bluuebunny/crossref_metadata_2025_split huggingface dataset:
Danegaptide for primary percutaneous coronary intervention in acute myocardial infarction patients: a phase 2 randomised clinical trial
Authors: Engstrøm Thomas , Nepper-Christensen Lars , Helqvist Steffen , Kløvgaard Lene , Holmvang Lene , Jørgensen Erik , Pedersen Frants , Saunamaki Kari , Tilsted Hans-Henrik , Steensberg Adam , Fabricius Søren , Mouritzen Ulrik , Vejlstrup Niels , Ahtarovski Kiril A , Göransson Christoffer , Bertelsen Litten , Kyhl Kasper , Olivecrona Göran , Kelbæk Henning , Lassen Jens Flensted , Køber Lars , Lønborg Jacob 
Published: March 2018

ObjectivesReperfusion immediately after reopening of the infarct-related artery in ST-segment elevation myocardial infarction (STEMI) may cause myocardial damage in addition to the ischaemic insult (reperfusion injury). The gap junction modulating peptide danegaptide has in animal models reduced this injury. We evaluated the effect of danegaptide on myocardial salvage in patients with STEMI.MethodsIn addition to primary percutaneous coronary intervention in STEMI patients with thrombolysis in myocardial infarction flow 0–1, single vessel disease and ischaemia time less than 6 hours, we tested, in a clinical proof-of-concept study, the therapeutic potential of danegaptide at two-dose levels. Primary outcome was myocardial salvage evaluated by cardiac MRI after 3 months.ResultsFrom November 2013 to August 2015, a total of 585 patients were randomly enrolled in the trial. Imaging criteria were fulfilled for 79 (high dose), 80 (low dose) and 84 (placebo) patients eligible for the per-protocol analysis. Danegaptide did not affect the myocardial salvage index (danegaptide high (63.9±14.9), danegaptide low (65.6±15.6) and control (66.7±11.7), P=0.40), final infarct size (danegaptide high (19.6±11.4 g), danegaptide low (18.6±9.6 g) and control (21.4±15.0 g), P=0.88) or left ventricular ejection fraction (danegaptide high (53.9%±9.5%), danegaptide low (52.7%±10.3%) and control (52.1%±10.9%), P=0.64). There was no difference between groups with regard to clinical outcome.ConclusionsAdministration of danegaptide to patients with STEMI did not improve myocardial salvage.Trial registration numberNCT01977755; Pre-results.
Retrospective natural history of thymidine kinase 2 deficiency
Authors: Garone Caterina , Taylor Robert W , Nascimento Andrés , Poulton Joanna , Fratter Carl , Domínguez-González Cristina , Evans Julie C , Loos Mariana , Isohanni Pirjo , Suomalainen Anu , Ram Dipak , Hughes M Imelda , McFarland Robert , Barca Emanuele , Lopez Gomez Carlos , Jayawant Sandeep , Thomas Neil D , Manzur Adnan Y , Kleinsteuber Karin , Martin Miguel A , Kerr Timothy , Gorman Grainne S , Sommerville Ewen W , Chinnery Patrick F , Hofer Monika , Karch Christoph , Ralph Jeffrey , Cámara Yolanda , Madruga-Garrido Marcos , Domínguez-Carral Jana , Ortez Carlos , Emperador Sonia , Montoya Julio , Chakrapani Anupam , Kriger Joshua F , Schoenaker Robert , Levin Bruce , Thompson John L P , Long Yuelin , Rahman Shamima , Donati Maria Alice , DiMauro Salvatore , Hirano Michio 
Published: March 2018

BackgroundThymine kinase 2 (TK2) is a mitochondrial matrix protein encoded in nuclear DNA and phosphorylates the pyrimidine nucleosides: thymidine and deoxycytidine. Autosomal recessive TK2 mutations cause a spectrum of disease from infantile onset to adult onset manifesting primarily as myopathy.ObjectiveTo perform a retrospective natural history study of a large cohort of patients with TK2 deficiency.MethodsThe study was conducted by 42 investigators across 31 academic medical centres.ResultsWe identified 92 patients with genetically confirmed diagnoses of TK2 deficiency: 67 from literature review and 25 unreported cases. Based on clinical and molecular genetics findings, we recognised three phenotypes with divergent survival: (1) infantile-onset myopathy (42.4%) with severe mitochondrial DNA (mtDNA) depletion, frequent neurological involvement and rapid progression to early mortality (median post-onset survival (POS) 1.00, CI 0.58 to 2.33 years); (2) childhood-onset myopathy (40.2%) with mtDNA depletion, moderate-to-severe progression of generalised weakness and median POS at least 13 years; and (3) late-onset myopathy (17.4%) with mild limb weakness at onset and slow progression to respiratory insufficiency with median POS of 23 years. Ophthalmoparesis and facial weakness are frequent in adults. Muscle biopsies show multiple mtDNA deletions often with mtDNA depletion.ConclusionsIn TK2 deficiency, age at onset, rate of weakness progression and POS are important variables that define three clinical subtypes. Nervous system involvement often complicates the clinical course of the infantile-onset form while extraocular muscle and facial involvement are characteristic of the late-onset form. Our observations provide essential information for planning future clinical trials in this disorder.
Newborn health benefits or financial risk protection? An ethical analysis of a real-life dilemma in a setting without universal health coverage
Authors: Onarheim Kristine Husøy , Norheim Ole Frithjof , Miljeteig Ingrid 
Published: March 2018

IntroductionHigh healthcare costs make illness precarious for both patients and their families’ economic situation. Despite the recent focus on the interconnection between health and financial risk at the systemic level, the ethical conflict between concerns for potential health benefits and financial risk protection at the household level in a low-income setting is less understood.MethodsUsing a seven-step ethical analysis, we examine a real-life dilemma faced by families and health workers at the micro level in Ethiopia and analyse the acceptability of limiting treatment for an ill newborn to protect against financial risk. We assess available evidence and ethical issues at stake and discuss the dilemma with respect to three priority setting criteria: health maximisation, priority to the worse-off and financial risk protection.ResultsGiving priority to health maximisation and extra priority to the worse-off suggests, in this particular case, that limiting treatment is not acceptable even if the total well-being gain from reduced financial risk is taken into account. Our conclusion depends on the facts of the case and the relative weight assigned to these criteria. However, there are problematic aspects with the premise of this dilemma. The most affected parties—the newborn, family members and health worker—cannot make free choices about whether to limit treatment or not, and we thereby accept deprivations of people’s substantive freedoms.ConclusionIn settings where healthcare is financed largely out-of-pocket, families and health workers face tragic trade-offs. As countries move towards universal health coverage, financial risk protection for high-priority services is necessary to promote fairness, improve health and reduce poverty.
Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients
Authors: L’Allinec Vincent , Ernst Marielle , Sevin-Allouet Mathieu , Testard Nathalie , Delasalle-Guyomarch Béatrice , Guillon Benoit , Mazighi Mikael , Desal Hubert , Bourcier Romain 
Published: March 2018

BackgroundAnticoagulated patients (APs) are currently excluded from acute ischemic stroke reperfusion therapy with intravenous recombinant tissue plasminogen activator (IV-rtPA); however, these patients could benefit from mechanical thrombectomy (MT). Evidence for MT in this condition remains scarce. The aim of this study was to analyze the safety and efficacy of MT in APs.MethodsWe analyzed three patient groups from two prospective registries: APs with MT (AP-MT group), non-anticoagulated patients treated with MT (NAP-MT group), and non-anticoagulated patients treated with IV-rtPA and MT (NAP-IVTMT group). Univariate and multivariate logistic regression were used to evaluate treatment efficacy with modified Rankin Scale (mRS) ≤2 and safety (radiologic intracranial hemorrhage (rICH), symptomatic intracranial hemorrhage (sICH) and death rate at 3 months) between groups.Results333 patients were included in the study, with 44 (12%) in the AP-MT group, 105 (31%) in the NAP-MT group, and 188 (57%) in the NAP-IVTMT group. Univariate analysis showed that the AP-MT group was older (P<0.001), more often had atrial fibrillation (P<0001), and had a higher ASPECTS (P<0.006 and P<0.002) compared with the NAP-MT group and NAP-IVTMT groups, respectively. Multivariate analysis showed that the AP-MT group had a lower risk of rICH (OR 2.77, 95% CI 1.01 to 7.61, P=0.05) but a higher risk of death at 3 months (OR 0.26, 95% CI 0.09 to 0.76, P=0.01) compared with the NAP-IVTMT group. No difference was found between the AP-MT and NAP-MT groups.ConclusionsWith regard to intracranial bleeding and functional outcome at 3 months, MT in APs seems as safe and efficient as in NAPs. However, there is a higher risk of death at 3 months in the AP-MT group compared with the NAP-IVTMT group.
Urinary excretion of platinum from South African precious metals refinery workers
Authors: Linde Stephanus J L , Franken Anja , du Plessis Johannes L 
Published: March 2018

BackgroundUrinary platinum (Pt) excretion is a reliable biomarker for occupational Pt exposure and has been previously reported for precious metals refinery workers in Europe but not for South Africa, the world’s largest producer of Pt.ObjectiveThis study aimed to quantify the urinary Pt excretion of South African precious metals refinery workers.MethodsSpot urine samples were collected from 40 workers (directly and indirectly exposed to Pt) at two South African precious metals refineries on three consecutive mornings prior to their shifts. Urine samples were analysed for Pt using inductively coupled plasma-mass spectrometry and were corrected for creatinine content.ResultsThe urinary Pt excretion of workers did not differ significantly between sampling days. Urinary Pt excretions ranged from <0.1 to 3.0 µg Pt/g creatinine with a geometric mean of 0.21 µg Pt/g creatinine (95% CI 0.17 to 0.26 µg Pt/g creatinine). The work area (P=0.0006; η2=0.567) and the number of years workers were employed at the refineries (P=0.003; η2=0.261) influenced their urinary Pt excretion according to effect size analyses. Directly exposed workers had significantly higher urinary Pt excretion compared with indirectly exposed workers (P=0.007).ConclusionThe urinary Pt excretion of South African precious metals refinery workers reported in this study is comparable with that of seven other studies conducted in precious metals refineries and automotive catalyst plants in Europe. The Pt body burden of workers is predominantly determined by their work area, years of employment in the refineries and whether they are directly or indirectly exposed to Pt.
Average Counting via Approximate Histograms
Authors: Cichoń Jacek , Gotfryd Karol 
Published: March 2018

We propose a new algorithm for the classical averaging problem for distributed wireless sensors networks. This subject has been studied extensively and there are many clever algorithms in the literature. These algorithms are based on the idea of local exchange of information. They behave well in dense networks (e.g., in networks whose connections form a complete graph), but their convergence to the real average is very slow in linear or cyclic graphs.
Our solution is different. In order to calculate the average, we first build an approximate histogram of observed data; then, from this histogram, we estimate the average. In our solution, we use the extreme propagation technique and probabilistic counters. It allows us to find the approximation of the average of a set of measurements done by sensor network with arbitrary precision, controlled by two parameters. Our method requires O(D) rounds, where D is the diameter of the network. We study the message complexity of this algorithm and show that it is of order O(log n) for each node, where n is the size of the network.
Geographic Inequalities in Progress against Lung Cancer among Women in the United States, 1990–2015
Authors: Ross Katherine , Kramer Michael R. , Jemal Ahmedin 
Published: March 2018

Abstract
Background: Lung cancer–related death rates in the United States have declined steadily since 1990 in men but not until the mid-2000s in women, with the gap in mortality narrowing during the most recent time period. We examined variation in the declining trend among women by county, where many tobacco control policies are implemented.
Methods: We obtained county-level lung cancer death rates among women from the National Center for Health Statistics mortality file and calculated relative changes from 1990–1999 to 2006–2015. Optimized hotspot analysis identified contiguous counties with small declines or increases in death rates.
Results: We identified two distinct clusters of counties: 669 in Appalachia and the Midwest (Hotspot 1) and 81 in the northern Midwest (Hotspot 2). From 1990–1999 to 2006–2015, death rates among women increased by 13% in Hotspot 1 and by 7% in Hotspot 2 counties, while rates decreased by 6% in the non-hotspot United States. From 1990–2015, death rate ratios (RRs) in hotspot versus non-hotspot counties changed from 4% lower (RR, 0.96; 95% CI, 0.94–0.99) to 28% higher [RR, 1.28; 95% confidence interval (CI), 1.25–1.31] for Hotspot 1 counties and from 18% lower (RR, 0.82; 95% CI, 0.76–0.89) to unity (RR, 0.99; 95% CI, 0.93–1.05) for Hotspot 2 counties.
Conclusions: We identified areas in the Midwest and Appalachia where progress against lung cancer mortality among women has lagged compared with a steady national decline.
Impact: Targeted tobacco control programs could reduce the excess burden of lung cancer among women living in hotspot counties and prevent widening geographic inequity. Cancer Epidemiol Biomarkers Prev; 27(11); 1261–4. ©2018 AACR.
Predictors of Acute Failure Ablation of Intra‐atrial Re‐entrant Tachycardia in Patients With Congenital Heart Disease: Cardiac Disease, Atypical Flutter, and Previous Atrial Fibrillation
Authors: Roca‐Luque Ivo , Rivas‐Gándara Nuria , Dos‐Subirà Laura , Francisco‐Pascual Jaume , Pijuan‐Domenech Antònia , Pérez‐Rodon Jordi , Santos‐Ortega Alba , Roses‐Noguer Ferran , Ferreira‐Gonzalez Ignacio , García‐Dorado García David , Moya Mitjans Angel 
Published: March 2018

Background

Intra‐atrial re‐entrant tachycardia (
IART
) in patients with congenital heart disease (
CHD
) increases morbidity and mortality. Radiofrequency catheter ablation has evolved as the first‐line treatment. The aim of this study was to analyze the acute success and to identify predictors of failed
IART
radiofrequency catheter ablation in
CHD
.

Methods and Results

The observational study included all consecutive patients with
CHD
who underwent a first ablation procedure for
IART
at a single center from January 2009 to December 2015 (94 patients, 39.4% female, age: 36.55±14.9 years). In the first procedure, 114
IART
were ablated (acute success: 74.6%; 1.21±0.41
IART
per patient) with an acute success of 74.5%. Cavotricuspid isthmus–related
IART
was the only arrhythmia in 51%; non–cavotricuspid isthmus–related
IART
was the only mechanism in 27.7% and 21.3% of the patients had both types of
IART
. Predictors of acute radiofrequency catheter ablation failure were as follows: nonrelated cavotricuspid isthmus
IART
(odds ratio 7.3; confidence interval [CI], 1.9–17.9;
P
=0.04), previous atrial fibrillation (odds ratio 6.1; CI, 1.3–18.4;
P
=0.02), transposition of great arteries (odds ratio, 4.9; CI, 1.4–17.2;
P
=0.01) and systemic ventricle dilation (odds ratio 4.8; CI, 1.1–21.7;
P
=0.04) with an area under the receiver operating characteristic curve of 0.83±0.056 (CI, 0.74–0.93,
P
=0.001). After a mean follow‐up longer than 3.5 years, 78.3% of the patients were in sinus rhythm (33.1% of the patients required more than 1 radiofrequency catheter ablation procedure).

Conclusions

Although ablation in
CHD
is a challenging procedure, acute success of 75% can be achieved in moderate–highly complex
CHD
patients in a referral center. Predictors of failed ablation are
IART
different from cavotricuspid isthmus, previous atrial fibrillation, and markers of complex
CHD
(transposition of great arteries, systemic ventricle dilation).
Reliability and convergent validity of the Emotional Intelligence Admission Essay Scale, revised
Authors: Gutman Sharon A , Falk-Kessler Janet P 
Published: March 2018

Introduction The purpose of this study was to reassess the reliability and convergent validity of the revised Emotional Intelligence Admission Essay Scale, and determine whether the scale could identify students demonstrating professional behavior problems in the classroom and fieldwork environments. Method Thirty-six student participants completed the revised Emotional Intelligence Admission Essay Scale and Schutte Assessing Emotions Scale. Interrater reliability, internal consistency, and convergent validity were established. Results Interrater reliability and internal consistency were found to be high (intraclass correlation coefficient = .82, p < .001; Cronbach’s alpha = .96, p < .001, respectively). When participants were separated by age, convergent validity between the Emotional Intelligence Admission Essay Scale and Schutte Assessing Emotions Scale of participants aged ≥ 26 years was high ( rs = .83, p < .002) compared to those ≤ 25 years ( rs = .58, p < .002). Six participants (16.6%) received Emotional Intelligence Admission Essay Scale scores of 0 and were identified as potentially exhibiting professional behavioral problems; three of these students demonstrated professional behavior problems in the academic and/or fieldwork settings. Conclusion The Emotional Intelligence Admission Essay Scale can be used as a screen to identify whether students may exhibit professional behavior problems; however, caution should be used as some identified students may be able to prevent professional behavior problems once aware of program expectations.
Prevalence of Cleft Lip/Palate in the Fangshan District of Beijing, 2006-2012
Authors: Yang Yanfen , Liu Hui , Ma Ruixin , Jin Lei 
Published: March 2018

Objective:To estimate the cleft lip with or without cleft palate (CL/P) prevalence among births between 2006 and 2012 in Fangshan district of Beijing, China.Design:Surveillance data analysis.Setting:All hospitals that provide obstetric services in the district.Patients:The CL/P cases presented for this report were from 13 weeks’ gestation to 7 days postpartum.Main Outcome Measures:The CL/P prevalence was defined as the number of cases per 10 000 births, including live births and stillbirths at 28 weeks’ gestation or beyond.Results:The overall CL/P prevalence was 18.9 (95% confidence interval [CI]: 15.1-22.7) per 10 000 births. From 2006 to 2012, the CL/P prevalence was 19.3, 20.2, 10.9, 16.1, 17.5, 25.4, and 22.3 per 10 000 births; annually, no significant change was noted ( Pfor trend= .311). The prevalence of cleft palate, cleft lip, and cleft lip and palate were 3.4 (95% CI: 2.0-5.4), 6.2 (95% CI: 4.2-8.8), and 9.4 (95% CI: 6.9-12.4) per 10 000 births, respectively. The CL/P prevalence among the nonpermanent residents (31.4 per 10 000 births) was 2.31 times that of permanent residents (13.6 per 10 000 births). Among nonpermanent residents, the CL/P prevalence showed an upward trend over the study period ( Pfor trend= .036), that increased from 38.8 (95% CI: 16.5-76.6) per 10 000 births in 2006 to 54.6 (95% CI: 25.7-100.4) per 10 000 births in 2012.Conclusions:The overall CL/P prevalence was stable in the Fangshan district. However, the CL/P prevalence of the nonpermanent residents increased significantly.
Exploring self-reflection in dual relationship decision-making
Authors: Brownlee Keith , LeBlanc Heather , Halverson Glenn , Piché Tammy , Brazeau James 
Published: March 2018

Summary Social workers practicing in small rural towns regularly encounter overlapping or dual relationships with clients. This can lead to boundary crossing and conflicts of interest that require an ethical decision. Previous research on how rural social workers approach ethical decision-making in these situations has suggested that while they might draw on ethical codes, many rely on intuitive or personal viewpoints rather than systematic decision-making processes. Although social workers are often trained to engage in self-reflection when faced with the complexities of practice and the possibilities of personal biases, the role of systematic self-reflection in personal decision-making about dual relationships has not been sufficiently documented in the literature. Using qualitative inquiry, this study explored the lived experiences with dual relationships reported by 44 practitioners working in small towns in rural Canada. Findings The findings confirm that practitioners were frequently guided in their decisions by an intuitive or emotional understanding of dual relationships rather than by external codes, and while self-reflection was seen to play a role, a formal or systematic approach to personal self-reflection was not reported. Applications The findings suggest that educational or professional development on more intentional use of self-reflection in practice would aid in safeguarding the client and the worker when dealing with dual relationships, while providing an ethical process congruent with a rural and remote community identity. Explicit decision-making would also make the process more defensible and justifiable, not only to themselves, but also to colleagues, supervisors, and to their professional association.
The effect of sildenafil on gastric motility and satiation in healthy controls
Authors: Carbone F , Tack J 
Published: March 2018

Sildenafil induces relaxation of smooth muscle cells by blocking PDE5. Dyspepsia is one of sildenafil's most frequently reported adverse events, suggesting its effect on gastric motility. Our aim was to study the effect of sildenafil on gastric accommodation (GA) and gastric emptying (GE) in healthy volunteers (HVs).MethodsSildenafil (50 mg) or placebo was randomly administered to 16 blinded HVs. After a manometry probe and an infusion catheter were positioned in the proximal stomach, the intragastric pressure (IGP) was measured before and during nutrient drink infusion (ND, 60 ml/min). HVs were asked to score their hunger, satiation and six epigastric symptoms at five‐minute intervals. The experiment ended when the HVs scored maximal satiation during ND infusion at one‐minute intervals. To assess GE, breath samples were collected every 15 minutes for six hours after the meal (244 kcal).ResultsND infusion induced a drop in proximal stomach IGP, which was suppressed by sildenafil (average area under the curve for sildenafil: −33.6 ± 8.8 mmHg; placebo: −60.8 ± 11.3 mmHg, p = 0.005). Sildenafil‐treated volunteers reached earlier maximal satiation compared to placebo (678 ± 70 ml vs. 836 ± 82.6 ml, p = 0.019). Finally, GE was significantly slower after sildenafil (90.6 ± 5.9 min vs. 76.6 ± 7.1 min, p = 0.04).ConclusionSildenafil inhibits GA, leading to significantly decreased nutrient tolerance, and slightly delays the GE rate in humans.