bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Significance of Pulse Pressure Variability During Mechanical Thrombectomy in Acute Ischemic Stroke Patients
Authors: Maïer Benjamin , Turc Guillaume , Taylor Guillaume , Blanc Raphaël , Obadia Michael , Smajda Stanislas , Desilles Jean‐Philippe , Redjem Hocine , Ciccio Gabriele , Boisseau William , Sabben Candice , Ben Machaa Malek , Hamdani Mylene , Leguen Morgan , Gayat Etienne , Blacher Jacques , Lapergue Bertrand , Piotin Michel , Mazighi Mikael ,   the Endovascular Treatment in Ischemic Stroke (ETIS) Investigators, Escalard Simon , Piotin Michel , Fahed Robert , Corabianu Ovide , de Broucker Thomas , Smadja Didier , Ille Olivier , Manchon Eric , Garcia Pierre‐Yves , Decroix J. P. , Wang A. , Wang A. , Evrard S. , Tchikviladzé M. , Bourdain F. , Coskun O. , Di Maria F. , Rodesch G. , Consoli A. , Tisserand M. , Pico F. , Rakotoharinandrasana H. , Tassan P. , Poll R. , Nighoghossian Norbert , Gory Benjamin , Riva Roberto , Eker O. , Derex Laurent , Cho Tae‐Hee , Mechtouff Laura , Lukaszewicz Anne‐Claire , Philippeau Frédéric , Cakmak Serkan , Blanc‐Lasserre Karine , Vallet Anne‐Evelyne 
Published: September 2018

Background

Studies on the role of blood pressure (
BP
) variability specifically during mechanical thrombectomy (
MT
) are sparse and limited. Moreover, pulse pressure (
PP
) has not been considered as a potent hemodynamic parameter to describe
BP
variability during
MT
. We assessed the impact of
PP
variability on functional outcome in acute ischemic stroke patients with large vessel occlusion during
MT
.

Methods and Results

Acute ischemic stroke patients presenting with large vessel occlusion from January 2012 to June 2016 were included.
BP
data during
MT
were prospectively collected in the ETIS (Endovascular Treatment in Ischemic Stroke) registry. Logistic regression models were used to assess the association between
PP
coefficients of variation and functional outcome at 3 months (modified Rankin Scale). Among the 343 included patients,
PP
variability was significantly associated with worse 3‐month modified Rankin Scale in univariable (odds ratio
[OR]
=1.56, 95% confidence interval [CI]: 1.24–1.96 per 1‐unit increase,
P
=0.0002) and multivariable ordinal logistic regression (adjusted
OR
=1.40, 95%
CI
: 1.09–1.79,
P
=0.008).
PP
variability was also associated with unfavorable outcome (modified Rankin Scale 3–6) in univariable (
OR
=1.53, 95%
CI
: 1.17–2.01,
P
=0.002) and multivariable analysis (adjusted
OR
=1.42, 95%
CI
: 1.02–1.98,
P
=0.04). There was an association between
PP
variability and 3‐month all‐cause mortality in univariable analysis (
OR
= 1.37, 95%
CI
: 1.01–1.85 per 1‐unit increase of the coefficient of variation of the
PP
,
P
=0.04), which did not remain significant after adjustment for potential confounders.

Conclusions

PP
variability during
MT
is an independent predictor of worse clinical outcome in acute ischemic stroke patients. These findings support the need for a close monitoring of
BP
variability during
MT
. Whether pharmacological interventions aiming at reducing
BP
variability during
MT
could impact functional outcome needs to be determined.
Pathoanatomic Findings Associated With Duty‐Related Cardiac Death in US Firefighters: A Case–Control Study
Authors: Smith Denise L. , Haller Jeannie M. , Korre Maria , Fehling Patricia C. , Sampani Konstantina , Grossi Porto Luiz Guilherme , Christophi Costas A. , Kales Stefanos N. 
Published: September 2018

Background
Sudden cardiac death accounts for the greatest proportion of duty‐related deaths among US firefighters. Increased understanding of the pathoanatomic causes of sudden cardiac death and the risk associated with underlying cardiac pathologies is needed to develop evidence‐based screening recommendations.

Methods and Results

Using autopsy data for duty‐related firefighter fatalities occurring between 1999 and 2014, this retrospective case–control study compared cardiac findings of male firefighters aged 18 to 65 years who died on duty of cardiac‐related causes with those who died of noncardiac trauma‐related causes. Data from 276 cardiac cases and 351 noncardiac trauma controls were analyzed. Among cardiac cases, the most prevalent (82%) underlying pathoanatomic substrate was comorbid coronary heart disease and cardiomegaly/left ventricular hypertrophy. Cardiac cases had a higher prevalence of cardiomegaly (heart weight >450 g), left ventricular hypertrophy (left ventricular wall thickness ≥1.2 cm), and severe coronary artery stenosis (≥75%) than trauma controls (all
P
<0.001). In multivariate analyses, heart weight >450 g, coronary artery stenosis ≥75%, and evidence of a prior myocardial infarction were strong independent predictors of cardiac death, with odds ratios of 6.1 (95% confidence interval, 3.6–10.4), 9.3 (95% confidence interval, 5.3–16.1), and 6.2 (95% confidence interval, 3.4–11.3), respectively.

Conclusions
The majority of cardiac fatalities had evidence of both coronary heart disease and increased heart mass, and each condition was independently associated with a markedly elevated risk of cardiac death. Targeted screening for coronary heart disease, increased heart mass, and evidence of prior myocardial infarction should be considered to reduce duty‐related cardiac deaths among firefighters.
Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study
Authors: Yano Yuichiro , Griswold Michael , Wang Wanmei , Greenland Philip , Lloyd‐Jones Donald M. , Heiss Gerardo , Gottesman Rebecca F. , Mosley Thomas H. 
Published: September 2018

Background

To understand how blood pressure (
BP
) from midlife and beyond is related to cognition in older age, a lifespan approach is needed. We assessed the associations of
BP
levels and variability from midlife on with subsequent cognitive change.

Methods and Results

The ARIC (Atherosclerosis Risk in Communities) Study participants underwent 4 clinic
BP
measurements (visit 1, 2, 3, and 4
BP
s) between 1987 and 1998, and their mean levels and average real variability (
ARV
) were assessed as exposures. A global cognitive
z
score, estimated from the Delayed Word Recall Test, Digit Symbol Substitution Test, and Word Fluency Test scores, was calculated at 1996 to 1998 (visit 4) and 2011 to 2013 (visit 5). Among 11 408 participants (mean age, 54 years; 56% women; 21% black race), mean systolic
BP
(
SBP
)/diastolic
BP
(
DBP
) level was 123/72 mm Hg, and

ARV
SBP

/

ARV
DBP

was 11/7 mm Hg. With linear mixed models, 1‐
SD
increases of

ARV
SBP

(standardized regression coefficient [95% confidence interval], −0.03 [−0.04 to −0.01] points) and

ARV
DBP

(standardized regression coefficient [95% confidence interval], −0.02 [−0.03 to −0.002] points; both
P
<0.05), but not mean
SBP
or
DBP
levels, were associated with lower global cognitive
z
scores at visit 4. In contrast, mean
SBP
(standardized regression coefficient [95% confidence interval], −0.04 [−0.06 to −0.02] points) or
DBP
(standardized regression coefficient [95% confidence interval], 0.04 [0.02–0.06] points; both
P
<0.001) level, but not

ARV
SBP

or

ARV
DBP

, was associated with change in global cognitive
z
scores from visits 4 to 5.

Conclusions

Greater visit‐to‐visit
SBP
or
DBP
variability from midlife on is modestly associated with lower cognitive function, whereas higher mean
SBP
and lower
DBP
levels from midlife to later life are modestly associated with cognitive decline in later life.
Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study
Authors: Kadri Amer N. , Abuamsha Hasan , Nusairat Leen , Kadri Nazih , Abuissa Hussam , Masri Ahmad , Hernandez Adrian V. 
Published: September 2018

Background
Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope.

Methods and Results

We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013–2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58–83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [
CI
], 0.6–0.7), female sex (OR, 0.9; 95% CI, 0.8–0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2–1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3–1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2–1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2–1.3), anemia (OR, 1.4; 95% CI, 1.4–1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3–1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5–1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6–1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4–1.6) or >5 days (OR, 2; 95% CI, 1.8–2), and having private insurance (OR, 0.6; 95% CI, 0.6–0.7).

Conclusions
The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.
Skin Autofluorescence–Indicated Advanced Glycation End Products as Predictors of Cardiovascular and All‐Cause Mortality in High‐Risk Subjects: A Systematic Review and Meta‐analysis
Authors: Cavero‐Redondo Ivan , Soriano‐Cano Alba , Álvarez‐Bueno Celia , Cunha Pedro G. , Martínez‐Hortelano Jose A. , Garrido‐Miguel Miriam , Berlanga‐Macías Carlos , Martínez‐Vizcaíno Vicente 
Published: September 2018

Background
Chronic deposits of advanced glycation end products produced by enzymatic glycation have been suggested as predictors of atherosclerotic‐related disorders. This study aimed to estimate the relationship between advanced glycation end products indicated by skin autofluorescence levels and the risk of cardiovascular and all‐cause mortality based on data from observational studies.

Methods and Results

We systematically searched Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Web of Science databases from their inceptions until November 2017 for observational studies addressing the association of advanced glycation end products by skin autofluorescence levels with cardiovascular and all‐cause mortality. The DerSimonian and Laird random‐effects method was used to compute pooled estimates of hazard ratios and their respective 95% confidence intervals for the risk of cardiovascular and all‐cause mortality associated with levels of advanced glycation end products by skin autofluorescence. Ten published studies were included in the systematic review and meta‐analysis. Higher skin autofluorescence levels were significantly associated with a higher pooled risk estimate for cardiovascular mortality (hazard ratio: 2.06; 95% confidence interval, 1.58–2.67), which might not be important to moderate heterogeneity (I
2
=34.7%;
P
=0.163), and for all‐cause mortality (hazard ratio: 1.91; 95% confidence interval, 1.42–2.56) with substantial heterogeneity (I
2
=60.8%;
P
=0.0.18).

Conclusions
Our data suggest that skin autofluorescence levels could be considered predictors of all‐cause mortality and cardiovascular mortality in patients at high and very high risk.
Frailty and Outcomes After Myocardial Infarction: Insights From the CONCORDANCE Registry
Authors: Patel Ashish , Goodman Shaun G. , Yan Andrew T. , Alexander Karen P. , Wong Camilla L. , Cheema Asim N. , Udell Jacob A. , Kaul Padma , D'Souza Mario , Hyun Karice , Adams Mark , Weaver James , Chew Derek P. , Brieger David , Bagai Akshay 
Published: September 2018

Background

Little is known about the prognostic implications of frailty, a state of susceptibility to stressors and poor recovery to homeostasis in older people, after myocardial infarction (
MI
).

Methods and Results

We studied 3944
MI
patients aged ≥65 years treated at 41 Australian hospitals from 2009 to 2016 in the CONCORDANCE (
Australian Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events
) registry. Frailty index (
FI
) was determined using the health deficit accumulation method. All‐cause and cardiac‐specific mortality at 6 months were compared between frail (
FI
>0.25) and nonfrail (
FI
≤0.25) patients. Among 1275 patients with ST‐segment–elevation MI (STEMI), 192 (15%) were frail, and among 2669 non‐STEMI (
NSTEMI)
patients, 902 (34%) were frail. Compared with nonfrail counterparts, frail
STEMI
patients received 30% less reperfusion therapy and 22% less revascularization during index hospitalization; frail
NSTEMI
patients received 30% less diagnostic angiography and 39% less revascularization. Unadjusted 6‐month all‐cause mortality (
STEMI
: 13% versus 3%;
NSTEMI
: 13% versus 4%) and cardiac‐specific mortality (
STEMI
: 6% versus 1.4%,
NSTEMI
: 3.2% versus 1.2%) were higher among frail patients. After adjustment for known prognosticators,
FI
was significantly associated with higher 6‐month all‐cause (
STEMI
:
odds ratio:
1.74 per 0.1
FI [
95% confidence interval, 1.37–2.22],
P
<0.001;
NSTEMI
:
odds ratio:
1.62 per 0.1
FI
[95%
confidence interval,
1.40–1.87],
P
<0.001) but not cardiac‐specific mortality (
STEMI
:
P
=0.99;
NSTEMI
:
P
=0.93).

Conclusions

Frail patients receive lower rates of invasive cardiac care during
MI
hospitalization. Increased frailty was independently associated with increased postdischarge all‐cause mortality but not cardiac‐specific mortality. These findings inform identification of frailty during
MI
hospitalization as a potential opportunity to address competing risks for mortality in this high‐risk population.
Thirty‐Day Readmission Rates, Timing, Causes, and Costs after ST‐Segment–Elevation Myocardial Infarction in the United States: A National Readmission Database Analysis 2010–2014
Authors: Kim Luke K. , Yeo Ilhwan , Cheung Jim W. , Swaminathan Rajesh V. , Wong S. Chiu , Charitakis Konstantinos , Adejumo Oluwayemisi , Chae John , Minutello Robert M. , Bergman Geoffrey , Singh Harsimran , Feldman Dmitriy N. 
Published: September 2018

Background

Readmission after ST‐segment–elevation myocardial infarction (
STEMI
) poses an enormous economic burden to the
US
healthcare system. Efforts to prevent readmissions should be based on understanding the timing and causes of these readmissions. This study aimed to investigate contemporary causes, timing, and cost of 30‐day readmissions after
STEMI
.

Methods and Results

All
STEMI
hospitalizations were selected in the Nationwide Readmissions Database (
NRD
) from 2010 to 2014. The 30‐day readmission rate as well as the primary cause and cost of readmission were examined. Multivariate regression analysis was performed to identify the predictors of 30‐day readmission and increased cumulative cost. From 2010 to 2014, the 30‐day readmission rate after
STEMI
was 12.3%. Within 7 days of discharge, 43.9% were readmitted, and 67.3% were readmitted within 14 days. The annual rate of 30‐day readmission decreased by 19% from 2010 to 2014 (
P
<0.001). Female sex,
AIDS
, anemia,
chronic kidney disease
, collagen vascular disease, diabetes mellitus, hypertension, pulmonary hypertension,
congestive heart failure
, atrial fibrillation, and increased length of stay were independent predictors of 30‐day readmission. A large proportion of patients (41.6%) were readmitted for noncardiac reasons. After multivariate adjustment, 30‐day readmission was associated with a 47.9% increase in cumulative cost (
P
<0.001).

Conclusions

Two thirds of patients were readmitted within the first 14 days after
STEMI
, and a large proportion of patients were readmitted for noncardiac reasons. Thirty‐day readmission was associated with an ≈50% increase in cumulative hospitalization costs. These findings highlight the importance of closer surveillance of both cardiac and general medical conditions in the first several weeks after
STEMI
discharge.
Cytochrome P450 1B1 Is Critical for Neointimal Growth in Wire‐Injured Carotid Artery of Male Mice
Authors: Mukherjee Kamalika , Song Chi Young , Estes Anne M. , Dhodi Ahmad N. , Ormseth Benjamin H. , Shin Ji Soo , Gonzalez Frank J. , Malik Kafait U. 
Published: September 2018

Background

We have reported that cytochrome P450 1B1 (
CYP
1B1), expressed in cardiovascular tissues, contributes to angiotensin
II
–induced vascular smooth muscle cell (
VSMC
) migration and proliferation and development of hypertension in various experimental animal models via generation of reactive oxygen species. This study was conducted to determine the contribution of
CYP
1B1 to platelet‐derived growth factor‐BB–induced
VSMC
migration and proliferation in vitro and to neointimal growth in vivo.

Methods and Results

VSMC
s isolated from aortas of male
Cyp1b1

+/+

and
Cyp1b1

−/−

mice were used for in vitro experiments. Moreover, carotid arteries of
Cyp1b1

+/+

and
Cyp1b1

−/−

mice were injured with a metal wire to assess neointimal growth after 14 days. Platelet‐derived growth factor‐
BB
–induced migration and proliferation and H
2
O
2
production were found to be attenuated in
VSMC
s from
Cyp1b1

−/−

mice and in
VSMC
s of
Cyp1b1

+/+

mice treated with 4‐hydroxy‐2,2,6,6‐tetramethylpiperidin‐1‐oxyl, a superoxide dismutase and catalase mimetic. In addition, wire injury resulted in neointimal growth, as indicated by increased intimal area, intima/media ratio, and percentage area of restenosis, as well as elastin disorganization and adventitial collagen deposition in carotid arteries of
Cyp1b1

+/+

mice, which were minimized in
Cyp1b1

−/−

mice. Wire injury also increased infiltration of inflammatory and immune cells, as indicated by expression of
CD
68
+
macrophages and
CD
3
+
T cells, respectively, in the injured arteries of
Cyp1b1

+/+

mice, but not
Cyp1b1

−/−

mice. Administration of 4‐hydroxy‐2,2,6,6‐tetramethylpiperidin‐1‐oxyl attenuated neointimal growth in wire‐injured carotid arteries of
Cyp1b1

+/+

mice.

Conclusions

These data suggest that
CYP
1B1‐dependent oxidative stress contributes to the neointimal growth caused by wire injury of carotid arteries of male mice.
Evaluation of decentralization and commercialization in the urban water sector of Yemen
Authors: Al-Saidi Mohammad 
Published: September 2018

The article analyzes decentralization and commercialization reforms in the Yemeni urban water and sanitation sector. The case study shows that sector reforms to increase the performance and independence of water utilities in developing countries can become entangled in conflicting political agendas, leading to the derailing of reforms. The reform process in the Yemeni case is presented as part of sector-wide policy change due to increasing scarcity, supply crises, and pressure from donors. A measurement framework for the level of decentralization and commercialization of water utilities is developed and applied. The future reform pathways are outlined, giving consideration to the current political reality in Yemen. Points for practitioners Water decentralization reforms need to follow technical considerations regarding the capacity and independence of utilities in order to enhance any positive impacts of decentralization. Institutional conflicts are difficult to tackle during an ongoing reform process, particularly in a context of corruption, politicization, and state fragility. There is a need for more context-specific reform agendas and better strategies to deal with conflicts and shield utilities from political interference. Further, effective commercialization requires a level of accountability at the local level and improved capacities of staff. Such capacities can be enhanced through trainings ahead of reforms.
Primary surgical repair of tetralogy of Fallot at under three months of age
Authors: Ho Andrew B , Bharucha Tara , Jones Eleanor , Thuraisingham Justin , Kaarne Markku , Viola Nicola 
Published: September 2018

Background Classical management of small infants with tetralogy of Fallot has involved placement of a Blalock-Taussig shunt followed later by complete repair, rather than primary complete repair which is the strategy adopted in larger infants. Some advantages of early complete repair compared to a staged strategy have been shown. We sought to review our institutional outcomes. Methods Patients under 3-months old undergoing complete surgical repair of tetralogy of Fallot in our institution between 2005 and 2015 were retrospectively reviewed and compared with an older control group matched by anatomical diagnosis and outflow tract intervention. Results Fourteen index cases (group A) and 14 controls (group B) were identified. At surgery, the median age was 43 days and weight 4.2 kg in group A, and 130 days and 6.1 kg in group B. Nine of 14 in group A were admitted for surgery as emergencies compared to none in group B. Peak inotrope score (22.3 vs. 12.8, p = 0.02) and intensive care unit stay (4.4 vs. 2.6 days, p = 0.02) were higher in group A. Bypass and crossclamp times, duration of intubation, and total length of stay did not differ. Conclusions We conclude that although babies undergoing early repair of tetralogy of Fallot have an increased need for intensive care support in the early postoperative period, the total length of stay is not prolonged despite more emergency admissions. As it is known that early repair may reduce long-term morbidity, we propose consideration of earlier complete repair of tetralogy of Fallot.
Dementia and its relationship with suicidality: A critical interpretive synthesis
Authors: Hodge Gary 
Published: September 2018

Objectives The objective of this literature review and synthesis of data was to consider the presence, drivers, and protectors of suicidality in people diagnosed with dementia. The review also considered what factors represented an increased risk of suicidality. Finally, it reflected on the morality and ethics of choice when discussing dying in dementia. Method This article used a critical interpretive synthesis model which interpreted data associated with the subject of suicidality in dementia. A sample frame was used to determine the quality and relevance of extracted data, and finally to construct a critical interpretive synthesis. Data were extracted from eight key papers. Results The review and synthesis concluded with eight synthetic constructs, and two concluding synthesised arguments. Argument one was the substantial increased risk of suicidality in people diagnosed with dementia and clinical depression. The second argument was that end-of-life discussions are common place in people with a dementia diagnosis and their families. Conclusion Death remains a difficult subject for some to discuss, especially when talking about suicidality. Nevertheless, having these conversations is possible, even when there are added complexities that a dementia diagnosis can bring. These conversations do, however, need to be individualized and measured. And, whilst respecting the person’s pre-morbid wishes, advance decisions and ethics of choice, we also need to consider the ongoing arguments of the ‘right to life’ versus the ‘right to die’. However, before these conversations can take place, additional suicidality risk factors such as a new and early dementia diagnosis and mental health comorbidities such as depression need to be acknowledged and addressed.