bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Ventricular Hypertrophy Regression During Antihypertensive Treatment in an Outpatient Clinic (the Campania Salute Network)
Authors: Lønnebakken Mai Tone , Izzo Raffaele , Mancusi Costantino , Gerdts Eva , Losi Maria Angela , Canciello Grazia , Giugliano Giuseppe , De Luca Nicola , Trimarco Bruno , de Simone Giovanni 
Published: March 2017

Background

Regression of left ventricular (
LV
) hypertrophy (
LVH
) has been a goal in clinical trials. This study tests the external validity of results of clinical trials on
LVH
regression using a large registry from a tertiary care center, to identify phenotypes less likely to achieve regression of
LVH
.

Methods and Results

Patients from the Campania Salute Network, free of prevalent cardiovascular disease, but with echocardiographic
LVH
(defined as
LV
mass index [LVMi] >47 g/m
2.7
in women and >50 g/m
2.7
in men) were included. During a median follow‐up of 67 months, clear‐cut regression of
LVH
was documented in 14% of patients (13±8% reduction of initial
LVMi
) or 23% when also considering those with a reduction of
LVMi
≥5 g/m
2.7
. Patients with persistent
LVH
were older with longer duration of hypertension, suboptimal blood pressure (BP) control, larger body mass index,
LV
mass, and carotid intima‐media thickness and included more women and subjects with diabetes mellitus, isolated systolic hypertension, and metabolic syndrome (all
P
<0.05). Number and class of antihypertensive drugs during follow‐up did not differ between groups. In multiple logistic regression analysis, older age, female sex, obesity, higher baseline
LVMi
and carotid intima‐media thickness, and suboptimal BP control were significant covariates of persistent
LVH
(all
P
≤0.01), independent of diabetes, duration of hypertension, isolated systolic hypertension, follow‐up time and number and class of antihypertensive drugs.

Conclusions

Early initiation of antihypertensive treatment, aggressive BP control, and attention to metabolic aspects are critical to avoid irreversible
LVH
.
Relationship Between Changes in the Temporal Dynamics of the Blood-Oxygen-Level-Dependent Signal and Hypoperfusion in Acute Ischemic Stroke
Authors: Khalil Ahmed A. , Ostwaldt Ann-Christin , Nierhaus Till , Ganeshan Ramanan , Audebert Heinrich J. , Villringer Kersten , Villringer Arno , Fiebach Jochen B. 
Published: March 2017

Background and Purpose—
Changes in the blood-oxygen-level-dependent (BOLD) signal provide a noninvasive measure of blood flow, but a detailed comparison with established perfusion parameters in acute stroke is lacking. We investigated the relationship between BOLD signal temporal delay and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in stroke patients.

Methods—
In 30 patients with acute (<24 hours) ischemic stroke, we performed Pearson correlation and multiple linear regression between DSC-MRI parameters (time to maximum [Tmax], mean transit time, cerebral blood flow, and cerebral blood volume) and BOLD-based parameters (BOLD delay and coefficient of BOLD variation). Prediction of severe hypoperfusion (Tmax >6 seconds) was assessed using receiver–operator characteristic (ROC) analysis.

Results—

Correlation was highest between Tmax and BOLD delay (venous sinus reference; time shift range 7; median
r
=0.60; interquartile range=0.49–0.71). Coefficient of BOLD variation correlated with cerebral blood volume (median
r
= 0.37; interquartile range=0.24–0.51). Mean
R
2
for predicting BOLD delay by DSC-MRI was 0.54 (SD=0.2) and for predicting coefficient of BOLD variation was 0.37 (SD=0.17). BOLD delay (whole-brain reference, time shift range 3) had an area under the curve of 0.76 for predicting severe hypoperfusion (sensitivity=69.2%; specificity=80%), whereas BOLD delay (venous sinus reference, time shift range 3) had an area under the curve of 0.76 (sensitivity=67.3%; specificity=83.5%).

Conclusions—
BOLD delay is related to macrovascular delay and microvascular hypoperfusion, can identify severely hypoperfused tissue in acute stroke, and is a promising alternative to gadolinium contrast agent–based perfusion assessment in acute stroke.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00715533 and NCT02077582.
Evaluation of Orographic Cloud Seeding Using a Bin Microphysics Scheme: Two-Dimensional Approach
Authors: Geresdi István , Xue Lulin , Rasmussen Roy 
Published: March 2017

AbstractA new version of a bin microphysical scheme implemented into the Weather Research and Forecasting (WRF) Model was used to study the effect of glaciogenic seeding on precipitation formation in orographic clouds. The tracking of silver iodide (AgI) particles inside of water drops allows the proper simulation of the immersion nucleation. The ice formations by deposition, condensational freezing, and contact nucleation of AgI particles are also simulated in the scheme. Cloud formation—both stably stratified and convective—and the spread of AgI particles were simulated by idealized flow over a two-dimensional (2D) bell-shaped mountain. The results of numerical experiments show the following: (i) Only the airborne seeding enhances precipitation in stably stratified layer clouds. Seeding can reduce or enhance precipitation in convective clouds. AgI seeding can significantly affect the spatial distribution of the surface precipitation in orographic clouds. (ii) The positive seeding effect is primarily due to additional diffusional growth of AgI-nucleated ice crystals in layer clouds. In convective clouds, seeding-induced changes of both diffusion and riming processes determine the seeding effect. (iii) The seeding effect is inversely related to the natural precipitation efficiency. (iv) Bulk seeding parameterization is adequate to simulate AgI seeding impacts on wintertime orographic clouds. More uncertainties of ground-seeding effects are found between bulk and bin simulations.
A study for improving the energy efficiency of lifts with adjustable counterweighting
Authors: Tukia Toni , Uimonen Semen , Siikonen Marja-Liisa , Hakala Harri , Lehtonen Matti 
Published: March 2017

This article presents a study of the potential energy efficiency improvement by means of adjusting the lift counterweight. The lift energy consumption in different counterweight set-ups is studied by employing measured lift traffic and energy consumption data from an office building in Finland. Overall, dimensioning the counterweight based on traffic analysis is one of the fastest and most cost-effective means of improving the energy efficiency of lifts. The results from the building imply, however, that with a relatively constant loading throughout the day, the continuous adjusting of the counterweight provides limited energy savings compared to systems where the counterweight is sized according to the average load. Nevertheless, active adjustment of the counterweight size may provide considerable savings in lift systems if there is a wide variation in the car loading between the hours of the day. Furthermore, reducing the counterweight potentially improves the ISO 25745-2 energy efficiency classification of the lift, thus increasing the product attractiveness in the market. Practical application: This article presents practical approaches to analysing the energy consumption of counterbalanced lifts. The modelled results can be used to optimise the mass of the counterweight in order to achieve considerable energy savings in the actual or expected traffic profile.
Using an Allometric Equation to Accurately Predict the Energy Expenditure of Children and Adolescents With Nonalcoholic Fatty Liver Disease
Authors: Martincevic Inez , Mouzaki Marialena 
Published: March 2017

AbstractBackground: Pediatric patients with nonalcoholic fatty liver disease (NAFLD) require targeted nutrition therapy that relies on calculating energy needs. Common energy equations are inaccurate in predicting resting energy expenditure (REE), influencing total energy expenditure (TEE) estimates. Equations based on allometric scaling are simple, accurate, void of subjective activity and/or stress factor bias, and they estimate TEE. Objective: To investigate the predictive accuracy of an allometric energy equation (AEE) in predicting TEE of children and adolescents with NAFLD. Methods: Retrospective study performed in a single institution. The allometric equation was used to calculate AEE, and the results were compared with TEE calculated using indirect calorimetry data (measured REE) multiplied by an activity factor (AF) of 1.5 or 1.7. Results: Fifty‐six patients with a mean age of 13 years were included in this study. The agreement between TEE (using an AF of 1.5) and AEE was −96 kcal/d (confidence interval, −29 to 221). The predictive accuracy of the allometric equation was not different between obese and nonobese patients. Conclusions: Allometric equations allow for accurate estimation of TEE in children with NAFLD.
3D Computed Tomography Evaluation of Morphological Changes in the Femoral Tunnel After Medial Patellofemoral Ligament Reconstruction With Hamstring Tendon Graft for Recurrent Patellar Dislocation
Authors: Kita Keisuke , Tanaka Yoshinari , Toritsuka Yukiyoshi , Amano Hiroshi , Uchida Ryohei , Shiozaki Yoshiki , Takao Rikio , Horibe Shuji 
Published: March 2017

Background: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. Purpose: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: Twenty-three patients with recurrent patellar dislocation were prospectively enrolled in this study. The patients included 6 males and 17 females with a mean age of 24 years (range, 14-53). The MPFL was reconstructed by creating 2 patellar bone sockets and 1 femoral bone socket anatomically under X-ray control, and the semitendinosus autograft was fixed with cortical suspension devices. Computed tomography scans obtained 3 weeks and 1 year after surgery were reconstructed into 3D constructs with a volume analyzer. Cross-sectional areas (CSAs) of the aperture and inside the femoral tunnel were compared between the 2 time points. Likewise, the location of tunnel walls and center of the femoral tunnel footprint were evaluated. Relationships were assessed between femoral tunnel morphological changes and potential risk factors—such as age, body mass index, sex, femoral tunnel positioning, patellar height, sulcus angle, congruence angle, lateral tilt angle, degree of trochlear dysplasia, lateral deviation of the tibial tubercle, and Kujala score. Results: No patient reported recurrence of patellar dislocation during the follow-up period. The CSA of the femoral tunnel aperture enlarged by 41.1% ± 34.7% ( P < .01). The center, anterior border, and proximal border of the femoral tunnel significantly shifted in the anterior direction ( P < .01). The distal border significantly shifted in both anterior and distal directions ( P < .01). Patella alta was associated with distal migration of the tunnel center ( P < .05). Morphological changes were not associated with other risk factors or Kujala score. Conclusion: The CSA of the femoral tunnel aperture enlarged, and the tunnel aperture migrated anteriorly with time after MPFL reconstruction. Risk factors for patellar dislocation other than patella alta did not influence morphological changes of the femoral tunnel.
Increased Risk of Revision After Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Allografts Compared With Autografts
Authors: Maletis Gregory B. , Chen Jason , Inacio Maria C.S. , Love Rebecca M. , Funahashi Tadashi T. 
Published: March 2017

Background: The use of allograft tissue for anterior cruciate ligament reconstruction (ACLR) remains controversial. Purpose: To compare the risk of aseptic revision between bone–patellar tendon–bone (BPTB) autografts and BPTB allografts. Study Design: Cohort study; Level of evidence, 2. Methods: A retrospective cohort study of prospectively collected data was conducted using the Kaiser Permanente ACLR Registry. A cohort of patients who underwent primary unilateral ACLR with BPTB autografts and BPTB allografts was identified. Aseptic revision was the endpoint. The type of graft and allograft processing method (nonprocessed, <1.8-Mrad, and ≥1.8-Mrad irradiation) were the exposures of interest evaluated. Age (≤21 and ≥22 years) was evaluated as an effect modifier. Analyses were adjusted for age, sex, and race. Kaplan-Meier curves and Cox proportional hazards models were employed. Hazard ratios (HRs) and 95% CIs are provided. Results: The BPTB cohort consisted of 5586 patients: 3783 (67.7%) were male, 2359 (42.2%) were white, 1029 (18.4%) had allografts (nonprocessed: 155; <1.8 Mrad: 525; ≥1.8 Mrad: 288), and 4557 (81.6%) had autografts. The median age was 34.9 years (interquartile range [IQR], 25.4-44.0) for allograft cases and 22.0 years (IQR, 17.6-30.0) for autograft cases. The estimated cumulative revision rate at 2 years was 4.1% (95% CI, 2.9%-5.9%) for allografts and 1.7% (95% CI, 1.3%-2.2%) for autografts. BPTB allografts had a significantly higher adjusted risk of revision than BPTB autografts (HR, 4.54; 95% CI, 3.03-6.79; P < .001). This higher risk of revision was consistent with all allograft processing methods when compared with autografts and was also consistently higher in patients with allografts regardless of age. Conclusion: When BPTB allograft tissue was used for ACLR, an overall 4.54 times adjusted higher risk of revision was observed compared with surgery performed with a BPTB autograft. Whether the tissue was irradiated with either high- or low-dose radiation, chemically processed, or not processed at all made little difference in the risk of revision. The differences in the revision risk were also consistent in younger and older patients. Surgeons and patients should be aware of the increased risk of revision when a BPTB allograft is used for ACLR.
3D-Printed Poly(ε-caprolactone) Scaffold Augmented With Mesenchymal Stem Cells for Total Meniscal Substitution: A 12- and 24-Week Animal Study in a Rabbit Model
Authors: Zhang Zheng-Zheng , Wang Shao-Jie , Zhang Ji-Ying , Jiang Wen-Bo , Huang Ai-Bing , Qi Yan-Song , Ding Jian-Xun , Chen Xue-Si , Jiang Dong , Yu Jia-Kuo 
Published: March 2017

Background: Total meniscectomy leads to knee osteoarthritis in the long term. The poly(ε-caprolactone) (PCL) scaffold is a promising material for meniscal tissue regeneration, but cell-free scaffolds result in relatively poor tissue regeneration and lead to joint degeneration. Hypothesis: A novel, 3-dimensional (3D)–printed PCL scaffold augmented with mesenchymal stem cells (MSCs) would offer benefits in meniscal regeneration and cartilage protection. Study Design: Controlled laboratory study. Methods: PCL meniscal scaffolds were 3D printed and seeded with bone marrow–derived MSCs. Seventy-two New Zealand White rabbits were included and were divided into 4 groups: cell-seeded scaffold, cell-free scaffold, sham operation, and total meniscectomy alone. The regeneration of the implanted tissue and the degeneration of articular cartilage were assessed by gross and microscopic (histological and scanning electron microscope) analysis at 12 and 24 weeks postoperatively. The mechanical properties of implants were also evaluated (tensile and compressive testing). Results: Compared with the cell-free group, the cell-seeded scaffold showed notably better gross appearance, with a shiny white color and a smooth surface. Fibrochondrocytes with extracellular collagen type I, II, and III and proteoglycans were found in both seeded and cell-free scaffold implants at 12 and 24 weeks, while the results were significantly better for the cell-seeded group at week 24. Furthermore, the cell-seeded group presented notably lower cartilage degeneration in both femur and tibia compared with the cell-free or meniscectomy group. Both the tensile and compressive properties of the implants in the cell-seeded group were significantly increased compared with those of the cell-free group. Conclusion: Seeding MSCs in the PCL scaffold increased its fibrocartilaginous tissue regeneration and mechanical strength, providing a functional replacement to protect articular cartilage from damage after total meniscectomy. Clinical Relevance: The study suggests the potential of the novel 3D PCL scaffold augmented with MSCs as an alternative meniscal substitution, although this approach requires further improvement before being used in clinical practice.
Risk factors to predict the development of chronic kidney disease in patients with lupus nephritis
Authors: Park D J , Kang J H , Lee J W , Lee K E , Kim T J , Park Y W , Lee J S , Choi Y D , Lee S S 
Published: March 2017

Objectives We analyzed the clinical follow-up results of 88 lupus nephritis patients to find prognostic factors for the development of chronic kidney disease in ethnically homogeneous Korean patients with biopsy-proven lupus nephritis. Methods Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained. Renal biopsy specimens were reclassified according to the International Society of Pathology/Renal Pathology Society classification, separately, by two renal pathologists blinded to the previous classification. Univariate and multivariate analyses were performed using the Cox proportional hazard regression model to identify independent risk factors for chronic kidney disease in lupus nephritis patients. Results Eighteen of 88 patients (20.5%) developed chronic kidney disease during a mean follow-up of 47.6 months (range: 12–96 months). Patients who developed chronic kidney disease were older at onset of lupus nephritis, had less education, and were more likely to have hypertension; they had lower serum albumin levels, lower platelet levels, higher serum creatinine levels, lower estimated glomerular filtration rate, higher chronicity index, and lower frequency of anti-ribosomal P antibodies, and they were less likely to be in complete remission in the first year. In stepwise multivariable analyses, hypertension, lower glomerular filtration rate, and failure to achieve complete remission in the first year of treatment were significant predictors of the development of chronic kidney disease in lupus nephritis patients. Conclusions These findings suggest that patients with hypertension and decreased kidney function at the onset of lupus nephritis and showing a poor response to immunosuppressive drugs in the first year should be monitored carefully and managed aggressively to avoid deterioration of kidney function.
The Puzzle of Egalitarianism. The Relationship between Employment, Wage Inequality, Social Expenditure and Poverty
Authors: Cantillon Bea , Marx Ive , Van Den Bosch Karel 
Published: March 2017

In social policy debates, there are fundamentally different views of links between such key variables as employment, low pay, social transfers and poverty. This paper reviews basic empirical evidence on the validity of these views and the policy prescriptions that follow from them, drawing mainly on cross-country comparative studies. These reveal that clear and striking cross-country correlations prevail, but not, as is often so readily suggested, between low pay (wage compression) and employment performance, or between employment performance and poverty. Instead, results indicate a strong but negative cross-country correlation between the level of social spending and the incidence of poverty, as well as a strong and positive cross-country correlation between the incidence of low pay and the incidence of relative poverty. While the former correlation has become part of the received wisdom in social policy research, the latter is more surprising, as the correlation is not due to a strong link between low pay and poverty at the individual level. In addition, the incidence of low wage employment and social expenditure are also strongly and (negatively) related. We examine these correlations in more depth, particularly the link between the level of social spending and poverty. Since there is such a clear and strong negative link between the level of social expenditure and the level of poverty, it is tempting to think that more social spending offers an easy means of reducing poverty. However, a simple simulation exercise using Luxemburg Income Study data from the mid 90's suggests that putting more money into social transfer systems as they currently exist in the EU would not have a positive outcome on poverty rates in all countries. In the final section of the paper, we briefly summarise the results, and put forward a recommendation for further research.
New Social Risks and Social Exclusion as a Challenge to Czech Social Policy
Authors: Sirovátka Tomáš 
Published: March 2017

Current demographic and social changes in (post)modern societies present new challenges to social policy in the form of a new and deepening social and economic imbalance – they are sometimes referred to as ‘new social risks’ – and among the direct consequences of these new risks is the phenomenon of social exclusion. In response to these challenges, European agendas for employment and for social inclusion, are being implemented. These guidelines are set out in programme documents such as National Action Plans for Employment (since 2005 National Reform Programmes) and National Action Plans for Social Inclusion. Given that the Method of Open Coordination is a rather ‘soft instrument’, specific implementation of these agendas in European countries is dependent on many aspects of the national context. In this article, we aim to describe the specifics of the Czech Republic's approach to the problems of social exclusion. We will first explore the emphasis laid on the new risks in Czech social policy measures and attempt to draw comparisons with other EU countries. Next, we will also pay attention to the Czech approach to the agenda for social inclusion, which is among the key agendas in this area.
The Management of Chronic Diseases in the Netherlands and in Germany
Authors: Sichert Markus , Walser Christina 
Published: March 2017

Chronic diseases pose significant challenges to health insurance systems. On the one hand, the supply of medical care to patients suffering from chronic diseases is very costly; on the other hand, more and more people are becoming chronically ill, and many of them suffer from diabetes. Against this background, steering mechanisms that address chronic disease management are needed, not only to cope with cost containment, but also to improve quality and to overcome obstructive interfaces of supply structures. This article analyses how these challenges are being dealt with and how the respective chronic diseases – the focus will be on diabetes – are managed in the Netherlands and in Germany. The approaches taken in each of these countries present examples of how structures for political and legal steering have been established within health care systems that are subject to frequent reform. Each approach is assessed by analysing the priority given to either regulatory or competitive elements, and particular reference will be made to (subordinated) implementation structures, contracts or models.