bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart Failure Increases the Risk of Adverse Renal Outcomes in Patients With Normal Kidney Function
Authors: George Lekha K. , Koshy Santhosh K.G. , Molnar Miklos Z. , Thomas Fridtjof , Lu Jun L. , Kalantar-Zadeh Kamyar , Kovesdy Csaba P. 
Published: August 2017

Background
Heart failure (HF) is associated with poor cardiac outcomes and mortality. It is not known whether HF leads to poor renal outcomes in patients with normal kidney function. We hypothesized that HF is associated with worse long-term renal outcomes.

Methods and Results

Among 3 570 865 US veterans with estimated glomerular filtration rate (eGFR) ≥60 mL min
−1
1.73 m
−2
during October 1, 2004 to September 30, 2006, we identified 156 743 with an
International Classification of Diseases
,
Ninth Revision
, diagnosis of HF. We examined the association of HF with incident chronic kidney disease (CKD), the composite of incident CKD or mortality, and rapid rate of eGFR decline (slopes steeper than −5 mL min
−1
1.73 m
−2
y
−1
) using Cox proportional hazard analyses and logistic regression. Adjustments were made for various confounders. The mean±standard deviation baseline age and eGFR of HF patients were 68±11 years and 78±14 mL min
−1
1.73 m
−2
and in patients without HF were 59±14 years and 84±16 mL min
−1
1.73 m
−2
, respectively. HF patients had higher prevalence of hypertension, diabetes mellitus, cardiac, peripheral vascular and chronic lung diseases, stroke, and dementia. Incidence of CKD was 69.0/1000 patient-years in HF patients versus 14.5/1000 patient-years in patients without HF, and 22% of patients with HF had rapid decline in eGFR compared with 8.5% in patients without HF. HF patients had a 2.12-, 2.06-, and 2.13-fold higher multivariable-adjusted risk of incident CKD, composite of CKD or mortality, and rapid eGFR decline, respectively.

Conclusions
HF is associated with significantly higher risk of incident CKD, incident CKD or mortality, and rapid eGFR decline. Early diagnosis and management of HF could help reduce the risk of long-term renal complications.
Vascular Endothelial Growth Factor and Ischemic Heart Disease Risk: A Mendelian Randomization Study
Authors: Au Yeung Shiu Lun , Lam Hugh Simon Hung San , Schooling C. Mary 
Published: August 2017

Background

Vascular endothelial growth factor (
VEGF
) has angiogenic and possibly proatherosclerotic properties. Observationally it is positively associated with cardiovascular disease, although these observations could be confounded or due to reverse causation. We assessed ischemic heart disease (
IHD
) risk by genetically predicted
VEGF
, ie, using Mendelian randomization.

Methods and Results

Single nucleotide polymorphisms (
SNP
s) predicting
VEGF
level, at genome‐wide significance, were applied to the CARDIoGRAMplusC4D 1000 Genomes‐based genome‐wide association study
IHD
case (n=60 801)‐control (n=123 504) study. We obtained unconfounded estimates using instrumental variable analysis by combining the Wald estimates for each
SNP
using inverse variance weighting and Mendelian randomization–Egger regression. Based on 9
SNP
s independently predicting
VEGF
(rs1740073 [
C6orf223
], rs2375981 [

KCNV
2

], rs2639990 [

ZADH
2

], rs4782371 [

ZFPM
1

], rs6921438 [

LOC
100132354

], rs7043199 [

VLDLR
‐
AS
1

], rs10761741 [

JMJD
1C

], rs6993770 [

ZFPM
2

], and rs114694170 [

MEF
2C

]),
VEGF
was unrelated to
IHD
(odds ratio 0.99 per log‐transformed pg/mL, 95%
CI
0.96‐1.02) using inverse variance weighting. However, Mendelian randomization–Egger regression suggested an inverse relation of
VEGF
with
IHD
(odds ratio 0.95, 95%
CI
0.91‐0.99), although the association was not evident after excluding the lead
SNP
(rs6921438) or additionally excluding the pleiotropic
SNP
(rs6993770).

Conclusions

Our study does not provide strong evidence for a positive effect of
VEGF
on
IHD
but does not rule out the possibility that some specific types of
VEGF
, for which genetic predictors have not yet been identified, might play a role.
Blood Pressure in 6‐Year‐Old Children Born Extremely Preterm
Authors: Edstedt Bonamy Anna‐Karin , Mohlkert Lilly‐Ann , Hallberg Jenny , Liuba Petru , Fellman Vineta , Domellöf Magnus , Norman Mikael 
Published: August 2017

Background
Advances in perinatal medicine have increased infant survival after very preterm birth. Although this progress is welcome, there is increasing concern that preterm birth is an emerging risk factor for hypertension at young age, with implications for the lifetime risk of cardiovascular disease.

Methods and Results

We measured casual blood pressures (BPs) in a population‐based cohort of 6‐year‐old survivors of extremely preterm birth (<27 gestational weeks; n=171) and in age‐ and sex‐matched controls born at term (n=172). Measured BP did not differ, but sex, age‐, and height‐adjusted median
z
scores were 0.14 SD higher (
P
=0.02) for systolic
BP
and 0.10 SD higher (
P
=0.01) for diastolic
BP
in children born extremely preterm than in controls. Among children born extremely preterm, shorter gestation, higher body mass index, and higher heart rate at follow‐up were all independently associated with higher
BP
at 6 years of age, whereas preeclampsia, smoking in pregnancy, neonatal morbidity, and perinatal corticosteroid therapy were not. In multivariate regression analyses, systolic
BP
decreased by 0.10 SD (
P
=0.08) and diastolic BP by 0.09 SD (
P
=0.02) for each week‐longer gestation.

Conclusions

Six‐year‐old children born extremely preterm have normal but slightly higher
BP
than their peers born at term. Although this finding is reassuring for children born preterm and their families, follow‐up at older age is warranted.
Long-Delay Arterial Spin Labeling Provides More Accurate Cerebral Blood Flow Measurements in Moyamoya Patients
Authors: Fan Audrey P. , Guo Jia , Khalighi Mohammad M. , Gulaka Praveen K. , Shen Bin , Park Jun Hyung , Gandhi Harsh , Holley Dawn , Rutledge Omar , Singh Prachi , Haywood Tom , Steinberg Gary K. , Chin Frederick T. , Zaharchuk Greg 
Published: August 2017

Background and Purpose—
Arterial spin labeling (ASL) MRI is a promising, noninvasive technique to image cerebral blood flow (CBF) but is difficult to use in cerebrovascular patients with abnormal, long arterial transit times through collateral pathways. To be clinically adopted, ASL must first be optimized and validated against a reference standard in these challenging patient cases.

Methods—

We compared standard-delay ASL (post-label delay=2.025 seconds), multidelay ASL (post-label delay=0.7–3.0 seconds), and long-label long-delay ASL acquisitions (post-label delay=4.0 seconds) against simultaneous [
15
O]-positron emission tomography (PET) CBF maps in 15 Moyamoya patients on a hybrid PET/MRI scanner. Dynamic susceptibility contrast was performed in each patient to identify areas of mild, moderate, and severe time-to-maximum (Tmax) delays. Relative CBF measurements by each ASL scan in 20 cortical regions were compared with the PET reference standard, and correlations were calculated for areas with moderate and severe Tmax delays.

Results—

Standard-delay ASL underestimated relative CBF by 20% in areas of severe Tmax delays, particularly in anterior and middle territories commonly affected by Moyamoya disease (
P
<0.001). Arterial transit times correction by multidelay acquisitions led to improved consistency with PET, but still underestimated CBF in the presence of long transit delays (
P
=0.02). Long-label long-delay ASL scans showed the strongest correlation relative to PET, and there was no difference in mean relative CBF between the modalities, even in areas of severe delays.

Conclusions—
Post-label delay times of ≥4 seconds are needed and may be combined with multidelay strategies for robust ASL assessment of CBF in Moyamoya disease.
Vascular Risk Factor Profiles Differ Between Magnetic Resonance Imaging-Defined Subtypes of Younger-Onset Lacunar Stroke
Authors: Rutten-Jacobs Loes C.A. , Markus Hugh S. 
Published: August 2017

Background and Purpose—
Differing associations of vascular risk factors with lacunar infarct have been reported, which is likely because of diagnostic differences and possible heterogeneity in the pathogenesis underlying lacunar infarction. In a large magnetic resonance imaging–verified cohort of lacunar infarct patients, we investigated the risk factor profile of lacunar infarction and magnetic resonance imaging characteristics.

Methods—
One thousand twenty-three patients with lacunar infarction (mean age, 56.7; SD, 8.5) were recruited from 72 stroke centers throughout the United Kingdom as part of the UK Young Lacunar Stroke DNA Study. Risk factor profiles were compared with 1961 stroke-free population controls with similar age. Furthermore, we tested risk factor profiles of lacunar stroke patients for association with the presence of multiple lacunar infarcts, white matter hyperintensities (WMH), and location of the acute lacunar infarct.

Results—
Hypertension (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.85–2.64), diabetes mellitus (OR, 2.10; 95% CI, 1.61–2.73), hyperlipidemia (OR, 1.74; 95% CI, 1.46–2.07), and smoking (OR, 1.65; 95% CI, 1.39–1.96) were independently associated in lacunar infarct patients compared with healthy controls. Patients with multiple lacunar infarcts were more likely to be men (OR, 2.53; 95% CI, 1.81–3.53) and have hypertension (OR, 1.54; 95% CI, 1.12–2.04) compared with patients with a single lacunar infarct, independent of other vascular risk factors. The presence of moderate-to-severe WMH versus no or mild WMH was independently associated with increased age (OR, 1.54; 95% CI, 1.12–2.04), hypertension (OR, 2.06; 95% CI, 1.44–2.95), and impaired renal function (OR, 0.90; 95% CI, 0.82–0.98).

Conclusions—
In this magnetic resonance imaging–verified lacunar stroke population, we identified a distinct risk factor profile in the group as a whole. However, there were differing risk factor profiles according to the presence of multiple lacunar infarcts and confluent WMH. The association of hypertension, smoking, and renal impairment with the presence of multiple lacunar infarcts and confluent WMH might reflect a diffuse small vessel arteriopathy.
Reproductive aspects of the Chocoan River turtle (Rhinoclemmys nasuta, Geoemydidae) along the Colombian Pacific coast
Authors: Garcés-Restrepo Mario Fernando , Rivera-Domínguez Natalia , Giraldo Alan , Carr John L. 
Published: August 2017

We collected data on several aspects of the reproductive biology of the Chocoan River Turtle (Rhinoclemmys nasuta) as part of a long-term demographic study (2005-2015), along the Pacific coast of the department of Valle del Cauca in Colombia. We palpated 659 females and found 77 gravid, with two peaks in the proportion of females gravid, one between May and June, and another from October to December; there was a significant correlation between the monthly proportion gravid and the monthly amount of precipitation (Spearman rank correlation , ). We obtained 13 eggs (mean length = 63.8 mm, mean width = 35.4 mm, mean weight = 45.8 g). Using egg volume as a general indicator of size, there was no significant relationship with female size. To induce oviposition, oxytocin, prostaglandin, or a combination of the two was injected into 37 gravid females with a success rate of 48.6%. We determined the duration of incubation for two individuals as 133 and 135 days. With this information, we fill some gaps in the knowledge of reproductive ecology of this species; however, the sample size is very low and primarily comes from a single insular population and therefore it is important to continue studies on aspects of reproductive ecology such as those evaluated in this study and other topics like sex determination.
Historical Spatial and Temporal Climate Trends in Southern Ontario, Canada
Authors: Wazneh Hussein , Arain M. Altaf , Coulibaly Paulin 
Published: August 2017

AbstractSpatial and temporal trends in historical temperature and precipitation extreme events were evaluated for southern Ontario, Canada. A number of climate indices were computed using observed and regional and global climate datasets for the area of study over the 1951–2013 period. A decrease in the frequency of cold temperature extremes and an increase in the frequency of warm temperature extremes was observed in the region. Overall, the numbers of extremely cold days decreased and hot nights increased. Nighttime warming was greater than daytime warming. The annual total precipitation and the frequency of extreme precipitation also increased. Spatially, for the precipitation indices, no significant trends were observed for annual total precipitation and extremely wet days in the southwest and the central part of Ontario. For temperature indices, cool days and warm night have significant trends in more than 90% of the study area. In general, the spatial variability of precipitation indices is much higher than that of temperature indices. In terms of comparisons between observed and simulated data, results showed large differences for both temperature and precipitation indices. For this region, the regional climate model was able to reproduce historical observed trends in climate indices very well as compared with global climate models. The statistical bias-correction method generally improved the ability of the global climate models to accurately simulate observed trends in climate indices.
An Extraction Method for Long-Term Tropical Cyclone Precipitation from Daily Rain Gauges
Authors: Zhu Laiyin , Quiring Steven M. 
Published: August 2017

Abstract
Tropical cyclone precipitation (TCP) can cause significant flooding in coastal areas around the world. This study compares multiple options of a new technique for developing a gridded daily TCP product at a spatial resolution of 0.25°. These options were evaluated using NASA’s Tropical Rainfall Measuring Mission (TRMM) Multisatellite Precipitation Analysis (TMPA) 3B42 product to determine the optimal approach. Results indicate that the technique is very sensitive to changes in wind corrections, interpolation method, and gauge density. The optimal method accounts for wind-induced gauge undercatch and uses a customized interpolation approach. It significantly reduces precipitation biases associated with gauge undercatch during windy conditions. The new TCP extraction approach can be used to examine variability and long-term trends in TCP, even in regions with relatively few gauges.
Pediatric Chronic Rhinosinusitis Management in Rhinologists and Pediatric Otolaryngologists
Authors: Beswick Daniel M. , Messner Anna H. , Hwang Peter H. 
Published: August 2017

Objective: To compare the management of pediatric chronic rhinosinusitis (PCRS) between members of the American Rhinologic Society (ARS) and the American Society of Pediatric Otolaryngology (ASPO). Study Design: Comparison of surveys. Methods: A web-based survey was distributed to ASPO membership twice in September-October 2016. Data were compared to previously published data from ARS membership in March-April 2016. Results: ASPO survey completion rate was 22%. ARS members were more likely to employ oral steroids in initial ( P = .025) and maximal medical management ( P = .001). ASPO members more commonly performed adenoidectomy before computed tomography (CT) ( P < .001). Both groups commonly included adenoidectomy as part of initial surgical management (90% vs 94%, P = .316), while ASPO members more frequently performed adenoidectomy alone (70% vs 43%, P = .001). If initial surgical treatment failed, both groups commonly performed endoscopic sinus surgery (ESS; 81% vs 88%, P = .56) with a similar extent including frontal ( P ≥ .207) and sphenoid ( P ≥ .304) surgery. Conclusions: Pediatric chronic rhinosinusitis management is similar between groups, yet there are differences including oral steroid use, relative order of CT versus adenoidectomy, and performing concomitant procedures with adenoidectomy. Both groups commonly perform ESS with similar surgical extent if prior surgical treatment fails. Management by both groups is largely in agreement with published consensus statements.
Surgical Management of Supraglottic Stenosis Using Intubationless Optiflow
Authors: Tam Kenric , Jeffery Caroline , Sung C. Kwang 
Published: August 2017

Objective: Airway management during endoscopic surgical treatment of supraglottic and pharyngeal stenosis is often challenging and can be accomplished by various means, including tracheostomy, jet ventilation, or direct laryngoscopy. We describe CO2 laser excision of supraglottic-pharyngeal stenosis using intubationless Optiflow high-flow nasal cannula (HFNC). Methods: A 55-year-old male presented with dyspnea and dysphagia secondary to severe supraglottic-pharyngeal stenosis in the setting of previous chemoradiation for a T0N2aM0 squamous cell carcinoma. Laryngoscopy revealed severe supraglottic-pharyngeal stenosis with tethering of the epiglottis to the lateral pharyngeal walls. Optiflow HFNC was used to deliver 70 L/min of oxygen. After anesthetic induction, CO2 laser microlaryngoscopy was utilized to release scar tissue along the lateral epiglottic border, opening up the supraglottic airway sufficiently for endotracheal intubation and further laser resection. Results: Airway management with Optiflow HFNC allowed initial endoscopic surgical access, partial stenotic release, and intubation. From anesthetic induction to intubation, the patient remained apneic for 26 minutes. The patient’s stenosis was successfully addressed, and 10-month follow-up demonstrated stable patency of the airway. Conclusion: Optiflow is an important new tool in the management of severe supraglottic stenosis. It provides sufficient oxygenation to perform extended apneic surgery and improves endoscopic surgical access in a limited airway.
Dysphagia in Rett Syndrome: A Descriptive Study
Authors: Mezzedimi Chiara , Livi Walter , De Felice Claudio , Cocca Serena 
Published: August 2017

Objectives: Rett syndrome (RS) is a neurodevelopmental disorder and the second major cause of mental retardation in females. The aim of this study was to evaluate swallowing problems of RS patients by endoscopic assessment and compile a list of suggestions for managing feeding and preventing complications. Methods: The sample consisted of 61 female patients (mean age = 13.6 years, range, 2-33 years) admitted to the Department of Neuropsychiatry, where they had previously been diagnosed with RS. Speech evaluation associated with observation during mealtimes was useful to formulate suggestions for caregivers. Results: Progressive deterioration of feeding was commonly noted by caregivers. Fifty-four patients had a history of recurrent episodes of bronchitis. Oral apraxia, dyskinetic tongue movements, prolonged oral stage, and poor bolus formation were the most common findings in all patients. Conclusions: Dysphagia was primarily limited to oral preparatory phases, while the pharyngeal phase was normal in most patients. The high percentage of dysphagia suggests the need to accurately monitor the feeding capability of RS children. It is critical to correctly inform caregivers about safe swallowing procedures to reduce the incidence of fatal complications.
CDC Screening Recommendation for Baby Boomers and Hepatitis C Virus Testing in the US Military Health System
Authors: Manjelievskaia Janna , Brown Derek , Shriver Craig D. , Zhu Kangmin 
Published: August 2017

Objectives: Chronic hepatitis C virus (HCV) is the most common blood-borne infection in the United States, with an estimated 2.7 to 3.9 million cases as of 2014. In August 2012, the Centers for Disease Control and Prevention (CDC) recommended 1-time HCV testing of all baby boomers. The objectives of this study were to (1) determine the proportion of people screened for HCV in the US Department of Defense Military Health System before and after the CDC screening recommendation for baby boomers and (2) assess whether certain patient or system factors were associated with screening for HCV before and after August 2012. Methods: We used a dataset containing 5% of beneficiaries randomly selected from the Military Health System Data Repository medical claims database for the period July 2011 through September 2013. Results: Of 108 223 people eligible for HCV screening during the first period (July 2011 through July 2012), 1812 (1.7%) were screened. Of 109 768 people eligible during the second period (September 2012 through September 2013), 2599 (2.4%) were screened. HCV screening receipt was related to benefit type (Prime before August 2012: adjusted odds ratio [aOR] = 2.16; 95% confidence interval [CI], 1.89-2.46; Prime after August 2012: aOR = 1.93; 95% CI, 1.73-2.16) and care source (direct care before August 2012: aOR = 1.80; 95% CI, 1.57-2.07; direct care after August 2012: aOR = 2.45; 95% CI, 2.18-2.75); male sex (aOR = 1.17; 95% CI, 1.06-1.29) and black race (aOR = 1.20; 95% CI, 1.05-1.37) were associated with HCV testing only before August 2012. Conclusions: Interventions should be implemented to increase awareness and knowledge of the current national HCV testing recommendation among baby boomers to seek out testing and health care providers to perform screening.
Community Evaluation of the National Diabetes Education Program’s Diabetes HealthSense Website
Authors: Sadler Michele DeBarthe , Saperstein Sandra L. , Carpenter Carrie , Devchand Roshni , Tuncer Diane , O’Brian Catherine , Nicols Christina , Gallivan Joanne 
Published: August 2017

Purpose The purpose of this study was to assess the impact of Diabetes HealthSense on knowledge, attitudes, and behavior changes that prevent, delay, or manage diabetes among people at risk (PAR) for diabetes and people with diabetes (PWD). Methods Using a 2-group pretest-posttest design, 15 community sites were randomly assigned to either an intervention or comparison group. Intervention participants attended a group education session with a diabetes educator, followed by 4 weeks of independent use of the Diabetes HealthSense website. The comparison group received no intervention. A total of 311 adults (n = 135 intervention, n = 176 comparison) completed both a pretest and posttest. Outcome measures examined changes in self-reported knowledge, self-efficacy, and behaviors that support diabetes prevention or management. Results Statistically significant within-group pretest to posttest changes were found for almost all outcome measures in the intervention group, with no significant changes in the comparison group. Significant between-group differences were also found for almost all outcome measures at posttest, with the intervention group having more positive outcomes than the comparison group. Conclusions Patient referral to online tools is considered one key component of initial and ongoing diabetes self-management education and support (DSME/S) and is recommended as a way to enhance and extend the reach of in-person diabetes education. Positive outcomes were found for PWD/PAR who used Diabetes HealthSense following a guided education session. Study results suggested that with guided exploration, Diabetes HealthSense provided a valuable tool for educators to use with patients to support and extend the reach of DSME/S.