Search Results (3)

(1) Background: Antiphospholipid syndrome (APS) is associated with thrombotic events and the laboratory identification of antiphospholipid antibodies (aPL), in which lupus anticoagulant (LA), anticardiolipin (aCL), and anti-β2 glycoprotein I antibodies are included. The aim of the current retrospective study is to examine clinical characteristics and risk factors of ischemic stroke as a clinical manifestation of APS. (2) Methods: Adult patients diagnosed with APS between 1 January 2009 and 1 June 2024 were retrospectively enrolled in this study. Sydney-revised Sapporo criteria were used for the diagnosis of APS, while ischemic stroke was diagnosed based on the acute onset of focal neurologic deficits and confirmed with radiological findings. (3) Results: We studied 115 patients with APS. Specifically, 28 (24.35%) patients, with a mean age (standard deviation) of 54 (±12.5), had ischemic stroke as a clinical manifestation of APS. In univariate analysis, stroke development was associated with the following factors: age (p < 0.001), livedo reticularis (p = 0.046), avascular necrosis (AVN) (p = 0.046), hypertension (p < 0.001), dyslipidemia (p = 0.013), aCL IgG (U/L) antibodies title (p = 0.035), and adjusted global APS score (aGAPSS) (p = 0.047), while in multivariate analysis, it was associated with age (p = 0.006), hypertension (p < 0.001), AVN (p = 0.006), livedo reticularis (p = 0.035), aCL IgG title (p = 0.004), and aGAPSS (p = 0.002). (4) Conclusions: Stroke is a common initial manifestation of APS, with cardiovascular risk factors, particularly hypertension, being highly prevalent. Full article

Background/Objectives: Our aim was to validate the performance of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for antiphospholipid syndrome (APS), published in 2023, in an APS cohort. Methods: A total of 193 patients, 83 with APS (secondary APS, n = 45; primary APS, n = 38) and 110 without APS (systemic lupus erythematosus (SLE), n = 100; others, n = 10), were included in this study. The performance (sensitivity, specificity and area under the curve (AUC)) of the 2023 ACR/EULAR classification criteria for APS was evaluated and the agreement with the revised Sapporo criteria was compared using the kappa test. Results: In our cohort, the sensitivity and specificity of the 2023 ACR/EULAR classification criteria for APS were 73% and 94%, respectively (AUC: 0.836, 95% CI: 0.772–0.899), while the sensitivity and specificity of the revised Sapporo criteria were 66% and 98%, respectively (95% CI: 0.756–0.888). The performance of the two sets of criteria in our cohort was significantly consistent and significant (p < 0.001). When the sensitivity, specificity and ROC curve analysis were performed again by excluding livedo racemosa, the sensitivity of the new criteria in our cohort was 62% and the specificity was 100% (AUC: 0.813, 95% CI: 0.746–0.881). Conclusions: Although the newly published criteria broaden the scope of APS classification by including clinical findings other than thrombosis and obstetric criteria, their sensitivity in our cohort was low. On the other hand, we found that the specificity of the criteria in our cohort reached 100% when livedo findings were excluded. Full article

Measures of sustainability-related participatory programs vary according to social and cultural contexts. Thus, this study proposed a stepwise participatory program in which stakeholders and randomly chosen citizens (citizen panels) were repeatedly and sequentially involved, and the citizen panels discharged discrete functions through all the planning stages. Procedural and outcome fairness was focal to the evaluation of the participatory program because these criteria are widely deemed essential for public acceptance. Evaluation by nonparticipants was imperative because of the limited number of participants, but sustainability plans affect and mandate the cooperation of the general public. Therefore, this study undertaken during the revision of the city of Sapporo’s environmental master plan compared evaluations of nonparticipants with those of participants from three stages of the stepwise participatory program applying backcasting scenario workshops. A two-wave mailout survey was administered to test two hypotheses: (a) workshop participants would evaluate the acceptance, process, outcome, and antecedent factors more positively than nonparticipants, and (b) procedural fairness and evaluation of expected outcomes would affect acceptance. The results supported these hypotheses. Procedural fairness was associated with acceptance most robustly and consistently. The study’s primary contribution to the extant literature entails accumulating empirical evidence on stepwise participatory programs. Full article