bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Administration of Eicosapentaenoic Acid Improves Post–Myocardial Infarction Cardiac Remodeling in Mice by Regulating Macrophage Polarization
Authors: Takamura Masayuki , Kurokawa Keisuke , Ootsuji Hiroshi , Inoue Oto , Okada Hikari , Nomura Ayano , Kaneko Shuichi , Usui Soichiro 
Published: February 2017

Background

Consumption of n‐3 fatty acids reduces the incidence of cardiovascular mortality in populations that consume diets rich in fish oil. Eicosapentaenoic acid (
EPA
) is an n‐3 fatty acid known to reduce the frequency of nonfatal coronary events; however, the frequency of mortality after myocardial infarction (
MI
) is not reduced. The aims of this study were to determine whether long‐term administration of
EPA
regulated cardiac remodeling after
MI
and to elucidate the underlying therapeutic mechanisms of
EPA
.

Methods and Results

C57
BL
/6J mice were divided into control (phosphate‐buffered saline–treated) and
EPA
‐treated groups. After 28 days of treatment, the mice were subjected to either sham surgery or
MI
by left anterior descending coronary artery ligation. Mortality due to
MI
or heart failure was significantly lower in the
EPA
‐treated mice than in the phosphate‐buffered saline–treated mice. However, the incidence of cardiac rupture was comparable between the
EPA
‐treated mice and the phosphate‐buffered saline–treated mice after
MI
. Echocardiographic tests indicated that
EPA
treatment attenuated post‐
MI
cardiac remodeling by preventing issues such as left ventricular systolic dysfunction and left ventricle dilatation 28 days after
MI
induction. Moreover, during the chronic remodeling phase, ie, 28 days after
MI
, flow cytometry demonstrated that
EPA
treatment significantly inhibited polarization toward proinflammatory M1 macrophages, but not anti‐inflammatory M2 macrophages, in the infarcted heart. Furthermore,
EPA
treatment attenuated fibrosis in the noninfarcted remote areas during the chronic phase.

Conclusions

Long‐term administration of
EPA
improved the prognosis of and attenuated chronic cardiac remodeling after
MI
by modulating the activation of proinflammatory M1 macrophages.
Mesoscale Modeling of the Meteorological Impacts of Irrigation during the 2012 Central Plains Drought
Authors: Aegerter Clint , Wang Jun , Ge Cui , Irmak Suat , Oglesby Robert , Wardlow Brian , Yang Haishun , You Jingshen , Shulski Martha 
Published: February 2017

AbstractIn the summer of 2012, the central plains of the United States experienced one of its most severe droughts on record. This study examines the meteorological impacts of irrigation during this drought through observations and model simulations using the Community Land Model coupled to the Weather Research and Forecasting (WRF) Model. A simple parameterization of irrigation processes is added into the WRF Model. In addition to keeping soil moisture in irrigated areas at a minimum of 50% of soil moisture hold capacity, this irrigation scheme has the following new features: 1) accurate representation of the spatial distribution of irrigation area in the study domain by using a MODIS-based land surface classification with 250-m pixel size and 2) improved representation of the time series of leaf area index (LAI) values derived from crop modeling and satellite observations in both irrigated and nonirrigated areas. Several numerical sensitivity experiments are conducted. The WRF-simulated temperature field when including soil moisture and LAI modification within the model is shown to be most consistent with ground and satellite observations, all indicating a temperature decrease of 2–3 K in irrigated areas relative to the control run. Modification of LAI in irrigated and dryland areas led to smaller changes, with a 0.2-K temperature decrease in irrigated areas and up to a 0.5-K temperature increase in dryland areas. Furthermore, the increased soil moisture and modified LAI are shown to lead to statistically significant increases in surface divergence and surface pressure and to decreases in planetary boundary layer height over irrigated areas.
An Explanation for the Sensitivity of the Mean State of the Community Atmosphere Model to Horizontal Resolution on Aquaplanets
Authors: Herrington Adam R. , Reed Kevin A. 
Published: February 2017

The sensitivity of the mean state of the Community Atmosphere Model to horizontal resolutions typical of present-day general circulation models is investigated in an aquaplanet configuration. Nonconvergence of the mean state is characterized by a progressive drying of the atmosphere and large reductions in cloud coverage with increasing resolution. Analyses of energy and moisture budgets indicate that these trends are balanced by variations in moisture transport by the resolved circulation, and a reduction in activity of the convection scheme. In contrast, the large-scale precipitation rate increases with resolution, which is approximately balanced by greater advection of dry static energy associated with more active resolved vertical motion in the ascent region of the Hadley cell. An explanation for the sensitivity of the mean state to horizontal resolution is proposed, based on linear Boussinesq theory. The authors hypothesize that an increase in horizontal resolution in the model leads to a reduction in horizontal scale of the diabatic forcing arising from the column physics, facilitating finescale flow and faster resolved convective updrafts within the dynamical core, and steering the coupled system toward a new mean state. This hypothesis attempts to explain the underlying mechanism driving the variations in moisture transport observed in the simulations.
Near-Surface Thermodynamic Sensitivities in Simulated Extreme-Rain-Producing Mesoscale Convective Systems
Authors: Schumacher Russ S. , Peters John M. 
Published: February 2017

Abstract
This study investigates the influences of low-level atmospheric water vapor on the precipitation produced by simulated warm-season midlatitude mesoscale convective systems (MCSs). In a series of semi-idealized numerical model experiments using initial conditions gleaned from composite environments from observed cases, small increases in moisture were applied to the model initial conditions over a layer either 600 m or 1 km deep. The precipitation produced by the MCS increased with larger moisture perturbations as expected, but the rainfall changes were disproportionate to the magnitude of the moisture perturbations. The experiment with the largest perturbation had a water vapor mixing ratio increase of approximately 2 g kg−1 over the lowest 1 km, corresponding to a 3.4% increase in vertically integrated water vapor, and the area-integrated MCS precipitation in this experiment increased by nearly 60% over the control. The locations of the heaviest rainfall also changed in response to differences in the strength and depth of the convectively generated cold pool. The MCSs in environments with larger initial moisture perturbations developed stronger cold pools, and the convection remained close to the outflow boundary, whereas the convective line was displaced farther behind the outflow boundary in the control and the simulations with smaller moisture perturbations. The high sensitivity of both the amount and location of MCS rainfall to small changes in low-level moisture demonstrates how small moisture errors in numerical weather prediction models may lead to large errors in their forecasts of MCS placement and behavior.
A Preliminary Case Report of a High-Quality Cost-effective Rigid Laryngoscopy Setup
Authors: Zhang Fan , McMurray J.Scott , Devine Erin E. , Xue Chao , McCulloch Timothy M. , Jiang Jack J. 
Published: February 2017

Objective: To evaluate a cost-effective modified rigid laryngoscopy setup with a portable light source and high-resolution commercially available digital camera for use in smaller otolaryngology and family practice clinics. Methods: The modified setup was used to obtain images of the larynx using both a traditional light source and a portable light source. Varying shutter speeds and ISOs were evaluated, and the optimal settings were determined for the modified setup. Results: Picture quality was adequate, and the portable light source was bright enough. ISO from 640 to 1600 with shutter speeds ranging from 1/60 to 1/160 are ideal under the normal light source, while it is better to set the ISO between 4000 and 10 000 with shutter speeds from 1/60 to 1/100 under the portable light source. Picture quality was adequate with a resolution of 2768 pixels × 1848 pixels with 350 dpi × 350 dpi. Conclusions: Results show that the modified setup obtains images of adequate quality for use in the clinic. Additionally, since the larynx requires the most illumination for endoscopic imaging, a similar setup would work for imaging the ear and nose. This setup may make laryngoscopic exams more accessible to patients at smaller laryngoscopy clinics or family practice providers.
Where have all the pilot studies gone? A follow-up on 30 years of pilot studies in Clinical Rehabilitation
Authors: Kaur Navaldeep , Figueiredo Sabrina , Bouchard Vanessa , Moriello Carolina , Mayo Nancy 
Published: February 2017

Introduction: Pilot studies are meritorious for determining the feasibility of a definitive clinical trial in terms of conduct and potential for efficacy, but their possible applications for planning a future trial are not always fully realized. The purpose of this review was to estimate the extent to which pilot/feasibility studies: (i) addressed needed objectives; (ii) led to definitive trials; and (iii) whether the subsequent undertaking of a definitive trial was influenced by the strength of the evidence of outcome improvement. Methods: Trials published in the journal Clinical Rehabilitation, since its inception, were eligible if the word ‘pilot’ or ‘feasibility’ was specified somewhere in the article. A total of 191 studies were reviewed, results were summarized descriptively, and between-group effect sizes were computed. Results: The specific purposes of piloting were stated in only 58% ( n = 110) of the studies. The most frequent purpose was to estimate the potential for efficacy (85%), followed by testing the feasibility of the intervention (60%). Only 12% of the studies were followed by a definitive trial; <4% of studies had a main study underway or a published study protocol. There was no relationship between observed effect size and follow-up of pilot studies, although the confidence intervals were very wide owing to small number of trials that followed on. Discussion: Labelling and reporting of pilot studies needs to be improved to be concordant with the recently issued CONSORT guidelines. Feasibility needs to be fully tested and demonstrated prior to committing considerable human and monetary resources.
Endovascular management for significant iatrogenic portal vein bleeding
Authors: Kim Jong Woo , Shin Ji Hoon , Park Jonathan K , Yoon Hyun-Ki , Ko Gi-Young , Gwon Dong Il , Kim Jin Hyoung , Sung Kyu-Bo 
Published: February 2017

Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4–240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.
Genotyping-guided approach versus the conventional approach in selection of oral P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome
Authors: Tam Chor Cheung , Kwok Janette , Wong Anthony , Yung Arthur , Shea Catherine , Kong Shun Ling , Tang Wing Hong , Siu David , Chan Raymond , Lee Stephen 
Published: February 2017

Objective The CYP2C19 loss-of-function (LoF) allele is present in half of the East Asian population and is associated with high on-treatment platelet reactivity (HTPR). This study aimed to investigate whether a rapid genotyping-guided approach is feasible and efficacious for selecting P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome (ACS). Methods This was a single-centre, prospective, randomized, open-label study. A total of 132 patients with ACS were randomized to the rapid genotyping-guided treatment group (GG, N = 65) or the standard treatment group (SG, N = 67). Patients in the GG group were genotyped by the Verigene system. Patients with the CYP2C19 LoF allele were switched to ticagrelor and all remaining patients continued on clopidogrel. The endpoints were HTPR at 24 hours after the first loading dose of clopidogrel and 1 month afterwards. Results Forty patients in the GG group switched to ticagrelor, while others continued on clopidogrel. The incidence of HTPR in the GG vs SG groups was 9.2% vs 40.3% at 24 hours and 6.5% vs 32.3% at 1 month, respectively. Rapid point-of-care genotyping showed 100% concordance with conventional genotyping by real-time polymerase chain reaction. Conclusions In Chinese patients suffering from ACS, the rapid genotyping-guided approach for selecting P2Y12 receptor blockers is feasible and reduces the incidence of HTPR. Clinical Trial Registration URL: http://clinicaltrials.gov . Unique identifier: NCT01994941.
Comparison of dexmedetomidine and propofol for conscious sedation in inguinal hernia repair: A prospective, randomized, controlled trial
Authors: Wang Hong-mei , Shi Xiao-yu , Qin Xia-rong , Zhou Jia-li , Xia Yan-fei 
Published: February 2017

Objective The ideal agents for conscious sedation during ambulatory inguinal hernia repair are still unclear. We aimed to compare the analgesic, sedative, haemodynamic, and side effects of dexmedetomidine with those of propofol in combination with fentanyl for conscious sedation in patients undergoing inguinal hernia repair. Methods Eighty patients undergoing unilateral inguinal hernia repair were prospectively randomized to receive either dexmedetomidine (n = 40) or propofol (n = 40). Dexmedetomidine and propofol dosages were adjusted to maintain the targeted level of sedation. Results After administration of sedative drugs, patients who received dexmedetomidine had a significantly lower heart rate. The intraoperative requirement of fentanyl was significantly lower in patients who received dexmedetomidine compared with patients who received propofol. Administration of dexmedetomidine was associated with a reduced postoperative pain score, longer time for onset of sedation, and a slightly longer recovery time. No serious adverse events occurred in either group. The patients’ overall satisfaction score was comparable between the two groups. Conclusion Dexmedetomidine is an effective adjuvant when co-administered with fentanyl for conscious sedation in patients who undergo inguinal hernia repair. Administration of dexmedetomidine decreases the requirement of fentanyl and the pain score, but slightly prolongs the time to sedation and recovery.
Efficacy and Safety of Patiromer in Hyperkalemia: A Systematic Review and Meta-Analysis
Authors: Das Saibal , Dey Jayanta Kumar , Sen Sumalya , Mukherjee Rishav 
Published: February 2017

Background: Patients at the highest risk of hyperkalemia are those with chronic kidney disease (CKD) stages 3 and 4. Objective: To evaluate the efficacy and safety of patiromer in hyperkalemia in patients with heart failure or CKD. Methods: The Cochrane Renal Group’s Specialized Register was searched through contact with the Trials’ Search Coordinator. We aimed at including randomized controlled trials with patiromer in patients with developed or risks of developing hyperkalemia, comparing against an active comparator or placebo. Three studies matched our inclusion and exclusion criteria, which we included in the meta-analysis. All-cause mortality, reduction in hospitalization, episodes of hypokalemia or hyperkalemia, and cardiovascular and gastrointestinal adverse events during the treatment period were our primary outcomes. Serial change in serum potassium (K+) until end of treatment or follow-up during the trial period and all other reported adverse reactions during the treatment period were our secondary outcomes. Meta-analysis (RevMan version 5.3.5) and descriptive statistics were used. Results: There was a non-significant improvement in all-cause mortality and serious cardiovascular events with patiromer than placebo. Hospitalization data were unavailable. Although serious gastrointestinal events were more common with placebo, there was a significant reduction ( P = .02) in the risk of non-serious gastrointestinal events with placebo. Patiromer lowered serum K+ more than placebo, and there were more patients developing hyperkalemia with placebo. High-dose patiromer was associated with better efficacy in some parameters but with more adverse events. Conclusion: Although patiromer seems promising, more trials with active comparator are essential to finalize its indication and use in hyperkalemia.
Including historical data in the analysis of clinical trials: Is it worth the effort?
Authors: van Rosmalen Joost , Dejardin David , van Norden Yvette , Löwenberg Bob , Lesaffre Emmanuel 
Published: February 2017

Data of previous trials with a similar setting are often available in the analysis of clinical trials. Several Bayesian methods have been proposed for including historical data as prior information in the analysis of the current trial, such as the (modified) power prior, the (robust) meta-analytic-predictive prior, the commensurate prior and methods proposed by Pocock and Murray et al. We compared these methods and illustrated their use in a practical setting, including an assessment of the comparability of the current and the historical data. The motivating data set consists of randomised controlled trials for acute myeloid leukaemia. A simulation study was used to compare the methods in terms of bias, precision, power and type I error rate. Methods that estimate parameters for the between-trial heterogeneity generally offer the best trade-off of power, precision and type I error, with the meta-analytic-predictive prior being the most promising method. The results show that it can be feasible to include historical data in the analysis of clinical trials, if an appropriate method is used to estimate the heterogeneity between trials, and the historical data satisfy criteria for comparability.
Endarterectomy for a symptomatic carotid web
Authors: Phair John , Trestman Eric B , Yean Chetra , Lipsitz Evan C 
Published: February 2017

Background We report a symptomatic carotid web successfully treated with carotid endarterectomy. A healthy 43-year-old woman presented with acute-onset left-sided weakness. Carotid web was evident on computed tomography angiography as a focal filling defect in the right common carotid artery. This right common carotid artery web extended into the ICA created an eddy resulting in turbulent flow. Subsequent acute embolus formation led to embolization and acute stroke. Method Review of the literature was performed using Medline Plus and PubMed databases. Result The patient underwent carotid endarterectomy with primary closure. Procedure was well tolerated and there was an uneventful recovery. Conclusion Arterial webs are a rare arteriopathy and a usual arrangement of fibromuscular intralumenal in-growth with unclear etiology. It is however, an important potential etiology of stroke in patients without traditional atherosclerotic risk factors. Carotid web and atypical carotid fibromuscular dysplasia should be considered in young, otherwise healthy patients presenting with stroke and without the typical risk factors for atherosclerotic carotid disease and stroke.
Public health campaigns and their effect on stroke knowledge in a high-risk urban population: A five-year study
Authors: Metias Maged M , Eisenberg Naomi , Clemente Michael D , Wooster Elizabeth M , Dueck Andrew D , Wooster Douglas L , Roche-Nagle Graham 
Published: February 2017

Background The level of knowledge of stroke risk factors and stroke symptoms within a population may determine their ability to recognize and ultimately react to a stroke. Independent agencies have addressed this through extensive awareness campaigns. The aim of this study was to determine the change in baseline knowledge of stroke risk factors, symptoms, and source of stroke knowledge in a high-risk Toronto population between 2010 and 2015. Methods Questionnaires were distributed to adults presenting to cardiovascular clinics at the University of Toronto in Toronto, Canada. In 2010 and 2015, a total of 207 and 818 individuals, respectively, participated in the study. Participants were identified as stroke literate if they identified (1) at least one stroke risk factor and (2) at least one stroke symptom. Results A total of 198 (95.6%) and 791 (96.7%) participants, respectively, completed the questionnaire in 2010 and 2015. The most frequently identified risk factors for stroke in 2010 and 2015 were, respectively, smoking (58.1%) and hypertension (49.0%). The most common stroke symptom identified was trouble speaking (56.6%) in 2010 and weakness, numbness or paralysis (67.1%) in 2015. Approximately equal percentages of respondents were able to identify ≥1 risk factor (80.3% vs. 83.1%, p = 0.34) and ≥1 symptom (90.9% vs. 88.7%, p = 0.38). Overall, the proportion of respondents who were able to correctly list ≥1 stroke risk factors and stroke symptoms was similar in both groups.(76.8% vs. 75.5%, p = 0.70). The most commonly reported stroke information resource was television (61.1% vs. 67.6%, p = 0.09). Conclusion Stroke literacy has remained stable in this selected high-risk population despite large investments in public campaigns over recent years. However, the baseline remains high over the study period. Evaluation of previous campaigns and development of targeted advertisements using more commonly used media sources offer opportunities to enhance education.