bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Vascular and Nonvascular Adverse Events and of Extended-Release Niacin With Laropiprant on Health and Healthcare Costs
Authors: Kent Seamus , Haynes Richard , Hopewell Jemma C. , Parish Sarah , Gray Alastair , Landray Martin J. , Collins Rory , Armitage Jane , Mihaylova Borislava 
Published: July 2016

Background—
Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), but its net effects on health and healthcare costs are unknown.

Methods and Results—
25 673 participants aged 50 to 80 years with previous cardiovascular disease were randomized to 2 g of extended-release niacin with 40 mg of laropiprant daily versus matching placebo, in addition to effective statin-based low-density lipoprotein cholesterol–lowering treatment. The net effects of niacin–laropiprant on quality–adjusted life years and hospital care costs (2012 UK £; converted into US $ using purchasing power parity index) during 4 years in HPS2-THRIVE were evaluated using estimates of the impact of serious adverse events on health-related quality of life and hospital care costs. During the study, participants assigned niacin–laropiprant experienced marginally but not statistically significantly lower survival (0.012 fewer years [standard error (SE) 0.007]), fewer quality-adjusted life years (0.023 [SE 0.007] fewer using UK EQ-5D scores; 0.020 [SE 0.006] fewer using US EQ-5D scores) and accrued greater hospital costs (UK £101 [SE £37]; US $145 [SE $53]). Stroke, heart failure, musculoskeletal events, gastrointestinal events, and infections were associated with significant decreases in health-related quality of life in both the year of the event and in subsequent years. All serious vascular and nonvascular events were associated with substantial increases in hospital care costs.

Conclusions—
In HPS2-THRIVE, the addition of extended-release niacin–laropiprant to statin-based therapy reduced quality of life–adjusted survival and increased hospital costs.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00461630.
Diabetes-Induced Jagged1 Overexpression in Endothelial Cells Causes Retinal Capillary Regression in a Murine Model of Diabetes Mellitus
Authors: Yoon Chang-Hwan , Choi Young-Eun , Cha Young Ryun , Koh Seok-Jin , Choi Jae-il , Kim Tae-Won , Woo Se Joon , Park Young-Bae , Chae In-Ho , Kim Hyo-Soo 
Published: July 2016

Background:
Several mechanisms have been proposed to account for diabetes-induced microvasculopathy (DMV). Although Notch signaling was reported to be affected by glucose metabolism in endothelial cells during developmental angiogenesis, it has not been investigated in vascular remodeling of adult capillaries in relation to diabetes mellitus.

Methods:
We induced diabetes mellitus in 8-week-old adult mice by intravenously administering streptozotocin. After 6 weeks, we harvested organs, including retina, heart, and skeletal muscle, and evaluated the capillaries with immunofluorescence and confocal microscopy. We modulated endothelial Notch signaling using chemical inhibitors in wild-type mice or transgenic mice, inducing conditional knockout of Jagged1 or Mib1.

Results:
DMV was characterized by capillary remodeling, regression, and decreased density. Notch ligand Jagged1, but not δ-like ligand 4, was markedly increased in endothelial cells of diabetic mice. Using endothelium-specific Jagged1 knockdown mice, we found that blocking Jagged1 prevented DMV even under diabetic conditions. Furthermore, in the inducible endothelium-specific Jagged1 knockdown mice, blocking Jagged1 even at 4 weeks after the establishment of DMV could reverse it, leading to normalization of retinal vasculature. A search for downstream signals revealed that diabetes mellitus decreased the nuclear localization of Notch1 intracellular domain and reduced the expression of VE-cadherin and N-cadherin in endothelial cells. Chemical Notch inhibition phenocopied DMV in normal mice.

Conclusions:
Our findings indicate that diabetes mellitus induces Jagged1 overexpression and suppresses Notch signaling in endothelial cells, leading to DMV in adult mice. We conclude that dysregulated intercellular Notch signaling may be a novel mechanism of DMV.
Underutilization of Ambulatory ECG Monitoring After Stroke and Transient Ischemic Attack
Authors: Edwards Jodi D. , Kapral Moira K. , Fang Jiming , Saposnik Gustavo , Gladstone David J. 
Published: July 2016

Background and Purpose—
Detection and treatment of atrial fibrillation is a major goal in secondary stroke prevention. Guidelines recommend at least 24 hours of ECG monitoring after stroke. However, it is unclear how often this is done in routine practice.

Methods—
In this longitudinal cohort study using data from the Ontario Stroke Registry, we analyzed consecutive patients presenting to designated stroke centers in Ontario, Canada (2003–2013) with a first acute ischemic stroke or transient ischemic attack (TIA) in sinus rhythm and without known atrial fibrillation. The primary outcome was the proportion of patients who received at least 24-hour Holter monitoring within 30 days after stroke/TIA. Secondary analyses assessed total duration of ECG monitoring completed within 90 days after stroke/TIA, temporal trends in monitoring use, and use of Holter monitoring relative to echocardiography.

Results—
Among 17 398 consecutive eligible patients (mean age 68.8±14.3 years), 30.6% had at least 24 hours of Holter monitoring within 30 days after stroke/TIA. Less than 1% of patients received prolonged monitoring beyond 48 hours. The median time to start monitoring was 9 days poststroke (interquartile range 3–25). Stroke/TIA patients were nearly twice as likely to receive an echocardiogram than a Holter monitor within 90 days (odds ratio 1.8, 95% confidence interval 1.67–2.01).

Conclusions—
Less than one third of patients in our cohort received guideline-recommended 24-hour Holter monitoring, and <1% received prolonged ambulatory ECG monitoring. These findings highlight a modifiable evidence-practice gap that likely contributes to an overdiagnosis of strokes as cryptogenic, an underdiagnosis of atrial fibrillation, and missed anticoagulant treatment opportunities for secondary stroke prevention.
Remote Intracerebral Hemorrhage After Intravenous Thrombolysis
Authors: Prats-Sánchez Luis , Camps-Renom Pol , Sotoca-Fernández Javier , Delgado-Mederos Raquel , Martínez-Domeño Alejandro , Marín Rebeca , Almendrote Miriam , Dorado Laura , Gomis Meritxell , Codas Javier , Llull Laura , Gómez González Alejandra , Roquer Jaume , Purroy Francisco , Gómez-Choco Manuel , Cánovas David , Cocho Dolores , Garces Moises , Abilleira Sonia , Martí-Fàbregas Joan 
Published: July 2016

Background and Purpose—
Remote parenchymal hemorrhage (rPH) after intravenous thrombolysis with recombinant tissue-type plasminogen activator may be associated with cerebral amyloid angiopathy, although supportive data are limited. We aimed to investigate risk factors of rPH after intravenous thrombolysis with recombinant tissue-type plasminogen activator.

Methods—
This is an observational study of patients with ischemic stroke who were treated with intravenous thrombolysis with recombinant tissue-type plasminogen activator and were included in a multicenter prospective registry. rPH was defined as any extraischemic hemorrhage detected in the follow-up computed tomography. We collected demographic, clinical, laboratory, radiological, and outcome variables. In the subset of patients who underwent a magnetic resonance imaging examination, we evaluated the distribution and burden of cerebral microbleeds, cortical superficial siderosis, leukoaraiosis, and recent silent ischemia in regions anatomically unrelated to the ischemic lesion that caused the initial symptoms. We compared patients with rPH with those without rPH or parenchymal hemorrhage. Independent risk factors for rPH were obtained by multivariable logistic regression analyses.

Results—
We evaluated 992 patients (mean age, 74.0±12.6 years; 52.9% were men), and 408 (41%) of them underwent a magnetic resonance imaging. Twenty-six patients (2.6%) had a rPH, 8 (0.8%) had both rPH and PH, 58 (5.8%) had PH, and 900 (90.7%) had no bleeding complication. Lobar cerebral microbleeds (odds ratio, 8.0; 95% confidence interval, 2.3–27.2) and recent silent ischemia (odds ratio, 4.8; 95% confidence interval, 1.6–14.1) increased the risk of rPH.

Conclusions—
The occurrence of rPH after intravenous thrombolysis with recombinant tissue-type plasminogen activator in patients with ischemic stroke is associated with lobar cerebral microbleeds and multiple ischemic lesions in different regions.
Generic redescription, two new species, and a key to the species of the cicada genus Ariasa Distant, 1905 with the description of a new genus (Hemiptera: Cicadidae: Cicadinae: Fidicinini)
Authors: SANBORN Allen F. 
Published: July 2016

The cicada genus Ariasa Distant, 1905 is redescribed. Ariasa albimaculosa n. sp. is described from Colombia and A. bartletti n. sp. is described from Peru. The current 14 species of Ariasa are listed along with their synonymies, known distribution of each species, and a key to the species is provided. The first records of Ariasa bilaqueata (Uhler, 1903) for Peru and French Guiana are provided. Cracenpsaltria brasiliorum (Kirkaldy, 1909) rev. stat., n. comb. is determined to be the correct name for the taxon Cicada marginata Olivier, 1790 and the new genus Cracenpsaltria n. gen. is erected for the taxon. The distribution of C. brasiliorum rev. stat., n. comb. is expanded to include Bolivia and Peru.
Anatomic Anterolateral Ligament Reconstruction of the Knee Leads to Overconstraint at Any Fixation Angle
Authors: Schon Jason M. , Moatshe Gilbert , Brady Alex W. , Serra Cruz Raphael , Chahla Jorge , Dornan Grant J. , Turnbull Travis Lee , Engebretsen Lars , LaPrade Robert F. 
Published: July 2016

Background: Anterior cruciate ligament (ACL) tears are one of the most common injuries among athletes. However, the ability to fully restore rotational stability with ACL reconstruction (ACLR) remains a challenge, as evidenced by the persistence of rotational instability in up to 25% of patients after surgery. Advocacy for reconstruction of the anterolateral ligament (ALL) is rapidly increasing because some biomechanical studies have reported that the ALL is a significant contributor to internal rotational stability of the knee. Hypothesis/Purpose: The purpose of this study was to assess the effect of ALL reconstruction (ALLR) graft fixation angle on knee joint kinematics in the clinically relevant setting of a concomitant ACLR and to determine the optimal ALLR graft fixation angle. It was hypothesized that all fixation angles would significantly reduce rotational laxity compared with the sectioned ALL state. Study Design: Controlled laboratory study. Methods: Ten nonpaired fresh-frozen human cadaveric knees underwent a full kinematic assessment in each of the following states: (1) intact; (2) anatomic single-bundle (SB) ACLR with intact ALL; (3) anatomic SB ACLR with sectioned ALL; (4) anatomic SB ACLR with 7 anatomic ALLR states using graft fixation angles of 0°, 15°, 30°, 45°, 60°, 75°, and 90°; and (5) sectioned ACL and ALL. Internal rotation during a 5-N·m internal rotation torque and anterior translation during an 88-N anterior load were recorded at 15° flexion intervals between 0° and 120°. Axial plane translation and internal rotation during a simulated pivot-shift test (combined 5-N·m internal rotation and 10-N·m valgus torques) were recorded between 0° and 60°. Kinematic changes were measured and compared with the intact state for all reconstructed and sectioned states. Results: Anatomic ALLR at all graft fixation angles significantly overconstrained internal rotation of the knee joint beyond 30° of flexion and at 45° and 60° during the pivot-shift test. Furthermore, there were no significant knee kinematic differences between any tested graft fixation angles during anterior drawer, pivot-shift, and internal rotation tests. Conclusion: Anatomic ALLR in conjunction with an ACLR significantly reduced rotatory laxity of the knee beyond 30° of knee flexion. However, ALLR, regardless of fixation angle, resulted in significant overconstraint of the knee. Clinical Relevance: ALLR at any fixation angle overconstrained native joint kinematics and should be performed with careful consideration. Further investigation into the application and target population for ALLR is strongly recommended.
Enhancing suicide risk assessment: a novel visual metaphor learning tool
Authors: Alyami Mohsen , Alyami Hussain , Sundram Frederick , Cheung Gary , Haarhoff Beverly A , Lyndon Mataroria P , Hill Andrew G 
Published: July 2016

Objective: Suicide risk assessment is variably taught and learnt by health professionals. The literature indicates that training programs of this fundamental competency need to be enhanced. To facilitate teaching and learning of this core clinical skill, we propose a novel visual metaphor in order to conceptualize suicide risk factors. The design of the proposed visual metaphor was informed by the Cognitive Load Theory to enhance deep learning of the various suicide risk factors. Conclusion: The visual metaphor depicting suicide risk factors can potentially improve memory and recall. It activates prior knowledge and is based on educational theory informed design principles.
Lifetime rates and correlates of crime victimisation in young people with mental ill-health
Authors: Purcell Rosemary , Harrigan Susy 
Published: July 2016

Objective: Research on crime victimisation in the mentally ill has focused on middle aged cohorts with long-standing illness and functional disability. The rates and correlates of victimisation in young cohorts is largely unknown. Methods: Participants ( n=776) were aged 12–25 years attending headspace centres in Australia, who consented to a clinical interview and provided self-reported data regarding lifetime victimisation. Results: A quarter of the sample (24.5%) reported crime victimisation, including 18.5% who experienced violent victimisation (mainly physical or sexual assault) and 14.1% non-violent crime. Both forms of victimisation were associated with illicit substance use, sexual orientation, and young adult age, while male gender was specifically associated with non-violent victimisation. Participants who reported violent victimisation were significantly more impaired both functionally and clinically than those reporting non-violent victimisation or no victimisation. Conclusions: Young people with mental ill-health are vulnerable to criminal victimisation, particularly violent assaults, although the lifetime rates of victimisation are substantially lower than those observed in older cohorts with serious mental illness. Effective, early intervention to address modifiable factors may reduce the risk of further victimisation.
Validation of a Spanish Version of the Marwit–Meuser Caregiver Grief Inventory Short Form in a Puerto Rican Sample
Authors: Alvelo Jaime , Cancio-Gonzalez Rafael E. , Collazo Andrés 
Published: July 2016

Purpose: This study was intended to adapt into Spanish and validate the short form of the Marwit–Meuser Caregiver Grief Inventory (MMCGI), an instrument for the assessment of levels of grief in caregivers of patients with dementia. Method: The adaptation was based on the cross-cultural equivalence model that included forward and backward translations, use of a bilingual committee, and a comprehension test. The validation study was carried out with 100 Puerto Rican caregivers. Results: Semantic and content equivalence were attained as judged by the bilingual committee. Conceptual equivalence was only partially supported as factor analysis failed to replicate the three-factor structure proposed for the original English version. A one-factor structure was the best suitable for the Spanish version. On the other hand, correlations of the total scores of this version of the instrument with measures of constructs expected to be related to grief supported conceptual equivalence. Discussion: The Spanish version of the MMCGI was found equivalent to the English counterpart except for its dimensionality.
Can Playing an End-of-Life Conversation Game Motivate People to Engage in Advance Care Planning?
Authors: Van Scoy Lauren J. , Green Michael J. , Reading Jean M. , Scott Allison M. , Chuang Cynthia H. , Levi Benjamin H. 
Published: July 2016

Background: Advance care planning (ACP) involves several behaviors that individuals undertake to prepare for future medical care should they lose decision-making capacity. The goal of this study was to assess whether playing a conversation game could motivate participants to engage in ACP. Methods: Sixty-eight English-speaking, adult volunteers (n = 17 games) from communities around Hershey, Pennsylvania, and Lexington, Kentucky, played a conversation card game about end-of-life issues. Readiness to engage in 4 ACP behaviors was measured by a validated questionnaire (based on the transtheoretical model) immediately before and 3 months postgame and a semistructured phone interview. These behaviors were (1) completing a living will; (2) completing a health-care proxy; (3) discussing end-of-life wishes with loved ones; and (4) discussing quality versus quantity of life with loved ones. Results: Participants’ (n = 68) mean age was 51.3 years (standard deviation = 0.7, range: 22-88); 94% of the participants were caucasian and 67% were female. Seventy-eight percent of the participants engaged in ACP behaviors within 3 months of playing the game (eg, updating documents, discussing end-of-life issues). Furthermore, 73% of the participants progressed in stage of change (ie, readiness) to perform at least 1 of the 4 behaviors. Scores on measures of decisional balance and processes of change increased significantly by 3 months postintervention. Conclusion: This pilot study found that individuals who played a conversation game had high rates of performing ACP behaviors within 3 months. These findings suggest that using a game format may be a useful way to motivate people to perform important ACP behaviors.
Radiographic Evaluation of Intermetatarsal Angle Correction Following First MTP Joint Arthrodesis for Severe Hallux Valgus
Authors: McKean R. Matthew , Bergin Patrick F. , Watson Geoffrey , Mehta Siddhant K. , Tarquinio Thom A. 
Published: July 2016

Background: Arthrodesis is a standard operative treatment for symptomatic arthritis of the first metatarsophalangeal (MTP) joint. Patients with degenerative joint disease (DJD), severe hallux valgus, and metatarsus primus varus may also require fusion of the first MTP joint. An important question in the latter group of patients is whether a proximal first metatarsal osteotomy is required, in addition to the first MTP joint fusion. Our hypothesis was that patients with severe hallux valgus and metatarsus primus varus, treated with first MTP joint arthrodesis alone, would have correction of the first-to-second intermetatarsal angle (1-2 IMA) and hallux valgus angle (HVA) to near population norms, without the addition of a proximal first metatarsal osteotomy. Methods: Preoperative and postoperative radiographs of 19 feet, in 17 patients, with preoperative IMA greater than 15 were analyzed. Weight-bearing radiographs were divided into pre- and postoperative cohorts. Three independent reviewers measured these radiographs and mean 1-2 IMA and HVA were calculated. Mean follow-up was 10 months. Results: The mean preoperative 1-2 IMA was 19.2 degrees (15.6-24.3). The mean preoperative HVA was 48.5 (36-56.6). The mean postoperative values for 1-2 IMA and HVA were 10.8 and 12.3 degrees, respectively. The mean change in IMA was 8.3 degrees and in the hallux valgus angle was 36.4 degrees. The differences between pre- and postoperative measurement for both angles were statistically significant ( P < .001). Seven of 19 (37%) feet were corrected to an IMA of less than 9 degrees (normal), whereas in 15/19 feet the postoperative IMA was 12.3 degrees or less. The postoperative HVA was less than 15 degrees in 15/19 (79%) feet. Conclusion: This pre- and postoperative radiographic analysis of patients with severe bunion deformity demonstrated that HVA and 1-2 IMA were acceptably corrected without the addition of a proximal first metatarsal osteotomy. Level of Evidence: Level III, retrospective comparative series.
A Bullous Flare of a Hyperkeratotic Affair
Authors: Klimas Natasha , West Cameron , Tarbox Michelle 
Published: July 2016

Background: Darier’s disease is an autosomal dominant genodermatosis typified by hyperkeratotic papules and plaques in a predominately seborrheic distribution. The vesiculo-bullous variant of Darier’s disease is rare. Several previously reported cases have demonstrated clinical and microscopic features resembling familial benign chronic pemphigus or Hailey-Hailey disease. Objectives: The objective of this report is to describe an uncommon presentation of Darier’s disease, which has been infrequently described in the literature. Methods: The authors present a case of bullous flare of long-standing Darier’s disease. Conclusions: Darier’s disease may assume several atypical morphologies, including vesiculo-bullous lesions.
Chronic p38 mitogen-activated protein kinase inhibition improves vascular function and remodeling in angiotensin II-dependent hypertension
Authors: Potthoff SA , Stamer S , Grave K , Königshausen E , Sivritas SH , Thieme M , Mori Y , Woznowski M , Rump LC , Stegbauer J 
Published: July 2016

Introduction: An excess of angiotensin II (Ang II) causes hypertension and vascular injury. Activation of mitogen-activated protein kinase p38 (p38-MAPK) plays a substantial role in Ang II-dependent organ damage. Recently, we showed that p38-MAPK activation regulates the pressor response to Ang II. This study evaluates the effect of chronic p38-MAPK inhibition in Ang II-dependent hypertension. Materials and methods: C57Bl/6J mice were infused with Ang II for 14 days and either treated with the p38-MAPK inhibitor BIRB796 (50 mg/kg/day) or the vehicle as the control. We assessed vascular function in the aorta and isolated perfused kidneys. Results: Chronic p38-MAPK inhibition did not alter blood pressure at the baseline, but attenuated Ang II-induced hypertension significantly (baseline: 122 ± 2 versus 119 ± 4 mmHg; Ang II: 173 ± 3 versus 155 ± 3 mmHg; p < 0.001). In addition, BIRB796 treatment improved vascular remodeling by reducing the aortic media-to-lumen ratio and decreasing the expression of the membrane metalloproteinases (MMP) MMP-1 and MMP-9. Moreover, renal vascular dysfunction induced by chronic Ang II infusion was significantly ameliorated in the BIRP796-treated mice. Acute p38-MAPK inhibition also improved vascular function in the aorta and kidneys of Ang II-treated mice, highlighting the important role of p38-MAPK activation in the pathogenesis of vascular dysfunction. Conclusions: Our findings indicated there is an important role for p38-MAPK in regulating blood pressure and vascular injury, and highlighted its potential as a pharmaceutical target.