bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Long-Term Recurrent Vascular Events After Ischemic Stroke at Young Age
Authors: Pezzini Alessandro , Grassi Mario , Lodigiani Corrado , Patella Rosalba , Gandolfo Carlo , Zini Andrea , DeLodovici Maria Luisa , Paciaroni Maurizio , Del Sette Massimo , Toriello Antonella , Musolino Rossella , Calabrò Rocco Salvatore , Bovi Paolo , Adami Alessandro , Silvestrelli Giorgio , Sessa Maria , Cavallini Anna , Marcheselli Simona , Bonifati Domenico Marco , Checcarelli Nicoletta , Tancredi Lucia , Chiti Alberto , Del Zotto Elisabetta , Spalloni Alessandra , Giossi Alessia , Volonghi Irene , Costa Paolo , Giacalone Giacomo , Ferrazzi Paola , Poli Loris , Morotti Andrea , Rasura Maurizia , Simone Anna Maria , Gamba Massimo , Cerrato Paolo , Micieli Giuseppe , Melis Maurizio , Massucco Davide , De Giuli Valeria , Iacoviello Licia , Padovani Alessandro 
Published: February 2014

Background—
Data on long-term risk and predictors of recurrent thrombotic events after ischemic stroke at a young age are limited.

Methods and Results—
We followed 1867 patients with first-ever ischemic stroke who were 18 to 45 years of age (mean age, 36.8±7.1 years; women, 49.0%), as part of the Italian Project on Stroke in Young Adults (IPSYS). Median follow-up was 40 months (25th to 75th percentile, 53). The primary end point was a composite of ischemic stroke, transient ischemic attack, myocardial infarction, or other arterial events. One hundred sixty-three patients had recurrent thrombotic events (average rate, 2.26 per 100 person-years at risk). At 10 years, cumulative risk was 14.7% (95% confidence interval, 12.2%–17.9%) for primary end point, 14.0% (95% confidence interval, 11.4%–17.1%) for brain ischemia, and 0.7% (95% confidence interval, 0.4%–1.3%) for myocardial infarction or other arterial events. Familial history of stroke, migraine with aura, circulating antiphospholipid antibodies, discontinuation of antiplatelet and antihypertensive medications, and any increase of 1 traditional vascular risk factor were independent predictors of the composite end point in multivariable Cox proportional hazards analysis. A point-scoring system for each variable was generated by their β-coefficients, and a predictive score (IPSYS score) was calculated as the sum of the weighted scores. The area under the receiver operating characteristic curve of the 0- to 5-year score was 0.66 (95% confidence interval, 0.61–0.71; mean, 10-fold internally cross-validated area under the receiver operating characteristic curve, 0.65).

Conclusions—
Among patients with ischemic stroke aged 18 to 45 years, the long-term risk of recurrent thrombotic events is associated with modifiable, age-specific risk factors. The IPSYS score may serve as a simple tool for risk estimation.
Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts
Authors: Zakai Neil A. , McClure Leslie A. , Judd Suzanne E. , Safford Monika M. , Folsom Aaron R. , Lutsey Pamela L. , Cushman Mary 
Published: February 2014

Background—
Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.

Methods and Results—

We ascertained VTE from 3 prospective studies: the Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor–adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20–2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96–1.54). In REGARDS, there was a significant region-by-race interaction (
P
=0.01): Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08–2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61–1.14).

Conclusions—
The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE.
Big Heads and Buddhist Demons: The Korean Musketry Revolution and the Northern Expeditions of 1654 and 1658
Authors: Kang Hyeok Hweon 
Published: February 2014

AbstractBoosted by superior firearms and competent riverine transportation, Cossack explorers of the Muscovite empire encountered little resistance in their eastward expansion across Siberia until they reached the Amur frontiers. The Cossacks arrived in 1643 and gained notoriety as Buddhist demons (luocha羅剎) for plundering the Mongol-Tungusic tribes of the region during the latter half of the seventeenth century. There ensued an effective military counterthrust by continental East Asians, including the Manchus, a new rising power in North China; Amurian natives such as the Daurs, Juchers, and Nanais; and Korean musketeers hailing from the Chosŏn dynasty. During the battles of 1654 and 1658, disciplined Korean musketeers known as Big Heads (taeduin大頭人) outgunned the Russians and helped repulse their incursions into the inner reaches of the Amur region. These marksmen were products of the Korean Musketry Revolution during the seventeenth century, which revamped the Chosŏn army arounden masseinfantry tactics and firearms units. These tactical changes sparked broader institutional changes within and beyond the Korean military apparatus, triggering a drastic growth in army size and challenging existing practices of commerce, conscription, census taking, and taxation. These reforms, though decelerated around the mid-eighteenth century, attest to the capabilities of seventeenth-century Chosŏn to successfully adapt to the challenges of early modern warfare, which increasingly harnessed the power of firearms and disciplined soldiers. This narrative of the Big Heads and Buddhist Demons explores new ground in understanding transcultural trends of musket-based warfare and joins Korea to the burgeoning field of global military history.
The Effects of a Community-Based, Culturally Tailored Diabetes Prevention Intervention for High-Risk Adults of Mexican Descent
Authors: Vincent Deborah , McEwen Marylyn M. , Hepworth Joseph T. , Stump Craig S. 
Published: February 2014

Purpose This article reports the results of a community-based, culturally tailored diabetes prevention program for overweight Mexican American adults on weight loss, waist circumference, diet and physical activity self-efficacy, and diet behaviors. Methods The intervention used content from the Diabetes Prevention Program but culturally tailored the delivery methods into a community-based program for Spanish-speaking adults of Mexican descent. The design was a randomized controlled trial (N = 58) comparing the effects of a 5-month educational intervention with an attention control group. The primary study outcome was weight loss. Secondary outcomes included change in waist circumference, body mass index, diet self-efficacy, and physical activity self-efficacy. Results There were significant intervention effects for weight, waist circumference, body mass index, and diet self-efficacy, with the intervention group doing better than the control group. These effects did not change over time. Conclusions Findings support the conclusion that a community-based, culturally tailored intervention is effective in reducing diabetes risk factors in a 5-month program.
Is Cardiology Evaluation Necessary in Children with Electrocardiogram Abnormalities Noted on Polysomnogram?
Authors: Baldassari Cristina M. , Beydoun Hind A. , Peak Jessica , Reed John H. 
Published: February 2014

Objectives(1) To determine the prevalence of cardiac disease in children with electrocardiogram (ECG) abnormalities on polysomnogram (PSG). (2) To assess whether factors such as family history of heart disease and severity of sleep apnea are associated with cardiac disease.Study DesignCase series with chart review from 2002 to 2012.SettingTertiary children's hospital.Subjects and MethodsChildren between 1 and 16 years of age with ECG abnormalities on PSG who were referred to cardiology for evaluation were included. Children with a known history of cardiac disease were excluded.ResultsSixty‐one children had ECG abnormalities on PSG and were subsequently referred to cardiology. The mean age was 6.5 years (SD, 4.5), and 64% (n = 39) of subjects were African American. The mean obstructive apnea hypopnea index (AHI) was 8.8 (SD, 13.3), and 26% of the children had severe obstructive sleep apnea (AHI >10). The most common ECG abnormality (n = 52) recorded on PSG was premature ventricular contractions. Thirty percent (n = 18) of children had marked arrhythmias noted on their PSG ECG. Most children referred to cardiology underwent echocardiogram (45/61) and 24‐hour arrhythmia monitoring (42/61). Five children (8%) had cardiac pathology, including atrial and ventricular ectopy, tuberous sclerosis, mitral regurgitation, and aortic insufficiency. Factors such as family history of heart disease (P =. 40) and severe OSA (P =. 74) were not associated with cardiac pathology.ConclusionCardiac pathology in children with abnormal ECGs on PSG is common. Cardiology referral in such patients should be considered. Further research is needed to determine the appropriate cardiac workup.
Implementation of Concussion Legislation and Extent of Concussion Education for Athletes, Parents, and Coaches in Washington State
Authors: Chrisman Sara P. , Schiff Melissa A. , Chung Shana K. , Herring Stanley A. , Rivara Frederick P. 
Published: February 2014

Background: Most states in the United States have passed laws regarding concussions, but little is known regarding the implementation of these laws. Hypothesis/Purpose: The purpose of this study was to survey high school coaches 3 years after the passage of a concussion law to evaluate the variation in concussion education and knowledge in the context of this law as well as measure the effects of sport (football vs soccer) and urban versus rural locations. The hypothesis was that concussion education and knowledge would be more extensive in football compared with soccer and in urban locations compared with rural locations. Study Design: Descriptive epidemiology study. Methods: A mixed-methods (paper and online) survey was conducted in 2012 to 2013 on a random sample of public high school football, girls’ soccer, and boys’ soccer coaches in Washington State, stratified by urban and rural locality. The survey covered the extent of concussion education for coaches, athletes, and parents as well as coaches’ concussion knowledge and experience. Results: Of 496 coaches contacted, 270 responded (54.4%). Nearly all coaches answered concussion knowledge questions correctly, and nearly all coaches received education via ≥2 modalities (written, video, slide presentation, test, and in person). Athlete education was less extensive, with 34.7% exposed to ≥2 modalities and 29.5% only signing a concussion information form. Parent education was even more limited, with 16.2% exposed to ≥2 modalities and 57.9% only signing a concussion information form. Significantly more football than soccer coaches gave their athletes an in-person talk about concussions (59.1% vs 39.4%, respectively; P = .002) and provided concussion education to athletes via ≥2 modalities (44.1% vs 29.7%, respectively; P = .02). Concussion education for coaches and parents was similar between sports, and concussion education for all parties was similar in urban and rural localities. Conclusion: Three years after the passage of a concussion law in Washington State, high school football and soccer coaches are receiving substantial concussion education and have good concussion knowledge. Concussion education for athletes and parents is more limited. Football players receive more extensive concussion education than do soccer players. Clinical Relevance: Clinicians should be aware that athletes and parents may not be receiving significant concussion education.
Arthroscopic Glenoid Bone Grafting With Nonrigid Fixation for Anterior Shoulder Instability
Authors: Zhao Jinzhong , Huangfu Xiaoqiao , Yang Xingguang , Xie Guoming , Xu Caiqi 
Published: February 2014

Background: The healing rate and clinical outcomes of glenoid bone grafting with nonrigid fixation for patients with recurrent anterior shoulder instability are unknown. Hypothesis: Glenoid bone grafting with nonrigid fixation can yield satisfactory results for patients with recurrent anterior shoulder instability with regard to graft healing and the restoration of shoulder stability. Study Design: Case series; Level of evidence, 4. Methods: A total of 52 patients with recurrent anterior shoulder instability underwent Bankart or bony Bankart repair as well as arthroscopic glenoid bone grafting. Allogenic bicortical iliac grafts were used. Instead of firm fixation, the grafts were tethered to the glenoid by sutures from anchors placed in the glenoid surface. Follow-up occurred at 3, 6, 12, and 24 months. Computed tomography and magnetic resonance imaging examinations were performed immediately after surgery and at each follow-up visit to evaluate the healing of the graft and the changes in the repaired capsule-labrum structure. Functional evaluations were taken at 24 months with the Oxford Shoulder Instability Score and the Rowe Score for Shoulder Instability. For the patients who underwent surgery 2.5 years earlier, an additional review was conducted to evaluate the latest stability status of the shoulder. Failure was defined as recurrence of dislocation or instability. Results: The mean follow-up time was 39 months (range, 24-64 months). In all cases, the grafts healed to the glenoid at 3 or 6 months, and glenoid remodeling was complete within 12 months; in most cases, a robust bone-capsule structure formed on the anterior side of the glenoid. The glenoid defect area changed from 32.7% ± 8.7% (range, 10.7% to 53.9%) to −16.3% ± 3.3% (range, −26.7% to 5.9%), and the glenoid defect width changed from 28.3% ± 8.7% (range, 10.4% to 54.5%) to −16.9% ± 7.3% (range, −33.4% to 2.8%). Compared with the presumed normal glenoid, the final glenoid surface area increased in 94.2% of patients and final glenoid width increased in 96.2% of patients. One patient experienced redislocation and 2 experienced a sense of instability without dislocation, which resulted in a failure rate of 5.8%. Six patients exhibited slight pain. The Oxford score improved from 29.7 ± 5.6 preoperatively to 42.4 ± 3.3 at 2 years postoperatively, and the Rowe score improved from 34.7 ± 6.1 preoperatively to 91.8 ± 2.8 at 2 years postoperatively. Conclusion: In this study, arthroscopic glenoid bone grafting with nonrigid fixation in combination with Bankart repair resulted in 100% graft healing and the satisfactory restoration of shoulder stability.
Effect of Capsular Release in the Treatment of Shoulder Stiffness Concomitant With Rotator Cuff Repair
Authors: Park Jin-Young , Chung Seok Won , Hassan Zulkifli , Bang Jin-Young , Oh Kyung-Soo 
Published: February 2014

Background: In spite of the high prevalence of shoulder stiffness during rotator cuff repair, optimal management remains unclear. Purpose: To identify the effect of capsular release during rotator cuff repair on the outcomes of patients with both shoulder stiffness and a rotator cuff tear, based on subgroup analyses. Study Design: Cohort study; Level of evidence, 3. Methods: Forty-nine consecutive patients (mean age, 61.5 ± 8.3 years) were enrolled who underwent arthroscopic repair of a small- to large-sized full-thickness rotator cuff tear and manipulation for concomitant shoulder stiffness (passive forward flexion ≤120°, external rotation at the side ≤45°). The first 21 consecutive patients underwent manipulation alone to treat stiffness; the second 28 consecutive patients underwent capsular release with manipulation. Among the 49 patients, 25 showed severe stiffness (forward flexion ≤100°, external rotation at the side ≤30°; 11 in the first series and 14 in the second series), and 15 had diabetes mellitus (30.6%; 6 in the first series and 9 in the second series). Shoulder range of motion was measured 6 weeks, 3 months, 6 months, and 1 year postoperatively and at final follow-up visit. Simultaneously, functional outcome was evaluated by visual analog scale for pain, American Shoulder and Elbow Surgeons score, Constant score, and muscle strength ratio (involved/uninvolved), and cuff integrity was assessed ultrasonographically at least 1 year postoperatively. Results: All range of motion measurements, functional scores, and muscle strength ratios significantly improved postoperatively regardless of the treatment method of stiffness. No outcome measure differed significantly between patients who did and did not undergo capsular release, regardless of the severity of stiffness, except for a temporary improvement in external rotation at side 3 months postoperatively in favor of those who underwent capsular release in cases with severe stiffness. Among patients with diabetes mellitus however, those who underwent capsular release showed greater improvement in forward flexion after 3 months and 1 year and in external rotation at the side for all time points (all P < .05), except for 6 weeks postoperatively; these patients also had a significantly higher final American Shoulder and Elbow Surgeons score ( P = .03). Of 21 patients who underwent manipulation alone and of 28 who underwent capsular release and manipulation, 2 and 1 developed retears, respectively. Conclusion: Both manipulation and capsular release with manipulation significantly improved range of motion and produced satisfactory functional outcomes. The outcomes did not differ between treatment methods for stiffness regardless of the severity of stiffness. In patients with diabetes mellitus however, capsular release at the time of rotator cuff repair seems to be beneficial, especially for external rotation and final postoperative function.
The Interhospital Medical Intensive Care Unit Transfer Instrument Facilitates Early Implementation of Critical Therapies and Is Associated With Fewer Emergent Procedures Upon Arrival
Authors: Malpass Howard Charles , Enfield Kyle B. , Keim-Malpass Jessica , Verghese George M. 
Published: February 2014

Background: Interhospital transportation of critically ill patients is challenging. The risk incurred by the patient is compounded when stabilization and application of appropriate therapies are delayed. The purpose of this study was to first develop an interhospital intensive care unit (ICU) transfer instrument to systematize communication and determine feasibility of use. Then, the transfer instrument was tested for effects on patient mortality, stability on arrival, and recommended therapy implementation. Method: The instrument was developed and pilot tested for 6 months to optimize function and applicability. Then, a before-and-after quasi-experimental study tested this instrument by assessing several key outcomes. Outcomes measured included 48-hour mortality, ICU mortality, hospital mortality, emergent intubation, emergent central venous catheter insertion, immediate change in antibiotics, and addition of vasopressors immediately on arrival. Patients were compared by age, gender, cause for admission, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. A standardized mortality ratio was calculated using the patient’s APACHE II score. Pretransport recommendations to referring physicians and adherence to recommendations were also measured. Results: The preintervention group consisted of 134 patients collected continuously over 6 months. The postintervention group was collected continuously over a 6-month period and included 77 patients. The interhospital ICU transfer instrument was associated with fewer emergent central venous catheter insertions and fewer changes in antibiotics on arrival. Recommendations to transferring physicians were followed 90% of the time. Conclusions: The interhospital ICU transfer instrument is a tool that is effective in coordinating the transfer of medical ICU patients. Implementation leads to timely critical interventions and may reduce mortality.
Natural convection with volumetric heat generation and external magnetic field in differentially heated enclosure
Authors: Berrahil Farid , Benissaad Smail , Chérifa Abid , Médale Marc 
Published: February 2014

Abstract This work presents a numerical study of natural convection in a laterally heated cavity filled with an electrically conductive fluid ([Formula: see text]) in the presence of an external magnetic field and an internal heat source. The finite volume method with the SIMPLER algorithm is used to solve the system of equations governing the magnetohydrodynamics flow. The influence of volumetric heating SQ on the flow structure and on the heat transfer within the cavity for Gr = 104, 105, and 106 was examined. The effects of aspect ratio ( A = 1, 0.5, and 2), Prandtl number (low Prandtl number fluids), and magnetic field ([Formula: see text] to [Formula: see text]) were determined in the steady state with internal heat generation. Two orientations of the magnetic field were considered in order to have better control of the flow. The strongest stabilization of the flow field with internal heat generation is found when the magnetic field is oriented horizontally.
Differential expression pattern of microRNAs in CD4+ and CD19+ cells from asymptomatic patients with systemic lupus erythematosus
Authors: Martínez-Ramos R , García-Lozano J-R , Lucena J-M , Castillo-Palma M-J , García-Hernández F , Rodríguez M-C , Núñez-Roldán A , González-Escribano M-F 
Published: February 2014

Objective The aim of this study was to investigate the pattern of microRNA (miRNA) expression in CD19+ and CD4+ cells from asymptomatic patients with systemic lupus erythematosus (SLE). Methods A screening of the expression of 377 miRNAs was performed in human CD4+ and CD19+ cells isolated from the peripheral blood by using a TaqMan Human MicroRNA Array. Validation of differential expression pattern of those was performed using TaqMan assays in these cell populations obtained from a larger cohort of patients and controls. Results According to the screening assays, three miRNAs were differentially expressed ( p value <0.1) in cell populations from both patients and controls: hsa-miR-143, hsa-miR-224 and hsa-miR-576-5p for CD4+ cells, and hsa-miR-10a, hsa-miR-31 and hsa-miR-345 for CD19+ cells. After validation, significant differences ( p value <0.05) were confirmed only for hsa-miR-143 and hsa-miR-224 in CD4+ cells and for hsa-miR-10a and hsa-miR-345 in CD19+ cells. In all cases, the miRNAs were over expressed in SLE patients compared with healthy donors. Conclusions Our results support a different pattern of miRNA expression in SLE patients.