bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nocturnal Non-dipping Blood Pressure Profile in Black Normotensives Is Associated with Cardiac Target Organ Damage
Authors: Mezue Kenechukwu , Isiguzo Godsent , Madu Chichi , Nwuruku Geoffrey , Rangaswami Janani , Baugh Dainia , Madu Ernest 
Published: July 2016

<p><strong>Purpose: </strong>A non-dipping pattern of nocturnal blood pressure in hypertensive patients is an established predictor of cardiovascular risk, especially in Blacks. However, data on non-dipping normotensives and cardiovascular risk in this population is sparse. In this study, we aim to determine if a non-dipping profile in a cohort of Black normotensives is associated with cardiac target organ damage. <strong></strong></p><p><strong>Methods: </strong>We studied ambulatory blood pressure patterns in 43 normotensive Black patients of Caribbean origin and classified their profiles as dippers (DP) and nondippers (NDP) based on their nocturnal blood pressure profiles. Cardiac target organ damage was estimated from 2-D echocardiogram. </p><p><strong>Results: </strong>The mean age of the cohort was 52 years. Both groups were similar with respect to baseline age, sex, weight, height, body mass index and daytime ambulatory BP. There was a statistically significant difference in nocturnal blood pressure between DP and NDP groups (112 ± 7/64 ± 2 mm Hg vs 117 ± 3/69 ± 2 mm Hg, P=.004). The NDP cohort showed evidence of cardiovascular target damage on echocardiography with a significantly increased relative wall thickness (.35 ± .07cm vs .42 ± .05 cm, P=.001), left ventricular mass index (95 ± 14 vs 105 ± 14 g/m2, P=.018) and left atrial volume index (26 ± 3.5 vs. 30 ± 3.4, P=.001). Left ventricular geometry in the non-dippers also showed increased concentric remodeling, concentric and eccentric hypertrophy. </p><p><strong>Conclusions: </strong>Our study demonstrates that nocturnal non-dipping of blood pressure in normotensive Blacks of Caribbean origin may be associated with cardiovascular end organ damage thereby providing new surveillance and therapeutic targets. <em>Ethn Dis.</em>2016;26(3):279-284; doi:10.18865/ed.26.3.279 </p><br /><p><strong> </strong></p>
Age, Race and Cardiovascular Outcomes in African American Veterans
Authors: Norris Keith C. , Mensah George A. , Boulware L. Ebony , Lu Jun L. , Ma Jennie Z. , Streja Elani , Molnar Miklos Z. , Kalantar-Zadeh Kamyar , Kovesdy Csaba P. 
Published: July 2016

<p><strong>Background: </strong>In the general population, compared wtih their White peers, African Americans suffer premature all-cause and cardiovascular (CV) deaths, attributed in part to reduced access to care and lower socioeconomic status. Prior reports indicated younger (aged 35 to 44 years) African Americans had a signficantly greater age-adjusted risk of death. Recent studies suggest that in a more egalitarian health care structure than typical United States (US) health care structures, African Americans may have similar or even better CV outcomes, but the impact of age is less well-known. <strong></strong></p><p><strong>Methods: </strong>We examined age stratified all-cause mortality, and incident coronary heart disease (CHD) and ischemic stroke in 3,072,966 patients (547,441 African American and 2,525,525 White) with an estimated glomerular filtration rate (eGFR)&gt;60 mL/min/1.73m2 receiving care from the US Veterans Health Administration. Outcomes were examined in Cox models adjusted for demographics, comorbidities, kidney function, blood pressure, socioeconomics and indicators of the quality of health care delivery. <strong></strong></p><p><strong>Results: </strong>African Americans had an overall 30% lower all-cause mortality (P&lt;.001) and 29% lower incidence of CHD (P&lt;.001) and higher incidence of ischemic stroke (aHR, 95%CI: 1.16, 1.13-1.18, P&lt;.001). The lower rates of mortality and CHD were strongest in younger African Americans and attenuated across patients aged <span style="text-decoration: underline;">&gt;</span>70 years. Stroke rates did not differ by race in persons aged &lt;70 years. <strong></strong></p><p><strong>Conclusions: </strong>Among patients with normal eGFR and receiving care in the Veterans Health Administration, younger African Americans had lower all-cause mortality and incidence of CHD and similar rates of stroke, independent of demographic, comorbidity and socioeconomic differences. The lower all-cause mortality persisted but attenuated with increasing age and the lower incidence of CHD ended at aged ≥80 years. The higher incidence of ischemic stroke in African Americans was driven by increasing risk in patients aged ≥70 years suggesting that the improved cardiovascular outcomes were most dramatic for younger African Americans. <em>Ethn Dis. </em>2016;26(3):305-314; doi:10.18865/ed.26.3.305 </p>
Non-White Race Is an Independent Risk Factor for Hospitalization for Aortic Dissection
Authors: Harris Donald , Klyushnenkova Elena , Kalsi Richa , Garrido Danon , Bhardwaj Abhishek , Rabin Joseph , Toursavadkohi Shahab , Diaz Jose , Crawford Robert 
Published: July 2016

<p><strong>Objective: </strong>To evaluate racial differences in the burden of aortic dissection. </p><p><strong>Design: </strong>Retrospective analysis of a comprehensive state-wide inpatient database. <strong></strong></p><p><strong>Setting: </strong>Acute care hospitals in the state of Maryland, 2009 – 2014. </p><p><strong>Participants: </strong>All hospitalized adults with aortic dissection (AD), stratified by race. </p><p><strong>Main Outcome Measures: </strong>Statewide and county-level population adjusted hospitalization rates, access to specialty aortic care, and mortality. <strong></strong></p><p><strong>Results: </strong>Of 3,719,412 admissions to Maryland hospitals during the study period, 3,190 had AD (.09%; 1665 White, 1525 non- White). Non-White race was more common in patients with AD than without (48% vs. 41%, P&lt;.0001). Adjusted for statewide demographics, admission for AD was 1.4 times more common among non-Whites (11 vs. 8 per 100,000, P&lt;.0001). Non-White race was an independent risk factor for AD admission (OR 1.5, 95% CI 1.4 – 1.7). Among patients with AD, non-Whites were younger and more often female, but had similar or lower rates of cardiovascular comorbidities. Non-White race was not associated with decreased access to care or increased mortality. <strong></strong></p><p><strong>Conclusion: </strong>Hospitalization for AD is more common among non-Whites, who develop AD at younger ages despite fewer comorbidities. While clinical correlates are limited from this dataset, this may reflect more severe pathophysiology related to clinical or socioeconomic factors among non-Whites. Further study is warranted to better define this disparity and identify high-risk subgroups who may benefit from aggressive primary prevention. <em>Ethn Dis. </em>2016;26(3):363-368; doi:10.18865/ed.26.3.363 </p>
A Perspective on Promoting Diversity in the Biomedical Research Workforce: The National Heart, Lung, and Blood Institute’s PRIDE Program
Authors: Boyington Josephine E.A. , Maihle Nita J. , Rice Treva K. , Gonzalez Juan E. , Hess Caryl A. , Makala Levi H. , Jeffe Donna B. , Ogedegbe Gbenga , Rao Dabeeru C. , Dávila-Román Victor G. , Pace Betty S. , Jean-Louis Girardin , Boutjdir Mohamed 
Published: July 2016

<p>Aspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants’ perceptions of PRIDE’s impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees’ testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators. <em>Ethn Dis. </em>2016;26(3):379- 386; doi:10.18865/ed.26.3.379 </p>
A Strategic Framework for Utilizing Late-Stage (T4) Translation Research to Address Health Inequities
Authors: Lopez-Class Maria , Peprah Emmanuel , Zhang Xinzhi , Kaufmann Peter G. , Engelgau Michael M. 
Published: July 2016

<p>Achieving health equity requires that every person has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. Inequity experienced by populations of lower socioeconomic status is reflected in differences in health status and mortality rates, as well as in the distribution of disease, disability and illness across these population groups. This article gives an overview of the health inequities literature associated with heart, lung, blood and sleep (HLBS) disorders. We present an ecological framework that provides a theoretical foundation to study late-stage T4 translation research that studies implementation strategies for proven effective interventions to address health inequities. <em>Ethn Dis. </em>2016;26(3):387-394; doi:10.18865/ ed.26.3.387 </p>
The Inaugural Elijah B. Saunders Memorial Lecture: The Global Consequences of Hypertension and Related Disparities
Authors: Mensah George A. 
Published: July 2016

<p>This inaugural memorial lecture provides an opportunity to celebrate the life of Elijah B. Saunders, MD, FACC and pays tribute to his pioneering spirit in the quest to advance health equity in the prevention and control of hypertension and cardiovascular diseases. It also enables an assessment of the state of the global burden of hypertension and related disparities. Despite the remarkable biomedical research progress made over the last half-century, hypertension remains the leading risk factor for global disease burden and the major preventable contributor to cardiovascular and all-cause mortality. Additionally, disparities in hypertension-related morbidity and mortality remain pervasive worldwide. National hypertension control rates showing progress often mask important suboptimal treatment and control in population groups defined by sex, race, ethnicity, geography, and social and environmental determinants. Within these groups, many hypertension-related disparities remain largely unchanged while other gaps have widened. In essence, current research has been relatively ineffective in guiding largescale, sustained elimination of hypertension-related disparities. An important explanation for these observations may be the significant advances made in observational epidemiological research, especially in improved surveillance and data collection that document the extent of disparities in marked contrast to the relative paucity of interventional disparities research. The paucity of these interventional research studies remains a continuing challenge. The time has come for renewed efforts in building strategic partnerships that leverage transdisciplinary, multi-sectoral expertise to provide global leadership in interventional implementation research for hypertension control and elimination of related disparities. Developing an appropriately skilled implementation research workforce will be crucial. The National Heart, Lung, and Blood Institute and its biomedical research funding partners remain committed to a strategic agenda of implementation research, training, and education for the prevention and control of hypertension and elimination of related disparities. <em>Ethn Dis. </em>2016;26(3):461-468; doi:10.18865/ed.26.3.461 </p>
PARC #2 Editorial
Authors: Medrano Leandro , Pina Sílvia Aparecida Mikami Gonçalves 
Published: July 2016

Passada quase uma década do início do século XXI, as alterações nos paradigmas da profissão parecem se transformar na velocidade acelerada das inovações das Tecnologias da Informação e Comunicação (TICs), ainda protagonistas de muitas das teses sobre a arquitetura e sociedade contemporâneas. Se no final dos anos 1990 e início deste século as discussões ainda permaneciam demasiadamente engendradas nas promessas das TICs e suas conseqüências (aceleração e ampliação da globalização, sociedade em rede, imaterialidade, ciberespaço etc.), hoje, no entanto, se pautam na instrumentalização desses e de outros recursos para ações efetivas aos espaços construídos pelo homem. A revista PARC mantém seu compromisso em ampliar o debate sobre a arquitetura contemporânea brasileira e internacional, divulgando artigos acadêmicos nas áreas de metodologia do projeto, teoria e crítica da arquitetura e tecnologia da construção civil. Assim são os artigos selecionados para este segundo número.
O Programa Monumenta e o modelo de centro histórico das cidades brasileiras
Authors: Schicchi Maria Cristina da Silva 
Published: July 2016

O texto analisa as experiências recentes de reabilitação de dois centros históricos brasileiros, Porto Alegre e Olinda, em especial, as intervenções realizadas pelo Programa Monumenta/BID, implementado pelo Ministério da Cultura e pelo IPHAN nas cidades brasileiras, na última década. A discussão é contextualizada pela análise mais geral de projetos e planos propostos para as áreas de implantação do programa. Na pesquisa de origem, os objetos de estudo foram os centros históricos de um conjunto de cidades portuárias latino-americanas que possuem significativo patrimônio urbano e arquitetônico e que sofreram intervenções recentes: Havana Velha, Montevidéu, Valparaíso, Porto Alegre, Belém, Rio de Janeiro e Olinda. A escolha do conjunto deve-se à premissa principal da pesquisa de que há uma simultaneidade nos processos de mudança em curso e uma similaridade nas formas de intervenção nas cidades latinoamericanas, de forma mais geral, dos quais as cidades brasileiras e, particularmente, os seus centros históricos, são também exemplos emblemáticos. Neste texto, como exemplos, são analisadas as mudanças urbanísticas operadas nos últimos quinze anos nas duas cidades citadas, nas quais se revela a importância que a questão da reabilitação do patrimônio urbano e arquitetônico ganhou como elemento motor de processos de intervenção em centros históricos, dentro do paradigma do desenvolvimento urbano sustentável. Como resultados, buscou-se evidenciar as estratégias de conservação destes centros, caracterizar e comparar as propostas de reabilitação e gestão adotadas e o papel dos diversos agentes que atuaram no processo.
Entre fotos, falas e fatos: A oficina historiográfica de Ana Maria Mauad da prática fotográfica à escrita videográfica como dimensões da experiência histórica
Authors: Soares Fagno da Silva 
Published: July 2016

Entrevista realizada com a historiadora Ana Maria Mauad de Sousa Andrade Essus, professora do Programa de Pós-Graduação de História Social da Universidade Federal de Fluminense (UFF), referência nos estudos em história oral e história visual no Brasil.

Ana Maria Mauad, pesquisadora de reconhecida atuação no mètier da história visual no Brasil. Seus estudos acerca de temáticas ligadas à História Oral, História Visual, História Pública, com especial interesse à reflexão crítica sobre fotografia e suas ressonâncias nacionais e internacionais. Pós-doutora em História pelo Museu Paulista da Universidade de São Paulo (USP, 2004), doutora em História Social pela Universidade Federal Fluminense (UFF, 1990). Atualmente coordena o Programa de Pós-Graduação em História Social da UFF, conceito máximo pela CAPES. É pesquisadora do Laboratório de História Oral e Imagem da LABHOI/UFF, membro da Associação Brasileira de História Oral-ABHO. Ao longo de sua carreira acadêmica publicou mais 50 artigos em periódicos nacionais e internacionais, organizou e/ou publicou 14 livros e aproximadamente 70 capítulos de livros. Esteve em 151 bancas de defesas de dissertações e teses. Orientou 55 monografias de graduação, 68 monografias de especialização, 62 dissertações e teses, tendo supervisionado 10 estágios pós-doutorais na UFF. Atuou como professora visitante em instituições internacionais como a University of California e a Universidad de Santiago de Chile. Participa do Conselho Editorial de importantes periódicos nacionais e internacionais na área de história.

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Debridement and Functional Rehabilitation for Achilles Tendon Infection Following Tendon Repair
Authors: Bae Seung Hwan , Lee Ho-Seong , Seo Sang Gyo , Kim Sang Woo , Gwak Heui-Chul , Bae Su-Young 
Published: July 2016

Background:
An infected Achilles tendon after tendon repair is particularly difficult to treat because of the poor vascularity of the tendon as well as the thin surrounding soft tissue. For treatment of an infected Achilles tendon following tendon repair, we first focused on complete debridement and then promoted fibrous scar healing of the Achilles tendon using functional treatment.

Methods:
We retrospectively reviewed all of the medical records of 15 tertiary referral patients with postoperative infection of the Achilles tendon occurring between 2007 and 2012. The mean follow-up time was 33 months (range, 22 to 97 months). The infected tissue and the necrotic tendon were debrided, and the ankle was placed in a short leg splint for 2 weeks. The splint was then replaced with an ankle brace for the next 4 weeks. Partial weight-bearing was allowed immediately, and full weight-bearing was allowed at 2 weeks postoperatively. We assessed and recorded the physical parameters such as the range of motion, calf circumference, ability to perform a single-limb heel rise, patient satisfaction, and Arner-Lindholm scale. Laboratory tests, postoperative ultrasonography, and isokinetic plantar flexion power tests were also performed.

Results:
At a mean time of 17 days (range, 8 to 30 days) after debridement, infection signs such as discharge from the wound, redness, and local warmth resolved. The wound had healed and the stitches were removed at a mean of 17 days following the wound repair. At the time of the latest follow-up, there were no signs of active infection. Achilles tendon continuity recovered in all patients by fibrous scar healing. Compared with the contralateral side, there was no difference in the ankle range of motion in 8 patients. According to the Arner-Lindholm scale, 9 of the 15 results were excellent and 6 were good. Ten patients were able to perform a single-limb heel rise. Eleven of 15 patients returned to their pre-injury recreational activities. Diffuse homogeneous echotexture of the Achilles tendon with continuity was observed on the ultrasonographic examination.

Conclusions:
In this retrospective series, radical debridement, combined with antibiotic therapy and functional rehabilitation, was successful in eradicating infection and maintaining function in patients with postoperative infection following Achilles tendon repair.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
In Vivo Efficacy of a “Smart” Antimicrobial Implant Coating
Authors: Stavrakis Alexandra I. , Zhu Suwei , Hegde Vishal , Loftin Amanda H. , Ashbaugh Alyssa G. , Niska Jared A. , Miller Lloyd S. , Segura Tatiana , Bernthal Nicholas M. 
Published: July 2016

Background:
Postoperative infection is a devastating complication following arthroplasty. The goals of this study were to introduce a “smart” implant coating that combines passive elution of antibiotic with an active-release mechanism that “targets” bacteria, and to use an established in vivo mouse model of post-arthroplasty infection to longitudinally evaluate the efficacy of this polymer implant coating in decreasing bacterial burden.

Methods:
A novel, biodegradable coating using branched poly(ethylene glycol)-poly(propylene sulfide) (PEG-PPS) polymer was designed to deliver antibiotics both passively and actively. In vitro-release kinetics were studied using high-performance liquid chromatography (HPLC) quantification in conditions representing both the physiologic environment and the more oxidative, hyperinflammatory environment of periprosthetic infection. The in vivo efficacy of the PEG-PPS coating delivering vancomycin and tigecycline was tested using an established mouse model of post-arthroplasty infection. Noninvasive bioluminescence imaging was used to quantify the bacterial burden; radiography, to assess osseointegration and bone resorption; and implant sonication, for colony counts.

Results:
In vitro-release kinetics confirmed passive elution above the minimum inhibitory concentration (MIC). A rapid release of antibiotic was noted when challenged with an oxidative environment (p < 0.05), confirming a “smart” active-release mechanism. The PEG-PPS coating with tigecycline significantly lowered the infection burden on all days, whereas PEG-PPS-vancomycin decreased infection on postoperative day (POD) 1, 3, 5, and 7 (p < 0.05). A mean of 0, 9, and 2.6 × 102 colony-forming units (CFUs) grew on culture from the implants treated with tigecycline, vancomycin, and PEG-PPS alone, respectively, and a mean of 1.2 × 102, 4.3 × 103, and 5.9 × 104 CFUs, respectively, on culture of the surrounding tissue (p < 0.05).

Conclusions:
The PEG-PPS coating provides a promising approach to preventing periprosthetic infection. This polymer is novel in that it combines both passive and active antibiotic-release mechanisms. The tigecycline-based coating outperformed the vancomycin-based coating in this study.

Clinical Relevance:
PEG-PPS polymer provides a controlled, “smart” local delivery of antibiotics that could be used to prevent postoperative implant-related infections.
The Pathogenesis and Treatment of Legg-Calvé-Perthes Disease
Authors: Ibrahim Talal , Little David G. 
Published: July 2016

➢ Legg-Calvé-Perthes disease is a childhood hip condition in which the blood supply to the capital femoral epiphysis is interrupted, causing osteonecrosis and chondronecrosis that lead to progressive deformity of the femoral head and secondary degenerative osteoarthritis in later life.➢ The etiology of Legg-Calvé-Perthes disease remains unclear, with both biological and mechanical factors playing important roles in the pathogenesis of the condition.➢ The treatment of Legg-Calvé-Perthes disease remains controversial but is dependent on several salient factors, including the age at clinical onset, the extent of epiphyseal involvement, the stage of the disease, and the degree of femoral head deformity.➢ The literature supports operative containment treatment in the early stage of disease. Such treatment has led to improved femoral head sphericity with better patient outcomes in multicenter prospective cohort studies.➢ The number of hips that need to be treated operatively in order to achieve a modest treatment effect remains high. Multicenter prospective cohort studies have shown that 6 to 7 patients need to be managed to create 1 spherical femoral head that would not have otherwise occurred.