bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-Sensitivity Cardiac Troponin I and the Diagnosis of Coronary Artery Disease in Patients With Suspected Angina Pectoris
Authors: Adamson Philip D. , Hunter Amanda , Madsen Debbie M. , Shah Anoop S.V. , McAllister David A. , Pawade Tania A. , Williams Michelle C. , Berry Colin , Boon Nicholas A. , Flather Marcus , Forbes John , McLean Scott , Roditi Giles , Timmis Adam D. , van Beek Edwin J.R. , Dweck Marc R. , Mickley Hans , Mills Nicholas L. , Newby David E. 
Published: February 2018

Background:
We determined whether high-sensitivity cardiac troponin I can improve the estimation of the pretest probability for obstructive coronary artery disease (CAD) in patients with suspected stable angina.

Methods and Results:

In a prespecified substudy of the SCOT-HEART trial (Scottish Computed Tomography of the Heart), plasma cardiac troponin was measured using a high-sensitivity single-molecule counting assay in 943 adults with suspected stable angina who had undergone coronary computed tomographic angiography. Rates of obstructive CAD were compared with the pretest probability determined by the CAD Consortium risk model with and without cardiac troponin concentrations. External validation was undertaken in an independent study population from Denmark comprising 487 patients with suspected stable angina. Higher cardiac troponin concentrations were associated with obstructive CAD with a 5-fold increase across quintiles (9%–48%;
P
<0.001) independent of known cardiovascular risk factors (odds ratio, 1.35; 95% confidence interval, 1.25–1.46 per doubling of troponin). Cardiac troponin concentrations improved the discrimination and calibration of the CAD Consortium model for identifying obstructive CAD (C statistic, 0.788–0.800;
P
=0.004; χ
2
=16.8 [
P
=0.032] to 14.3 [
P
=0.074]). The updated model also improved classification of the American College of Cardiology/American Heart Association pretest probability risk categories (net reclassification improvement, 0.062; 95% confidence interval, 0.035–0.089). The revised model achieved similar improvements in discrimination and calibration when applied in the external validation cohort.

Conclusions:
High-sensitivity cardiac troponin I concentration is an independent predictor of obstructive CAD in patients with suspected stable angina. Use of this test may improve the selection of patients for further investigation and treatment.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01149590.
Status of Hypertension in China
Authors: Wang Zengwu , Chen Zuo , Zhang Linfeng , Wang Xin , Hao Guang , Zhang Zugui , Shao Lan , Tian Ye , Dong Ying , Zheng Congyi , Wang Jiali , Zhu Manlu , Weintraub William S. , Gao Runlin ,   On behalf of the China Hypertension Survey Investigators*
Published: February 2018

Background:
Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.

Methods:
A stratified multistage random sampling method was used to obtain a nationally representative sample of 451 755 residents ≥18 years of age from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mm Hg/or diastolic BP (DBP) ≥90 mm Hg or use of antihypertensive medication within 2 weeks. Pre-HTN was defined as SBP 120 to 139 mm Hg and DBP 80 to 89 mm Hg without antihypertensive medication. HTN control was defined as SBP <140 mm Hg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP ≥130 or DBP ≥80 mm Hg) and control rate (SBP <130 and DBP <80 mm Hg) of HTN were also estimated according to the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline.

Results:

Overall, 23.2% (≈244.5 million) of the Chinese adult population ≥18 years of age had HTN, and another 41.3% (≈435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% versus 23.1%,
P
=0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy, and 31.7% of treated hypertensive patients used ≥2 medications. The prevalence of HTN based on the 2017 American College of Cardiology/American Heart Association guideline was twice as high as that based on 2010 Chinese guideline (46.4%), whereas the control rate fell to 3.0%.

Conclusions:
In China, there is a high prevalence of HTN and pre-HTN, and awareness, treatment, and control of HTN were low. Management of medical therapy for HTN needs to improve.
Lung Function, Inflammation, and Endothelin‐1 in Congenital Heart Disease–Associated Pulmonary Arterial Hypertension
Authors: Low Andrew , George Sarah , Howard Luke , Bell Nicholas , Millar Ann , Tulloh Robert M. R. 
Published: February 2018

Background

Breathlessness is the most common symptom in people with pulmonary arterial hypertension and congenital heart disease (
CHD
‐
APAH
), previously thought to be caused by worsening
PAH
, but perhaps also by inflammation and abnormalities of lung function. We studied lung function and airway inflammation in patients with
CHD
‐
APAH
and compared the results with controls.

Methods and Results

Sixty people were recruited into the study: 20
CHD
‐
APAH
, 20
CHD
controls, and 20 healthy controls. Spirometry, gas transfer, whole body plethysmography and lung clearance index, 6‐minute walk distance, and medical research council dyspnea scoring were performed. Inflammatory markers and endothelin‐1 levels were determined in blood and induced sputum. The
CHD
‐
APAH
group had abnormal lung function with lung restriction, airway obstruction, and ventilation heterogeneity. Inverse correlations were shown for
CHD
‐
APAH
between medical research council dyspnea score and percent predicted peak expiratory flow (
r
=−0.5383,
P
=0.0174), percent predicted forced expiratory flow rate at 50% of forced vital capacity (
r
=−0.5316,
P
=0.0192), as well as for percent predicted forced expiratory volume in 1 s (
r
=−0.6662,
P
=0.0018) and percent predicted forced vital capacity (
r
=−0.5536,
P
=0.0186). The
CHD
‐
APAH
patients were more breathless with lower 6‐minute walk distance (360 m versus 558 m versus 622 m,
P
=0.00001). Endothelin‐1, interleukin (
IL
)‐β,
IL
‐6,
IL
‐8, tumor necrosis factor α, and vascular endothelial growth factor were significantly higher in
CHD
‐
APAH
than controls. Serum endothelin‐1 for
CHD
‐
APAH
correlated with airflow obstruction with significant negative correlations with percent predicted forced expiratory flow rate at 75% of forced vital capacity (
r
=−0.5858,
P
=0.0135).

Conclusions

Raised biomarkers for inflammation were found in
CHD
‐
APAH
. Significant abnormalities in airway physiology may contribute to the dyspnea but are not driven by inflammation as assessed by circulating and sputum cytokines. A relationship between increased serum endothelin‐1 and airway dysfunction may relate to its bronchoconstrictive properties.
Diversity of entomopathogenic nematodes and their symbiotic bacteria in south African plantations and indigenous forests
Authors: Abate Birhan A. , Slippers Bernard , Wingfield Michael J. , Malan Antoinette P. , Hurley Brett P. 
Published: February 2018

Summary
The occurrence and diversity of entomopathogenic nematodes (EPN) and their symbiotic bacteria was evaluated in commercial forestry plantations (Eucalyptus spp., Pinus spp. and Acacia mearnsii) and indigenous forests in South Africa. EPN were most prevalent in A. mearnsii plantations, accounting for 60.7% of the isolates, while indigenous forests, plantations of Pinus spp. and Eucalyptus spp. accounted for 35.7, 3.6 and 0% of the isolates, respectively. DNA sequences of the internal transcribed spacer (ITS) and D2-D3 28S rDNA regions were used to identify the nematode species. Four Steinernema spp. were identified, including S. citrae, S. sacchari, two undescribed species, as well as Heterorhabditis bacteriophora and H. baujardi. Heterorhabditis baujardi is reported from South Africa for the first time. Analysis of 16S rRNA of the bacteria confirmed the presence of at least three Xenorhabdus species from Steinernema isolates and two subspecies of Photorhabdus luminescens from Heterorhabditis species.
The ‘Galleon System’ and Chinese Trade in Manila at the Turn of the 16th Century
Authors: Iaccarino Ubaldo 
Published: February 2018

When the mission of the Basque adelantado Miguel López de Legazpi reached Luzon – the northernmost isle of the Philippine archipelago – in 1570, the ambitious Spanish conquistadores met the ‘Sangley’ merchants for the first time.
During the 1570s many Chinese junks started to connect Manila with the ports of Fujian province and transformed the Philippine capital in a crossroads of the silk to silver exchange between China, Japan and the two Americas.
Following the establishment of the Manila-Acapulco-Callao triangular trade line and with the influx of the precious ‘reals of eight’ from Mexico, the so-called ‘Naos de China’ started to enrich both the Spaniards and the ‘Sangleys’, triggering an irreversible process that led to the establishment of a ‘Galleon System’ in just two decades.
This paper will discuss the role of Chinese trade in the Philippines at the close of the 16th century from the founding of Manila in 1571 to the establishment of the ‘Galleon System’ by the early 1590s.
Back to the Roots: The Imperial City of Shenyang as a Symbol of the Manchu Ethnic Identity of the Qing Dynasty
Authors: Sepe Agostino 
Published: February 2018

At the UNESCO meeting held in Suzhou on the 2nd of July 2004, the Imperial City of Shenyang was listed as a World Cultural Heritage Site, so that now it is recorded together with the Forbidden City of Beijing as one single item: Imperial Palaces of the Ming and Qing Dynasties, Ming Qing gongdian 明清宮殿. Nevertheless, the importance of Shenyang Palace is not at all due to its similarity to the one in Beijing. The part of the Shenyang Imperial City built before the Manchu conquest of Beijing in 1644 mirrors the culture of the Manchu people and the institutions of its rulers in its architectural style. The part built during Qianlong’s reign, on the other hand, is evidence of the devotion of Later Qing emperors (from Kangxi to Daoguang) towards their ancestors and their Manchu origins. At the same time, the palace also reflects the sinicization of the Manchus and the merging of the two different cultures and institutional systems, both in some of its buildings and in its whole. These two aspects clearly distinguish the Palace from the Forbidden City and confer it with immense historical and cultural value.
It is, therefore, from these points of view that I will deal with Shenyang Imperial City in this paper, whose purpose is to demonstrate how the palace is a symbol of the origins and the history of China’s last dynasty.
The most ancient sources I will base my work on are Qing shilu 清實錄 (I will mainly refer to the sections regarding the Qing emperors from Nurhaci to Qianlong) and Manwen laodang 滿文老檔, which is a source of the utmost importance for the study of Qing history before the conquest of Beijing.
朝鮮燕行使視野下的乾隆禁教期間耶穌會士。 以洪大容的《湛軒燕記》為研究對象
Authors: Law Lok-yin (Login) 
Published: February 2018

The Chosŏn Envoys to Beijing and their View on the Jesuits in the Qianlong Period of Persecution: Hong Tae-yong’s Tamhŏnyŏnki as a Case Study

As Matteo Ricci arrived to China, the Jesuits began their missionary activities in the Empire spurring new cultural interactions between East and West. While the current scholarship is particularly focused on the activities between late Ming and early Qing, the activities that took place during the Qianlong persecution have been ignored by the academia. At that time, however, some missionaries were still working at the Qintianjian (Imperial Astronomical Bureau), also trying to preach
sermons to Chinese common people as well as to other individuals, such as the members of the Korean embassies to Beijing.
Members of Chosŏn envoys to Beijing (Yŏnhaengsa) were granted by the Qing court the permission to visit different places in Beijing, therefore getting in contact with different people and activities. They got the opportunity to visit the church in the capital city and to meet the Jesuits, as well. This opportunity aroused the envoys’ curiosity about the Jesuits’ culture and religion. In 1765, one of the members of the embassy, Hong Tae-yong (1731-1783), got the opportunity to interact with two members of the Jesuits, Ferdinand Avguštin Hallerstein (1703-1774) and Antoine Gogeisi (1701-1771): that encounter helped Hong to learn more about the situation of Beijing missionaries which he successively recorded in his travel journal Tamhŏnyŏnki.
The records of Tamhŏnyŏnki about the missionaries and Hong Tae-yong’s interest on Catholic Church were related to the social and intellectual background of Hong Tae-yong in Chosŏn Kingdom. The Tamhŏnyŏnki’s records not only help us understand the envoys’ interest in Beijing’s Catholic culture, but they also reshape the discourse of the missionaries’ activities during the period of persecution, providing evidence that the missionaries were still working hard on their religious activities at that time. Also, the Tamhŏnyŏnki encouraged other intellectuals in Chosŏn to understand Western culture in general and Catholicism. This text, then, shows how the Korean envoys’ travel journals shaped the image of the missionaries, thus shedding new light on Ming-Qing Catholicism as well as on the development of Western learning in the Korean peninsula.
Extracorporeal membrane oxygenation as a rescue measure after thoracic surgery
Authors: Harris Dwight D , Saha Sibu P 
Published: February 2018

Background Extracorporeal membrane oxygenation is used for many different conditions including respiratory distress, cardiogenic shock, and trauma. In these patient groups, extracorporeal membrane oxygenation has been extensively studied. Recently, it has been used as a rescue measure in patients experiencing acute respiratory distress after thoracic surgery. The goal of our study was to examine the efficacy and cost-effectiveness of extracorporeal membrane oxygenation as a rescue measure after thoracic surgery at a single center. Methods We conducted a retrospective review of all patients who received extracorporeal membrane oxygenation after thoracic surgery at the University of Kentucky from January 9, 2012 to January 9, 2017. Eight patients were identified. Results The average time on extracorporeal membrane oxygenation was 9.125 days, and the average hospital stay was 65.125 days. Of the 8 patients placed on extracorporeal membrane oxygenation, 3 survived to discharge. Of the 3 patients who survived to discharge, 1 died within 6 months and 2 have been followed up for less than 4 months. The average total charge per patient was calculated to be $1,053,551, and the average charge per day was $16,177. The contribution margin was $109,200 per case. Conclusions Extracorporeal membrane oxygenation is a tool that saves lives in many different patient populations but it does not appear to be as effective in patients experiencing acute respiratory distress syndrome after thoracic surgery. Extracorporeal membrane oxygenation in this group also uses a tremendous amount of hospital resources.
Excitotoxicity in the pathogenesis of neurological and psychiatric disorders: Therapeutic implications
Authors: Olloquequi Jordi , Cornejo-Córdova Elizabeth , Verdaguer Ester , Soriano Francesc X , Binvignat Octavio , Auladell Carme , Camins Antoni 
Published: February 2018

Neurological and psychiatric disorders are leading contributors to the global disease burden, having a serious impact on the quality of life of both patients and their relatives. Although the molecular events underlying these heterogeneous diseases remain poorly understood, some studies have raised the idea of common mechanisms involved. In excitotoxicity, there is an excessive activation of glutamate receptors by excitatory amino acids, leading to neuronal damage. Thus, the excessive release of glutamate can lead to a dysregulation of Ca2+ homeostasis, triggering the production of free radicals and oxidative stress, mitochondrial dysfunction and eventually cell death. Although there is a consensus in considering excitotoxicity as a hallmark in most neurodegenerative diseases, increasing evidence points to the relevant role of this pathological mechanism in other illnesses affecting the central nervous system. Consequently, antagonists of glutamate receptors are used in current treatments or in clinical trials in both neurological and psychiatric disorders. However, drugs modulating other aspects of the excitotoxic mechanism could be more beneficial. This review discusses how excitotoxicity is involved in the pathogenesis of different neurological and psychiatric disorders and the promising strategies targeting the excitotoxic insult.
Uterine artery embolization in a sheep model: biodegradable versus non-degradable microspheres
Authors: Keussen Inger , Bengtsson Johan , Gavier-Widén Dolores , Karlstam Erika 
Published: February 2018

Background Transarterial embolization with particles is a relatively common treatment method in both malignant and benign disorders. Permanent occlusion of the uterine arteries may sometimes be disadvantageous. Purpose To compare the local tissue effects, possible side effects, and extent of recanalization following uterine artery embolization, using either degradable or non-degradable microspheres in a sheep model. Material and Methods In 22 female sheep, the uterine artery (UA) was unilaterally, superselectively embolized, with either degradable starch microspheres-DSM (group A) or calibrated gelatin coated spherical shape tris-acryl microspheres-TGMS (group B). The completion of embolization was confirmed by angiography. The animals were kept in the animal research facilities for 14 days and sacrificed following new angiographic evaluation. Gross and histological examination of the uterus and other organs was performed. Results The procedure was successful in all animals. At final angiographic evaluation recanalization was found in 82% of the ewes in group A and in 18% in group B. At histopathological examination, tissue impairment was similar in both groups, whereas vascular changes were more pronounced in the TGMS-group. Conclusion Embolization with DSM was associated with significantly higher degree of recanalization, than after embolization with TGMS.
BOLD MRI to evaluate early development of renal injury in a rat model of diabetes
Authors: Wang Qidong , Guo Chuangen , Zhang Lan , Zhang Rui , Wang Zhaoming , Xu Ying , Xiao Wenbo 
Published: February 2018

Objective To investigate changes in renal oxygenation levels by blood-oxygenation-level dependent (BOLD)-magnetic resonance imaging (MRI), and to evaluate BOLD-MRI for detecting early diabetic renal injury. Methods Seventy-five rats, with unilateral nephrectomy, were randomly divided into streptozotocin-induced diabetes mellitus (DM, n = 65) and normal control (NC, n = 10) groups. BOLD-MRI scans were performed at baseline (both groups) and at 3, 7, 14, 21, 28, 35, 42, 49, 56, 63 and 70 days (DM only). Renal cortical (C) and medullary (M) R2* signals were measured and R2* medulla/cortex ratio (MCR) was calculated. Results DM-group CR2* and MR2* values were significantly higher than NC values following diabetes induction. R2* values increased gradually and peaked at day 35 (CR2*, 33.95 ± 0.34 s–1; MR2*, 43.79 ± 1.46 s–1), then dropped gradually (CR2*, 33.17 ± 0.69 s–1; MR2*, 41.61 ± 0.95 s–1 at day 70). DM-group MCR rose gradually from 1.12 to 1.32 at day 42, then decreased to 1.25 by day 70. Conclusions BOLD-MRI can be used to non-invasively evaluate renal hypoxia and early diabetic renal injury in diabetic rats. MCR may be adopted to reflect dynamic changes in renal hypoxia.
An algorithm for managing adults who refuse medical treatment in New South Wales
Authors: Cheng Kylie , Wand Anne , Ryan Christopher , Callaghan Sascha 
Published: February 2018

Objectives: The assessment and management of a patient who refuses medical treatment requires clinical skill, and consideration of the relevant law and the patient’s decision-making capacity. Psychiatrists are often asked to advise in these situations. We aimed to develop an algorithm describing the relevant legal pathways to assist clinicians, especially psychiatrists, working in New South Wales (NSW), Australia. Methods: We reviewed the academic literature on treatment refusal, relevant legislation, judicial rulings and NSW Health policy directives and guidelines. We consulted with clinicians and representatives of relevant tribunals. Results: We developed an algorithm for managing patients who refuse medical treatment in NSW. The algorithm emphases the evaluation of decision-making capacity and tracks separate pathways depending upon a person’s status under the Mental Health Act 2007 (NSW). Conclusions: The algorithm provides a clear decision tree for clinicians responding to a patient refusing medical treatment in NSW.
An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding
Authors: Peanchitlertkajorn Supakit , Mercado Ana , Daskalogiannakis John , Hathaway Ronald , Russell Kathleen , Semb Gunvor , Shaw William , Lamichane Manish , Cohen Marilyn , Long Ross E. 
Published: February 2018

Objective: To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction. Design: Retrospective cohort study. Setting: Four cleft centers in North America. Patients: 135 subjects with repaired CUCLP. Methods: Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics. Results: Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences ( P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83). Conclusion: The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component.