bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes in 995 unselected real-world patients treated with an ultrathin biodegradable polymer-coated sirolimus-eluting stent: 12-month results from the FLEX Registry
Authors: Lemos Pedro A , Chandwani Prakash , Saxena Sudheer , Ramachandran Padma Kumar , Abhyankar Atul , Campos Carlos M , Marchini Julio Flavio , Galon Micheli Zanotti , Verma Puneet , Sandhu Manjinder Singh , Parikh Nikhil , Bhupali Ashok , Jain Sharad , Prajapati Jayesh 
Published: February 2016

ObjectivesTo evaluate, in the FLEX Registry, clinical outcomes of an ultrathin (60 µm) biodegradable polymer-coated Supraflex sirolimus-eluting stent (SES) for the treatment of coronary artery disease. Additionally, to determine the vascular response to the Supraflex SES through optical coherence tomography (OCT) analysis.SettingMulticentre, single-arm, all-comers, observational registry of patients who were treated with the Supraflex SES, between July 2013 and May 2014, at nine different centres in India.Participants995 patients (1242 lesions) who were treated with the Supraflex SES, between July 2013 and May 2014, at nine different centres in India. A total of 47 participants underwent OCT analysis at 6 months’ follow-up.InterventionsPercutaneous coronary intervention with Supraflex SES,Primary and secondary outcome measuresThe primary endpoint—the rate of major adverse cardiac events (defined as a composite of cardiac death, myocardial infarction (MI), target lesion revascularisation (TLR))—was analysed during 12 months.ResultsAt 12 months, the primary endpoint occurred in 36 (3.7%) of 980 patients, consisting of 18 (1.8%) cardiac deaths, 16 (1.6%) MI, 7 (0.7%) TLR and 2 (0.2%) cases of non-target lesion target vessel revascularization. In a subset of 47 patients, 1227 cross-sections (9309 struts) were analysed at 6 months by OCT. Overall, a high percentage of struts was covered (98.1%), with a mean neointimal thickness of 0.13±0.06 µm.ConclusionsThe FLEX Registry evaluated clinical outcomes in real-world and more complex cohorts and thus provides evidence that the Supraflex SEX can be used safely and routinely in a broader percutaneous coronary intervention population. Also, the Supraflex SES showed high percentage of stent strut coverage and good stent apposition during OCT follow-up.
ASPECTS discrepancies between CT and MR imaging: analysis and implications for triage protocols in acute ischemic stroke
Authors: Hui Ferdinand K , Obuchowski Nancy A , John Seby , Toth Gabor , Katzan Irene , Wisco Dolora , Cheng-Ching Esteban , Uchino Ken , Man Shu-Mei , Hussain Shazam 
Published: February 2016

BackgroundOptimal imaging triage for intervention for large vessel occlusions remains unclear. MR-based imaging provides ischemic core volumes at the cost of increased imaging time. CT Alberta Stroke Program Early CT Score (ASPECTS) estimates are faster, but may be less sensitive.ObjectiveTo assesses the rate at which MRI changed management in comparison with CT imaging alone.MethodsRetrospective analysis of patients with acute ischemic stroke undergoing imaging triage for endovascular therapy was performed between 2008 and 2013. Univariate and multivariate analyses were performed. Multivariate logistic regression was used to evaluate the effect of time on disagreement in MRI and CT ASPECTS scores.ResultsA total of 241 patients underwent both diffusion-weighted imaging (DWI) and CT. Six patients with DWI ASPECTS ≥6 and CT ASPECTS <6 were omitted, leaving 235 patients. For 47 patients, disagreement between the two modalities resulted in different treatment recommendations. The estimated probability of disagreement was 20.0% (95% CI 15.4% to 25.6%). In a multivariate logistic regression, CT ASPECTS >7 (p=0.004) and admission National Institutes of Health Stroke Scale (NIHSS) score <16 (p=0.008) were simultaneously significant predictors of agreement in ASPECTS. The time between modalities was a marginally significant predictor (p=0.080).ConclusionsThe study suggests that patients with NIHSS scores at admission of <16 and patients with CT ASPECTS >7 have a higher likelihood of agreement between CT and DWI based on an ASPECTS cut-off value of 6. Additional MRI for triage in patients with NIHSS at admission of >16, and ASPECTS of 6 or 7 may be more likely to change management. Unsurprisingly, patients with low CT ASPECTS had good correlation with MRI ASPECTS.
Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral artery occlusion treated with thrombectomy
Authors: Kleine Justus F , Wunderlich Silke , Zimmer Claus , Kaesmacher Johannes 
Published: February 2016

BackgroundThe Thrombolysis in Cerebral Infarction (TICI) scale is the most widely applied scoring system to grade technical results of recanalizing therapies in acute ischemic stroke (AIS). TICI 2b and TICI 3 are conventionally subsumed as ‘successful recanalization’. Previous studies reported conflicting results for the clinical relevance of achieving complete (TICI 3) versus ‘almost’ complete reperfusion (TICI 2b).ObjectiveTo examine if neurologic outcome differs significantly between TICI 2b and TICI 3 in patients with AIS with middle cerebral artery (MCA) occlusion treated ‘successfully’ with mechanical thrombectomy (MTE).MethodsRetrospective analysis of prospectively collected data from 352 consecutive patients with isolated MCA occlusion subjected to MTE between January 2007 and July 2015.Results262 of the 277 successfully treated patients had adequate follow-up and were included. Patients (n=119) in the TICI 3 group had a lower National Institutes of Health Stroke Scale score at discharge (NIHSS-DIS; median 5 vs 7, p=0.005), and showed higher rates of strong neurologic improvement (ΔNIHSS≥8 or NIHSS-DIS≤1, 68.4% vs 37.1%, p=0.002) and favorable NIHSS outcome (NIHSS-DIS≤5, 49.2% vs 31.9%, p=0.005). Hospital stays were shorter in the TICI 3 group (median 10 vs 12 days, p=0.014). After adjusting for relevant baseline and treatment parameters, TICI 3 was independently associated with strong neurologic improvement (OR=4.3, 95% CI 2.2 to 8.3, p<0.001) and favorable NIHSS outcome (OR=3.0, 95% CI 1.5 to 6.3, p=0.003).ConclusionsNeurologic outcome is substantially better in TICI 3 than TICI 2b patients, and hospital stays are shorter. Endovascular strategies that consequently strive to achieve TICI 3 may be warranted and cost-effective, and should be examined by future research. TICI 3 rates should be included as a safety measure in studies evaluating MTE devices and techniques.
Hybrid textures of neutrino mass matrix under the lamppost of latest neutrino and cosmology data
Authors: Kalita Rupam , Borah Debasish 
Published: February 2016

In this paper, we study all possible neutrino mass matrices with one zero element and two equal nonzero elements, known as hybrid texture neutrino mass matrices. In the diagonal charged lepton basis, we consider 39 such possible cases which are consistent with the latest neutrino data. Using the two constraints on neutrino mass matrix elements imposed by hybrid textures, we numerically evaluate the neutrino parameters like the lightest neutrino mass [Formula: see text], one Dirac CP phase [Formula: see text] and two Majorana CP phases [Formula: see text], [Formula: see text] by using the global fit [Formula: see text] values of three mixing angles and two mass squared differences. We then constrain this parameter space by using the cosmological upper bound on the sum of absolute neutrino masses given by Planck experiment. We also calculate the effective neutrino mass [Formula: see text] for this region of parameter space which can have relevance in future neutrinoless double beta decay experiments. We finally discriminate between these hybrid texture mass matrices from the requirement of producing correct baryon asymmetry through type I seesaw leptogenesis. We also constrain the light neutrino parameter space as well as the lightest right-handed neutrino mass from the constraint on baryon asymmetry of the Universe from Planck experiment.
Research Priorities, Measures, and Recommendations for Assessment of Tobacco Use in Clinical Cancer Research
Authors: Land Stephanie R. , Toll Benjamin A. , Moinpour Carol M. , Mitchell Sandra A. , Ostroff Jamie S. , Hatsukami Dorothy K. , Duffy Sonia A. , Gritz Ellen R. , Rigotti Nancy A. , Brandon Thomas H. , Prindiville Sheila A. , Sarna Linda P. , Schnoll Robert A. , Herbst Roy S. , Cinciripini Paul M. , Leischow Scott J. , Dresler Carolyn M. , Fiore Michael C. , Warren Graham W. 
Published: February 2016

Abstract
There is strong evidence that cigarette smoking causes adverse outcomes in people with cancer. However, more research is needed regarding those effects and the effects of alternative tobacco products and of secondhand smoke, the effects of cessation (before diagnosis, during treatment, or during survivorship), the biologic mechanisms, and optimal strategies for tobacco dependence treatment in oncology. Fundamentally, tobacco is an important source of variation in clinical treatment trials. Nevertheless, tobacco use assessment has not been uniform in clinical trials. Progress has been impeded by a lack of consensus regarding tobacco use assessment suitable for cancer patients. The NCI-AACR Cancer Patient Tobacco Use Assessment Task Force identified priority research areas and developed recommendations for assessment items and timing of assessment in cancer research. A cognitive interview study was conducted with 30 cancer patients at the NIH Clinical Center to evaluate and improve the measurement items. The resulting Cancer Patient Tobacco Use Questionnaire (C-TUQ) includes “Core” items for minimal assessment of tobacco use at initial and follow-up time points, and an “Extension” set. Domains include the following: cigarette and other tobacco use status, intensity, and past use; use relative to cancer diagnosis and treatment; cessation approaches and history; and secondhand smoke exposure. The Task Force recommends that assessment occur at study entry and, at a minimum, at the end of protocol therapy in clinical trials. Broad adoption of the recommended measures and timing protocol, and pursuit of the recommended research priorities, will help us to achieve a clearer understanding of the significance of tobacco use and cessation for cancer patients. Clin Cancer Res; 22(8); 1907–13. ©2016 AACR.
Feasibility and Acute Hemodynamic Effect of Left Ventricular Septal Pacing by Transvenous Approach Through the Interventricular Septum
Authors: Mafi-Rad Masih , Luermans Justin G.L.M. , Blaauw Yuri , Janssen Michel , Crijns Harry J. , Prinzen Frits W. , Vernooy Kevin 
Published: February 2016

Background—
Left ventricular septal (LVS) pacing reduces ventricular dyssynchrony and improves cardiac function relative to right ventricular apex (RVA) pacing in animals. We aimed to establish permanent placement of an LVS pacing lead in patients using a transvenous approach through the interventricular septum.

Methods and Results—

Ten patients with sinus node dysfunction scheduled for dual-chamber pacemaker implantation were prospectively enrolled. A custom pacing lead with extended helix was introduced via the left subclavian vein and, after positioning against the right ventricular septum (RVS) using a preshaped guiding catheter, driven through the interventricular septum to the LVS. The acute hemodynamic effect of RVA, RVS, and LVS pacing was evaluated by invasive LVdP/dtmax measurements. The lead was successfully delivered to the LVS in all patients. Procedure time and fluoroscopy time shortened with experience. QRS duration was shorter during LVS pacing (144±20 ms) than during RVA (172±33 ms;
P
=0.02 versus LVS) and RVS pacing (165±17 ms;
P
=0.004 versus LVS). RVA and RVS pacing reduced LVdP/dtmax compared with baseline atrial pacing (−7.1±4.1% and −6.9±4.3%, respectively), whereas LVS pacing maintained LVdP/dtmax at baseline level (1.0±4.3%;
P
=0.001 versus RVA and RVS). R-wave amplitude and pacing threshold were 12.2±6.7 mV and 0.5±0.2 V at implant and remained stable during 6-month follow-up without lead-related complications.

Conclusions—
Permanent placement of an LVS pacing lead by transvenous approach through the interventricular septum is feasible in patients. LVS pacing preserves acute left ventricular pump function. This new pacing method could serve as an alternative and hemodynamically preferable approach for antibradycardia pacing.
Silent Brain Infarction and Risk of Future Stroke
Authors: Gupta Ajay , Giambrone Ashley E. , Gialdini Gino , Finn Caitlin , Delgado Diana , Gutierrez Jose , Wright Clinton , Beiser Alexa S. , Seshadri Sudha , Pandya Ankur , Kamel Hooman 
Published: February 2016

Background and Purpose—
Silent brain infarction (SBI) on magnetic resonance imaging has been proposed as a subclinical risk marker for future symptomatic stroke. We performed a systematic review and meta-analysis to summarize the association between magnetic resonance imaging–defined SBI and future stroke risk.

Methods—
We searched the medical literature to identify cohort studies involving adults with SBI detected by magnetic resonance imaging who were subsequently followed up for incident clinically defined stroke. Study data and quality assessment were recorded in duplicate with disagreements in data extraction resolved by a third reader. Strength association between magnetic resonance imaging–detected SBI and future symptomatic stroke was measured by an hazard ratio.

Results—

The meta-analysis included 13 studies (14 764 subjects) with a mean follow-up ranging from 25.7 to 174 months. SBI predicted the occurrence of stroke with a random effects crude relative risk of 2.94 (95% confidence interval, 2.24–3.86,
P
<0.001;
Q
=39.65,
P
<0.001). In the 8 studies of 10 427 subjects providing hazard ratio adjusted for cardiovascular risk factors, SBI was an independent predictor of incident stroke (hazard ratio, 2.08 [95% confidence interval, 1.69–2.56;
P
<0.001];
Q
=8.99;
P
=0.25). In a subgroup analysis pooling 9483 stroke-free individuals from large population-based studies, SBI was present in ≈18% of participants and remained a strong predictor of future stroke (hazard ratio, 2.06 [95% confidence interval, 1.64–2.59];
P
<0.01).

Conclusions—
SBI is present in ≈1 in 5 stroke-free older adults and is associated with a 2-fold increased risk of future stroke. Future studies of in-depth stroke risk evaluations and intensive prevention measures are warranted in patients with clinically unrecognized radiologically evident brain infarctions.
Participation in Pre–High School Football and Neurological, Neuroradiological, and Neuropsychological Findings in Later Life
Authors: Solomon Gary S. , Kuhn Andrew W. , Zuckerman Scott L. , Casson Ira R. , Viano David C. , Lovell Mark R. , Sills Allen K. 
Published: February 2016

Background: A recent study found that an earlier age of first exposure (AFE) to tackle football was associated with long-term neurocognitive impairment in retired National Football League (NFL) players. Purpose: To assess the association between years of exposure to pre–high school football (PreYOE) and neuroradiological, neurological, and neuropsychological outcome measures in a different sample of retired NFL players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Forty-five former NFL players were included in this study. All participants prospectively completed extensive history taking, a neurological examination, brain magnetic resonance imaging, and a comprehensive battery of neuropsychological tests. To measure the associations between PreYOE and these outcome measures, multiple regression models were utilized while controlling for several covariates. Results: After applying a Bonferroni correction for multiple comparisons, none of the neurological, neuroradiological, or neuropsychological outcome measures yielded a significant relationship with PreYOE. A second Bonferroni-corrected analysis of a subset of these athletes with self-reported learning disability yielded no significant relationships on paper-and-pencil neurocognitive tests but did result in a significant association between learning disability and computerized indices of visual motor speed and reaction time. Conclusion: The current study failed to replicate the results of a prior study, which concluded that an earlier AFE to tackle football might result in long-term neurocognitive deficits. In 45 retired NFL athletes, there were no associations between PreYOE and neuroradiological, neurological, and neuropsychological outcome measures.
Outcomes of the Remplissage Procedure and Its Effects on Return to Sports
Authors: Garcia Grant H. , Wu Hao-Hua , Liu Joseph N. , Huffman G. Russell , Kelly John D. 
Published: February 2016

Background: Short-term outcomes for patients with large, engaging Hill-Sachs lesions who underwent remplissage have demonstrated good results. However, limited data are available for longer term outcomes. Purpose: To evaluate the long-term outcomes of remplissage and determine the long-term rate of return to specific sports postoperatively. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of patients treated with the remplissage procedure from 2007 to 2013. All underwent preoperative magnetic resonance imaging demonstrating large Hill-Sachs lesions by the Rowe criteria and glenoid bone loss <20%. All Hill-Sachs lesions were “off track” by an arthroscopic examination and preoperative imaging. At final follow-up, patients underwent a range of motion evaluation and were administered a detailed outcome survey, which included Western Ontario Shoulder Instability Index (WOSI) and American Shoulder and Elbow Surgeons (ASES) scores as well as questions regarding sports, employment, physical activities, and dislocation events. Results: A total of 50 patients (51 shoulders) were included in the study. The average patient age at surgery was 29.8 years (range, 15.0-72.4 years), and the average follow-up time was 60.7 months (range, 25.5-97.6 months); 20.0% of patients underwent previous surgery on their shoulder. The average postoperative WOSI score was 79.5%, and the average ASES score was 89.3. Six shoulders had dislocation events (11.8%) postoperatively: 3 were traumatic, and 3 were atraumatic. Increased preoperative dislocations led to a greater risk of a postoperative dislocation ( P < .001). There was also a trend toward higher postoperative dislocation rates in patients who underwent revision ( P = .062). The average loss of external rotation was 5.26° ( P = .13). The rate of return to ≥1 sports was 95.5% of patients at an average of 7.0 months postoperatively; 81.0% returned to their previous intensity and level of sport. Of patients who played a throwing sport, 65.5% (n = 19) stated that they had problems throwing, and 58.6% (n = 17) felt that they could not normally wind up throwing a ball. Direct rates of return to overhead sports were volleyball, 100%; basketball, 69%; baseball, 50%; and football, 50%. Conclusion: The redislocation rate after remplissage was 11.8% at an average of 5 years, with 95.5% of patients returning to full sports at an average of 7 months. For throwing sports, 65.5% of patients complained of decreased range of motion during throwing. The results should be considered preoperatively in candidates for remplissage who are engaged in throwing sports.
The Impact of Detention on the Health of Asylum Seekers
Authors: Filges Trine , Montgomery Edith , Kastrup Marianne 
Published: February 2016

Objectives: This review assesses the evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers. Method and Analysis: We followed Campbell Collaboration guidelines to conduct a systematic review. Meta-analytic methods were used to quantitatively synthesize the study results. Results: Primary study effect sizes for post-traumatic stress disorder, depression, and anxiety, while the asylum seekers were still detained lies in the range 0.35–0.99, all favoring the nondetained asylum group. Author’s Conclusions: There is some evidence to suggest an independent adverse effect of detention on the mental health of asylum seekers. The conclusions should however be interpreted with caution as they are based on few studies. More research is needed in order to fully investigate the effect of detention on mental health.
Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation
Authors: Kamal Arif H. , Bull Janet , Wolf Steven P. , Portman Diane , Strand Jacob , Johnson Kimberly S. 
Published: February 2016

Context: Differences among patient populations that present to consultative palliative care are not known. Such an appreciation would inform health-care delivery tailored to unique populations. Objectives: We aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. Methods: We analyzed patient-reported, clinician-entered clinical encounter data from a large, multisite community-based, nonhospice palliative care collaborative. We included first specialty palliative care consultations from January 1, 2014, to July 2, 2015, across 15 sites within the Global Palliative Care Quality Alliance registry. Demographics, disease, performance status, advance care planning, and symptom prevalence/severity were compared. Results: Of 775 patients, 12.9% (N = 100) were AA. African Americans were younger (63 vs 75.4 years, P < .0001). A larger proportion of AAs had a diagnosis of cancer (45.0% vs 36.3%, P = .09) and in the hospital (71% vs 61.8%, P = .07). African Americans were more likely to have a Palliative Performance Score of 0 to 30 (35.6% vs 23.7%, P = .049). Around 50% in both racial groups were full code; slightly more than 40% had an advance directive. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity (66.0% vs 56.1%, P = .06). Conclusion: All patients present to palliative care consultations with significant symptom and advance care planning needs. Further research is needed to identify how to deliver palliative care: earlier, in noncancer conditions, and improve pain management in AA populations.
The interpreter as co-interviewer: the role of the interpreter during interviews in cross-language health research
Authors: Suurmond Jeanine , Woudstra Anke , Essink-Bot Marie-Louise 
Published: February 2016

Objective Interviews with ethnic minority patients provide a rich source of data to understand their perspectives of disease and its management. Language barriers are, however, often a problem so interpreters need to be used. We explored the impact of the interpreter on cross-language interviews between researchers and respondents. Methods Secondary analysis of four interviews between researchers and patients involving professional interpreters. Results Interpreters were actively involved and influenced the interview in several ways: they assumed the interviewer’s communicative role, edited information; initiated information-seeking, took over control of the interview, and took over the respondent’s role. While the interpreter supported the interviewer, they posed risks to the quality of the interview. Conclusion Researchers need to be aware of the influence of interpreters. Researchers should instruct interpreters carefully about their roles though they may benefit from interpreters’ strategies to support them.