bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes
Authors: Nazerian Peiman , Mueller Christian , Soeiro Alexandre de Matos , Leidel Bernd A. , Salvadeo Sibilla Anna Teresa , Giachino Francesca , Vanni Simone , Grimm Karin , Oliveira Múcio Tavares , Pivetta Emanuele , Lupia Enrico , Grifoni Stefano , Morello Fulvio , Capretti Elisa , Castelli Matteo , Gualtieri Simona , Trausi Federica , Battista Stefania , Bima Paolo , Carbone Federica , Tizzani Maria , Veglio Maria G. , Badertscher Patrick , Boeddinghaus Jasper , Nestelberger Thomas , Twerenbold Raphael 
Published: October 2017

Background:
Acute aortic syndromes (AASs) are rare and severe cardiovascular emergencies with unspecific symptoms. For AASs, both misdiagnosis and overtesting are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS but is inadequate as a stand-alone test. Integration of pretest probability assessment with DD testing is feasible, but the safety and efficiency of such a diagnostic strategy are currently unknown.

Methods:
In a multicenter prospective observational study involving 6 hospitals in 4 countries from 2014 to 2016, consecutive outpatients were eligible if they had ≥1 of the following: chest/abdominal/back pain, syncope, perfusion deficit, and if AAS was in the differential diagnosis. The tool for pretest probability assessment was the aortic dissection detection risk score (ADD-RS, 0–3) per current guidelines. DD was considered negative (DD−) if <500 ng/mL. Final case adjudication was based on conclusive diagnostic imaging, autopsy, surgery, or 14-day follow-up. Outcomes were the failure rate and efficiency of a diagnostic strategy for ruling out AAS in patients with ADD-RS=0/DD− or ADD-RS ≤1/DD−.

Results:
A total of 1850 patients were analyzed. Of these, 438 patients (24%) had ADD-RS=0, 1071 patients (58%) had ADD-RS=1, and 341 patients (18%) had ADD-RS >1. Two hundred forty-one patients (13%) had AAS: 125 had type A aortic dissection, 53 had type B aortic dissection, 35 had intramural aortic hematoma, 18 had aortic rupture, and 10 had penetrating aortic ulcer. A positive DD test result had an overall sensitivity of 96.7% (95% confidence interval [CI], 93.6–98.6) and a specificity of 64% (95% CI, 61.6–66.4) for the diagnosis of AAS; 8 patients with AAS had DD−. In 294 patients with ADD-RS=0/DD−, 1 case of AAS was observed. This yielded a failure rate of 0.3% (95% CI, 0.1–1.9) and an efficiency of 15.9% (95% CI, 14.3–17.6) for the ADD-RS=0/DD− strategy. In 924 patients with ADD-RS ≤1/DD−, 3 cases of AAS were observed. This yielded a failure rate of 0.3% (95% CI, 0.1–1) and an efficiency of 49.9% (95% CI, 47.7–52.2) for the ADD-RS ≤1/DD− strategy.

Conclusions:
Integration of ADD-RS (either ADD-RS=0 or ADD-RS ≤1) with DD may be considered to standardize diagnostic rule out of AAS.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02086136.
Added Value of Vessel Wall Magnetic Resonance Imaging for Differentiation of Nonocclusive Intracranial Vasculopathies
Authors: Mossa-Basha Mahmud , Shibata Dean K. , Hallam Danial K. , de Havenon Adam , Hippe Daniel S. , Becker Kyra J. , Tirschwell David L. , Hatsukami Thomas , Balu Niranjan , Yuan Chun 
Published: October 2017

Background and Purpose—
Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone.

Methods—
We retrospectively reviewed images from patients with both luminal and IVWI to identify cases with clinically defined intracranial vasculopathies: atherosclerosis (intracranial atherosclerotic disease), reversible cerebral vasoconstriction syndrome, and inflammatory vasculopathy. Two neuroradiologists blinded to clinical data reviewed the luminal imaging of defined luminal stenoses/irregularities and evaluated the pattern of involvement to make a presumed diagnosis with diagnostic confidence. Six weeks later, the 2 raters rereviewed the luminal imaging in addition to IVWI for the pattern of wall involvement, presence and pattern of postcontrast enhancement, and presumed diagnosis and confidence. Analysis was performed on per-lesion and per-patient bases.

Results—

Thirty intracranial atherosclerotic disease, 12 inflammatory vasculopathies, and 12 reversible cerebral vasoconstriction syndrome patients with 201 lesions (90 intracranial atherosclerotic disease, 64 reversible cerebral vasoconstriction syndrome, and 47 inflammatory vasculopathy lesions) were included. For both per-lesion and per-patient analyses, there was significant diagnostic accuracy improvement with luminal imaging+IVWI when compared with luminal imaging alone (per-lesion: 88.8% versus 36.1%;
P
<0.001 and per-patient: 96.3% versus 43.5%;
P
<0.001, respectively). There was substantial interrater diagnostic agreement for luminal imaging+IVWI (κ=0.72) and only slight agreement for luminal imaging (κ=0.04). Although there was a significant correlation for both luminal and IVWI pattern of wall involvement with diagnosis, there was a stronger correlation for IVWI finding of lesion eccentricity and intracranial atherosclerotic disease diagnosis than for luminal imaging (κ=0.69 versus 0.18;
P
<0.001).

Conclusions—
IVWI can significantly improve the differentiation of nonocclusive intracranial vasculopathies when combined with traditional luminal imaging modalities.
Comparison of Outcomes in Patients With Generalized Ligamentous Laxity and Without Generalized Laxity in the Arthroscopic Modified Broström Operation for Chronic Lateral Ankle Instability
Authors: Yeo Eui Dong , Park Ji Young , Kim Jin Hyeung , Lee Young Koo 
Published: October 2017

Background: The arthroscopic modified Broström operation (MBO) has been frequently used to treat chronic lateral ankle instability (CLAI). However, no reports comparing the clinical outcomes between patients with or without generalized ligamentous laxity (laxity or no laxity, respectively) currently exist. The purpose of this study was to compare the clinical outcomes of the 2 groups with CLAI. Methods: Between January 2013 and November 2015, arthroscopic MBO was performed on 99 patients with CLAI. Patients were divided into 2 groups: the laxity group (24 ankles) and no laxity group (75 ankles). Generalized ligamentous laxity was defined as a Beighton score of 4 or more points. Evaluation tools included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot ankle score, a pain visual analog scale (VAS), and talar tilt angle. Results: The change in talar tilt angle from preoperative to 12 months postoperative was significantly greater in the laxity group (–6.9 ± 5.2) compared with the no-laxity group (–4.2 ± 4.2) ( P = .03). The final follow-up AOFAS hindfoot ankle score and pain VAS in both groups showed improvement compared with the preoperative values. Conclusion: All groups achieved successful clinical and radiological final follow-up outcomes. Arthroscopic MBO should be considered a reasonable method in patients who have chronic lateral ankle instability, regardless of generalized ligamentous laxity. Level of Evidence: III, comparative study.
Effect of Gender on Mechanical Properties of the Plantar Fascia and Heel Fat Pad
Authors: Taş Serkan 
Published: October 2017

Background. The purpose of the study was to investigate the plantar fascia and heel fat pad stiffness and thickness parameters in females and compare these values with those of males. Methods. This study was carried out in 60 healthy sedentary participants (30 female, 30 male) between the ages of 19 and 50 years. Shear wave velocity (SWV) and thickness of the plantar fascia and heel fat pad were measured with an ultrasonography device. Results. Males had a higher plantar fascia ( P = .037) and heel fat pad ( P = .001) thickness compared with females, but SWV of the plantar fascia ( P = .673), heel fat pad microchamber layer ( P = .240), and heel fat pad macrochamber layer ( P = .636) were similar in both groups. Body mass had a strong correlation with the plantar fascia ( r = 0.64, P < .001) and heel fat pad thickness ( r = 0.68, P < .001). Height had a moderate correlation with the plantar fascia ( r = 0.44, P < .001) and heel fat pad thickness ( r = 0.42, P = .001). Conclusion. Plantar fascia and heel fat pad stiffness were similar in both genders; however, females had a lower plantar fascia and heel fat pad thickness compared with males. Correlation analysis results suggest that higher plantar fascia and heel fat pad thickness in males may be related to higher body mass and height. Levels of Evidence: Level III: Retrospective comparative study
The effect of plasma auto-IgGs on CD4+ T cell apoptosis and recovery in HIV-infected patients under antiretroviral therapy
Authors: Luo Zhenwu , Zhou Zejun , Ogunrinde Elizabeth , Zhang Tao , Li Zhen , Martin Lisa , Wan Zhuang , Wu Hao , Qin Zhiqiang , Ou Tongwen , Zhang Jiafeng , Ma Lei , Liao Guoyang , Heath Sonya , Huang Lei , Jiang Wei 
Published: October 2017

Abstract
Although effective antiretroviral therapy (ART) suppresses HIV viral replication, prevents AIDS-related complications, and prolongs life, a proportion of patients fails to restore the patients’ CD4+ T cell number to the level of healthy individuals. Increased mortality and morbidity have been observed in these patients. In the current study, we have investigated the role of auto-IgGs in CD4+ T cell apoptosis and recovery in a cross-sectional study. All HIV+ subjects were on viral-suppressive ART treatment with a different degree of CD4+ T cell reconstitution. Total auto-IgG binding on CD4+ T cell surfaces and its associated apoptosis and CD4+ T cell recovery were analyzed by flow cytometry ex vivo. Total IgGs from plasma were tested for their binding capacities to CD4+ T cell surfaces and their mediation to CD4+ T cell death through NK cell cytotoxicity in vitro. HIV+ subjects had increased surface binding of auto-IgGs on CD4+ T cells compared with healthy controls, and IgG binding was associated with elevated CD4+ T cell apoptosis in HIV+ subjects but not in healthy controls. Plasma IgGs from HIV+ subjects bound to CD4+ T cells and induced cell apoptosis through NK cytotoxicity in vitro. Soluble CD4 (sCD4) preincubation prevented NK cell-mediated CD4+ T cell death. Our results suggest that plasma autoantibodies may play a role in some HIV+ patients with poor CD4+ T cell recovery under viral-suppressive ART.
The Association Between IGF-I and IGFBP-3 and Incident Diabetes in an Older Population of Men and Women in the Cardiovascular Health Study
Authors: Aneke-Nash Chino S , Xue Xiaonan , Qi Qibin , Biggs Mary L , Cappola Anne , Kuller Lewis , Pollak Michael , Psaty Bruce M , Siscovick David , Mukamal Kenneth , Strickler Howard D , Kaplan Robert C 
Published: October 2017

AbstractContextInsulin-like growth factor-I (IGF-I) has structural and functional similarities to insulin and may play a role in glucose homeostasis, along with insulin-like growth factor binding protein-3 (IGFBP-3), which binds the majority of circulating IGF-I.ObjectiveTo assess whether IGF-I and IGFBP-3 are associated with a higher risk of incident diabetes in older adults.DesignParticipants in the Cardiovascular Health Study (n = 3133), a cohort of adults aged ≥65 years, were observed for 16 years (n = 3133) for the development of incident diabetes. Statistical models were fit separately for men and women because of interactions with sex (P interaction: IGF-I, 0.02; IGFBP-3, 0.009) and were adjusted for relevant covariates.SettingGeneral community.ParticipantsOlder adults who were nondiabetic at baseline and who did not develop diabetes within the first year of follow-up.InterventionsNot applicable.Main Outcome MeasureIncident diabetes as measured by fasting plasma glucose (FPG) ≥126 mg/dL, non-FPG ≥200 mg/dL, use of pharmacological treatment of diabetes, or existence of two or more inpatient or three or more outpatient or (at least one inpatient and at least one outpatient) Centers for Medicare & Medicaid Services claims with the diagnostic International Classification of Diseases, Ninth Revision, Clinical Modification code of 250.xx.ResultsIn women, higher IGFBP-3 (hazard ratio tertile 3 vs tertile 1 = 2.30; 95% confidence interval, 1.55 to 3.40; P trend &lt; 0.0001) was significantly associated with incident diabetes. Total IGF-I was not significantly associated with incident diabetes. In men, neither IGF-I nor IGFBP-3 was significantly associated with incident diabetes.ConclusionsWe confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population, establishing that this association is present among women but could not be shown to be associated in men.
Factors influencing black men and their partners' knowledge of prostate cancer screening: a literature review
Authors: Ahiagba Phyllis , Alexis Obrey , Worsley Aaron James 
Published: October 2017

Prostate cancer is the most commonly diagnosed cancer in men in the UK, with 46 690 new cases in 2014. While there is sufficient research on this topic in the USA, there is no review in the UK regarding both black men and their significant others' perspective on prostate cancer screening. Aim: To identify and explore factors that may influence black men and their significant others' knowledge and awareness of prostate cancer screening. Method: A literature search revealed seven relevant articles. Results: Six of the seven articles were conducted in the USA. The results are described using four themes: perception of prostate cancer screening, fear, anxiety and discomfort, misinformation about prostate cancer screening procedures and communication and decision-making. Conclusion: The evidence suggests that some black men and their significant others had knowledge and awareness of prostate cancer screening. However, their views were influenced by misperceptions, misinformation, fear and anxiety around screening procedures and mortality. Communication and spousal support were important in decision making.
Reducing anti-psychotic prescribing for care home residents with dementia
Authors: Latham Isabelle , Brooker Dawn 
Published: October 2017

This article reports on the outcome and evaluation of the focused intervention training and support (FITS) into practice programme, a training and support programme for care home staff aimed at reducing inappropriate anti-psychotic prescribing for people living with dementia by implementing alternative psychosocial interventions. This programme was adapted from an original randomised-controlled trial that successfully reduced the prescribing of anti-psychotic medications in care homes. The aim of the new programme was to replicate the impact of the original trial, but using a less resource-intense model, so that it could be implemented across care homes in the UK within existing resource conditions. The programme successfully reduced anti-psychotic prescribing and improved staff knowledge and attitudes. Barriers and facilitators of implementation were identified at four key levels: the dementia care coach; the care home; the organisation; and external relationships. Crucial to success was the provision of dedicated time for dementia care coaches to implement, the ongoing support provided by the expert-practitioner role, and the quality of relationships with prescribers. The implications of these for the FITS into practice programme, other similar interventions, and the work of prescribers with care homes are discussed.
Analisis kesesuaian dan daya dukung lingkungan untuk pengembangan wisata bahari di Pulau Bawean Kabupaten Gresik Provinsi Jaya Timur
Authors: Sukandar Sukandar , Dewi Citra S. U. , Handayani Muliawati 
Published: October 2017

Bawean Island has potency as a ecotourism destination in Gresik District, Province of Jaya timur. This island is one of the popular destination for local tourist, and the visitors are increasing over the years; but there was no study on the suitability and carrying capacity of the island for marine ecotourism activities. The purpose of this study was to analysis the suitability and carrying capacity of Bawean Island for marine tourism. The Results of the analysis showed that the area of marine ocotourism in Bawean is Suitable (S1) for marine ecotourism development with a value for leisure travel 88.33%, snorkeling activity was 84.21%; and diving 81.48%. The total value carrying capacity of region was 398 persons/day.Pulau Bawean memiliki potensi sebagai daerah tujuan wisata bahari di kabupaten Gresikproins Jaya timur. Pulau ini telah menjadi tujuan wisata lokal bagi masyarakat Jaya timur dan jumlah kunjungan wisatawan semakin meningkat dari tahun ke tahun. Namu belum ada kajian mengenai kesesuaian dan daya dukung lingkungan di Pulau Bawean sebagai kawsan wisata bahari. Oleh karena itu penelitian ini bertujuan untuk mengkaji kesesuaian dan daya dukung Pulau Bawean sebagai kawasan wisata bahari. Hasil analisis menunjukkan bahwa Pulau Bawean sesuai (S1) untuk dikembangkan sebagai kawasan wisata bahari dengan nilai untuk wisata rekreasi pantai sebesar 88,33%, wisata snorkeling sebesar 84,21% dan wisata selam sebesar 81,48%. Nilai total daya dukung kawasan sebesar 398 orang/hari.
Hubungan panjang berat dan faktor kondisi ikan belodok (Famili: Gobiidae) pada ekosistem mangrove di Desa Pulau Sembilan Kabupaten Langkat Provinsi Sumatera Utara
Authors: Bidawi Bill Maulana , Desrita Desrita , Yunasfi Yunasfi 
Published: October 2017

The aims of the research was to examine the lenght weight relationships, growth pattern and condition factor of mudskipper (Family: Gobiidae) at the mangrove ecosystem. The research was conducted for two months from March to April 2016 at the mangrove ecosystem in the Sembilan Island village. The result showed that there are three species of mudskipper found in study area, namely Periophthalmus chrysospilos, Periophthalmus gracilis, and Boleophthalmus boddarti. The growth pattern of mudskipper with a value b 3, indicate a allometrik negative growth pattern and the condition factor was between 1-2.Penelitian ini bertujuan untuk menganalisis hubungan panjang bobot, pola pertumbuhan dan faktor kondisi ikan belodok (Famili: Gobiidae) pada ekosistem mangrove di di desa Pulau Sembilan Langkat. Penelitian dilaksanakan selama dua bulan yaitu Maret sampai April 2016. Penelitian ini menggunakan metode purposive random sampling. Hasil penelitian ditemukan 3 spesies ikan belodok di lokasi penelitian yaitu Periophthalmus chrysospilos, Periophthalmu sgracilis, dan Boleophthalmus boddarti. Pola pertumbuhan ikan belodok dengan nilai b 3, mengindikasikan pola pertumbuhan allometrik negatif. Faktor kondisi dari Ikan Belodok berkisar 1 – 2.
Status klorofil-a di Perairan Teluk Pria Laot Sabang, Provinsi Aceh
Authors: Agustina Sri , Musman Musri , Ishaq Muhammad 
Published: October 2017

Study about chlorophyll-a state in Teluk Pria Laot Sabang has been done in October 2016. The objective of this study was to analyze the chlorophyll-a concentration and phytoplankton abundance in Teluk Pria Laot Sabang. Samples were collected at a station located at 5,84653oN and 95,29001oE during 4 days (4, 6, 8, and 10th October 2016) which each day had 4 sampling times (07:00 am, 10:00 am, 01:00 pm, and 04:00 pm). Chlorophyll-a, phytoplankton, and nutrient analysis were conducted at chemistry laboratory of Teacher Training and Education Faculty, Syiah Kuala University, marine chemistry laboratory of Marine and Fisheries Faculty, Syiah Kuala University, and Unit of Environment Research and Development, Banda Aceh. The result showed that chlorophyll-a concentration ranged 0,02 – 1,7 µg/L withthe highest average (0,64 µg/L) was obtained at 01:00 pm. In addition,phytoplankton abundance was found ranged3539,4 ind/L – 8687,3 ind/L andthe highest average (6435,0 ind/L) appeared at 10:00 am. Nitrate and phosphate concentration which were above the minimum value of threshold revealed that this area was rich in nutrient availabilityto support the phytoplankton growth. Chlorophyll-a concentrations are likely influenced by light intensity with rich nutrient availability than phytoplankton abundance. According to chlorophyll-a concentration, Teluk Pria Laot Sabang is categorized as Oligothropic area.Penelitian tentang status klorofil-a di Teluk Pria Laot Sabang telah dilakukan pada Bulan Oktober 2016. Tujuan dari penelitian ini adalah untuk mengetahui konsentrasi klorofil-a dan kelimpahan fitoplankton di Teluk Pria Laot Sabang. Sampel dikumpulkan pada stasiun yang terletak pada koordinat 5,84653oLU dan 95,29001oBT selama 4 hari dengan 4 kali waktu pengambilan per hari (pukul 07.00, 10.00, 13.00, dan 16.00 WIB). Analisis klorofil-a, fitoplankton dan nutrien dilakukan di Laboratorium FKIP – kimia Unsyiah, Laboratorium Kimia Laut, FKP Unsyiah, Balai Penelitian dan Pengembangan Lingkungan (BPPL) Banda Aceh. Hasil penelitian menunjukkan bahwa konsentrasi klorofil-a berkisar 0,02– 1,7µg/Ldengan nilai rata – rata konsentrasi klorofil-a tertinggi 0,64µg/L didapatkan pada waktu pengambilan pukul 13:00 WIB. Kelimpahan fitoplankton yang diperoleh berkisar 3539,4 ind/L – 8687,3 ind/L dengan rata – rata tertinggi dengan nilai 6435,0 ind/L diperoleh pada pukul 10:00 WIB. Konsentrasi nitrat dan fosfat yang berada di atas ambang batas minimal menggambarkan bahwa daerah ini menyuplai nutrien yang cukup untuk pertumbuhan fitoplankton. Fluktuasi konsentrasi klorofil-a lebih cenderung mengikuti perubahan intensitas cahaya matahari dengan ketersediaan nutrien (nitrat dan fosfat) yang cukup. Berdasarkan konsentrasi klorofil-a yang diperoleh, Perairan Teluk Pria Laot Sabang dikategorikan sebagaidaerah oligotrofik.