bluuebunny/crossref_metadata_2025_split huggingface dataset:
ЛЕЙКОЦИТАРНІ ІНДЕКСИ У ПРОГНОЗУВАННІ КЛІНІЧНИХ НАСЛІДКІВ ЗАПАЛЬНИХ ПРОЦЕСІВ ЖІНОЧИХ СТАТЕВИХ ОРГАНІВ
Authors: Rozhkovska N. M. , Sytnyk P. V. , Golubenko M. Y. , Sadovnycha O. O. 
Published: October 2017

Мета дослідження – оцінка діагностичної цінності лейкоцитарних індексів у прогнозуванні клінічних наслідків запальних захворювань органів таза (ЗЗОТ) у жінок.Матеріали та методи. Проведений аналіз клінічних вислідів у 75 жінок із гнійно-запальними захворюваннями органів малого таза. Всім жінкам проведено дослідження загальноклінічних та біохімічних показників, а також фізикальні дослідження за стандартними методиками. На підставі одержаних даних розраховували стандартні лейкоцитарні індекси.Результати дослідження та їх обговорення. Усім хворим протягом двох перших діб виконані оперативні втручання (екстирпація матки, надпіхвова ампутація матки, аднексектомія, тубектомія). Післяопераційні ускладнення спостерігались у 16 (76,2 %) хворих у вигляді проявів інфекції рани, гіпертермії. Після проведеного лікування відбулася нормалізація показників лейкоцитарних індексів у більшості (88,0 %) пацієнтів. Найбільш прогностично цінними в прогнозуванні клінічних наслідків були у пацієнток із гнійно-запальними захворюваннями органів малого таза саме гематологічний показник інтоксикації (ГПІ) та лейкоцитарний індекс інтоксикації за Кальф-Каліфом.Висновки. 1. Для жінок, хворих на запальні захворювання органів малого таза характерні помірно виражена анемія, гіповолемія, лейкоцитоз із зсувом вліво, відносна моноцитопенія. 2. Найбільш високі прогностичні характеристики щодо оцінки тяжкості захворювання при даній патології має ГПІ (J=0,38), якому незначно поступається ЛІІКК (J=0,37).
Impact of the Commercialization of Three Generic Angiotensin II Receptor Blockers on Adverse Events in Quebec, Canada
Authors: Leclerc Jacinthe , Blais Claudia , Rochette Louis , Hamel Denis , Guénette Line , Poirier Paul 
Published: October 2017

Background—
Once the patent of a brand-name drug expires, generic drugs are commercialized, and substitution from brand-name to generics may occur. Generic drug equivalence is evaluated through comparative bioavailability studies. Few studies have assessed outcomes after generic drug commercialization at a population level. We evaluated the impact of 3 generic angiotensin II receptor blockers commercialization on adverse events: hospitalizations or emergency room consultations.

Methods and Results—

This is an interrupted time series analysis using the Quebec Integrated Chronic Disease Surveillance System. Rates of adverse events for losartan, valsartan, and candesartan users (N=136 177) aged ≥66 years were calculated monthly, 24 months before and 12 months after generics commercialization. Periods before and after generics commercialization were compared by negative binomial segmented regression models. Sensitivity analyses were also conducted. For all users, there was a monthly mean rate of 100 adverse events for 1000 angiotensin II receptor blocker users before and after generic commercialization. Among generic users of losartan, valsartan, and candesartan, there was an increase in rates of adverse events of 8.0% (difference of proportions versus brand-name, 7.5% [95% confidence interval, −0.9% to 15.9%];
P
=0.0643), 11.7% (difference of proportions, 17.1% [95% confidence interval, 9.9%–24.3%];
P
<0.0001), and 14.0% (difference of proportions, 16.6% [95% confidence interval, 7.9%–25.3%];
P
<0.0001), respectively, the month of generic commercialization. The monthly trend of adverse events was affected for generic versus brand-name losartan users only (difference of proportions, 2.0% [0.7%–3.4%];
P
=0.0033) ≤1 year after generics commercialization. Similar results were found in sensitivity analyses.

Conclusions—
Among generic users, immediate or delayed differences in adverse events rates were observed right after generic commercialization for 3 antihypertensive drugs. Rates of adverse events remained higher for generic users. Increases were more pronounced for generic candesartan, which is the studied product with the largest difference in comparative bioavailability. Risk and survival analysis studies controlling for several potential confounding factors are required to better characterize generic substitution.
Delayed Repolarization Underlies Ventricular Arrhythmias in Rats With Heart Failure and Preserved Ejection Fraction
Authors: Cho Jae Hyung , Zhang Rui , Kilfoil Peter J. , Gallet Romain , de Couto Geoffrey , Bresee Catherine , Goldhaber Joshua I. , Marbán Eduardo , Cingolani Eugenio 
Published: October 2017

Background:
Heart failure with preserved ejection fraction (HFpEF) represents approximately half of heart failure, and its incidence continues to increase. The leading cause of mortality in HFpEF is sudden death, but little is known about the underlying mechanisms.

Methods:
Dahl salt-sensitive rats were fed a high-salt diet (8% NaCl) from 7 weeks of age to induce HFpEF (n=38). Rats fed a normal-salt diet (0.3% NaCl) served as controls (n=13). Echocardiograms were performed to assess systolic and diastolic function from 14 weeks of age. HFpEF-verified and control rats underwent programmed electrical stimulation. Corrected QT interval was measured by surface ECG. The mechanisms of ventricular arrhythmias (VA) were probed by optical mapping, whole-cell patch clamp to measure action potential duration and ionic currents, and quantitative polymerase chain reaction and Western blotting to investigate changes in ion channel expression.

Results:

After 7 weeks of a high-salt diet, 31 of 38 rats showed diastolic dysfunction and preserved ejection fraction along with signs of heart failure and hence were diagnosed with HFpEF. Programmed electric stimulation demonstrated increased susceptibility to VA in HFpEF rats (
P
<0.001 versus controls). The arrhythmogenicity index was increased (
P
<0.001) and the corrected QT interval on ECG was prolonged (
P
<0.001) in HFpEF rats. Optical mapping of HFpEF hearts demonstrated prolonged action potentials (
P
<0.05) and multiple reentry circuits during induced VA. Single-cell recordings of cardiomyocytes isolated from HFpEF rats confirmed a delay of repolarization (
P
=0.001) and revealed downregulation of transient outward potassium current (
I
to
;
P
<0.05). The rapid components of the delayed rectifier potassium current (
I
Kr
) and the inward rectifier potassium current (
I
K1
) were also downregulated (
P
<0.05), but the current densities were much lower than for
I
to
. In accordance with the reduction of
I
to
, both
Kcnd3
transcript and Kv4.3 protein levels were decreased in HFpEF rat hearts.

Conclusions:
Susceptibility to VA was markedly increased in rats with HFpEF. Underlying abnormalities include QT prolongation, delayed repolarization from downregulation of potassium currents, and multiple reentry circuits during VA. Our findings are consistent with the hypothesis that potassium current downregulation leads to abnormal repolarization in HFpEF, which in turn predisposes to VA and sudden cardiac death.
Outcome of Stable Patients With Acute Myocardial Infarction and Coronary Artery Bypass Surgery Within 48 Hours: A Single‐Center, Retrospective Experience
Authors: Grothusen Christina , Friedrich Christine , Loehr Johannes , Meinert Jette , Ohnewald Eva , Ulbricht Ulysses , Attmann Tim , Haneya Assad , Huenges Katharina , Freitag‐Wolf Sandra , Schoettler Jan , Cremer Jochen 
Published: October 2017

Background

The optimal timing of coronary artery bypass grafting (
CABG
) in clinically stable patients with acute myocardial infarction who are unsuitable for percutaneous coronary intervention is unclear. We report our experience with early
CABG
in these patients.

Methods and Results

Between January 2001 and May 2015, 766 patients with
ST
‐segment–elevation myocardial infarction (
STEMI
, n=305) or non‐
STEMI
(NSTEMI, n=461) not including cardiogenic shock underwent
CABG
within 48 hours at our department.
STEMI
patients were younger than non‐
STEMI
patients (age 65 years [range: 58–72] versus 70 years [range: 62–75],
P
<0.001) with a lower Euro
SCORE II
(4.12 [range: 2.75–5.81] versus 4.58 [range: 2.80–7.74],
P
=0.009).
STEMI
patients had undergone preoperative percutaneous coronary intervention more often (20.3% versus 7.8%,
P
<0.001). Time to surgery was shorter in
STEMI
compared with non‐STEMI patients (5.0 hours [range: 3.2–8.8] versus 11.7 hours [range: 6.4–22.0],
P
<0.001). No significant differences concerning arterial graft use (93.8% versus 94.8%,
P
=0.540) or complete revascularization (87.5% versus 83.4%,
P
=0.121) were observed. The rate of strokes did not differ between the groups (2.0% versus 3.9%,
P
=0.134). Thirty‐day mortality was lower in
STEMI
patients (2.7% versus 6.6%
P
=0.018), especially when
CABG
was performed within 6 hours (1.8% versus 7.1%,
P
=0.041). Survival of
STEMI
and non‐STEMI patients was 94% versus 88% after 1 year (
P
<0.001), 87% versus 73% after 5 years (
P
<0.001), and 74% versus 57% after 10 years (
P
<0.001). Independent predictors of 30‐day and long‐term mortality included preoperatively increased lactate values, age, atrial fibrillation, and reduced left ventricular function.

Conclusions

Stable
STEMI
patients showed a lower rate of perioperative complications and better survival compared with non‐
STEMI
patients when
CABG
was performed within 48 hours.
Longitudinal Heart Failure Medication Use and Adherence Following Left Ventricular Assist Device Implantation in Privately Insured Patients
Authors: Tan Nicholas Y. , Sangaralingham Lindsey R. , Schilz Stephanie R. , Dunlay Shannon M. 
Published: October 2017

Background
There are few data describing the longitudinal use of and adherence to heart failure medications following left ventricular assist device (LVAD) implantation.

Methods and Results

Using a large US commercial insurance database, patients who received an
LVAD
(
International Classification of Diseases, 9th Revision, Clinical Modification
code 37.66) and survived to hospital discharge without heart transplantation between January 1, 2006, and March 31, 2015, were identified. Heart failure medication use from 3 months before 1‐year post‐
LVAD
was examined using linked pharmacy claims. Differences in the proportion of patients taking heart failure medications post
LVAD
compared with pre
LVAD
were examined using McNemar test. Predictors of post‐
LVAD
medication use and poor medication adherence (proportion of days covered <0.8) were identified via logistic regression. Among 362 patients (mean age, 57.4 years; 75.1% men), compared with pre
LVAD
, the proportion of patients taking anticoagulants and antiarrhythmics following
LVAD
increased; mineralocorticoid receptor antagonists, thiazide diuretics, and digoxin decreased; and β‐blockers, angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and loop diuretics did not change. Pre‐
LVAD
medication use was associated with post‐
LVAD
use across all medication classes. The proportion of patients with poor medication adherence was 28.8%, 39.0%, and 36.0% for β‐blockers, angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and anticoagulants, respectively. Many patients with poor adherence completely discontinued use of the medication.

Conclusions

Neurohormonal antagonist use after
LVAD
was inconsistent, perhaps reflecting uncertainty of therapeutic benefit in this population. Medication adherence post‐
LVAD
was poor in many patients. Further work is needed to delineate the reasons for nonadherence after
LVAD
.
Contemporary Primary Prevention Aspirin Use by Cardiovascular Disease Risk: Impact of US Preventive Services Task Force Recommendations, 2007—2015: A Serial, Cross‐sectional Study
Authors: Van't Hof Jeremy R. , Duval Sue , Walts Adrienne , Kopecky Stephen L. , Luepker Russell V. , Hirsch Alan T. 
Published: October 2017

Background

No previous study has evaluated the impact of past
US
Preventive Services Task Force statements on primary prevention (
PP
) aspirin use in a primary care setting. The aim of this study was to evaluate temporal changes in
PP
aspirin use in a primary care population, stratifying patients by their 10‐year global cardiovascular disease risk, in response to the 2009 statement.

Methods and Results

This study estimated biannual aspirin use prevalence using electronic health record data from primary care clinics within the Fairview Health System (Minnesota) from 2007 to 2015. A total of 94 270 patient encounters had complete data to estimate a 10‐year cardiovascular disease risk score using the 2013 American College of Cardiology/American Heart Association global risk estimator. Patients were stratified into low‐ (<10%), intermediate‐ (10–20%), and high‐ (≥20%) risk groups. Over the 9‐year period,
PP
aspirin use averaged 43%. When stratified by low, intermediate and high risk, average
PP
aspirin use was 41%, 63%, and 73%, respectively. Average
PP
aspirin use decreased after the publication of the 2009
US
Preventive Services Task Force recommendation statement: from 45% to 40% in the low‐risk group; from 66% to 62% in the intermediate‐risk group; and from 76% to 73% in the high‐risk group, before and after the guideline.

Conclusions

Publication of the 2009
US
Preventive Services Task Force recommendation was not associated with an increase in aspirin use. High risk PP patients utilized aspirin at high rates. Patients at intermediate risk were less intensively treated, and patients at low risk used aspirin at relatively high rates. These data may inform future aspirin guideline dissemination.
Association Between Onset-to-Door Time and Clinical Outcomes After Ischemic Stroke
Authors: Matsuo Ryu , Yamaguchi Yuko , Matsushita Tomonaga , Hata Jun , Kiyuna Fumi , Fukuda Kenji , Wakisaka Yoshinobu , Kuroda Junya , Ago Tetsuro , Kitazono Takanari , Kamouchi Masahiro , Ishitsuka Takao , Ibayashi Setsuro , Kusuda Kenji , Fujii Kenichiro , Nagao Tetsuhiko , Okada Yasushi , Yasaka Masahiro , Ooboshi Hiroaki , Irie Katsumi , Omae Tsuyoshi , Toyoda Kazunori , Nakane Hiroshi , Sugimori Hiroshi , Arakawa Shuji , Tetsuro Ago , Kitayama Jiro , Fujimoto Shigeru , Arihiro Shoji , Fukushima Yoshihisa 
Published: October 2017

Background and Purpose—
The role of early hospital arrival in improving poststroke clinical outcomes in patients without reperfusion treatment remains unclear. This study aimed to determine whether early hospital arrival was associated with favorable outcomes in patients without reperfusion treatment or with minor stroke.

Methods—

This multicenter, hospital-based study included 6780 consecutive patients (aged, 69.9±12.2 years; 63.9% men) with ischemic stroke who were prospectively registered in Fukuoka, Japan, between July 2007 and December 2014. Onset-to-door time was categorized as
T
0-1
, ≤1 hour;
T
1-2
, >1 and ≤2 hours;
T
2-3
, >2 and ≤3 hours;
T
3-6
, >3 and ≤6 hours;
T
6-12
, >6 and ≤12 hours;
T
12-24
, >12 and ≤24 hours; and
T
24-
, >24 hours. The main outcomes were neurological improvement (decrease in National Institutes of Health Stroke Scale score of ≥4 during hospitalization or 0 at discharge) and good functional outcome (3-month modified Rankin Scale score of 0–1). Associations between onset-to-door time and main outcomes were evaluated after adjusting for potential confounders using logistic regression analysis.

Results—

Odds ratios (95% confidence intervals) increased significantly with shorter onset-to-door times within 6 hours, for both neurological improvement (
T
0-
1
, 2.79 [2.28–3.42];
T
1-2
, 2.49 [2.02–3.07];
T
2-3
, 1.52 [1.21–1.92];
T
3-6
, 1.72 [1.44–2.05], with reference to
T
24-
) and good functional outcome (
T
0-1
, 2.68 [2.05–3.49],
T
1-2
2.10 [1.60–2.77],
T
2-3
1.53 [1.15–2.03],
T
3-6
1.31 [1.05–1.64], with reference to
T
24-
), even after adjusting for potential confounding factors including reperfusion treatment and basal National Institutes of Health Stroke Scale. These associations were maintained in 6216 patients without reperfusion treatment and in 4793 patients with minor stroke (National Institutes of Health Stroke Scale ≤4 on hospital arrival).

Conclusions—
Early hospital arrival within 6 hours after stroke onset is associated with favorable outcomes after ischemic stroke, regardless of reperfusion treatment or stroke severity.
Serum Potassium Is Positively Associated With Stroke and Mortality in the Large, Population-Based Malmö Preventive Project Cohort
Authors: Johnson Linda S. , Mattsson Nick , Sajadieh Ahmad , Wollmer Per , Söderholm Martin 
Published: October 2017

Background and Purpose—
Low serum potassium is associated with stroke in populations with cardiovascular disease, hypertension, and diabetes mellitus but has not been studied in a mainly healthy population. We aimed to study the relation between serum potassium and incident stroke and mortality in the Malmö Preventive Project, a large cohort with screening in early mid-life and follow-up >25 years.

Methods—
Serum potassium measurements and covariates were available in 21 353 individuals (79% men, mean age 44 years). Mean follow-up time was 26.9 years for stroke analyses and 29.3 years for mortality analyses. There were 2061 incident stroke events and 8709 deaths. Cox regression analyses adjusted for multiple stroke risk factors (age, sex, height, weight, systolic blood pressure, fasting blood glucose, serum sodium, current smoking, prevalent diabetes mellitus, prevalent coronary artery disease, and treatment for hypertension) were fitted.

Results—

There was an independent, linear association between serum potassium, per mmol/L increase, and both stroke (hazard ratio, 1.33; 95% confidence interval, 1.17–1.52;
P
<0.0001) and mortality (hazard ratio, 1.20; 95% confidence interval, 1.13–1.28;
P
<0.0001). This was significant in subjects both older and younger than the median age (46.5 years), and there was evidence of an interaction with serum sodium. The association was positive and significant for both ischemic stroke and intracerebral hemorrhage and in both hypertensive and normotensive subjects.

Conclusions—
Serum potassium, measured in early mid-life, was linearly associated with both incidence of ischemic stroke and intracerebral hemorrhage and all-cause mortality. An interaction with serum sodium implies that factors related to electrolyte balance and incident hypertension may be mediating factors.
eu External Representation Post-Lisbon: The Performance of eu Diplomacy in Belarus, Moldova and Ukraine
Authors: Baltag Dorina 
Published: October 2017

Summary
The European Union (eu) today has quasi-embassies at its disposal in third countries — the eu delegations — which represent the Union’s eyes, ears and face. Following the Treaty of Lisbon, these delegations assumed the role of the rotating Presidencies and oversee the conduct of eu diplomatic affairs. In practice, this implies representing the eu and cooperating with eu member states’ embassies on matters not only relevant for aid and trade, but also for foreign and security policy. By employing performance criteria such as effectiveness, relevance and capability, this article uncovers the particularities of the practices of European diplomatic cooperation among eu delegations and national embassies in Belarus, Moldova and Ukraine. Drawing on fieldwork conducted in Minsk, Chisinau and Kiev from 2013-2016, the article explores practices of European cooperation abroad, shows how eu diplomatic actors identify a common approach and emphasizes certain capability issues faced by the eu in these countries.
Self-Determination, Human Rights, and the Nation-State
Authors: Pentassuglia Gaetano 
Published: October 2017

Abstract
In this article I examine selective dimensions of the nexus among the right to self-determination, human rights, and the ‘nation-state’ as they relate to claims made by certain ethno-cultural minority groups. I first discuss some conceptual extensions of ‘national’ claims and their underlying relation to international law and state sovereignty. Then, I critique elements of ‘national’ self-determination that are supposedly constitutive of the law of self-determination, including arguments about sub-national groups as ‘peoples’, and discuss some alternative approaches to the role of international law vis-à-vis this sort of claims. Finally, I argue that international human rights law can offer a synthesis of the above nexus insofar as it works, not so much as a platform for accepting or rejecting seemingly ‘absolute’ rights or solely enabling legal-institutional ad hocism, but rather as a general process-based framework for assessing group- related pathologies that are (directly or indirectly) of international law’s own making.
Improving the Quality of Heavy Precipitation Estimates from Satellite Passive Microwave Rainfall Retrievals
Authors: Petković Veljko , Kummerow Christian D. , Randel David L. , Pierce Jeffrey R. , Kodros John K. 
Published: October 2017

Abstract
Prominent achievements made in addressing global precipitation using satellite passive microwave retrievals are often overshadowed by their performance at finer spatial and temporal scales, where large variability in cloud morphology poses an obstacle for accurate precipitation measurements. This is especially true over land, with precipitation estimates being based on an observed mean relationship between high-frequency (e.g., 89 GHz) brightness temperature depression (i.e., the ice-scattering signature) and surface precipitation rate. This indirect relationship between the observed (brightness temperatures) and state (precipitation) vectors often leads to inaccurate estimates, with more pronounced biases (e.g., −30% over the United States) observed during extreme events. This study seeks to mitigate these errors by employing previously established relationships between cloud structures and large-scale environments such as CAPE, wind shear, humidity distribution, and aerosol concentrations to form a stronger relationship between precipitation and the scattering signal. The GPM passive microwave operational precipitation retrieval (GPROF) for the GMI sensor is modified to offer additional information on atmospheric conditions to its Bayesian-based algorithm. The modified algorithm is allowed to use the large-scale environment to filter out a priori states that do not match the general synoptic condition relevant to the observation and thus reduces the difference between the assumed and observed variability in the ice-to-rain ratio. Using the ground Multi-Radar Multi-Sensor (MRMS) network over the United States, the results demonstrate outstanding potential in improving the accuracy of heavy precipitation over land. It is found that individual synoptic parameters can remove 20%–30% of existing bias and up to 50% when combined, while preserving the overall performance of the algorithm.