bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competing risk analysis of factors related to long-term incidence of CHD
Authors: MacKenzie Gilbert , Greig Mary , Hay Iris , Pemberton John 
Published: July 2016

BackgroundThe 5-year follow-up results for the 1202 middle-aged men prospective study of coronary heart disease (CHD) incidence were published in 1980. This paper extends the follow-up, relating the development of CHD to 10 risk factors.MethodsThe population studied comprised all men born in the 10-year period 1909–1918 aged 45–64 years at baseline who were registered in 6 group practices in Belfast. Some 1202 CHD-free men entered the study. Study end points included: (a) the development of CHD, (b) the development of myocardial infarction, (c) the development of angina pectoris, (d) death from myocardial infarction and (e) death from other causes. The men were followed for an average of 6.9 years, and the influence of 10 risk factors was assessed by Cox's proportional hazards model in a competing risk framework.ResultsThe analysis of first major CHD event identified four risk factors—diastolic blood pressure, serum cholesterol, T wave abnormality and tobacco index. First myocardial infarction depended on diastolic blood pressure, ST abnormality and tobacco index, while time to first angina pectoris depended on serum cholesterol, T abnormality, tobacco index and age at entry. These findings do not support the hypothesis of a common risk factor profile in the myocardial infarction and angina pectoris groups. The sensitivity of all models was poor.DiscussionThe study confirms the role of known risk factors in the development of first CHD event. It also suggests that the risk factors involved in developing myocardial infarction and angina pectoris differ. The poor sensitivity of models suggests the presence of unmeasured risk factors in the aetiology of CHD.
Double Higgs mechanisms, supermassive stable particles and the vacuum energy
Authors: Santillán Osvaldo P. , Gabbanelli Luciano 
Published: July 2016

In the present work, a hidden scenario which cast a long-lived superheavy particle [Formula: see text] and simultaneously an extremely light particle [Formula: see text] with mass [Formula: see text] eV is presented. The potential energy [Formula: see text] of the particle [Formula: see text] models the vacuum energy density of the universe [Formula: see text]. On the other hand, the [Formula: see text] particle may act as superheavy dark matter at present times and the products of its decay may be observed in high energy cosmic ray events. The hidden sector proposed here include light fermions with masses near the neutrino mass [Formula: see text] eV and superheavy ones with masses of the order of the GUT scale, interacting through a hidden SU(2)L interaction which also affects the ordinary sector. The construction of such combined scenario is nontrivial since the presence of light particles may spoil the stability of the heavy particle [Formula: see text]. However, double Higgs mechanisms may be helpful for overcoming this problem. In this context, the stability of the superheavy particle [Formula: see text] is ensured due to chiral symmetry arguments elaborated in the text.
A Disputa pelo Sentido da “Mineiridade”: A Construção da Imagem de Aécio Neves na Disputa Presidencial de 2014
Authors: Oliveira Luiz Ademir de , Figueira Leal Paulo Roberto 
Published: July 2016

O artigo discute as construções identitárias do candidato Aécio Neves (PSDB) na disputa presidencial de 2014, tendo em vista que o tucano acionou símbolos que remetem à cultura da mineiridade. Ao mesmo tempo, o candidato priorizou, em vários momentos da propaganda, a campanha negativa de ataques à adversária Dilma Rousseff (PT), principalmente vinculando-a à era petista, à crise econômica e aos escândalos de corrupção na Petrobras. Pretende-se compreender como se dá esta mistura do velho e do novo numa política cada vez mais teatral e adaptada à lógica midiática, em que confluem os meios de comunicação massivos e os meios digitais. Serão analisados os programas do candidato no Horário Gratuito de Propaganda Eleitoral (HGPE) na televisão e as postagens em sua fanpage no Facebook.
Transapical Beating-Heart Mitral Valve Repair With an Expanded Polytetrafluoroethylene Cordal Implantation Device
Authors: Gammie James S. , Wilson Peter , Bartus Krzysztof , Gackowski Andrzej , Hung Judy , D’Ambra Michael N. , Kolsut Piotr , Bittle Gregory J. , Szymanski Piotr , Sadowski Jerzy , Kapelak Boguslaw , Bilewska Agata , Kusmierczyk Mariusz , Ghoreishi Mehrdad 
Published: July 2016

Background:
Degenerative mitral valve (MV) disease is a common cause of severe mitral regurgitation (MR) and accounts for the majority of MV operations. Conventional MV surgery requires cardiopulmonary bypass, aortic cross-clamping, cardioplegia, and a thoracotomy or sternotomy and, therefore, is associated with significant disability, risks, and unpredictable rates of MV repair. Transesophageal echocardiography–guided beating-heart MV repair with expanded polytetrafluoroethylene cordal insertion has the potential to significantly reduce surgical morbidity. We report the first-in-human clinical experience with a novel preformed expanded polytetrafluoroethylene knot implantation device (Harpoon TSD-5) designed to treat degenerative MR.

Methods:
Through a small left thoracotomy, the device was inserted into the heart and guided by transesophageal echocardiography to the ventricular surface of the prolapsed leaflet. Multiple expanded polytetrafluoroethylene cords were anchored in the leaflet and then adjusted to the correct length to restore MV leaflet coaptation and secured at the epicardium.

Results:

Eleven patients with posterior leaflet prolapse and severe MR, with mean±SD age of 65±13 years and mean ejection fraction of 69±7%, were treated with 100% procedural success. Immediate postprocedural mean MR grade was trace. At 1 month, the mean MR grade was mild with significant decreases in end-diastolic volume (139 to 107 mL;
P
=0.03) and left atrial volume (118 to 85 mL;
P
=0.04).

Conclusions:
A novel device used for beating-heart image-guided MV repair demonstrates a significant reduction in MR with favorable left ventricular and left atrial reverse remodeling. This approach has the potential to decrease invasiveness and surgical morbidity. Further follow-up is necessary to assess long-term efficacy.

Clinical Trial Registration:

URL:
https://clinicaltrials.gov
. Unique identifier: NCT02432196.
Universal Classification System Type of Incident Myocardial Infarction in Patients With Stable Atherosclerosis: Observations From Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)‐TIMI 50
Authors: Kidd Stephen K. , Bonaca Marc P. , Braunwald Eugene , De Ferrari Gaetano M. , Lewis Basil S. , Merlini Piera A. , Murphy Sabina A. , Scirica Benjamin M. , White Harvey D. , Morrow David A. 
Published: July 2016

Background

Our dual aims were as follows: (1) to classify new or recurrent myocardial infarctions (
MI
) in patients with stable atherosclerosis using the Universal Definition of
MI
classification system; and (2) to characterize the effects of vorapaxar, a first‐in‐class platelet protease‐activated receptor ‐1 antagonist, on new or recurrent
MI
.

Methods and Results

We analyzed data from
TRA
2°P‐
TIMI
50, a multinational, randomized, double‐blind, placebo‐controlled trial of vorapaxar. This analysis included 20 770 patients with previous
MI
or peripheral arterial disease without a history of transient ischemic attack or stroke. Each new or recurrent
MI
after randomization that met the trial end point definition was further categorized according to the European Society of Cardiology, American College of Cardiology, American Heart Association, World Heart Federation Universal Definition classification of type and size. Of 1095 incident
MI
s, 77% were spontaneous (Type 1), with a smaller number (9.8%) of secondary
MI
s (Type 2). Vorapaxar reduced Type 1
MI
(hazard ratio [
HR
] 0.84,
CI
0.73–0.98,
P
=0.024), with a similar pattern for Type 2
MI
(
HR
0.74,
CI
0.49–1.10,
P
=0.13). Notably, vorapaxar showed a consistent pattern of reduction across size of
MI
s, including
MI
s in the highest Universal
MI
size class (≥10× upper reference limit,
HR
0.83,
CI
0.70–0.98,
P
=0.025). As such, there was a significant reduction in larger, spontaneous
MI
s (Type 1, ≥10× upper reference limit,
HR
0.81,
CI
0.67–0.99,
P
=0.036), and a consistent pattern with respect to fatal
MI
(
HR
0.66,
CI
0.39–1.11,
P
=0.12).

Conclusions

Among stable patients with established atherosclerosis, the most common type of incident
MI
is spontaneous
MI
, and the reduction in
MI
with vorapaxar was consistent across
MI
s of varying type and size, including spontaneous infarctions ≥10× upper reference limit.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
00526474.
Responses of Tropical Ocean Clouds and Precipitation to the Large-Scale Circulation: Atmospheric-Water-Budget-Related Phase Space and Dynamical Regimes
Authors: Wong Sun , Del Genio Anthony D. , Wang Tao , Kahn Brian H. , Fetzer Eric J. , L’Ecuyer Tristan S. 
Published: July 2016

Abstract
An atmospheric-water-budget-related phase space is constructed with the tendency terms related to dynamical convergence (QCON ≡ −Q∇ ⋅ V) and moisture advection (QADV ≡ −V ⋅ ∇Q) in the water budget equation. Over the tropical oceans, QCON accounts for large-scale dynamical conditions related to conditional instability, and QADV accounts for conditions related to lower-tropospheric moisture gradient. Two reanalysis products [MERRA and ERA-Interim (ERAi)] are used to calculate QCON and QADV. Using the phase space as a reference frame, the Moderate Resolution Imaging Spectroradiometer (MODIS) cloud-top pressure (CTP) and cloud optical depth (COD) are used to evaluate simulated clouds in the GISS-E2 general circulation model. In regimes of divergence over the tropical oceans, moist advection yields frequent high- to midlevel medium-thickness to thick clouds associated with moderate stratiform precipitation, while dry advection yields low-level thin clouds associated with shallow convection with lowered cloud tops. In regimes with convergence, moist and dry advection modulate the relative abundance of high-level thick clouds and low-level thin to medium-thickness clouds. GISS-E2 qualitatively reproduces the cloud property dependence on moisture budget tendencies in regimes of convergence but with larger COD compared to MODIS. Low-level thick clouds in GISS-E2 are the most frequent in regimes of near-zero convergence and moist advection instead of those of large-scale divergence. Compared to the Global Precipitation Climatology Project product, MERRA, ERAi, and GISS-E2 have more rain in regimes with deep convection and less rain in regimes with shallow convection.
Turning waste medicines to cost savings: A pilot study on the feasibility of medication recycling as a solution to drug wastage
Authors: Toh Ming Ren , Chew Lita 
Published: July 2016

Background: Unused medicines represent a major source of wastage in healthcare systems around the world. Previous studies have suggested the potential cost savings from recycling the waste medicines. However, issues of product safety and integrity often deter healthcare institutions from recycling donated medications. Aim: To evaluate the feasibility of medication recycling and to assess the actual cost savings from recycling waste medicines and whether reusability of waste medicines differed among various drug classes and donor sources. Design and setting: Donated medications from hospitals, private medical clinics and patients were collected and assessed using a medication recycling protocol in a hospice care setting from November 2013 through January 2014. Costs were calculated using a reference pricing list from a public hospital. Results: A total of 244 donations, amounting to 20,759 dosage units, were collected during the study period. Most donations (90.8%) were reusable, providing a total of S$5266 in cost savings. Less than 2 h daily was spent by a single pharmacy technician on the sorting and distributing processes. Medications donated by health facilities were thrice more likely to be reusable than those by patients (odds ratio = 3.614, 95% confidence interval = 3.127, 4.176). Medications belonging to Anatomical Therapeutic Chemical class G (0.0%), H (8.2%) and L (30.0%) were the least reusable. Conclusion: Most donated medications were reusable. The current protocol can be further streamlined to focus on the more reusable donor sources and drug classes and validated in other settings. Overall, we opine that it is feasible to practise medication recycling on a larger scale to reduce medication wastage.
Persistent triple antiphospholipid antibody positivity as a strong risk factor of first thrombosis, in a long-term follow-up study of patients without history of thrombosis or obstetrical morbidity
Authors: Yelnik C M , Urbanski G , Drumez E , Sobanski V , Maillard H , Lanteri A , Morell-Dubois S , Caron C , Dubucquoi S , Launay D , Duhamel A , Hachulla E , Hatron P Y , Lambert M 
Published: July 2016

Introduction The long-term risk of first thrombosis and benefit of prophylaxis in antiphospholipid antibody (aPL) carriers without history of thrombosis or obstetrical morbidity is poorly known. This study aimed to evaluate the long-term rate and risk factors associated with a first thrombosis in those patients. Patients and methods After a prior study ended in December 2005 and was already published, we extended the follow-up period of our cohort of aPL carriers. Results Ninety-eight of the 103 patients of the previous study were included. The annual first thrombosis rate was 2.3% per patient-year during a median of 13 years (6–17). None of the baseline characteristics was predictive of risk of first thrombosis, but persistent aPL over time were associated with an increased risk. The stronger association was found in triple aPL-positive carriers: OR 3.38 (95% CI: 1.24–9.22). Of note, conversely to our previous findings, no benefit of aspirin prophylaxis was observed. Conclusion The risk of first thrombosis in aPL carriers without history of thrombosis or obstetrical morbidity was significant, persisted linearly over time and was associated with persistent aPL. This risk was especially increased in triple aPL-positive carriers, in whom a close follow-up seems to be necessary. Nevertheless, the benefit of aspirin prophylaxis remained unclear.
Non-inferiority tests for anti-infective drugs using control group quantiles
Authors: Fay Michael P , Follmann Dean A 
Published: July 2016

Background/Aims: In testing for non-inferiority of anti-infective drugs, the primary endpoint is often the difference in the proportion of failures between the test and control group at a landmark time. The landmark time is chosen to approximately correspond to the qth historic quantile of the control group, and the non-inferiority margin is selected to be reasonable for the target level q. For designing these studies, a troubling issue is that the landmark time must be pre-specified, but there is no guarantee that the proportion of control failures at the landmark time will be close to the target level q. If the landmark time is far from the target control quantile, then the pre-specified non-inferiority margin may not longer be reasonable. Exact variable margin tests have been developed by Röhmel and Kieser to address this problem, but these tests can have poor power if the observed control failure rate at the landmark time is far from its historic value. Methods: We develop a new variable margin non-inferiority test where we continue sampling until a pre-specified proportion of failures, q, have occurred in the control group, where q is the target quantile level. The test does not require any assumptions on the failure time distributions, and hence, no knowledge of the true [Formula: see text] control quantile for the study is needed. Results: Our new test is exact and has power comparable to (or greater than) its competitors when the true control quantile from the study equals (or differs moderately from) its historic value. Our nivm R package performs the test and gives confidence intervals on the difference in failure rates at the true target control quantile. The tests can be applied to time to cure or other numeric variables as well. Conclusion: A substantial proportion of new anti-infective drugs being developed use non-inferiority tests in their development, and typically, a pre-specified landmark time and its associated difference margin are set at the design stage to match a specific target control quantile. If through changing standard of care or selection of a different population the target quantile for the control group changes from its historic value, then the appropriateness of the pre-specified margin at the landmark time may be questionable. Our proposed test avoids this problem by sampling until a pre-specified proportion of the controls have failed.
Epidemiology of Operative Procedures in an NCAA Division I Football Team Over 10 Seasons
Authors: Mehran Nima , Photopoulos Christos D. , Narvy Steven J. , Romano Russ , Gamradt Seth C. , Tibone James E. 
Published: July 2016

Background: Injury rates are high for collegiate football players. Few studies have evaluated the epidemiology of surgical procedures in National Collegiate Athletic Association (NCAA) Division I collegiate football players. Purpose: To determine the most common surgical procedures performed in collegiate football players over a 10-year period. Study Design: Descriptive epidemiological study. Methods: From the 2004-2005 season through the 2013-2014 season, all surgical procedures performed on athletes from a single NCAA Division I college football team during athletic participation were reviewed. Surgeries were categorized by anatomic location, and operative reports were used to obtain further surgical details. Data collected over this 10-season span included type of injury, primary procedures, reoperations, and cause of reoperation, all categorized by specific anatomic locations and position played. Results: From the 2004-2005 through the 2013-2014 seasons, 254 operations were performed on 207 players, averaging 25.4 surgical procedures per year. The majority of surgeries performed were orthopaedic procedures (92.1%, n = 234). However, there were multiple nonorthopaedic procedures (7.9%, n = 20). The most common procedure performed was arthroscopic shoulder labral repair (12.2%, n = 31). Partial meniscectomy (11.8%, n = 30), arthroscopic anterior cruciate ligament (ACL) reconstruction (9.4% n = 24), and arthroscopic hip labral repair (5.9% n = 15) were the other commonly performed procedures. There were a total of 29 reoperations performed; thus, 12.9% of primary procedures had a reoperation. The most common revision procedure was a revision open reduction internal fixation of stress fractures in the foot as a result of a symptomatic nonunion (33.33%, n = 4) and revision ACL reconstruction (12.5%, n = 3). By position, relative to the number of athletes at each position, linebackers (30.5%) and defensive linemen (29.1%) were the most likely to undergo surgery while kickers (6%) were the least likely. Conclusion: In NCAA Division I college football players, the most commonly performed surgeries conducted for injuries were orthopaedic in nature. Of these, arthroscopic shoulder labral repair was the most common, followed closely by partial meniscectomy. Nonorthopaedic procedures nonetheless accounted for a sizable portion of surgical volume. Familiarity with this injury and surgical spectrum is of utmost importance for the team physician treating these high-level contact athletes.
Conduct problems co-occur with hyperactivity in children with language impairment: A longitudinal study from childhood to adolescence
Authors: Pickles Andrew , Durkin Kevin , Mok Pearl LH , Toseeb Umar , Conti-Ramsden Gina 
Published: July 2016

Background Language impairment is a common developmental disorder which is frequently associated with externalising problems. In this study, we investigate for the first time, joint trajectories of conduct problems and hyperactivity in children with language impairment from childhood to adolescence. We determine patterns of co-occurrence of symptoms and identify specific risk and protective factors. Methods We develop a trajectory grouping method to examine simultaneously the conduct and hyperactivity problem scores of 164 children with language impairment at 7, 8, 11 and 16 years of age. Results We identified five groups of children with distinct trajectories of symptoms. Three trajectory groups all had different conduct/hyperactivity problems: a persistent problems group (15%), an adolescent-onset group (24%) and a childhood-limited group (17%). There were two trajectory groups that did not show conduct problems. Conclusions Conduct problems always co-occurred with hyperactivity in children with language impairment regardless of differences in the onset of symptoms (childhood versus adolescence) or their persistence (persistent versus childhood limited). Reading difficulties were strongly associated with mixed conduct/hyperactivity problems that started early (childhood) and continued into adolescence (the persistent trajectory group). Prosocial behaviours were found to be protective against conduct problems.
Altered fibrinolysis in autosomal dominant thrombomodulin-associated coagulopathy
Authors: Burley Kate , Whyte Claire S. , Westbury Sarah K. , Walker Mary , Stirrups Kathleen E. , Turro Ernest ,   NIHR BioResource, Chapman Oliver G. , Reilly-Stitt Christopher , Mutch Nicola J. , Mumford Andrew D. 
Published: July 2016

Key Points
TM-AC is a heritable bleeding disorder in which high plasma TM levels reduce thrombin generation. High plasma TM levels also delay clot lysis by enhancing TM/thrombin-mediated activation of TAFI.