bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selective EGFR (Epidermal Growth Factor Receptor) Deletion in Myeloid Cells Limits Atherosclerosis—Brief Report
Authors: Zeboudj Lynda , Giraud Andréas , Guyonnet Lea , Zhang Yujiao , Laurans Ludivine , Esposito Bruno , Vilar Jose , Chipont Anna , Papac-Milicevic Nikolina , Binder Christoph J. , Tedgui Alain , Mallat Ziad , Tharaux Pierre-Louis , Ait-Oufella Hafid 
Published: November 2017

Objective—
To determine the consequences of specific inhibition of EGFR (epidermal growth factor receptor) in myeloid cells in atherosclerosis development.

Approach and Results—

Atherosclerotic lesion size was significantly reduced in irradiated
Ldlr
−/−
mice reconstituted with
LysM

Cre+

Egfr

lox/lox

bone marrow, compared with chimeric
Ldlr
−/−
mice reconstituted with
LysM

Cre−

Egfr

lox/lox

bone marrow, after 4 (−43%;
P
<0.05), 7 (−34%;
P
<0.05), and 12 weeks (−54%;
P
<0.001) of high-fat diet. Reduction of lesion size was associated with marked reduction in macrophage accumulation and necrotic core size. Specific deletion of
Egfr
in myeloid cells reduced TNF-α (tumor necrosis factor-α) and IL (interleukin)-6 production by stimulated macrophages but had no effect on IL-10 and IL-12p70 secretion. Finally, we found that myeloid deletion of
Egfr
limited cytoskeletal rearrangements and also lipid uptake by macrophages through a downregulation of the scavenger receptor CD36 (cluster of differentiation 36).

Conclusions—

Gene deletion of
Egfr
in myeloid cells limits IL-6 and TNF-α production, lipid uptake, and consecutively reduces atherosclerosis development.
Visit‐to‐Visit Variability of Fasting Plasma Glucose and the Risk of Cardiovascular Disease and All‐Cause Mortality in the General Population
Authors: Wang Anxin , Liu Xiaoxue , Xu Jie , Han Xiaochen , Su Zhaoping , Chen Shuohua , Zhang Nan , Wu Shouling , Wang Yongjun , Wang Yilong 
Published: November 2017

Background

The association of short‐term variability of fasting plasma glucose (
FPG
) and mortality has been well investigated. However, the relationships between visit‐to‐visit variability of
FPG
over longer periods of follow‐up and cardiovascular disease (
CVD
) and all‐cause mortality are unclear. This study aimed to investigate these relationships.

Methods and Results

The current analysis included 53 607 Chinese participants (mean age, 49.10 years) who were free of
CVD
in the Kailuan study. Participants were divided into 4 categories by quartiles of visit‐to‐visit variability of
FPG
. Visit‐to‐visit variability of
FPG
was defined as the coefficient of variation of 3 values of
FPG
that were measured from the examination periods of 2006 to 2007, 2008 to 2009, and 2010 to 2011. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for
CVD
and all‐cause mortality. After a mean follow‐up of 4.93 years, 4261 individuals developed
CVD
and 1545 individuals died. The incidence of
CVD
and all‐cause mortality was 5.04 and 5.85 per 1000 person‐years, respectively. After adjusting for mean
FPG
and other potential confounders, individuals in the highest quartile of variability of
FPG
compared with participants in the lowest quartile showed a 26% greater risk of developing
CVD
(hazard ratio, 1.26; 95% confidence interval, 1.08–1.47) and a 46% greater risk for all‐cause mortality (hazard ratio, 1.46; 95% confidence interval, 1.25–1.70).

Conclusions

Independent of mean
FPG
and other baseline parameters, elevated visit‐to‐visit variability of
FPG
significantly increases the risk of
CVD
and all‐cause mortality in the general population. Measuring long‐term visit‐to‐visit variability of
FPG
is helpful for predicting the risk for
CVD
and all‐cause mortality.
Implicit Gender Bias and the Use of Cardiovascular Tests Among Cardiologists
Authors: Daugherty Stacie L. , Blair Irene V. , Havranek Edward P. , Furniss Anna , Dickinson L. Miriam , Karimkhani Elhum , Main Deborah S. , Masoudi Frederick A. 
Published: November 2017

Background
Physicians' gender bias may contribute to gender disparities in cardiovascular testing. We used the Implicit Association Test to examine the association of implicit gender biases with decisions to use cardiovascular tests.

Methods and Results

In 2014, cardiologists completed Implicit Association Tests and a clinical vignette with patient gender randomly assigned. The Implicit Association Tests measured implicit gender bias for the characteristics of strength and risk taking. The vignette represented an intermediate likelihood of coronary artery disease regardless of patient gender: chest pain (part 1) followed by an abnormal exercise treadmill test (part 2). Cardiologists rated the likelihood of coronary artery disease and the usefulness of stress testing and angiography for the assigned patient. Of the 503 respondents (9.3% of eligible; 87% male, median age of 45 years, 58% in private practice), the majority associated strength or risk taking implicitly with male more than female patients. The estimated likelihood of coronary artery disease for both parts of the vignette was similar by patient gender. The utility of secondary stress testing after an abnormal exercise treadmill test was rated as “high” more often for female than male patients (32.8% versus 24.3%,
P
=0.04); this difference did not vary with implicit bias. Angiography was more consistently rated as having “high” utility for male versus female patients (part 1: 19.7% versus 9.8%; part 2: 73.7% versus 64.3%;
P
<0.05 for both); this difference was larger for cardiologists with higher implicit gender bias on risk taking (
P
=0.01).

Conclusions
Cardiologists have varying degrees of implicit gender bias. This bias explained some, but not all, of the gender variability in simulated clinical decision‐making for suspected coronary artery disease.
Role of Depression and Social Isolation at Time of Waitlisting for Survival 8 Years After Heart Transplantation
Authors: Spaderna Heike , Zittermann Armin , Reichenspurner Hermann , Ziegler Corinna , Smits Jacqueline , Weidner Gerdi 
Published: November 2017

Background

We evaluated depression and social isolation assessed at time of waitlisting as predictors of survival in heart transplant (
HT
x) recipients.

Methods and Results

Between 2005 and 2006, 318 adult
HT
x candidates were enrolled in the Waiting for a New Heart Study, and 164 received transplantation. Patients were followed until February 2013. Psychosocial characteristics were assessed by questionnaires. Eurotransplant provided medical data at waitlisting, transplantation dates, and donor characteristics; hospitals reported medical data at
HT
x and date of death after
HT
x. During a median follow‐up of 70 months (<1–93 months post‐
HT
x), 56 (38%) of 148 transplanted patients with complete data died. Depression scores were unrelated to social isolation, and neither correlated with disease severity. Higher depression scores increased the risk of dying (hazard ratio=1.07, 95% confidence interval, 1.01, 1.15,
P
=0.032), which was moderated by social isolation scores (significant interaction term; hazard ratio = 0.985, 95% confidence interval, 0.973, 0.998;
P
=0.022). These findings were maintained in multivariate models controlling for covariates (
P
values 0.020–0.039). Actuarial 1‐year/5‐year survival was best for patients with low depression who were not socially isolated at waitlisting (86% after 1 year, 79% after 5 years). Survival of those who were either depressed, or socially isolated or both, was lower, especially 5 years posttransplant (56%, 60%, and 62%, respectively).

Conclusions

Low depression in conjunction with social integration at time of waitlisting is related to enhanced chances for survival after
HT
x. Both factors should be considered for inclusion in standardized assessments and interventions for
HT
x candidates.
Interaction of Superinertial Waves with Submesoscale Cyclonic Filaments in the North Wall of the Gulf Stream
Authors: Whitt Daniel B. , Thomas Leif N. , Klymak Jody M. , Lee Craig M. , D’Asaro Eric A. 
Published: November 2017

AbstractHigh-resolution, nearly Lagrangian observations of velocity and density made in the North Wall of the Gulf Stream reveal banded shear structures characteristic of near-inertial waves (NIWs). Here, the current follows submesoscale dynamics, with Rossby and Richardson numbers near one, and the vertical vorticity is positive. This allows for a unique analysis of the interaction of NIWs with a submesoscale current dominated by cyclonic as opposed to anticyclonic vorticity. Rotary spectra reveal that the vertical shear vector rotates primarily clockwise with depth and with time at frequencies near and above the local Coriolis frequency f. At some depths, more than half of the measured shear variance is explained by clockwise rotary motions with frequencies between f and 1.7f. The dominant superinertial frequencies are consistent with those inferred from a dispersion relation for NIWs in submesoscale currents that depends on the observed aspect ratio of the wave shear as well as the vertical vorticity, baroclinicity, and stratification of the balanced flow. These observations motivate a ray tracing calculation of superinertial wave propagation in the North Wall, where multiple filaments of strong cyclonic vorticity strongly modify wave propagation. The calculation shows that the minimum permissible frequency for inertia–gravity waves is mostly greater than the Coriolis frequency, and superinertial waves can be trapped and amplified at slantwise critical layers between cyclonic vortex filaments, providing a new plausible explanation for why the observed shear variance is dominated by superinertial waves.
Aspiration as a Function of Age, Sex, Liquid Type, Bolus Volume, and Bolus Delivery Across the Healthy Adult Life Span
Authors: Butler Susan G. , Stuart Andrew , Markley Lisa , Feng Xin , Kritchevsky Stephen B. 
Published: November 2017

Objectives: The purpose of this investigation was to examine, via flexible endoscopic evaluation of swallowing (FEES), factors that affect penetration and aspiration during swallowing across the adult lifespan. Methods: Healthy adults (N = 203) across the third to ninth decades of life participated. Penetration Aspiration Scale (PAS) scores were assessed during FEES as a function of age, sex, liquid type (water and skim, 2%, and whole milk), volume (5, 10, 15, and 20 ml), and delivery (cup and straw). Results: The PAS scores differed significantly by liquid type ( P < .0001) and age group ( P < .0001). In general, PAS scores were higher for milk versus water swallows and for older age groups. Significant interactions of liquid type by age ( P = .0042) and sex by volume ( P = .020) were also evidenced. In addition, the odds of penetration and aspiration increased significantly with milks compared to water and age ( P < .05). Increased bolus volume also increased the odds of aspiration ( P < .05). Conclusions: Aspiration may be an underappreciated phenomenon in healthy adults. The inclusion of both water and milk test boluses of various volumes during FEES may be important for the appropriate assessment of adult penetration and aspiration.
Exploring young Australian adults’ asthma management to develop an educational video
Authors: Coombs Nicole , Allen Louise , Cooper Simon , Cant Robyn , Beauchamp Alison , Laszcyk Jacki , Giannis Anita , Hopmans Ruben , Bullock Shane , Waller Susan , McKenna Lisa , Peck Blake 
Published: November 2017

Objective: This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group. Design: Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video. Setting: Participants were students at two universities in the state of Victoria, Australia. Method: In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed. Results: A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial maternal reliance; ‘Health literacy: family and Dr Google’, denoting low health literacy levels with passive reluctant involvement in personal health management; and ‘Information gathering – one size doesn’t fit all’ – in the form of the need for immediate gratification and resource variety. Based on interviewees’ words and terminology, we designed an interactive branching educational video for YouTube portraying a young person (an actor) during an asthma flare-up. Conclusion: Young adults lacked insight into their condition and even after moving away from home, relied on Google searches and/or parents’ advice. To enhance health-seeking behaviours, interactive programmes with smartphone access may be valuable. Our open access programme Help Trent Vent provides an educational resource for young people with asthma and for health education teams, to reinforce asthma knowledge.
A physical activity intervention in a Bingo club: Significance of the setting
Authors: Evans Josie MM , Connelly Jenni , Jepson Ruth , Gray Cindy , Shepherd Ashley , Mackison Dionne 
Published: November 2017

Objective: A Bingo club was selected for the design and delivery of a health intervention (Well!Bingo) in order to engage with older women living in areas of socio-economic disadvantage. In the light of our experience, we discuss the significance of the setting in relation to a typology of health promotion settings. Design and Setting: The Well!Bingo physical activity intervention was piloted in a Bingo club in Scotland. Methods: In a pilot feasibility study, women were recruited face-to-face at a Bingo club over 2 weeks. The 12-week intervention consisted of three different structured exercise sessions per week, followed by refreshments, with trained instructors delivering a schedule of simple pre-defined health messages. Participants completed a baseline questionnaire, and in-depth qualitative interviews were carried out with participants and instructors post-intervention. For this paper, using the framework method, we retrieved and analysed the data coded as relating to the setting. Results: Eighteen women (55-92 years) took part in intervention sessions. Half lived in areas of socio-economic deprivation. Practical and social familiarity with the setting (a sense of belonging and being with people like themselves) encouraged them to take part, and implicit features of the setting may have enhanced recruitment and effectiveness. Discussion: In settings-based health promotion, a Bingo club could be seen as a ‘passive’ setting, simply facilitating access to a target population. It cannot be an ‘active setting’, because health promotion will never be a core activity and features cannot be drawn upon to influence change. However, calling it a passive setting overlooks the importance of characteristics that may enhance recruitment and effectiveness. This highlights the need to extend current concepts of ‘passive’ health promotion settings.
Psychometric Properties of the Perceived Wellness Culture and Environment Support Scale
Authors: Melnyk Bernadette Mazurek , Szalacha Laura A. , Amaya Megan 
Published: November 2017

Objective: This study reports on the psychometric properties of the 11-item Perceived Wellness Culture and Environment Support Scale (PWCESS) and its relationship with employee healthy lifestyle beliefs and behaviors. Methods: Faculty and staff (N = 3959) at a large public university in the United States mid-west completed the PWCESS along with healthy lifestyle beliefs and behaviors scales. Data were randomly split into 2 halves to explore the PWCESS’ validity and reliability and the second half to confirm findings. Results: Principal components analysis indicated a unidimensional construct. The PWCESS was positively related to healthy lifestyle beliefs and behaviors supporting the scale’s validity. Confirmatory factor analysis supported the unidimensional construct (Cronbach’s α = .92). Conclusion: Strong evidence supports the validity and reliability of the PWCESS. Future use of this scale could guide workplace intervention strategies to improve organizational wellness culture and employee health outcomes.
A Randomized Controlled Trial of Strategies to Improve Family Members’ Preparedness for Surrogate Decision-Making
Authors: Green Michael J. , Van Scoy Lauren J. , Foy Andrew J. , Stewart Renee R. , Sampath Ramya , Schubart Jane R. , Lehman Erik B. , Dimmock Anne E. F. , Bucher Ashley M. , Lehmann Lisa S. , Harlow Alyssa F. , Yang Chengwu , Levi Benjamin H. 
Published: November 2017

Objective: To evaluate 2 strategies for preparing family members for surrogate decision-making. Design: A 2 × 2 factorial, randomized controlled trial testing whether: (1) comprehensive online advance care planning (ACP) is superior to basic ACP, and (2) having patients engage in ACP together with family members is superior to ACP done by patients alone. Setting: Tertiary care centers in Hershey, Pennsylvania, and Boston, Massachusetts. Participants: Dyads of patients with advanced, severe illness (mean age 64; 46% female; 72% white) and family members who would be their surrogate decision-makers (mean age 56; 75% female; 75% white). Interventions: Basic ACP: state-approved online advance directive plus brochure. Making Your Wishes Known (MYWK): Comprehensive ACP decision aid including education and values clarification. Measurements: Pre–post changes in family member self-efficacy (100-point scale) and postintervention concordance between patients and family members using clinical vignettes. Results: A total 285 dyads enrolled; 267 patients and 267 family members completed measures. Baseline self-efficacy in both MYWK and basic ACP groups was high (90.2 and 90.1, respectively), and increased postintervention to 92.1 for MYWK ( P = .13) and 93.3 for basic ACP ( P = .004), with no between-group difference. Baseline self-efficacy in alone and together groups was also high (90.2 and 90.1, respectively), and increased to 92.6 for alone ( P = .03) and 92.8 for together ( P = .03), with no between-group difference. Overall adjusted concordance was higher in MYWK compared to basic ACP (85.2% vs 79.7%; P = .032), with no between-group difference. Conclusion: The disconnect between confidence and performance raises questions about how to prepare family members to be surrogate decision-makers.
Endovascular Stent Can Be the Treatment of Choice for Spontaneous Iliac Vein Rupture: A Case Report
Authors: Chen Yen-Cheng , Huang Chien-Lin , Huang Jiann-Woei 
Published: November 2017

Introduction: Spontaneous iliac vein rupture is a rare but lethal disease. Most patients suffer from shock status in the emergency department. Until now, open laparotomy combined with primary suture is the most common treatment of iliac vein rupture. However, there is high mortality and morbidity in the patients who underwent open laparotomy. Case Presentation: A 71-year-old woman denied trauma history and sustained hypovolemic shock. The abdominal computed tomography showed one huge retroperitoneal hematoma. The emergency angiography revealed one obvious rupture point on the left external iliac vein. We repaired the lesion with endovascular stent and open laparotomy for abdominal decompression. The patient progressed well and was discharged. Conclusion: Endovascular repair is an effective and safe treatment. Compared with open laparotomy and primary suture, stent leads to fewer complications and a lower mortality rate.
HIV-Related Knowledge among PLWHA Attending a Tertiary Care Hospital at Coastal South India—A Facility-Based Study
Authors: Banagi Yathiraj Arjun , Unnikrishnan Bhaskaran , Ramapuram John T. , Thapar Rekha , Mithra Prasanna , Madi Deepak , Kumar Nithin , Kulkarni Vaman , Holla Ramesh , Ambalavanan Jayachidambaram , Darshan BB 
Published: November 2017

Background: Adequate knowledge about HIV/AIDS among people living with HIV (PLHIV) is essential for the prevention of HIV transmission. Methods: A cross-sectional study consisting of 409 PLHIV aged ≥18 years were interviewed regarding their HIV-related knowledge, from April 2014 to April 2015. HIV-related knowledge was assessed using the HIV knowledge questionnaire 18 . Univariate and multivariate analyses were done to determine the factors associated with high HIV-related knowledge. Odds ratios with its corresponding 95% confidence intervals were reported. A value of P < .05 was considered to be statistically significant. Results: Among 409 PLHIV, 46.2% had high HIV-related knowledge. Univariate analysis yields factors like upper socioeconomic status, those who are literates, unemployed, and adherent to antiretroviral therapy (ART) were associated with higher HIV-related knowledge. On multivariate analysis, upper socioeconomic status and adherence to ART were the factors that remained significantly associated with higher HIV-related knowledge. Conclusion: HIV-related knowledge among PLHIV can be improved through HIV educational programs.
The economic burden of stroke care in England, Wales and Northern Ireland: Using a national stroke register to estimate and report patient-level health economic outcomes in stroke
Authors: Xu Xiang-Ming , Vestesson Emma , Paley Lizz , Desikan Anita , Wonderling David , Hoffman Alex , Wolfe Charles DA , Rudd Anthony G , Bray Benjamin D 
Published: November 2017

Introduction Stroke registries are used in many settings to measure stroke treatment and outcomes, but rarely include data on health economic outcomes. We aimed to extend the Sentinel Stroke National Audit Programme registry of England, Wales and Northern Ireland to derive and report patient-level estimates of the cost of stroke care. Methods An individual patient simulation model was built to estimate health and social care costs at one and five years after stroke, and the cost-benefits of thrombolysis and early supported discharge. Costs were stratified according to age, sex, stroke type (ischaemic or primary intracerebral haemorrhage) and stroke severity. The results were illustrated using data on all patients with stroke included in Sentinel Stroke National Audit Programme from April 2015 to March 2016 (n = 84,184). Results The total cost of health and social care for patients with acute stroke each year in England, Wales and Northern Ireland was £3.60 billion in the first five years after admission (mean per patient cost: £46,039). There was fivefold variation in the magnitude of costs between patients, ranging from £19,101 to £107,336. Costs increased with older age, increasing stroke severity and intracerebral hemorrhage stroke. Increasing the proportion of eligible patients receiving thrombolysis or early supported discharge was estimated to save health and social care costs by five years after stroke. Discussion The cost of stroke care is large and varies widely between patients. Increasing the proportion of eligible patients receiving thrombolysis or early supported discharge could contribute to reducing the financial burden of stroke. Conclusion Extending stroke registers to report individualised data on costs may enhance their potential to support quality improvement and research.