bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study
Authors: Reinhard Mark , Schousboe Karoline , Andersen Ulrik B. , Buus Niels Henrik , Rantanen Jesper Moesgaard , Bech Jesper Nørgaard , Mafi Hossein Mohit , Langfeldt Sten , Bharadwaz Arindam , Hørlyck Arne , Jensen Mogens Kærsgaard , Jeppesen Jørgen , Olsen Michael Hecht , Jacobsen Ib Abildgaard , Bibby Bo Martin , Christensen Kent Lodberg 
Published: March 2022

Background
The aim of this study was to prospectively evaluate the effects of renal artery stenting in consecutive patients with severe atherosclerotic renal artery stenosis and high‐risk clinical presentations as defined in a national protocol developed in 2015.

Methods and Results

Since the protocol was initiated, 102 patients have been referred for revascularization according to the following high‐risk criteria: severe renal artery stenosis (≥70%) with true resistant hypertension, rapidly declining kidney function, or recurrent heart failure/sudden pulmonary edema. At baseline, the mean 24‐hour ambulatory systolic blood pressure was 166.2 mm Hg (95% CI, 162.0–170.4), the defined daily dose of antihypertensive medication was 6.5 (95% CI, 5.8–7.3), and the estimated glomerular filtration rate was 41.1 mL/min per 1.73m
2
(95% CI, 36.6–45.6). In 96 patients with available 3‐month follow‐up data, mean 24‐hour ambulatory systolic blood pressure decreased by 19.6 mm Hg (95% CI, 15.4–23.8;
P<
0.001), the defined daily dose of antihypertensive medication was reduced by 52% (95% CI, 41%–62%;
P
<0.001), and estimated glomerular filtration rate increased by 7.8 mL/min per 1.73m
2
(95% CI, 4.5–11.1;
P
<0.001). All changes persisted after 24 months follow‐up. Among 17 patients with a history of hospitalization for acute decompensated heart failure, 14 patients had no new episodes after successful revascularization.

Conclusions
In this prospective cohort study, we observed a reduction in blood pressure and antihypertensive medication, an increase in estimated glomerular filtration rate, and a decrease in new hospital admissions attributable to heart failure/sudden pulmonary edema after renal artery stenting.

Registration

URL:
https://clinicaltrials.gov
. Identifier: NCT02770066.
Interpersonal Trauma and Risk of Incident Cardiovascular Disease Events Among Women
Authors: Thurston Rebecca C. , Chang Yuefang , Matthews Karen A. , Harlow Sioban , El Khoudary Samar R. , Janssen Imke , Derby Carol 
Published: March 2022

Background
Traumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of subsequent clinical CVD events.

Methods and Results

A total of 2201 women, aged 42 to 52 years at baseline, underwent up to 16 in‐person visits over 22 years. Measures included questionnaires (including of childhood physical/sexual abuse, adult physical/sexual abuse, and IPV), physical measures, phlebotomy, and reported CVD events (myocardial infarction, stroke, heart failure, and revascularization). Death certificates were collected. Relationships between childhood abuse, adult abuse, and IPV with incident fatal/nonfatal CVD were tested in Cox proportional hazards models. Women with a childhood abuse history had increased risk for incident CVD (versus no abuse; hazard ratio [HR] [95% CI], 1.65 [1.12–2.44];
P
=0.01; adjusted for demographics and CVD risk factors); associations were strongest for childhood sexual abuse. Adult abuse was not significantly associated with CVD. Women with IPV had a doubling of risk for incident CVD in demographic‐adjusted models (versus no IPV; IPV: HR [95% CI], 2.06 [1.01–4.23];
P
=0.04; no partner: HR [95% CI], 1.79 [0.91–3.53];
P
=0.09); systolic blood pressure partially mediated relationships between IPV and CVD.

Conclusions
Childhood abuse, particularly sexual abuse, was associated with increased risk of CVD in women. IPV was associated with risk for CVD, with the higher systolic blood pressure among IPV‐exposed women important in these associations. Interpersonal violence prevention may contribute to CVD risk reduction in women.
Association of Socioeconomic Status With Outcomes and Care Quality in Patients Presenting With Undifferentiated Chest Pain in the Setting of Universal Health Care Coverage
Authors: Dawson Luke P. , Andrew Emily , Nehme Ziad , Bloom Jason , Biswas Sinjini , Cox Shelley , Anderson David , Stephenson Michael , Lefkovits Jeffrey , Taylor Andrew J. , Kaye David , Smith Karen , Stub Dion 
Published: March 2022

BACKGROUND
This study aimed to assess whether there are disparities in incidence rates, care, and outcomes for patients with chest pain attended by emergency medical services according to socioeconomic status (SES) in a universal health coverage setting.

METHODS AND RESULTS

This was a population‐based cohort study of individually linked ambulance, emergency, hospital admission, and mortality data in the state of Victoria, Australia, from January 2015 to June 2019 that included 183 232 consecutive emergency medical services attendances for adults with nontraumatic chest pain (mean age 62 [SD 18] years; 51% women) and excluded out‐of‐hospital cardiac arrest and ST‐segment–elevation myocardial infarction. Age‐standardized incidence of chest pain was higher for patients residing in lower SES areas (lowest SES quintile 1595 versus highest SES quintile 760 per 100 000 person‐years;
P
<0.001). Patients of lower SES were less likely to attend metropolitan, private, or revascularization‐capable hospitals and had greater comorbidities. In multivariable models adjusted for clinical characteristics and final diagnosis, lower SES quintiles were associated with increased risks of 30‐day and long‐term mortality, readmission for chest pain and acute coronary syndrome, lower acuity emergency department triage categorization, emergency department length of stay >4 hours, and emergency department or emergency medical services discharge without hospital admission and were inversely associated with use of prehospital ECGs and transfer to a revascularization‐capable hospital for patients presenting to non‐percutaneous coronary intervention centers.

CONCLUSIONS
In this study, lower SES was associated with a higher incidence of chest pain presentations to emergency medical services and differences in care and outcomes. These findings suggest that substantial disparities for socioeconomically disadvantaged chest pain cohorts exist, even in the setting of universal health care access.
Understanding Physician and Patient Preferences for Thrombolysis in Ischemic Stroke Eligible for Endovascular Thrombectomy
Authors: Singh Nishita , Kashani Nima , Ganesh Aravind , Kenney Carol , Ben‐Israel David , Joundi Raed , Katsanos Aristeidis H. , Alrohimi Anas , Bala Fouzi , Shamy Michel , Tkach Aleksander , Swartz Richard H. , Buck Brian H. , Demchuk Andrew M. , Hill Michael D. , Thavorn Kednapa , Sajobi Tolulope , Almekhlafi Mohammed , Dowlatshahi Dar , Menon Bijoy K. 
Published: March 2022

Background
In light of evidence from recent trials that endovascular thrombectomy (EVT) alone may potentially be noninferior to combined treatment, that is, with intravenous thrombolysis (IVT) with alteplase and EVT, we sought to understand physician and patient preferences around this issue.

Methods
We conducted a 2‐stage mixed methods study that included a structured, international, web‐based cross‐sectional survey among stroke physicians, and a focus group involving stroke survivors and caregivers. Demographic information was collected from all participants. The survey offered multiple choice questions and options to respond via free text which was analyzed quantitatively. The focus group was conducted online and analyzed qualitatively using a grounded theory approach.

Results
A total of 225 physicians (67% men) from 44 countries completed the survey. Most participants (70%) were between 31 and 50 years of age. Survey results showed that in current practice, 90% respondents would offer IVT to patients with large vessel occlusion stroke eligible for both IVT and EVT. When asked if their practice would change in light of recent trials, 63% responded no. When asked about the appropriate timing for IVT in the setting of large vessel occlusion stroke with EVT availability, 56% preferred to administer IVT immediately, 21% were willing to defer the decision for 30 minutes from groin puncture, and 8% were willing to defer for 60 minutes from groin puncture to assess if reperfusion was achieved with EVT. A total of 61% participants would choose to use tenecteplase over alteplase as the preferred drug for IVT if both drugs are backed by evidence. The focus group identified a need to better understand patient characteristics that may benefit from EVT‐only or combined strategies. The focus group also identified the need for more data to inform physician decision making.

Conclusions
Most physicians surveyed prefer IVT before EVT in patients with acute ischemic stroke attributable to large vessel occlusion, although there was some uncertainty around this issue. The need for further studies, including data on IVT with tenecteplase and among various patient subgroups to inform decision making, was apparent from both the survey and the patient focus group.
Association of the
RNF213
p.R4810K Variant With the Outer Diameter of Cervical Arteries in Patients With Ischemic Stroke
Authors: Yamaguchi Eriko , Yoshimoto Takeshi , Ogura Shiori , Saito Kozue , Saito Satoshi , Hattori Yorito , Wasida Kazuo , Nishimura Kunihiro , Toyoda Kazunori , Koga Masatoshi , Ihara Masafumi 
Published: March 2022

Background

We investigated the impact of the p.R4810K variant of
RNF213
(ring finger protein 213) gene, a susceptibility gene of moyamoya disease in East Asia, on the outer diameter of cervical parts of carotid and vertebral arteries (VAs).

Methods
We examined consecutive Japanese patients with ischemic stroke who underwent carotid ultrasonography between 2015 and 2019. Patient background and the carotid ultrasonography‐measured outer diameter of extracranial cervical arteries, including the common carotid artery, internal carotid artery, external carotid artery, and cervical VA, were compared between variant carriers and noncarriers. Outer diameters of each artery were defined as the mean distance from far to near wall adventitia of right and left target arteries using carotid ultrasonography. The average diameter of both cervical portions of common carotid arteries, internal carotid arteries, external carotid arteries, and the dominant side diameter of both cervical VAs were used.

Results

Of the 617 adult patients (204 women; median age, 74 years) analyzed, 26 (4.2%) carried the
RNF213
p.R4810K variant. Variant carriers were significantly younger (
P
<0.01) and had more frequent steno‐occlusion of the M1 segment of the middle cerebral artery (
P
<0.01). Multivariate logistic regression analysis showed that variant carriers had significantly smaller mean diameters in the common carotid artery (7.25 versus 8.22 mm; adjusted odds ratio [aOR] per 1 mm decrease, 2.94; 95% CI, 1.69–5.00), cervical internal carotid artery (4.99 versus 5.55 mm; aOR, 1.66; 95% CI, 1.03–2.70), and cervical VA (3.55 versus 4.10 mm; aOR, 2.56; 95% CI, 1.33–4.76) than noncarriers. Mean diameters of the common carotid artery (aOR, 3.44; 95% CI, 2.08–5.88) and cervical internal carotid artery (aOR, 2.04; 95% CI, 1.23–3.33) and the dominant diameter of the cervical VA (aOR, 3.23; 95% CI, 1.72–5.88) were also smaller in variant carriers even when the analysis was restricted to patients without bilateral steno‐occlusion in target vessels or intracranial arteries distal to target vessels.

Conclusion

RNF213
p.R4810K variant carriers have smaller cervical arterial outer diameters in both anterior and posterior circulations than noncarriers with ischemic stroke.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02251665.
“The Benefit Of Positron Emission Tomography/Computed Tomography In Stage I And Stage II Melanomas With High-Risk Decisiondx-Melanoma Scores”
Authors: Williams Andrew , Hamilton Owen , Likar Carly , Thomay Alan , Garland-Kledzik Mary 
Published: March 2022

Introduction Early detection of melanoma is instrumental as the 5-year survival decreases from 93.3% to <50% when metastases are present. 1 - 3 Distinguishing which patients require closer follow-up can be difficult for melanoma patients. Developments by Castle Biosciences’ (Friendswood, TX) DecisionDx-Melanoma (DDx-M) use 31 melanoma associated genes to stratify melanomas into 4 classes with 1A having lowest risk of morbidity and mortality and 2B the highest. 5 We assessed the benefit of providing additional 18FDG-PET-CT and brain MRI to genetically high-risk patients who may have otherwise been overlooked. Methods 297 patients at our institution had biopsies sent for DDx-M between 2014 and 2021. Patients found to have Class 2 melanomas received additional screening with yearly 18FDG-PET-CT scans and brain MRIs. Patients with Class 2 DDx-M scores and negative SLNB were included in the study. 66 met inclusion criteria and received imaging. Results Within 3 years of follow-up, 8/66 (12.1%) patients had metastases detected by 18FDG-PET-CT scans. No patients with stage IA or IB went on to develop metastases. Discussion 18FDG-PET-CT scans detect metastases in < 3% of the time when all stage I and II patients are scanned; however, by using DDx-M in our screening protocols, we achieved a detection rate of 12.1%. 6 , 7 These patients went on to receive treatment and would have otherwise progressed undetected, leading to higher morbidity and mortality. Conclusion We suggest all patients with initial stage II or above melanomas receive a DDx-M score and those with class 2 receive yearly 18FDG-PET-CT/brain MRI imaging.
Capital, Caste, and Patriarchy: Theory of Marriage Formation in India
Authors: Srivastava Abhilasha , Willoughby John 
Published: March 2022

This article presents a theory of marriage formation in India and grounds it with primary qualitative data. India presents a unique case for interrogating the institution of marriage because here, violent kinship-based patriarchy and the neoliberal promises of individual freedom and choice coexist. This article draws on literatures from Marxist, Feminist political economy, economic anthropology, and the political economy of caste to contend that a synthesis of Social Reproduction Theory and Ambedkarite theory of caste and Brahminical Patriarchy presents a better theoretical framework to critically examine the relationship between market and nonmarket social relations in India. We argue that in India, marriage is an institution that provides the essential legitimizing framework for the reproduction of social order, as well as the social relations of class, caste, and gender. Empirical analysis shows that Brahminical Patriarchy amalgamates with social relations of neoliberal capital within the institution of marriage to create new forms of regressive social norms and oppressions. This study also complicates the neat distinction between market and nonmarket relations and, in extension, between economic and social realms of life. JEL Classification: B54, B14, Z13, J12
Prospective Results of the Modified Glide Path Technique for Improved Syndesmotic Reduction During Ankle Fracture Fixation
Authors: Harris Mitchell C. , Lause Gregory , Unangst Alicia , Arthur Jacob , Song Daniel , Lustik Michael , Lindell Kenneth K. , Ryan Paul 
Published: March 2022

Background: Malreduction after syndesmotic stabilization occurs in as many as 52% of cases and has been shown to detrimentally affect clinical outcomes. We propose that the modified Glide Path technique reduces the occurrence of syndesmotic malreduction. Methods: This study is a prospective series comparing 16 patients reduced with the modified Glide Path technique with a retrospectively reviewed series of 25 patients reduced with a traditional technique using fluoroscopy and a clamp. The modified Glide Path technique consists of manual reduction of the fibula and placement of a Kirschner wire through the fibula and tibia along the transmalleolar axis. The syndesmosis can then be reduced along the glide path created by the Kirschner wire to prevent posterior or anterior malreduction. Computed tomographic scans of the repaired and contralateral ankles were obtained postoperatively to assess reduction. Results: We found a statistically significant decrease of syndesmotic malreductions using the modified Glide Path technique when compared with technique that did not use a glide path. In our study, 2 of 16 patients (12.5%) had syndesmotic malreductions using the modified Glide Path technique, compared with 11 of 25 patients (44%) with syndesmotic malreductions in the historical cohort. Conclusion: The modified Glide Path technique is a simple method for ankle syndesmotic reduction. The technique has lower rates of malreduction compared with historical methods and may be useful for most operative syndesmotic injuries. Level of Evidence: Level II, prospective cohort study.
Pre-hospital trauma triage: Outcomes of interfacility transferred trauma patients meeting pre-hospital triage criteria
Authors: Li Winny , Mok Garrick , Nolan Brodie 
Published: March 2022

Introduction In Ontario, Canada, paramedics use the Field Trauma Triage Standard to identify patients at risk for severe injury. These triage criteria encompass physiologic, anatomic, mechanism of injury, and special considerations to identify patients that should be transported directly to a trauma center. Patients meeting any one of these criteria mandate direct transfer to a trauma center. This study evaluated whether severely injured trauma patients that underwent an interfacility transfer met these triage criteria. The secondary objective was to assess the impact of failed triage application on in-hospital mortality. Methods This is a retrospective cohort study of interfacility trauma transfers to an adult trauma center over a 3-year period that were either admitted to the intensive care unit, received an operation within 4 h of arrival, or died within 48 h of arrival. Data were abstracted from the hospital’s trauma registry and chart review of electronic medical records. Frequency of patients meeting pre-hospital triage criteria and which specific criteria were collected. Multivariable logistic regression was performed to assess the impact of missed pre-hospital triage on in-hospital mortality. Results There were 1008 interfacility patients during the study period, of which 340 patients met inclusion criteria; 78.5% ( n = 267) of interfacility transports had met at least one triage criteria. Most frequent criteria met were: Glasgow Coma Scale <14 (42.4%), high risk motor-vehicle collision (22.1%), and systolic blood pressure <90 mmHg (19.4%). When adjusted for injury severity score and age, patients who met triage criteria were not at increased odds of death (OR 2.38, 95% CI: 0.87–6.46) compared to interfacility patients that did not meet criteria. Conclusion: A majority of critically injured interfacility transfers met initial trauma triage criteria. These patients are at high risk for preventable morbidity and mortality. This study indicates the need to understand the barriers to pre-hospital adherence to trauma triage guidelines.
Cleft complications: Severely rotated maxillary permanent central incisors
Authors: Hameed Othman , Good Sarah 
Published: March 2022

The maxillary permanent central incisor (MPCI) has been reported to be rotated in up to 96% of cleft patients. A severely rotated MPCI is highly visible when smiling, drawing attention to a repaired cleft lip, and is often the main presenting complaint of a patient with cleft lip and palate attending for orthodontic treatment. The benefit of interceptive orthodontic treatment to alleviate these concerns must be weighed up against the consequences of adding to the already substantial orthodontic burden likely to be faced by these patients. Despite the high prevalence of this dental abnormality among cleft patients, there is little published in the literature regarding this type of malocclusion. This paper explores the aetiology, presentation and management of this condition, using examples from cases treated within our department. In addition, the commonly found pre-existing anomaly of a short root length is discussed, in combination with the implications this may have upon orthodontic treatment planning for a rotated MPCI.
Endovascular Treatment of Abdominal Aortic Aneurysm With Severe Angulation of Infrarenal Aortic Neck by Gore Conformable Endograft
Authors: Mascoli Chiara , Faggioli Gianluca , Goretti Martina , Gallitto Enrico , Pini Rodolfo , Logiacco Antonino Maria , Vacirca Andrea , Gargiulo, Prof Mauro 
Published: March 2022

Introduction: The aim of the study is to report a single-center experience with the Gore Excluder conformable endograft with active control system (CEXC Device, W.L. Gore and Associates, Flagstaff, AZ, USA) in abdominal aortic aneurysms (AAAs) with severe infrarenal neck angulation. Methods: All patients underwent EVAR with CEXC Device between September 2018 and 2020, were prospectively enrolled, and retrospectively analyzed. Anatomical details of the proximal aortic neck were evaluated. Early endpoints were the use of repositionability and angulation system, intraoperative unplanned cuff, technical success (TS), 30-day morbidity/mortality, and reintervention. Follow-up endpoints were type-I endoleaks, endograft migration, aortic neck dilatation, aneurismal sac shrinkage, survival (S), and freedom from reintervention (FFR). Results: Twenty-five patients were enrolled (median age: 80 [range = 60-90] years, median AAA diameter: 60 [range = 52-90] mm). All patients had severe infrarenal neck angulation (beta angle ≧ 60°), and 11 (44%) of those had neck beta angle ≧ 90°. Median infrarenal neck angle, length, and diameter were 70° (range = 60°-90°), 22 (range = 13-42) mm and 22 (range = 18-31) mm, respectively. Endograft repositioning system was employed in 15 (60%) cases and the median number of repositioning maneuvers was 1 (range:0-4). Active angulation system was used in 17 (68%) patients. The median proximal diameter of the main-body and oversize were 28 (range = 23-36) mm and 28% (range = 21%-38%), respectively. Proximal cuff was positioned in 1 (4%) patient. Technical success was achieved in all cases. Intraoperative and perioperative morbidity and mortality were 12% and 0%, respectively. Perioperative type-I/III and II endoleaks were observed in 0 and 4 (16%) patients, respectively. The median follow-up was 12 months (range: 3-30). One patient died at 12-month for AAA-unrelated causes. Abdominal aortic aneurysm-sac shrinkage and stability were observed in 9 (36%) and 15 (60%) cases, respectively. No type-I/III endoleak and reintervention occurred during the follow-up. One persistent type-II endoleak was observed. Estimated survival at 24 months was 92%. Conclusion: According to the present data, the CEXC Device allows an excellent rate of TS in severe angulated aortic neck. This preliminary data, could increase the rate of patients eligible for EVAR.