bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefit of carotid revascularisation for women with symptomatic carotid stenosis: protocol for a systematic review
Authors: Bereznyakova Olena , Dewar Brian , Dowlatshahi Dar , Howard Virginia , Hamel Candyce , Gocan Sophia , Fedyk Mark , Shamy Michel 
Published: November 2019

IntroductionCarotid intervention in the form of endarterectomy or stenting is the current standard of care for the majority of patients with symptomatic high-grade carotid stenosis. However, some randomised controlled trials (RCT) have demonstrated that women benefited significantly less from intervention than men. It is unclear if this is a true phenomenon or a study sampling artefact, as women were severely under-represented in all RCTs of carotid revascularisation. A systematic review is needed to summarise the existing data and to answer the question of whether a women-only trial for symptomatic patients with ipsilateral carotid stenosis is scientifically necessary and ethically permissible.Methods and analysisWe will systematically search Medline, Embase, PubMed and the Cochrane libraries for all studies with data from RCTs that included women and compared either endarterectomy with stenting or revascularisation (by means of endarterectomy or stenting) with medical therapy in patients with symptomatic carotid stenosis. Search dates will be restricted to 1991–2018. Two reviewers will conduct screening search results, study selection, data extraction and quality assessment. We will include all studies reporting outcomes of interest. Planned subgroup analysis based on revascularisation technique, degree of stenosis and timing of intervention from the index event will be conducted with enough data.Ethics and disseminationThis research is exempt of ethics approval as no primary data will be collected. The results will be published in peer-reviewed journals and disseminated through national and international-level conferences and scientific meetings. The result of this comprehensive review will provide useful information on whether further RCTs are required to study a women-only population with symptomatic carotid disease.PROSPERO registration numberCRD42019134967.
Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies
Authors: Bjørnnes Ann Kristin , Moons Philip , Parry Monica , Halvorsen Sigrun , Tønnessen Theis , Lie Irene 
Published: November 2019

ObjectivesTo provide a comprehensive synthesis of informal caregivers’ experiences of caring for a significant other following discharge from cardiac surgery.DesignSystematic integrated review without meta-analysis.Data sourcesA bibliographic search for publications indexed in six databases (Cochrane Library, CINAHL, MEDLINE, EMBASE, AMED and PsycINFO), including a scan of grey literature sources (GreyNet International, Google Scholar, Web of Science, WorldCat and the Clinical Trials Registry) was conducted in October 2018.Eligibility criteria for selecting studiesStudies were included if they described views and perspectives of informal caregivers of cardiac surgery patients (non-intervention studies (qualitative and quantitative)), and the effectiveness of interventions to evaluate support programme for informal caregivers of cardiac surgery patients (intervention studies).ResultsOf the 4912 articles identified in searches, 42 primary research studies were included in a narrative synthesis with 5292 participants, including 3231 (62%) caregivers of whom 2557 (79%) were women. The median sample size across studies was 96 (range 6–734). Three major themes emerged from the qualitative study data: (1) caregiver information needs; (2) caregiver work challenges and (3) caregivers adaption to recovery. Across the observational studies (n=22), similar themes were found. The trend across seven intervention studies focused on caregiver information needs related to patient disease management and symptom monitoring, and support for caregivers to reduce symptoms of emotional distress.ConclusionInformal caregivers want to assist in the care of their significant others after hospital discharge postcardiac surgery. However, caregivers feel insecure and overwhelmed and they lack clear/concise discharge information and follow-up support during the early at-home recovery period. The burden of caregiving has been recognised and reported since the early 1990s, but there remains a limited number of studies that assesses the effectiveness of caregiver interventions.PROSPERO registration numberCRD42018096590.
GARFIELD-AF model for prediction of stroke and major bleeding in atrial fibrillation: a Danish nationwide validation study
Authors: Dalgaard Frederik , Pieper Karen , Verheugt Freek , Camm A John , Fox Keith AA , Kakkar Ajay K , Pallisgaard Jannik L , Rasmussen Peter V , Weert Henk van , Lindhardt Tommi Bo , Torp-Pedersen Christian , Gislason Gunnar H , Ruwald Martin H , Harskamp Ralf E 
Published: November 2019

ObjectivesTo externally validate the accuracy of the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) model against existing risk scores for stroke and major bleeding risk in patients with non-valvular AF in a population-based cohort.DesignRetrospective cohort study.SettingDanish nationwide registries.Participants90 693 patients with newly diagnosed non-valvular AF were included between 2010 and 2016, with follow-up censored at 1 year.Primary and secondary outcome measuresExternal validation was performed using discrimination and calibration plots. C-statistics were compared with CHA2DS2VASc score for ischaemic stroke/systemic embolism (SE) and HAS-BLED score for major bleeding/haemorrhagic stroke outcomes.ResultsOf the 90 693 included, 51 180 patients received oral anticoagulants (OAC). Overall median age (Q1, Q3) were 75 (66–83) years and 48 486 (53.5%) were male. At 1-year follow-up, a total of 2094 (2.3%) strokes/SE, 2642 (2.9%) major bleedings and 10 915 (12.0%) deaths occurred. The GARFIELD-AF model was well calibrated with the predicted risk for stroke/SE and major bleeding. The discriminatory value of GARFIELD-AF risk model was superior to CHA2DS2VASc for predicting stroke in the overall cohort (C-index: 0.71, 95% CI: 0.70 to 0.72 vs C-index: 0.67, 95% CI: 0.66 to 0.68, p<0.001) as well as in low-risk patients (C-index: 0.64, 95% CI: 0.59 to 0.69 vs C-index: 0.57, 95% CI: 0.53 to 0.61, p=0.007). The GARFIELD-AF model was comparable to HAS-BLED in predicting the risk of major bleeding in patients on OAC therapy (C-index: 0.64, 95% CI: 0.63 to 0.66 vs C-index: 0.64, 95% CI: 0.63 to 0.65, p=0.60).ConclusionIn a nationwide Danish cohort with non-valvular AF, the GARFIELD-AF model adequately predicted the risk of ischaemic stroke/SE and major bleeding. Our external validation confirms that the GARFIELD-AF model was superior to CHA2DS2VASc in predicting stroke/SE and comparable with HAS-BLED for predicting major bleeding.
Group education for adolescents with type 1 diabetes during transition from paediatric to adult care: study protocol for a multisite, randomised controlled, superiority trial (GET-IT-T1D)
Authors: Mok Elise , Henderson Melanie , Dasgupta Kaberi , Rahme Elham , Hajizadeh Mohammad , Bell Lorraine , Prevost Melinda , Frei Jennifer , Nakhla Meranda 
Published: November 2019

IntroductionTransition from paediatric to adult care is challenging for adolescents and emerging adults (ages 18 to 30 years) with type 1 diabetes (T1D). This transition is characterised by a deterioration in glycaemic control (haemoglobin A1c (HbA1c)), decreased clinical attendance, poor self-management and increased acute T1D-related complications. However, evidence to guide delivery of transition care is lacking. Given the effectiveness of group education in adult diabetes glycaemic control and improvements in qualitative measures in paediatric diabetes, group education is a potentially feasible and cost-effective alternative for the delivery of transition care. In emerging adults with T1D, we aim to assess the effectiveness of group education visits compared with usual care on HbA1c, T1D-related complications, psychosocial measures and cost-effectiveness after the transfer to adult care.Methods and analysisIn a multisite, assessor-blinded, randomised, two-arm, parallel-group, superiority trial, 212 adolescents with T1D (ages 17 years) are randomised to 12 months group education versus usual T1D care before transfer to adult care. Visits in the active arm consist of group education sessions followed by usual T1D care visits every 3 months. Primary outcome is change in HbA1c measured at 24 months. Secondary outcomes are delays in establishing adult diabetes care, T1D-related hospitalisations and emergency department visits, severe hypoglycaemia, stigma, self-efficacy, diabetes knowledge, transition readiness, diabetes distress, quality of life and cost-effectiveness at 12 and 24 months follow-up. Analysis will be by intention-to-treat. Change in HbA1c will be calculated and compared between arms using differences (95% CI), along with cost-effectiveness analysis. A similar approach will be conducted to examine between-arm differences in secondary outcomes.Ethics and disseminationThe study was approved by McGill University Health Centre Research Ethics Board (GET-IT/MP-37-2019-4434, version ‘Final 1.0 from November 2018). Study results will be disseminated through peer-reviewed publications.Trial registration numberNCT03703440.
Seasonal variability of lung function and Asthma Quality of Life Questionnaire Scores in adults with uncontrolled asthma
Authors: Bauer Rebecca N , Yang Xiaoying , Staton Tracy L , Olsson Julie , Holweg Cecile T J , Arron Joseph R , Matthews John G , Choy David F 
Published: November 2019

IntroductionAsthma exacerbations spike in the spring and autumn months, yet the seasonal variation of asthma symptoms and lung function is poorly studied.MethodsSeasonal variation of lung function, rescue medication use and patient-reported symptoms was evaluated byposthocanalyses of the Phase III lebrikizumab (anti-IL-13) LAVOLTA I and II studies in 2148 subjects with uncontrolled asthma. Lung function measurements (prebronchodilator FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF)), rescue medication use and Standardised Asthma Quality of Life Questionnaire (AQLQ(S)) were measured every 4 weeks over 52 weeks. By-month estimates normalised by hemispheric season were based on mixed-effect models with repeated measures (MMRM), adjusted by study stratification factors as covariates when appropriate. The dependency of clinical outcomes with seasonal variability was assessed by employing linear contrasts comparing hemisphere normalised December versus July group means from an MMRM regression and presented as the difference in means (adjusted 95% CI).ResultsFEV1, FVC and PEF, rescue medication use and AQLQ(S) progressively worsened towards winter, unlike spring and autumn surges in asthma exacerbations. The December versus July mean differences were: (1) PEF=−6.5 (–8.7 to –4.2) L/min, 2) prebronchodilator FEV1=−42 (–57 to –27) mL, (3) FVC=−41 (−59 to –23) mL and (4) AQLQ(S)=−0.15 (–0.19 to –0.1) units. Among AQLQ questions, discomfort or distress related to cough was most variable with respect to season (−0.33 (−0.42 to –0.24) units).DiscussionInterpretation of interventional studies biased by seasonal exposures may be confounded by seasonal variability.Trials registration numbersNCT01867125andNCT01868061.
Skeletal muscle mass in relation to 10 year cardiovascular disease incidence among middle aged and older adults: the ATTICA study
Authors: Tyrovolas Stefanos , Panagiotakos Demosthenes , Georgousopoulou Ekavi , Chrysohoou Christina , Tousoulis Dimitrios , Haro Josep Maria , Pitsavos Christos 
Published: November 2019

BackgroundSkeletal muscle mass (SMM) is inversely associated with cardiometabolic health and the ageing process. The aim of the present work was to evaluate the relation between SMM and 10 year cardiovascular disease (CVD) incidence, among CVD-free adults 45+ years old.MethodsATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek general population (Caucasians; age ≥18 years; 1514 men). The 10 year study follow-up (2011–2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). The working sample consisted of 1019 participants, 45+ years old (men: n=534; women: n=485). A skeletal muscle mass index (SMI) was created to reflect SMM, using appendicular skeletal muscle mass (ASM) standardised by body mass index (BMI). ASM and SMI were calculated with specific indirect population formulas.ResultsThe 10 year CVD incidence increased significantly across the baseline SMI tertiles (p<0.001). Baseline SMM showed a significant inverse association with the 10 year CVD incidence (HR 0.06, 95% CI 0.005 to 0.78), even after adjusting for various confounders. Additionally, participants in the highest SMM tertile had 81% (95% CI 0.04 to 0.85) lower risk for a CVD event as compared with those in the lowest SMM tertile.ConclusionsThe presented findings support the importance of SMM evaluation in the prediction of long-term CVD risk among adults 45+ years old without pre-existing CVD. Preservation of SMM may contribute to CVD health.
Safety and efficacy of an open-cell stent and double-balloon protection for unstable plaques: analysis of 184 consecutive carotid artery stentings
Authors: Funakoshi Yusuke , Imamura Hirotoshi , Tani Shoichi , Adachi Hidemitsu , Fukumitsu Ryu , Sunohara Tadashi , Omura Yoshihiro , Matsui Yuichi , Sasaki Natsuhi , Fukuda Tatsumaru , Akiyama Ryo , Horiuchi Kazufumi , Kajiura Shinji , Shigeyasu Masashi , Iihara Koji , Sakai Nobuyuki 
Published: November 2019

IntroductionIn our institute, most cases of carotid artery stenosis are treated by carotid artery stenting (CAS) with an open-cell stent and double-balloon protection, even if plaques are unstable. This study was performed to examine the outcome of CAS with an open-cell stent and double-balloon protection for unstable plaques.MethodsA total of 184 CAS procedures in our institute between October 2010 and February 2018 were assessed. Ultrasonography findings of low-echo plaques, plaque ulceration, or both were defined as unstable plaques. A plaque-to-muscle ratio (PMR) of >1.8 on T1-weighted black blood imaging using spin-echo was also defined as an unstable plaque. Seventy-four unstable plaques on ultrasonography and 86 unstable plaques evaluated by PMR were included. Open-cell stents and double-balloon protection (proximal balloon protection during lesion crossing and distal balloon protection after lesion crossing) were used in all cases.ResultsOn ultrasonography, perioperative asymptomatic thromboembolization was significantly more frequent in the unstable plaque group (39/74, 52.7%) than in the stable plaque group (41/110, 37.3%, p=0.0384). Asymptomatic thromboembolization was also significantly more frequent in the PMR >1.8 group (44/86, 51.2%) than in the PMR <1.8 group (36/98, 36.7%, p=0.0489). However, symptomatic thromboembolization was rare (n=5, 2.7%), and all of these patients had minor stroke. During the 4-year follow-up, the risk of ipsilateral stroke was 0.28% and 0.27% per year in patients with symptomatic and asymptomatic lesions, respectively.ConclusionsThe outcomes of CAS with an open-cell stent and double-balloon protection are acceptable. This method is effective and safe, even if carotid artery stenosis comprises unstable plaques.
MRI-guided pulmonary vein isolation for atrial fibrillation: what is good enough? An early health technology assessment
Authors: Wenker Steven , van Lieshout Chris , Frederix Geert , van der Heijden Jeroen , Loh Peter , Chamuleau Steven A J , van Slochteren Frebus 
Published: November 2019

Next to anticoagulation, pulmonary vein isolation (PVI) is the most important interventional procedure in the treatment of atrial fibrillation (AF). Despite widespread clinical application of this therapy, patients often require multiple procedures to reach clinical success. In contrast to conventional imaging modalities, MRI allows direct visualisation of the ablation lesion. Therefore, the use of real-time MRI to guide cardiac electrophysiology procedures may increase clinical effectiveness. An essential aspect, from a decision-making point of view, is the effect on costs and the potential cost-effectiveness of new technologies. Generally, health technology assessment (HTA) studies are performed when innovations are close to clinical application. However,earlystage HTA can inform users, researchers and funders about the ultimate clinical and economic potential of a future innovation. Ultimately, this can guide funding allocation. In this study, we performed an early HTA evaluate MRI-guided PVIs.MethodsWe performed an economic evaluation using a decision tree with a time-horizon of 1 year. We calculated theclinical effectiveness(defined as the proportion of patients that is long-term free of AF after a single procedure) required for MRI-guided PVI to be cost-effective compared with conventional treatment.ResultsDepending on thecost-effectiveness threshold(willingness to pay for one additional quality-of-life adjusted life year (QALY), interventional MRI (iMRI) guidance for PVI can be cost-effective if clinical effectiveness is 69.8% (at €80 000/QALY) and 77.1% (at €20 000/QALY), compared with 64% for fluoroscopy-guided procedures.ConclusionUsing an early HTA, we established a clinical effectiveness threshold for interventional MRI-guided PVIs that can inform a clinical implementation strategy. If crucial technologies are developed, it seems plausible that iMRI-guided PVIs will be able to reach this threshold.
Berea sandstone: A heritage stone of international significance from Ohio, USA
Authors: Hannibal Joseph T. 
Published: November 2019

Abstract
Berea sandstone, a potential Global Heritage Stone Resource, has been one of the most widely used sandstones in North America. This Paleozoic sandstone, quarried for more than 200 years in Ohio, has been used across much of the continent. Thousands of commercial, residential, ecclesiastical, government and other structures have been built with Berea sandstone, including Thomas Worthington's mansion in Chillicothe, Ohio, the Michigan Capitol in Lansing, Michigan, the Carnegie Library and Natural History Museum Building in Pittsburgh, Pennsylvania, and parts of the Parliament buildings in Canada. Grindstones made from Berea sandstone were shipped throughout North America, as well as to the Caribbean, South America, Europe and Asia. The stone is celebrated in a number of locations, notably Berea and Amherst, where quarries have been important historical sources of this stone. It has been known by a number of different geological and commercial names, including Berea grit and Amherst stone, complicating its identification from historical sources. Stone from the most productive quarries, however, was known to be homogeneous and can be identified by its quartz–arenite to sublithic–arenite composition, its fine to medium sand (125–350 µm) grain size and iron-cement spots. Berea sandstone continues to be quarried today in Erie and Lorain counties.
Triggers of sand remobilization in deep marine deposits
Authors: Hermanrud C. , Christensen E. , Haugvaldstad M. , Røynestad L. M. , Tjensvold I. T. , Watsend L. 
Published: November 2019

Abstract
Sand injections are overrepresented in deep marine deposits and other settings with slope instabilities. We have examined seismic data from the North Sea to reveal their main trigger mechanisms. This was performed by inspection of local seismic observations in the Oligocene to Miocene sediments above the Utsira High and analyses of regional distribution of mounds at the top Hordaland Group surface in the northern North Sea. We make the observations that (1) the uplift of jack-up folds is in most cases larger than the sand thickness within the mounds, (2) onlap to mounds is present in periods with sand deposition, but no such onlap is seen in mudstones that were deposited in periods with little or no sand input, (3) onlapping to several Oligocene surfaces is seen above the Utsira High, (4) rim synclines are not present adjacent to Oligocene and Miocene mounds and (5) mounds that affect the top Hordaland Group surface are present in basin flanks and at basin-flank transitions but not in basin centres. We suggest that triggering by incipient slab sliding can explain these observations.
Archaeointensity of nineteenth-century Scottish firebricks from a foundry in Melbourne, Australia: comparisons with field models and magnetic observatory data
Authors: Lisé-Pronovost Agathe , Mallett Tom , Herries Andy I. R. 
Published: November 2019

Abstract
An archaeomagnetic intensity study was conducted on nineteenth-century firebricks manufactured in Scotland and used in an iron foundry in Melbourne, Australia, between 1842 and 1864 CE. Archaeointensity results obtained from bricks with a single component of magnetization gave values of 61.45 ± 0.89 and 61.92 ± 6.84 μT. These values are in agreement with historical absolute intensity measurements taken at the Melbourne geomagnetic observatory between 1858 and 1863 CE (61.17 ± 0.078 μT) and with the gufm1 model based on mariners’ data. A high-temperature vector component, presumably acquired at the time of manufacture in Scotland, was isolated in certain firebricks and an archaeointensity of 48.3 ± 8.39 μT was obtained, which is consistent with the gufm1 model for Scotland at this time (48.79 μT). The dual archaeointensity record of the firebricks supports their geographical provenance, highlighting the potential for archaeointensity data to be used in archaeological artefact-sourcing studies, whilst anomalously high intensities recorded in one of the bricks highlight potential contamination issues from non-Earth magnetic fields in archaeometallurgical contexts. The new Melbourne archaeointensity data are the most precisely dated archaeomagnetic data produced so far for Australia.
How the Geological Survey of Sweden contributes digital data for sustainable development
Authors: Söderberg Lena , Stölen Lars-Kristian , Levén Jakob , Snowball Lovisa Zillén , Reginiussen Helge 
Published: November 2019

Abstract

Changes in society coupled with more ambitious environmental goals increase the need to make the benefits of geological knowledge visible. The Geological Survey of Sweden (SGU) is therefore evolving from its historical role as a ‘knowledge bank’ to become part of the integrated flow of public information. Three examples of the ongoing digital transformation, and how this will enable the SGU to contribute digital geological data for sustainable development, are:

more automated data collection to monitor drinking water to be able to foresee water shortages;

several new non-traditional marine projects, producing new information and recommendations for innovative measures to support Blue Growth, management and planning;

an online virtual archive containing new data adding to our understanding of bedrock and mineral deposits, in turn leading to more efficient use of Sweden's mineral resources.