bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of Thin-Capped Fibroatheromas in Intravascular Optical Coherence Tomography Images
Authors: Phipps Jennifer E. , Hoyt Taylor , Vela Deborah , Wang Tianyi , Michalek Joel E. , Buja L. Maximilian , Jang Ik-Kyung , Milner Thomas E. , Feldman Marc D. 
Published: July 2016

Background—
Intravascular optical coherence tomography (IVOCT) images are recorded by detecting light backscattered within coronary arteries. We hypothesize that non–thin-capped fibroatheroma (TCFA) causes may scatter light to create the false appearance of IVOCT TCFA.

Methods and Results—
Ten human cadaver hearts were imaged with IVOCT (n=14 coronary arteries). IVOCT and histological TCFA images were coregistered and compared. Of 21 IVOCT TCFAs (fibrous cap <65 μm, lipid arc >1 quadrant), only 8 were true histological TCFA. Foam cell infiltration was responsible for 70% of false IVOCT TCFA and caused both thick-capped fibroatheromas to appear as TCFA, and the appearance of TCFAs when no lipid core was present. Other false IVOCT TCFA causes included smooth muscle cell–rich fibrous tissue (12%) and loose connective tissue (9%). If the lipid arc >1 quadrant (obtuse) criterion was disregarded, 45 IVOCT TCFAs were identified, and sensitivity of IVOCT TCFA detection increased from 63% to 87%, and specificity remained high at 92%.

Conclusions—
We demonstrate that IVOCT can exhibit 87% (95% CI, 75%–93%) sensitivity and 92% specificity (95% CI, 86%–96%) to detect all lipid arcs (both obtuse and acute, <1 quadrant) TCFA, and we also propose new mechanisms involving light scattering that explain why other plaque components can masquerade as TCFA and cause low positive predictive value of IVOCT for TCFA detection (47% for obtuse lipid arcs). Disregarding the lipid arc >1 quadrant requirement enhances the ability of IVOCT to detect TCFA.
Derivation and Validation of Prognosis-Based Age Cutoffs to Define Elderly in Cardiac Surgery
Authors: Afilalo Jonathan , Steele Russell , Manning Warren J. , Khabbaz Kamal R. , Rudski Lawrence G. , Langlois Yves , Morin Jean-Francois , Picard Michael H. 
Published: July 2016

Background—
The age cutoff to define elderly is controversial in cardiac surgery, empirically ranging from ≥65 to ≥80 years. Beyond semantics, this has important implications as a starting point for clinical care pathways and inclusion in trials. We sought to characterize the relationship between age and adverse outcomes in patients undergoing cardiac surgery and to derive and validate prognosis-based age cutoffs.

Methods and Results—
Six thousand five hundred seventy one consecutive adult patients undergoing cardiac surgery at 3 hospitals in the United States and Canada were included in the cohort. Logistic regression models and generalized additive models with thin-plate splines were fit to the data. The age distribution was 50 to 59 years in 1244 (18.9%), 60 to 69 years in 2144 (32.6%), 70 to 79 years in 2000 (30.4%), ≥80 years in 1183 (18.0%) patients. After controlling for sex and type of operation, the relationship between age and 30-day operative mortality was found to be nonlinear. Receiver operating characteristic analysis showed that the optimal cutoffs to identify older patients at higher risk of operative mortality were greater than 74, 78, and 75 years for isolated coronary bypass, isolated valve surgery, and coronary bypass plus valve surgery, respectively. These age cutoffs were validated in an independent cohort.

Conclusions—
The relationship between age and operative mortality is not linear, manifesting a steeper rise after age 75 for coronary bypass and approaching octogenarian age for isolated valve surgery. Rather than using arbitrary age cutoffs to define elderly, the outcomes-based cutoff of ≥75 years should be used to identify the population of older adults that has higher risk and may benefit from preoperative geriatric evaluation and optimization.
Long-Term Outcome After Carotid Artery Stenting
Authors: Jonsson Magnus , Lindström David , Gillgren Peter , Wanhainen Anders , Malmstedt Jonas 
Published: July 2016

Background and Purpose—
Long-term outcome after carotid artery stenting (CAS), a less invasive technique than carotid endarterectomy (CEA), for prevention of stroke, is unclear. The aim was to assess long-term outcomes after CAS, compared with CEA, in a nationwide cohort study.

Methods—
All patients registered in the national Swedish Vascular Registry (Swedvasc) treated with primary CAS between 2005 and 2012 were identified. For every CAS, 2 CEA controls, matched for sex, age, procedure year, and indication (symtomatic/asymtomatic), were chosen. Postoperative stroke was identified by cross-matching the cohort with the InPatient Registry and charts review. Primary end point was ipsilateral stroke or death >30 days postoperatively.

Results—
A total of 1157 patients were included, 409 CAS and 748 CEA; 73% men with mean age 70 years and 69% were symptomatic. Risk factor profile was similar between the 2 groups. Median follow-up time was 4.1 years. Ipsilateral stroke or death of >30 days postoperatively occurred in 95 of 394 in the CAS group versus 120 of 724 in the CEA group (adjusted hazard ratio, 1.59; 95% confidence interval, 1.15–2.18). The corresponding adjusted rates for death, ipsilateral stroke of >30 days, and any stroke or death of >30 days were 25.7% versus 18.6% (hazard ratio, 1.20; 95% confidence interval, 0.84–1.72), 9.4% versus 2.9% (hazard ratio, 3.40; 95% confidence interval, 1.53–7.53), 34.2% versus 23.6% (hazard ratio, 1.49; 95% confidence interval, 1.10–2.00) for the CAS group versus CEA group, respectively.

Conclusions—
In this nationwide cohort study, CAS was associated with an increased long-term risk of ipsilateral stroke and death during after the perioperative phase when compared with CEA.
Family History and Risk of Recurrent Stroke
Authors: Chung Jong-Won , Kim Beom Joon , Han Moon-Ku , Kang Kyusik , Park Jong-Moo , Park Sang-Soon , Park Tai Hwan , Cho Yong-Jin , Hong Keun-Sik , Lee Kyung Bok , Kim Jae Guk , Ko Youngchai , Lee SooJoo , Nah Hyun-Wook , Kim Dae-Hyun , Cha Jae-Kwan , Oh Mi-Sun , Yu Kyung-Ho , Lee Byung-Chul , Jang Myung Suk , Lee Ji Sung , Lee Juneyoung , Bae Hee-Joon 
Published: July 2016

Background and Purpose—
The association between family history of stroke and stroke recurrence remains unclear.

Methods—
Using a web-based multicenter stroke registry database, information on history of stroke in first-degree relatives was collected prospectively for acute ischemic stroke patients who were hospitalized within 7 days of onset. The collected information was categorized as follows: type of the affected relative(s) with stroke (paternal, maternal, sibling, or 2 or more) and age of the relative’s stroke onset (<50, 50–59, 60–69, and ≥70 years). Stroke recurrence was captured prospectively using a predetermined protocol. Subgroup analyses were performed according to the patient’s age at the index stroke.

Results—
Among 7642 patients, 937 (12.3%) had a history of stroke in their first-degree relatives and 475 (6.2%: 201 within and 274 after 3 weeks from index stroke) experienced stroke recurrence (median follow-up, 365 days). In multivariable Cox proportional hazard models, overall family history was not associated with stroke recurrence (hazard ratio, 1.08; 95% confidence interval, 0.81–1.43). However, the details of their family histories, including relative’s age at stroke onset (<50 years: hazard ratio, 2.14; 95% confidence interval, 1.004–4.54) and stroke history in a sibling (hazard ratio, 1.67; 95% confidence interval, 1.09–2.58), were independently associated with stroke recurrence after adjusting for potential confounders. The associations appeared to be stronger in young adults with stroke (age, <55 years) than in older stroke patients.

Conclusions—
This study suggests that elevated risks of recurrent stroke are associated with having relatives with early-onset stroke and siblings with stroke histories, implying that additional precautions may be needed in such populations.
Endoscopic Endonasal Repair of Septal Perforation with Interpositional Auricular Cartilage Grafting via a Mucosal Regeneration Technique
Authors: Ozturan Orhan , Yenigun Alper , Senturk Erol , Eren Sabri Baki , Aksoy Fadlullah 
Published: July 2016

We evaluated the efficacy of interpositional auricular cartilage grafting for perforation with an endoscopic endonasal approach via a mucosal regeneration technique. In total, 12 patients with symptomatic septal perforations were operated on by way of an endoscopic endonasal approach after an adequately sized cartilage graft was harvested. The graft was inserted between the circumferentially incised and elevated flaps of the perforation and secured by vertical and horizontal nonabsorbable aligning approximation stitches and prolonged placement of silicone splints. The average perforation size was 12.3 mm (range, 4‐19 mm). Bleeding, incrustation, pain, whistling respiration, and nasal congestion symptoms were relieved entirely in 10 of 12 patients (83.3%) who had successful treatment. This study showed that an endoscopic endonasal approach via a mucosal regeneration technique without direct mucosa‐to‐mucosa repair can be applied successfully without disrupting the neighboring nasal structures for septal perforations up to 20 mm and as effectively as other, more complex surgical interventions.
Appropriateness and avoidability of terminal hospital admissions: Results of a survey among family physicians
Authors: Reyniers Thijs , Deliens Luc , Pasman H Roeline W , Vander Stichele Robert , Sijnave Bart , Houttekier Dirk , Cohen Joachim 
Published: July 2016

Background: Although the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life. Aim: To examine what proportion of terminal hospital admissions among their patients family physicians consider to have been avoidable and/or inappropriate; which patient, family physician and admission factors are associated with the perceived inappropriateness or avoidability of terminal hospital admissions; and which interventions could have prevented them, from the perspective of family physicians. Design: Survey among family physicians, linked to medical record data. Setting: Patients who had died non-suddenly in the acute hospital setting of a university hospital in Belgium between January and August 2014. Results: We received 245 completed questionnaires (response rate 70%) and 77% of those hospital deaths ( n = 189) were considered to be non-sudden. Almost 14% of all terminal hospital admissions were considered to be potentially inappropriate, almost 14% potentially avoidable and 8% both, according to family physicians. The terminal hospital admission was more likely to be considered potentially inappropriate or potentially avoidable for patients who had died of cancer, when the patient’s life expectancy at the time of admission was limited, by family physicians who had had palliative care training at basic, postgraduate or post-academic level, and when the admission was initiated by the patient, partner or other family. Conclusion: Timely communication with the patient about their limited life expectancy and the provision of better support to family caregivers may be important strategies in reducing the number of hospital deaths.
Crowdsourcing for self-monitoring: Using the Traffic Light Diet and crowdsourcing to provide dietary feedback
Authors: Turner-McGrievy Gabrielle M , Wilcox Sara , Kaczynski Andrew T , Spruijt-Metz Donna , Hutto Brent E , Muth Eric R , Hoover Adam 
Published: July 2016

Background Smartphone photography and crowdsourcing feedback could reduce participant burden for dietary self-monitoring. Objectives To assess if untrained individuals can accurately crowdsource diet quality ratings of food photos using the Traffic Light Diet (TLD) approach. Methods Participants were recruited via Amazon Mechanical Turk and read a one-page description on the TLD. The study examined the participant accuracy score (total number of correctly categorized foods as red, yellow, or green per person), the food accuracy score (accuracy by which each food was categorized), and if the accuracy of ratings increased when more users were included in the crowdsourcing. For each of a range of possible crowd sizes ( n = 15, n = 30, etc.), 10,000 bootstrap samples were drawn and a 95% confidence interval (CI) for accuracy constructed using the 2.5th and 97.5th percentiles. Results Participants ( n = 75; body mass index 28.0 ± 7.5; age 36 ± 11; 59% attempting weight loss) rated 10 foods as red, yellow, or green. Raters demonstrated high red/yellow/green accuracy (>75%) examining all foods. Mean accuracy score per participant was 77.6 ± 14.0%. Individual photos were rated accurately the majority of the time (range = 50%–100%). There was little variation in the 95% CI for each of the five different crowd sizes, indicating that large numbers of individuals may not be needed to accurately crowdsource foods. Conclusions Nutrition-novice users can be trained easily to rate foods using the TLD. Since feedback from crowdsourcing relies on the agreement of the majority, this method holds promise as a low-burden approach to providing diet-quality feedback.
Oxidative modifications of glyceraldehyde 3-phosphate dehydrogenase regulate metabolic reprogramming of stored red blood cells
Authors: Reisz Julie A. , Wither Matthew J. , Dzieciatkowska Monika , Nemkov Travis , Issaian Aaron , Yoshida Tatsuro , Dunham Andrew J. , Hill Ryan C. , Hansen Kirk C. , D’Alessandro Angelo 
Published: July 2016

Key Points
Reversible oxidation of GAPDH promotes metabolic reprogramming of stored RBCs, as gleaned through tracing with 13C1,2,3-glucose. Storage-induced redox imbalance promotes vesiculation of irreversibly oxidized GAPDH, as determined through switch-tag redox proteomics.
Platelet lysate as a substitute for animal serum for the ex-vivo expansion of mesenchymal stem/stromal cells: present and future
Authors: Astori Giuseppe , Amati Eliana , Bambi Franco , Bernardi Martina , Chieregato Katia , Schäfer Richard , Sella Sabrina , Rodeghiero Francesco 
Published: July 2016

AbstractThe use of fetal bovine serum (FBS) as a cell culture supplement is discouraged by regulatory authorities to limit the risk of zoonoses and xenogeneic immune reactions in the transplanted host. Additionally, FBS production came under scrutiny due to animal welfare concerns. Platelet derivatives have been proposed as FBS substitutes for the ex-vivo expansion of mesenchymal stem/stromal cells (MSCs) since platelet-derived growth factors can promote MSC ex-vivo expansion. Platelet-derived growth factors are present in platelet lysate (PL) obtained after repeated freezing–thawing cycles of the platelet-rich plasma or by applying physiological stimuli such as thrombin or CaCl2.PL-expanded MSCs have been used already in the clinic, taking advantage of their faster proliferation compared with FBS-expanded preparations. Should PL be applied to other biopharmaceutical products, its demand is likely to increase dramatically. The use of fresh platelet units for the production of PL raises concerns due to limited availability of platelet donors. Expired units might represent an alternative, but further data are needed to define safety, including pathogen reduction, and functionality of the obtained PL. In addition, relevant questions concerning the definition of PL release criteria, including concentration ranges of specific growth factors in PL batches for various clinical indications, also need to be addressed. We are still far from a common definition of PL and standardized PL manufacture due to our limited knowledge of the mechanisms that mediate PL-promoting cell growth. Here, we concisely discuss aspects of PL as MSC culture supplement as a preliminary step towards an agreed definition of the required characteristics of PL for the requirements of manufacturers and users.
Willingness to Participate in a Randomized Trial Comparing Catheters to Fistulas for Vascular Access in Incident Hemodialysis Patients: An International Survey of Nephrologists
Authors: Poinen Krishna , Oliver Matthew J. , Ravani Pietro , Van der Veer Sabine N. , Jager Kitty J. , Van Biesen Wim , Polkinghorne Kevan R. , Rosenfeld Aviva , Lewin Adriane M. , Dulai Mandeep , Quinn Robert R. 
Published: July 2016

Background: Current guidelines favor fistulas over catheters as vascular access. Yet, the observational literature comparing fistulas to catheters has important limitations and biases that may be difficult to overcome in the absence of randomization. However, it is not clear if physicians would be willing to participate in a clinical trial comparing fistulas to catheters. Objectives: We also sought to elicit participants' opinions on willingness to participate in a future trial regarding catheters and fistulas. Design: We created a three-part survey consisting of 19 questions. We collected demographic information, respondents' knowledge of the vascular access literature, appropriateness of current guideline recommendations, and their willingness to participate in a future trial. Setting: Participants were recruited from Canada, Europe, Australia, and New Zealand. Participants: Participants include physicians and trainees who are involved in the care of end-stage renal disease patients requiring vascular access. Measurements: Descriptive statistics were used to describe baseline characteristics of respondents according to geographic location. We used logistic regression to model willingness to participate in a future trial. Methods: We surveyed nephrologists from Canada, Europe, Australia, and New Zealand to assess their willingness to participate in a randomized trial comparing fistulas to catheters in incident hemodialysis patients. Results: Our results show that in Canada, 86 % of respondents were willing to participate in a trial (32 % in all patients; 54 % only in patients at high risk of primary failure). In Europe and Australia/New Zealand, the willingness to participate in a trial that included all patients was lower (28 % in Europe; 25 % in Australia/New Zealand), as was a trial that included patients at high risk of primary failure (38 % in Europe; 39 % in Australia/New Zealand). Nephrologists who have been in practice for a few years, saw a larger volume of patients, or self-identified as experts in vascular access literature were more likely to participate in a trial. (Continued on next page) Limitations: Survey distribution was limited to vascular access experts in participating European countries and ultimately led to a discrepancy in numbers of European to non-European respondents overall. Canadian views are likely over-represented in the overall outcomes. Conclusions: Our survey results suggest that nephrologists believe there is equipoise surrounding the optimal vascular access strategy and that a randomized controlled study should be undertaken, but restricted to those individuals with a high risk of primary fistula failure.
Recognizing IgG4-Related Tubulointerstitial Nephritis
Authors: Mann Shawna , Seidman Michael A. , Barbour Sean J. , Levin Adeera , Carruthers Mollie , Chen Luke Y. C. 
Published: July 2016

Purpose of the review: Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder affecting nearly all organs, including the kidney. Tubulointerstitial nephritis (IgG4-TIN) is the most common form of IgG4-related kidney disease (IgG4-RKD) and is the focus of this concise review. Objective: The study aims to describe when IgG4-TIN should be suspected and to summarize the diagnosis, treatment, and natural history of the disease. Sources of information: Ovid MEDLINE, Google Scholar, and PubMed were searched for full-text English language articles up to January 2016. References included in the manuscript were chosen at the authors' discretion based on their relevance to the subject of the review. Findings: IgG4-TIN should be considered in patients presenting with abnormal urinalysis, abnormal kidney function, renal lesions on imaging, and elevated IgG, IgE, or hypocomplementemia. Diagnosis of IgG4-TIN requires a combination of histologic features (plasma cell-enriched TIN with >10 IgG4+ plasma cells/hpf, +/– TBM immune complex deposits in many cases) and at least one of the following: – Characteristic radiologic findings (small peripheral low-attenuation cortical nodules, round or wedge-shaped lesions, or diffuse patchy involvement) – Elevated serum IgG4 level – Characteristic findings of IgG4-RD in other organs Other conditions such as lupus, vasculitis, diabetic nephropathy, and lymphoma must be excluded, as these can also present with IgG4+ plasma cells in the renal parenchyma. IgG4-TIN is generally responsive to steroids and B cell depletion with rituximab, but relapses are common and patients require close long-term follow-up. Limitations: Available data on IgG4-TIN are from retrospective observational studies. Implications: IgG4-TIN is a distinct and emerging subtype of interstitial nephritis. Nephrologists must be aware of this entity and how to definitively diagnose and treat it. Prospective studies and ideally multi-center clinical trials are needed to study the epidemiology, treatment, and natural history of this disease.
Class 3 semaphorins induce F-actin reorganization in human dendritic cells: Role in cell migration
Authors: Curreli Sabrina , Wong Bin Sheng , Latinovic Olga , Konstantopoulos Konstantinos , Stamatos Nicholas M 
Published: July 2016

Abstract
Class 3 semaphorins (Semas) are soluble proteins that are well recognized for their role in guiding axonal migration during neuronal development. In the immune system, Sema3A has been shown to influence murine dendritic cell (DC) migration by signaling through a neuropilin (NRP)-1/plexin-A1 coreceptor axis. Potential roles for class 3 Semas in human DCs have yet to be described. We tested the hypothesis that Sema3A, -3C, and -3F, each with a unique NRP-1 and/or NRP-2 binding specificity, influence human DC migration. In this report, we find that although NRP-1 and NRP-2 are expressed in human immature DCs (imDCs), NRP-2 expression increases as cells mature further, whereas expression of NRP-1 declines dramatically. Elevated levels of RNA encoding plexin-A1 and -A3 are present in both imDCs and mature DC (mDCs), supporting the relevance of Sema/NRP/plexin signaling pathways in these cells. Sema3A, -3C, and -3F bind to human DCs, with Sema3F binding predominantly through NRP-2. The binding of these Semas leads to reorganization of actin filaments at the plasma membrane and increased transwell migration in the absence or presence of chemokine CCL19. Microfluidic chamber assays failed to demonstrate consistent changes in speed of Sema3C-treated DCs, suggesting increased cell deformability as a possible explanation for enhanced transwell migration. Although monocytes express RNA encoding Sema3A, -3C, and -3F, only RNA encoding Sema3C increases robustly during DC differentiation. These data suggest that Sema3A, -3C, and -3F, likely with coreceptors NRP-1, NRP-2, and plexin-A1 and/or -A3, promote migration and possibly other activities of human DCs during innate and adaptive immune responses.