bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Echocardiography to Estimate Pulmonary Artery Pressures With Exercise
Authors: van Riel Annelieke C.M.J. , Opotowsky Alexander R. , Santos Mário , Rivero Jose M. , Dhimitri Andy , Mulder Barbara J.M. , Bouma Berto J. , Landzberg Michael J. , Waxman Aaron B. , Systrom David M. , Shah Amil M. 
Published: March 2017

Background—
Exercise echocardiography is often applied as a noninvasive strategy to screen for abnormal pulmonary hemodynamic response, but it is technically challenging, and limited data exist regarding its accuracy to estimate pulmonary arterial pressure during exercise.

Methods and Results—

Among 65 patients with exertional intolerance undergoing upright invasive exercise testing, tricuspid regurgitation (TR) Doppler estimates and invasive measurement of pulmonary arterial pressure at rest and peak exercise were simultaneously obtained. TR Doppler envelopes were assessed for quality. Correlation, Bland–Altman, and receiver-operating characteristic curve analyses were performed to evaluate agreement and diagnostic accuracy. Mean age was 62±13 years, and 31% were male. High-quality (grade A) TR Doppler was present in 68% at rest and 34% at peak exercise. For grade A TR signals, echocardiographic measures of systolic pulmonary arterial pressure correlated reasonably well with invasive measurement at rest (
r
=0.72,
P
<0.001; bias, −2.9±8.0 mm Hg) and peak exercise (
r
=0.75,
P
<0.001; bias, −1.9±15.6 mm Hg). Lower quality TR signals (grade B and C) correlated poorly with invasive measurements overall. In patients with grade A TR signals, mean pulmonary arterial pressure-to-workload ratio at a threshold of 1.4 mm Hg/10 W was able to identify abnormal pulmonary hemodynamic response during exercise (>3.0 mm Hg/L per minute increase), with 91% sensitivity and 82% specificity (area under the curve, 0.90; 95% confidence interval, 0.77–1.0;
P
=0.001).

Conclusions—
Agreement between echocardiographic and invasive measures of pulmonary pressures during upright exercise is good among the subset of patients with high-quality TR Doppler signal. While the limits of agreement are broad, our results suggest that in those patients, sensitivity is adequate to screen for abnormal pulmonary hemodynamic response during exercise.
Trained Cohorts of University Students are a Useful Resource for Conducting Dietary Surveys in Mongolia
Authors: Bromage Sabri , Chung Holly Ya-Fan , Bonville Hannah , Sprenger Jeannie Choi , Lander Rebecca , Ganmaa Davaasambuu 
Published: March 2017

Background: Population-based dietary assessment is important for informing national nutrition policy. The developing country setting presents challenges for robust implementation of dietary surveys, yet effective nutrition interventions are often urgently required. Objective: To develop and evaluate a low-cost approach to epidemiologic dietary assessment in Mongolia, involving the use of large cohorts of local public health and medical students as research assistants for collecting diet records. Methods: From 2011 to 2016, over 200 Mongolian medical and public health university students were trained to collect paired summer and winter 3-day weighed diet records from urban and rural study populations across the geographic expanse of Mongolia. Students were supervised during data collection, and their performance and experience during training and data collection were qualitatively evaluated from their own perspectives as well as those of the investigators. Results: Students collected detailed and thorough diet records and generally reported positive feedback regarding training and data collection. Frequent supervision of students during data collection proved to be extremely worthwhile. While rural participants were amenable to having students follow them, students faced several challenges in assessing the diets of urban participants. These challenges may best be addressed by separately training these participants beforehand. Conclusions: With adequate training and supervision, university students may be a useful and cost-effective resource for large-scale dietary surveys in regions where their use would be practical and culturally appropriate. Further research is warranted to study how well this approach may be adapted outside Mongolia and to other dietary assessment methods and technologies.
Trends in Iron, Zinc, and Vitamin A Status Biomarkers Among Colombian Children: Results From 2 Nationally Representative Surveys
Authors: Li Wenchao , Herrán Oscar F. , Villamor Eduardo 
Published: March 2017

Background: Micronutrient deficiencies are still highly prevalent in countries undergoing the nutrition transition, but nationally representative data documenting their burden in children are exceedingly rare. Objective: To examine the distribution and recent trends in micronutrient status biomarkers of Colombian children. Methods: We compared the distributions of plasma ferritin, serum zinc, and vitamin A in Colombian children between 2005 and 2010 using 2 cross-sectional, nationally representative surveys overall and by categories of sociodemographic variables. Analysis for ferritin included boys and nonpregnant girls aged 1 to 17 years. Analyses for zinc and vitamin A included children aged 1 to 4 years. Results: The mean 2010 to 2005 differences in ferritin, zinc, and vitamin A were 2.5 µg/L (95% confidence interval [CI]: 1.3 to 3.7), −34.9 µg/dL (95% CI: −39.6 to −30.2), and −11.5 µg/dL (95% CI: −12.3 to −10.7), respectively, after adjusting for sociodemographic characteristics. These differences varied significantly by region of residence. In 2010, region of residence was a significant correlate for all 3 micronutrients. Other important correlates included age and maternal education for ferritin and body mass index-for-age Z score, maternal education, wealth index, food insecurity, and urbanicity for vitamin A. Conclusions: Plasma ferritin was slightly higher in 2010 than in 2005, whereas serum zinc and vitamin A were substantially lower in 2010. In the absence of obvious causal explanations, it is uncertain whether this decline represents a worsening of micronutrient status in Colombian children or an artifact due to systematic laboratory or data management errors incurred in the surveys.
Leisure-Time Physical Activity and Characteristics of Social Network Support for Exercise Among Latinas
Authors: Soto Sandra H. , Arredondo Elva M. , Haughton Jessica , Shakya Holly 
Published: March 2017

Purpose: To examine the association between characteristics of social support for exercise and moderate-to-vigorous leisure-time physical activity (LTPA) among Latinas. Design: This cross-sectional study used baseline data from a cluster randomized controlled trial. Setting: The study was conducted in 16 churches located in San Diego County. Participants: Participants (N = 436) were Latinas between 18 and 65 years old who did not self-report >150 minutes or did not exceed 250 minutes of moderate-to-vigorous PA per week measured by accelerometer. Measures: Latinas listed up to 6 individuals who had provided support for exercise within the past 6 months, including their gender, relationship with the respondent, types of support provided, and respondent’s satisfaction with support. Self-reported LTPA was dichotomized (none vs any). Analyses: We generated dyads between Latinas who named ≥1 supporter (n = 323) and each supporter they named (n = 569 dyads). Logistic regression analyses were conducted using generalized estimating equations to adjust for multiple observations per participant. Results: Having an exercise partner (odds ratio [OR]: 2.16; 95% confidence interval [CI]: 1.01-4.62), help with household duties (OR: 2.70; 95% CI: 1.35-3.38), being “very much” satisfied with support (OR: 2.33; 95% CI: 1.26-4.30), and naming >2 supporters (OR: 2.57; 95% CI: 1.06-6.25) was positively associated with LTPA. Conclusions: Findings suggest specific aspects of support for exercise that should be targeted in future interventions to promote LTPA.
Prospective validation of a novel renal activity index of lupus nephritis
Authors: Gulati G , Bennett M R , Abulaban K , Song H , Zhang X , Ma Q , Brodsky S V , Nadasdy T , Haffner C , Wiley K , Ardoin S P , Devarajan P , Ying J , Rovin B H , Brunner H I 
Published: March 2017

Objectives The renal activity index for lupus (RAIL) score was developed in children with lupus nephritis as a weighted sum of six urine biomarkers (UBMs) (neutrophil gelatinase-associated lipocalin, monocyte chemotactic protein 1, ceruloplasmin, adiponectin, hemopexin and kidney injury molecule 1) measured in a random urine sample. We aimed at prospectively validating the RAIL in adults with lupus nephritis. Methods Urine from 79 adults was collected at the time of kidney biopsy to assay the RAIL UBMs. Using receiver operating characteristic curve analysis, we evaluated the accuracy of the RAIL to discriminate high lupus nephritis activity status (National Institutes of Health activity index (NIH-AI) score >10), from low/moderate lupus nephritis activity status (NIH-AI score ≤10). Results In this mixed racial cohort, high lupus nephritis activity was present in 15 patients (19%), and 71% had proliferative lupus nephritis. Use of the identical RAIL algorithm developed in children resulted in only fair prediction of lupus nephritis activity status of adults (area under the receiver operating characteristic curve (AUC) 0.62). Alternative weightings of the six RAIL UBMs as suggested by logistic regression yielded excellent accuracy to predict lupus nephritis activity status (AUC 0.88). Accuracy of the model did not improve with adjustment of the UBMs for urine creatinine or albumin, and was little influenced by concurrent kidney damage. Conclusions The RAIL UBMs provide excellent prediction of lupus nephritis activity in adults. Age adaption of the RAIL is warranted to optimize its discriminative validity to predict high lupus nephritis activity status non-invasively.
Subacromial Decompression in Patients with Impingement Syndrome Results in Better Clinical Outcome Compared to Physiotherapy in the Long Term. A Prospective Randomised Study
Authors: Farfaras Stefanos , Sernert Ninni , Rostgard-Christensen Lars , Hallstrom Erling , Kartus Juri T. 
Published: March 2017

Objectives: The long-term outcome after treatment of subacromial impingement syndrome (SAIS) with either non-surgical or surgical methods is not thoroughly investigated. The purpose of this study was to evaluate the long-term clinical outcome, the presence of rotator-cuff injuries and osteoarthritis after both surgical and non-surgical treatment. Methods: Eighty-seven patients with SAIS were randomised to three groups: open acromioplasty (OSG), arthroscopic acromioplasty (ASG) or physiotherapy (PTG). The Constant score and the Watson & Sonnabend score were used as outcome measures. Furthermore, bilateral ultrasound examinations to detect rotator-cuff ruptures and bilateral x-rays to detect osteoarthritis were performed. Sixty-six patients (76%) attended the clinical follow-up, 14 (SD 1.5) years after the initial treatment. Results: The groups were demographically comparable at baseline. The Constant score had improved significantly at follow-up in both the OSG and the ASG (p=0.003 and 0.011 respectively). No improvement was detected in the PTG. The OSG revealed a significant improvement compared to the PTG at follow-up (p=0.011), otherwise no significant differences were found. For the Watson & Sonnabend score the OSG revealed significant improvement in 13/14 questions. The corresponding was found in the ASG and the PTG in 9/14 questions (p=0.14). Using ultra-sound 1/20 patients in the OSG revealed a full-thickness rotator cuff rupture on the index side. The corresponding was found for 1/18 in the ASG and 4/28 in the PTG (p=0.29). On the contralateral side 2/20 patients in the OSG revealed a full-thickness rotator cuff tear. The corresponding was found for 1/18 in the ASG and 4/28 in the PTG (p=0.36). On the x-rays 3/20 patients in the OSG revealed moderate or severe osteoarthritis in the index shoulder. The corresponding was found for 1/18 in the ASG and 0/28 in the PTG (p=0.12). 1/20 patients in the OSG revealed osteoarthritis in the contra-lateral shoulder. The corresponding was found for 1/18 in the ASG and 0/28 in the PTG (p=0.11). Conclusion: In the long term surgical treatment of SAIS appears to render better clinical results than physiotherapy. No significant differences were found between the groups in terms of the presence of full thickness rotator cuff ruptures and osteoarthritis.
Tendonopathy Does Not Predict Rotator Cuff Healing
Authors: Sethi Paul M. , Sheth Chirag D. , McCarthy Mary Beth , Cote Mark P. , Mazzocca Augustus D. 
Published: March 2017

Objectives: Numerous studies have identified risk factors which may decrease the chance of successful rotator cuff healing after surgery. Surgeons may also rely on intraoperative tendon quality to predict healing. There is no data that correlates how the gross tendon morphology and the degree of tendonopathy may impact patient outcome or post-operative tendon healing. The purposes of this study were to 1) compare the gross appearance of the supraspinatus tendon during arthroscopic rotator cuff repair with its histological degree of tendonopathy using the Bonar scoring system, and 2) to determine if either histological appearance or gross appearance correlated with Goutallier grade of fatty infiltration, or post-operative repair integrity. Our hypothesis was that there would be a statistical correlation between gross appearance and histological Bonar score, and that gross appearance would correlate with Goutallier grade and rate of healing. Methods: Demographic data from 105 patients undergoing (supraspinatus) rotator cuff repair were obtained. During surgery, the supraspinatus tendon was rated on thickness, fraying, and stiffness. Tendon tissue was also recovered for histological analysis based on the Bonar scoring system. Post-operative ASES and SST scores, as well as ultrasound assessment of healing, were obtained. Statistical analysis based on demographic data was carried out. Correlation between gross appearance of the supraspinatus tendon and rotator cuff histology (Bonar score) was determined. Correlation of gross appearance with Goutallier grade of fatty infiltration, and with post-operative repair integrity was also determined. Results: Gross appearance of torn rotator cuff tendon tissue did not correlate with histological appearance. Neither hisological score nor gross appearance correlated with demographic data, Goutallier grade, or post-operative repair status. Goutallier grade and vascularity were weakly correlated (rho=0.22, p=0.03) Conclusion: The degree of tendonopathy (Bonar Score) did not correlate with morphological appearance of the rotator cuff tendon, and neither of these parameters correlated with rotator cuff healing or patient outcome. Unlike fatty infiltration, or Goutallier scores, which evaluate the degree of muscle disease, this study suggests that the degree of tendonopathy may not be predictive of suboptimal outcomes. In light of these results, abnormal gross tendon appearance should not impact repair effort or technique. [Figure: see text][Figure: see text][Table: see text][Table: see text][Table: see text]
Surgical Treatment of Lateral Epicondylitis
Authors: Kroslak Martin , Murrell George A.C. 
Published: March 2017

Objectives: A number of surgical techniques for managing tennis elbow have been described, one of the commonest (Nirschl & Pettrone. J Bone Joint Surg Am, 61(6A): 832-839) involves excising the affected portion of extensor carpi radialis brevis (ECRB) origin. The results of this technique, as well as most other described surgical techniques for this condition, have been reported as excellent, yet none have been compared with placebo surgery. Methods: This study was a prospective, randomised, double blinded, placebo controlled clinical trial investigating the surgical excision of the macroscopically degenerated portion of ECRB (Nirschl technique; n=13) compared with a sham operation (skin incision and exposure of ECRB alone; n=13) to manage tennis elbow, in patients with tennis elbow for more than 6 months who failed at least two non-surgical modalities. The primary outcome measure was defined as patient rated frequency of elbow pain with activity at 6 months post-surgery. Secondary outcome measures included patient rated frequency and severity of pain, functional outcomes, range of motion, epicondyle tenderness and strength at 6 months and >12 months post-surgery. Results: The two groups were matched for age, gender, hand dominance and duration of symptoms. Both the surgery and placebo procedures improved patient rated pain frequency and severity, elbow stiffness, difficulty with picking up objects, twisting motions and overall elbow rating over 6 months and at >12 months (p<0.01). Both procedures also improved epicondyle tenderness, pronation-supination range, grip strength and modified ORI-TETS at 6 months (p<0.05). No significant difference was observed between the groups in any parameter at any stage. No side effects or complications were reported. The study was stopped before the calculated number of patients were enrolled, as a post-hoc analysis showed over 6500 patients would need to be recruited in each group to see a significant difference between the groups at 26 weeks, when measuring patient rated frequency of elbow pain with activity. Conclusion: This study indicates that the surgical excision of the degenerative portion of ECRB offers no additional benefit over and above placebo surgery for the management of chronic tennis elbow. [Figure: see text]
Do Outcomes of Osteochondral Allograft Transplantation Differ Based on Age
Authors: Frank Rachel M. , Lee Simon , Poland Sarah Glen , Cole Brian J. 
Published: March 2017

Objectives: Osteochondral allograft transplantation (OAT) is being performed with increasing frequency, though to date, the impact of patient age on outcomes and failure rates has not been assessed. The purpose of this study was to determine clinical outcomes for patients over 40 years of age undergoing OAT compared to a cohort of patients under 40. Methods: A review of prospectively collected data of patients who underwent OAT by a single surgeon with a minimum follow-up of 2 years was conducted. Patients <40 or ≥40 years were grouped. The reoperation rate, failure rate, timing of reoperation, procedures performed, findings at surgery, and patient reported outcome scores were reviewed. Failure was defined by revision OAT, conversion to knee arthroplasty, or gross appearance of graft failure at 2nd look arthroscopy. Descriptive statistics, fisher’s exact or chi-square testing, and Mann-Whitney U testing were performed, with P<0.05 set as significant. Results: A total of 170 patients who underwent OAT with an average follow-up of 5.0±2.7 years (range, 2.0-15.1) were included; 115 patients <40 years (average age 27.6±7.31 years, 58 males, 57 females) and 55 patients ≥40 years (average age 44.9±4.0 years, 33 males, 22 females). There were no differences detected in the number of pre-OAT surgeries between the groups (<40: 2.70±1.91; ≥40: 2.13±1.04; P=0.085). The ≥40 patients demonstrated significantly higher BMI (<40: 25.94±5.02 kg/m2; ≥40: 28.11±5.22 kg/m2; P=0.018), higher prevalence of workers’ compensation patients (<40: 17%; ≥40: 33%; P=0.028), and lower prevalence of concomitant distal femoral osteotomy (<40: 8%; ≥40: 0%; P=0.028). There were no differences detected in reoperation rate (<40: 38%; ≥40: 36%; P=0.867), time to reoperation (<40: 2.12±1.90; ≥40: 3.43±3.43; P=0.126), or failure rate (<40: 13%; ≥40: 16%; P=0.639) between each group. Patients in both groups demonstrated significant improvement in Lysholm, IKCD, KOOS, WOMAC, and SF-12 physical subscale as compared to preoperative values (P>0.05 for all for both groups). The SF-12 mental subscale was not significantly improved at final follow-up for either group. The older group demonstrated significantly higher Lysholm (P=0.045) and KOOS-sport (P=0.015) scores compared to the younger group at final recent follow-up. There were no other significant differences in patient reported outcomes scores, other concomitant surgeries, or defect sizes. Conclusion: Patients ≥40 years of age undergoing OAT have similar survival and reoperation rates at 5 years following surgery compared to younger patients. The <40 patients demonstrated lower Lysholm and KOOS-sport scores, potentially attributable to higher expectations of return to function post-operatively as compared to older patients. This information can be used to counsel patients when being offered OAT as part of a knee joint preservation strategy.
Evaluation of energy metabolism in septic patients with and without AKI
Authors: Sanches Ana Cláudia Soncini , de Góes Cassiana Regina , Bufarah Marina Nogueira Berbel , de Oliveira Mariana Cassani , Balbi André Luis , Ponce Daniela 
Published: March 2017

Abstract
Background
The determination of resting energy expenditure (REE) in critically ill patients could prevent complications such as hypo- and hyperalimentation.
This study aims to describe the REE in septic patients with and without acute kidney injury (AKI) and compare the REE estimated by the Harris-Benedict equation (HB) with the REE measured by indirect calorimetry (IC).

Methods
Prospective and observational study was performed. Septic patients older than 18 years, undergoing mechanical ventilation, with or without AKI defined by KDIGO criteria, and admitted to the Intensive Care Unit of University Hospital from Brazil were included. The REE was estimated by HB equation and measured by the IC within 72 h after the diagnosis of sepsis and 7 days after the initial measure.

Results
Sixty-eight patients were evaluated, age was 62.5 ± 16.6 years, 64.7% were male, 63.2% had AKI, and SOFA was 9.8 ± 2.35. The measured REE was 1857.5 ± 685.32 kcal, while the estimated REE was 1514.8 ± 356.72 kcal, with adequacy of 123.5 ± 43%. Septic patients without AKI (n = 25) and with AKI (n = 43) had measured REE statistically higher than the estimated one (1855.0 (1631.75–2052.75) vs. 1551.0 kcal (1349.0–1719.25), p = 0.007 and 1868.0 (1219.5–2364.75) vs. 1388.0 kcal (1254.0–1665.5), p = 0.026, respectively). There was no significant difference between the two groups (with and without AKI) in measured and estimated REE (p = 0.63 and 0.64, respectively). There was no significant difference in evolutional REE (1845.95 ± 658.27 kcal vs. 1809.54 ± 755.08 kcal, p = 0.86).

Conclusions
The REE measured by IC was significantly higher than that estimated by HB equation in both septic with and without AKI. There was no significant difference in REE between the septic patients with and without AKI, suggesting that AKI does not influence the energy metabolism of septic patients.
Novel Hydrogen-Bonding Pattern of Water in Polycarbonate
Authors: Iwamoto Reikichi , Kusanagi Hiroshi , Harui Rika 
Published: March 2017

Abstract
We study the hydrogen-bonding structure of the water in polycarbonate (PC) (OC6H4C(CH3)2C6H4OCO)n by near- and mid-infrared spectroscopy. We extensively analyze the effects of the hydration interaction on the near- and mid-infrared absorptions of the hydrating water and on those of the phenyl and carbonyl groups, either of which should interact with the water in PC. The analysis has consistently led us to the conclusion that the water is hydrogen bonded to the phenyl group but not to the carbonate C=O, against the prediction that the hydrogen-bonding energy of the water to the former should be significantly smaller than that to the latter (P. R. Rablen et al., J. Phys. Chem. A1998, 102, 3782). To explain the unexpected hydration, we propose a novel hydration pattern, in which the water is fittingly settled into the “phenyl hollow” formed by the two adjacent phenyl groups, obliquely connected by -C(CH3)2- in-between. The key factor of the hydration pattern or that the water symmetrically acts as proton donor to the π clouds of the phenyl groups has been proved to be perfectly consistent with the observed spectral features of the hydrating water.