bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Mellitus Prevalence and Burden among Community Acquired Pneumonia Patients
Authors: Ibrahem Reda Abdel Latif , El Najjar Mostafa , Raouf Korani Mohamed Abdel 
Published: April 2018

<strong></strong>This work aimed at measuring the prevalence of Diabetes Mellitus among community acquired pneumonia (CAP) patients and declaring its effect on CAP patient's outcome. Both community acquired pneumonia and diabetes mellitus are common in Egypt, and patients with associated CAP and DM need special care and supervision. This prospective study was carried out on 108 CAP patients admitted to Abassia Chest Hospital during the period from January 2016 to December 2016. Clinical and radiological diagnosis of pneumonia and DM diagnosis were performed. DM recorded a prevalence of 39.8% among community acquired pneumonia patients. Disturbed level of consciousness is more frequent among diabetic patients than non diabetics. Diabetic patients recorded higher rate of hospital admission, longer duration of hospital stay, higher rate of ICU admission and more sever pneumonia than among non diabetic patients. CURB-65 score showed significant positive correlation with HbA1c of the patients. Associated community-acquired pneumonia and diabetes mellitus is frequent in our locality and labor a double burden on the affected patients leading to poorer prognosis, higher rate of hospitalization with longer duration of hospital stay and ICU admission. So CAP patients with DM need intimate care.
O-Linked β-N-Acetylglucosamine Modification of A20 Enhances the Inhibition of NF-κB (Nuclear Factor-κB) Activation and Elicits Vascular Protection After Acute Endoluminal Arterial Injury
Authors: Yao Dan , Xu Lijuan , Xu Oufan , Li Rujun , Chen Mingxing , Shen Hui , Zhu Huajiang , Zhang Fengyi , Yao Deshang , Chen Yiu-Fai , Oparil Suzanne , Zhang Zhengang , Gong Kaizheng 
Published: April 2018

Objective—
Recently, we have demonstrated that acute glucosamine-induced augmentation of protein O-linked β-N-acetylglucosamine (O-GlcNAc) levels inhibits inflammation in isolated vascular smooth muscle cells and neointimal formation in a rat model of carotid injury by interfering with NF-κB (nuclear factor-κB) signaling. However, the specific molecular target for O-GlcNAcylation that is responsible for glucosamine-induced vascular protection remains unclear. In this study, we test the hypothesis that increased A20 (also known as TNFAIP3 [tumor necrosis factor α-induced protein 3]) O-GlcNAcylation is required for glucosamine-mediated inhibition of inflammation and vascular protection.

Approach and Results—
In cultured rat vascular smooth muscle cells, both glucosamine and the selective O-linked N-acetylglucosaminidase inhibitor thiamet G significantly increased A20 O-GlcNAcylation. Thiamet G treatment did not increase A20 protein expression but did significantly enhance binding to TAX1BP1 (Tax1-binding protein 1), a key regulatory protein for A20 activity. Adenovirus-mediated A20 overexpression further enhanced the effects of thiamet G on prevention of TNF-α (tumor necrosis factor-α)–induced IκB (inhibitor of κB) degradation, p65 phosphorylation, and increases in DNA-binding activity. A20 overexpression enhanced the inhibitory effects of thiamet G on TNF-α–induced proinflammatory cytokine expression and vascular smooth muscle cell migration and proliferation, whereas silencing endogenous A20 by transfection of specific A20 shRNA significantly attenuated these inhibitory effects. In balloon-injured rat carotid arteries, glucosamine treatment markedly inhibited neointimal formation and p65 activation compared with vehicle treatment. Adenoviral delivery of A20 shRNA to the injured arteries dramatically reduced balloon injury–induced A20 expression and inflammatory response compared with scramble shRNA and completely abolished the vascular protection of glucosamine.

Conclusions—
These results suggest that O-GlcNAcylation of A20 plays a key role in the negative regulation of NF-κB signaling cascades in TNF-α–treated vascular smooth muscle cells in culture and in acutely injured arteries, thus protecting against inflammation-induced vascular injury.
Settlement of Stenotic Site and Enhancement of Risk Factor Load for Atherosclerosis in Left Anterior Descending Coronary Artery by Myocardial Bridge
Authors: Akishima-Fukasawa Yuri , Ishikawa Yukio , Mikami Tetuo , Akasaka Yoshikiyo , Ishii Toshiharu 
Published: April 2018

Objective—
The aim of this study was to investigate the influence of a myocardial bridge (MB) on atherosclerosis development in the left anterior descending artery of the normal heart and the importance of traditional risk factors (RFs). An additional objective was to determine the correlation between intimal thickening and luminal narrowing.

Approach and Results—

The left anterior descending artery from 150 autopsied hearts was treated with formalin perfusion fixation, and each left anterior descending artery was serially cross-sectioned. The intima–media and luminal stenosis ratios were examined using computer-assisted histomorphometry. The luminal stenosis ratio was closely correlated with the intima–media ratio (
r
=0.792;
P
<0.001). When an MB was present, the luminal stenosis ratios proximal to the MB in the RF (+) group were significantly greater than those in the RF (−) group (
P
=0.022 by a multiple comparison test), but there were no differences between the RF (+) and RF (−) groups when an MB was absent. In addition, the site of the greatest stenosis in the MB (+) RF (+) group was 2.5 cm proximal to the MB entrance. Multivariate analyses indicated that age was an independent factor for luminal stenosis ratios ≥50% and 60% (
P
=0.002 and 0.029, respectively). Furthermore, the presence of an MB plus RFs was an independent factor for a luminal stenosis ratio ≥70% (
P
=0.037).

Conclusions—
An MB enhances left anterior descending artery atherosclerosis development at a site proximal to the MB entrance, particularly in subjects who have some RFs.
Prevalence and Progression of Late Gadolinium Enhancement in Children and Adolescents With Hypertrophic Cardiomyopathy
Authors: Axelsson Raja Anna , Farhad Hoshang , Valente Anne Marie , Couce John-Paul , Jefferies John Lynn , Bundgaard Henning , Zahka Kenneth , Lever Harry , Murphy Anne M. , Ashley Euan , Day Sharlene M. , Sherrid Mark V. , Shi Ling , Bluemke David A. , Canter Charles E. , Colan Steven D. , Ho Carolyn Y. , Towbin Jeff , Russell Mark , Patel Amit , Kim Bette , Taylor Matthew , Mestroni Luisa 
Published: April 2018

Background:
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) is believed to represent dense replacement fibrosis. It is seen in ≈60% of adult patients with hypertrophic cardiomyopathy (HCM). However, the prevalence of LGE in children and adolescents with HCM is not well established. In addition, longitudinal studies describing the development and evolution of LGE in pediatric HCM are lacking. This study assesses the prevalence, progression, and clinical correlations of LGE in children and adolescents with, or genetically predisposed to, HCM.

Methods:
CMR scans from 195 patients ≤21 years of age were analyzed in an observational, retrospective study, including 155 patients with overt HCM and 40 sarcomere mutation carriers without left ventricular (LV) hypertrophy. The extent of LGE was quantified by measuring regions with signal intensity >6 SD above nulled remote myocardium.

Results:

Patients were 14.3±4.5 years of age at baseline and 68% were male. LGE was present in 70 (46%) patients with overt HCM (median extent, 3.3%; interquartile range, 0.8–7.1%), but absent in mutation carriers without LV hypertrophy. Thirty-one patients had >1 CMR (median interval between studies, 2.4 years; interquartile range, 1.5–3.2 years). LGE was detected in 13 patients (42%) at baseline and in 16 patients (52%) at follow-up CMR. The median extent of LGE increased by 2.4 g/y (range, 0–13.2 g/y) from 2.9% (interquartile range, 0.8–3.2%) of LV mass to 4.3% (interquartile range, 2.9–6.8%) (
P
=0.02). In addition to LGE, LV mass and left atrial volume, indexed to body surface area, and
z
score for LV mass, as well, increased significantly from first to most recent CMR.

Conclusions:
LGE was present in 46% of children and adolescents with overt HCM, in contrast to ≈60% typically reported in adult HCM. In the subset of patients with serial imaging, statistically significant increases in LGE, LV mass, and left atrial size were detected over 2.5 years, indicating disease progression over time. Further prospective studies are required to confirm these findings and to better understand the clinical implications of LGE in pediatric HCM.
Efficacy and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Asians With Nonvalvular Atrial Fibrillation
Authors: Chan Yi‐Hsin , See Lai‐Chu , Tu Hui‐Tzu , Yeh Yung‐Hsin , Chang Shang‐Hung , Wu Lung‐Sheng , Lee Hsin‐Fu , Wang Chun‐Li , Kuo Chang‐Fu , Kuo Chi‐Tai 
Published: April 2018

Background

Whether non–vitamin K antagonist oral anticoagulants (
NOAC
s) are superior to warfarin among Asians with nonvalvular atrial fibrillation remains unclear.

Methods and Results

In this nationwide retrospective cohort study collected from Taiwan National Health Insurance Research Database, there were 5843, 20 079, 27 777, and 19 375 nonvalvular atrial fibrillation patients taking apixaban, dabigatran, rivaroxaban and warfarin, respectively, from June 1, 2012 to December 31, 2016. Propensity‐score weighting was used to balance covariates across study groups. Patients were followed until the first occurrence of any efficacy or safety outcome or the end date of study. Hazard ratios (95% confidence intervals) comparing apixaban, dabigatran, and rivaroxaban with warfarin were: ischemic stroke/systemic embolism (
IS
/
SE
), 0.55 (0.43–0.69), 0.82 (0.68–0.98), and 0.81 (0.67–0.97); major bleeding, 0.41 (0.31–0.53), 0.65 (0.53–0.80), and 0.58 (0.46–0.72); and all‐cause mortality, 0.58 (0.51–0.66), 0.61 (0.54–0.68), and 0.57 (0.51–0.65). A total of 3623 (62%), 17 760 (88%), and 26 000 (94%) patients were taking low‐dose apixaban (2.5 mg twice daily), dabigatran (110 mg twice daily), and rivaroxaban (10–15 mg once daily), respectively. Similar to all‐dose
NOAC
s, all low‐dose
NOAC
s had lower risk of
IS
/
SE
, major bleeding, and mortality when compared with warfarin. In contrast to other standard‐dose
NOAC
s, apixaban was associated with lower risks of
IS
/
SE
(0.45 [0.31–0.65]), major bleeding (0.29 [0.18–0.46]), and mortality (0.23 [0.17–0.31]) than warfarin.

Conclusions

All
NOAC
s were associated with lower risk of
IS
/
SE
, major bleeding, and mortality compared with warfarin in the largest real‐world practice among Asians with nonvalvular atrial fibrillation. All low‐dose
NOAC
s had lower risk of
IS
/
SE
, major bleeding, and mortality when compared with warfarin. Standard‐dose apixaban caused a lower risk of
IS
/
SE
, major bleeding, and mortality compared with warfarin.
Genome‐Wide Associations of Global Electrical Heterogeneity ECG Phenotype: The ARIC (Atherosclerosis Risk in Communities) Study and CHS (Cardiovascular Health Study)
Authors: Tereshchenko Larisa G. , Sotoodehnia Nona , Sitlani Colleen M. , Ashar Foram N. , Kabir Muammar , Biggs Mary L. , Morley Michael P. , Waks Jonathan W. , Soliman Elsayed Z. , Buxton Alfred E. , Biering‐Sørensen Tor , Solomon Scott D. , Post Wendy S. , Cappola Thomas P. , Siscovick David S. , Arking Dan E. 
Published: April 2018

Background

ECG
global electrical heterogeneity (
GEH
) is associated with sudden cardiac death. We hypothesized that a genome‐wide association study would identify genetic loci related to
GEH
.

Methods and Results

We tested genotyped and imputed variants in black (N=3057) and white (N=10 769) participants in the ARIC (Atherosclerosis Risk in Communities) study and CHS (Cardiovascular Health Study).
GEH
(
QRS
‐T angle, sum absolute
QRST
integral, spatial ventricular gradient magnitude, elevation, azimuth) was measured on 12‐lead
ECG
s. Linear regression models were constructed with each
GEH
variable as an outcome, adjusted for age, sex, height, body mass index, study site, and principal components to account for ancestry.
GWAS
identified 10 loci that showed genome‐wide significant association with
GEH
in whites or joint ancestry. The strongest signal (rs7301677, near

TBX
3

) was associated with
QRS
‐T angle (white standardized β+0.16 [95%
CI
0.13–0.19];
P
=1.5×10
−26
), spatial ventricular gradient elevation (+0.11 [0.08–0.14];
P
=2.1×10
−12
), and spatial ventricular gradient magnitude (−0.12 [95%
CI
−0.15 to −0.09];
P
=5.9×10
−15
). Altogether,
GEH
‐
SNP
s explained 1.1% to 1.6% of
GEH
variance. Loci on chromosomes 4 (near

HMCN
2

), 5 (

IGF
1R

), 11 (11p11.2 region cluster), and 7 (near

ACTB

) are novel
ECG
phenotype‐associated loci. Several loci significantly associated with gene expression in the left ventricle (

HMCN
2

locus—with

HMCN
2

;

IGF
1R

locus—with

IGF
1R

), and atria (

RP
11‐481J2.2

locus—with expression of a long non‐coding
RNA
and

NDRG
4

).

Conclusions

We identified 10 genetic loci associated with
ECG GEH
. Replication of
GEH GWAS
findings in independent cohorts is warranted. Further studies of
GEH
‐loci may uncover mechanisms of arrhythmogenic remodeling in response to cardiovascular risk factors.
Modeling the Transition From Decompensated to Pathological Hypertrophy
Authors: Pascual Florencia , Schisler Jonathan C. , Grevengoed Trisha J. , Willis Monte S. , Coleman Rosalind A. 
Published: April 2018

Background

Long‐chain acyl‐CoA synthetases (
ACSL
) catalyze the conversion of long‐chain fatty acids to fatty acyl‐CoAs. Cardiac‐specific
ACSL
1 temporal knockout at 2 months results in a shift from
FA
oxidation toward glycolysis that promotes
mTORC
1‐mediated ventricular hypertrophy. We used unbiased metabolomics and gene expression analyses to examine the early effects of genetic inactivation of fatty acid oxidation on cardiac metabolism, hypertrophy development, and function.

Methods and Results

Global cardiac transcriptional analysis revealed differential expression of genes involved in cardiac metabolism, fibrosis, and hypertrophy development in
Acsl1

H−/−

hearts 2 weeks after
Acsl1
ablation. Comparison of the 2‐ and 10‐week transcriptional responses uncovered 137 genes whose expression was uniquely changed upon knockdown of cardiac
ACSL
1, including the distinct upregulation of fibrosis genes, a phenomenon not observed after complete
ACSL
1 knockout. Metabolomic analysis identified metabolites altered in hearts displaying partially reduced
ACSL
activity, and rapamycin treatment normalized the cardiac metabolomic fingerprint.

Conclusions

Short‐term cardiac‐specific
ACSL
1 inactivation resulted in metabolic and transcriptional derangements distinct from those observed upon complete
ACSL
1 knockout, suggesting heart‐specific
mTOR
(mechanistic target of rapamycin) signaling that occurs during the early stages of substrate switching. The hypertrophy observed with partial
Acsl1
ablation occurs in the context of normal cardiac function and is reminiscent of a physiological process, making this a useful model to study the transition from physiological to pathological hypertrophy.
Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals
Authors: Yan Bryan P. , Lai William H. S. , Chan Christy K. Y. , Chan Stephen Chun‐Hin , Chan Lok‐Hei , Lam Ka‐Ming , Lau Ho‐Wang , Ng Chak‐Ming , Tai Lok‐Yin , Yip Kin‐Wai , To Olivia T. L. , Freedman Ben , Poh Yukkee C. , Poh Ming‐Zher 
Published: April 2018

Background

We aimed to evaluate a novel method of atrial fibrillation (
AF
) screening using an
iP
hone camera to detect and analyze photoplethysmographic signals from the face without physical contact by extracting subtle beat‐to‐beat variations of skin color that reflect the cardiac pulsatile signal.

Methods and Results

Patients admitted to the cardiology ward of the hospital for clinical reasons were recruited. Simultaneous facial and fingertip photoplethysmographic measurements were obtained from 217 hospital inpatients (mean age, 70.3±13.9 years; 71.4% men) facing the front camera and with an index finger covering the back camera of 2 independent
iP
hones before a 12‐lead ECG was recorded. Backdrop and background light intensity was monitored during signal acquisition. Three successive 20‐second (total, 60 seconds) recordings were acquired per patient and analyzed for heart rate regularity by Cardiio Rhythm (Cardiio Inc, Cambridge,
MA
) smartphone application. Pulse irregularity in ≥1 photoplethysmographic readings or 3 uninterpretable photoplethysmographic readings were considered a positive
AF
screening result.
AF
was present on 12‐lead
ECG
in 34.6% (n=75/217) patients. The Cardiio Rhythm facial photoplethysmographic application demonstrated high sensitivity (95%; 95% confidence interval, 87%–98%) and specificity (96%; 95% confidence interval, 91%–98%) in discriminating
AF
from sinus rhythm compared with 12‐lead
ECG
. The positive and negative predictive values were 92% (95% confidence interval, 84%–96%) and 97% (95% confidence interval, 93%–99%), respectively.

Conclusions

Detection of a facial photoplethysmographic signal to determine pulse irregularity attributable to
AF
is feasible. The Cardiio Rhythm smartphone application showed high sensitivity and specificity, with low negative likelihood ratio for
AF
from facial photoplethysmographic signals. The convenience of a contact‐free approach is attractive for community screening and has the potential to be useful for distant
AF
screening.
Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke
Authors: Feld Jody A. , Zukowski Lisa A. , Howard Annie G. , Giuliani Carol A. , Altmann Lori J.P. , Najafi Bijan , Plummer Prudence 
Published: April 2018

Background and Purpose—
Gait speed does not adequately predict whether stroke survivors will be active in the community. This may be because traditional single-task gait speed does not sufficiently reproduce the demands of walking in the real world. This study assessed whether dual-task gait speed accounts for variance in daily ambulatory activity above what can be predicted with habitual (single task) gait speed in community-dwelling stroke survivors.

Methods—

Twenty-eight community-dwelling individuals, 58.2 years of age (SD=16.6), 8.9 months poststroke (interquartile range, 3.7–19.4), completed a gait and cognitive task in single- and dual-task conditions. Daily ambulatory activity was captured using a physical activity monitor. A regression analysis examined
R

2

changes with single- and dual-task gait speed.

Results—

Single-task gait speed explained 15.3% of the variance in daily ambulatory activity (
P
=0.04). Adding dual-task gait speed to the regression model increased the variance explained by an additional 20.6% (
P
=0.04).

Conclusions—
Gait speed assessed under attention-demanding conditions may improve explanation of variance in daily ambulatory activity after stroke.
Lipid-Lowering Agents and High HDL (High-Density Lipoprotein) Are Inversely Associated With Intracranial Aneurysm Rupture
Authors: Can Anil , Castro Victor M. , Dligach Dmitriy , Finan Sean , Yu Sheng , Gainer Vivian , Shadick Nancy A. , Savova Guergana , Murphy Shawn , Cai Tianxi , Weiss Scott T. , Du Rose 
Published: April 2018

Background and Purpose—
Growing evidence from experimental animal models and clinical studies suggests the protective effect of statin use against rupture of intracranial aneurysms; however, results from large studies detailing the relationship between intracranial aneurysm rupture and total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipoprotein), and lipid-lowering agent use are lacking.

Methods—
The medical records of 4701 patients with 6411 intracranial aneurysms diagnosed at the Massachusetts General Hospital and the Brigham and Women’s Hospital between 1990 and 2016 were reviewed and analyzed. Patients were separated into ruptured and nonruptured groups. Univariable and multivariable logistic regression analyses were performed to determine the effects of lipids (total cholesterol, LDL, and HDL) and lipid-lowering medications on intracranial aneurysm rupture risk. Propensity score weighting was used to account for differences in baseline characteristics of the cohorts.

Results—
Lipid-lowering agent use was significantly inversely associated with rupture status (odds ratio, 0.58; 95% confidence interval, 0.47–0.71). In a subgroup analysis of complete cases that includes both lipid-lowering agent use and lipid values, higher HDL levels (odds ratio, 0.95; 95% confidence interval, 0.93–0.98) and lipid-lowering agent use (odds ratio, 0.41; 95% confidence interval, 0.23–0.73) were both significantly and inversely associated with rupture status, whereas total cholesterol and LDL levels were not significant. A monotonic exposure–response curve between HDL levels and risk of aneurysmal rupture was obtained.

Conclusions—
Higher HDL values and the use of lipid-lowering agents are significantly inversely associated with ruptured intracranial aneurysms.
Affect and Sensation: Plato’s Embodied Cognition
Authors: McCready-Flora Ian 
Published: April 2018

AbstractI argue that Plato, in theTimaeus, draws deep theoretical distinctions between sensation and affect, which comprises pleasure, pain, desire and emotion. Sensation (but not affect) is both ‘fine-grained’ (having orderly causal connections with its fundamental explanatory items) and ‘immediate’ (being provoked absent any mediating psychological state). Emotions, by contrast, are mediated and coarse-grained. Pleasure and pain are coarse-grained but, in a range of important cases, immediate. TheTheaetetusassimilates affect to sensation in a way theTimaeusdoes not. Smell frustrates Timaeus because it is coarse-grained, although unlike pleasure and pain it is so by accident of physiology.
Practical and Productive Thinking in Aristotle
Authors: Müller Jozef 
Published: April 2018

Abstract
I argue that, on Aristotle’s account, practical thinking (unlike productive thinking) has as its origin a desire whose object is the very thing that one reasons about how to promote. This means: (a) there is only a contingent relationship between the desire that one practically reasons about how to satisfy and the action one decides on; (b) practical thinking and action (unlike productive thinking and production) cannot be separated from the agent. I also show how my account of practical thinking can shed new light on Aristotle’s claim that the virtuous agent must decide on her virtuous actions ‘for themselves’.
Modeling a Stratocumulus-Topped PBL: Intercomparison among Different One-Dimensional Codes and with Large Eddy Simulation
Authors: Bechtold P. , Krueger S. K. , Lewellen W. S. , van Meijgaard E. , Moeng C.-H. , Randall D. A. , van Ulden A. , Wang S. 
Published: April 2018

Several one-dimensional (ID) cloud/turbulence ensemble modeling results of an idealized nighttime marine stratocumulus case are compared to large eddy simulation (LES). This type of model intercomparison was one of the objects of the first Global Energy and Water Cycle Experiment Cloud System Study boundary layer modeling workshop held at the National Center for Atmospheric Research on 16–18 August 1994.
Presented are results obtained with different 1D models, ranging from bulk models (including only one or two vertical layers) to various types (first order to third order) of multilayer turbulence closure models. The ID results fall within the scatter of the LES results. It is shown that ID models can reasonably represent the main features (cloud water content, cloud fraction, and some turbulence statistics) of a well-mixed stratocumulus-topped boundary layer.
Also addressed is the question of what model complexity is necessary and can be afforded for a reasonable representation of stratocumulus clouds in mesoscale or global-scale operational models. Bulk models seem to be more appropriate for climate studies, whereas a multilayer turbulence scheme is best suited in mesoscale models having at least 100- to 200-m vertical resolution inside the boundary layer.