bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histological and Histometric Characterization of Myocardial Fibrosis in End-Stage Hypertrophic Cardiomyopathy
Authors: Galati Giuseppe , Leone Ornella , Pasquale Ferdinando , Olivotto Iacopo , Biagini Elena , Grigioni Francesco , Pilato Emanuele , Lorenzini Massimiliano , Corti Barbara , Foà Alberto , Agostini Valentina , Cecchi Franco , Rapezzi Claudio 
Published: September 2016

Background—
Although noninvasively detected myocardial fibrosis (MF) has clinical implications in hypertrophic cardiomyopathy, the extent, type, and distribution of ventricular MF have never been extensively pathologically characterized. We assessed the overall amount, apex-to-base, circumferential, epicardial–endocardial distribution, pattern, and type of MF in 30 transplanted hearts of end-stage, hypertrophic cardiomyopathy.

Methods and Results—

Visual and morphometric histological analyses at basal, midventricular, and apical levels were performed. Overall MF ranged from 23.1% to 55.9% (mean=37.3±8.4%). Prevalent types of MF were as follows: replacement in 53.3%, interstitial-perimyocyte in 13.3%, and mixed in 33.3%. Considering left ventricular base-to-apex distribution, MF was 31.9%, 43%, and 46.2% at basal, midventricular, and apical level, respectively (
P
<0.001). Circumferential distributions (mean percentage of MF within the section) were as follows: anterior 11.9%, anterolateral 15.8%, inferolateral 7.0%, inferior 24.3%, anteroseptal 11%, midseptal 10.7%, and posteroseptal 11.4%; circumferential distributions for anterior and inferior right ventricular walls were 3.4% and 4.5%, respectively. Epicardial–endocardial distributions were as follows: trabecular 26.1% and subendocardial 20.2%, midwall 33.4%, and subepicardial 20.3%. Main patterns identified were as follows: midwall in 33.3% of the hearts, transmural in 23.3%, midwall–subepicardial in 23.3%, and midwall-subendocardial in 20%.

Conclusions—
In end-stage, hypertrophic cardiomyopathy patients undergoing transplantation, more than one-third of the left ventricular myocardium was replaced by fibrosis, mainly of replacement type. MF preferentially involved the left ventricular apex and the midwall. Inferior and anterior walls and septum were maximally involved, whereas inferolateral and right ventricular were usually spared. These observations reflect the complex pathophysiology of hypertrophic cardiomyopathy and may provide clues for the timely recognition of disease progression by imaging techniques capable of quantifying MF.
Effects of Sacubitril/Valsartan in the PARADIGM-HF Trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) According to Background Therapy
Authors: Okumura Naoki , Jhund Pardeep S. , Gong Jianjian , Lefkowitz Martin P. , Rizkala Adel R. , Rouleau Jean L. , Shi Victor C. , Swedberg Karl , Zile Michael R. , Solomon Scott D. , Packer Milton , McMurray John J.V. 
Published: September 2016

Background—
In the PARADIGM-HF trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure), the angiotensin receptor neprilysin inhibitor sacubitril/valsartan was more effective than the angiotensin-converting enzyme inhibitor enalapril in patients with heart failure and reduced ejection fraction. We examined whether this benefit was consistent irrespective of background therapy.

Methods and Results—

We examined the effect of study treatment in the following subgroups: diuretics (yes/no), digitalis glycoside (yes/no), mineralocorticoid receptor antagonist (yes/no), and defibrillating device (implanted defibrillating device, yes/no). We also examined the effect of study drug according to β-blocker dose (≥50% and <50% of target dose) and according to whether patients had undergone previous coronary revascularization. We analyzed the primary composite end point of cardiovascular death or heart failure hospitalization, as well as cardiovascular death. Most randomized patients (n=8399) were treated with a diuretic (80%) and β-blocker (93%); 47% of those taking a β-blocker were treated with ≥50% of the recommended dose. In addition, 4671 (56%) were treated with a mineralocorticoid receptor antagonist, 2539 (30%) with digoxin, and 1243 (15%) had a defibrillating device; 2640 (31%) had undergone coronary revascularization. Overall, the sacubitril/valsartan versus enalapril hazard ratio for the primary composite end point was 0.80 (95% confidence interval, 0.73–0.87;
P
<0.001) and for cardiovascular death was 0.80 (0.71–0.89;
P
<0.001). The effect of sacubitril/valsartan was consistent across all subgroups examined. The hazard ratio for primary end point ranged from 0.74 to 0.85 and for cardiovascular death ranged from 0.75 to 0.89, with no treatment-by-subgroup interaction.

Conclusions—
The benefit of sacubitril/valsartan, over an angiotensin-converting enzyme inhibitor, was consistent regardless of background therapy and irrespective of previous coronary revascularization or β-blocker dose.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01035255.
Afro-Caribbean Heart Failure in the United Kingdom
Authors: Dungu Jason N. , Papadopoulou Sofia A. , Wykes Katharine , Mahmood Ihtisham , Marshall Joseph , Valencia Oswaldo , Fontana Marianna , Whelan Carol J. , Gillmore Julian D. , Hawkins Philip N. , Anderson Lisa J. 
Published: September 2016

Background—
It has been reported that subjects of African descent present with heart failure at a younger age and because of different causes than whites. We present contemporary data from UK Afro-Caribbean patients in London.

Methods and Results—

All patients with heart failure presenting to St George’s Hospital Heart Failure clinic between 2005 and 2012 were included (n=1392). Patients were predominantly white (71%) and male (67%), and median age at presentation was 73 years (range, 18–100 years). In 211 Afro-Caribbean patients, the most common cause of heart failure was nonischemic dilated cardiomyopathy in 27.5% (whites, 19.9%;
P
<0.001). Lower rates of ischemic cardiomyopathy were observed (13% versus 41%;
P
<0.001). The fourth most common cause of heart failure in Afro-Caribbeans was cardiac amyloidosis (11.4%). The prevalence may have been even higher as not all patients were tested for amyloidosis. Patients with ATTR V122I had the worst prognosis compared with other causes of Afro-Caribbean heart failure and white patients. To better understand this condition, we analyzed data from the largest international cohort of ATTR V122I patients, followed up at the UK National Amyloidosis Center (n=72). Patients presented with cardiac failure (median age, 75 [range, 59–90] years). Median survival was 2.6 years from diagnosis.

Conclusions—
In London, the cause of heart failure varies depending on ethnicity and affects age of presentation and outcomes. In Afro-Caribbean patients, ATTR V122I is an underappreciated cause of heart failure, and cardiomyopathy is often misattributed to hypertension. As promising TTR therapies are in development, increased awareness and proactive detection are needed.
WMO World Record Lightning Extremes: Longest Reported Flash Distance and Longest Reported Flash Duration
Authors: Lang Timothy J. , Pédeboy Stéphane , Rison William , Cerveny Randall S. , Montanyà Joan , Chauzy Serge , MacGorman Donald R. , Holle Ronald L. , Ávila Eldo E. , Zhang Yijun , Carbin Gregory , Mansell Edward R. , Kuleshov Yuriy , Peterson Thomas C. , Brunet Manola , Driouech Fatima , Krahenbuhl Daniel S. 
Published: September 2016

Abstract
A World Meteorological Organization weather and climate extremes committee has judged that the world’s longest reported distance for a single lightning flash occurred with a horizontal distance of 321 km (199.5 mi) over Oklahoma in 2007, while the world’s longest reported duration for a single lightning flash is an event that lasted continuously for 7.74 s over southern France in 2012. In addition, the committee has unanimously recommended amendment of the AMS Glossary of Meteorology definition of lightning discharge as a “series of electrical processes taking place within 1 s” by removing the phrase “within 1 s” and replacing it with “continuously.” Validation of these new world extremes 1) demonstrates the recent and ongoing dramatic augmentations and improvements to regional lightning detection and measurement networks, 2) provides reinforcement regarding the dangers of lightning, and 3) provides new information for lightning engineering concerns.
Are Sudden Stratospheric Warmings Generic? Insights from an Idealized GCM
Authors: Jucker Martin 
Published: September 2016

Abstract
This work examines the life cycle of sudden stratospheric warmings (SSWs) from composites of a large number of events. The events are sampled from idealized general circulation model (GCM) integrations and form a database of several hundred major, displacement, splitting, and weak vortex events. It is shown that except for a few details, the generic zonal-mean evolution does not depend on the definition used to detect SSWs. In all cases, the composites show the stratosphere in a positive annular mode phase prior to the events and a barotropic response in the stratosphere at onset. There is a clear positive peak in upward Eliassen–Palm (EP) flux prior to the onset date in the stratosphere and a much weaker peak in the troposphere, making the evolution more consistent with the picture of the stratosphere acting as a variable filter of tropospheric EP flux, rather than SSWs being forced by a strong “burst” in the troposphere. When comparing composites of SSWs from the database with apparent influence at the surface (downward “propagating”) to those without such influence, the only significant differences are a somewhat more barotropic response at the onset date and longer persistence in the lower stratosphere after the onset for propagating SSWs. There is no significant difference in EP flux between propagating and nonpropagating events, and none of the definitions considered here shows a particular skill in selecting propagating events.
The Microphysical Properties of Small Ice Particles Measured by the Small Ice Detector-3 Probe during the MACPEX Field Campaign
Authors: Schmitt Carl G. , Schnaiter Martin , Heymsfield Andrew J. , Yang Ping , Hirst Edwin , Bansemer Aaron 
Published: September 2016

Abstract
A reliable understanding of the microphysical properties of ice particles in atmospheric clouds is critical for assessing cloud radiative forcing effects in climate studies. Ice particle microphysical properties such as size, shape, and surface roughness all have substantial effects on the single-scattering characteristics of the particles. A recently developed ice particle probe, the Small Ice Detector-3 (SID-3), measures the two-dimensional near-forward light-scattering patterns of sampled ice particles. These scattering patterns provide a wealth of information for understanding the microphysical and radiative characteristics of ice particles. The SID-3 was operated successfully on 12 aircraft flights during the NASA Midlatitude Airborne Cirrus Properties Experiment (MACPEX) field campaign in April 2011. In this study, SID-3 measurements are used to investigate the frequency of occurrence of a number of ice particle properties observed during MACPEX. Individual scattering patterns (7.5°–23°) are used to infer properties of the observed particles as well as to calculate partial scattering functions (PSFs) for ensembles of particles in the measured size range (~5–100 μm). PSFs are compared to ray-tracing-based phase functions to infer additional properties of the particles. Two quantitative values—halo ratio and steepness ratio—are used to characterize PSFs. The MACPEX dataset suggests that most atmospheric ice particles have rough surfaces or are complex in nature. PSFs calculated for particles that were characterized as having smooth surfaces also appeared to more closely resemble rough crystal PSFs. PSFs measured with SID-3 compare well with those calculated for droxtals with rough surfaces.
Vessel Size and Long-Term Outcomes After Limus-Based Drug-Eluting Stent Implantation Focusing on Medium- and Small-Diameter Vessels
Authors: Hsieh I-Chang , Hsieh Ming-Jer , Chang Shang-Hung , Wang Chao-Yung , Lee Cheng-Hung , Yang Chia-Hung , Chen Dong-Yi , Tsai Ming-Lung , Chen Chun-Chi 
Published: September 2016

Introduction: This study aimed to evaluate the efficacy and safety of limus-based drug-eluting stent (DES) implanted in medium or small coronary vessels during a very long-term follow-up period. Methods: A total of 2383 patients treated with 2916 limus-based DES between April 2003 and March 2015 were evaluated. The enrolled patients were stratified into 3 groups according to the reference vessel diameter: group A: ≤2.5 mm; group B: 2.51 to 3.00 mm; group C: 3.01 to 3.50 mm. Results: Group A had a significantly higher loss index and binary restenosis rate than the other 2 groups at 9 months of angiographic follow-up. Group A also had a significantly higher rate of target lesion revascularization and a lower rate of major adverse cardiovascular event–free survival than the other 2 groups after a follow-up period of 68 ± 59 months. The long-term cardiovascular event–free survival curves based on a Cox regression model showed large vessel size, and second-generation DES had better outcomes. Conclusion: An inverse relationship between vessel size (≤3.5 mm) and clinical outcomes was noted in patients who received limus-based DES implantation.
Morell Mackenzie’s Contribution to the Description of Spasmodic Dysphonia
Authors: Lorch Marjorie Perlman , Whurr Renata 
Published: September 2016

Objectives: Since the middle of the 20th century, most discussions of spasmodic dysphonia (SD) reference a paper by Ludwig Traube published in1871 as the first historical citation, crediting him with priority for this clinical syndrome. However, our recent research has determined that the original observation by Traube was published in 1864 and does not in fact describe what is currently recognized as SD. It appears that many clinics throughout Europe and North America were investigating and publishing observations on a range of voice disorders. Methods: The wider context of work on laryngeal disorders in the 1860s-1870s is considered. One of Traube’s contemporaries, Morell Mackenzie, made significant contributions to the understanding of laryngeal movement disorder and its consequences for the voice. These will be examined to gain a clearer focus on the characterization of this disorder. Results: The clinical descriptions published by Morrell Mackenzie in the 1860s provide details that conform quite closely to our current-day understanding of SD. Conclusions: The citation of Traube’s “hysterical” patient links to mid 20th–century views of the functional nature of SD and the utility of psychiatric treatment. The description presented by Mackenzie is consistent with current views of SD as a movement disorder.
Trends in Psychological Symptoms among Canadian Adolescents from 2002 to 2014: Gender and Socioeconomic Differences
Authors: Gariépy Geneviève , Elgar Frank J. 
Published: September 2016

Objective: To describe trends in psychological health symptoms in Canadian youth from 2002 to 2014 and examine gender and socioeconomic differences in these trends. Method: We used data from the Canadian Health Behaviour in School-aged Children (HBSC) study. We assessed psychological symptoms from a validated symptom checklist and calculated a symptom score (range, 0-16). We stratified our analyses by gender and affluence tertile based on an index of material assets. We then plotted trends in symptom score and calculated the probability of experiencing specific symptoms over time. Results: Between 2002 and 2014, psychological symptom score increased by 1.01 (95% confidence interval [CI], 0.73 to 1.41), 1.08 (95% CI, 0.79 to 1.37), and 0.84 (95% CI, 0.55 to 1.13) points in girls in the low-, middle-, and high-affluence tertiles, respectively. In boys, psychological symptoms decreased by –0.39 (95% CI, –0.66 to –0.12) and –0.12 (95% CI, –0.43 to 0.19) points in the high- and middle-affluence tertiles, respectively, and increased by 0.30 (95% CI, –0.04 to 0.63) points in the low-affluence tertile. The probability of feeling anxious and having sleep problems at least once a week notably increased in girls from all affluence groups, while the probability of feeling depressed and irritable decreased among boys from the high-affluence tertile. Conclusion: Psychological symptoms increased in Canadian adolescent girls across all affluence groups while they remained stable in boys from low and middle affluence and decreased in boys from high affluence. Specific psychological symptoms followed distinct trends. Further research is needed to uncover the mechanisms driving these trends.
Early Recognition and Treatment of Sepsis After the Addition of Lactate to the Laboratory’s Critical Result Call List
Authors: Kuttab Hani I. , Sterk Ethan , Rech Megan A. , Nghiem Trac , Bahar Burak , Kahn Stephen 
Published: September 2016

Purpose: Screening of patients with sepsis is needed to increase recognition and allow for earlier interventions. There is no consensus on whether the addition of lactate to the critical result laboratory’s call list should be a standard practice. Materials and Methods: This was a retrospective cohort study that compared management and outcomes of patients with sepsis having lactate ≥4 mmol/L before (group 1) and after (group 2) the addition of a critical result threshold of lactate of ≥4 mmol/L to the critical result laboratory’s call list and its effects on time to antibiotics and intravenous fluids (IVFs). Results: One hundred twenty-one patients were included. Lactate was higher in group 1 (7.0 ± 4.3 vs 5.6 ± 2.0, P = 0.03). More patients in group 2 received hydrocortisone (1.9% vs 22.4%, P = .001). Hospital mortality, 30-day mortality, and 90-day mortality were significantly lower in group 2 (59.3% vs 32.8%, P = .003; 68.5% vs 37.3%, P ≤ .001; 68.5% vs 41.8%, P = .002). There were no significant differences in total volume of IVFs (2400.8 ± 1720.0 vs 2483.7 ± 2155.7, P = 0.83), time to start IVFs (184.0 ± 283.2 vs 115.6 ± 190.5, P = 0.27), or antibiotics (184.8 ± 187.1 vs 133.7 ± 137.4, P = 0.16). Conclusion: Addition of lactate to the critical result laboratory’s call list did not lead to a statistically significant improvement in time to IVFs or antibiotics, although the average time to antibiotics and IVFs decreased by 51.1 and 68.4 minutes, respectively. Hospital mortality, 30-day mortality, and 90-day mortality were lower in group 2, which may be, in part, due to increased recognition of severe sepsis by critical result notification and earlier intervention.
Preemptive Local Anesthesia in Ankle Arthroscopy
Authors: Liszka Henryk , Gądek Artur 
Published: September 2016

Background: Complex anesthesia is increasingly used in order to reduce postoperative pain and accelerate rehabilitation. The aim of this study was to evaluate the efficacy and safety of preemptive local anesthesia combined with general or spinal anesthesia in ankle arthroscopy. Methods: From January 2014 to February 2016, 80 ankle anterior arthroscopies were performed. Patients were randomly assigned to one of 4 groups, depending on the type of anesthesia: A, general and local preemptive; B, spinal and local preemptive; C, general and placebo; D, spinal and placebo. After general or spinal anesthesia, each patient randomly received an injection of 7 mL of a mixture of local anesthetics or the same amount of normal saline. After 2, 4, 8, 12, 16, 24, 48, and 72 hours following the release of the tourniquet, the pain intensity level was measured with a visual analog scale (VAS). The use of additional analgesics and any adverse effects were also noted. Results: Preemptive local anesthesia (groups A and B) resulted in a significantly lower level of pain intensity during the first 24 hours after surgery. Until 8 hours after the release of the tourniquet, the pain intensity level was statistically lower in the groups A, B, and D in comparison to C. During hospitalization, none of the patients from groups A and B received on-demand ketoprofen intravenously. No side effects of local anesthetic agents were observed. Two patients had transient numbness and paresthesia in the field of sensory nerve innervation of the dorsal intermediate cutaneous nerve of the foot. Conclusion: Preemptive operative site infiltration with a mixture of local anesthetics performed in ankle arthroscopy was a safe procedure. It reduced the level of intensity of postoperative pain and the amount of analgesics used. Level of Evidence: Level I, prospective randomized study.
Clinical and Functional Outcomes of Gastrocnemius Recession for Chronic Achilles Tendinopathy
Authors: Molund Marius , Lapinskas Saulius Rytas , Nilsen Fredrik Andre , Hvaal Kjetil Harald 
Published: September 2016

Background: Although gastrocnemius recession has been proposed and used in the treatment of chronic noninsertional Achilles tendinopathy, only weak evidence exists to support this operative indication. The purpose of our study was to assess the clinical and functional outcomes of patients treated with gastrocnemius recession at 2 institutions for this problem. Methods: Thirty-four patients were identified through our medical records and asked to participate in this study. Thirty patients (35 legs) responded to the invitation. Sixteen patients were eligible for clinical follow-up, and 14 patients responded by letter or telephone interview. Two patients did not want to participate, and 2 patients could not be reached. Data were collected by a satisfaction questionnaire, the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire, a visual analog scale (VAS) for pain, a functional test battery, and a clinical examination. Results: A subgroup with preoperative data (n = 8) showed an increase in the mean VISA-A score from 39.5 to 91.9. The mean overall VISA-A score (n = 30) was 91.4 at follow-up. The mean VAS for pain score when walking decreased from 7.5 before surgery to 0.8 after surgery. Twenty-eight of 30 patients reported that they were satisfied with their results after surgery. Functional testing showed no difference in gastrocnemius-soleus function between the operated and nonoperated leg (n = 10). Conclusion: The findings support the promising results from other studies regarding gastrocnemius recession as an effective and safe way of treating chronic Achilles tendinopathy. The patients recovered both in terms of pain and function. Level of Evidence: Level IV, retrospective case series.