bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated Pulse Wave Velocity Is Associated With All‐Cause Mortality During 8.5 Years Follow‐up in Patients Undergoing Elective Coronary Angiography
Authors: Laugesen Esben , Olesen Kevin K. W. , Peters Christian Daugaard , Buus Niels Henrik , Maeng Michael , Botker Hans Erik , Poulsen Per L. 
Published: May 2022

Background
Estimated pulse wave velocity (ePWV) calculated by equations using age and blood pressure has been suggested as a new marker of mortality and cardiovascular risk. However, the prognostic potential of ePWV during long‐term follow‐up in patients with symptoms of stable angina remains unknown.

Methods and Results

In this study, ePWV was calculated in 25 066 patients without diabetes, previous myocardial infarction (MI), stroke, heart failure, or valvular disease (mean age 63.7±10.5 years, 58% male) with stable angina pectoris undergoing elective coronary angiography during 2003 to 2016. Multivariable Cox models were used to assess the association with incident all‐cause mortality, MI, and stroke. Discrimination was assessed using Harrell´s C‐index. During a median follow‐up period of 8.5 years (interquartile range 5.5–11.3 years), 779 strokes, 1233 MIs, and 4112 deaths were recorded. ePWV was associated with all‐cause mortality (hazard ratio [HR] per 1 m/s, 1.13; 95% CI, 1.05–1.21) and MI (HR per 1 m/s 1.23, 95% CI, 1.09–1.39) after adjusting for age, systolic blood pressure, body mass index, smoking, estimated glomerular filtration rate, Charlson Comorbidity Index score, antihypertensive treatment, statins, aspirin, and number of diseased coronary arteries. Compared with traditional risk factors, the adjusted model with ePWV was associated with a minor but likely not clinically relevant increase in discrimination for mortality, 76.63% with ePWV versus 76.56% without ePWV,
P
<0.05.

Conclusions
In patients with stable angina pectoris, ePWV was associated with all‐cause mortality and MI beyond traditional risk factors. However, the added prediction of mortality was not improved to a clinically relevant extent.
Incidence and Prognostic Implications of Readmissions Caused by Thrombotic Events After a Heart Failure Hospitalization
Authors: Chaudhury Pulkit , Alvarez Paulino , Michael Madonna , Saad Marwan , Bishop G. Jay , Hanna Mazen , Menon Venu , Starling Randall C. , Spyropoulos Alex C. , Desai Milind , Mentias Amgad 
Published: May 2022

Background
Readmission occurs in 1 out of 3 patients with heart failure (HF). We aimed to study the incidence and prognostic implications of rehospitalizations because of arterial thromboembolism events (ATEs) and venous thromboembolism events (VTEs) after discharge in patients with HF.

Methods and Results

We identified Medicare beneficiaries who were admitted with a primary diagnosis of HF from 2014 to 2019, with a hospital stay ranging between 3 and10 days, followed by discharge to home. We calculated incidence of ATEs (myocardial infarction, ischemic stroke, or systemic embolism) and VTEs (deep venous thrombosis and pulmonary embolism) up to 90 days after discharge. Out of 2 953 299 patients admitted with HF during the study period, a total of 585 353 patients met the inclusion criteria, and 36.6% were readmitted within 90 days of discharge. The incidence of readmission due ATEs, VTEs, HF, and all other reasons was 3.4%, 0.5%, 13.2%, and 19.5%, respectively. Incidence of thromboembolic events was highest within 14 days after discharge. Factors associated with ATEs included prior coronary, peripheral, or cerebrovascular disease and for VTEs included malignancy and prior liver or lung disease. ATE/VTE readmission had a 30‐day mortality of 19.9%. After a median follow‐up period of 25.6 months, ATE and VTE readmissions were associated with higher risk of mortality (hazard ratio, 2.76 [95% CI, 2.71–2.81] and 2.17 [95% CI, 2.08–2.27], respectively;
P
<0.001 for both) compared with no readmission on time‐dependent Cox regression.

Conclusions
After a HF hospitalization, 3.9% of patients were readmitted with a thromboembolic event that was associated with 2‐ to 3‐fold greater risk of mortality in follow‐up.
The Declining Use of Opioids at a Level 1 Trauma Center
Authors: Oladokun Olufemi C. , Glatt Jennifer L. , Ferrel Ethan A. , Bonnin Sophia S. , Miljkovic Stephanie , Hsueh Katherine , Lawson Abby M. , Yossi Christopher , Chapple Kristina M. , Weinberg Jordan A. , Soe-Lin Hahn 
Published: May 2022

Background The epidemic of opioid-related overdose in the United States prompted a public health response that included implementation of opioid prescribing guidelines and restrictions. Such directives, however, were not applicable to hospitalized trauma patients. We hypothesized that although prescribing mandates did not apply to hospitalized trauma patients, inpatient opioid administration had nonetheless decreased over time. Methods Opioid administrations for each patient admitted to a level I trauma center between January 1, 2016 and July 31, 2020 were converted into oral morphine milligram equivalents (MMEs) and summed at the patient level to obtain a total amount of MME administered for each hospitalization. MME was natural log transformed to achieve a normal distribution. General linear models were then used to determine the average patient MME administered by year. Patients who were pregnant or mechanically ventilated during their hospitalization were excluded. Results Six thousand five hundred ninety-four patients were included in our analysis, of which 5037 (76.4%) were treated with opioids during their hospitalization (morphine 72.7%, oxycodone 9.6%, tramadol 10.2%, fentanyl 5.5%, and hydromorphone 2.1%). The percentage of patients administered an opioid decreased stepwise from 79.3% in 2016 to 71.4% in 2020 (P < .001). For patients administered opioids, a 28% decrease in average total MME from 2016 to 2020 (P < .001) was observed. When stratified by ISS (<9, 9-15, 16+), average total MME consistently trended downward over time. Conclusion Our trauma center realized a stepwise reduction in opioid administration in the absence of rules or restrictions surrounding in-hospital opioid prescribing.
The Illicit Ecosystem of Hacking: A Longitudinal Network Analysis of Website Defacement Groups
Authors: Perkins Robert C. , Ouellet Marie , Howell Christian J. , Maimon David 
Published: May 2022

Over the past four decades, research on hackers has widely propagated within the social sciences. Although this area of scholarship yields rich insight into the interpersonal dynamics of hackers, research on the unique ecosystems they create and inhabit is scant in comparison. The current study aims to offer a more complete assessment of hackers’ ecosystems by incorporating the group affiliations which link hackers to one another. Using 12 months of archived website defacement data containing individuals’ self-reported group affiliations alongside their hacking activities, the study reconstructs the social network of hacker groups over time. Findings reveal the illicit ecosystem to be loosely connected, yet densely clustered around a few central groups. The ecosystem also maintained its network features across the observation period with no sign of structural degradation. These findings corroborate extant research on the social environments of hackers, offer an innovative look into the illicit ecosystem of website defacers, and serve as a steppingstone to extend investigations of criminal behavior to the group-level.
What is the Effectiveness of Premaxilla Surgical Repositioning and its Stabilization Methods in Mixed Dentition Patients With Bilateral Cleft Lip and Palate?
Authors: Normande Neto Henrique de Vicq , Oliveira-Neto Olavo Barbosa , Ribeiro Igor Lerner Hora , Andrade Clarisse Samara de , Sales Pedro Henrique da Hora , Lima Fernando José Camello de 
Published: May 2022

Objective Verify the effectiveness of surgical repositioning of the premaxilla and its stabilization methods in patients with bilateral cleft lip and palate during mixed dentition. Design Systematic review. Material and Methods The search was conducted in 7 databases (eg, Medline via PubMed; Scopus; Central Cochrane; LILACS; Embase, Web of Science; and Sigle via OpenGrey until August 2021), using the descriptors “premaxilla”, “cleft Palate”, and “bone transplantation”. Inclusion criteria Clinical trials and observational studies that have patients with bilateral cleft who had a need for superior/posterior repositioning of the premaxilla on mixed dentition; Studies in any language was evaluted whitout time restriction of publication. Results From 5572 records, 6 studies were included in the review with a total sample of 212 patients. Regarding the type of stabilization used in the premaxilla, the hybrid method (rigid and complementary semi-rigid stabilization) predominated, being observed in 184 patients (86.8%). A total of 17 failures were identified related to the surgical repositioning of the premaxilla, corresponding to 8% of the total number of surgeries. A meta-analysis of prevalence was performed, only with the retrospective studies. It was observed that the effectiveness rate of premaxilla repositioning was 92%, with a CI between 0.04 and 0.13, with all included studies showing a similar failure rate (0.08-0.09). The included studies also showed great homogeneity in this analysis (I2 = 0%; P = .75). Conclusion Although there are several alternatives and techniques for repositioning and stabilizing the premaxilla, the statistical result did not differ between the different techniques.
Prevalence and Distribution of Vaccine-Preventable Genital Human Papillomavirus(HPV) Genotypes in Ghanaian Women Presenting for Screening
Authors: Donkoh Emmanuel T. , Asmah Richard H. , Agyemang-Yeboah Francis , Dabo Ellis O. , Wiredu Edwin K. 
Published: May 2022

Background Cervical cancer is the most common gynaecologic cancer in Ghana where it is also the second most common cause of all female cancers. A number of vaccines are available to provide both individual and population-level protection against persistent infection with high-risk human papillomaviruses (HR-HPV) and reduce the burden of cervical cancer. Data on the epidemiology of vaccine-preventable papillomaviruses in Ghana is scant. Methods A cross-sectional observational study was implemented from May 2011 to November 2014 to understand the epidemiology of genital human papillomavirus (HPV) genotypes and cervical dysplasia in the Greater Kumasi area of Ghana. A nested multiplex polymerase chain reaction (NMPCR) assay incorporating degenerate E6/E7 consensus primers and type-specific primers was used for the detection and typing of eighteen (18) HPV genotypes among women who had never attended cervical screening prior to this study. Results The general prevalence of HPV infection in Kumasi was 37.2%. The age-standardized prevalence was 40.9% overall. The frequency of HR-HPV genotypes present in decreasing order were HPV-52, -56, -35, -18, -58, -68, -51, -39, -45, -16, -59, -33 and -31. Low-risk HPVs were also detected in the following order: HPV-42, -43, -66, -6/11 and -44. Conclusions The study shows that currently available prophylactic vaccines have the potential to be useful in the primary prevention of HPV infections in the country. This study strengthens the belief that prophylactic HPV vaccination could be a long-term strategy to reduce the burden of HPV infections and potentially reduce the burden of HPV-associated cancers and epithelial cell abnormalities among health-seeking women in Kumasi. Efforts to make vaccines available to young girls should be prioritized.
D-dimer to Creatinine Ratio: A Novel Biomarker Associated with Gensini Score in ST-Segment Elevation Myocardial Infarction Patients
Authors: Yang Jiaojiao , Zhao Yingjie , Li Yong , Tang Jianmin , Zhao Yipin 
Published: May 2022

Objective We propose for the first time that D-dimer to creatinine ratio (DCR) may serve as a new clinical biomarker and explore its association with ST-segment elevation myocardial infarction (STEMI). Methods 347 STEMI patients with complete D-dimer and creatinine were included in the analysis. According to the median of DCR value, patients were divided into the lower DCR group (DCR < 1.402, n = 173) and the higher DCR group (DCR ≥ 1.402, n = 174), and the differences between the two groups were compared. In addition, patients were divided into four groups according to the quartiles of Gensini score: Group 1(Gensini score ≤ 34, n = 88); Group 2(34 < Gensini score ≤ 65, n = 88); Group 3(65 < Gensini score ≤100, n = 87); Group 4(Gensini score ＞100, n = 84). Multivariate linear and multivariate logistic regression analyzes were performed to determine independent predictors of the Gensini score. Results High DCR group had higher Gensini score compared with the low DCR group ( P < .05). DCR was positively correlated with Gensini score (r = 0.493, P < .001). Multiple linear regression analysis showed that Previous MI (r = 11.312, P = .035) and DCR (r = 5.129, P < .001) were independent risk factors associated with the Gensini score. Multivariate logistic regression analysis showed that, compared to Group 1, DCR was an independent risk factor in Group 2, Group 3, Group 4 ( P < .001). Conclusions As a new and useful clinical biomarker, DCR was positively correlated with coronary Gensini score in STEMI patients.
ADHD Symptoms, Peer Problems, and Emotion Dysregulation as Longitudinal and Concurrent Predictors of Adolescent Borderline Personality Features
Authors: McQuade Julia D. 
Published: May 2022

Objective: ADHD and borderline personality (BP) disorder are highly comorbid and characterized by emotion dysregulation and peer problems. However, limited research has examined social and emotional predictors of BP features in samples that include youth with ADHD. Method: Using a sample of 124 youth with and without ADHD (52% female), ADHD symptoms, peer problems, and emotion dysregulation were assessed in childhood (8–13 years) and in adolescence, along with BP features (13–18 years). Results: In addition to the significant effect of ADHD symptoms, teacher-rated child peer victimization and adolescent-reported peer victimization, poorer close friendships, and emotion dysregulation domains significantly predicted adolescent BP features. Greater parent-rated child and adolescent emotion dysregulation domains also significantly predicted adolescent BP features, with ADHD symptoms no longer significant. Conclusion: Even for youth with ADHD, peer and emotional vulnerabilities in childhood and adolescence may serve as important markers of risk for adolescent BP features.
Survey of risk factors and frequency of clinical signs observed with feline cognitive dysfunction syndrome
Authors: MacQuiddy Brittany , Moreno Julie , Frank Jade , McGrath Stephanie 
Published: May 2022

Objectives The aims of this study were to distribute a survey to cat owners to identify common clinical signs of feline cognitive dysfunction (FCD) and to evaluate for potential risk factors. Methods A questionnaire was developed and adapted based on previously validated canine cognitive dysfunction questionnaires. This questionnaire was distributed to 4342 cat owners who had presented to Colorado State University Veterinary Teaching Hospital between 2015 and 2020. Cats aged ⩾8 years with signs of cognitive dysfunction and no underlying medical conditions were classified as the FCD-positive group. Cats aged ⩾8 years with no signs of cognitive dysfunction were classified as the FCD-negative control group. Chi-square or Fisher’s exact tests were used to determine associations between categorical variables and a P value <0.05 was considered indicative of evidence of association. Results A total of 615 completed survey responses were recorded, which was a response rate of 14.2%. Among those, 80 (13%) cats were identified as the FCD-positive group and 114 (18.5%) were identified as the FCD-negative control group. The most common clinical sign in the FCD-positive group was inappropriate vocalization (32/80, 40.0%). The only variable determined to have an association with the FCD group (positive or negative), with a P value of 0.033, was the environmental setting. Cats living in a rural environment (FCD-positive or -negative) had the largest contribution to the χ2 statistic. Conclusion and relevance The observed number of FCD-positive cats living in a rural community was less than the expected value based on the χ2 tests. This is suggestive of an association between living in a rural environment and a reduced chance of cognitive dysfunction. There are many factors such as air pollution, social interactions and environmental enrichment that need to be studied further to determine how they relate to FCD as this could not be concluded from this study.
Post-traumatic headache: Pathophysiology and management - A review
Authors: Blumenfeld Andrew , McVige Jennifer , Knievel Kerry 
Published: May 2022

Background Post-traumatic headache (PTH) is a common secondary headache due to traumatic brain injury. In the past, significant research has been conducted to understand the pathophysiology and treatment options for PTH. However, PTH still lacks evidence-based treatment, and most of the management depends on the primary phenotype observed in the patient. Objective The main objective of this review is to provide a single reference that covers the current understanding of the pathophysiology and the treatment options available for PTH. Methods A detailed literature search on PubMed was performed, and a narrative review was prepared. Results The pathophysiology of PTH is multifactorial. Acute PTH may be attributed to increased peripheral pain sensitization with impaired pain inhibiting pathways. Chronic or persistent PTH may be due to a chronic inflammatory response and peripheral as well as central sensitization. The mechanism responsible for the transition of acute to persistent PTH is unknown. The migraine-like phenotype is reported to be the most prevalent headache type seen in PTH. New targets for preventive treatment have been identified in recent years, such as neuropeptides like calcitonin-gene-related peptide (CGRP), nitric oxide, and glutamate. The preventive pharmacological and non-pharmacological strategies employed for migraine (e.g. anti-CGRP monoclonal antibodies, onabotulinumtoxinA, physical therapy, cognitive and behavioral treatment, and neurostimulation techniques) have shown in preliminary studies that they are potentially efficacious, but large, randomized, double blind, placebo controlled trials are needed to further establish these as treatment options for PTH. Conclusions The lack of evidence-based treatment for PTH has created a need for future large trials to confirm the safety and efficacy of the currently employed treatments.
Statistical Fragility of Single-Row Versus Double-Row Anchoring for Rotator Cuff Repair: A Systematic Review of Comparative Studies
Authors: Fackler Nathan P. , Ehlers Cooper B. , Callan Kylie T. , Amirhekmat Arya , Smith Eric J. , Parisien Robert L. , Wang Dean 
Published: May 2022

Background: Comparative studies and randomized controlled trials (RCTs) often use the P (probability) value to convey the statistical significance of their findings. P values are an imperfect measure, however, and are vulnerable to a small number of outcome reversals to alter statistical significance. The inclusion of a fragility index (FI) and fragility quotient (FQ) may aid in the interpretation of a study’s statistical strength. Purpose/Hypothesis: The purpose of this study was to examine the statistical stability of studies comparing single-row to double-row rotator cuff repair. It was hypothesized that the findings of these studies would be vulnerable to a small number of outcome event reversals, often fewer than the number of patients lost to follow-up. Study Design: Systematic review; Level of evidence, 3. Methods: We analyzed comparative studies and RCTs on primary single-row versus double-row rotator cuff repair that were published between 2000 and 2021 in 10 leading orthopaedic journals. Statistical significance was defined as a P < .05. The FI for each outcome was determined by the number of event reversals necessary to alter significance. The FQ was calculated by dividing the FI by the respective sample size. Results: Of 4896 studies screened, 22 comparative studies, 10 of which were RCTs, were ultimately included for analysis. A total of 74 outcomes were examined. Overall, the median FI was 2 (interquartile range [IQR], 1-3), and the median FQ was 0.035 (IQR, 0.020-0.057). The mean FI was 2.55 ± 1.29, and the mean FQ was 0.043 ± 0.027. In 64% of outcomes, the FI was less than the number of patients lost to follow-up.) Additionally, 81% of significant outcomes needed just a single outcome reversal to lose their significance. Conclusion: Over half of the studies currently used to guide clinical practice have a number of patients lost to follow-up greater than their FI. The results of these studies should be interpreted within the context of these limitations. Future analyses may benefit from the inclusion of the FI and the FQ in their statistical analyses.
Association Between Meeting Return-to-Sport Criteria and Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction
Authors: Ueda Yuya , Matsushita Takehiko , Shibata Yohei , Takiguchi Kohei , Ono Kumiko , Kida Akihiro , Ono Rei , Nagai Kanto , Hoshino Yuichi , Matsumoto Tomoyuki , Sakai Yoshitada , Kuroda Ryosuke 
Published: May 2022

Background: The relationship between meeting return-to-sport criteria and psychological readiness after anterior cruciate ligament (ACL) reconstruction is unknown. Purposes: To examine (1) whether patients who met 1 of the criteria for return to sport had higher psychological readiness than those who did not meet any of the criteria and (2) if those who met more criteria had higher psychological readiness. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included 144 patients who underwent unilateral ACL reconstruction. All patients had regularly participated in some sport activities before an ACL rupture. At 12 months postoperatively, each patient completed 3 knee function tests (isokinetic quadriceps strength, isokinetic hamstring strength, and single-leg hop distance) and 2 self-reported measures (International Knee Documentation Committee [IKDC] 2000 subjective form and ACL–Return to Sport after Injury [ACL-RSI] scale); the ACL-RSI scale was used to measure psychological readiness to return to sport. The 4 criteria for return to sport were a limb symmetry index (LSI) ≥90% for each of the 3 function tests in addition to an IKDC score ≥90. Multivariate regression analysis was used to determine the association between meeting the individual criteria and the ACL-RSI score. In addition, the patients were divided into 5 groups according to the number of criteria met, and the Kruskal-Wallis and Steel-Dwass tests were used to compare the ACL-RSI scores among the groups. Results: Overall, 23 patients (16.0%) met none of the criteria for return to sport, 27 (18.7%) met 1 of the criteria, 34 (23.6%) met 2 criteria, 35 (24.3%) met 3 criteria, and 25 (17.4%) met all 4 criteria. Meeting the criteria for the hamstring strength LSI ( P = .002), single-leg hop distance LSI ( P = .004), and IKDC subjective score ( P < .001) was each associated with higher ACL-RSI scores. Significant differences in ACL-RSI scores were found between patients who met none versus 2, 3, and 4 of the return-to-sport criteria ( P < .001 for all) and between patients who met 1 versus 4 criteria ( P < .001). Conclusion: Meeting return-to-sport criteria was positively associated with psychological readiness, and the patients who met multiple criteria had higher psychological readiness.