bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrocardiographic Strain Pattern Is Associated With Left Ventricular Concentric Remodeling, Scar, and Mortality Over 10 Years: The Multi‐Ethnic Study of Atherosclerosis
Authors: Inoue Yuko Y. , Soliman Elsayed Z. , Yoneyama Kihei , Ambale‐Venkatesh Bharath , Wu Colin O. , Sparapani Rodney , Bluemke David A. , Lima João A.C. , Ashikaga Hiroshi 
Published: September 2017

Background
Both ECG strain pattern and QRS measured left ventricular (LV) hypertrophy criteria are associated with LV hypertrophy and have been used for risk stratification. However, the independent predictive value of ECG strain in apparently healthy individuals in predicting mortality and adverse cardiovascular events is unclear.

Methods and Results

MESA (Multi‐Ethnic Study of Atherosclerosis) is a multicenter, prospective cohort of 6441 participants (mean age, 62 years; 54% women). In 2847 of these participants, cardiac magnetic resonance imaging was repeated ≈10 years later (Year‐10). At Year‐10, 1759 participants underwent cardiac magnetic resonance imaging with gadolinium to detect myocardial scar. During a median follow‐up of 11.7 years, ECG strain (n=168, 2.6%) was significantly associated with all‐cause death (adjusted hazard ratio, 1.33; 95% confidence interval, 1.01–1.77;
P
=0.045), heart failure (2.62; 1.73–3.97;
P
<0.001), myocardial infarction (1.86; 1.09–3.18;
P
=0.024), and incident cardiovascular disease (1.45; 1.06–2.00;
P
=0.022). ECG strain was also associated with an increase in LV mass (β=9.29 g;
P
<0.001) and LV mass‐to‐volume ratio (β=0.07 g/mL;
P
=0.007) and a decline in LV ejection fraction (β=−3.30%;
P
<0.001). Moreover, ECG strain either at baseline and Year‐10 was associated with LV scar (odds ratio, 4.93 and 5.22;
P
=0.002 and <0.001, respectively), whereas these associations were not observed in ECG LV hypertrophy.

Conclusions
ECG strain is independently associated with all‐cause mortality, adverse cardiovascular events, development of LV concentric remodeling and systolic dysfunction, and myocardial scar over 10 years in multiethnic participants without past cardiovascular disease. ECG strain may be an early marker of LV structural remodeling that contributes to development of adverse cardiovascular events.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov/
. Unique identifier: NCT00005487.
Patient, Family, and Physician Satisfaction With Planning for Direct Discharge to Home From Intensive Care Units: Direct From ICU Sent Home Study
Authors: Lam Joyce Nga Hei , Lau Vincent I. , Priestap Fran A. , Basmaji John , Ball Ian M. 
Published: September 2017

Background: In the new era of decreasing hospital bed availability, there is an increasing rate of direct discharge to home (DDH) from intensive care units (ICUs), despite sparse literature informing this practice. Objectives: To evaluate patient, family, and ICU attending physician satisfaction with planning for DDH from the ICU and intensivists’ current DDH practices and perceptions. Methods: Prospective cohort study, using convenience sampling, of adult patients undergoing DDH from an ICU between February 2016 and February 2017 using a modified FS-ICU 24 satisfaction survey completed by patients, family members, and attending physicians at the time of patient discharge to home from the ICU. Results: Seventy-two percent of patients, 37% of family members, and 100% of ICU physicians recruited completed the survey. A majority of patients (89%) and families (78%) were satisfied or very satisfied with DDH. Only 6% of patients and 8% of families were dissatisfied to very dissatisfied with DDH. Conversely, ICU physician satisfaction varied, with only 5% being very comfortable with DDH and the majority (50%) only somewhat comfortable. Twenty percent of staff consultants were uncomfortable to very uncomfortable with the practice of DDH. Thirty-one percent of staff physician respondents felt that patient and family discomfort would be barriers to DDH. Compared to physicians and other allied health professionals, nurses were identified as the most helpful members of the health-care team in preparation for DDH by 98% of patients and 92% of family members. The DDH rates have increased for the past 12 years in our ICUs but declined during the study period (February 2016 to February 2017). Conclusions: Patients and family members are satisfied with the practice of DDH from ICU, although ICU physician satisfaction is more variable. Physician comfort may be improved by data informing which patients may be safely DDH from the ICU.
Outcomes of Talus Fractures Associated With High-Energy Combat Trauma
Authors: Junge Travis , Bellamy Jaime , Dowd Thomas , Osborn Patrick 
Published: September 2017

Background: Talus fractures are infrequent injuries that are often associated with poor clinical outcomes. Literature reviewing talus fractures is limited to a civilian population, with few studies characterizing these injuries sustained in active duty personnel. The aim of this study was to characterize talus fractures sustained in combat trauma by reporting their surgical outcomes. Methods: The Department of Defense Trauma Registry (DoDTR) was queried to identify US service members who sustained talus fractures in battle conditions between 2001 and 2014. These patients underwent a retrospective chart review. Injury and fracture patterns were characterized. We examined the incidence of secondary surgical procedures and reviewed patients undergoing early and late transtibial amputations. Forty-eight talus fractures were identified. Results: All injuries were related to high-energy trauma: 43 (90%) resulting from improvised explosive devices (IED), 3 (6%) from gunshot wounds (GSW), and 2 (4%) from propelled explosive devices. Ten (20.8%) patients underwent early transtibial amputation. Early amputations were associated with calcaneus fractures (10/10 vs 16/38, P = .0009) but not with open fractures (8/10 vs 20/38, P = .163). Twenty-six fractures were available with longer term follow-up. Twenty-three fractures had associated injuries to the ipsilateral lower extremity. Sixteen (61.54%) injuries underwent a total of 26 additional surgical procedures. Eight fractures required secondary fusions (30.8%). Subtalar fusions were associated with ipsilateral calcaneus fractures (5/6 vs 2/10, P = .03). One patient underwent a delayed transtibial amputation 17 months after injury. Conclusions: Talus fractures sustained within the combat environment were associated with high rates of early amputations and secondary surgical intervention. When the limb was salvaged, patients could expect the need for additional procedures to address ongoing issues. Level of Evidence: Level IV, case series.
Optical coherence tomography angiography retinal vascular network assessment in multiple sclerosis
Authors: Lanzillo Roberta , Cennamo Gilda , Criscuolo Chiara , Carotenuto Antonio , Velotti Nunzio , Sparnelli Federica , Cianflone Alessandra , Moccia Marcello , Brescia Morra Vincenzo 
Published: September 2017

Background: Optical coherence tomography (OCT) angiography is a new method to assess the density of the vascular networks. Vascular abnormalities are considered involved in multiple sclerosis (MS) pathology. Objective: To assess the presence of vascular abnormalities in MS and to evaluate their correlation to disease features. Methods: A total of 50 MS patients with and without history of optic neuritis (ON) and 46 healthy subjects were included. All underwent spectral domain (SD)-OCT and OCT angiography. Clinical history, Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS) and disease duration were collected. Results: Angio-OCT showed a vessel density reduction in eyes of MS patients when compared to controls. A statistically significant reduction in all SD-OCT and OCT angiography parameters was noticed both in eyes with and without ON when compared with control eyes. We found an inverse correlation between SD-OCT parameters and MSSS ( p = 0.003) and between vessel density parameters and EDSS ( p = 0.007). Conclusion: We report a vessel density reduction in retina of MS patients. We highlight the clinical correlation between vessel density and EDSS, suggesting that angio-OCT could be a good marker of disease and of disability in MS.
Symptoms, acceptance of illness and health-related quality of life in patients with atrial fibrillation
Authors: Jankowska-Polańska Beata , Kaczan Aleksandra , Lomper Katarzyna , Nowakowski Dariusz , Dudek Krzysztof 
Published: September 2017

Introduction: Acceptance of illness plays a key role, allowing the patient to adapt to the disease and its treatment, and to maintain their health-related quality of life (HRQOL) despite chronic conditions. Aim: The aim of the study was to assess the relationship between severity of arrhythmia symptoms, acceptance of illness and HRQOL in patients with atrial fibrillation. Methods: The study included 99 patients (mean age 64.6) treated for atrial fibrillation. Three standardized instruments were used: the World Health Organization Quality of Life (WHOQoL-BREF) questionnaire, the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Acceptance of Illness Scale (AIS). Results: Patients with high illness acceptance levels obtained better results in all WHOQoL-BREF domains: physical (57.0±8.9 vs. 51.1±12.5 vs. 42.0±6.2; p<0.001), social (62.6±19.8 vs. 52.5±20.0 vs. 45.7±16.0; p=0.019) and environmental (62.9±12.7 vs. 52.7±7.6 vs. 60.7±3.6; p<0.001), and in the ASTA HRQOL scale (10.5±5.4 vs. 16.1±7.6 vs. 20.3±0.5; p<0.001). Multiple-factor analysis showed AIS to be a statistically significant independent determinant of HRQOL in the physical domain of the WHOQoL (β=0.242) and in the overall HRQOL assessment in the ASTA HRQOL scale (β= −0.362). Other statistically significant independent predictors included: the negative impact of female sex on the physical (β= −0.291) and social (β= −0.284) domains of the WHOQOL-BREF, and the positive impact of urban residence on the physical WHOQOL-BREF domain and on symptom intensity in the ASTA symptom scale. Conclusions: Acceptance of illness is an important factor which has been shown to impact on HRQOL in atrial fibrillation. Female sex is a predictor of worse HRQOL, while urban residence improves HRQOL in the physical domain and decreases symptom intensity (ASTA symptom scale).
Life as a Political Problem: The Post-Human Turn in Political Theory
Authors: Zolkos Magdalena 
Published: September 2017

The post-human turn in political theory has challenged the anthropocentric assumption that individuated human agency is the exclusive domain of political action, subjectivity, and community. Recently, there has emerged an important intersection between, on one hand, the “post-human turn” in political theory and, on the other hand, the critical studies of neoliberal governance and ideology, which define the contemporary historical moment in terms of the late capitalist monitoring, regulation, and exploitation of biological life of populations. In this context, the post-human turn in political theory has meant the extension of focus from human agency to include animals, plants, inanimate objects, and machines. Focusing on the work of Catherine Malabou, Maurizio Lazzarato, Brian Massumi, Brad Evans, and Julian Reid, I discuss some of the problems that arise from the attempt at non-anthropocentric theorizing of politics, including what it means—theoretically, politically, and epistemologically—to consider biological and machinic units in terms of political agency. I suggest that the problems encountered by these post-humanist contributions to the field of political theory are epistemological, analytical, and political. I focus in particular on whether the non-anthropocentric refiguring of politics offers new critical insights into, and resistances against, neoliberal governance. Bhandar B and Goldberg-Hiller J (eds) (2015) Plastic Materialities: Politics, Legality, and Metamorphosis in the work of Catherine Malabou. Durham, NC: Duke University Press. Evans B and Reid J (2014) Resilient Life: The Art of Living Dangerously. Cambridge: Polity Press. Lazzarato M (2014) Signs and Machines: Capitalism and the Production of Subjectivity (trans J D Jordan). Los Angeles, CA: Semiotext(e). Massumi B (2014) What Animals Teach us about Politics. Durham, NC: Duke University Press.
Intrafractional Tracking Accuracy of a Transperineal Ultrasound Image Guidance System for Prostate Radiotherapy
Authors: Yu Amy S. , Najafi Mohammad , Hristov Dimitre H. , Phillips Tiffany 
Published: September 2017

Purpose: The aim of this study is to evaluate the tracking accuracy of a commercial ultrasound system under relevant treatment conditions and demonstrate its clinical utility for detecting significant treatment deviations arising from inadvertent intrafractional target motion. Methods: A multimodality male pelvic phantom was used to simulate prostate image-guided radiotherapy with the system under evaluation. Target motion was simulated by placing the phantom on a motion platform. The tracking accuracy of the ultrasound system was evaluated using an independent optical tracking system under the conditions of beam-on, beam-off, poor image quality with an acoustic shadow introduced, and different phantom motion cycles. The time delay between the ultrasound-detected and actual phantom motion was investigated. A clinical case example of prostate treatment is presented as a demonstration of the utility of the system in practice. Results: Time delay between the motion phantom and ultrasound tracking system is 223 ± 45.2 milliseconds including video and optical tracking system frame rates. The tracking accuracy and precision were better with a longer period. The precision of ultrasound tracking performance in the axial (superior–inferior) direction was better than that in the lateral (left–right) direction (root mean square errors are 0.18 and 0.25 mm, respectively). The accuracy of ultrasound tracking performance in the lateral direction was better than that in the axial direction (the mean position errors are 0.23 and 0.45 mm, respectively). Interference by radiation and image quality do not affect tracking ability significantly. Further, utilizing the tracking system as part of a clinical study for prostate treatment further verified the accuracy and clinical appropriateness. Conclusions: It is feasible to use transperineal ultrasound daily to monitor prostate motion during treatment. Our results verify the accuracy and precision of an ultrasound system under typical external beam treatment conditions and further demonstrate that the tracking system was able to identify important prostate shifts in a clinical case.
Cascade of care among HIV patients diagnosed in 2013 in Georgia: Risk factors for late diagnosis and attrition from HIV care
Authors: Ruadze Ekaterine , Chkhartishvili Nikoloz , Chokoshvili Otar , Tsertsvadze Tengiz 
Published: September 2017

Introduction: The major challenge in the HIV epidemic in Georgia is a high proportion of undiagnosed people living with HIV (estimated 48%) as well as a very high proportion of late presentations for care, with 66% presenting for HIV care with CD4 count <350 and 40% with <200 cells/mm3, in 2013. The objectives of this study was to evaluate patient engagement in the continuum of HIV care for HIV patients diagnosed in 2013 and, within this cohort, to evaluate factors associated with late diagnosis and attrition from care. Methods: Factors associated with late diagnosis were analyzed through binary logistic regression. Exposure variables were the mode of HIV transmission (injecting drug use, male-to-male contact, and heterosexual contact), gender (male vs female), and age (categorized by median value ≤36 vs >36). In addition, CD4 count at diagnosis (cells/mm3) (≤350 or >350) together with all above factors were tested for the association with attrition through Poisson regression. Results: Overall, 317 patients retained in care, representing 65% of those diagnosed (n = 488). Out of eligible 295 patients, 89.5% were on treatment and 84% of those viral load count was measured after 6 months of antiretroviral treatment initiation had HIV-1 viral load <1000 copies/mL. Patients reporting injecting drug use as a route-of HIV transmission had two times the odds (95% confidence interval = 1.34–3.49) to be diagnosed late and patients reporting male-to-male contact as a way of HIV transmission had half the odds (odds ratio = 0.46 (95% confidence interval = 0.26–0.81)) of late diagnosis compared to patients acquiring HIV through heterosexual contact. Patients older than 36 years were more likely to being diagnosed late. Conclusion: More attention should be given to injecting drug users as they represent the most at-risk population for late diagnosis together with older age and attrition.
Evaluation of Calcium Release from Pulp-capping Material Using International Organization for Standardization Guidelines
Authors: Masabni Omar , Wheater Michelle 
Published: September 2017

Aims and Objectives: Cytotoxicity assays are one of the methods used to assess the biocompatibility of dental materials. The objective of this study was to determine if surface area/volume ratios designated by the International Organization for Standardization (ISO) for biological evaluation of medical devices affects cytotoxicity and calcium release in an endodontic pulp-capping materials. Material and Methods: Human periodontal ligament fibroblasts (PDLFb) were treated with extractables derived from the calcium silicate pulp-capping material TheraCal LC at pellet surface area/culture medium volume ratios of 0.2, 0.5, and 1.0 cm2/mL. A colorimetric cytotoxicity assay (MTT) and phase-contrast microscopy was used to assess biocompatibility against the fibroblasts. The concentration of calcium leached into culture medium from TheraCal LC at pellet surface area/culture medium volume ratios of 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, and 6.0 cm2/mL after 24 hours was determined by colorimetric assay. Results: Both MTT assays and microscopy demonstrate that at a pellet surface area/culture medium volume ratio of 1.0 cm2/mL TheraCal LC extractable challenge to fibroblasts results in a significant decrease in cell viability ( P < 0.001) compared to control. TheraCal LC calcium release into culture medium varied with the surface area/volume ratio, with concentrations ranging from 2 to 8 times the calcium concentration in culture medium. Conclusion: Pellet surface area/culture medium volume ratios impacted parameters of TheraCal LC used in in vitro studies to determine biocompatibility with oral tissues. The ISO guidelines should be followed for all in vitro cytotoxicity studies of dental materials.
Oral Care Effect on Intubated Patient with 0.2 per cent Chlorhexidine Gluconate and Tooth Brushing in Intensive Care Unit
Authors: Khan Mohammad , Mohamed Zeehaida , Ali Saedah , Saddki Norkhafizah , Masudi Sam’an Malik , Sukminingrum Ninin 
Published: September 2017

Aims and Objectives: Ventilator-associated pneumonia is associated with increased morbidity and mortality. The aim of this pilot study was to determine the effectiveness of oral care with both tooth brushing and 0.2 per cent chlor-hexidine gluconate compared to 0.2 per cent chlorhexidine gluconate alone for the intubated patient in an intensive care unit (ICU). Materials and Methods: Patient screening was done over a period of two months. After taking informed consent, those ICU patients were divided into two groups. Only nine subjects were enrolled. During the study, the experimental group (N = 4) got oral care that consisted of both tooth brushing and 0.2 per cent chlorhexidine gluconate thrice a day. The control group got oral care with 0.2 per cent chlorhexidine gluconate alone thrice a day. The data were analysed by IBM statistical software SPPS, version 24. Results: Preliminary results suggest that the risk of ventilator-associated pneumonia in intubated patients can be reduced by maintaining thrice-daily oral care involving both tooth brushing and 0.2 per cent chlorhexidine gluconate. Conclusion: Thrice-daily oral care consisted of both tooth brushing and 0.2 per cent chlorhexidine gluconate might be a promise as a ventilator-associated pneumonia-reduction strategy in ICU. Furthermore, more studies are required for its application widely.
Simplified Method of Detection of Dialister invisus and Olsenella uli in Oral Cavity Samples by Polymerase Chain Reaction
Authors: Kugaji Manohar S. , Bhat Kishore G. , Joshi Vinayak M. , Pujar Madhu , Mavani Pratik T. 
Published: September 2017

Aims and Objectives: The oral microbial flora is highly complex and diverse with obligate anaerobic bacteria as the predominant component. Most of these are not yet cultivated/difficult to cultivate due to technical limitations. In this study, we aim to detect two novel oral bacterial species Dialister invisus and Olsenella uli by simplified and economical procedure of polymerase chain reaction (PCR) and study their association with primary and persistent endodontic infections. Material and Methods: The study involved 60 patients that included 30 patients of primary endodontic infections and 30 with persistent endodontic infections. The sample collection from the root canal was performed by universally accepted protocol by using sterile paper points. The deoxyribonucleic acid (DNA) extraction was done, followed by PCR with species specific primers. We made several changes to the protocol mentioned by original authors. We adopted a one-step protocol for amplification of bacterial DNA, omitting the 16SrDNA amplification step with universal primers. Results: It was seen that 7 (23.3 %) samples in primary endodontic infection group and 24 (80 %) samples in persistent endodontic infection group were positive for D. invisus. On the other hand, 11 (36.6 %) patients of primary endodontic infection showed positivity for O. uli in comparison to 9 (30 %) of persistent endodontic infection. Conclusion: The results from the present study showed efficient amplification of both O. uli and D. invisus in a single-step PCR. Hence, we conclude that the modified protocol used here with taq polymerase enzyme offers a faster and cheaper alternative to nested PCR without compromising the quality of amplification process.