bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuropeptide-Y causes coronary microvascular constriction and is associated with reduced ejection fraction following ST-elevation myocardial infarction
Authors: Herring Neil , Tapoulal Nidi , Kalla Manish , Ye Xi , Borysova Lyudmyla , Lee Regent , Dall’Armellina Erica , Stanley Christopher , Ascione Raimondo , Lu Chieh-Ju , Banning Adrian P , Choudhury Robin P , Neubauer Stefan , Dora Kim , Kharbanda Rajesh K , Channon Keith M ,   Oxford Acute Myocardial Infarction (OxAMI) Study, Banning Adrian P , Choudhury Robin P , Neubauer Stefan , Dora Kim , Kharbanda Rajesh K , Channon Keith M 
Published: February 2019

Abstract

Aims
The co-transmitter neuropeptide-Y (NPY) is released during high sympathetic drive, including ST-elevation myocardial infarction (STEMI), and can be a potent vasoconstrictor. We hypothesized that myocardial NPY levels correlate with reperfusion and subsequent recovery following primary percutaneous coronary intervention (PPCI), and sought to determine if and how NPY constricts the coronary microvasculature.

Methods and results
Peripheral venous NPY levels were significantly higher in patients with STEMI (n = 45) compared to acute coronary syndromes/stable angina ( n = 48) or with normal coronary arteries (NC, n = 16). Overall coronary sinus (CS) and peripheral venous NPY levels were significantly positively correlated (r = 0.79). STEMI patients with the highest CS NPY levels had significantly lower coronary flow reserve, and higher index of microvascular resistance measured with a coronary flow wire. After 2 days they also had significantly higher levels of myocardial oedema and microvascular obstruction on cardiac magnetic resonance imaging, and significantly lower ejection fractions and ventricular dilatation 6 months later. NPY (100–250 nM) caused significant vasoconstriction of rat microvascular coronary arteries via increasing vascular smooth muscle calcium waves, and also significantly increased coronary vascular resistance and infarct size in Langendorff hearts. These effects were blocked by the Y1 receptor antagonist BIBO3304 (1 μM). Immunohistochemistry of the human coronary microvasculature demonstrated the presence of vascular smooth muscle Y1 receptors.

Conclusion
High CS NPY levels immediately after reperfusion correlate with microvascular dysfunction, greater myocardial injury, and reduced ejection fraction 6 months after STEMI. NPY constricts the coronary microcirculation via the Y1 receptor, and antagonists may be a useful PPCI adjunct therapy.
Antithrombotic treatment in patients with atrial fibrillation and acute coronary syndromes: results of the European Heart Rhythm Association survey
Authors: Lane Deirdre A , Dagres Nikolaos , Dan Gheorghe-Andrei , García Seara Javier , Iliodromitis Konstantinos , Lenarczyk Radoslaw , Lip Gregory Y H , Mansourati Jacques , Marín Francisco , Scherr Daniel , Potpara Tatjana S 
Published: February 2019

Abstract
The management of an acute coronary syndrome (ACS) in a patient with existing atrial fibrillation (AF) often presents a management dilemma both in the acute phase and post-ACS, since the majority of AF patients will already be receiving oral anticoagulation (OAC) for stroke prevention and will require further antithrombotic treatment to reduce the risk of in-stent thrombosis or recurrent cardiac events. Current practice recommendations are based largely on consensus option as there is limited evidence from randomized controlled trials. Prior to the launch of the new European Heart Rhythm Association (EHRA) consensus document, a survey was undertaken to examine current clinical management of these patients across centres in Europe. Forty-seven centres submitted valid responses, with the majority (70.2%) being university hospitals. This EHRA survey demonstrated overall the management of ACS in AF patients is consistent with the available guidance. Most centres would use triple therapy for a short duration (4 weeks) and predominantly utilize a strategy of OAC (vitamin K antagonist, VKA or non-vitamin K antagonist oral anticoagulant, NOAC) plus aspirin and clopidogrel, followed by dual therapy [(N)OAC plus clopidogrel] until 12 months post-percutaneous coronary intervention, followed by (N)OAC monotherapy indefinitely. Where NOAC was used in combination with antiplatelet(s), the lower dose of the respective NOAC was preferred, in accordance with current recommendations.
Multidimensional Sleep and Mortality in Older Adults: A Machine-Learning Comparison With Other Risk Factors
Authors: Wallace Meredith L , Buysse Daniel J , Redline Susan , Stone Katie L , Ensrud Kristine , Leng Yue , Ancoli-Israel Sonia , Hall Martica H 
Published: February 2019

Abstract

Background
Sleep characteristics related to duration, timing, continuity, and sleepiness are associated with mortality in older adults, but rarely considered in health recommendations. We applied machine learning to: (i) establish the predictive ability of a multidimensional self-reported sleep domain for all-cause and cardiovascular mortality in older adults relative to other established risk factors and (ii) to identify which sleep characteristics are most predictive.

Methods
The analytic sample includes N = 8,668 older adults (54% female) aged 65–99 years with self-reported sleep characterization and longitudinal follow-up (≤15.5 years), aggregated from three epidemiological cohorts. We used variable importance (VIMP) metrics from a random survival forest to rank the predictive abilities of 47 measures and domains to which they belong. VIMPs > 0 indicate predictive variables/domains.

Results
Multidimensional sleep was a significant predictor of all-cause (VIMP [99.9% confidence interval {CI}] = 0.94 [0.60, 1.29]) and cardiovascular (1.98 [1.31, 2.64]) mortality. For all-cause mortality, it ranked below that of the sociodemographic (3.94 [3.02, 4.87]), physical health (3.79 [3.01, 4.57]), and medication (1.33 [0.94, 1.73]) domains but above that of the health behaviors domain (0.22 [0.06, 0.38]). The domains were ranked similarly for cardiovascular mortality. The most predictive individual sleep characteristics across outcomes were time in bed, hours spent napping, and wake-up time.

Conclusion
Multidimensional sleep is an important predictor of mortality that should be considered among other more routinely used predictors. Future research should develop tools for measuring multidimensional sleep—especially those incorporating time in bed, napping, and timing—and test mechanistic pathways through which these characteristics relate to mortality.
Education and Cognition in Middle Age and Later Life: The Mediating Role of Physical and Cognitive Activity
Authors: Liu Yujun , Lachman Margie E 
Published: February 2019

Abstract

Objectives
Although educational attainment is related to cognitive function in later life, little is known about the mechanisms involved. This study assessed the independent mediating effects of two behavioral variables, physical and cognitive activity, on the association between educational attainment and cognitive function and change.

Methods
Data were derived from the three waves of the Midlife in the United States (MIDUS) study. Predictors (educational attainment) were from the 1995 baseline, mediators (physical and cognitive activities) were from the 2004 wave, and outcomes (cognitive function) were from the 2004 and 2013 waves. Conditional process modeling was applied using PROCESS in SPSS.

Results
There were both direct and indirect effects of educational attainment on level and change of executive function (EF) and episodic memory (EM). Physical activity and cognitive activity were both significant mediators for cognitive level. For mediators of change, however, cognitive activity was significant for EF and physical activity was significant for EM.

Discussion
Physical and cognitive activity are discussed as possible factors for protecting against cognitive decline in later life. The findings have implications for advancing supportive policies and practices related to maximizing the benefits of education and physical and cognitive activities for cognition in middle age and later life.
Parent–Adult Child Relations of Chinese Older Immigrants in the United States: Is There an Optimal Type?
Authors: Guo Man , Stensland Meredith , Li Mengting , Dong Xinqi 
Published: February 2019

Abstract

Objectives
This study aims to identify (a) different types of parent–child relations among Chinese older immigrants, (b) predictors of each relation type, and (c) the most “optimal” type that is associated with better psychological well-being of the older adults.

Methods
Data were derived from 3,109 Chinese elderly adults in Chicago. Latent Class Analysis was used to identify structures of parent–child relations based on eight indicators of family solidarity. Logistic regressions were used to predict the relation types. Negative binomial and logistic regressions were used to examine the associations between the relation types and depression and quality of life (QoL).

Results
Four types of parent–child relations emerged: unobligated ambivalent (44.77%), tight-knit (40.11%), detached (10.28%), and commanding conflicted (4.84%). Older adults’ age, gender, marital status, health status, and immigration/acculturation experience were related to their relation types. While tight-knit relation was associated with the fewest depressive symptoms, older adults with unobligated ambivalent relations were the least likely to report good QoL.

Discussion
The study illustrates the diverse and complex ways in which Chinese older immigrants and their children are connected. The findings suggest that a departure from the traditional norm of filial piety may present a risk factor for this population’s mental health.
Measuring Activity Limitations Within the National Health and Aging Trends Study (NHATS)
Authors: Marfeo Elizabeth E , Ni Pengsheng , Keeney Tamra , Jette Alan 
Published: February 2019

Abstract

Background and Objectives
To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS) .

Research Design and Methods
We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015.

Results
Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach’s alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90).

Discussion and Implications
Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items.
Indoor Nature Interventions for Health and Wellbeing of Older Adults in Residential Settings: A Systematic Review
Authors: Yeo Nicola L , Elliott Lewis R , Bethel Alison , White Mathew P , Dean Sarah G , Garside Ruth 
Published: February 2019

AbstractBackground and ObjectivesHaving contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. We conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings.Research Design and MethodsSearch terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). We also pursued grey literature, global clinical trials registries, and a range of supplementary methods.ResultsOf 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction.Discussion and ImplicationsThere is inconsistent evidence that indoor nature exposures are beneficial for older care residents. We expect that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.
Trajectories of Homebound Status in Medicare Beneficiaries Aged 65 and Older
Authors: Xiang Xiaoling , Chen Jieling , Kim MinHee 
Published: February 2019

Abstract

Background and Objectives
The purpose of this study was to examine the trajectories of homebound status in older adults and to investigate the risk factors in shaping the pattern of these trajectories.

Research Design and Methods
The study sample was a nationally representative sample of Medicare beneficiaries aged 65 and older (N = 7,607) from the National Health and Aging Trends Study (Round 1–Round 7). Homebound state was defined as never or rarely went out the home in the last month. Homebound trajectories were identified using an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression was used to examine risk factors of homebound trajectories.

Results
Three trajectory groups were identified: the “never” group (65.5%) remained nonhomebound; the “chronic” group were largely persistently homebound (8.3%); and the “onset” group (26.2%) had a rapid increase in their risk of being homebound over the 7-year period. The following factors increased the relative risk for being on the “onset” and “chronic” versus the “never” trajectory: older age, Hispanic ethnicity, social isolation, past or current smoking, instrumental activities of daily living limitations, probable dementia, and use of a walker or wheelchair. Male sex and living alone were associated with a lower risk of being on the “chronic” trajectory, whereas depression and anxiety symptoms, chronic conditions, and activities of daily living limitations increased the risk.

Discussion and Implications
The progression of homebound status among community-dwelling older adults followed three distinct trajectories over a 7-year period. Addressing social isolation and other risk factors may prevent or delay the progression to homebound state.
Early outcomes and computational fluid dynamic analyses of chimney reconstruction in the Norwood procedure
Authors: Asada Satoshi , Yamagishi Masaaki , Itatani Keiichi , Maeda Yoshinobu , Taniguchi Satoshi , Fujita Shuhei , Hongu Hisayuki , Yaku Hitoshi 
Published: February 2019

Abstract

OBJECTIVES
The ideal configuration of a reconstructed aortic arch in the Norwood procedure for hypoplastic left heart syndrome is still a matter of debate. Chimney reconstruction was developed to avoid postoperative complications and turbulent flow in the aortic arch. This study sought to clarify early outcomes of the procedure and verify its haemodynamic advantages using computational fluid dynamics (CFD).

METHODS
Fourteen consecutive patients with hypoplastic left heart syndrome or a variant who underwent chimney reconstruction in the Norwood procedure between January 2013 and March 2018 were enrolled. Median age and body weight at the time of operation were 2.5 months and 4.1 kg, respectively. Thirteen patients (93.9%) had been palliated with previous bilateral pulmonary artery (PA) banding. In addition, patient-specific CFD models of neoarches based on postoperative computed tomograms from 6 patients were created and the flow profiles analysed.

RESULTS
Survival rates at 1, 3 and 5 years were 76.6%, 67.3% and 67.3%, respectively. No patient developed left PA compression by neoaorta, neoaortic dilation or neoaortic insufficiency. Only 2 patients (14.3%) required surgical intervention for recoarctation. Fontan completion was performed on 5 patients. On CFD analysis, all reconstructed aortic arches showed low energy loss (9.16–14.4 mW/m2) and low wall shear stresses.

CONCLUSIONS
Chimney reconstruction was a feasible technique when homografts were not readily available. CFD analyses underscored the fact that this technique produced excellent flow profiles. Larger studies should be conducted to clarify long-term outcomes.
Preoperative pulmonary function in all comers for cardiac surgery predicts mortality
Authors: Risom Emilie C , Buggeskov Katrine B , Mogensen Ulla B , Sundskard Martin , Mortensen Jann , Ravn Hanne B 
Published: February 2019

Abstract

OBJECTIVES
Although reduced lung function and chronic obstructive pulmonary disease (COPD) is associated with higher risk of death following cardiac surgery, preoperative spirometry is not performed routinely. The aim of this study was to investigate the relationship between preoperative lung function and postoperative complications in all comers for cardiac surgery irrespective of smoking or COPD history.

METHODS
Preoperative spirometry was performed in elective adult cardiac surgery patients. Airflow obstruction was defined as the ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio below the lower limit of normal (LLN) and reduced forced ventilatory capacity defined as FEV1 <LLN.

RESULTS
A history of COPD was reported by 132 (19%) patients; however, only 74 (56%) had spirometry-verified airflow obstruction. Conversely, 64 (12%) of the 551 patients not reporting a history of COPD had spirometry-verified airflow obstruction. The probability of death was significantly higher in patients with airflow obstruction (8.8% vs 4.5%, P = 0.04) and in patients with a FEV1 <LLN (8.7% vs 3.7%, P = 0.007). In the multivariate analysis were age [hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.0–2.5; P = 0.04], prolonged cardiopulmonary bypass time (HR 1.2, 95% CI 1.02–1.3; P = 0.03), reduced kidney function (HR 2.5, 95% CI 1.2–5.6; P = 0.02) and FEV1 <LLN (HR 2.4, 95% CI 1.1–5.2; P = 0.03) all independently associated with an increased risk of death.

CONCLUSIONS
Preoperative spirometry reclassified 18% of the patients. A reduced FEV1 independently doubled the risk of death. Inclusion of preoperative spirometry in routine screening of cardiac surgical patients may improve risk prediction and identify high-risk patients.

Clinical trial registration number
NCT01614951 (ClinicalTrials.gov).
On the Boundedness of Anti-Canonical Volumes of Singular Fano3-Folds in Characteristicp&gt; 5
Authors: Das Omprokash 
Published: February 2019

AbstractIn this article, we prove the following version of the weak Borisov-Alexeev-Borisov (Weak-BAB) conjecture for $3$-folds in $\operatorname{char} p&gt;5$: fix a set $I\subseteq [0, 1)$ which satisfies the descending chain condition (DCC) and an algebraically closed field $k$ of characteristic $p&gt;5$. Let ${\mathfrak{D}}$ be a collection of klt pairs $(X, \Delta )$ satisfying the following properties: (1) $X$ is a projective $3$-fold, (2) $\Delta $ is an ${\mathbb{R}}$-divisor with coefficients in $I$, (3) $K_X+\Delta \equiv 0$, and (4) $-K_X$ is ample. Then the set $\{\operatorname{vol}_X(-K_X) \ | \ (X, \Delta )\in{\mathfrak{D}}\mbox{ for some }\Delta \}$ is bounded from above.
The Effect of the Free Primary Education Policy on School Enrolment and Relative Grade Attainment in Lesotho†
Authors: Moshoeshoe Ramaele , Ardington Cally , Piraino Patrizio 
Published: February 2019

Abstract
We examine the impact of Lesotho’s Free Primary Education (FPE) programme on enrolment and relative grade attainment. The programme was sequentially implemented by first abolishing school fees in grade one in the year 2000. The timing of the implementation created changes in programme coverage across age groups over time. We employ a difference-in-differences strategy that exploits these variations to identify the effects of the FPE policy. Using data from the 2000 Multiple Indicator Cluster Survey and the 2002 Core Welfare Indicators Questionnaire survey, we find that the FPE policy increased enrolment of primary school-age children by 19.1 percentage points between 1999 and 2002. We also find that the policy had a negative effect on relative grade attainment: post-FPE, children had 0.15 fewer grades per year of age compared to pre-FPE. We do not find evidence of sibling effects.
Female Reproductive System Morphology and the Development of a Physiological Age-Grading System for Bagrada hilaris (Hemiptera: Pentatomidae)
Authors: Grodowitz Michael J , Reed Darcy A , Elliott Brad , Perring Thomas M 
Published: February 2019

Abstract
In this paper, we describe the morphology of the female Bagrada hilaris (Burmeister) reproductive system and develop a physiological age-grading system related to egg production. The female reproductive system is composed of two meroistic and telotrophic ovaries each containing 5–6 tubular ovarioles. The ovarioles unite into the lateral oviduct which combine to form the common oviduct. The ovarioles are composed of two regions; the distal germarium and the tubular vitellarium which contains maturing follicles. Each follicle is surrounded by a layer of cells; the follicular epithelium. As the follicle passes from the ovariole to the lateral oviducts the follicular epithelial cells slough off and accumulate in the base of the ovarioles and are known as follicular relics. The continuum of ovarian development is divided into two categories: nulliparous (‘nonreproducing’) and parous (‘reproducing’). The nulliparous category is characterized by the absence of follicular relics or eggs in the oviducts as opposed to the parous category where follicular relics and, in many cases, eggs occurred in the oviducts. The nulliparous category is divided further into two stages; N1 and N2 based on ovariole differentiation. The parous category is divided into three stages; P1, P2, and P3, based on the quantity and appearance of follicular relics. Females characterized as P3 produced three times more eggs (79.2 eggs ± 5.7) than females characterized as P1 (27.1 eggs ± 6.0).