bluuebunny/crossref_metadata_2025_split huggingface dataset:
Convalescent troponin and cardiovascular death following acute coronary syndrome
Authors: Adamson Philip D , McAllister David , Pilbrow Anna , Pickering John William , Poppe Katrina , Shah Anoop , Whalley Gillian , Ellis Chris , Mills Nicholas L , Newby David E , Pemberton Chris , Troughton Richard W , Doughty Rob N , Richards A Mark 
Published: July 2019

ObjectivesHigh-sensitivity cardiac troponin testing is used in the diagnosis of acute coronary syndromes but its role during convalescence is unknown. We investigated the long-term prognostic significance of serial convalescent high-sensitivity cardiac troponin concentrations following acute coronary syndrome.MethodsIn a prospective multicentre observational cohort study of 2140 patients with acute coronary syndrome, cardiac troponin I concentrations were measured in 1776 patients at 4 and 12 months following the index event. Patients were stratified into three groups according to the troponin concentration at 4 months using the 99th centile (women>16 ng/L, men>34 ng/L) and median concentration of those within the reference range. The primary outcome was cardiovascular death.ResultsTroponin concentrations at 4 months were measurable in 99.0% (1759/1776) of patients (67±12 years, 72% male), and were ≤5 ng/L (median) and >99th centile in 44.8% (795) and 9.3% (166), respectively. There were 202 (11.4%) cardiovascular deaths after a median of 4.8 years. After adjusting for the Global Registry of Acute Coronary Events score, troponin remained an independent predictor of cardiovascular death (HR 1.4, 95% CI 1.3 to 1.5 per doubling) with the highest risk observed in those with increasing concentrations at 12 months. Patients with 4-month troponin concentrations >99th centile were at increased risk of cardiovascular death compared with those ≤5 ng/L (29.5% (49/166) vs 4.3% (34/795); adjusted HR 4.9, 95% CI 3.8 to 23.7).ConclusionsConvalescent cardiac troponin concentrations predict long-term cardiovascular death following acute coronary syndrome. Recognising this risk by monitoring troponin may improve targeting of therapeutic interventions.Trial registration numberACTRN12605000431628;Results.
Sex disparities in the management of coronary heart disease in general practices in Australia
Authors: Lee Crystal Man Ying , Mnatzaganian George , Woodward Mark , Chow Clara K , Sitas Freddy , Robinson Suzanne , Huxley Rachel R 
Published: July 2019

ObjectivesTo determine whether sex differences exist in the management of patients with a history of coronary heart disease (CHD) in primary care.MethodsGeneral practice records of patients aged ≥18 years with a history of CHD in a large general practice dataset in Australia, MedicineInsight, were analysed. Sex-specific, age-standardised proportions of patients prescribed with recommended medications; assessed for cardiovascular risk factors; and achieved treatment targets according to the General Practice Management Plan were reported.ResultsRecords of 130 926 patients (47% women) from 438 sites were available from 2014 to 2018. Women were less likely to be prescribed with recommended medications (prescribed ≥3 medications: women 44%, men 61%; p<0.001). Younger patients, especially women aged <45 years, were substantially underprescribed (aged <45 years prescribed ≥3 medications: women 2%, men 8%; p<0.001). Lower proportions of women were assessed for cardiovascular risk factors (blood test for lipids: women 70%–76%, men 77%–81%; p<0.001). Body size was not commonly assessed (body mass index: women 59%, men 62%; p<0.001; waist: women 23%, men 25%; p<0.001). Higher proportions of women than men achieved targets for most risk factors (achieved ≥4 targets in patients assessed for all risk factors: women 82%, men 76%).ConclusionGaps in preventative management including prescription of indicated medications and risk factor monitoring have been reported from the late 1990s and this large-scale general practice data analysis indicate they still persist. Moreover, the gap is larger in women compared to men. We need new ways to address these gaps and the sex inequity.
Usefulness of high-resolution three-dimensional proton density-weighted turbo spin-echo MRI in distinguishing a junctional dilatation from an intracranial aneurysm of the posterior communicating artery: a pilot study
Authors: Kim Sunghan , Chung Joonho , Cha Jihoon , Kim Byung Moon , Kim Dong Joon , Kim Yong Bae , Lee Jae Whan , Huh Seung Kon , Park Keun Young 
Published: July 2019

BackgroundDiscriminating a junctional dilatation from a true saccular aneurysm is clinically important.PurposeTo evaluate the usefulness of high-resolution three-dimensional proton density-weighted turbo spin-echo magnetic resonance imaging (PD MRI) in distinguishing a junctional dilatation from an aneurysm of the posterior communicating artery (PcomA).MethodsEighty-two consecutive patients with 83 PcomA lesions, which were evaluated by time-of-flight (TOF) MR angiography (MRA), PD MRI, and digital subtraction angiography (DSA), were enrolled. These radiologic data were retrospectively and independently reviewed by two neurosurgeons, and each diagnosis based on TOF MRA, PD MRI, and DSA was compared. The diagnostic efficacy (interobserver agreement, intermodality agreement, and diagnostic performance) of PD MRI was compared with that of TOF MRA.ResultsPD MRI showed higher AC1 (Gwet’s agreement coefficient, PD MRI: 0.8942, 95% CI 0.8204 to 0.968; TOF MRA: 0.7185, 95% CI 0.5753 to 0.8617) and prevalence-adjusted bias-adjusted kappa coefficient (PABAK) (PD MRI: 0.8554, TOF MRA: 0.5904) than TOF MRA for interobserver agreement. For intermodality agreement, PD MRI also showed higher AC1 (PD MRI: 0.9069, 95% CI 0.8374 to 0.9764; TOF MRA: 0.7983, 95% CI 0.6969 to 0.8996) and PABAK (PD MRI: 0.8735, TOF MRA: 0.7289) than TOF MRA. The diagnostic performance of PD MRI was statistically superior to that of TOF MRA in sensitivity, specificity, positive predictive value, and negative predictive value.ConclusionsPD MRI could provide excellent diagnostic accuracy and better information in distinguishing a junctional dilatation from a true saccular aneurysm of the PcomA compared with TOF MRA.
Using G-FAST to recognize emergent large vessel occlusion: a training program for a prehospital bypass strategy
Authors: Chiu Yu-Chen , Tang Sung-Chun , Sun Jen-Tang , Tsai Li-Kai , Hsieh Ming-Ju , Lee Chung-Wei , Jeng Jiann-Shing , Lee Yu-Ching , Chien Yu-Chun , Wang Yao-Cheng , Chiang Wen-Chu , Ma Matthew Huei-Ming 
Published: July 2019

IntroductionThe shorter the time between the onset of symptoms and reperfusion using endovascular thrombectomy, the better the functional outcome of patients. A training program was designed for emergency medical technicians (EMTs) to learn the gaze-face-arm-speech-time test (G-FAST) score for initiating a prehospital bypass strategy in an urban city. This study aimed to evaluate the effect of the training program on EMTs.MethodsAll EMTs in the city were invited to join the training program. The program consisted of a 30 min lecture and a 20 min video which demonstrated the G-FAST evaluation. The participants underwent tests before and after the program. The tests included (1) a questionnaire of knowledge, attitudes, confidence, and behaviors towards stroke care; and (2) watching 10 different scenarios in a video and answering questions, including eight sub-questions of G-FAST parameters, and choosing a suitable receiving hospital.ResultsIn total, 1058 EMTs completed the training program. After the program, significant improvement was noted in knowledge, attitudes, and confidence, as well as scenario judgement. The performance of the EMTs in evaluating G-FAST criteria in comatose patients was relatively poor in the pre-test and improved significantly after the training course. Although the participants answered the G-FAST items correctly, they tended to overtriage the patients and refer them to higher-level hospitals.ConclusionsA short training program can improve the ability to identify stroke patients and choose a suitable receiving hospital. A future training program could put further emphasis on how to evaluate comatose patients and choose a suitable receiving hospital.
A Mutation in Histone H2B Represents a New Class of Oncogenic Driver
Authors: Bennett Richard L. , Bele Aditya , Small Eliza C. , Will Christine M. , Nabet Behnam , Oyer Jon A. , Huang Xiaoxiao , Ghosh Rajarshi P. , Grzybowski Adrian T. , Yu Tao , Zhang Qiao , Riva Alberto , Lele Tanmay P. , Schatz George C. , Kelleher Neil L. , Ruthenburg Alexander J. , Liphardt Jan , Licht Jonathan D. 
Published: July 2019

Abstract

By examination of the cancer genomics database, we identified a new set of mutations in core histones that frequently recur in cancer patient samples and are predicted to disrupt nucleosome stability. In support of this idea, we characterized a glutamate to lysine mutation of histone H2B at amino acid 76 (H2B-E76K), found particularly in bladder and head and neck cancers, that disrupts the interaction between H2B and H4. Although H2B-E76K forms dimers with H2A, it does not form stable histone octamers with H3 and H4 in vitro, and when reconstituted with DNA forms unstable nucleosomes with increased sensitivity to nuclease. Expression of the equivalent H2B mutant in yeast restricted growth at high temperature and led to defective nucleosome-mediated gene repression. Significantly, H2B-E76K expression in the normal mammary epithelial cell line MCF10A increased cellular proliferation, cooperated with mutant PIK3CA to promote colony formation, and caused a significant drift in gene expression and fundamental changes in chromatin accessibility, particularly at gene regulatory elements. Taken together, these data demonstrate that mutations in the globular domains of core histones may give rise to an oncogenic program due to nucleosome dysfunction and deregulation of gene expression.

Significance:
Mutations in the core histones frequently occur in cancer and represent a new mechanism of epigenetic dysfunction that involves destabilization of the nucleosome, deregulation of chromatin accessibility, and alteration of gene expression to drive cellular transformation.
See related commentary by Sarthy and Henikoff, p. 1346.
This article is highlighted in the In This Issue feature, p. 1325
Engineered Adoptive T-cell Therapy Prolongs Survival in a Preclinical Model of Advanced-Stage Ovarian Cancer
Authors: Anderson Kristin G. , Voillet Valentin , Bates Breanna M. , Chiu Edison Y. , Burnett Madison G. , Garcia Nicolas M. , Oda Shannon K. , Morse Christopher B. , Stromnes Ingunn M. , Drescher Charles W. , Gottardo Raphael , Greenberg Philip D. 
Published: July 2019

Abstract
Adoptive T-cell therapy using high-affinity T-cell receptors (TCR) to target tumor antigens has potential for improving outcomes in high-grade serous ovarian cancer (HGSOC) patients. Ovarian tumors develop a hostile, multicomponent tumor microenvironment containing suppressive cells, inhibitory ligands, and soluble factors that facilitate evasion of antitumor immune responses. Developing and validating an immunocompetent mouse model of metastatic ovarian cancer that shares antigenic and immunosuppressive qualities of human disease would facilitate establishing effective T-cell therapies. We used deep transcriptome profiling and IHC analysis of human HGSOC tumors and disseminated mouse ID8VEGF tumors to compare immunologic features. We then evaluated the ability of CD8 T cells engineered to express a high-affinity TCR specific for mesothelin, an ovarian cancer antigen, to infiltrate advanced ID8VEGF murine ovarian tumors and control tumor growth. Human CD8 T cells engineered to target mesothelin were also evaluated for ability to kill HLA-A2+ HGSOC lines. IHC and gene-expression profiling revealed striking similarities between tumors of both species, including processing/presentation of a leading candidate target antigen, suppressive immune cell infiltration, and expression of molecules that inhibit T-cell function. Engineered T cells targeting mesothelin infiltrated mouse tumors but became progressively dysfunctional and failed to persist. Treatment with repeated doses of T cells maintained functional activity, significantly prolonging survival of mice harboring late-stage disease at treatment onset. Human CD8 T cells engineered to target mesothelin were tumoricidal for three HGSOC lines. Treatment with engineered T cells may have clinical applicability in patients with advanced-stage HGSOC.
RIKADA Study Reveals Risk Factors in Pediatric Primary Cardiomyopathy
Authors: Al‐Wakeel‐Marquard Nadya , Degener Franziska , Herbst Christopher , Kühnisch Jirko , Dartsch Josephine , Schmitt Boris , Kuehne Titus , Messroghli Daniel , Berger Felix , Klaassen Sabine 
Published: July 2019

Background
Cardiomyopathies are heterogeneous diseases with clinical presentations varying from asymptomatic to life‐threatening events, including severe heart failure and sudden cardiac death. The role of underlying genetic and disease‐modulating factors in children and adolescents is relatively unknown. In this prospective study, in‐depth phenotypic and genetic characterization of pediatric patients with primary cardiomyopathy and their first‐degree family members (FMs) was performed. Outcome was assessed to identify clinical risk factors.

Methods and Results

Sixty index patients with primary cardiomyopathy (median age: 7.8 years) and 124 FMs were enrolled in the RIKADA (Risk Stratification in Children and Adolescents with Primary Cardiomyopathy) study. Family screening included cardiac workup and genetic testing. Using cardiologic screening, we identified 17 FMs with cardiomyopathies and 30 FMs with suspected cardiomyopathies. Adverse events appeared in 32% of index patients and were more common in those with lower body surface area (
P
=0.019), increased NT‐proBNP (N‐terminal pro–brain natriuretic peptide;
P
<0.001), and left ventricular dysfunction (
P
<0.001) and dilatation (
P
=0.005). The worst prognosis was observed in dilated and restrictive cardiomyopathies. Genetic variants of interest were detected in patients (79%) and FMs (67%). In all 15 families with at least 1 FM with cardiomyopathy, we found a variant of interest in the index patient. Increased number of variants of interest per patient was associated with adverse events (
P
=0.021). Late gadolinium enhancement was related to positive genotypes in patients (
P
=0.041).

Conclusions
Lower body surface area, increased NT‐proBNP, left ventricular dysfunction or dilatation, late gadolinium enhancement, and increased number of variants of interest were associated with adverse outcome and should be considered for risk assessment in pediatric primary cardiomyopathies.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov/
. Unique identifier: NCT03572569.
Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One‐Month Results
Authors: Leone Antonio Maria , Burzotta Francesco , Aurigemma Cristina , De Maria Giovanni Luigi , Zambrano Aniello , Zimbardo Giuseppe , Arioti Manfredi , Cerracchio Emma , Vergallo Rocco , Trani Carlo , Crea Filippo 
Published: July 2019

Background

Fractional flow reserve (
FFR
) and optical coherence tomography (
OCT
) may help both in assessment and in percutaneous coronary intervention optimization of angiographically intermediate coronary lesions. We designed a prospective trial comparing the clinical and economic outcomes associated with
FFR
or
OCT
in angiographically intermediate coronary lesions.

Methods and Results

Three hundred fifty patients with angiographically intermediate coronary lesions (n=446) were randomized to
FFR
or
OCT
guidance. In the
FFR
arm, percutaneous coronary intervention was performed if
FFR
was ≤0.80 aiming for a postprocedure
FFR
>0.90. In the
OCT
arm, percutaneous coronary intervention was performed if percentage of area stenosis was ≥75% or 50% to 75% with minimal lumen area <2.5 mm
2
or plaque ulceration. Costs, angina frequency, and major adverse cardiac events were assessed at 1 month and at 13 months. We present early data at 1 month consistent with a prespecified analysis of secondary end points. Patients randomized to
FFR
, as compared with
OCT
, were significantly more commonly managed with medical therapy alone (67.7% versus 41.1%;
P
<0.001), required less contrast media (245±137 versus 280±129 mL;
P
=0.004), and exhibited a lower occurrence of contrast‐induced acute kidney injury (1.7% versus 8.6%;
P
=0.034). At 1 month, in comparison to
FFR
,
OCT
was associated with increased total costs (2831±1288 versus 4292±3844 euros/patient;
P
<0.001) whereas occurrence of major adverse cardiac events or significant angina was similar.

Conclusions

In patients with angiographically intermediate coronary lesions, a functional guidance by
FFR
, as compared with
OCT
, increased the rate of patients treated with medical therapy alone. This translated into a significant reduction in administered contrast, contrast‐induced acute kidney injury, and total costs at 1 month with
FFR
.

Clinical Trial Registration

URL
:
http://www.clinicaltrialsgov
. Unique identifier:
NCT
01824030.
The Religious Gender Gap within Dutch Relationships: Explaining the Persistent Religious Gender Gap in the Netherlands Using a Multifactorial Approach
Authors: Kregting Joris , Scheepers Peer , Vermeer Paul , Hermans Chris 
Published: July 2019

Abstract
Like other Western countries, in the Netherlands women continue to demonstrate higher levels of religiosity than men. In this article, we set out to explain this Dutch religious gender gap regarding belief in God, prayer and church attendance. Using high quality survey data (LISS 2015), a comprehensive model is built combining social and psychological differences between Dutch men and women. These gender differences are operationalized where they are most strongly experienced, i.e. within personal relationships. We find that the gender gaps within Dutch relationships regarding belief in God and prayer can be explained by gendered religious socialization and gendered mental health dependency—and for belief in God additionally by the gendered level of agreeableness. For the gender gap regarding church attendance, gendered religious socialization explains the religious gender gap.
Religion and Inclusive Society: Attitudes towards the Poor among Muslim and Christian Students in Surabaya
Authors: Sterkens Carl , Isharianto Rafael , Vermeer Paul 
Published: July 2019

Abstract
This study explores attitudes towards the poor among Christian and Muslim secondary school students in Indonesia. Are there significant differences between Muslims and Christians with regard to these attitudes and, if any, how could they be explained? The authors argue that there is little reason to expect differences based on religious affiliation alone, because both Christianity and Islam pay special attention to poverty alleviation and economic justice in teachings and moral guidelines. However, specific religious beliefs and practices could still result in different attitudes towards the poor among Muslims and Christians. This study investigates to what extent beliefs such as attitudes towards religious plurality, fundamentalism, religious salience and religious practices are related with attitudes towards the poor. The potential differential effects of non-religious factors like socio-economic status, social dominance orientation, bonding and bridging social capital, compassion and school activities are also taken into account.
A Glass Half Full?
Authors: Bordin Fernando Lusa 
Published: July 2019

Abstract
Much has been said about the shortcomings of the two-element test for customary international law, the traditional methodology on which the ILC has focused in its recently completed study on the identification of custom. But custom as a source of law is notoriously elusive and slippery, and the deficiencies of the traditional methodology, for which there is no easy fix, are a reflection of a decentralised international legal system lacking a legislature and a system of courts with compulsory jurisdiction. The article offers some thoughts on the character of the two-element approach as an evaluative test, and the functions that it performs in structuring and constraining international legal reasoning in a way that safeguards the equality of States. By reflecting on the methodology’s constructive role, the article cautions against overly alarmist predictions that customary international law is a dancefloor.
Taxonomic revision of the genus Anostomoides (Characiformes: Anostomidae)
Authors: ASSEGA FERNANDO MASSAYUKI , BIRINDELLI JOSÉ LUÍS OLIVAN 
Published: July 2019

A taxonomic revision of Anostomoides is herein presented based on a comprehensive revision of specimens deposited in fish collections and the literature. The present revision proposes that A. laticeps is a junior synonym of A. atrianalis, while A. passionis is a junior synonym of Leporinus nattereri, and the latter is thus transferred to Anostomoides, forming the new combination Anostomoides nattereri. Principal Components Analysis (PCA) showed that examined specimens form two distinct morphotypes, corroborating the validity of both A. atrianalis and A. nattereri. Anostomoides nattereri is distinguished from A. atrianalis by having four branchiostegal rays (vs. three), three pores in infraorbital one (vs. four), 37–39 pored lateral-line scales (vs. 41–44), lower lip with rounded dermal papillae (vs. forming ridges), three dark rounded midlateral blotches (vs. three or four vertically elongated blotches and/or a faded dark longitudinal stripe), dark lines between scale series on posterior half of body on specimens smaller than 150 mm SL (vs. dark lines absent), a greater body depth (27.6–36.2 % vs. 24.5–38.7% of SL) and smaller interorbital distance (34.4–53.8 % vs. 42.6–67.3 % of HL). Anostomoides nattereri is distributed across several tributaries of the Amazon and Orinoco rivers, whereas A. atrianalis is widespread throughout the Amazon, Orinoco, and Essequibo basins. The genus Anostomoides is currently diagnosed based on a combination of non-exclusive characters: upturned or slightly upturned mouth with four premaxillary teeth including symphyseal tooth bicuspid or with blunt cutting edge, remaining teeth slightly tricuspid (with medial cuspid distinctly larger); four dentary teeth, symphyseal tooth with truncate cutting edge (without cusps); second tooth with a single large cusp, and two lateral teeth with three or slightly more small cusps.