlations with the MARS ( r = 0.00-0.24, P < .01) and SF-36 GH ( r = 0.16-0.34, P < .01 ). At 2 years, the PROMIS PF CAT showed good to excellent correlations with all PRO instruments ( r = 0.42-0.72, P < .01), including the MARS ( r = 0.42, P < .01), indicating frequent return to preinjury function. The PROMIS PF CAT had the fewest ceiling or floor effects of all instruments tested, and patients answered, on average, 4 questions. There was no significant difference in baseline physical function scores between subgroups; at follow-up, all groups showed improvements in scores that were not statistically different. Conclusion: The PROMIS PF CAT is a valid tool to assess outcomes after ACL reconstruction up to 2 years after surgery, demonstrating the highest responsiveness to change with the fewest ceiling and floor effects and a low time burden among all instruments tested. The PROMIS PF CAT is a beneficial alternative for assessing physical function in adults before and after ACL reconstruction.
Acromial Fractures in Reverse Shoulder Arthroplasty: A Clinical and Radiographic Analysis
Authors: Werthel Jean-David , Schoch Bradley S , van Veen Steven C , Elhassan Bassem T , An Kai-Nan , Cofield Robert H , Sperling John W 
Published: May 2018

Background The purpose of this study is to assess the incidence of acromial stress fractures in a population of reverse shoulder arthroplasties (RSA) and determine potential risk factors for fracture. Patients and Methods Between August 2004 and December 2013, 1082 primary RSA were performed at a single institution. Twelve (1.11%) patients were diagnosed with a postoperative acromial stress fracture. This group was case-matched to a control group of 48 shoulders. Clinical and radiographic risk factors for fracture were assessed. Results Compared to controls, fractures were less satisfied with their outcome despite equivalent American Shoulder and Elbow Surgeons scores, pain scores, and range of motion. Osteoporosis was significantly associated with acromial fractures ( P = .027). A smaller lateral offset of the greater tuberosity, greater arm lengthening, and a thinner acromion were more common in the fracture group ( P = .026, P = .004, and P = .008, respectively). Conclusions In summary, postoperative acromial stress fractures appear to be incidental lesions with little influence on the outcome after RSA. The combination of a thin acromion and superior migration of the humeral head increase the risk of acromial fracture. Lateralized designs that do not excessively verticalize the deltoid line of pull on the acromion may decrease the risk of postoperative acromial fractures.
Identification of patients with hemoglobin SS/Sβ0 thalassemia disease and pain crises within electronic health records
Authors: Singh Ashima , Mora Javier , Panepinto Julie A. 
Published: May 2018

Key Points
The algorithms have high sensitivity and specificity to identify patients with hemoglobin SS/Sβ0 thalassemia and acute care pain encounters. Codes conforming to common data model are provided to facilitate adoption of algorithms and standardize definitions for EHR-based research.
Notch-1 Signaling Activation and Progesterone Receptor Expression in Ectopic Lesions of Women With Endometriosis
Authors: Brown Dustin M , Lee Hsiu-Chi , Liu Shi , Quick Charles M , Fernandes Lorenzo M , Simmen Frank A , Tsai Shaw-Jenq , Simmen Rosalia C M 
Published: May 2018

Abstract

Context
Progesterone (P) resistance is a hallmark of endometriosis, but the underlying mechanism(s) for loss of P sensitivity leading to lesion establishment remains poorly understood.

Objective
To evaluate the association between Notch-1 signaling activation and P resistance in the progression of endometriosis.

Design
Case control study; archived formalin-fixed, paraffin-embedded tissues.

Setting
University hospitals (United States, Taiwan).

Patients
Women with endometriosis; human endometrial stromal cell line (HESC).

Intervention
Eutopic endometria (EU) and ectopic lesions (ECs) were collected from surgically diagnosed patients. Archived tissue sections of EU and ECs were identified. HESCs were treated with N-[N-(3,5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester (DAPT) and valproic acid (VPA) to, respectively, suppress and induce Notch-1 activation.

Outcome Measures
Tissues were analyzed for Notch Intra-Cellular Domain 1 (NICD1) and progesterone receptor (PGR) protein expression by immunohistochemistry and for transcript levels of NICD1 target genes HES1, PGR, and PGR-B by quantitative reverse transcription polymerase chain reaction. DAPT- or VPA-treated HESCs with and without P cotreatment were evaluated for cell numbers and for PGR, HES1, and PGR target gene DKK1 transcript levels.

Results
Nuclear-localized stromal NICD1 protein levels were inversely associated with those of total PGR in EU and ECs. Stromal ECs displayed higher HES1 and lower total PGR and PGR-B transcript levels than EU. In HESCs, DAPT reduction of NICD1 decreased cell numbers and increased PGR transcript and nuclear PGR protein levels and, with P cotreatment, maintained P sensitivity. Conversely, VPA induction of NICD1 decreased PGR transcript levels and, with P cotreatment, abrogated P-induced DKK1 and maintained HES1 transcript levels.

Conclusions
Aberrant Notch-1 activation is associated with decreased PGR that contributes to P resistance in endometriosis.