bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants, Prevalence, and Trajectory of Long-Term Post-Stroke Cognitive Impairment: Results from a 4-Year Follow-Up of the ARCOS-IV Study
Authors: Mahon Susan , Parmar Priya , Barker-Collo Suzanne , Krishnamurthi Rita , Jones Kelly , Theadom Alice , Feigin Valery 
Published: November 2017

<b><i>Background:</i></b> The long-term (&#x3e;12 months) prevalence, predictors, and trajectory of post-stroke cognitive deficits are not well established, especially at a community level. This study investigated the longitudinal course and prevalence of cognitive impairment in an incidence cohort, identifying factors associated with declining cognition. <b><i>Methods:</i></b> Two hundred fifty-seven participants (mean age = 67.93 ± 13.59) of first-ever stroke survivors, completed cognitive assessments within 2 weeks post stroke, and/or 1, 6, 12, and 48-month. Multivariate linear and logistic models were used to identify baseline predictors (reported as OR with 95% CI) and trajectory of cognitive impairment. <b><i>Results:</i></b> Cognitive functioning significantly declined by 2.8 points by 4 years post stroke. Eighty-four percent of stroke survivors had cognitive impairment indicative of post-stroke dementia (mean Montreal cognitive assessment = 20 ± 4.7) at 4-year. There were significant as­sociations between progressive cognitive decline and the ­following factors: male gender (OR 2.9, 95% CI 1.6–5.9, ­<i>p</i> = 0.0171), coronary artery disease (OR 2.96, 95% CI 1.35–6.49, <i>p</i> = 0.0070), arrhythmia (OR 2.21, 95% CI 1.07–4.57, <i>p</i> = 0.0317), not in a relationship (OR 2.8, 95% CI 1.4–5.50, <i>p</i> &#x3c; 0.0001), and not employed (OR 4.9, 95% CI 1.9–12.1, <i>p</i> &#x3c; 0.0001). <b><i>Conclusions:</i></b> Cognitive deficits remain highly prevalent at 4-year post stroke. Early identification of those at higher risk of declining cognition is vital to target rehabilitation interventions at the acute stage and improve overall outcomes.
Stable Isotope Kinetic Study of ApoM (Apolipoprotein M)
Authors: Croyal Mikaël , Billon-Crossouard Stéphanie , Goulitquer Sophie , Aguesse Audrey , León Luis , Fall Fanta , Chétiveaux Maud , Moyon Thomas , Blanchard Valentin , Ouguerram Khadija , Lambert Gilles , Nobécourt Estelle , Krempf Michel 
Published: November 2017

Objective—
ApoM (apolipoprotein M) binds primarily to high-density lipoprotein before to be exchanged with apoB (apolipoprotein B)–containing lipoproteins. Low-density lipoprotein (LDL) receptor–mediated clearance of apoB-containing particles could influence plasma apoM kinetics and decrease its antiatherogenic properties. In humans, we aimed to describe the interaction of apoM kinetics with other components of lipid metabolism to better define its potential benefit on atherosclerosis.

Approach and Results—

Fourteen male subjects received a primed infusion of
2
H
3
-leucine for 14 hours, and analyses were performed by liquid chromatography–tandem mass spectrometry from the hourly plasma samples. Fractional catabolic rates and production rates within lipoproteins were calculated using compartmental models. ApoM was found not only in high-density lipoprotein (59%) and LDL (4%) but also in a non–lipoprotein-related compartment (37%). The apoM distribution was heterogeneous within LDL and non–lipoprotein-related compartments according to plasma triglycerides (
r
=0.86;
P
<0.001). The relationships between sphingosine-1-phosphate and apoM were confirmed in all compartments (
r
range, 0.55–0.89;
P
<0.05). ApoM fractional catabolic rates and production rates were 0.16±0.07 pool/d and 0.14±0.06 mg/kg per day in high-density lipoprotein and 0.56±0.10 pool/d and 0.03±0.01 mg/kg per day in LDL, respectively. Fractional catabolic rates of LDL-apoM and LDL-apoB100 were correlated (
r
=0.55;
P
=0.042). Significant correlations were found between triglycerides and production rates of LDL-apoM (
r
=0.73;
P
<0.004).

Conclusions—
In humans, LDL kinetics play a key role in apoM turnover. Plasma triglycerides act on both apoM and sphingosine-1-phosphate distributions between lipoproteins. These results confirmed that apoM could be bound to high-density lipoprotein after secretion and then quickly exchanged with a non–lipoprotein-related compartment and to LDL to be slowly catabolized.
Architectural T-Wave Analysis and Identification of On-Therapy Breakthrough Arrhythmic Risk in Type 1 and Type 2 Long-QT Syndrome
Authors: Sugrue Alan , Rohatgi Ram K. , Noseworthy Peter A. , Kremen Vaclav , Bos J. Martijn , Qiang Bo , Sapir Yehu , Attia Zachi I. , Scott Christopher G. , Brady Peter , Asirvatham Samuel J. , Friedman Paul A. , Ackerman Michael J. 
Published: November 2017

Background:
Although the hallmark of long-QT syndrome (LQTS) is abnormal cardiac repolarization, there are varying degrees of phenotypic expression and arrhythmic risk. Our aim was to evaluate the performance of a morphological T-wave analysis program in defining breakthrough LQTS arrhythmic risk beyond the QTc value.

Methods and Results:

We analyzed 407 genetically confirmed patients with LQT1 (n=246; 43% men) and LQT2 (n=161; 41% men) over the mean follow-up period of 6.4±3.9 years. ECG analysis was conducted using a novel, proprietary T-wave analysis program. Time to a LQTS-associated cardiac event was analyzed using Cox proportional hazards regression methods. Twenty-three patients experienced ≥1 defined breakthrough cardiac arrhythmic events with 5- and 10-year event rates of 4% and 7%. Two independent predictors of future LQTS-associated cardiac events from the surface ECG were identified: left slope of T wave in lead V6 (hazard ratio=0.40 [0.24–0.69];
P
<0.001) and T-wave center of gravity
x
axis (last 25% of wave) in lead I (hazard ratio=1.90 [1.21–2.99];
P
=0.005), C statistic of 0.77 (0.65–0.89). When added to the QTc (C statistic 0.68 for QTc alone), discrimination improved to 0.78. Genotype analysis showed weaker association between these T-wave variables and LQT1-triggered events while these features were stronger in patients with LQT2 and significantly outperformed the QTc (C statistic, 0.82 [0.71–0.93]).

Conclusion:
Detailed morphological analysis of the T wave provides novel insights into risk of breakthrough arrhythmic events in LQTS, particularly LQT2. This observation has the potential to guide clinical decision making and further refine risk stratification.
Magnitude of Soluble ST2 as a Novel Biomarker for Acute Aortic Dissection
Authors: Wang Yuan , Tan Xin , Gao Hai , Yuan Hui , Hu Rong , Jia Lixin , Zhu Junming , Sun Lizhong , Zhang Hongjia , Huang Lianjun , Zhao Dong , Gao Pei , Du Jie 
Published: November 2017

Background:
Misdiagnosis of acute aortic dissection (AAD) can lead to significant morbidity and death. Soluble ST2 (sST2) is a cardiovascular injury–related biomarker. The extent to which sST2 is elevated in AAD and whether sST2 can discriminate AAD from other causes of sudden-onset severe chest pain are unknown.

Methods:
We measured plasma concentrations of sST2 (R&D Systems assay) in 1360 patients, including 1027 participants in the retrospective discovery set and 333 patients with initial suspicion of AAD enrolled in the prospective validation cohort. Measures of discrimination for differentiating AAD from other causes of chest pain were calculated.

Results:

In the acute phase, sST2 levels were higher in patients with AAD than those with either acute myocardial infarction in the first case-control discovery set within 24 hours of symptom onset or with patients with pulmonary embolism in the second discovery set (medians of 129.2 ng/mL versus 14.7 with
P
<0.001 for AAD versus acute myocardial infarction and 88.6 versus 9.3 with
P
<0.001 for AAD versus pulmonary embolism). In the prospective validation set, sST2 was most elevated in patients with AAD (median [25th, 75th percentile]: 76.4 [49.6, 130.3]) and modestly elevated in acute myocardial infarction (25.0 [15.5, 37.2]), pulmonary embolism (14.9 [10.2, 30.1]), and angina patients (21.5 [13.1, 27.6], all
P
<0.001 versus AAD). The area under receiver operating characteristic curve for patients with AAD versus all control patients within 24 hours of presenting at the emergency department was 0.97 (0.95, 0.98) for sST2, 0.91 (0.88, 0.94) for D-dimer, and 0.50 (0.44, 0.56) for cardiac troponin I, respectively. At a cutoff level of 34.6 ng/mL, sST2 had a sensitivity of 99.1%, specificity of 84.9%, positive predictive value of 68.7%, negative predictive value of 99.7%, positive likelihood ratio of 6.6, and negative likelihood ratio of 0.01.

Conclusions:
Among patients with suspected aortic dissection in the emergency department, sST2 showed superior overall diagnostic performance to D-dimer or cardiac troponin I. Additional study is needed to determine whether sST2 might be a useful rule-out marker for AAD in the emergency room.
Imaging Characteristics of Venous Parenchymal Abnormalities
Authors: Arnoux Audrey , Triquenot-Bagan Aude , Andriuta Daniela , Wallon David , Guegan-Massardier Evelyne , Leclercq Claire , Martinaud Olivier , Castier-Amouyel Mélody , Godefroy Olivier , Bugnicourt Jean-Marc 
Published: November 2017

Background and Purpose—
There are few published data on the patterns of parenchymal imaging abnormalities in a context of cerebral venous thrombosis (CVT). The objectives of the present study were to describe the patterns of parenchymal lesions associated with CVT and to determine the lesion sites.

Methods—
We included 44 consecutively hospitalized patients with CVT and parenchymal lesions on magnetic resonance imaging. The diagnosis of CVT had been confirmed by magnetic resonance imaging/magnetic resonance venography. Magnetic resonance imaging patterns for CVT were retrospectively analyzed with regard to the lesion’s type, shape, and site.

Results—

The most frequent stroke subtype was hemorrhagic ischemia (in 56.8% of cases), followed by intracerebral hematoma (in 22.72% of cases) and nonhemorrhagic ischemia (in 20.45% of cases). Although there were no significant differences between these 3 groups with regard to the clinical and radiological characteristics, we observed a nonsignificant trend (
P
=0.08) toward a shorter time interval between hospital admission and magnetic resonance imaging for nonhemorrhagic stroke. The CVT parenchymal abnormalities were centered on 6 main foci and were related to the site of venous occlusion: (1) the inferior parietal lobule (n=20; 44.5%), associated mainly with occlusion of the transverse sinus (n=10) or pure cortical veins (n=10); (2) the inferior and posterior temporal regions (n=10; 22.75%), associated mainly with occlusion of the transverse sinus (n=9); (3) the parasagittal frontal region (n=6; 13.6%), associated mainly with occlusion of the superior sagittal sinus (n=4) or the transverse sinus (n=4); (4) the thalamus (n=5; 11.3%) associated with occlusion of the straight sinus (n=5); (5) the cerebellar hemisphere (n=2; 4.5%), associated in both cases with occlusion of the transverse sinus; and (6) the deep hemispheric regions (n=3; 6.8%), associated with occlusion of the superior sagittal sinus in all cases.

Conclusions—
Parenchymal lesions caused by CVT display specific anatomic patterns, which is mainly determined by the site of venous occlusion.
Protection against Domestic Violence in Jordanian Law and International Conventions
Authors: Nasrawin Laith K. 
Published: November 2017

Abstract
This article addresses the issue of protection against domestic violence in both Jordanian law and international conventions. It does so by defining domestic violence and its various causes and by exploring the relevant global standards and best international practices for combating it. The article also deals with the reality of protection against domestic violence in Jordan by referring to the special protection of the family and to the related follow-up by national and governmental institutions, and the relevant national standards. The Law Regarding Protection from Domestic Violence (Law No. 6/2008) contains protective provisions and other treatments to reduce this phenomenon, but it fails to provide optimal protection against domestic violence. The article proposes a set of recommendations to improve national standards for protection against domestic violence so that Jordan’s laws concerning protection against domestic violence conform to international standards.
Real-Time Determination of Earth Radiation Budget Spectral Signatures for Nonlinear Unfiltering of Results from MERBE
Authors: Matthews Grant 
Published: November 2017

AbstractAmong the best ways to gain more certainty in climate model prediction is to compare and constrain simulations with worldwide satellite measurements of the Earth radiation budget (ERB) short- and longwave radiant fluxes (SW and LW), which drive climate processes. Recent calls to ensure orbital ERB measurements track true climate, rather than instrument changes, led to the creation of the Moon and Earth Radiation Budget Experiment (MERBE). This independent project is recalibrating multiple existing ERB devices from different international space agencies so they adhere to common SI-traceable radiometric standards, by regularly sampling the unaltering constants of lunar reflectivity/emissivity, thus ensuring no artificial trends exist. This work details the use of MODTRAN to give an instantaneous SW and LW Earth spectrum for all scenes viewed by devices in the project, to then be used with instrument spectral responses for unfiltering radiances. In the majority of cases when data from a collocated imager are available, a dual-layer unfiltering is also performed separately on cloudy and cloud-free areas, yielding clear and overcast ERB spectral results. Additionally, use is made of improved in-flight methods to derive spectral responses from a previous American Meteorological Society study, and comparisons between Earth MERBE radiances from two identical devices operating on Terra/Aqua are shown along with results from the CERES project. These demonstrate an order of magnitude improvement in relative accuracy for edition 1 MERBE results over CERES and show that the latest CERES data are less accurate and stable than claimed.
Plasma-Lyte 148 vs. Hartmann’s solution for cardiopulmonary bypass pump prime: a prospective double-blind randomized trial
Authors: Weinberg Laurence , Chiam Elizabeth , Hooper James , Liskaser Frank , Hawkins Angela Kim , Massie Denise , Ellis Andrew , Tan Chong O , Story David , Bellomo Rinaldo 
Published: November 2017

Background: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann’s solution (HS) have differential mechanisms of action in their contribution to acid-base changes. Methods: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS. The primary endpoint was the standard base excess (SBE) value measured at 60 minutes after full CPB flows (SBE60min). Secondary outcomes included changes in SBE, pH, chloride, sodium, lactate, gluconate, acetate, strong ion difference and strong ion gap at two (T2min), five (T5min), ten (T10min), thirty (T30min) and sixty (T60min) minutes on CPB. The primary outcome was measured using a two-tailed Welch’s t-test. Repeated measures ANOVA was used to test for differences between time points. Results: Twenty-five participants were randomized to PL and 25 to HS. Baseline characteristics, EURO and APACHE scores, biochemistry, hematology and volumes of cardioplegia were similar. Mean (SD) SBE at T60min was -1.3 (1.4) in the PL group and -0.1 (2.7) in the HS group; p=0.55. No significant differences in SBE between the groups was observed during the first 60 minutes (p=0.48). During CPB, there was hyperacetatemia and hypergluconatemia in the PL group and hyperlactatemia and hyperchloremia in the HS group. No significant difference between the groups in plasma bicarbonate levels and total weak acid levels were found. Complications and intensive care unit and hospital length of stays were similar. Conclusions: During CPB, PL and HS did not cause a significant metabolic acidosis. There was hyperacetatemia and hypergluconatemia with PL and hyperchloremia and hyperlactatemia with HS. These physiochemical effects appear clinically innocuous.
Factors Associated With Caregivers’ Resilience in a Terminal Cancer Care Setting
Authors: Hwang In Cheol , Kim Young Sung , Lee Yong Joo , Choi Youn Seon , Hwang Sun Wook , Kim Hyo Min , Koh Su-Jin 
Published: November 2017

Background: Resilience implies characteristics such as self-efficacy, adaptability to change, optimism, and the ability to recover from traumatic stress. Studies on resilience in family caregivers (FCs) of patients with terminal cancer are rare. This study aims to examine the factors associated with FCs’ resilience in a terminal cancer care setting. Methods: This is a cross-sectional study of 273 FCs from 7 hospice and palliative care units in Korea. Resilience was categorized as high and low, and factors associated with resilience were grouped or categorized into subscales. A multivariate logistic regression analysis was used to examine relevant factors. Results: High FCs’ resilience was significantly associated with FCs’ health status, depression, and social support. In a multivariate regression model, FCs’ perception of good health (adjusted odds ratio [aOR] = 2.26, 95% confidence interval [CI] = 1.16-4.40), positive social support (aOR = 3.70, 95% CI = 1.07-12.87), and absence of depression (aOR = 3.12, 95% CI = 1.59-6.13) remained significantly associated with high FCs’ resilience. Conclusion: Lack of family support is associated with and may be a cause of diminished resilience. And more concern should be paid to FCs to improve FCs’ health and emotional status. Education programs might be effective for improving caregivers’ resilience. Further research with supportive interventions is indicated.
Can Engaged and Positive Employees Delight Customers?
Authors: Shaheen Musarrat , Zeba Farrah , Mohanty Pankaj Kumar 
Published: November 2017

The Problem Although there have been a plethora of studies on the determinants of customer delight in marketing literature, less attention has been given to understand the role of employees’ work engagement and psychological capital (PsyCap) in satisfying and delighting customers. The objective of the present study is threefold—the first is to examine how engaged employees are positive and efficacious; the second is to investigate how engaged, positive, and efficacious employees delight patients specifically in the health care sector; and the third is to examine how the relationship between employees’ positive PsyCap and customer delight is mediated by beneficiary contact, which is the perception of employees about the meaningful impact of their efforts on their patients. The Solution Previous studies have shown that employees who are absorbed, dedicated, and immersed in their work are more confident and positive at their workplace. Engaged, positive, and confident employees not only keep themselves but also their customers happy and positive through their optimistic outlook and efficacious work behavior. Responses are collected from 200 employees and their 200 patients from different hospitals of India. Hierarchical regression analysis shows a significant and positive relationship between work engagement, PsyCap, and customer delight. Work engagement is found to predict PsyCap and customer delight. Beneficiary contact is found to mediate between the relationship of PsyCap and customer delight. The originality of the article lies in its interdisciplinary approach to understand how engaged and dedicated employees keep themselves and their patients positive and delighted. The Stakeholders This study is of relevance to human resource development (HRD) professionals, customer relationship managers of the health care sector, and also academicians belonging to the disciplines of marketing and human resource management. The findings of this study would help them understand how engaged employees lead to employees’ positive PsyCap and customer delight. Furthermore, they will also understand the vital role of the interface between employees and customers, as beneficiary contact mediates the relationship of employees’ PsyCap and customer delight.
Salvage of mangled upper extremity using the Masquelet technique in a child: A case report
Authors: Alassaf Nabil , Alhoukail Amro , Alsahli Abdullah , Althubaiti Ghazi 
Published: November 2017

Aim: To report our experience with the Masquelet concept in a pediatric upper extremity following an open injury to the elbow. Methods: A case report and literature review. Results: An 11-year-old boy was transferred to our institution after a motor vehicle collision. There was a primary loss of the ulnohumeral articulation and the surrounding soft tissues as well as the ulnar nerve. Reconstruction used the Masquelet-induced membrane technique and a soft tissue flap. At the 30-month follow-up, the extremity was pain free and functional. Conclusion: This case highlights the value of the Masquelet technique in pediatric extremity injuries, where there is a loss of a major articular segment, as well as significant soft tissue compromise.
A simple suture-guiding device for minimally invasive Achilles tendon repair
Authors: Obut Sinan , Gultekin Alper , Unal Meric , Serarslan Ulaş , Tuhanioğlu Ümit 
Published: November 2017

Background: Our hypothesis is to utilize a simple suture-guiding device for minimally invasive repair of Achilles tendon without any extra cost with a minimal risk of rerupture. The purpose of this study is to investigate the results of our minimally invasive technique for Achilles tendon repair using a simple ovarian clamp for suture guiding. Materials and Methods: Twenty patients with acute Achilles tendon rupture were treated with minimally invasive repair by an expert orthopaedic surgeon. Instead of an Achillon device, an ovarian clamp was directed to the proximal and distal parts of the Achilles tendon. All data relating to daily activities, walking, climbing stairs, sports activity, American Orthopaedic Foot and Ankle Society (AOFAS) and Thermannscores were recorded. Sural nerve was evaluated with physical examination for paraesthesia, hyperaesthesia, lateralis cruris and foot pain in all patient controls. Results: The average AOFAS score was 97.06 (76–100). All patients had intact Achilles tendon at last control. No rerupture was observed. Average time taken to return to work was 30.8 days (28–60 days). After 6 months, all patients returned to their previous sports activities. Conclusion: For Achilles tendon ruptures, minimally invasive repair techniques have shown successful results with low complication rates. Besides their success, some suture-guiding devices bring extra costs for patients or health insurance. Minimally invasive techniques may be performed with devices without any extra cost. Our new suture-guiding device provides knot placement under paratenon like Achillon device to improve outcomes, provides early return to work and minimizes the complications. Finally, our suture-guiding device has no extra cost.
Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy
Authors: Jackson William G. , Oromendia Clara , Unlu Ozan , Erkan Doruk , DeSancho Maria T. 
Published: November 2017

Key Points
There is currently no clear consensus on the best approach to the management of patients with APS and arterial thrombosis. Combined antiplatelet and anticoagulant therapy may decrease risk of thrombosis recurrence in patients with APS and arterial thrombosis.
Buccal epithelial cells display somatic, bone marrow–derived CALR mutation
Authors: Gilles Scott R. , Baughn Linda B. , Schomaker Matthew L. , Courville Elizabeth L. , Nelson Andrew C. , Sachs Zohar 
Published: November 2017

Key Points
Buccal epithelial cells harbor an MPN-associated CALR mutation in a patient with CALR-mutant essential thrombocytosis, Ph+ CML, and no germ line CALR mutation.