bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of determinants of walking fitness in patients attending cardiac rehabilitation
Authors: Doherty Patrick , Alotaibi Jassas FM 
Published: March 2017

AimThis study aims to investigate the ability of patients’ baseline characteristics to predict the distance walked during the incremental shuttle walk test (ISWT) in the cardiac rehabilitation (CR) population and to produce reference values to guide practice.MethodsSecondary analysis was conducted on National Audit Cardiac Rehabilitation data collected between 2010 and 2015. Patients (n=8863) were included if they were aged ≥18 years and had a recorded ISWT score assessed before starting CR. Stepwise regression was used to identify factors predicting the ISWT distance. Age, gender, body mass index, height, weight; presence of hypertension, dyslipidemia or diabetes; smoking and physical activity were independent variables. ISWT distance was the dependent variable. The 25th, 50th and 75th percentiles of the ISWT distance were used as reference values.ResultsAge and gender explained 27% of the variance of the distance covered in the ISWT (R2=0.27, adjusted R2=0.27,Standard Error of the Estimate (SEE) = 148.7, p<0.001). Reference values using age and gender categories were developed.ConclusionAge and gender were the significant factors for predicting the walking fitness in the CR population, with age being the best predictor. The age and gender reference values produced represent a potentially valuable tool to be used in the clinical setting.
Effect of peritoneal lavage solution temperature on body temperature in anaesthetised cats and small dogs
Authors: Barnes D. C. , Leece E. A. , Trimble T. A , Demetriou J. L. 
Published: March 2017

A prospective, randomised, non‐blinded, clinical study to assess the effect of peritoneal lavage using warmed fluid on body temperature in anesthetised cats and dogs of less than 10 kg body mass undergoing coeliotomy. A standardised anaesthetic protocol was used. Oesophageal and rectal temperatures were measured at various time points. At the end of surgery, group 1 patients (n=10) were lavaged with 200 ml/kg sterile isotonic saline at 34±1°C and group 2 (n=10) at 40±1°C. Groups were similar with respect to age, mass, body condition and surgical incision length. Duration of anaesthesia, surgical procedures and peritoneal lavage was similar between groups. Linear regression showed no significant change in oesophageal temperature during the lavage period for group 1 (P=0.64), but a significant increase for group 2 patients (P<0.0001), with mean temperature changes of −0.5°C (from (36.3°C to 35.9°C) and +0.9°C (from 35.4°C to 36.3°C), respectively. Similar results were found for rectal temperature, with mean changes of −0.5°C and +0.8°C (P=0.922 and 0.045), respectively. The use of isotonic crystalloid solution for peritoneal lavage at a temperature of 40±1°C significantly warms small animal patients, when applied in a clinical setting, compared with lavage solution at 34±1°C.
High-resolution estimates of rates of depositional processes from an alluvial fan succession in the Miocene of the Ebro Basin, northern Spain
Authors: Nichols Gary 
Published: March 2017

Abstract

Obtaining estimates of the rates of sedimentation and frequency of depositional events at high resolution from pre-Quaternary successions is rarely possible, particularly in coarse-grained clastic successions of continental basin margins. In the Miocene strata of the Ebro Basin, northern Spain, basin-marginal deposits interpreted as the products of alluvial fans are part of the continuous aggradational fill of a basin of internal drainage. A palaeomagnetic reversal stratigraphy has been established in basin-centre sediments and correlation across to the basin margin makes it possible to estimate the rate of aggradation within the fan successions to be 90 mm ka
−1
. The deposits of one alluvial fan near the village of Linás de Marcuello have been analysed in the context of these rates to provide estimates of the frequency of depositional events. This analysis suggests that deposition on gravel bars approximately 700 mm thick in stream channel deposits occurred at intervals of 70–200 years over a 2.2 myr time period. This is the first time an estimate of the frequency of depositional events has been obtained at such high resolution from a pre-Quaternary alluvial fan succession.
Cell-Cycle Regulation Accounts for Variability in Ki-67 Expression Levels
Authors: Sobecki Michal , Mrouj Karim , Colinge Jacques , Gerbe François , Jay Philippe , Krasinska Liliana , Dulic Vjekoslav , Fisher Daniel 
Published: March 2017

AbstractThe cell proliferation antigen Ki-67 is widely used in cancer histopathology, but estimations of Ki-67 expression levels are inconsistent and understanding of its regulation is limited. Here we show that cell-cycle regulation underlies variable Ki-67 expression in all situations analyzed, including nontransformed human cells, normal mouse intestinal epithelia and adenomas, human cancer cell lines with or without drug treatments, and human breast and colon cancers. In normal cells, Ki-67 was a late marker of cell-cycle entry; Ki-67 mRNA oscillated with highest levels in G2 while protein levels increased throughout the cell cycle, peaking in mitosis. Inhibition of CDK4/CDK6 revealed proteasome-mediated Ki-67 degradation in G1. After cell-cycle exit, low-level Ki-67 expression persisted but was undetectable in fully quiescent differentiated cells or senescent cells. CDK4/CDK6 inhibition in vitro and in tumors in mice caused G1 cell-cycle arrest and eliminated Ki-67 mRNA in RB1-positive cells but had no effect in RB1-negative cells, which continued to proliferate and express Ki-67. Thus, Ki-67 expression varies due to cell-cycle regulation, but it remains a reliable readout for effects of CDK4/CDK6 inhibitors on cell proliferation. Cancer Res; 77(10); 2722–34. ©2017 AACR.
A Model-Based Personalized Cancer Screening Strategy for Detecting Early-Stage Tumors Using Blood-Borne Biomarkers
Authors: Hori Sharon Seiko , Lutz Amelie M. , Paulmurugan Ramasamy , Gambhir Sanjiv Sam 
Published: March 2017

Abstract
An effective cancer blood biomarker screening strategy must distinguish aggressive from nonaggressive tumors at an early, intervenable time. However, for blood-based strategies to be useful, the quantity of biomarker shed into the blood and its relationship to tumor growth or progression must be validated. To study how blood biomarker levels correlate with early-stage viable tumor growth in a mouse model of human cancer, we monitored early tumor growth of engineered human ovarian cancer cells (A2780) implanted orthotopically into nude mice. Biomarker shedding was monitored by serial blood sampling, whereas tumor viability and volume were monitored by bioluminescence imaging and ultrasound imaging. From these metrics, we developed a mathematical model of cancer biomarker kinetics that accounts for biomarker shedding from tumor and healthy cells, biomarker entry into vasculature, biomarker elimination from plasma, and subject-specific tumor growth. We validated the model in a separate set of mice in which subject-specific tumor growth rates were accurately predicted. To illustrate clinical translation of this strategy, we allometrically scaled model parameters from mouse to human and used parameters for PSA shedding and prostate cancer. In this manner, we found that blood biomarker sampling data alone were capable of enabling the detection and discrimination of simulated aggressive (2-month tumor doubling time) and nonaggressive (18-month tumor doubling time) tumors as early as 7.2 months and 8.9 years before clinical imaging, respectively. Our model and screening strategy offers broad impact in their applicability to any solid cancer and associated biomarkers shed, thereby allowing a distinction between aggressive and nonaggressive tumors using blood biomarker sampling data alone. Cancer Res; 77(10); 2570–84. ©2017 AACR.
Validation of Noninvasive Measurement of Cardiac Output Using Inert Gas Rebreathing in a Cohort of Patients With Heart Failure and Reduced Ejection Fraction
Authors: Hassan Mohamed , Wagdy Kerolos , Kharabish Ahmed , Selwanos Peter Philip , Nabil Ahmed , Elguindy Ahmed , ElFaramawy Amr , Elmahdy Mahmoud F. , Mahmoud Hani , Yacoub Magdi H. 
Published: March 2017

Background—
Cardiac output (CO) is a key indicator of cardiac function in patients with heart failure. No completely accurate method is available for measuring CO in all patients. The objective of this study was to validate CO measurement using the inert gas rebreathing (IGR) method against other noninvasive and invasive methods of CO quantification in a cohort of patients with heart failure and reduced ejection fraction.

Methods and Results—

The study included 97 patients with heart failure and reduced ejection fraction (age 42±15.5 years; 64 patients (65.9%) had idiopathic dilated cardiomyopathy and 21 patients (21.6%) had ischemic heart disease). Median left ventricle ejection fraction was 24% (10%–36%). Patients with atrial fibrillation were excluded. CO was measured using 4 methods (IGR, cardiac magnetic resonance imaging, cardiac catheterization, and echocardiography) and indexed to body surface area (cardiac index [CI]). All studies were performed within 48 hours. Median CI measured by IGR was 1.75, by cardiac magnetic resonance imaging was 1.82, by cardiac catheterization was 1.65, and by echo was 1.7 L·min
−1
·m
−2
. There were significant modest linear correlations between IGR-derived CI and cardiac magnetic resonance imaging–derived CI (
r
=0.7;
P
<0.001), as well as cardiac catheterization–derived CI (
r
=0.6;
P
<0.001). Using Bland–Altman analysis, the agreement between the IGR method and the other methods was as good as the agreement between any 2 other methods with each other.

Conclusions—
The IGR method is a simple, accurate, and reproducible noninvasive method for quantification of CO in patients with advanced heart failure. The prognostic value of this simple measurement needs to be studied prospectively.
Independent Modular Filter for Embolic Protection in Carotid Stenting
Authors: Scheinert Dierk , Reimers Bernhard , Cremonesi Alberto , Schmidt Andrej , Sievert Horst , Rohde Stefan , Schofer Joachim , Mudra Harald G. , Bosiers Marc , Zeller Thomas , Pacchioni Andrea , Rosenschein Uri 
Published: March 2017

Background—
Embolic protection during carotid artery stenting reduces the rate of thromboembolic events. The Wirion Embolic Protection System is used to deploy an independent distal filter using any 0.014″ guidewire. WISE study (Wirion Study Europe) evaluated the safety and performance of Wirion Embolic Protection System in patients undergoing carotid artery stenting.

Methods and Results—

A prospective, multicenter, nonrandomized, open-label, single-arm study of carotid artery stenting in high surgical risk patients was performed. The primary end point, a composite of death, stroke, and myocardial infarction at 30 days, was compared with performance goal derived from historical controls. Secondary end points were components of the primary end point and the device, angiographic, procedural, and clinical success rates. Preplanned interim analysis was performed on the first 120 patients. At interim analysis, the primary end point was significantly lower for the Wirion Embolic Protection System group, compared with historical data (3.3% versus 6.3%, respectively;
P
value =0.0008). Analysis of primary end point components in the WISE group, compared with the historical control group, shows numerically lower mortality (0% versus 1.7%, respectively;
P
=0.21), stroke (2.5% versus 4.6%, respectively;
P
=0.18), and myocardial infarction (0.8% versus 1.5%, respectively;
P
=0.50). Device, angiographic, procedural, and clinical success was achieved in 99.2%, 99.1%, 98.3%, and 96.6% of cases, respectively.

Conclusions—
The data suggest that independent modular filter use in carotid artery stenting in high surgical risk patients is safe and effective. The outcomes suggest that use of an independent modular filter may be associated with a lower rate of embolic complications associated with carotid stent placement.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01783639.
Timely Reperfusion in Stroke and Myocardial Infarction Is Not Correlated
Authors: Sauser Zachrison Kori , Levine Deborah A. , Fonarow Gregg C. , Bhatt Deepak L. , Cox Margueritte , Schulte Phillip , Smith Eric E. , Suter Robert E. , Xian Ying , Schwamm Lee H. 
Published: March 2017

Background—
Timely reperfusion is critical in acute ischemic stroke (AIS) and ST-segment–elevation myocardial infarction (STEMI). The degree to which hospital performance is correlated on emergent STEMI and AIS care is unknown. Primary objective of this study was to determine whether there was a positive correlation between hospital performance on door-to-balloon (D2B) time for STEMI and door-to-needle (DTN) time for AIS, with and without controlling for patient and hospital differences.

Methods and Results—

Prospective study of all hospitals in both Get With The Guidelines-Stroke and Get With The Guidelines-Coronary Artery Disease from 2006 to 2009 and treating ≥10 patients. We compared hospital-level DTN time and D2B time using Spearman rank correlation coefficients and hierarchical linear regression modeling. There were 43 hospitals with 1976 AIS and 59 823 STEMI patients. Hospitals’ DTN times for AIS did not correlate with D2B times for STEMI (ρ=−0.09;
P
=0.55). There was no correlation between hospitals’ proportion of eligible patients treated within target time windows for AIS and STEMI (median DTN time <60 minutes: 21% [interquartile range, 11–30]; median D2B time <90 minutes: 68% [interquartile range, 62–79]; ρ=−0.14;
P
=0.36). The lack of correlation between hospitals’ DTN and D2B times persisted after risk adjustment. We also correlated hospitals’ DTN time and D2B time data from 2013 to 2014 using Get With The Guidelines (DTN time) and Hospital Compare (D2B time). From 2013 to 2014, hospitals’ DTN time performance in Get With The Guidelines was not correlated with D2B time performance in Hospital Compare (n=546 hospitals).

Conclusions—
We found no correlation between hospitals’ observed or risk-adjusted DTN and D2B times. Opportunities exist to improve hospitals’ performance of time-critical care processes for AIS and STEMI in a coordinated approach.
Baseline Hemodynamic Impairment and Future Stroke Risk in Adult Idiopathic Moyamoya Phenomenon
Authors: Derdeyn Colin P. , Zipfel Gregory J. , Zazulia Allyson R. , Davis Patricia H. , Prabhakaran Shyam , Ivan Cristina S. , Aiyagari Venkatesh , Sagar James R. , Hantler Nancy , Shinawi Lina , Lee John J. , Jafri Hussain , Grubb Robert L. , Miller J. Philip , Dacey Ralph G. 
Published: March 2017

Background and Purpose—
The purpose was to test the hypothesis that increased oxygen extraction fraction (OEF), a marker of severe hemodynamic impairment measured by positron emission tomography, is an independent risk factor for subsequent ischemic stroke in this population.

Methods—
Adults with idiopathic moyamoya phenomena were recruited between 2005 and 2012 for a prospective, multicenter, blindly adjudicated, longitudinal cohort study. Measurements of OEF were obtained on enrollment. Subjects were followed up for the occurrence of ipsilateral ischemic stroke at 6-month intervals. Patients were censored at the time of surgical revascularization or at last follow-up. The primary analysis was time to ischemic stroke in the territory of the occlusive vasculopathy.

Results—
Forty-nine subjects were followed up during a median of 3.7 years. One of 16 patients with increased OEF on enrollment had an ischemic stroke and another had an intraparenchymal hemorrhage. Three of 33 patients with normal OEF had an ischemic stroke. On a per-hemisphere basis, 21 of 79 hemispheres with moyamoya vasculopathy had increased OEF at baseline. No ischemic strokes and one hemorrhage occurred in a hemisphere with increased OEF (n=21). Sixteen patients (20 hemispheres), including 5 with increased OEF at enrollment, were censored at a mean of 5.3 months after enrollment for revascularization surgery.

Conclusions—
The risk of new or recurrent stroke was lower than expected. The low event rate, low prevalence of increased OEF, and potential selection bias introduced by revascularization surgery limit strong conclusions about the association of increased OEF and future stroke risk.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00629915.
Intraoperative Completion Studies, Local Anesthesia, and Antiplatelet Medication Are Associated With Lower Risk in Carotid Endarterectomy
Authors: Knappich Christoph , Kuehnl Andreas , Tsantilas Pavlos , Schmid Sofie , Breitkreuz Thorben , Kallmayer Michael , Zimmermann Alexander , Eckstein Hans-Henning 
Published: March 2017

Background and Purpose—
In Germany, all surgical and endovascular procedures on the carotid bifurcation must be documented in a statutory nationwide quality assurance database. We aimed to analyze the association between procedural and perioperative variables and in-hospital stroke or death rates after carotid endarterectomy.

Methods—
Between 2009 and 2014, overall 142 074 elective carotid endarterectomy procedures for asymptomatic or symptomatic carotid artery stenosis were documented in the database. The primary outcome of this secondary data analysis was in-hospital stroke or death. Major stroke or death, stroke, and death, each until discharge were secondary outcomes. Adjusted relative risks (RRs) were assessed by multivariable multilevel regression analyses.

Results—
The primary outcome occurred in 1.8% of patients, with a rate of 1.4% in asymptomatic and 2.5% in symptomatic patients, respectively. In the multivariable analysis, lower risks of stroke or death were independently associated with local anesthesia (versus general anesthesia: RR, 0.85; 95% confidence interval [CI], 0.75–0.95), carotid endarterectomy with patch plasty compared with primary closure (RR, 0.71; 95% CI, 0.52–0.97), intraoperative completion studies by duplex ultrasound (RR, 0.74; 95% CI, 0.63–0.88) or angiography (RR, 0.80; 95% CI, 0.71–0.90), and perioperative antiplatelet medication (RR, 0.83; 95% CI, 0.71–0.97). No shunting and a short cross-clamp time were also associated with lower risks; however, these are suspected to be confounded.

Conclusions—
Local anesthesia, patch plasty compared with primary closure, intraoperative completion studies by duplex ultrasound or angiography, and perioperative antiplatelet medication were independently associated with lower in-hospital stroke or death rates after carotid endarterectomy.
Individual and System Contributions to Race and Sex Disparities in Thrombolysis Use for Stroke Patients in the United States
Authors: Faigle Roland , Urrutia Victor C. , Cooper Lisa A. , Gottesman Rebecca F. 
Published: March 2017

Background and Purpose—
Intravenous thrombolysis (IVT) is underutilized in ethnic minorities and women. To disentangle individual and system-based factors determining disparities in IVT use, we investigated race/sex differences in IVT utilization among hospitals serving varying proportions of minority patients.

Methods—
Ischemic stroke admissions were identified from the Nationwide Inpatient Sample between 2007 and 2011. Hospitals were categorized based on the percentage of minority patients admitted with stroke (<25% minority patients [white hospitals], 25% to 50% minority patients [mixed hospitals], or >50% minority patients [minority hospitals]). Logistic regression was used to evaluate the association between race/sex and IVT use within and between the different hospital strata.

Results—
Among 337 201 stroke admissions, white men had the highest odds of IVT among all race/sex groups in any hospital strata, and the odds of IVT for white men did not differ by hospital strata. For white women and minority men, the odds of IVT were significantly lower in minority hospitals compared with white hospitals (odds ratio, 0.83; 95% confidence interval, 0.71–0.97, for white women; and odds ratio, 0.82; 95% confidence interval, 0.69–0.99, for minority men). Race disparities in IVT use among women were observed in white hospitals (odds ratio, 0.88; 95% confidence interval, 0.78–0.99, in minority compared with white women), but not in minority hospitals (odds ratio, 0.94, 95% confidence interval, 0.82–1.09). Sex disparities in IVT use were observed among whites but not among minorities.

Conclusions—
Minority men and white women have significantly lower odds of IVT in minority hospitals compared with white hospitals. IVT use in white men does not differ by hospital strata.
Predictive Value of RAPID Assessed Perfusion Thresholds on Final Infarct Volume in SWIFT PRIME (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment)
Authors: Mokin Maxim , Levy Elad I. , Saver Jeffrey L. , Siddiqui Adnan H. , Goyal Mayank , Bonafé Alain , Cognard Christophe , Jahan Reza , Albers Gregory W. 
Published: March 2017

Background and Purpose—
Computed tomography perfusion imaging can estimate the size of the ischemic core, which can be used for the selection of patients for endovascular therapy. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) thresholds chosen to identify ischemic core influence the accuracy of prediction. We aimed to analyze the accuracy of various rCBV and rCBF thresholds for predicting the 27-hour infarct volume using RAPID automated analysis software from the SWIFT PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment) data.

Methods—
Patients from the SWIFT PRIME study who achieved complete reperfusion based on time until the residue function reached its peak >6 s perfusion maps obtained at 27 hours were included. Patients from both the intravenous tissue-type plasminogen activator only and endovascular groups were included in analysis. Final infarct volume was determined on magnetic resonance imaging (fluid-attenuated inversion recovery images) or computed tomography scans obtained 27 hours after symptom onset. The predicted ischemic core volumes on rCBV and rCBF maps using thresholds ranging between 0.2 and 0.8 were compared with the actual infarct volume to determine the most accurate thresholds.

Results—
Among the 47 subjects, the following baseline computed tomography perfusion thresholds most accurately predicted the actual 27-hour infarct volume: rCBV=0.32, median absolute error (MAE)=9 mL; rCBV=0.34, MAE=9 mL; rCBF=0.30, MAE=8.8 mL; rCBF=0.32, MAE=7 mL; and rCBF=0.34, MAE=7.3.

Conclusions—
Brain regions with rCBF 0.30 to 0.34 or rCBV 0.32 to 0.34 thresholds provided the most accurate prediction of infarct volume in patients who achieved complete reperfusion with MAEs of ≤9 mL.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01657461.
Leveraging increased cytoplasmic nucleoside kinase activity to target mtDNA and oxidative phosphorylation in AML
Authors: Liyanage Sanduni U. , Hurren Rose , Voisin Veronique , Bridon Gaëlle , Wang Xiaoming , Xu ChangJiang , MacLean Neil , Siriwardena Thirushi P. , Gronda Marcela , Yehudai Dana , Sriskanthadevan Shrivani , Avizonis Daina , Shamas-Din Aisha , Minden Mark D. , Bader Gary D. , Laposa Rebecca , Schimmer Aaron D. 
Published: March 2017

Key PointsAML cells have increased cytoplasmic nucleoside kinase expression, which functionally contribute to mtDNA biosynthesis. AML cells preferentially activated the nucleoside analog ddC, which inhibited mtDNA replication, oxphos, and induced anti-AML effects.
An intracytoplasmic β3 Leu718 deletion in a patient with a novel platelet phenotype
Authors: Nurden Paquita , Bordet Jean-Claude , Pillois Xavier , Nurden Alan T. 
Published: March 2017

Key Points
A novel heterozygous ITGB3 Leu718del shows loss of synchronization between the intracytoplasmic tail of β3 with that of αIIb. Decreased activation of αIIbβ3 accompanies enlarged platelets that contain giant granules and give a poor aggregation response.