bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gleason grade grouping of prostate cancer is of prognostic value in Asian men
Authors: Yeong Joe , Sultana Rehena , Teo Jonathan , Huang Hong Hong , Yuen John , Tan Puay Hoon , Khor Li Yan 
Published: March 2017

AimThe International Society of Urological Pathology made recommendations for the use of Grade Groups (GG) originally described by Epstein and colleagues over Gleason score (GS) alone in 2014, which was subsequently adopted by the WHO classification in 2016. The majority of studies validating this revision have been in Caucasian populations. We therefore asked whether the new GG system was retrospectively associated with biochemical disease-free survival in a mixed-ethnicity cohort of Asian men.MethodsA total of 680 radical prostatectomies (RPs) from 2005 to 2014 were included. GS from initial biopsy and RP were compared and used to allocate cases to GG, defined as: 1 (GS≤6); 2 (GS 3+4=7); 3 (GS 4+3=7); 4 (GS 4+4=8/5+3=8/3+5=8) and 5 (GS 9–10). Biochemical recurrence was defined as two consecutive post-RP prostate-specific antigen (PSA) levels of >0.2 ng/mL after post-RP PSA reaching the nadir of <0.1 ng/mL.ResultsOur data showed that Kaplan–Meier analysis revealed significant differences in biochemical recurrence within Gleason GG based on either biopsy or prostatectomy scoring. Multivariate analysis further confirmed that a higher GG was significantly associated with risk of biochemical recurrence. This GG system had a higher prognostic discrimination for both initial biopsy and RP than GS.ConclusionsOur study validates the use of the revised and updated GG system in a mixed-ethnicity population of Asian men. Higher GG was significantly associated with increased risk of biochemical recurrence. We therefore recommend its use to inform clinical management for patients with prostate cancer.
Socioeconomic gradients in all-cause, premature and avoidable mortality among immigrants and long-term residents using linked death records in Ontario, Canada
Authors: Khan Anam M , Urquia Marcelo , Kornas Kathy , Henry David , Cheng Stephanie Y , Bornbaum Catherine , Rosella Laura C 
Published: March 2017

BackgroundImmigrants have been shown to possess a health advantage, yet are also more likely to reside in arduous economic conditions. Little is known about if and how the socioeconomic gradient for all-cause, premature and avoidable mortality differs according to immigration status.MethodsUsing several linked population-based vital and demographic databases from Ontario, we examined a cohort of all deaths in the province between 2002 and 2012. We constructed count models, adjusted for relevant covariates, to attain age-adjusted mortality rates and rate ratios for all-cause, premature and avoidable mortality across income quintile in immigrants and long-term residents, stratified by sex.ResultsA downward gradient in age-adjusted all-cause mortality was observed with increasing income quintile, in immigrants (males: Q5: 13.32, Q1: 20.18; females: Q5: 9.88, Q1: 12.51) and long-term residents (males: Q5: 33.25, Q1: 57.67; females: Q5: 22.31, Q1: 36.76). Comparing the lowest and highest income quintiles, male and female immigrants had a 56% and 28% lower all-cause mortality rate, respectively. Similar trends were observed for premature and avoidable mortality. Although immigrants had consistently lower mortality rates compared with long-term residents, trends only differed statistically across immigration status for females (p<0.05).ConclusionsThis study illustrated the presence of income disparities as it pertains to all-cause, premature, and avoidable mortality, irrespective of immigration status. Additionally, the immigrant health advantage was observed and income disparities were less pronounced in immigrants compared with long-term residents. These findings support the need to examine the factors that drive inequalities in mortality within and across immigration status.
Effect of Ni–P alloy coating on microstructures and properties of vacuum brazed joints of SiCp/Al composites
Authors: Wang Peng , Gao Zeng , Cheng Dongfeng , Xu Dongxia , Niu Jitai 
Published: March 2017

Compared without electroless Ni–P alloy coating on the SiCp/Al composites, the paper describes the effect of Ni–P deposited layer on the microstructure evolution, shear strength, airtightness and fracture behavior of vacuum brazed joints. Void free and compact reaction layers along the 6063Al/Ni–P deposited layer/filler metal interfaces indicated that the joints exhibit high airtightness with He-leakage less than [Formula: see text] [Formula: see text]. Energy Dispersive X-ray Spectroscopy (EDS) analysis showed that the reaction layers mainly included brittle Al–Ni and Al–Cu–Ni intermetallics, where fracture occurred in priority and the shear strength was less than 90 MPa. However, without Ni–P alloy coating, sound joints with high shear strength of 100.1 MPa but low airtightness with He-leakage higher than [Formula: see text] were also obtained at 590[Formula: see text]C for soaking time of 30 min. In this case, a few holes that occurred along the filler metal/SiC particle interface significantly decreased the compactness of the joints. Therefore, according to the requirements in practical applications, suitable choice was provided in this research.
A Combined PD-1/C5a Blockade Synergistically Protects against Lung Cancer Growth and Metastasis
Authors: Ajona Daniel , Ortiz-Espinosa Sergio , Moreno Haritz , Lozano Teresa , Pajares María J. , Agorreta Jackeline , Bértolo Cristina , Lasarte Juan J. , Vicent Silvestre , Hoehlig Kai , Vater Axel , Lecanda Fernando , Montuenga Luis M. , Pio Ruben 
Published: March 2017

Abstract
Disruption of the programmed cell death protein 1 (PD-1) pathway with immune checkpoint inhibitors represents a major breakthrough in the treatment of non–small cell lung cancer. We hypothesized that combined inhibition of C5a/C5aR1 and PD-1 signaling may have a synergistic antitumor effect. The RMP1-14 antibody was used to block PD-1, and an L-aptamer was used to inhibit signaling of complement C5a with its receptors. Using syngeneic models of lung cancer, we demonstrate that the combination of C5a and PD-1 blockade markedly reduces tumor growth and metastasis and leads to prolonged survival. This effect is accompanied by a negative association between the frequency of CD8 T cells and myeloid-derived suppressor cells within tumors, which may result in a more complete reversal of CD8 T-cell exhaustion. Our study provides support for the clinical evaluation of anti–PD-1 and anti-C5a drugs as a novel combination therapeutic strategy for lung cancer.
Significance: Using a variety of preclinical models of lung cancer, we demonstrate that the blockade of C5a results in a substantial improvement in the efficacy of anti–PD-1 antibodies against lung cancer growth and metastasis. This study provides the preclinical rationale for the combined blockade of PD-1/PD-L1 and C5a to restore antitumor immune responses, inhibit tumor cell growth, and improve outcomes of patients with lung cancer. Cancer Discov; 7(7); 694–703. ©2017 AACR.
This article is highlighted in the In This Issue feature, p. 653
Feasibility of Rapid Linear-Endocardial and Epicardial Ventricular Ablation Using an Irrigated Multipolar Radiofrequency Ablation Catheter
Authors: Nazer Babak , Walters Tomos E. , Duggirala Srikant , Gerstenfeld Edward P. 
Published: March 2017

Background—
A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern.

Methods and Results—

We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds;
P
<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm;
P
<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm
3
;
P
=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted.

Conclusions—
Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.
Evaluation of Right Ventricular Systolic Function in Chagas Disease Using Cardiac Magnetic Resonance Imaging
Authors: Moreira Henrique T. , Volpe Gustavo J. , Marin-Neto José A. , Ambale-Venkatesh Bharath , Nwabuo Chike C. , Trad Henrique S. , Romano Minna M.D. , Pazin-Filho Antonio , Maciel Benedito C. , Lima João A.C. , Schmidt André 
Published: March 2017

Background—
Right ventricular (RV) impairment is postulated to be responsible for prominent systemic congestion in Chagas disease. However, occurrence of primary RV dysfunction in Chagas disease remains controversial. We aimed to study RV systolic function in patients with Chagas disease using cardiac magnetic resonance.

Methods and Results—

This cross-sectional study included 158 individuals with chronic Chagas disease who underwent cardiac magnetic resonance. RV systolic dysfunction was defined as reduced RV ejection fraction based on predefined cutoffs accounting for age and sex. Multivariable logistic regression was used to verify the relationship of RV systolic dysfunction with age, sex, functional class, use of medications for heart failure, atrial fibrillation, and left ventricular systolic dysfunction. Mean age was 54±13 years, 51.2% men. RV systolic dysfunction was identified in 58 (37%) individuals. Although usually associated with reduced left ventricular ejection fraction, isolated RV systolic dysfunction was found in 7 (4.4%) patients, 2 of them in early stages of Chagas disease. Presence of RV dysfunction was not significantly different in patients with indeterminate/digestive form of Chagas disease (35.7%) compared with those with Chagas cardiomyopathy (36.8%) (
P
=1.000).

Conclusions—
In chronic Chagas disease, RV systolic dysfunction is more commonly associated with left ventricular systolic dysfunction, although isolated and early RV dysfunction can also be identified.
China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients
Authors: Men Xi , Sun Wei , Fan Fangfang , Zhao Min , Huang Xiao , Wang Yu , Liu Lishun , Liu Ran , Sun Weiping , Peng Qing , Qin Xianhui , Tang Genfu , Li Jianping , Zhang Yan , Cai Yefeng , Hou Fan Fan , Wang Binyan , Xu Xiping , Cheng Xiaoshu , Sun Ningling , Huang Yining , Huo Yong 
Published: March 2017

Background
The optimal range of blood pressure variability remains unclear. We aimed to stratify the degree of risk of stroke based on visit‐to‐visit systolic blood pressure (SBP) variability in a large Chinese hypertensive population in 32 communities.

Methods and Results

We retrospectively analyzed the data of 20 702 hypertensive patients from the China Stroke Primary Prevention Trial. The participants were randomized into 2 treatment groups to receive either enalapril or enalapril plus folic acid. Their blood pressures were measured every 3 months. The outcome was the first stroke. Three parameters of SBP variability were calculated: standard deviation, coefficient of variation, and average real variability. The records of first 4, 6, 8, 10 and 12 visits at which SBP was measured were used to calculate SBP variability and to predict subsequent stroke risk in adjusted Cox regression models. After median follow‐up of 4.5 years, 597 patients had experienced stroke. Visit‐to‐visit SBP variability was an independent predictor of subsequent stroke (eg, the hazard ratio for the highest quintile of average real variability [22.67–61.07 mm Hg] over 6 visits was 1.55, 95% CI 1.07–2.25,
P
=0.021), independent of mean SBP over the follow‐up period. Its value was more predictive when more blood pressure records were used.

Conclusions
Visit‐to‐visit SBP variability is an independent predictor of primary stroke in Chinese hypertensive patients. This predictive value depends on the number of blood pressure measurements used to calculate variability but is independent of mean SBP.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00794885.
Lay Bystanders' Perspectives on What Facilitates Cardiopulmonary Resuscitation and Use of Automated External Defibrillators in Real Cardiac Arrests
Authors: Malta Hansen Carolina , Rosenkranz Simone Mørk , Folke Fredrik , Zinckernagel Line , Tjørnhøj‐Thomsen Tine , Torp‐Pedersen Christian , Sondergaard Kathrine B. , Nichol Graham , Hulvej Rod Morten 
Published: March 2017

Background
Many patients who suffer an out‐of‐hospital cardiac arrest will fail to receive bystander intervention (cardiopulmonary resuscitation [CPR] or defibrillation) despite widespread CPR training and the dissemination of automated external defibrillators (AEDs). We sought to investigate what factors encourage lay bystanders to initiate CPR and AED use in a cohort of bystanders previously trained in CPR techniques who were present at an out‐of‐hospital cardiac arrest.

Methods and Results
One‐hundred and twenty‐eight semistructured qualitative interviews with CPR‐trained lay bystanders to consecutive out‐of‐hospital cardiac arrest, where an AED was present were conducted (from January 2012 to April 2015, in Denmark). Purposive maximum variation sampling was used to establish the breadth of the bystander perspective. Twenty‐six of the 128 interviews were chosen for further in‐depth analyses, until data saturation. We used cross‐sectional indexing (using software), and inductive in‐depth thematic analyses, to identify those factors that facilitated CPR and AED use. In addition to prior hands‐on CPR training, the following were described as facilitators: prior knowledge that intervention is crucial in improving survival, cannot cause substantial harm, and that the AED will provide guidance through CPR; prior hands‐on training in AED use; during CPR performance, teamwork (ie, support), using the AED voice prompt and a ventilation mask, as well as demonstrating leadership and feeling a moral obligation to act.

Conclusions
Several factors other than previous hands‐on CPR training facilitate lay bystander instigation of CPR and AED use. The recognition and modification of these factors may increase lay bystander CPR rates and patient survival following an out‐of‐hospital cardiac arrest.
Risk of Inhospital Stroke or Death Is Associated With Age But Not Sex in Patients Treated With Carotid Endarterectomy for Asymptomatic or Symptomatic Stenosis in Routine Practice: Secondary Data Analysis of the Nationwide German Statutory Quality Assurance Database From 2009 to 2014
Authors: Schmid Sofie , Tsantilas Pavlos , Knappich Christoph , Kallmayer Michael , König Thomas , Breitkreuz Thorben , Zimmermann Alexander , Kuehnl Andreas , Eckstein Hans‐Henning 
Published: March 2017

Background
Guideline recommendations on carotid endarterectomy are based predominantly on randomized, controlled trials, in which women or elderly patients are often under‐represented. This study analyzed the association of age and sex with the risk of in‐hospital stroke or death following carotid endarterectomy under routine conditions in Germany.

Methods and Results

Secondary data analysis using the Statutory German Quality Assurance Database on all carotid endarterectomy procedures (n=142 074) performed between 2009 and 2014. Primary outcome was any stroke or death until discharge; secondary outcomes were any in‐hospital stroke (alone), and death (alone). Descriptive statistics and multilevel multivariable regression analyses were applied. Patients were predominately male (68%), with mean age 71 years. Carotid stenosis was symptomatic in 40%. Primary outcome occurred in 1.8% of women and 1.9% of men. Multivariable regression analysis revealed that more‐advanced age was associated with a higher primary outcome rate (relative risk [RR] per 10‐year increase: 1.19; 95%
CI
, 1.14–1.24). Risk of death (alone) was associated with age (
RR
, 1.68; 95%
CI
, 1.54–1.84). Age was associated with the risk of stroke (alone;
RR
, 1.05; 95%
CI
, 1.00–1.11). Sex was not associated with primary outcome rate (1.01; 95%
CI
, 0.93–1.10), nor did it significantly modify the age effect.

Conclusions
This study shows that increasing age, but not sex, is associated with a higher risk of in‐hospital stroke or death following carotid endarterectomy under everyday conditions in Germany. Whereas the risk of death (alone) is significantly associated with age, the association between age and the risk of stroke (alone) can be considered of minor importance.
Mff‐Dependent Mitochondrial Fission Contributes to the Pathogenesis of Cardiac Microvasculature Ischemia/Reperfusion Injury via Induction of mROS‐Mediated Cardiolipin Oxidation and HK2/VDAC1 Disassociation‐Involved mPTP Opening
Authors: Zhou Hao , Hu Shunying , Jin Qinhua , Shi Chen , Zhang Ying , Zhu Pingjun , Ma Qiang , Tian Feng , Chen Yundai 
Published: March 2017

Background
The cardiac microvascular system ischemia/reperfusion injury following percutaneous coronary intervention is a clinical thorny problem. This study explores the mechanisms by which ischemia/reperfusion injury induces cardiac microcirculation collapse.

Methods and Results

In wild‐type mice, mitochondrial fission factor (Mff) expression increased in response to acute microvascular ischemia/reperfusion injury. Compared with wild‐type mice, homozygous Mff‐deficient (Mff
gt
) mice exhibited a smaller infarcted area, restored cardiac function, improved blood flow, and reduced microcirculation perfusion defects. Histopathology analysis demonstrated that cardiac microcirculation endothelial cells (
CMECs
) in Mff
gt
mice had an intact endothelial barrier, recovered phospho‐endothelial nitric oxide synthase production, opened lumen, undivided mitochondrial structures, and less
CMEC
death. In vitro, Mff‐deficient
CMEC
s (derived from Mff
gt
mice or Mff small interfering RNA–treated) demonstrated less mitochondrial fission and mitochondrial‐dependent apoptosis compared with cells derived from wild‐type mice. The loss of Mff inhibited mitochondrial permeability transition pore opening via blocking the oligomerization of voltage‐dependent anion channel 1 and subsequent hexokinase 2 separation from mitochondria. Moreover, Mff deficiency reduced the cyt‐c leakage into the cytoplasm by alleviating cardiolipin oxidation resulting from damage to the electron transport chain complexes and mitochondrial reactive oxygen species overproduction.

Conclusions
This evidence clearly illustrates that microcirculatory ischemia/reperfusion injury can be attributed to Mff‐dependent mitochondrial fission via voltage‐dependent anion channel 1/hexokinase 2–mediated mitochondrial permeability transition pore opening and mitochondrial reactive oxygen species/cardiolipin involved cyt‐c release.
Application of Physical Filter Initialization in 4DVar
Authors: Peng Wei , Liang Xudong , Zhang Xin , Huang Xiangyu , Lu Bing , Fu Qiao 
Published: March 2017

Abstract
Generally, the results of data assimilation are not well balanced dynamically due to errors in background, observations, or the model itself. So, initialization methods have been introduced to remove spurious gravity waves from the analysis. One of the initialization methods is digital filter initialization (DFI), which has been used in operational forecast systems, though its physical meaning is not well understood. Other methods eliminate high-frequency noise in optimized initial conditions by introducing physical constraints, such as the model constraint scheme, which minimizes the time tendency of model variables. In this study, a physical filter initialization (PFI) scheme, based on the model constraint scheme, is implemented in the four-dimensional variational data assimilation (4DVar) system of the Weather Research and Forecasting (WRF) Model. The impacts of the PFI scheme are examined by both single-observation and real-data experiments. The results indicate that the PFI scheme can eliminate high-frequency noise effectively, obtain flow-dependent analysis increments, and shorten forecast spinup time. Consequently, the precipitation forecast is improved to a certain extent, especially during the first few hours thanks to the shorter spinup time.
What makes a mobile app successful in supporting health behaviour change?
Authors: Fitzgerald Martin , McClelland Tracy 
Published: March 2017

Introduction: Health promotion apps designed to support and reinforce health behaviours or to reduce risk behaviours are the most commonly downloaded apps. Such technologies have the potential to reach and deliver health care to new populations. But the extent to which they are successful in enabling the adoption of new and desired behaviours can vary. Some apps are more effective than others, some are free to download while others require a nominal or substantial charge. Cost alone is not indicative of quality or effectiveness. This is important because the use of health apps by the public will likely increase, as is the expectation that health care professionals understand this technology and its heuristic role in personalised health. Practitioners therefore need to be better informed regarding what makes a health app appealing to service users and successful as an intervention to facilitate behaviour change. Objective: This paper describes and discusses how the structure and content of health care apps can facilitate or inhibit behavioural change. The aim is to support practitioners in the screening and identification of suitable apps for clinical use. Method: Theory and literature review. Conclusion: App content that involved clinician input at the design stage and included internal drivers such as motivation, self-efficacy and illness understanding and external drivers such as illness information, social networking and user compatibility tend to do better in facilitating behaviour change than those that do not. Of these factors, motivation is considered to be the most important.