bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of prediction value of four bleeding risk scores for pulmonary embolism with anticoagulation: A real‐world study in Chinese patients
Authors: Zhang Zhu , Lei Jieping , Zhai Zhenguo , Yang Yuanhua , Wan Jun , Xie Wanmu , Wang Chen 
Published: January 2019

AbstractBackgroundMajor bleeding (MB) and clinically relevant bleeding (CRB) are the most common seen complications associated with anticoagulation treatment for pulmonary embolism (PE) patients. A bleeding risk score (BRS) may help to accurately determine the risk of bleeding and make better decisions for patients in clinical practice.MethodsPatients diagnosed as acute PE and who met the inclusion criteria in Beijing Chao‐Yang Hospital from January 2009 to September 2013 were consecutively enrolled. Baseline data were collected. Four BRS (Kuijer score, RIETE score, Kearon score and Nieuwenhuis score) were assessed and compared using the area under the receiver operating characteristic curve (AUC).ResultsA total number of 563 patients were included in the study. Of which, 16 had MB and 89 had CRB within three months of anticoagulation treatment. Three months' cumulative incidence for MB and CRB events was 0.03 (95% CI 0.01‐0.05) and 0.17 (95% CI 0.12‐0.21), respectively. In our study population, the AUCs for Kuijer, RIETE, Kearon and Nieuwenhuis scores were 0.57 (95% CI 0.44~0.68), 0.56 (95% CI 0.45‐0.71), 0.75 (95% CI 0.60~0.89) and 0.59 (95% CI 0.41~0.74), respectively. In addition, the AUCs of four BRS for CRB were all poor, with values less than 0.65.ConclusionsOnly the Kearon score appeared to have more accuracy in predicting the risk of MB. Further large prospective studies are needed to externally validate a BRS for CRB.
Temporal trends in survival following ward‐based NIV for acute hypercapnic respiratory failure in patients with COPD
Authors: Trethewey Samuel P. , Edgar Ross G. , Morlet Julien , Mukherjee Rahul , Turner Alice M. 
Published: January 2019

AbstractIntroductionNon‐invasive ventilation (NIV) is recommended for treatment of acute hypercapnic respiratory failure (AHRF) in acute exacerbations of COPD. National UK audit data suggests that mortality rates are rising in COPD patients treated with NIV.ObjectiveTo investigate temporal trends in in‐hospital mortality in COPD patients undergoing a first episode of ward‐based NIV for AHRF.MethodsRetrospective study of hospitalised COPD patients treated with a first episode of ward‐based NIV at a large UK teaching hospital between 2004 and 2017. Patients were split into two cohorts based on year of admission, 2004‐2010 (Cohort 1) and 2013‐2017 (Cohort 2), to facilitate comparison of patient characteristics.ResultsIn total, 547 unique patients were studied. There was no difference in in‐hospital mortality rate between the time periods studied (17.6% vs 20.5%, P = .378). In Cohort 2 there were more females, a higher rate of co‐morbid bronchiectasis and pneumonia on admission and more severe acidosis, hypercapnia and hypoxia. More patients in Cohort 2 had NIV as the ceiling of treatment. Patients in Cohort 2 experienced a longer time from AHRF diagnosis to application of NIV, higher maximum inspiratory positive airway pressure, lower maximum oxygen and shorter duration of NIV. Finally, patients in Cohort 2 experienced a shorter hospital length of stay (LOS), with no differences observed in rate of transfer to critical care or intubation.ConclusionIn‐hospital mortality remained stable and LOS decreased over time, despite greater comorbidity and more severe AHRF in COPD patients treated for the first time with ward‐based NIV.
Invasive pulmonary aspergillosis in patients with influenza infection: A retrospective study and review of the literature
Authors: Huang Linna , Zhang Nannan , Huang Xu , Xiong Shuyu , Feng Yingying , Zhang Yi , Li Min , Zhan Qingyuan 
Published: January 2019

AbstractIntroductionThere has been a rapid increase in the number of influenza and invasive pulmonary aspergillosis (IPA) co‐infection.ObjectivesTo explore the risk factors and predictors of a poor prognosis in influenza and IPA co‐infection.MethodsWe included patients with confirmed influenza during the 2017‐2018 influenza season and cases of influenza and IPA co‐infection in the literature.ResultsA total of 64 patients with influenza infection were admitted to ICU. Of these patients, 18 were co‐infected with IPA. Others were assigned to the control group (n = 46). A total of 45 patients from the literature were added to the IPA group (n = 63). A multivariate logistic regression suggested that influenza patients who were given steroids after ICU admission, who had a white blood count (WBC) of more than 10*109/L on ICU admission and whose CT findings manifested as multiple nodules and cavities might have a higher risk of developing IPA. Compared to survivors, non‐survivors had higher sequential organ failure assessment (SOFA) scores (16 ± 4 points vs 8 ± 4 points, P < 0.001), lower CD4+ T cell counts on ICU admission [315 (83‐466) cells/μL vs 152 (50‐220) cells/μL, P = 0.031] and more requirement extracorporeal membrane oxygenation (ECMO) support [13 (50%) vs 7 (18.9%), P = 0.015].ConclusionsInfluenza patients who are given steroids after ICU admission, who have WBCs of greater than 10*109/L on ICU admission, and whose CT imaging shows multiple nodules and cavities might have a high risk of IPA. Higher SOFA scores, CD4+ T cell counts lower than 200 cells/μL on ICU admission and more ECMO requirement might be predictors of a poor prognosis.
Chylous ascites following laparoscopic live donor nephrectomy: A new improved treatment paradigm
Authors: Dale Leigh‐Anne , Sandoval Pedro Rodrigo , Ratner Lloyd E. 
Published: January 2019

AbstractChylous ascites is a difficult, albeit uncommon complication of laparoscopic live donor nephrectomy (LLDN). Lymphatic leak is believed to be a result of injury to the cisterna chyli, regional lymph nodes, or other peri‐aortic lymphatics intraoperatively. Recommended management with dietary modifications can result in malnutrition and immunodeficiency. We present four patients who developed chylous ascites following LLDN. Approach to these patients evolved over time. Our initial two patients were successfully treated with a combination of surgical intervention followed by drain placement, after the failure of conservative management. The latter two cases were successfully treated with prompt intra‐abdominal drain placement, without dietary modifications. Our cohort challenges the standard of care for treatment of chylous ascites after LLDN. We believe that prompt diagnosis and placement of an intra‐abdominal drain can be used safely in select patients that develop this complication. We hypothesize that continuously draining the lymphatic leak, thus avoiding the re‐accumulation of ascites, allows bowel and mesentery to make contact and adhere to the retroperitoneal tissue. We believe that prompt, initial, percutaneous drain placement is a viable alternative to both conservative and reoperative management in the treatment of chylous ascites after LLDN and should be considered as a reasonable first‐line therapy.
Are melanocortin peptides future therapeutics for cutaneous wound healing?
Authors: Böhm Markus , Luger Thomas 
Published: January 2019

AbstractCutaneous wound healing is a complex process divided into different phases, that is an inflammatory, proliferative and remodelling phase. During these phases, a variety of resident skin cell types but also cells of the immune system orchestrate the healing process. In the last year, it has been shown that the majority of cutaneous cell types express the melanocortin 1 receptor (MC1R) that binds α‐melanocyte‐stimulating hormone (α‐MSH) with high affinity and elicits pleiotropic biological effects, for example modulation of inflammation and immune responses, cytoprotection, antioxidative defense and collagen turnover. Truncated α‐MSHpeptides such as Lys‐Pro‐Val (KPV) as well as derivatives like Lys‐d‐Pro‐Thr (KdPT), the latter containing the amino acid sequence 193‐195 of interleukin‐1β, have been found to possess anti‐inflammatory effects but to lack the pigment‐inducing activity of α‐MSH. We propose here that such peptides are promising future candidates for the treatment of cutaneous wounds and skin ulcers. Experimental approaches in silico,in vitro,ex vivo and in animal models are outlined. This is followed by an unbiased discussion of the pro and contra arguments of such peptides as future candidates for the therapeutic management of cutaneous wounds and a review of the so‐far available data on melanocortin peptides and derivatives in wound healing.
Mass spectrometry‐based proteomics reveals the distinct nature of the skin proteomes of photoaged compared to intrinsically aged skin
Authors: Newton V.L. , Riba‐Garcia I. , Griffiths C.E.M. , Rawlings A.V. , Voegeli R. , Unwin R.D. , Sherratt M.J. , Watson R.E.B. 
Published: January 2019

AbstractObjectiveWith increasing age, skin is subject to alterations in its organization, which impact on its function as well as having clinical consequences. Proteomics is a useful tool for non‐targeted, semi‐quantitative simultaneous investigation of high numbers of proteins. In the current study, we utilize proteomics to characterize and contrast age‐associated differences in photoexposed and photoprotected skin, with a focus on the epidermis, dermal–epidermal junction and papillary dermis.MethodsSkin biopsies from buttock (photoprotected) and forearm (photoexposed) of healthy volunteers (aged 18–30 or ≥65 years) were transversely sectioned from the stratum corneum to a depth of 250 μm. Following SDS‐PAGE, each sample lane was segmented prior to analysis by liquid chromatography‐mass spectrometry/mass spectrometry. Pathway analysis was carried out using Ingenuity IPA.ResultsComparison of skin proteomes at buttock and forearm sites revealed differences in relative protein abundance. Ageing in skin on the photoexposed forearm resulted in 80% of the altered proteins being increased with age, in contrast to the photoprotected buttock where 74% of altered proteins with age were reduced. Functionally, age‐altered proteins in the photoexposed forearm were associated with conferring structure, energy and metabolism. In the photoprotected buttock, proteins associated with gene expression, free‐radical scavenging, protein synthesis and protein degradation were most frequently altered.ConclusionThis study highlights the necessity of not considering photoageing as an accelerated intrinsic ageing, but as a distinct physiological process.
Accuracy of detecting vertical root fractures in non‐root filled teeth using cone beam computed tomography: effect of voxel size and fracture width
Authors: Guo X. L. , Li G. , Zheng J. Q. , Ma R. H. , Liu F. C. , Yuan F. S. , Lyu P. J. , Guo Y. J. , Yin S. 
Published: January 2019

AbstractAimTo investigate simultaneously the effect of voxel size and fracture width on the accuracy of detecting vertical root fractures (VRFs) in non‐root filled teeth when using cone beam computed tomography.MethodologyFifty‐one of 161 extracted human permanent teeth (16 anterior teeth, 132 premolars and 13 mandibular molars) were selected randomly for VRF induction with two fracture widths. All teeth were scanned with four CBCT units at different voxel sizes provided by the units. Three observers classified the presence or absence of VRF using a 5‐point scale. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the ROC curve (AUC) were calculated. AUCs amongst voxel sizes and between the fracture widths were compared using the Z test. Intra‐ and inter‐observer agreement was assessed using weighted Cohen kappa.ResultsFor the NewTom VGi and ProMax 3D Mid CBCT unit, no significant differences were found amongst voxel sizes for the AUCs, irrespective of the fracture width (P > 0.05). There were significant differences between images scanned with voxel size 250 and 160 μm (P = 0.02), and images scanned with voxel size 250 and 80 μm for AUCs in the narrow VRF group for the 3D Accuitomo 170 unit (P = 0.03). For i‐CAT FLX, significant differences were found between the voxel protocols of 300 μm and of the other three voxel sizes for AUC, sensitivity and NPV (P < 0.05). Significant differences between the wide and the narrow VRF groups for AUCs were found for 3D Accuitomo 170 (P = 0.01) and ProMax 3D Mid (P < 0.01).ConclusionsCone beam computed tomography was accurate for detecting VRF in non‐root filled teeth. Fracture width had an effect on the detection of VRF. The effect of the voxel size on the detection of VRF depended on the CBCT unit used.
HOW WELL DID SOCIAL SECURITY MITIGATE THE EFFECTS OF THE GREAT RECESSION?
Authors: Peterman William B. , Sommer Kamila 
Published: January 2019

AbstractUsing a computational life cycle model, this article assesses how Social Security affects the welfare of different types of individuals during the Great Recession. Overall, we find that Social Security reduces the average welfare losses for agents alive at the time of the Great Recession by the equivalent of 1.4% of expected future lifetime consumption. Moreover, we show that although the program mitigates some of the welfare losses for most agents, it is particularly effective at mitigating the losses for agents who are poorer and/or older at the time of the shock.
Mixed alkali effects in Er3+‐doped borate glasses: Influence on physical, mechanical, and photoluminescence properties
Authors: Hu Qingliu , Wang Tongyao , Chu Yushi , Wang Xin , Du Yanqiu , Ren Jing , Yang Xinghua , Yang Guang , Kong Xueqian , Wang Pengfei 
Published: January 2019

AbstractEngineering borate glass structure by simple compositional modification is essential to meet the particular demands from both industrial and photonic research communities. In this article, we demonstrate how the mixing of Li2O with Na2O, K2O, or Cs2O influences the relative abundance of 3‐ and 4‐coordinated borons in the glass network, as exhibited by nuclear magnetic resonance (NMR) and Raman spectra. A systematic study is given of the alkali mixing effect on the glass properties including: glass transition temperature, microhardness, density, refractive index, and particularly the near‐infrared photoluminescence properties (eg, bandwidth and lifetime) of Er3+ which has been barely studied in mixed alkali borate glasses. It is interesting to note that the glass transition temperature, refractive index and emission lifetime of Er3+ manifest mixed alkali effect, in sharp contrast with microhardness, density, and emission bandwidth which vary monotonically upon the alkali mixing. The possible causes for the differences are discussed in the light of the compositional dependence of boron species and nonbridging oxygen upon alkali mixing.
Ablation of ventricular arrhythmias with predominant monophasic “R” waves in precordial leads from the left sinus of Valsalva: Electrocardiographic and electrophysiologic characteristics
Authors: Yang Jian‐du , Sun Qi , Guo Xiao‐gang , Zhou Gong‐bu , Liu Xu , Luo Bin , Wei Hui‐qiang , Xie Hai‐yang , Liang Jackson J , Ma Jian 
Published: January 2019

AbstractBackgroundWhile the left sinus of Valsalva (LSV) is a frequent origin of ventricular arrhythmias (VAs). Uncommonly, VAs with right bundle branch block (RBBB) morphology may be successfully terminated from the LSV.ObjectiveWe aimed to investigate the electrocardiographic and electrophysiologic characteristics of VAs with RBBB which were successfully eliminated from the LSV.MethodsWe identified patients with VAs successfully ablated from the LSV from January 2014 to December 2017 and compared electrophysiologic characteristics and ablation sites of those VAs with RBBB versus a control group of patients with left bundle branch block morphology.ResultsWe identified 18 patients with RBBB and predominant “R” waves in the precordial leads. In 12 (66.7%) patients, a small “s” wave in lead V2 and positive “R” in the remaining pericardial leads could be seen. Overall, a single “V” potential was seen in 72.2% of patients in the study group, while discrete potentials were recorded in 80% of the patients in the control group. The majority (88.9%) of the VAs could only be terminated at the nadir of the LSV in the study group. After mean follow‐up of 33 ± 14 months, 93.8% and 92% were free of VAs after initial ablation in study and control group, respectively (P = 0.99).ConclusionSome VAs with predominant monophasic “R” wave in precordial leads could be terminated from LSV, especially a small “s” wave in lead V2 was recorded. The nadir of LSV is highly successful for RBBB VAs and single electrogram was recorded at the target for most of the cases.
Atrial fibrosis in non–atrial fibrillation individuals and prediction of atrial fibrillation by use of late gadolinium enhancement magnetic resonance imaging
Authors: Siebermair Johannes , Suksaranjit Promporn , McGann Christopher J , Peterson Kathryn A , Kheirkhahan Mobin , Baher Alex A , Damal Kavitha , Wakili Reza , Marrouche Nassir F , Wilson Brent D 
Published: January 2019

AbstractIntroductionBesides the traditional concept of atrial fibrillation (AF) perpetuating atrial structural remodeling, there is increasing evidence that atrial fibrosis might precede AF, highlighting the need for better characterization of the fibrotic substrate. We aimed to assess atrial fibrosis by use of late gadolinium enhancement magnetic resonance imaging (LGE‐MRI) in non‐AF individuals and to identify predisposing risk factors. A second aim was to establish a risk score for the prevalence of AF using atrial fibrosis in addition to established clinical variables.Methods and ResultsNon‐AF individuals without structural heart disease (n = 91) and matched AF controls (n = 91) underwent MRI for assessment of LGE. According to the established UTAH classification, atrial LGE ≥20% was considered extensive.Mean left atrial (LA) fibrosis in non‐AF and AF individuals were 8.8 ± 6.5% and 12.5 ± 5.8%, respectively. Body mass index (BMI) >30 kg/m
2 and LA volume were predictors of atrial fibrosis. Diastolic function was not significantly different with respect to atrial fibrosis. A novel scoring system for the prevalence of AF (2 points for arterial hypertension and/or left ventricular ejection fraction <55%; 3 points for atrial fibrosis >6%) was derived demonstrating that patients in the intermediate/high‐risk group had a significantly increased risk of AF.ConclusionThis study reports unexpectedly high atrial fibrosis in non‐AF patients without apparent heart disease, highlighting the concept that structural fibrotic alterations may precede AF onset in a significant proportion of individuals. BMI as a predictor of atrial fibrosis suggests that lifestyle and drug intervention, that is, weight reduction, could positively influence fibrosis development. The derived risk score for AF prevalence provides the basis for prospective studies on AF incidence.
Catheter ablation of supraventricular tachycardia in patients with dextrocardia and situs inversus
Authors: Zhou Gong‐Bu , Ma Jian , Zhang Jin‐Lin , Guo Xiao‐Gang , Yang Jian‐Du , Liu Shu‐Wang , Ouyang Fei‐Fan 
Published: January 2019

AbstractBackgroundDextrocardia with situs inversus is a rare cardiac positional anomaly. Catheter ablation procedures performed in this set of patients have not been sufficiently reported.MethodsA total of 10 patients with dextrocardia and situs inversus who received catheter ablation for supraventricular tachycardia (SVT) were included from a cohort of over 20 000 cases of catheter ablation for SVT in three centers from 2005 to 2016. All patients underwent electrophysiologic study and catheter ablation of SVT. Ablation targets were selected based on different tachycardia mechanisms with the primary endpoint of noninduction of tachycardia.ResultsThe average age was 32.4 ± 5.6 years. Congenitally corrected transposition of great arteries (TGA) with situs inversus and D‐looping of the ventricles and aorta (congenitally corrected TGA {I,D,D}) was found in four patients, while the other six patients exhibited mirror‐image dextrocardia {I,L,L}. The mechanisms of SVT were atrioventricular nodal reentrant tachycardia in four patients, atrioventricular reentrant tachycardia in three, typical atrial flutter in one, intra‐atrial reentrant tachycardia in one, and focal atrial tachycardia in one. Immediate procedural success was achieved in 9 out of 10 patients with no procedural complications. During a follow‐up period of 6.3 ± 3.5 years on average, all patients remained free from recurrent tachycardia.ConclusionsFor patients with dextrocardia and situs inversus, catheter ablation of SVT is safe and feasible. Differences in catheter maneuver and fluroscopy projection, along with difficulties in distorted anatomy are major obstacles for successful ablation.
Early repolarization and risk of lone atrial fibrillation
Authors: Hasegawa Yuki , Watanabe Hiroshi , Ikami Yasuhiro , Otsuki Sou , Iijima Kenichi , Yagihara Nobue , Sato Akinori , Izumi Daisuke , Minamino Tohru 
Published: January 2019

AbstractIntroductionEarly repolarization syndrome is a recently proposed condition characterized by an early repolarization pattern in the electrocardiogram (ECG) and ventricular fibrillation in the absence of structural heart abnormalities. Although some studies have suggested that early repolarization is associated with frequency of atrial fibrillation, the association of early repolarization with atrial fibrillation is not well known.HypothesisEarly repolarization indicates the substrate for atrial fibrillation in addition to that for ventricular fibrillation.MethodThis study included 79 patients (57 men [72%]; age, 45 ± 12 years) aged less than 60 years who had paroxysmal lone atrial fibrillation and 395 age‐ and sex‐matched healthy controls (patient:control ratio, 1:5). Patients who had structural heart disease, hypertension, diabetes, hyperthyroidism, history of successful resuscitation, or the Brugada type ECG were excluded. ECGs recorded during sinus rhythm were compared between patients with atrial fibrillation and healthy controls.ResultsEarly repolarization in the inferior and/or lateral leads was more common in patients with atrial fibrillation (25%) than controls (10%; P = 0.001). The location and magnitude of early repolarization were similar between the two groups. Other electrocardiographic measurements were not different between the two groups. Among patients with atrial fibrillation, there was no difference in clinical characteristics including age at atrial fibrillation development, sex, and body mass index between patients with early repolarization and those without early repolarization. Electrocardiographic measurements were not different between patients with early repolarization and those without early repolarization.ConclusionEarly repolarization was associated with lone atrial fibrillation. Early repolarization may indicate increased susceptibility to atrial fibrillation.