bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystathionine γ-Lyase Modulates Flow-Dependent Vascular Remodeling
Authors: Yuan Shuai , Yurdagul Arif , Peretik Jonette M. , Alfaidi Mabruka , Al Yafeai Zaki , Pardue Sibile , Pearson Brenna H. , Kevil Christopher G. , Orr A. Wayne 
Published: July 2018

Objective—

Flow patterns differentially regulate endothelial cell phenotype, with laminar flow promoting vasodilation and disturbed flow promoting endothelial proinflammatory activation. CSE (cystathionine γ-lyase), a major source of hydrogen sulfide (H
2
S) in endothelial cells, critically regulates cardiovascular function, by both promoting vasodilation and reducing endothelial activation. Therefore, we sought to investigate the role of CSE in the endothelial response to flow.

Approach and Results—

Wild-type C57Bl/6J and
CSE
knockout (
CSE
−/−
) mice underwent partial carotid ligation to induce disturbed flow in the left carotid. In addition, endothelial cells isolated from wild-type and CSE

−/−

mice were exposed to either laminar or oscillatory flow, an in vitro model of disturbed flow. Interestingly, laminar flow significantly reduced CSE expression in vitro, and only disturbed flow regions show discernable CSE protein expression in vivo, correlating with enhanced H
2
S production in wild-type C57BL/6J but not
CSE
−/−
mice. Lack of CSE limited disturbed flow-induced proinflammatory gene expression (ICAM-1[intercellular adhesion molecule 1], VCAM-1 [vascular cell adhesion molecular 1]) and monocyte infiltration and
CSE
−/−
endothelial cells showed reduced NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) activation and proinflammatory gene expression in response to oscillatory flow in vitro. In addition,
CSE
−/−
mice showed reduced inward remodeling after partial carotid ligation.
CSE
−/−
mice showed elevated vascular nitrite levels (measure of nitric oxide [NO]) in the unligated carotids, suggesting an elevation in baseline NO production, and the NO scavenger 2-(4-carboxyphenyl)-4,5-dihydro-4,4,5,5-tetramethyl-1H-imidazolyl-1-oxy-3-oxide normalized the reduced inward remodeling, but not inflammation, of ligated carotids in
CSE
−/−
mice.

Conclusions—
CSE expression in disturbed flow regions critically regulates both endothelial activation and flow-dependent vascular remodeling, in part through altered NO availability.
HeartLogic Multisensor Algorithm Identifies Patients During Periods of Significantly Increased Risk of Heart Failure Events
Authors: Gardner Roy S. , Singh Jagmeet P. , Stancak Branislav , Nair Devi G. , Cao Michael , Schulze Christopher , Thakur Pramodsingh H. , An Qi , Wehrenberg Scott , Hammill Eric F. , Zhang Yi , Boehmer John P. 
Published: July 2018

Background:
Care of heart failure (HF) patients results in a high burden on healthcare resources, and estimating prognosis is becoming increasingly important to triage resources wisely. Natriuretic peptides are recommended prognosticators in chronic HF. Our objective was to evaluate whether a multisensor HF index and alert algorithm (HeartLogic) replaces or augments current HF risk stratification.

Methods and Results:
MultiSENSE (Multisensor Chronic Evaluation in Ambulatory Heart Failure Patients) enrolled 900 patients with cardiac resynchronization therapy defibrillators enabled for collection of heart sounds, respiration, thoracic impedance, heart rate, and activity data. The HeartLogic algorithm automatically calculated a daily HF index and identified periods IN or OUT of an active alert state relative to a configurable threshold. Patients experienced 192 independently adjudicated HF events (average rate, 0.20/patient-year [pt-yr]) during 1 year of follow-up. HF event rates while IN alert was 10-fold higher than OUT of alert (0.80 versus 0.08 events/pt-yr). Combined with NT-proBNP (N-terminal pro-B-type natriuretic peptide) at enrollment (relative to 1000 pg/mL threshold, event rate was 0.42 [HIGH] versus 0.07 [LOW] events/pt-yr), substratification found the lowest risk group (LOW NT-proBNP and OUT of alert) experienced 0.02 events/pt-yr, whereas the highest risk group (HIGH NT-proBNP and IN alert) was associated with a 50-fold increased risk of an HF event (1.00 events/pt-yr) relative to the lowest risk group.

Conclusions:
Dynamic assessment using implantable device sensors within HeartLogic by itself or in conjunction with NT-proBNP measurements can identify time-intervals when patients are at significantly increased risk of worsening HF and potentially better triage resources to this vulnerable patient population.

Clinical Trial Registration:

https://www.clinicaltrials.gov
. Unique identifier: NCT01128166.
Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All‐Cause Mortality in the REGARDS Study
Authors: Shikany James M. , Safford Monika M. , Bryan Joanna , Newby P. K. , Richman Joshua S. , Durant Raegan W. , Brown Todd M. , Judd Suzanne E. 
Published: July 2018

Background

Previously, we reported on associations between dietary patterns and incident acute coronary heart disease (
CHD
) in the
REGARDS
(Reasons for Geographic and Racial Differences in Stroke) study. Here, we investigated the associations of dietary patterns and a dietary index with recurrent
CHD
events and all‐cause mortality in
REGARDS
participants with existing
CHD
.

Methods and Results

We included data from 3562 participants with existing
CHD
in
REGARDS
. We used Cox proportional hazards regression to examine the hazard of first recurrence of
CHD
events—definite or probable
MI
or acute
CHD
death—and all‐cause mortality associated with quartiles of empirically derived dietary patterns (convenience, plant‐based, sweets, Southern, and alcohol and salads) and the Mediterranean diet score. Over a median 7.1 years (interquartile range, 4.4, 8.9 years) follow‐up, there were 581 recurrent
CHD
events and 1098 deaths. In multivariable‐adjusted models, the Mediterranean diet score was inversely associated with the hazard of recurrent
CHD
events (hazard ratio for highest score versus lowest score, 0.78; 95% confidence interval, 0.62–0.98;

P
T

rend
=0.036). The Southern dietary pattern was adversely associated with the hazard of all‐cause mortality (hazard ratio for Q4 versus Q1, 1.57; 95% confidence interval, 1.28–1.91;
P
Trend
<0.001). The Mediterranean diet score was inversely associated with the hazard of all‐cause mortality (hazard ratio for highest score versus lowest score, 0.80; 95% confidence interval, 0.67–0.95;

P
T

rend
=0.014).

Conclusions

The Southern dietary pattern was associated with a greater hazard of all‐cause mortality in
REGARDS
participants. Greater adherence to the Mediterranean diet was associated with both a lower hazard of recurrent
CHD
events and all‐cause mortality.
Deleterious Effects of Cold Air Inhalation on Coronary Physiological Indices in Patients With Obstructive Coronary Artery Disease
Authors: Williams Rupert P. , Asrress Kaleab N. , Lumley Matthew , Arri Satpal , Patterson Tiffany , Ellis Howard , Manou‐Stathopoulou Vasiliki , Macfarlane Catherine , Chandran Shruthi , Moschonas Kostantinos , Oakeshott Pippa , Lockie Timothy , Chiribiri Amedeo , Clapp Brian , Perera Divaka , Plein Sven , Marber Michael S. , Redwood Simon R. 
Published: July 2018

Background

Cold air inhalation during exercise increases cardiac mortality, but the pathophysiology is unclear. During cold and exercise, dual‐sensor intracoronary wires measured coronary microvascular resistance (
MVR
) and blood flow velocity (
CBF
), and cardiac magnetic resonance measured subendocardial perfusion.

Methods and Results

Forty‐two patients (62±9 years) undergoing cardiac catheterization, 32 with obstructive coronary stenoses and 10 without, performed either (1) 5 minutes of cold air inhalation (5°F) or (2) two 5‐minute supine‐cycling periods: 1 at room temperature and 1 during cold air inhalation (5°F) (randomized order). We compared rest and peak stress
MVR
,
CBF
, and subendocardial perfusion measurements. In patients with unobstructed coronary arteries (n=10), cold air inhalation at rest
decreased
MVR
by 6% (
P
=0.41), increasing
CBF
by 20% (
P
<0.01). However, in patients with obstructive stenoses (n=10), cold air inhalation at rest
increased
MVR
by 17% (
P
<0.01), reducing
CBF
by 3% (
P
=0.85). Consequently, in patients with obstructive stenoses undergoing the cardiac magnetic resonance protocol (n=10), cold air inhalation reduced subendocardial perfusion (
P
<0.05). Only patients with obstructive stenoses performed this protocol (n=12). Cycling at room temperature decreased
MVR
by 29% (
P
<0.001) and increased
CBF
by 61% (
P
<0.001). However, cold air inhalation during cycling blunted these adaptations in
MVR
(
P
=0.12) and
CBF
(
P
<0.05), an effect attributable to defective early diastolic
CBF
acceleration (
P
<0.05) and associated with greater
ST
‐segment depression (
P
<0.05).

Conclusions

In patients with obstructive coronary stenoses, cold air inhalation causes deleterious changes in
MVR
and
CBF
. These diminish or abolish the normal adaptations during exertion that ordinarily match myocardial blood supply to demand.
Admission Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker of Outcomes in Large Vessel Occlusion Strokes
Authors: Goyal Nitin , Tsivgoulis Georgios , Chang Jason J. , Malhotra Konark , Pandhi Abhi , Ishfaq Muhammad F. , Alsbrook Diana , Arthur Adam S. , Elijovich Lucas , Alexandrov Andrei V. 
Published: July 2018

Background and Purpose—
The purpose of this study is to evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR) at admission with safety and efficacy outcomes in acute stroke patients with large vessel occlusion after mechanical thrombectomy.

Methods—
Consecutive large vessel occlusion patients treated with mechanical thrombectomy during a 4-year period were evaluated. Outcome measures included symptomatic intracranial hemorrhage, 3-month mortality, successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b/3), and 3-month functional independence (modified Rankin Scale scores of 0–2).

Results—

A total of 293 large vessel occlusion patients underwent mechanical thrombectomy (median admission NLR, 3.5; interquartile range [IQR], 1.7–6.8). In initial univariable analyses, higher median admission NLR values were documented in patients with symptomatic intracranial hemorrhage (8.5; IQR, 4.7–11.3) versus (3.9; IQR, 1.9–6.5);
P
<0.001 and individuals who were dead at 3-months (5.4; IQR, 2.8–9.6) versus (4.0; IQR, 1.8–6.4);
P
=0.004. Lower NLR values were recorded in patients with 3-month functional independence (3.7; IQR, 1.7–6.5) versus (4.3; IQR, 2.6–8.3);
P
=0.039. After adjustment for potential confounders, a 1-point increase in NLR was independently associated with higher odds of symptomatic intracranial hemorrhage (odds ratio, 1.11; 95% CI, 1.03–1.20;
P
=0.006) and 3-month mortality (odds ratio, 1.08; 95% CI, 1.01–1.16;
P
=0.014).

Conclusions—
Higher admission NLR is an independent predictor of symptomatic intracranial hemorrhage and 3-month mortality in large vessel occlusion patients treated with mechanical thrombectomy, and it may identify a target group for testing adjunctive anti-inflammatory therapies.
Clinical Prediction Rules to Classify Types of Stroke at Prehospital Stage
Authors: Uchida Kazutaka , Yoshimura Shinichi , Hiyama Nagayasu , Oki Yoshiharu , Matsumoto Tsuyoshi , Tokuda Ryo , Yamaura Ikuya , Saito Shin , Takeuchi Masataka , Shigeta Keigo , Araki Hayato , Morimoto Takeshi 
Published: July 2018

Background and Purpose—
Endovascular therapy is effective against acute cerebral large vessel occlusion (LVO). However, many patients do not receive such interventions because of the lack of timely identification of the type of stroke. If the types of stroke (any stroke, LVO, intracranial hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) were to be predicted at the prehospital stage, better access to appropriate interventions would be possible. Japan Urgent Stroke Triage (JUST) score was clinical prediction rule to classify suspected patients of acute stroke into different types at the prehospital stage.

Methods—
We obtained information for signs and symptoms and medical history of consecutive suspected patients of acute stroke at prehospital stage from paramedics and final diagnosis from the receiving hospital. We constructed derivation cohort in the historical multicenter cohort study from June 2015 to March 2016 and validation cohort in the prospective multicenter cohort study from August 2016 to July 2017. The derivation and the validation cohorts included 1229 and 1007 patients, respectively. We constructed multivariate logistic regression models with 21 variables to develop clinical prediction rules, which distinguish between different types of stroke: any stroke, LVO, ICH, and SAH.

Results—
Among the 1229 patients (median age, 72 years; 55% men) in the derivation cohort, 533 stroke, 104 LVO, 169 ICH, and 57 SAH cases were observed. The developed rules showed that the areas under the receiver operating curves were 0.88 for any stroke, 0.92 for LVO, 0.84 for ICH, and 0.89 for SAH. The validation cohort of 1007 patients (median age, 75 years; 56% men) showed that the areas under the curves of any stroke, LVO, ICH, and SAH were 0.80, 0.85, 0.77, and 0.94, respectively.

Conclusions—
These clinical prediction rules can help paramedics classify the suspected patients of stroke into any stroke, LVO, ICH, and SAH groups with excellent accuracy.
Improvement and Validation of the Common Land Model on Cropland Covered by Plastic Film in the Arid Region of China
Authors: Lu Sha , Zuo Hongchao 
Published: July 2018

AbstractPlastic mulch is a technology used worldwide to inhibit soil evaporation and increase crop yield. The properties of plastic film are significantly different from those of the soil. Plastic mulch not only significantly alters the physical attributes of the underlying surface, but also blocks the energy and mass exchanges between the land surface and the atmosphere. This latter situation has not been depicted in current land-surface models. This study develops a detailed new model, known as CoLM-mulch, by incorporating a plastic mulch–layer submodel and a dynamic parameterization scheme of surface albedo into the Common Land Model (CoLM) land-surface process model. The updated model elements are based on data collected from an experiment that examined land–atmosphere interaction at a plastic-film-covered cropland site in an arid region of northwestern China. Results suggest that the improved CoLM-mulch could reasonably simulate the diurnal variations of soil temperature and moisture, together with radiation, water, heat, and carbon dioxide (CO2) fluxes, on the cropland underlying a surface with a plastic film covering. The CoLM-mulch efficiency is higher, the deviations between the simulations and observations are minor, and the dynamic parameterization scheme for surface albedo is more reasonable and appropriate. Relative to CoLM simulations, the inclusion of plastic mulch with special optical properties in the model shows slight improvements in the simulations of the surface albedo and the radiation balance. By limiting the underlying soil evaporation and changing the aerodynamic resistances, plastic mulch in the model has influences on the turbulent exchanges between the atmosphere and the land surface. The soil temperature and moisture are improved by the inclusion of transparent plastic mulch in the model, which not only suppresses the CO2 generated by soil respiration, but also alters the CO2 exchange process between the canopy and the atmosphere as a result of the vegetation net assimilation controlled by the soil water and heat conditions.
The importance of scene photography in routine coronial practice: Results of an audit with an illustrative case of suspected suicidal fatal air embolism
Authors: Johnson George A , Smith Philip , Robinson Jamie , Collis Sallyanne A , Johnson Christopher Paul 
Published: July 2018

Pathologists providing a coronial autopsy service are very reliant on the information, including that concerning the body at the scene, provided prior to the post-mortem examination. This ensures the case is appropriate for a non-forensic autopsy and allows proper interpretation of the pathological and laboratory findings. We present the results of an audit of the extent and accuracy of the information provided (in terms of a set of descriptors), in relation to the body at the scene; whether just the information on the coronial autopsy request form 97a is used, or if it is supplemented with details from the police form 97 and statements from attending officers and scene witnesses. The scene photographs were then reviewed to assess the accuracy of the other information sources and their value to the reporting pathologist. The audit showed that scene photographs are undertaken surprisingly frequently (29.6%) but this was only clear from the coronial request in 22% of referrals. More information was consistently available in the police information for most of the scene descriptors. This was usually accurate, but only partially so, with an average of 19% of relevant features. Viewing the scene photographs was deemed beneficial or essential in 51% and 41.1% of cases. The value of scene photography is then illustrated in a case of suspected suicidal venous air embolism, where subsequent review of the images pointed strongly to the rapidity of death, with minimal blood loss but obvious targeting of a very large varicose saphenous vein in the upper thigh.
Consumption of licit and illicit substances in Portuguese young people: a population-based cross-sectional study
Authors: Silva Carlos Franclim , Rocha Paula , Santos Paulo 
Published: July 2018

Background The consumption of addictive substances is common in adolescence and raises concerns about future addiction. We investigated addictive substance consumption among young people to inform the design of drug intervention programmes. Methods Participants were a population-based sample of 14- to 24-year-olds from Paredes, northern Portugal. A self-report questionnaire measured social and health variables, including tobacco, alcohol and illicit drug consumption. Results Data were analysed for 731 valid responses. Participants who had drunk alcohol did so first at 14.7 years (mean); 15.3% (95% confidence intervals [CI]: 12.9–18.1) drank alcohol regularly (more than 1/week, adjusted for age and sex) (95% CI: 12.9–18.1). Participants who had smoked tobacco did so first at 14.8 years (mean); 16.6% (95% CI: 14.0–19.5) were regular smokers. Illicit drug consumption was reported by 16.7% of participants (95% CI: 14.2–19.6) and 10.4% consumed drugs regularly. Conclusion We found a high prevalence of addictive substance consumption, particularly alcohol. As cultural attitudes likely influence alcohol consumption, a multigenerational approach is needed to address adolescent consumption. Participants’ main sources of drug information were family members. Strategies are needed to promote drug literacy in parents and other relatives to change adolescents’ culturally acquired habits of addictive substance consumption.
Information and communication technology use within occupational therapy home assessments: A scoping review
Authors: Ninnis Kayla , Van Den Berg Maayken , Lannin Natasha A , George Stacey , Laver Kate 
Published: July 2018

Introduction Home assessments conducted by occupational therapists can identify hazards and prevent falls. However, they may not be conducted because of limited time or long distances between the therapist’s workplace and the person’s home. Developments in technologies may overcome such barriers and could improve the quality of the home assessment process. Method This scoping review synthesises the findings of studies evaluating information and communication technology use within occupational therapy home assessments. Results Fourteen studies were included and revealed the two main approaches to technology use: the development of new applications and the use of existing and readily available technologies. Facilitators and barriers to use were also identified. Facilitators included usefulness, ease of use and the potential for cost-effectiveness. Barriers to use included poor usability, unsuitability for some populations and perceived threat to the role of occupational therapy. The synthesis revealed that traditional in-home assessments conducted by therapists are more sensitive in identifying hazards. Conclusion The availability of new technologies offers potential to improve service delivery; however these technologies are underutilised in clinical practice. Technologies may offer advantages in the conduct of home assessments, especially regarding efficiency, but have not yet been shown to be superior in terms of patient outcome.
The EMALT Score: An Improved Model for Prediction of Early Mortality in Liver Transplant Recipients
Authors: Lindenmeyer Christina C. , Kim Ahyoung , Sanghi Vedha , Lopez Rocio , Niyazi Fadi , Mehta Neal A. , Flocco Gianina , Kapoor Aanchal , Carey William D. , Romero-Marrero Carlos 
Published: July 2018

Purpose: Needs, risks, and outcomes of patients admitted to a post liver transplant intensive care unit (POLTICU) differ in important ways from those admitted to pretransplant intensive care units (ICUs). The aim of this study was to create the optimal model to risk stratify POLTICU patients. Methods: Consecutive patients who underwent first deceased donor liver transplantation (LT) at a large United States center between 2008 and 2014 were followed from admission to LT and to discharge or death. Receiver–operating characteristic analysis was performed to assess the value of various scores in predicting in-hospital mortality. A predictive model was developed using logistic regression analysis. Results: A total of 697 patients underwent LT, and 3.2% died without leaving the hospital. A model for in-hospital mortality was derived from variables available within 24 hours of admission to the POLTICU. Key variables best predicting survival were white blood cell count, 24-hour urine output, and serum glucose. A model using these variables performed with an area under the curve (AUC) of 0.88, compared to the Acute Physiology and Chronic Health Evaluation III and Model for End-Stage Liver Disease, which performed with AUCs of 0.74 and 0.60, respectively. Conclusion: An improved model, the early mortality after LT (EMALT) score, performs better than conventional models in predicting in-hospital mortality after LT.
Assessment of India’s Fiscal and External Sector Vulnerability: A Balance Sheet Approach
Authors: Pradhan Krishanu 
Published: July 2018

The article is an attempt to assess India’s fiscal and external sector vulnerability in the context of the deterioration in major macroeconomic indicators in recent years. The balance sheet approach (BSA) developed mainly by the International Monetary Fund (IMF) is applied to analyse episodes of major fiscal, financial and external payment crises in developing countries between the late 1990s to early 2000. The present work assesses the vulnerability in India’s fiscal and external sectors by descriptive and comparative analyses of relevant indicators and developing a composite vulnerability index (CVI) consisting of the indicators under study. Fiscal or external sector vulnerability can also be assessed by how easily or smoothly a government or a nation can finance its budgetary deficit or rollover of debt or the external sector funding needs. The method of financing and management of debt-related liabilities become important in this context. This may get reflected in currency composition, maturity pattern and ownership pattern of liabilities. The CVI score and favourable currency composition, maturity pattern and ownership pattern of liabilities largely helped India reduce both fiscal and external sector liabilities significantly in recent years. JEL Classification: E60, F34, H63