bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis
Authors: Comerota Anthony J. , Kearon Clive , Gu Chu-Shu , Julian Jim A. , Goldhaber Samuel Z. , Kahn Susan R. , Jaff Michael R. , Razavi Mahmood K. , Kindzelski Andrei L. , Bashir Riyaz , Patel Parag , Sharafuddin Mel , Sichlau Michael J. , Saad Wael E. , Assi Zakaria , Hofmann Lawrence V. , Kennedy Margaret , Vedantham Suresh ,   For the ATTRACT Trial Investigators
Published: January 2019

Background:
The ATTRACT trial (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) previously reported that pharmacomechanical catheter–directed thrombolysis (PCDT) did not prevent postthrombotic syndrome (PTS) in patients with acute proximal deep vein thrombosis. In the current analysis, we examine the effect of PCDT in ATTRACT patients with iliofemoral deep vein thrombosis.

Methods:
Within a large multicenter randomized trial, 391 patients with acute deep vein thrombosis involving the iliac or common femoral veins were randomized to PCDT with anticoagulation versus anticoagulation alone (No-PCDT) and were followed for 24 months to compare short-term and long-term outcomes.

Results:

Between 6 and 24 months, there was no difference in the occurrence of PTS (Villalta scale ≥5 or ulcer: 49% PCDT versus 51% No-PCDT; risk ratio, 0.95; 95% CI, 0.78–1.15;
P
=0.59). PCDT led to reduced PTS severity as shown by lower mean Villalta and Venous Clinical Severity Scores (
P
<0.01 for comparisons at 6, 12, 18, and 24 months), and fewer patients with moderate-or-severe PTS (Villalta scale ≥10 or ulcer: 18% versus 28%; risk ratio, 0.65; 95% CI, 0.45–0.94;
P
=0.021) or severe PTS (Villalta scale ≥15 or ulcer: 8.7% versus 15%; risk ratio, 0.57; 95% CI, 0.32–1.01;
P
=0.048; and Venous Clinical Severity Score ≥8: 6.6% versus 14%; risk ratio, 0.46; 95% CI, 0.24–0.87;
P
=0.013). From baseline, PCDT led to greater reduction in leg pain and swelling (
P
<0.01 for comparisons at 10 and 30 days) and greater improvement in venous disease–specific quality of life (Venous Insufficiency Epidemiological and Economic Study Quality of Life unit difference 5.6 through 24 months,
P
=0.029), but no difference in generic quality of life (
P
>0.2 for comparisons of SF-36 mental and physical component summary scores through 24 months). In patients having PCDT versus No-PCDT, major bleeding within 10 days occurred in 1.5% versus 0.5% (
P
=0.32), and recurrent venous thromboembolism over 24 months was observed in 13% versus 9.2% (
P
=0.21).

Conclusions:
In patients with acute iliofemoral deep vein thrombosis, PCDT did not influence the occurrence of PTS or recurrent venous thromboembolism. However, PCDT significantly reduced early leg symptoms and, over 24 months, reduced PTS severity scores, reduced the proportion of patients who developed moderate-or-severe PTS, and resulted in greater improvement in venous disease–specific quality of life.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00790335.
A Three-Arm Randomized Trial of Different Renal Denervation Devices and Techniques in Patients With Resistant Hypertension (RADIOSOUND-HTN)
Authors: Fengler Karl , Rommel Karl-Philipp , Blazek Stephan , Besler Christian , Hartung Philipp , von Roeder Maximilian , Petzold Martin , Winkler Sindy , Höllriegel Robert , Desch Steffen , Thiele Holger , Lurz Philipp 
Published: January 2019

Background:
Both radiofrequency and ultrasound endovascular renal sympathetic denervation (RDN) have proven clinical efficacy for the treatment of hypertension. We performed a head-to-head comparison of these technologies.

Methods:
Patients with resistant hypertension were randomly assigned in a 1:1:1 manner to receive either treatment with (1) radiofrequency RDN of the main renal arteries; (2) radiofrequency RDN of the main renal arteries, side branches, and accessories; or (3) an endovascular ultrasound–based RDN of the main renal artery. The primary end point was change in systolic daytime ambulatory blood pressure at 3 months.

Results:

Between June 2015 and June 2018, 120 patients were enrolled (mean age, 64±9 years±SD; mean daytime blood pressure, 153/86±12/13 mm Hg). Of these, 39 were randomly assigned to radiofrequency main renal artery ablation, 39 to combined radiofrequency ablation of the main artery and branches, and 42 to ultrasound-based treatment. Baseline daytime blood pressure, clinical characteristics, and treatment were well balanced between the groups. At 3 months, systolic daytime ambulatory blood pressure decreased by 9.5±12.3 mm Hg (
P
<0.001) in the whole cohort. Although blood pressure was significantly more reduced in the ultrasound ablation group than in the radiofrequency ablation group of the main renal artery (–13.2±13.7 versus –6.5±10.3 mm Hg; mean difference, –6.7 mm Hg; global
P
=0.038 by ANOVA, adjusted
P
=0.043), no significant difference was found between the radiofrequency ablation groups (–8.3±11.7 mm Hg for additional side branch ablation; mean difference, –1.8 mm Hg; adjusted
P
>0.99). Similarly, the blood pressure reduction was not found to be significantly different between the ultrasound and the side branch ablation groups. Frequencies of blood pressure response ≥5 mm Hg were not significantly different (global
P
=0.77).

Conclusions:
In patients with resistant hypertension, endovascular ultrasound–based RDN was found to be superior to radiofrequency ablation of the main renal arteries only, whereas a combined approach of radiofrequency ablation of the main arteries, accessories, and side branches was not.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02920034.
Cardiac Biomarkers and Left Ventricular Hypertrophy in Relation to Outcomes in Patients With Atrial Fibrillation: Experiences From the RE‐LY Trial
Authors: Hijazi Ziad , Verdecchia Paolo , Oldgren Jonas , Andersson Ulrika , Reboldi Gianpaolo , Di Pasquale Giuseppe , Mazzotta Giovanni , Angeli Fabio , Eikelboom John W. , Ezekowitz Michael D. , Connolly Stuart J. , Yusuf Salim , Wallentin Lars 
Published: January 2019

Background

Cardiac biomarkers and left ventricular hypertrophy (
LVH
) are related to the risk of stroke and death in patients with atrial fibrillation. We investigated the interrelationship between
LVH
and cardiac biomarkers and their independent associations with outcomes.

Methods and Results

Plasma samples were obtained at baseline in 5275 patients with atrial fibrillation in the
RE
‐
LY
(Randomized Evaluation of Long‐Term Anticoagulation Therapy) trial.
NT
‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), cardiac troponin I and T, and growth differentiation factor‐15 were determined using high‐sensitivity (hs) assays.
LVH
was defined by
ECG
. Cox models were adjusted for baseline characteristics,
LVH
, and biomarkers.
LVH
was present in 1257 patients. During a median follow‐up of 2.0 years, 165 patients developed a stroke and 370 died.
LVH
was significantly (
P
<0.0001) associated with higher levels of all biomarkers in linear regression analyses adjusting for baseline characteristics. Geometric mean ratios (95% CIs) were as follows:
NT
‐pro
BNP
, 1.32 (1.25–1.38); hs cardiac troponin I, 1.67 (1.57–1.78); hs troponin T, 1.38 (1.32–1.44); and growth differentiation factor‐15, 1.09 (1.05–1.12). For stroke, the hazard ratios (95% CIs) per 50% increase were as follows:
NT
‐pro
BNP,
1.09 (1.00–1.19); hs cardiac troponin I, 1.09 (1.03–1.15); hs troponin T, 1.14 (1.06–1.24); and growth differentiation factor‐15, 1.22 (1.08–1.38) (all
P
<0.05). For death, hazard ratios (95% CIs) were as follows:
NT
‐pro
BNP
, 1.24 (1.17–1.31); hs cardiac troponin I, 1.13 (1.10–1.17); hs troponin T, 1.28 (1.23–1.34); and growth differentiation factor‐15, 1.31 (1.22–1.42) (all
P
<0.0001).
LVH
was not significantly associated with stroke or death after adjustment for biomarkers.

Conclusions

Cardiac biomarkers are significantly associated with
LVH
. The prognostic value of biomarkers for stroke and death is not affected by
LVH
. The prognostic information of
LVH
is attenuated in the presence of cardiac biomarkers.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00262600.
Exercise Training Adds Cardiometabolic Benefits of a Paleolithic Diet in Type 2 Diabetes Mellitus
Authors: Otten Julia , Andersson Jonas , Ståhl Jens , Stomby Andreas , Saleh Ahmed , Waling Maria , Ryberg Mats , Hauksson Jon , Svensson Michael , Johansson Bengt , Olsson Tommy 
Published: January 2019

Background
The accumulation of myocardial triglycerides and remodeling of the left ventricle are common features in type 2 diabetes mellitus and represent potential risk factors for the development of diastolic and systolic dysfunction. A few studies have investigated the separate effects of diet and exercise training on cardiac function, but none have investigated myocardial changes in response to a combined diet and exercise intervention. This 12‐week randomized study assessed the effects of a Paleolithic diet, with and without additional supervised exercise training, on cardiac fat, structure, and function.

Methods and Results

Twenty‐two overweight and obese subjects with type 2 diabetes mellitus were randomized to either a Paleolithic diet and standard‐care exercise recommendations (
PD
) or to a Paleolithic diet plus supervised exercise training 3 hours per week (
PD
‐
EX
). This study includes secondary end points related to cardiac structure and function, ie, myocardial triglycerides levels, cardiac morphology, and strain were measured using cardiovascular magnetic resonance, including proton spectroscopy, at baseline and after 12 weeks. Both groups showed major favorable metabolic changes. The
PD
‐
EX
group showed significant decreases in myocardial triglycerides levels (−45%,
P
=0.038) and left ventricle mass to end‐diastolic volume ratio (−13%,
P
=0.008) while the left ventricle end‐diastolic volume and stroke volume increased significantly (+14%,
P
=0.004 and +17%,
P
=0.008, respectively). These variables were unchanged in the
PD
group.

Conclusions
Exercise training plus a Paleolithic diet reduced myocardial triglycerides levels and improved left ventricle remodeling in overweight/obese subjects with type 2 diabetes mellitus.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01513798.
Differential Phenotypes in Perivascular Adipose Tissue Surrounding the Internal Thoracic Artery and Diseased Coronary Artery
Authors: Numaguchi Ryosuke , Furuhashi Masato , Matsumoto Megumi , Sato Hiroshi , Yanase Yosuke , Kuroda Yosuke , Harada Ryo , Ito Toshiro , Higashiura Yukimura , Koyama Masayuki , Tanaka Marenao , Moniwa Norihito , Nakamura Masanori , Doi Hirosato , Miura Tetsuji , Kawaharada Nobuyoshi 
Published: January 2019

Background

Perivascular adipose tissue (
PVAT
) is causally associated with vascular function and the pathogenesis of vascular disease in association with metabolically driven chronic inflammation called metaflammation. However, the difference in
PVAT
surrounding the coronary artery (
CA
‐
PVAT
) and that surrounding the internal thoracic artery (ITA‐PVAT), a vessel resistant to atherosclerosis, remains unclear. Herein, we investigated whether
CA
‐
PVAT
,
ITA
‐
PVAT
, and subcutaneous adipose tissue (
SCAT
) have distinct phenotypes.

Methods and Results

Fat pads were sampled from 44 patients (men/women, 36:8; age, 67±13 years) with CA disease who underwent elective CA bypass grafting. Adipocyte size in
ITA
‐
PVAT
and that in
CA
‐
PVAT
were significantly smaller than that in
SCAT
. A greater extent of fibrosis and increased gene expression levels of fibrosis‐related molecules were observed in
CA
‐
PVAT
than those in
SCAT
and those in
ITA
‐
PVAT
.
CA
‐
PVAT
exhibited more pronounced metaflammation, as indicated by a significantly larger extent of
CD
68‐positive and
CD
11c‐positive M1 macrophages, a lower ratio of
CD
206‐positive M2 to
CD
11c‐positive M1 macrophages, a lower gene expression level of adiponectin, and higher gene expression levels of inflammatory cytokines and inflammasome‐ and endoplasmic reticulum stress–related molecules, than did
ITA
‐
PVAT
and
SCAT
. Expression patterns of adipocyte developmental and pattern‐forming genes were totally different among
SCAT
,
ITA
‐
PVAT,
and
CA
‐
PVAT
.

Conclusions

The phenotype of
ITA
‐
PVAT
is closer to that of
SCAT
than that of
CA
‐
PVAT
, which may result from inherent differences in adipocytes.
ITA
‐
PVAT
appears to be protected from metaflammation and consecutive adipose tissue remodeling, which may contribute to the decreased atherosclerotic plaque burden in the ITA.
Increased Incidence of Stroke, but Not Coronary Heart Disease, in Elderly Patients With Sleep Apnea
Authors: Catalan-Serra Pablo , Campos-Rodriguez Francisco , Reyes-Nuñez Nuria , Selma-Ferrer Maria Jose , Navarro-Soriano Cristina , Ballester-Canelles Marta , Soler-Cataluña Juan-José , Roman-Sanchez Pilar , Almeida-Gonzalez Carmen V. , Martinez-Garcia Miguel A. 
Published: January 2019

Background and Purpose—
The influence of age on the relationship between obstructive sleep apnea (OSA) and the incidence of hard cardiovascular events remains controversial. We sought to analyze the relationship between OSA and the incidence of stroke and coronary heart disease in a large cohort of elderly patients, as well as to investigate the role of continuous positive airway pressure (CPAP) treatment in these associations.

Methods—
Post hoc analysis of a prospective observational study of consecutive patients ≥65 years studied for OSA suspicion at 2 Spanish University Hospitals. Patients with an apnea-hypopnea index (AHI) <15 were the reference group. OSA was defined by an AHI ≥15 and classified as untreated (CPAP not prescribed or compliance <4 hours/day), mild-moderate (AHI 15–29), untreated severe (AHI ≥30), and CPAP-treated (AHI ≥15 and CPAP compliance ≥4 hours/day).

Results—
859 and 794 elderly patients were included in the stroke and coronary heart disease analyses, respectively. The median (interquartile range) follow-up was 72 (50–88.5) and 71 (51.5–89) months, respectively. Compared with the reference group, the fully adjusted hazard ratios for the incidence of stroke were 3.42 (95% CI, 1.37–8.52), 1.02 (95% CI, 0.41–2.56), and 1.76 (95% CI, 0.62–4.97) for the untreated severe OSA group, CPAP-treated group, and untreated mild-moderate OSA group, respectively. No associations were shown between any of the different OSA groups and coronary heart disease incidence.

Conclusions—
The incidence of stroke, but not coronary heart disease, is increased in elderly patients with untreated severe OSA. Adequate CPAP treatment may reduce this risk.
The Application of an Evolutionary Programming Process to a Simulation of the ETEX Large-Scale Airborne Dispersion Experiment
Authors: Werth David , Maze Grace , Buckley Robert , Chiswell Steven 
Published: January 2019

AbstractAirborne tracer simulations are typically performed using a dispersion model driven by a high-resolution meteorological model. Besides solving the dynamic equations of momentum, heat, and moisture on the resolved model grid, mesoscale models must account for subgrid-scale fluxes and other unresolved processes. These are estimated through parameterization schemes of eddy diffusion, convection, and surface interactions, and they make use of prescribed parameters set by the user. Such “free” model parameters are often poorly constrained, and a range of plausible values exists for each. Evolutionary programming (EP) is a process to improve the selection of the parameters. A population of simulations is first run with a different set of parameter values for each member, and the member judged most accurate is selected as the “parent” of a new “generation.” After a number of iterations, the simulations should approach a configuration that is best adapted to the atmospheric conditions. We apply the EP process to simulate the first release of the 1994 European Tracer Experiment (ETEX) project, which comprised two experiments in which a tracer was released in western France and sampled by an observing network. The EP process is used to improve a simulation of the RAMS mesoscale weather model, with weather data collected during ETEX being used to “score” the individual members according to how well each simulation matches the observations. The meteorological simulations from before and after application of the EP process are each used to force a dispersion model to create a simulation of the ETEX release, and substantial improvement is observed when these are validated against sampled tracer concentrations.
On the Seasonal Cycle of the Tropical South Indian Ocean. Part I: Mixed Layer Heat and Salt Budgets
Authors: Soares Saulo M. , Richards Kelvin J. , Bryan Frank O. , Yoneyama Kunio 
Published: January 2019

AbstractScale interactions in the coupled ocean and atmosphere of the tropics play a crucial role in shaping the climate state and its spatial and temporal variability. The mechanisms driving the seasonal cycles of mixed layer (ML) temperature and salinity in the tropical south Indian Ocean (TSIO) are revisited and quantified using model and observations to form a basis on which to assess the cycle’s impact on shorter and longer time scale variability in the region. Budgets of ML heat for the western, central, and eastern TSIO in both model and observations indicate that seasonality in ML temperature is driven by surface heat fluxes in all regions; ocean processes, however, are essential to explain east–west differences in the cycle. In contrast, the salt budgets show that ML salinity in the west and central regions of the TSIO is driven by horizontal advection, with salinity increasing during austral winter mainly due to meridional advection, and freshening during spring–summer due to zonal advection; in the east, no single mechanism appears to dominate ML salinity seasonality. The ML seasonal cycle across the entire region is very much influenced by the basin-scale adjustment that occurs in response to monsoon winds in the eastern side of the basin. Zonal advection, as part of the adjustment process, is the key mechanism responsible for bringing fresher/colder waters from the east to the central and western TSIO during austral spring, leading to a lag in the coldest ML temperatures in the east relative to the west/central TSIO, and effectively coupling the eastern and western TSIO beyond simply Rossby wave dynamics.
Public Sector: Its Genesis and its Managers
Authors: Tandon Prakash 
Published: January 2019

This article is based on four lectures that the author delivered at the Indian Institute of Management Ahmedabad, in December, 1974. Part I of the article deals with the various reasons for the emergence of the public sector in different countries, different ways in which social control can be exercised, and the raison d'etre for the public sector in India in the background of the Avadi Resolution. Starting with an overview of the status of professional management in the country. Part II traces the Indian manager's origin from the days of the East India Company, highlights the coexistence of professionalism with internationalism, and concludes that the Indian manager should be not only well versed in the universal principles of management, but also be trained in how to deal with environmental constraints —especially the resistance to change. Part III analyses the problems of the public sectorambivalent attitude, absence of clear‐cut goals, accountability in retrospect, administrative culture, monopoly or semimonopoly situation, and poor labour-management relations—and suggests that a new breed of managers will emerge in the public sector possessing skills and flexibility to work through environmental challenges and through the altogether new testing situations in which they are often placed. Part IV examines the available choices—mixed economy as it is, a state and a joint sector, a state sector with a private ancillary sector around it, or a total state sector—and concludes by suggesting a nine-point strategy for the success of public sector in India.
Adoption Process and Marketing of Social Change: A Case Study of the Family Planning Programme
Authors: Bhatnagar S.C. 
Published: January 2019

Traditionally demographic and economic variables have been suggested for segmenting the family planning market. This paper argues that for designing effective communication strategies, couple's stage of adoption is a better basis for segmenting the family planning market. However, the major difficulty in using the suggested approach is the inadequate knowledge of the process of adoption. Therefore, a model of adoption is proposed. The methodology consisting of a heuristic built around automatic interaction detector (AID) is described. The validity and the salient features of the proposed adoption model are discussed. The segmentation scheme is proposed on the basis of the stages of adoption in family planning. Unlike conventional KAP researches, the segments provide a description of a couple in a multi‐dimensional space. The usefulness of the segmentation scheme in the design of work methodology for the worker is discussed. Finally, for planning at the district level, the implications of regional difference in the distribution of couples in the different market segments are discussed. This article is based on the author's doctoral dissertation, “Adoption of Family Planning : A Process Model and Optimal Pattern of Field Workers' Visits.” The dissertation was partially financed by the Population Project Unit of the Indian Institute of Management, Ahmedabad.
Characteristics of patients with enhancing intracranial atherosclerosis and association between plaque enhancement and recent cerebrovascular ischemic events: a high-resolution magnetic resonance imaging study
Authors: Huang Juan , Jiao Sheng , Zhao Xihai , Zhang Jintao , Zhang Chen , Chen Min , Song Yan 
Published: January 2019

Background Atherosclerotic plaque inflammation is a well-known risk factor for the development of ischemic stroke. Purpose To investigate the characteristics of patients with enhancing intracranial atherosclerosis and the relationship between plaque enhancement and recent cerebrovascular ischemic events by using high-resolution magnetic resonance imaging (HR-MRI). Material and Methods A total of 141 patients (102 men; mean age = 61.1 ± 11.4 years) with intracranial atherosclerotic plaque who underwent HR-MRI were enrolled in this study. The contrast ratio (CR) and contrast enhancement of the plaques were measured. Binary logistic regression was used to estimate the association between plaque enhancement and clinical and plaque characteristics. The relationship between plaque enhancement and recent ischemic events was evaluated by multivariate logistic regression analysis. Results Of 141 patients, plaque enhancement was detected in 80 (56.7%). Compared to patients without plaque enhancement, those with plaque enhancement had significantly lower level of high-density lipoprotein cholesterol, greater maximum plaque length, and more severe luminal stenosis. Luminal stenosis was independently associated with plaque enhancement (odds ratio [OR] = 1.026; 95% confidence interval [CI] = 1.014–1.039). Multivariate regression analysis showed that plaque enhancement was an independent indicator for recent ischemic events after adjusting for confounding factors (OR = 9.521; 95% CI = 4.301–19.900) (all P < 0.05). Conclusion Luminal stenosis is independently associated with plaque enhancement. We observed a strong association between plaque enhancement and recent ischemic events, which suggests that plaque enhancement may serve as an indicator of its instability.