bluuebunny/crossref_metadata_2025_split huggingface dataset:
In‐Hospital Outcomes of Dual Loading Antiplatelet Therapy in Patients 75 Years and Older With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Findings From the CCC‐ACS (Improving Care for Cardiovascular Disease in China‐Acute Coronary Syndrome) Project
Authors: Zhao Guanqi , Zhou Mengge , Ma Changsheng , Huo Yong , Smith Sidney C. , Fonarow Gregg C. , Ge Junbo , Han Yaling , Liu Jing , Hao Yongchen , Liu Jun , Wang Xiao , Taubert Kathryn A. , Morgan Louise , Zhao Dong , Nie Shaoping ,   the CCC‐ACS Investigators
Published: March 2018

Background

Elderly patients with acute coronary syndrome (
ACS
) are at high risk for ischemic and bleeding events. This study aimed to evaluate the clinical effectiveness and safety of dual loading antiplatelet therapy for patients 75 years and older undergoing percutaneous coronary intervention for ACS.

Methods and Results

The Improving Care for Cardiovascular Disease in China‐
ACS
project was a collaborative study of the American Heart Association and Chinese Society of Cardiology. A total of 5887 patients 75 years and older with
ACS
who had percutaneous coronary intervention and received dual antiplatelet therapy with aspirin and P2Y
12
inhibitors (clopidogrel or ticagrelor) between November 2014 and June 2017 were enrolled. The primary effectiveness and safety outcomes were in‐hospital major adverse cardiovascular events and major bleeding. Hazard ratios (
HRs
) of in‐hospital outcomes with different loading statuses of antiplatelet therapy were estimated using Cox proportional hazard models with multivariate adjustment. A propensity score–matched analysis was also conducted. Compared with patients receiving a dual nonloading dose, patients taking a dual loading dose had increased risks of both major adverse cardiovascular events (
HR
, 1.66, 95% confidence interval, 1.13–2.44; [
P
=0.010]) and major bleeding (
HR
, 2.34, 95% confidence interval, 1.75–3.13; [
P
<0.001]). Among 3284 propensity score–matched patients, a dual loading dose was associated with a 1.36‐fold risk of major adverse cardiovascular events (HR, 1.36; 95% confidence interval, 0.88–2.11 [
P
=0.168]) and a 2.08‐fold risk of major bleeding (
HR
, 2.08; 95% confidence interval, 1.47–2.93 [
P
<0.001]).

Conclusions
A dual loading dose of antiplatelet therapy was associated with increased major bleeding risk but not with decreased major adverse cardiovascular events risk among patients 75 years and older undergoing percutaneous coronary intervention for ACS in China.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifier:
NCT
02306616.
Association of Electronic Health Record Use With Quality of Care and Outcomes in Heart Failure: An Analysis of Get With The Guidelines—Heart Failure
Authors: Selvaraj Senthil , Fonarow Gregg C. , Sheng Shubin , Matsouaka Roland A. , DeVore Adam D. , Heidenreich Paul A. , Hernandez Adrian F. , Yancy Clyde W. , Bhatt Deepak L. 
Published: March 2018

Background

Adoption of electronic health record (
EHR
) systems has increased significantly across the nation. Whether
EHR
use has translated into improved quality of care and outcomes in heart failure (
HF
) is not well studied.

Methods and Results

We examined participants from the Get With The Guidelines—
HF
registry who were admitted with
HF
in 2008 (N=21 222), using various degrees of
EHR
implementation (no
EHR
, partial
EHR
, and full
EHR
). We performed multivariable logistic regression to determine the relation between
EHR
status and several in‐hospital quality metrics and outcomes. In a substudy of Medicare participants (N=8421), we assessed the relation between
EHR
status and rates of 30‐day mortality, readmission, and a composite outcome. In the cohort, the mean age was 71±15 years, 49% were women, and 64% were white. The mean ejection fraction was 39±17%. Participants were admitted to hospitals with no
EHR
(N=1484), partial
EHR
(N=13 473), and full
EHR
(N=6265). There was no association between
EHR
status and several quality metrics (aside from β blocker at discharge) or in‐hospital outcomes on multivariable adjusted logistic regression (
P
>0.05 for all comparisons). In the Medicare cohort, there was no association between
EHR
status and 30‐day mortality, readmission, or the combined outcome.

Conclusions

In a large registry of hospitalized patients with HF, there was no association between degrees of
EHR
implementation and several quality metrics and 30‐day postdischarge death or readmission. Our results suggest that
EHR
may not be sufficient to improve
HF
quality or related outcomes.
Association of Left Atrial Function Index with Atrial Fibrillation and Cardiovascular Disease: The Framingham Offspring Study
Authors: Sardana Mayank , Lessard Darleen , Tsao Connie W. , Parikh Nisha I. , Barton Bruce A. , Nah Gregory , Thomas Randell C. , Cheng Susan , Schiller Nelson B. , Aragam Jayashri R. , Mitchell Gary F. , Vaze Aditya , Benjamin Emelia J. , Vasan Ramachandran S. , McManus David D. 
Published: March 2018

Background

Left atrial (
LA
) size, a marker of atrial structural remodeling, is associated with increased risk for atrial fibrillation (
AF
) and cardiovascular disease (
CVD
).
LA
function may also relate to
AF
and
CVD
, irrespective of
LA
structure. We tested the hypothesis that
LA
function index (
LAFI
), an echocardiographic index of
LA
structure and function, may better characterize adverse
LA
remodeling and predict incident
AF
and
CVD
than existing measures.

Methods and Results

In 1786 Framingham Offspring Study eighth examination participants (mean age, 66±9 years; 53% women), we related
LA
diameter and
LAFI
(derived from the
LA
emptying fraction, left ventricular outflow tract velocity time integral, and indexed maximal
LA
volume) to incidence of
AF
and
CVD
on follow‐up. Over a median follow‐up of 8.3 years (range, 7.5–9.1 years), 145 participants developed
AF
and 139 developed
CVD
. Mean
LAFI
was 34.5±12.7. In adjusted Cox regression models, lower
LAFI
was associated with higher risk of incident
AF
(hazard ratio=3.83, 95% confidence interval=2.23–6.59, lowest [Q1] compared with highest [Q4]
LAFI
quartile) and over 2‐fold higher risk of incident
CVD
(hazard ratio=2.20, 95% confidence interval=1.32–3.68, Q1 versus Q4). Addition of
LAFI
, indexed maximum
LA
volume, or
LA
diameter to prediction models for
AF
or
CVD
did not significantly improve model discrimination for either outcome.

Conclusions

In our prospective investigation of a moderate‐sized community‐based sample,
LAFI
, a composite measure of
LA
size and function, was associated with incident
AF
and
CVD
. Addition of
LAFI
to the risk prediction models for
AF
or
CVD
, however, did not significantly improve their performance.
The importance of early life experiences for the development of behavioural disorders in domestic dogs
Authors: Dietz Lisa , Arnold Anne-Marie K. , Goerlich-Jansson Vivian C. , Vinke Claudia M. 
Published: March 2018

Abstract
Behavioural disorders are a major reason for euthanasia and sheltering of pet dogs. The prevention and treatment of behavioural disorders requires a better understanding of the underlying causes. Early life experiences, such as maternal care, attachment and socialisation, have long lasting and serious consequences for the behavioural and physiological development of an individual. The complex interplay between these factors is likely to have consequences for the future dog-owner bond and the vulnerability to develop behavioural disorders. Here, we summarise the current literature on the interactions between maternal care, attachment formation, and the sensitive socialisation period and their potential consequences on adult dog behaviour. Based on the findings we highlight gaps in knowledge and provide suggestions for future research which are necessary to formulate recommendations for pet dog breeding and socialisation.
A Missed Encounter
Authors: Lučin Bratislav 
Published: March 2018

Abstract
The paper gives an account of the relation between the Croatian humanist Franciscus Tranquillus Andronicus Parthenius and Desiderius Erasmus. The main source is Erasmus’ letter to Tranquillus of 28 June 1519; another document is Erasmus’ Convivium poeticum, first printed in 1523, in which a character named Parthenius appears. An analysis of Erasmus’ letter and of the context in which it was written reveals that Tranquillus’ visit to Louvain happened at a very inconvenient time for Erasmus, especially because he had to carefully deal with the conservative theologians, who were trying to extinguish the recently established Collegium Trilingue in Louvain. As for the identity of Parthenius in the Convivium poeticum, a new hint is given for his identification with Tranquillus.
Which Praise of Folly Did the Spanish Censors Read?
Authors: Ledo Jorge 
Published: March 2018

Abstract
The discovery and subsequent edition of the only known sixteenth-century Spanish translation of The Praise of Folly (which should now be dated ca. 1532–1535) put into question the notion that Erasmus was almost exclusively received as a doctrinal author in sixteenth-century Spain. To bolster this argument, these pages examine the 1536 Spanish translation of Alberto Pio’s Tres et viginti libri locos lucubrationum variarum D. Erasmi Roterodami. Though this translation was not unknown to scholars, none realized that book IV, part 1 included a partial translation, paraphrase, and commentary of the Praise of Folly. Once recognized, this translation allows us more accurately to date the Moria de Erasmo and in turn demands an explanation of why Pio’s lengthy text was translated into Spanish. Moreover, this material helps to explain what texts the Spanish censors had in mind when referring to the “Moria of Erasmus in romance, Latin, and any other language.”
Analytical evidence to show letters impregnated with novel psychoactive substances are a means of getting drugs to inmates within the UK prison service
Authors: Ford Loretta T , Berg Jonathan D 
Published: March 2018

Introduction Novel psychotropic substances also known as legal highs are a major concern in UK prisons, fuelling violence and putting a strain on resources for inmates requiring medical treatment for adverse effects. We provide a clinical toxicology service including routine screening for novel psychoactive substances. In 2015, we were approached by Her Majesty Prison Service search dog training team to advise on which novel psychoactive substances to target, and again in 2016 to further provide analytical support to test five letters which the dogs positively identified for novel psychotropic substances during routine searches of prison mail rooms. Here we provide the first analytical confirmation that letters sent to inmates are being used to smuggle novel psychotropic substances into UK prisons. Results Novel psychotropic substances were detected on all five letters and these included the stimulants ethylphenidate, methiopropamine and methoxiphenidaine, the sedative etizolam and the third generation synthetic cannabinoids 5F-AKB-48, AB-FUBINACA, MDMB-CHMICA. Other compounds detected include the class A drug cocaine, class B drug methylphenidate and the cutting agents lignocaine, benzocaine and procaine. Conclusion Novel psychotropic substances smuggled into UK prisons is a major safety and security concern. By analytically confirming letters sent to inmates do contain novel psychotropic substances, we have produced categorical evidence to support anecdotal suggestions that novel psychotropic substances are entering UK prisons in this manner.
Supporting LGBTIQ+ students in higher education in Australia: Diversity, inclusion and visibility
Authors: Waling Andrea , Roffee James A 
Published: March 2018

Objective: Using student narratives of experiences of exclusion and non-inclusion at university, this paper builds an evidence base for, and explores ways in which universities can respond to, the contemporary concerns of lesbian, gay, bisexual, transgender/transsexual, intersex and queer/questioning (LGBTIQ+) undergraduate students. Design: Qualitative exploratory study of undergraduate students who identify as LGBTIQ+ regarding their experiences of exclusion and non-inclusion at university. Setting: Large metropolitan university in Australia. Methods: Sixteen semi-formal interviews with undergraduate students who identify as LGBTIQ+ attending a large Australian university. Data were analysed using phenomenological analysis. Results: Students indicated university-level gaps in service provision and failures to support them in their attempts to access, or create opportunities to access, information regarding sexual and mental health and improve inclusion. They also indicated the importance of queer visibility and its impact in creating a positive experience for LGBTIQ+ members of a campus community. Conclusions: Universities should be aware of the need for formalised diversity and inclusion programmes to tackle contemporary experiences of exclusion. Universities can harness and support student initiatives to better serve the LGBTIQ+ campus community, responding to gaps in knowledge, resources and service needs. These gaps include resources and information regarding sexual health, the provision of gender-neutral toilets and other facilities, and support for peer-led programmes to enhance inclusion. Universities should help increase the visibility of a diverse queer presence on campus to help prevent experiences of exclusion.
Measuring program fidelity in case management for high risk families. Validation of the Functional Family Parole-Global Rating Measure
Authors: Busschers Inge , Boendermaker Leonieke , Dinkgreve Marc , Stams Geert Jan 
Published: March 2018

Summary Program fidelity instruments are a key ingredient for clinical supervision and implementation as well as effectiveness studies. This study examines the factor structure of the Functional Family Parole services Global Rating Measure (FFP-GRM); the program fidelity instrument of Functional Family Parole services for case management in youth parole, child protection and child welfare services. Between October 2012 and February 2015, program fidelity was measured with the FFP-GRM by Functional Family Parole supervisors. Confirmatory factor analysis was performed on 380 cases and internal consistency reliability coefficients were calculated. Findings Confirmatory factor analyses showed that the 33-item and four-factor model of the FFP-GRM achieved a good fit to the data. Internal validity testing results showed that subscale Cronbach’s α ranged between .82 and .90. Applications Findings affirm a good fit to the data and a good-to-excellent internal consistency of the FFP-GRM, which is considered sufficient to justify its use. The results are discussed with regard to the use of fidelity instruments for both clinical and research purposes.
Readability, suitability, and writing for clients with limited literacy skills
Authors: Ames Natalie 
Published: March 2018

Summary This study evaluated 56 documents developed by 11 nonprofit and public social service agencies to provide information to clients. The author used the Flesch Reading Ease, Simple Measure of Goobledegook (SMOG), and Gunning Fog Index formulas to assess reading grade levels and the Suitability Assessment of Material to evaluate overall suitability for readers with limited literacy skills. Findings All documents but one were above the recommended fifth grade level for low-literacy materials. Suitability Assessment of Material scores indicated 44.6% ( n = 26) were not appropriately formatted for readers with limited literacy skills. Applications Findings suggest a need for improving social service agencies’ and practitioners’ knowledge and awareness of the importance of assessing the readability and suitability of print materials, especially those intended for clients.
Featured Article: AMPKα2 deficiency enhanced susceptibility to ventricular arrhythmias in mice by the role of β-adrenoceptor signaling
Authors: Cao Hong , Wang Xin , Ying Shaozheng , Huang Congxin 
Published: March 2018

AMP-activated protein kinase-α2 is the main catalytic subunit of the heart, which is mainly located in cardiac myocytes. The effect of AMP-activated protein kinase-α2 on the cardiac electrophysiology is barely studied. From the previous study, it is possible that AMP-activated protein kinase-α2 may have some effect on the electrophysiology of the heart. To prove the hypothesis, we used the AMP-activated protein kinase-α2 knockout (AMPKα2−/−) mice to estimate the electrophysiological characteristics of AMPKα2−/− mice and try to find the mechanism between them. We used AMP-activated protein kinase-α2 gene knockout (AMPKα2−/−) mice and control wild-type mice as the experimental animals. In the experiment, we measured the monophasic action potential duration and test the inducibility to ventricular arrhythmia in isolated mice heart with and without β-adrenoceptor antagonist metoprolol. Meanwhile, plasma concentration of catecholamine was collected. We found that AMPKα2−/− significantly shortened 90% repolarization of monophasic action potential (MAP) (MAPD90) than wild-type (47.4 ± 2.6 ms vs. 55.5 ± 2.4 ms, n = 10, P < 0.05) and were more vulnerable to be induced to ventricular arrhythmias (70% (7/10) vs. 10% (1/10), P < 0.05), accompanied by the higher concentration of catecholamine (epinephrine: 1.75 ± 0.18 nmol/L vs. 0.68 ± 0.10 nmol/L n = 10, P < 0.05; norepinephrine: 9.56 ± 0.71 nmol/L vs. 2.52 ± 0.31 nmol/L n = 10, P < 0.05). The shortening of MAPD90 and increased inducibility to ventricular arrhythmias of AMPKα2−/− could almost be abolished when perfusion with β-adrenoceptor antagonist metoprolol. It indicated that the β-adrenoceptor activation resulting from catecholamine release was mainly responsible for the relating changes of electrophysiology of AMPKα2−/−. It had great clinical significance, as in patients who had problem with AMP-activated protein kinase-α2 gene, we might use β-adrenoceptor antagonists as the prevention of arrhythmias in future. Impact statement As far as we know, this is the first time the role of AMP-activated protein kinase-α2 (AMPKα2) on the cardiac electrophysiology is explored, and we found that the β-adrenoceptor activation resulting from catecholamine release was mainly responsible for the changes of electrophysiology related to the absence of AMPKα2. This has great clinical significance, as in patients who have problems with AMPKα2 gene, we may use β-adrenoceptor antagonists for the prevention of arrhythmias in future.
Measurable Residual Disease at Induction Redefines Partial Response in Acute Myeloid Leukemia and Stratifies Outcomes in Patients at Standard Risk Without NPM1 Mutations
Authors: Freeman Sylvie D. , Hills Robert K. , Virgo Paul , Khan Naeem , Couzens Steve , Dillon Richard , Gilkes Amanda , Upton Laura , Nielsen Ove Juul , Cavenagh James D. , Jones Gail , Khwaja Asim , Cahalin Paul , Thomas Ian , Grimwade David , Burnett Alan K. , Russell Nigel H. 
Published: March 2018

Purpose We investigated the effect on outcome of measurable or minimal residual disease (MRD) status after each induction course to evaluate the extent of its predictive value for acute myeloid leukemia (AML) risk groups, including NPM1 wild-type (wt) standard risk, when incorporated with other induction response criteria. Methods As part of the NCRI AML17 trial, 2,450 younger adult patients with AML or high-risk myelodysplastic syndrome had prospective multiparameter flow cytometric MRD (MFC-MRD) assessment. After course 1 (C1), responses were categorized as resistant disease (RD), partial remission (PR), and complete remission (CR) or complete remission with absolute neutrophil count < 1,000/µL or thrombocytopenia < 100,000/μL (CRi) by clinicians, with CR/CRi subdivided by MFC-MRD assay into MRD+ and MRD−. Patients without high-risk factors, including Flt3 internal tandem duplication wt/− NPM1-wt subgroup, received a second daunorubicin/cytosine arabinoside induction; course 2 (C2) was intensified for patients with high-risk factors. Results Survival outcomes from PR and MRD+ responses after C1 were similar, particularly for good- to standard-risk subgroups (5-year overall survival [OS], 27% RD v 46% PR v 51% MRD+ v 70% MRD−; P < .001). Adjusted analyses confirmed significant OS differences between C1 RD versus PR/MRD+ but not PR versus MRD+. CRi after C1 reduced OS in MRD+ (19% CRi v 45% CR; P = .001) patients, with a smaller effect after C2. The prognostic effect of C2 MFC-MRD status (relapse: hazard ratio [HR], 1.88 [95% CI, 1.50 to 2.36], P < .001; survival: HR, 1.77 [95% CI, 1.41 to 2.22], P < .001) remained significant when adjusting for C1 response. MRD positivity appeared less discriminatory in poor-risk patients by stratified analyses. For the NPM1-wt standard-risk subgroup, C2 MRD+ was significantly associated with poorer outcomes (OS, 33% v 63% MRD−, P = .003; relapse incidence, 89% when MRD+ ≥ 0.1%); transplant benefit was more apparent in patients with MRD+ (HR, 0.72; 95% CI, 0.31 to 1.69) than those with MRD− (HR, 1.68 [95% CI, 0.75 to 3.85]; P = .16 for interaction). Conclusion MFC-MRD can improve outcome stratification by extending the definition of partial response after first induction and may help predict NPM1-wt standard-risk patients with poor outcome who benefit from transplant in the first CR.
Small Animal Review
Authors: Tennant Bryn 
Published: March 2018

Introduction: Gastrointestinal lymphoma is a not-uncommon enteropathy that generally carries a poor prognosis. Early recognition and typing of lymphoma may improve survival times; dogs with low grade lymphomas show survival times in excess of 400 days. As lymphoma does not affect all regions of the gastrointestinal tract, sampling from all regions is essential.
Managing allergic rhinitis in people with respiratory conditions
Authors: Scullion Jane , Holmes Steve 
Published: March 2018

Allergic rhinitis is common in people with asthma. The link with COPD is less well known. Jane Scullion and Steve Holmes provide an overview of the condition and how it can be diagnosed and treated in people with respiratory conditions Allergic rhinitis—a reaction to airborne allergens—is very common, affecting 10–15% of children and 26% of adults in the UK. Symptoms include sneezing, rhinorrhoea, and nasal obstruction, often accompanied by itching of the eyes, nose, and palate. Allergic rhinitis is well-known to co-exist with asthma. The link between chronic obstructive pulmonary disease and allergic rhinitis is less well-known. Studies have shown the presence of allergic rhinitis increases the risk of asthma attacks and emergency hospitalisation in patients with asthma. The risks for chronic obstructive pulmonary disease are less well researched. It is important to consider rhinitis in people with asthma and chronic obstructive pulmonary disease, and, as far as possible, provide a robust diagnosis which will inform targeted treatment for our patients' symptoms. There are several medications that can be used to treat allergic rhinitis and improve quality of life for patients.
The safe storage and management of vaccines
Authors: Armstrong Kirsty 
Published: March 2018

Vaccines need to be stored correctly to avoid wastage and promote efficacy. Kirsty Armstrong provides an overview of the available advice After clean water, vaccination is the most effective intervention that health professionals can make to improve patient outcomes, but it is essential that vaccines are stored, administered and disposed of correctly. There are many elements of immunisation and vaccination that are beyond the control of immunisers, such as the correct strain selection, the manufacture of vaccines, patient metabolism of the vaccine and financial considerations. The correct storage and administration of vaccines, which practice nurses can control, maintains their efficacy and reduces the chances of lowered vaccine potency.