bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Coronary Artery Calcium Scanning Beyond Coronary Computed Tomographic Angiography in the Emergency Department Evaluation for Acute Chest Pain
Authors: Pursnani Amit , Chou Eric T. , Zakroysky Pearl , Deaño Roderick C. , Mamuya Wilfred S. , Woodard Pamela K. , Nagurney John T. , Fleg Jerome L. , Lee Hang , Schoenfeld David , Udelson James E. , Hoffmann Udo , Truong Quynh A. 
Published: February 2015

Background—
Whether a coronary artery calcium (CAC) scan provides added value to coronary computed tomographic angiography (CCTA) in emergency department patients with acute chest pain remains unsettled. We sought to determine the value of CAC scan in patients with acute chest pain undergoing CCTA.

Methods and Results—

In the multicenter Rule Out Myocardial Infarction using Computer-Assisted Tomography (ROMICAT) II trial, we enrolled low-intermediate risk emergency department patients with symptoms suggesting acute coronary syndrome (ACS). In this prespecified subanalysis of 473 patients (54±8 years, 53% men) who underwent both CAC scanning and CCTA, the ACS rate was 8%. Overall, 53% of patients had CAC=0 of whom 2 (0.8%) developed ACS, whereas 7% had CAC>400 with 49% whom developed ACS. C-statistic of CAC>0 was 0.76, whereas that using the optimal cut point of CAC≥22 was 0.81. Continuous CAC score had lower discriminatory capacity than CCTA (c-statistic, 0.86 versus 0.92;
P
=0.03). Compared with CCTA alone, there was no benefit combining CAC score with CCTA (c-statistic, 0.93;
P
=0.88) or with selective CCTA strategies after initial CAC>0 or optimal cut point CAC≥22 (
P
≥0.09). Mean radiation dose from CAC acquisition was 1.4±0.7 mSv. Higher CAC scores resulted in more nondiagnostic CCTA studies although the majority remained interpretable.

Conclusions—
In emergency department patients with acute chest pain, CAC score does not provide incremental value beyond CCTA for ACS diagnosis. CAC=0 does not exclude ACS, nor a high CAC score preclude interpretation of CCTA in most patients. Thus, CAC results should not influence the decision to proceed with CCTA, and the decision to perform a CAC scan should be balanced with the additional radiation exposure required.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01084239.
Invasive Evaluation of Patients With Angina in the Absence of Obstructive Coronary Artery Disease
Authors: Lee Bong-Ki , Lim Hong-Seok , Fearon William F. , Yong Andy S. , Yamada Ryotaro , Tanaka Shigemitsu , Lee David P. , Yeung Alan C. , Tremmel Jennifer A. 
Published: February 2015

Background—
More than 20% of patients presenting to the cardiac catheterization laboratory with angina have no angiographic evidence of coronary artery disease. Despite a “normal” angiogram, these patients often have persistent symptoms, recurrent hospitalizations, a poor functional status, and adverse cardiovascular outcomes, without a clear diagnosis.

Methods and Results—
In 139 patients with angina in the absence of obstructive coronary artery disease (no diameter stenosis >50%), endothelial function was assessed; the index of microcirculatory resistance, coronary flow reserve, and fractional flow reserve were measured; and intravascular ultrasound was performed. There were no complications. The average age was 54.0±11.4 years, and 107 (77%) were women. All patients had at least some evidence of atherosclerosis based on an intravascular ultrasound examination of the left anterior descending artery. Endothelial dysfunction (a decrease in luminal diameter of >20% after intracoronary acetylcholine) was present in 61 patients (44%). Microvascular impairment (an index of microcirculatory resistance ≥25) was present in 29 patients (21%). Seven patients (5%) had a fractional flow reserve ≤0.80. A myocardial bridge was present in 70 patients (58%). Overall, only 32 patients (23%) had no coronary explanation for their angina, with normal endothelial function, normal coronary physiological assessment, and no myocardial bridging.

Conclusions—
The majority of patients with angina in the absence of obstructive coronary artery disease have occult coronary abnormalities. A comprehensive invasive assessment of these patients at the time of coronary angiography can be performed safely and provides important diagnostic information that may affect treatment and outcomes.
Antipsychotic Drugs and the Risk of Ventricular Arrhythmia and/or Sudden Cardiac Death: A Nation‐wide Case‐Crossover Study
Authors: Wu Chi‐Shin , Tsai Yu‐Ting , Tsai Hui‐Ju 
Published: February 2015

Background

Antipsychotics have been linked to prolongation of the
QT
interval. However, little is known about the risk of ventricular arrhythmia (VA) and/or sudden cardiac death (SCD) associated with individual antipsychotic drug use. This study was designed to investigate the association between specific antipsychotic drugs and the risk of
VA
and/or
SCD
.

Methods and Results

We conducted a case‐crossover study using a nation‐wide population‐based sample obtained from Taiwan's National Health Insurance Research Database. A total of 17 718 patients with incident VA and/or SCD were enrolled. Conditional logistic regression models were applied to examine the effects of antipsychotic drug use on the risk of
VA
/
SCD
during various case and control time windows of 7, 14, and 28 days. The effect of the potency of a human ether‐à‐go‐go‐related gene (
hERG)
potassium channel blockade was also assessed. Antipsychotic drug use was associated with a 1.53‐fold increased risk of VA and/or SCD. Antipsychotic drugs with increased risk included clothiapine, haloperidol, prochlorperazine, thioridazine, olanzapine, quetiapine, risperidone, and sulpiride. The association was significantly higher among those with short‐term use. Antipsychotics with a high potency of the
hERG
potassium channel blockade had the highest risk of VA and/or SCD.

Conclusion
Use of antipsychotic drugs is associated with an increased risk of VA and/or SCD. Careful evaluations of the risks and benefits of antipsychotic treatment are highly recommended.
Endothelial p53 Deletion Improves Angiogenesis and Prevents Cardiac Fibrosis and Heart Failure Induced by Pressure Overload in Mice
Authors: Gogiraju Rajinikanth , Xu Xingbo , Bochenek Magdalena L. , Steinbrecher Julia H. , Lehnart Stephan E. , Wenzel Philip , Kessel Michael , Zeisberg Elisabeth M. , Dobbelstein Matthias , Schäfer Katrin 
Published: February 2015

Background
Cardiac dysfunction developing in response to chronic pressure overload is associated with apoptotic cell death and myocardial vessel rarefaction. We examined whether deletion of tumor suppressor p53 in endothelial cells may prevent the transition from cardiac hypertrophy to heart failure.

Methods and Results

Mice with endothelial‐specific deletion of p53 (End.p53‐
KO
) were generated by crossing p53
fl/fl
mice with mice expressing Cre recombinase under control of an inducible Tie2 promoter. Cardiac hypertrophy was induced by transverse aortic constriction. Serial echocardiography measurements revealed improved cardiac function in End.p53‐
KO
mice that also exhibited better survival. Cardiac hypertrophy was associated with increased p53 levels in End.p53‐
WT
controls, whereas banded hearts of End.p53‐
KO
mice exhibited lower numbers of apoptotic endothelial and non‐endothelial cells and altered
mRNA
levels of genes regulating cell cycle progression (p21), apoptosis (Puma), or proliferation (Pcna). A higher cardiac capillary density and improved myocardial perfusion was observed, and pharmacological inhibition or genetic deletion of p53 also promoted endothelial sprouting in vitro and new vessel formation following hindlimb ischemia in vivo. Hearts of End.p53‐
KO
mice exhibited markedly less fibrosis compared with End.p53‐
WT
controls, and lower
mRNA
levels of p53‐regulated genes involved in extracellular matrix production and turnover (eg, Bmp‐7, Ctgf, or Pai‐1), or of transcription factors involved in controlling mesenchymal differentiation were observed.

Conclusions
Our analyses reveal that accumulation of p53 in endothelial cells contributes to blood vessel rarefaction and fibrosis during chronic cardiac pressure overload and suggest that endothelial cells may be a therapeutic target for preserving cardiac function during hypertrophy.
Endothelial Trauma From Mechanical Thrombectomy in Acute Stroke
Authors: Teng Dayu , Pannell Jeffrey Scott , Rennert Robert C. , Li Jieying , Li Yi-Shuan , Wong Victor W. , Chien Shu , Khalessi Alexander A. 
Published: February 2015

Background and Purpose—
Endovascular thrombectomy has shown promise for the treatment of acute strokes resulting from large-vessel occlusion. Reperfusion-related injury may contribute to the observed decoupling of angiographic and clinical outcomes. Iatrogenic disruption of the endothelium during thrombectomy is potentially a key mediator of this process that requires further study.

Methods—
An in vitro live-cell platform was developed to study the effect of various commercially available endovascular devices on the endothelium. In vivo validation was performed using porcine subjects.

Results—
This novel in vitro platform permitted high-resolution quantification and characterization of the pattern and timing of endothelial-cell injury among endovascular thrombectomy devices and vessel diameters. Thrombectomy devices displayed heterogeneous effects on the endothelium; the device performance assessed in vitro was substantiated by in vivo findings.

Conclusions—
In vitro live-cell artificial vessel modeling enables a detailed study of the endothelium after thrombectomy and may contribute to future device design. Large animal studies confirm the relevance of this in vitro system to investigate endothelial physiology. This artificial vessel model may represent a practical, scalable, and physiologically relevant system to assess new endovascular technologies.
Beautiful bright belly: A distinctive new microhylid frog (Amphibia: Stumpffia) from eastern Madagascar
Authors: Glaw Frank , Vallan Denis , Andreone Franco , Edmonds Devin , Dolch Rainer , Vences Miguel 
Published: February 2015

We describe a new red-bellied species of the microhylid frog genus Stumpffia from the Andasibe region (18°56' S, 48°25' E, ca. 900 m elevation) in central-eastern Madagascar. Stumpffia kibomena sp. nov. differs from all other described Stumpffia species in coloration, morphology, and by genetic differentiation in the mitochondrial 16S rRNA gene (≥8.6% uncorrected p-distance to all other nominal species of the genus). It is furthermore distinguished from most other Stumpffia species by its advertisement calls. The new species is reliably known only from a few specimens collected in the Andasibe region and based on the limited knowledge we suggest its IUCN Red List classification as "Data Deficient".
Effects of Snow Cover and Atmospheric Stability on Winter PM2.5 Concentrations in Western U.S. Valleys
Authors: Green Mark C. , Chow Judith C. , Watson John G. , Dick Kevin , Inouye Daniel 
Published: February 2015

AbstractMany populated valleys in the western United States experience increased concentrations of particulate matter with diameter of less than 2.5 μm (PM2.5) during winter stagnation conditions. Further study into the chemical components composing wintertime PM2.5 and how the composition and level of wintertime PM2.5 are related to meteorological conditions can lead to a better understanding of the causes of high PM2.5 and aid in development and application of emission controls. The results can also aid in short-term air-pollution forecasting and implementation of periodic emission controls such as burning bans. This study examines relationships between PM2.5 concentrations and wintertime atmospheric stability (defined by heat deficit) during snow-covered and snow-free conditions from 2000 to 2013 for five western U.S. urbanizations: Salt Lake City, Utah; Reno, Nevada; Boise, Idaho; Missoula, Montana; and Spokane, Washington. Radiosonde data were used where available to calculate daily heat deficit, which was compared with PM2.5 concentration for days with snow cover and days with no snow cover. Chemically speciated PM2.5 data were compared for snow-cover and snow-free days to see whether the chemical abundances varied by day category. Wintertime PM2.5 levels were highly correlated with heat deficit for all cities except Spokane, where the airport sounding does not represent the urban valley. For a given static stability, snow-cover days experienced higher PM2.5 levels than did snow-free days, mainly because of enhanced ammonium nitrate concentrations. Normalizing average PM2.5 to the heat deficit reduced year-to-year PM2.5 variability, resulting in stronger downward trends, mostly because of reduced carbonaceous aerosol concentrations. The study was limited to western U.S. cities, but similar results are expected for other urban areas in mountainous terrain with cold, snowy winters.
Do Assimilated Drifter Velocities Improve Lagrangian Predictability in an Operational Ocean Model?
Authors: Muscarella Philip , Carrier Matthew J. , Ngodock Hans , Smith Scott , Lipphardt B. L. , Kirwan A. D. , Huntley Helga S. 
Published: February 2015

Abstract
The Lagrangian predictability of general circulation models is limited by the need for high-resolution data streams to constrain small-scale dynamical features. Here velocity observations from Lagrangian drifters deployed in the Gulf of Mexico during the summer 2012 Grand Lagrangian Deployment (GLAD) experiment are assimilated into the Naval Coastal Ocean Model (NCOM) 4D variational (4DVAR) analysis system to examine their impact on Lagrangian predictability. NCOM-4DVAR is a weak-constraint assimilation system using the indirect representer method. Velocities derived from drifter trajectories, as well as satellite and in situ observations, are assimilated. Lagrangian forecast skill is assessed using separation distance and angular differences between simulated and observed trajectory positions. Results show that assimilating drifter velocities substantially improves the model forecast shape and position of a Loop Current ring. These gains in mesoscale Eulerian forecast skill also improve Lagrangian forecasts, reducing the growth rate of separation distances between observed and simulated drifters by approximately 7.3 km day−1 on average, when compared with forecasts that assimilate only temperature and salinity observations. Trajectory angular differences are also reduced.
Medical Treatment of Traumatic Anosmia
Authors: Jiang Rong‐San , Twu Chih‐Wen , Liang Kai‐Li 
Published: February 2015

ObjectivesTo study the effects of zinc and steroid in the treatment of traumatic anosmia.Study DesignA prospective, randomized study.SettingAcademic medical center.Subjects and MethodsPatients with a clear history of loss of smell after head injury and whose thresholds were −1 measured by the phenyl ethyl alcohol threshold test were included in this study from January 2010 to May 2013. They were randomly divided into 4 groups. Patients in group 1 were treated with zinc gluconate for a month and high‐dose prednisolone with tapering for 2 weeks. Those in group 2 took only zinc gluconate, and those in group 3 took only prednisolone. Patients in group 4 did not take any medicine. All patients were followed up by phenyl ethyl alcohol threshold testing, and magnetic resonance imaging was performed to measure the volume of olfactory bulbs.ResultsThirty‐nine patients in group 1, 35 in group 2, 34 in group 3, and 37 in group 4 completed the study. The recovery of olfactory function was observed in 11 patients (28.2%) in group 1, in 9 (25.7%) in group 2, in 4 (11.8%) in group 3, and in 1 (2.7%) in group 4. The recovery rates of olfactory function of groups 1 and 2 were significantly higher than the recovery rate of group 4. The volume of olfactory bulbs was not significantly different between those with and without improved olfactory function.ConclusionOur results show that zinc gluconate has a promising effect in treating traumatic anosmia.
State of Otolaryngology Match
Authors: Cabrera‐Muffly Cristina , Sheeder Jeanelle , Abaza Mona 
Published: February 2015

ObjectiveTo examine fluctuations in supply and demand of otolaryngology residency positions after the shift from an “early match” coordinated by the San Francisco match to a “conventional” matching process through the National Residency Matching Program (NRMP). To determine whether competition among otolaryngology residency positions have changed during this time frame.DesignDatabase analysis.Subjects and MethodsMatching statistics from 1998 to 2013 were obtained for all first‐year residency positions through the NRMP. Matching statistics from 1998 to 2005 were obtained for otolaryngology residency positions through the San Francisco match. Univariate analysis was performed, with a P value less than. 05 determined as significant.ResultsThe number of otolaryngology positions and applicants remained proportional to the overall number of positions and applicants in the NRMP match. Otolaryngology applicants per position and the matching rate of all applicants did not change between the 2 time periods studied. The overall match rate of US seniors applying to otolaryngology did not change, while the match rate of non–US seniors decreased significantly following initiation of the conventional match. There was no significant change in United States Medical Licensing Exam step 1 scores or percentage of unfilled otolaryngology residency positions between the 2 time periods.ConclusionsWhen comparing the early versus conventional otolaryngology match time periods, the only major change was the decreased percentage of matching among non–US senior applicants. Despite a significant shift in match timing after 2006, the supply, demand, and competitiveness of otolaryngology residency positions have not changed significantly.
Prevalence of hepatitis E virus in Chinese blood donors
Authors: Ma Li , Sun Pan , Lin Fangzhao , Wang Hongjie , Rong Xia , Dai Yudong , Liu Jianqiang , Qian Liqiong , Fang Min , Su Na , Xiao Wei , Ye Shengliang , Li Changqing 
Published: February 2015

Objective To investigate the prevalence of hepatitis E virus (HEV) antibodies and RNA in voluntary blood donors, in China. Methods Serum samples from blood donors were collected sequentially at six blood donation centres in five geographical regions of China. Donors were stratified between two groups according to their serum alanine aminotransferase (ALT) concentration (≤40 U/l and >40 U/l. Enzyme-linked immunosorbent assay and reverse transcription–polymerase chain reaction were used to quantify anti-HEV antibodies and RNA, respectively. Results In total, 21.1% (172/816) of donors were positive for anti-HEV immunoglobulin (Ig) G (elevated ALT samples group 18.9% [85/450]; normal ALT group 23.8% [87/366]), and 0.5% (four of 816) donors were positive for anti-HEV IgM (elevated ALT group 0.9% [four of 450]; normal ALT group 0% [none of 366]). The rate of anti-HEV IgG seropositivity was significantly higher in male than in female donors. No serum sample tested positive for HEV RNA. Conclusion The prevalence of anti-HEV antibodies in blood donors in China is high, regardless of ALT concentration.
The Effect of Acetabular Rim Recession on Anterior Acetabular Coverage
Authors: Kling Scott , Karns Michael R. , Gebhart Jeremy , Kosmas Christos , Robbin Mark , Nho Shane J. , Bedi Asheesh , Salata Michael J. 
Published: February 2015

Background: The majority of rim recession for femoroacetabular impingement (FAI) is performed anteriorly and has traditionally been assessed by the lateral center-edge (CE) angle, which correlates most closely with lateral coverage. The radiographic false-profile view permits measurement of anterior coverage via the anterior CE angle and more closely correlates with anterior coverage. Purpose: To answer the following questions: (1) How does incremental anterior rim recession change lateral and anterior CE angles? and (2) Can these changes be predicted by a formula? Study Design: Descriptive laboratory study. Methods: Twelve cadaveric hips were dissected free of soft tissue to expose the anterior acetabular rim. Incremental resections of 2.5 mm (range, 0-10 mm) were performed from the 12- to 3-o’clock position using a Dremel rotary tool. Anteroposterior hip and false-profile radiographs were obtained at each interval using a fluoroscopic C-arm. The lateral and anterior CE angles were measured by 3 orthopaedic surgeons. Results: The average preresection lateral CE angle was 35.1°, and the mean decrease in lateral CE angle from 0 to 10 mm was 9.9°; the average preresection anterior CE angle was 38.4° and the mean decrease in anterior CE angle from 0 to 10 mm was 18.2°. The anterior CE angle decreased by a factor of 1.9 when compared with the lateral CE angle ( P = 2 × 10−7). The lateral CE angle decreased by approximately 1° (1.0°) per millimeter of rim recessed. The anterior CE angle decreased by approximately 2° (1.8°) per millimeter of rim recessed. Conclusion: The lateral CE angle should not be extrapolated to reflect anterior acetabular coverage. The anterior CE angle is a superior marker and predictably decreases with rim recession at double the rate of the lateral CE angle. Clinical Relevance: The false-profile view is recommended in the perioperative workup for all patients undergoing arthroscopic treatment of pincer impingement.
Single-Photon-Emission Computed Tomography in Painful Total Ankle Replacements
Authors: Mason Lyndon W. , Wyatt James , Butcher Clifford , Wieshmann Hülya , Molloy Andrew P. 
Published: February 2015

Background: The use of single-photon-emission computed tomography (SPECT) in identifying unexplained pain in the foot and ankle has been described, where other imaging modalities have failed. The investigation of a painful total ankle replacement (TAR) is difficult, often not delineating a definitive cause. Our aim in this study was to investigate the use of SPECT-CT imaging in painful TARs. Methods: We performed a retrospective analysis of SPECT imaging performed for painful TARs in our department between October 2010 and December 2014. There were 14 patients identified who had undergone SPECT-CT imaging for a painful TAR. The mean age was 63.1 years, with a male/female sex ratio of 2:3 and a minimum time from surgery to imaging of 18 months. Results: Of the 14 patients, 13 were positive for increased osteoblastic activity in relation to the periprosthetic area consistent with implant loosening. The most common finding was tracer activity in relation to the talar component in 13 cases. There was additional tracer activity localized to the tibial component in 5 of these cases. In 10 of the 13 cases with prosthetic loosening/failure of bony ongrowth, there was no evidence of loosening on the plain radiographs. Infection was ruled out by using joint aspiration as clinically indicated. Conclusion: In our series, SPECT-CT imaging revealed a high incidence of medial sided talar prosthesis activity consistent with loosening. The finding of a high incidence of talar nonintegration illustrates the limitations of conventional radiology in follow-up of total ankle replacements, as this was not apparent on plain radiographs. We therefore conclude that there should be a high index of suspicion for talar prosthesis nonintegration in patients with otherwise unexplained ongoing medial pain in total ankle replacements. Level of Evidence: Level IV, retrospective case series.