bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
Authors: Pack Quinn R. , Priya Aruna , Lagu Tara C. , Pekow Penelope S. , Atreya Auras , Rigotti Nancy A. , Lindenauer Peter K. 
Published: September 2018

Background

Little is known about the safety of nicotine replacement therapy (
NRT
) in smokers hospitalized with coronary heart disease.

Methods and Results

We examined the short‐term safety of
NRT
use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse sample of
US
hospitals in the year 2014. We compared smokers who started
NRT
in the first 2 days of hospitalization with smokers without any exposure to
NRT
and adjusted for baseline differences through propensity score matching. Outcomes included inpatient mortality, hospital length of stay, and 1‐month readmission. From 270 hospitals, we included 27 459 smokers (mean age, 58 years; 69% men; 56.9% in intensive care unit), of whom 4885 (17.8%) received
NRT
(97.2% used the nicotine patch, at a median dose of 21 mg/d for 3 days). After propensity matching, covariates were well balanced within each patient group. Among patients with myocardial infarction, compared with patients who did not receive
NRT
, those who received
NRT
showed no difference in mortality (2.1% versus 2.3%;
P
=0.98), mean length of stay (4.4±3.5 versus 4.3±3.3 days;
P
=0.60), or 1‐month readmission (15.8% versus 14.6%;
P
=0.31). Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery.

Conclusions

Among smokers hospitalized for treatment of coronary heart disease, use of
NRT
was not associated with any differences in short‐term outcomes. Given the known beneficial effects of
NRT
in treating nicotine withdrawal, reducing cravings, and promoting smoking cessation after discharge, our findings suggest that
NRT
is a safe and reasonable treatment option.
Novel Noninvasive Assessment of Pulmonary Arterial Stiffness Using Velocity Transfer Function
Authors: Gupta Ankur , Sharifov Oleg F. , Lloyd Steven G. , Tallaj Jose A. , Aban Inmaculada , Dell'italia Louis J. , Denney Thomas S. , Gupta Himanshu 
Published: September 2018

Background

Pulmonary artery (
PA
) stiffness is associated with increased pulmonary vascular resistance (
PVR
).
PA
stiffness is accurately described by invasive
PA
impedance because it considers pulsatile blood flow through elastic
PA
s. We hypothesized that
PA
stiffness and impedance could be evaluated noninvasively by
PA
velocity transfer function (
VTF
), calculated as a ratio of the frequency spectra of output/input mean velocity profiles in
PA
s.

Methods and Results

In 20 participants (55±19 years, 14 women) undergoing clinically indicated right‐sided heart catheterization, comprehensive phase‐contrast and cine‐cardiac magnetic resonance imaging was performed to calculate
PA VTF
, along with right ventricular mass and function.
PA
impedance was measured as a ratio of frequency spectra of invasive
PA
pressure and echocardiographically derived
PA
flow waveforms. Mean
PA
pressure was 29.5±13.6 mm Hg, and
PVR
was 3.5±2.8 Wood units. A mixed‐effects model showed
VTF
was significantly associated with
PA
impedance independent of elevation in pulmonary capillary wedge pressure (
P
=0.005). The mean of higher frequency moduli of
VTF
correlated with
PVR
(ρ=0.63;
P
=0.003) and discriminated subjects with low (n=10) versus elevated
PVR
(≥2.5 Wood units, n=10), with an area under the curve of 0.95, similar to discrimination by impedance (area under the curve=0.93).
VTF
had a strong inverse association with right ventricular ejection fraction (ρ=−0.73;
P
<0.001) and a significant positive correlation with right ventricular mass index (ρ=0.51;
P
=0.02).

Conclusions

VTF
, a novel right ventricular–
PA
axis coupling parameter, is a surrogate for
PA
impedance with the potential to assess
PA
stiffness and elevation in
PVR
noninvasively and reliably using cardiac magnetic resonance imaging.
Mitochondrial and Contractile Function of Human Right Atrial Tissue in Response to Remote Ischemic Conditioning
Authors: Kleinbongard Petra , Gedik Nilguen , Kirca Mücella , Stoian Leanda , Frey Ulrich , Zandi Afsaneh , Thielmann Matthias , Jakob Heinz , Peters Jürgen , Kamler Markus , Heusch Gerd 
Published: September 2018

Background

Remote ischemic preconditioning (
RIPC
) by repeated brief cycles of limb ischemia/reperfusion attenuates myocardial ischemia/reperfusion injury. We aimed to identify a functional parameter reflecting the
RIPC
‐induced protection in human. Therefore, we measured mitochondrial function in right atrial tissue and contractile function of isolated right atrial trabeculae before and during hypoxia/reoxygenation from patients undergoing coronary artery bypass grafting with
RIPC
or placebo, respectively.

Methods and Results

One hundred thirty‐seven patients under isoflurane anesthesia underwent
RIPC
(3×5 minutes blood pressure cuff inflation on the left upper arm/5 minutes deflation, n=67) or placebo (cuff uninflated, n=70), and right atrial appendages were harvested before ischemic cardioplegic arrest. Myocardial protection by
RIPC
was assessed from serum troponin I/T concentrations over 72 hours after surgery. Atrial tissue was obtained for isolation of mitochondria (
RIPC
/placebo: n=10/10). Trabeculae were dissected for contractile function measurements at baseline and after hypoxia/reoxygenation (60 min/30 min) and for western blot analysis after hypoxia/reoxygenation (
RIPC
/placebo, n=57/60). Associated with cardioprotection by
RIPC
(26% decrease in the area under the curve of troponin I/T), mitochondrial adenosine diphosphate–stimulated complex I respiration (+10%), adenosine triphosphate production (+46%), and calcium retention capacity (+37%) were greater, whereas reactive oxygen species production (−24%) was less with
RIPC
than placebo. Contractile function was improved by
RIPC
(baseline, +7%; reoxygenation, +24%). Expression and phosphorylation of proteins, which have previously been associated with cardioprotection, were not different between
RIPC
and placebo.

Conclusions

Cardioprotection by
RIPC
goes along with improved mitochondrial and contractile function of human right atrial tissue.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01406678.
Renal Soluble Guanylate Cyclase Is Downregulated in Sunitinib‐Induced Hypertension
Authors: Witte Jeannine , Mühlbauer Melanie , Braun Diana , Steinbach Antje , Golchert Janine , Rettig Rainer , Grisk Olaf 
Published: September 2018

Background
The tyrosine kinase inhibitor sunitinib causes hypertension associated with reduced nitric oxide (NO) availability, elevated renal vascular resistance, and decreased fractional sodium excretion. We tested whether (1) nitrate supplementation mitigates sunitinib‐induced hypertension and NO contributes less to renal vascular resistance as well as fractional sodium excretion regulation in sunitinib‐treated rats than in controls; and (2) renal soluble guanylate cyclase (sGC) is downregulated and sGC activation lowers arterial pressure in rats with sunitinib‐induced hypertension.

Methods and Results

Arterial pressure responses to nitrate supplementation and the effects of systemic and intrarenal NO synthase (NOS) inhibition on renal hemodynamics and fractional sodium excretion were assessed in sunitinib‐treated rats and controls. Renal NOS and sGC mRNA as well as protein abundances were determined by quantitative polymerase chain reaction and Western blot. The effect of the sGC activator cinaciguat on arterial pressure was investigated in sunitinib‐treated rats. Nitrate supplementation did not mitigate sunitinib‐induced hypertension. Endothelium‐dependent reductions in renal vascular resistance were similar in control and sunitinib‐treated animals without and with systemic NOS inhibition. Selective intrarenal NOS inhibition lowered renal medullary blood flow in control but not in sunitinib‐treated rats without significant effects on fractional sodium excretion. Renal cortical sGC mRNA and sGC α
1
‐subunit protein abundance were less in sunitinib‐treated rats than in controls, and cinaciguat effectively lowered arterial pressure by 15‐20 mm Hg in sunitinib‐treated rats.

Conclusions
Renal cortical sGC is downregulated in the presence of intact endothelium‐dependent renal vascular resistance regulation in developing sunitinib‐induced hypertension. This suggests that sGC downregulation occurs outside the renal vasculature, increases renal sodium retention, and contributes to nitrate resistance of sunitinib‐induced hypertension.
Predicting Bleeding Events in Anticoagulated Patients With Atrial Fibrillation: A Comparison Between the HAS‐BLED and GARFIELD‐AF Bleeding Scores
Authors: Proietti Marco , Rivera‐Caravaca José Miguel , Esteve‐Pastor María Asunción , Romiti Giulio Francesco , Marin Francísco , Lip Gregory Y. H. 
Published: September 2018

Background
Patients with atrial fibrillation (AF) treated with oral anticoagulants may be exposed to an increased risk of bleeding events. The HAS‐BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INRs, Elderly, Drugs or alcohol) score is a simple, well‐established, clinical bleeding‐risk prediction score. Recently, a new algorithm‐based score was proposed, the GARFIELD‐AF (Global Anticoagulant in the Field–AF) bleeding score. We compared HAS‐BLED and GARFIELD‐AF scores in predicting adjudicated bleeding events in a clinical trial cohort of patients with AF taking anticoagulants, in the first external comparative validation of both scores.

Methods and Results

We analyzed patients from the SPORTIF (Stroke Prevention Using an Oral Thrombin Inhibitor in Patients With AF) III and V trials. All patients assigned to the warfarin arm with information to calculate the scores were considered. Outcomes were major, major/clinically relevant nonmajor, and any bleeding. A total of 3550 warfarin‐treated patients were available for analysis. Of these patients, 2519 (71.0%) had a HAS‐BLED score ≥3, whereas based on GARFIELD‐AF median value, 2056 (57.9%) were categorized as “high score.” Both HAS‐BLED and GARFIELD‐AF C‐indexes showed modest predictive value (C‐index [95% confidence interval] for major bleeding, 0.58 [0.56–0.60] and 0.56 [0.54–0.57], respectively); however, GARFIELD‐AF was not predictive of any bleeding. The GARFIELD‐AF bleeding score had a significantly lower sensitivity and a negative reclassification for any bleeding compared with HAS‐BLED, assessed by integrated discrimination improvement and net reclassification improvement (both
P
<0.001). HAS‐BLED showed a 5% net benefit for any bleeding occurrence.

Conclusions
The algorithm‐based GARFIELD‐AF bleeding score did not show any significant improvement in major and major/clinically relevant nonmajor prediction compared with the simple HAS‐BLED score. For clinical usefulness in prediction of any bleeding, the HAS‐BLED score showed a significant net benefit compared with the GARFIELD‐AF.
Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV
Authors: Alvi Raza M. , Neilan Anne M. , Tariq Noor , Awadalla Magid , Rokicki Adam , Hassan Malek , Afshar Maryam , Mulligan Connor P. , Triant Virginia A. , Zanni Markella V. , Neilan Tomas G. 
Published: September 2018

Background

People living with
HIV
(
PHIV
) are at an increased risk for sudden cardiac death, and implantable cardioverter‐defibrillators (
ICDs
) prevent
SCD
. There are no data on the incidence, predictors, and effects of
ICD
therapies among
PHIV
.

Methods and Results

We compared
ICD
discharge rates between 59
PHIV
and 267 uninfected controls. For
PHIV
, we tested the association of traditional cardiovascular risk factors and
HIV
‐specific parameters with an
ICD
discharge and then tested whether an
ICD
discharge among
PHIV
was associated with cardiovascular mortality or an admission for heart failure. The indication for
ICD
insertion was similar among groups. Compared with controls,
PHIV
with an
ICD
were more likely to have coronary artery disease and to use cocaine. In follow‐up,
PHIV
had a higher
ICD
discharge rate (39% versus 20%;
P
=0.001; median follow‐up period, 19 months). Among
PHIV
, cocaine use, coronary artery disease,
QRS
duration, and higher New York Heart Association class were associated with an
ICD
discharge. An
ICD
discharge had a prognostic effect, with a subsequent 1.7‐fold increase in heart failure admission and a 2‐fold increase in cardiovascular mortality, an effect consistent across racial/ethnic and sex categories.

Conclusions

ICD
discharge rates are higher among
PHIV
compared with uninfected controls. Among
PHIV
, cocaine use and New York Heart Association class are associated with increased
ICD
discharge, and an
ICD
discharge is associated with a subsequent increase in admission for heart failure and cardiovascular mortality.
Mitochondrial DNA Sequence Variants Associated With Blood Pressure Among 2 Cohorts of Older Adults
Authors: Buford Thomas W. , Manini Todd M. , Kairalla John A. , McDermott Mary M. , Vaz Fragoso Carlos A. , Chen Haiying , Fielding Roger A. , King Abby C. , Newman Anne B. , Tranah Gregory J. 
Published: September 2018

Background
Age‐related changes in blood pressure are associated with a variety of poor health outcomes. Genetic factors are proposed contributors to age‐related increases in blood pressure, but few genetic loci have been identified. We examined the role of mitochondrial genomic variation in blood pressure by sequencing the mitochondrial genome.

Methods and Results

Mitochondrial
DNA
(mt
DNA
) data from 1755 participants from the LIFE (Lifestyle Interventions and Independence for Elders) studies and 788 participants from the Health ABC (Health, Aging, and Body Composition) study were evaluated using replication analysis followed by meta‐analysis. Participants were aged ≥69 years, of diverse racial backgrounds, and assessed for systolic blood pressure (
SBP
), diastolic blood pressure, and mean arterial pressure. After meta‐analysis across the
LIFE
and Health
ABC
studies, statistically significant associations of mt
DNA
variants with higher
SBP
(m.3197T>C, 16S
rRNA
;
P
=0.0005) and mean arterial pressure (m.15924A>G, t‐RNA‐thr;
P
=0.004) were identified in white participants. Among black participants, statistically significant associations with higher
SBP
(m.93A>G,
HVII
; m.16183A>C,
HVI
; both
P
=0.0001) and mean arterial pressure (m.16172T>C,
HVI
; m.16183A>C,
HVI
; m.16189T>C,
HVI
; m.12705C>T; all
P
's<0.0004) were observed. Significant pooled effects on
SBP
were observed across all transfer
RNA
regions (
P
=0.0056) in white participants. The individual and aggregate variant results are statistically significant after multiple comparisons adjustment for the number of mt
DNA
variants and mitochondrial regions examined.

Conclusions

These results suggest that mt
DNA
‐encoded variants are associated with variation in
SBP
and mean arterial pressure among older adults. These results may help identify mitochondrial activities to explain differences in blood pressure in older adults and generate new hypotheses surrounding mt
DNA
variation and the regulation of blood pressure.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifiers:
NCT
01072500 and
NCT
00116194.
Learning from Excellence: the ‘Yaytix’ programme
Authors: Chain Gabriel , Marshall Emma , Geddie Cathy , Joseph Sonia , Chain Benjamin , Clark Claire 
Published: September 2018

Background and aims Learning from error can have a negative impact on the staff involved in the error (‘second victim phenomenon’1). We created a project, based on the principles of the Learning from Excellence project,2 to learn from excellence and correct the imbalance of negative to positive feedback in the context of hospital practice. Methods and results Using a questionnaire, we surveyed staff on existing feedback mechanisms and morale. We then introduced a system where staff recorded and commented on examples of excellence in practice. Recipients and their supervisors received copies of these reports and the feedback was analysed and discussed with senior staff (consultant, senior charge nurse, managers). We re-audited the staff two months after starting this project and noted improvements in staff morale and in positive reporting. Conclusions This project has improved the process of giving and learning from positive feedback and had a significant impact on staff morale. We can also demonstrate an example of improved clinical practice (from feedback received) and will now attempt to measure clinical outcomes with a new prospective study. Finally, we hope to set up a regional programme of reporting excellence in South-East Scotland.
Pulmonary vein thrombosis after lobectomy with vein stump closure by ligation
Authors: Miyoshi Ryo , Nishikawa Shigeto , Tamari Shigeyuki , Noguchi Misa , Hijiya Kyoko , Chihara Koji 
Published: September 2018

Objectives Thrombosis in the pulmonary vein stump after a left upper lobectomy is a rare but potentially life-threatening complication, and the pulmonary vein stump length plays an important role here. We assessed the frequency and risk factors for thrombosis in patients undergoing lobectomy with division of the superior pulmonary vein using ligation. Methods We retrospectively reviewed 425 patients with primary lung cancer who underwent lobectomy or bilobectomy in our institution from 2008 to 2016, with contrast-enhanced chest computed tomography within a year after lobectomy. The superior pulmonary vein was divided by thread ligation, while the inferior pulmonary vein was divided using a linear stapler. The pulmonary vein stump length was measured using contrast-enhanced chest computed tomography. Results Four (0.9%) of the 425 patients experienced thrombosis in the pulmonary vein stump within 6 months after lobectomy. All 4 patients had undergone a left upper lobectomy, and 4.1% of this subset developed thrombus. One patient with a thrombus in the pulmonary vein stump experienced renal and cerebral infarction after a left upper lobectomy. The left superior pulmonary vein stump was significantly longer than the other pulmonary vein stumps. Conclusions Thrombosis in the pulmonary vein stump occurred in 4.1% of patients undergoing a left upper lobectomy with pulmonary vein stump closure by thread ligation, which is a relatively low frequency. Superior pulmonary vein stump closure using thread ligation might help prevent pulmonary vein stump thrombus after a left upper lobectomy.
Acral Lentiginous Melanoma: Survival Analysis of 715 Cases
Authors: Lino-Silva Leonardo S. , Zepeda-Najar César , Salcedo-Hernández Rosa A. , Martínez-Said Héctor 
Published: September 2018

Introduction: Acral lentiginous melanoma (ALM) is an aggressive variant of melanoma; the incidence, prevalence, and prognosis differ among populations. We analyzed clinicopathological features and survival in Hispanics, a population with high ALM prevalence. Material and Methods: From 1144 patients with melanoma, we analyzed 715 ALMs and 429 non-ALMs from the National Referral Cancer Centre and compared survival. Results: Of the ALM group, 62.8% were female; the median age was 58 years. The mean Breslow thickness was 3.56 ± 7.16 mm. ALM patients showed an estimated 5-year disease-specific survival (DSS) of 53.3%, 52.7%, and 40.8% for stage I, II, and III, respectively. For non-ALM patients, the DSS rates were 66%, 60.8%, and 48.4% for stage I, II, and III disease, respectively. Overall, the 1-, 3-, and 5-year DSS rates for patients with ALM were 85.1%, 59.4%, and 46.3%, respectively; for non-ALM patients, they were 81.3%, 64.8%, and 55.7%, respectively ( P = .168). In the multivariate analysis, factors associated with decreased DSS were high Breslow thickness, recurrence, ulceration, male sex, and advanced stage. Conclusions: The 1-, 3-, and 5-year DSS rates of patients with ALM were not statistically different from those of non-ALM patients. In addition to known adverse prognostic factors, male sex was also associated with worse survival.
An analysis of low ambient pressure on fire risks associated with rigid polyurethane building façade insulation under various width constructions
Authors: Ma Xin , Tu Ran , Zeng Yi , Fang Tingyong 
Published: September 2018

The fire risk associated with the use of rigid polyurethane foam (PUR) as thermal insulation material in building façades was investigated. To assess the effect of ambient pressure, the combustion of PUR boards was examined at both Lhasa (with an ambient pressure of 66.5 kPa) and Hefei (99.8 kPa) in China, utilizing pool fire theory. The effects of pressure and sample width on important combustion parameters were analysed including flame spreading rate, flame height and mass loss rate. Effects of pressure on the combustion mechanism of the PUR were determined based on resulting data. The mass loss rate at lower pressure was found to be slower and unique, and relatively stable melting-flowing pool fire flame front was observed. In this respect, the combustion behaviour of PUR was different to that of other solid fuels commonly applied to building façades. Data obtained at the lower pressure using various widths showed that the average flame spreading rate was proportional to the pressure raised to an exponent ranging from 0.47 to 0.73. This result is similar to trends normally observed when the burning rate is largely driven by radiative heat transfer. The flame height was only minimally affected by pressure but increased with increases in the sample width. Finally, a linear relationship was determined between the pressure index values obtained from plots of flame height versus pressure and the sample width.