bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of de novo and acute decompensated heart failure patients according to ejection fraction
Authors: Choi Ki Hong , Lee Ga Yeon , Choi Jin-Oh , Jeon Eun-Seok , Lee Hae-Young , Cho Hyun-Jai , Lee Sang Eun , Kim Min-Seok , Kim Jae-Joong , Hwang Kyung-Kuk , Chae Shung Chull , Baek Sang Hong , Kang Seok-Min , Choi Dong-Ju , Yoo Byung-Su , Kim Kye Hun , Park Hyun-Young , Cho Myeong-Chan , Oh Byung-Hee 
Published: October 2017

ObjectiveThere are conflicting results among previous studies regarding the prognosis of heart failure with preserved ejection fraction (HFpEF) compared with heart failure with reduced ejection fraction (HFrEF). This study aimed to compare the outcomes of patients with de novo acute heart failure (AHF) or acute decompensated HF (ADHF) according to HFpEF (EF≥50%), or HFrEF (EF<40%) and to define the prognosis of patients with HF with mid-range EF (HFmrEF, 40≤EF<50%).MethodsBetween March 2011 and February 2014, 5625 consecutive patients with AHF were recruited from 10 university hospitals. A total of 5414 (96.2%) patients with EF data were enrolled, which consisted of 2867 (53.0%) patients with de novo and 2547 (47.0%) with ADHF. Each of the enrolled group was stratified by EF.ResultsIn de novo, all-cause death rates were not significantly different between HFpEF and HFrEF (HFpEF vs HFrEF, 206/744 (27.7%) vs 438/1631 (26.9%), HRadj 1.15, 95% CI 0.96 to 1.38, p=0.14). However, among patients with ADHF, HFrEF had a significantly higher mortality rate compared with HFpEF (HFpEF vs HFrEF, 245/613 (40.0%) vs 694/1551 (44.7%), HRadj 1.25, 95% CI 1.06 to 1.47, p=0.007). Also, in ADHF, HFmrEF was associated with a significantly lower mortality rate within 1 year compared with HFrEF (HFmrEF vs HFrEF, 88/383 (23.0%) vs 430/1551 (27.7%), HRadj 1.31, 95% CI 1.03 to 1.65, p=0.03), but a significantly higher mortality rate after 1 year compared with HFpEF (HFmrEF vs HFpEF, 83/295 (28.1%) vs 101/469 (21.5%), HRadj 0.70, 95% CI 0.52 to 0.96, p=0.02).ConclusionsHFpEF may indicate a better prognosis compared with HFrEF in ADHF, but not in de novo AHF. For patients with ADHF, the prognosis associated with HFmrEF was similar to that of HFpEF within the first year following hospitalisation and similar to HFrEF 1  year after hospitalisation.
Differences in relative and absolute effectiveness of oral P2Y12 inhibition in men and women: a meta-analysis and modelling study
Authors: Lee Kuan Ken , Welton Nicky , Shah Anoop S , Adamson Philip D , Dias Sofia , Anand Atul , Newby David E , Mills Nicholas L , McAllister David A 
Published: October 2017

ObjectiveTo estimate the absolute treatment effects of newer P2Y12 inhibitors (ticagrelor and prasugrel) compared with clopidogrel in men and women with acute coronary syndrome (ACS).MethodsWe searched Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials of oral P2Y12 inhibitors for acute stroke or ACS. Age-specific and sex-specific mortality was obtained for all patients admitted to hospital with myocardial infarction in Scotland from 2006 to 2010 (prior to introduction of prasugrel or ticagrelor).ResultsFrom 9277 articles, nine fulfilled our inclusion criteria. Three trials compared newer P2Y12 inhibitors to clopidogrel in ACS, in which the treatment rate ratio (RR) for major adverse cardiovascular events in men was 0.80 (95% CI 0.69 to 0.93). For the same outcome, across all nine trials, the sex–treatment interaction RR was 1.08 (95% CI 0.98 to 1.19). Combining these estimates yielded a treatment RR in women of 0.86 (95% CI 0.72 to 1.04).17 842 women and 27 818 men were admitted to hospital with myocardial infarction. Mortality was higher for women than men for all-cause (5708, 32.0% vs 5891, 21.2%), cardiovascular (4032, 22.6% vs 4117, 14.8%) and bleeding (193, 1.1% vs 228, 0.8%) deaths.On applying the sex-specific RRs to this population, the absolute risk reduction for mortality at 1 year was similar for women and men for all-cause (2.30% (95% CI −0.92% to 5.22%) vs 2.47% (95% CI 0.62% to 4.10%)), cardiovascular (2.70% (95% CI −0.63% to 5.74%)) vs 2.72% (95% CI 0.92% to 4.35%)) and bleeding (−0.27% (95% CI −1.06% to 0.30%) vs −0.18% (95% CI −0.71% to 0.24%)) deaths.ConclusionNewer P2Y12 inhibitors may be slightly less efficacious in women than men, but the absolute risk reduction is similar in both sexes.
Contemporary outcomes in reoperative mitral valve surgery
Authors: Mehaffey Hunter J , Hawkins Robert B , Schubert Sarah , Fonner Clifford , Yarboro Leora T , Quader Mohammed , Speir Alan , Rich Jeff , Kron Irving L , Ailawadi Gorav 
Published: October 2017

ObjectiveData suggest that redo mitral valve surgery is being performed in increasing numbers, possibly with superior results according to single-centre studies. The purpose of this study is to describe outcomes of redo mitral valve surgery and identify risk-adjusted predictors of poor outcomes.MethodsAll (11 973) open mitral valve cases were evaluated (2002–2016) from a regional Society of Thoracic Surgery (STS) database. Patients were stratified by primary versus redo mitral valve surgery. Mixed effects logistic regression models including hospital as a random effect were used to identify risk factors for patients undergoing redo mitral valve surgery.ResultsOf all mitral valve cases, 1096 (9.7%) had a previous mitral operation. Redo patients had higher rates of valve replacement and preoperative comorbidities resulting in more complications, operative mortalities (11.1%vs6.5%, p<0.0001) and higher resource utilisation. Several factors independently increased risk for composite STS major morbidity and 30-day mortality, including cardiogenic shock (OR 10.3, p=0.0001), severe tricuspid insufficiency (OR 2.3, p=0.001), urgent/emergent status (OR 1.8, p=0.001) and concurrent coronary artery bypass grafting (OR 2.4, p=0.002). The volume of redo mitral valve surgery increased 10% per year and the observed-to-expected ratios (O/E) for operative mortality in redo mitral surgery improved from 1.44 early in the study period to 0.72 in the most recent era.ConclusionsRedo mitral valve surgery accounts for approximately 10% of mitral valve operations and is associated with increased risk and resource utilisation. However, as the volume of redo mitral surgery increases, outcomes have dramatically improved and are now better than predicted.
Ethical issues in the slaughterhouse
Authors: Cranley John 
Published: October 2017

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved.In addition, a possible way forward is suggested; however, there is rarely a cut‐and‐ dried answer in such cases, and readers may wish to suggest an alternative. This month's dilemma, ‘Ethical issues in the slaughterhouse’, was submitted and is discussed by John Cranley. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue.The series is being coordinated by Steven McCulloch, a practising vet with a PhD in the ethics of veterinary policy. It aims to provide a framework that will help practitioners find solutions when facing similar dilemmas.
Determinants of social inequalities in stroke incidence across Europe: a collaborative analysis of 126 635 individuals from 48 cohort studies
Authors: Ferrario Marco M , Veronesi Giovanni , Kee Frank , Chambless Lloyd E , Kuulasmaa Kari , Jørgensen Torben , Amouyel Philippe , Arveiler Dominique , Bobak Martin , Cesana Giancarlo , Drygas Wojciech , Ferrieres Jean , Giampaoli Simona , Iacoviello Licia , Nikitin Yuri , Pajak Andrzej , Peters Annette , Salomaa Veikko , Soderberg Stefan , Tamosiunas Abdonas , Wilsgaard Tom , Tunstall-Pedoe Hugh 
Published: October 2017

BackgroundKnowledge on the origins of the social gradient in stroke incidence in different populations is limited. This study aims to estimate the burden of educational class inequalities in stroke incidence and to assess the contribution of risk factors in determining these inequalities across Europe.Materials and methodsThe MORGAM (MOnica Risk, Genetics, Archiving and Monograph) Study comprises 48 cohorts recruited mostly in the 1980s and 1990s in four European regions using standardised procedures for baseline risk factor assessment and fatal and non-fatal stroke ascertainment and adjudication during follow-up. Among the 126 635 middle-aged participants, initially free of cardiovascular diseases, generating 3788 first stroke events during a median follow-up of 10 years, we estimated differences in stroke rates and HRs for the least versus the most educated individuals.ResultsCompared with their most educated counterparts, the overall age-adjusted excess hazard for stroke was 1.54 (95% CI 1.25 to 1.91) and 1.41 (95% CI 1.16 to 1.71) in least educated men and women, respectively, with little heterogeneity across populations. Educational class inequalities accounted for 86–413 and 78–156 additional stroke events per 100 000 person-years in the least compared with most educated men and women, respectively. The additional events were equivalent to 47%–130% and 40%–89% of the average incidence rates. Inequalities in risk factors accounted for 45%–70% of the social gap in incidence in the Nordic countries, the UK and Lithuania-Kaunas (men), but for no more than 17% in Central and South Europe. The major contributors were cigarette smoking, alcohol intake and body mass index.ConclusionsSocial inequalities in stroke incidence contribute substantially to the disease rates in Europe. Healthier lifestyles in the most disadvantaged individuals should have a prominent impact in reducing both inequalities and the stroke burden.
Effects of health-oriented descriptors on combustible cigarette and electronic cigarette packaging: an experiment among adult smokers in the United States
Authors: Sanders-Jackson Ashley , Tan Andy S L , Yie Kyeungyeun 
Published: October 2017

ObjectiveCertain tobacco companies use health-oriented descriptors (eg, 100% organic) on product packaging and advertising of combustible cigarettes or electronic cigarettes (e-cigarettes) that create a ‘health halo’ around smoking and vaping. Previous observational research suggests that such language may be associated with more favourable attitudes and reduced risk perceptions toward these brands compared with others. This study aimed to determine the effects of health-oriented descriptors on smokers’ attitude toward the brand, perception of packaging information, comparative harm versus other brands and intention to purchase either combustible cigarettes or e-cigarettes.MethodUS adult smokers were randomly assigned to view either a health-oriented language package (‘100% organic,’ ‘all natural’ or ‘no additives’), traditional marketing language package (‘fine quality,’ ‘premium blend’ or ‘100% original’) or a no-language package of a combustible cigarette brand (Study 1, n=405) or an e-cigarette brand (Study 2, n=396) in an experimental design.ResultsStudy 1: Participants in the health-oriented condition reported more favourable perceptions toward the package information, lower comparative harm and higher intention to purchase combustible cigarettes versus the no language control. In addition, participants in the health-oriented condition reported more positive attitude toward the brand and lower comparative harm versus the traditional marketing condition. Study 2: Compared with the traditional marketing condition, participants in the health-oriented condition reported greater intention to purchase Absolute e-cigarettes. There were no significant differences in attitude toward the brand, perception of packaging information and comparative harm versus other brands across conditions.ConclusionsThe effect of health-oriented language was significant for combustible cigarettesand e-cigarette packages. Policies to restrict health-oriented language on cigarette and e-cigarette packaging are recommended.
A NOVEL APPROACH TO DETECT EPILEPTIC SEIZURES USING A COMBINATION OF TUNABLE-Q WAVELET TRANSFORM AND FRACTAL DIMENSION
Authors: SHARMA MANISH , PACHORI RAM BILAS 
Published: October 2017

The detection and quantification of seizures can be achieved through the analysis of nonstationary electroencephalogram (EEG) signals. The detection of these intractable seizures involving human beings is a challenging and difficult task. The analysis of EEG through human inspection is prone to errors and may lead to false conclusions. The computer-aided systems have been developed to assist neurophysiologists in the identification of seizure activities accurately. We propose a new machine learning and signal processing-based automated system that can detect epileptic episodes accurately. The proposed algorithm employs a promising time-frequency tool called tunable-Q wavelet transform (TQWT) to decompose EEG signals into various sub-bands (SBs). The fractal dimensions (FDs) of the SBs have been used as the discriminating features. The TQWT has many attractive features, such as tunable oscillatory attribute and time-invariance property, which are favorable for the analysis of nonstationary and transient signals. Fractal dimension is a nonlinear chaotic trait that has been proven to be very useful in the analysis and classifications of nonstationary signals including EEG. First, we decompose EEG signals into the desired SBs. Then, we compute FD for each SB. These FDs of the SBs have been applied to the least-squares support vector machine (LS-SVM) classifier with radial basis function (RBF) kernel. We have used 10-fold cross-validation to ensure reliable performance and avoid the possible over-fitting of the model. In the proposed study, we investigate the following four popular classification tasks (CTs) related to different classes of EEG signals: (i) normal versus seizure (ii) seizure-free versus seizure (iii) nonseizure versus Seizure (iv) normal versus seizure-free. The proposed model surpassed existing models in the area under the receiver operating characteristics (ROC) curve, Matthew’s correlation coefficient (MCC), average classification accuracy (ACA), and average classification sensitivity (ACS). The proposed system attained perfect 100% ACS for all CTs considered in this study. The method achieved the highest classification accuracy as well as the largest area under ROC curve (AUC) for all classes. The salient feature of our proposed model is that, though many models exist in the literature, which gave high ACA, however, their performance has not been evaluated using MCC and AUC along with ACA simultaneously. The evaluation of the performance in terms of only ACA which may be misleading. Hence, the performance of the proposed model has been assessed not only in terms of ACA but also in terms AUC and MCC. Moreover, the performance of the model has been found to be almost equivalent to a perfect model, and the performance of the proposed model surpasses the existing models for the CTs investigated by us. Therefore, the proposed model is expected to assist clinicians in analyzing seizures accurately in less time without any error.
An interview with David Ayman Shamma
Authors: Riegler Michael , Shamma David Ayman 
Published: October 2017

About David Ayman Shamma:
I am a Principal Investigator and Senior Scientist at Centrum Wiskunde & Informatica (CWI) where I lead a team looking at Social Computing, Internet of Things (IoT), and fashion. Formerly, I was Director of Research at Yahoo Labs where I ran the HCI Research Group and I was the scientific liaison to Flickr (where I co-founded the Data-science group there). Broadly speaking, I design and prototype systems for multimedia-mediated communication, as well as, develops targeted methods and metrics for understanding how people communicate online in small environments and at web scale. Additionally, I create media art installations that have been reviewed by The New York Times, International Herald Tribune, and Chicago Magazine and exhibited internationally, including Second City Chicago, the Berkeley Art Museum, SIGGRAPH ETECH, Chicago Improv Festival, and Wired NextFest/NextMusic.
I have a Ph.D. in Computer Science from the Intelligent Information Laboratory at Northwestern University and a B.S./M.S. from the Institute for Human and Machine Cognition at The University of West Florida. Before Yahoo!, I was an instructor at the Medill School of Journalism; I have also taught courses in Computer Science and Studio Art departments. Prior to receiving my Ph.D., I was a visiting research scientist for the Center for Mars Exploration at NASA Ames Research Center.
Excess ω-6 fatty acids influx in aging drives metabolic dysregulation, electrocardiographic alterations, and low-grade chronic inflammation
Authors: Kain Vasundhara , Ingle Kevin A. , Kachman Maureen , Baum Heidi , Shanmugam Gobinath , Rajasekaran Namakkal S. , Young Martin E. , Halade Ganesh V. 
Published: October 2017

Maintaining a balance of ω-6 and ω-3 fatty acids is essential for cardiac health. Current ω-6 and ω-3 fatty acids in the American diet have shifted from the ideal ratio of 2:1 to almost 20:1; while there is a body of evidence that suggests the negative impact of such a shift in younger organisms, the underlying age-related metabolic signaling in response to the excess influx of ω-6 fatty acids is incompletely understood. In the present study, young (6 mo old) and aging (≥18 mo old) mice were fed for 2 mo with a ω-6-enriched diet. Excess intake of ω-6 enrichment decreased the total lean mass and increased nighttime carbohydrate utilization, with higher levels of cardiac cytokines indicating low-grade chronic inflammation. Dobutamine-induced stress tests displayed an increase in PR interval, a sign of an atrioventricular defect in ω-6-fed aging mice. Excess ω-6 fatty acid intake in aging mice showed decreased 12-lipoxygenase with a concomitant increase in 15-lipoxygenase levels, resulting in the generation of 15( S)-hydroxyeicosatetraenoic acid, whereas cyclooxygenase-1 and -2 generated prostaglandin E2, leukotriene B4, and thromboxane B2. Furthermore, excessive ω-6 fatty acids led to dysregulated nuclear erythroid 2-related factor 2/antioxidant-responsive element in aging mice. Moreover, ω-6 fatty acid-mediated changes were profound in aging mice with respect to the eicosanoid profile while minimal changes were observed in the size and shape of cardiomyocytes. These findings provide compelling evidence that surplus consumption of ω-6 fatty acids, coupled with insufficient intake of ω-3 fatty acids, is linked to abnormal changes in ECG. These manifestations contribute to functional deficiencies and expansion of the inflammatory mediator milieu during later stages of aging. NEW & NOTEWORTHY Aging has a profound impact on the metabolism of fatty acids to maintain heart function. The excess influx of ω-6 fatty acids in aging perturbed electrocardiography with marked signs of inflammation and a dysregulated oxidative-redox balance. Thus, the quality and quantity of fatty acids determine the cardiac pathology and energy utilization in aging.
Exaggerated cardiovascular responses to treadmill running in rats with peripheral arterial insufficiency
Authors: Kuczmarski J. Matthew , Unrath Kellee , Thomas Gail D. 
Published: October 2017

Patients with atherosclerotic peripheral artery disease have an augmented pressor response to treadmill walking, but the underlying mechanisms remain poorly understood and difficult to isolate because of the confounding presence of numerous cardiovascular risk factors. In the present study, we tested the hypothesis that a chronic deficit in muscle blood flow capacity would be sufficient to trigger an exaggerated pressor response to dynamic exercise. Sprague-Dawley rats (5 male and 5 female) were instrumented with radiotelemetry devices to measure the cardiovascular responses to treadmill running before and after bilateral femoral artery ligation, which has been previously shown to reduce the blood flow capacity of distal hindlimb muscles by >60%. Treadmill running evoked reproducible increases in mean arterial pressure (MAP) and heart rate (HR), which were significantly augmented 3 days after femoral artery ligation in both male rats [ΔMAP: +10 ± 1 (SE) vs. +18 ± 3 mmHg and ΔHR: +94 ± 12 vs. +148 ± 15 beats/min, P < 0.05] and female rats (ΔMAP: +16 ± 3 vs. +30 ± 5 mmHg and ΔHR: +128 ± 20 vs. +178 ± 19 beats/min, P < 0.05). Similar exaggerated MAP and HR responses were observed at repeated intervals between 3 and 65 days postligation. These findings indicate that a chronic deficit in muscle blood flow capacity is an important, persistent cause of the abnormal pressor and cardioaccelerator responses to dynamic exercise in both male and female rats with peripheral arterial insufficiency. NEW & NOTEWORTHY Using radiotelemetry to assess cardiovascular effects of exercise, we showed that femoral artery obstruction in male and female rats is an important, persistent cause of exaggerated pressor and cardioaccelerator responses to treadmill running. This translational model reproduces the abnormal cardiovascular response to exercise seen in patients with peripheral artery disease. Listen to this article’s corresponding podcast at http://ajpheart.podbean.com/e/treadmill-bp-in-simulated-peripheral-artery-disease/ .
Brown adipocytes postnatally arise through both differentiation from progenitors and conversion from white adipocytes in Syrian hamster
Authors: Okamatsu-Ogura Yuko , Nio-Kobayashi Junko , Nagaya Kazuki , Tsubota Ayumi , Kimura Kazuhiro 
Published: October 2017

To investigate the postnatal development of brown adipose tissue (BAT) in Syrian hamsters, we histologically examined interscapular fat tissue from 5–16-day-old pups, focusing on how brown adipocytes arise. Interscapular fat of 5-day-old hamsters mainly consisted of white adipocytes containing large unilocular lipid droplets, as observed in typical white adipose tissue (WAT). On day 7, clusters of small, proliferative nonadipocytes with a strong immunoreactivity for Ki67 appeared near the edge of the interscapular fat tissue. The area of the Ki67-positive regions expanded to ~50% of the total tissue area by day 10. The interscapular fat showed the typical BAT feature by day 16. A brown adipocyte-specific marker, uncoupling protein-1, was clearly detected on day 10 and thereafter, while not detected on day 7. During conversion of interscapular fat from WAT to BAT, unilocular adipocytes completely and rapidly disappeared without obvious apoptosis. Dual immunofluorescence staining for Ki67 and monocarboxylate transporter 1 (MCT1), another selective marker for brown adipocytes, revealed that most of the proliferating cells were of the brown adipocyte lineage. Electron microscopic examination showed that some of the white adipocytes contained small lipid droplets in addition to the large droplet and expressed MCT1 as do progenitor and mature brown adipocytes, implying a direct conversion from white to brown adipocytes. These results suggest that BAT of Syrian hamsters develops postnatally through two different pathways: the proliferation and differentiation of brown adipocyte progenitors and the conversion of unilocular adipocytes to multilocular brown adipocytes.NEW & NOTEWORTHY Brown and white adipose tissues (BAT and WAT, respectively) are quite different in morphological features and function; however, the boundary between these tissues is obscure. In this study, we histologically evaluated the process of BAT development in Syrian hamsters, which shows postnatal conversion of WAT to BAT. Our results suggest that brown adipocytes arise through two different pathways: the proliferation and differentiation of brown adipocyte progenitors and the conversion from white adipocytes.