bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic Valve Annular Sizing
Authors: George Isaac , Guglielmetti Laura C. , Bettinger Nicolas , Moss Andrew , Wang Catherine , Kheysin Nathan , Hahn Rebecca , Kodali Susheel , Leon Martin , Bapat Vinayak , Borger Michael A. , Williams Mathew , Smith Craig , Khalique Omar K. 
Published: May 2017

Background—
Appropriate valve sizing is critical in aortic valve replacement. We hypothesized that direct intraoperative valve sizing results in smaller aortic annular diameters compared with sizing based on systolic-phase multidetector computerized tomographic (MDCT) imaging.

Methods and Results—
We retrospectively analyzed 78 patients undergoing surgical aortic valve replacement for severe aortic stenosis between 2012 and 2014 at our institution. Preoperative MDCT measurements of the aortic annulus served as basis for assignment to a theoretical surgical valve size, which was then (1) compared to the implanted valve size and (2) to a theoretical transcatheter aortic valve replacement valve size. To quantify the resulting differences, geometric orifice areas (GOA) were calculated. MDCT-based sizing produced the same valve size for n=34 patients (group CT-same), a larger valve with a 25% increased GOA in n=32 patients (group CT-Lg) and a smaller GOA by 22% in n=12 patients (group CT-Sm). On the basis of MDCT measurements, 41% of valves implanted were undersized. The comparison of intraoperative implanted to a theoretical transcatheter aortic valve replacement valve size resulted in GOAs 25% larger for patients in group CT-same, 40.6% larger in group CT-Lg and 14.6% larger in group CT-Sm.

Conclusions—
Preoperative MDCT measurements differ substantially from direct intraoperative assessment of the aortic annulus. Implanted surgical aortic valve replacement valves were smaller relative to MDCT-based sizing in 41% of patients, and the potential GOA was between 25% and 40.6% larger if patients had undergone transcatheter aortic valve replacement.
Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
Authors: Qiu Shanhu , Cai Xue , Sun Zilin , Li Ling , Zuegel Martina , Steinacker Juergen Michael , Schumann Uwe 
Published: May 2017

Background

Heart rate recovery (
HRR
) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population.

Methods and Results

A literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95%
CI
s for the association between baseline
HRR
and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated
HRR
versus fast
HRR
that served as the referent were 1.69 (95%
CI
1.05–2.71) for cardiovascular events and 1.68 (95%
CI
1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in
HRR
, the hazard ratios were 1.13 (95%
CI
1.05–1.21) and 1.09 (95%
CI
1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated
HRR
and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all
P
<0.05).

Conclusions

Attenuated
HRR
is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording
HRR
for risk assessment in clinical practice as a routine.
Haptoglobin Hp2 Variant Promotes Premature Cardiovascular Death in Stroke Survivors
Authors: Ijäs Petra , Melkas Susanna , Saksi Jani , Jula Antti , Jauhiainen Matti , Oksala Niku , Pohjasvaara Tarja , Kaste Markku , Karhunen Pekka J. , Lindsberg Perttu , Erkinjuntti Timo 
Published: May 2017

Background and Purpose—

Haptoglobin (Hp) is an acute phase plasma protein protecting tissues from oxidative damage. It exists in 2 variant alleles (
hp1/hp2
) giving rise to 3 protein isoforms with different biochemical properties and efficiency to limit oxidative stress. We previously found that
hp2
variant is associated with stroke risk in the patients with carotid stenosis and the risk of ischemic cardiovascular events in a general population cohort. This study examined the hypothesis that Hp genotype is associated with general cardiovascular risk in patients with stroke.

Methods—
Hp was genotyped in SAM study (Helsinki Stroke Aging Memory, n=378). A total of 1426 individuals ascertained from a nationally representative cross-sectional health survey served as population controls.

Results—

Hp genotype frequencies were 15.6% (
hp1-1
), 44.2% (
hp1-2
), and 40.2% (
hp2-2
) in patients with stroke. During a mean of 7.5-year follow-up after first-ever stroke,
hp2
carriers had a substantially higher rate of cardiac deaths (24.5% versus 8.5%;
P
=0.006) and a trend toward more fatal strokes (23.5% versus 13.6%;
P
=0.122). The combined risk of ischemic cardiovascular deaths was 2.4-fold higher among
hp2
carriers (95% confidence interval, 1.28–4.43) after adjustment for major cardiovascular risk factors.

Conclusions—

Hp2
allele is associated with premature ischemic cardiovascular deaths after first-ever ischemic stroke.
Dietary Protein Intake and Stroke Risk in a General Japanese Population
Authors: Ozawa Mio , Yoshida Daigo , Hata Jun , Ohara Tomoyuki , Mukai Naoko , Shibata Mao , Uchida Kazuhiro , Nagata Masashi , Kitazono Takanari , Kiyohara Yutaka , Ninomiya Toshiharu 
Published: May 2017

Background and Purpose—
The influence of dietary protein intake on stroke risk is an area of interest. We investigated the association between dietary protein intake and stroke risk in Japanese, considering sources of protein.

Methods—
A total of 2400 subjects aged 40 to 79 years were followed up for 19 years. Dietary protein intake was estimated using a 70-item semiquantitative food frequency questionnaire. The risk estimates for incident stroke and its subtypes were calculated using a Cox proportional hazards model.

Results—

During the follow-up, 254 participants experienced stroke events; of these, 172 had ischemic stroke, and 58 had intracerebral hemorrhage. Higher total protein intake was significantly associated with lower risks of stroke and intracerebral hemorrhage (both
P
for trend <0.05). With regard to sources of protein, the risks of total stroke and ischemic stroke significantly decreased by 40% (95% confidence interval, 12%–59%) and 40% (5%–62%), respectively, in subjects with the highest quartile of vegetable protein intake compared with those with the lowest one. In contrast, subjects with the highest quartile of animal protein intake had a 53% (4%–77%) lower risk of intracerebral hemorrhage. Vegetable protein intake was positively correlated with intakes of soybean products, vegetable, and algae, whereas animal protein intake was positively correlated with intakes of fish, meat, eggs, and milk/dairy products. Both types of protein intakes were negatively correlated with intakes of rice and alcohol.

Conclusions—
Our findings suggest that higher dietary protein intake is associated with a reduced risk of stroke in the general Japanese population.
Poststroke Sonic Hedgehog Agonist Treatment Improves Functional Recovery by Enhancing Neurogenesis and Angiogenesis
Authors: Jin Yongming , Barnett Austin , Zhang Yifan , Yu Xin , Luo Yu 
Published: May 2017

Background and Purpose—
Because of the limitation in treatment window of the r-tPA (recombinant tissue-type plasminogen activator), the development of delayed treatment for stroke is needed. In this study, we examined the efficacy of delayed poststroke treatment (post 3–8 days) of the sonic hedgehog pathway agonist on functional recovery and the underlying mechanisms.

Methods—
We evaluated functional recovery at 1 month after stroke using locomotion analysis and Barnes maze test for cognitive function. We used a genetically inducible neural stem cell–specific reporter mouse line (nestin-CreERT2-R26R-YFP) to label and track their proliferation, survival, and differentiation in ischemic brain. Brain tissue damage, angiogenesis, and cerebral blood flow recovery was evaluated using magnetic resonance imaging techniques and immunostaining.

Results—
Our results show that delayed treatment of sonic hedgehog pathway agonist in stroke mice results in enhanced functional recovery both in locomotor function and in cognitive function at 1 month after stroke. Furthermore, using the Nestincre-ERT2-YFP mice, we showed that poststroke sonic hedgehog pathway agonist treatment increased surviving newly born cells derived from both subventricular zone and subgranular zone neural stem cells, total surviving DCX+ (Doublecortin) neuroblast cells, and neurons (NeuN+/YFP+) in the ischemic brain. Sonic hedgehog pathway agonist treatment also improved the brain tissue repair in ischemic region supported by our T2-weighted magnetic resonance imaging, cerebral blood flow map by arterial spin labeling, and immunohistochemistry (α-smooth muscle actin and CD31 immunostaining).

Conclusions—
These data confirm an important role for the hedgehog pathway in poststroke brain repair and functional recovery, suggesting a prolonged treatment window for potential treatment strategy to modulate sonic hedgehog pathway after stroke.
Clinical Significance of Isolated Atypical Transient Symptoms in a Cohort With Transient Ischemic Attack
Authors: Lavallée Philippa C. , Sissani Leila , Labreuche Julien , Meseguer Elena , Cabrejo Lucie , Guidoux Céline , Klein Isabelle F. , Touboul Pierre-Jean , Amarenco Pierre 
Published: May 2017

Background and Purpose—
Contrary to typical transient symptoms (TS), atypical TS, such as partial sensory deficit, dysarthria, vertigo/unsteadiness, unusual cortical visual deficit, and diplopia, are not usually classified as symptoms of transient ischemic attack when they occur in isolation, and their clinical relevance is frequently denied.

Methods—
Consecutive patients with recent TS admitted in our transient ischemic attack clinic (2003–2008) had systematic brain, arterial, and cardiac investigations. We compared the prevalence of recent infarction on brain imaging, major investigational findings (symptomatic intracranial or extracranial atherosclerotic stenosis ≥50%, cervical arterial dissection, and major source of cardiac embolism), and 1-year risk of major vascular events in patients with isolated typical or atypical TS and nonisolated TS, after exclusion of the main differential diagnoses.

Results—

Among 1850 patients with possible or definite ischemic diagnoses, 798 (43.1%) had isolated TS: 621 (33.6%) typical and 177 (9.6%) atypical. Acute infarction on brain imaging was similar in patients with isolated atypical and typical TS but less frequent than in patients with nonisolated TS, observed in 10.0%, 11.5%, and 15.3%, respectively (
P
<0.0001). Major investigational findings were found in 18.1%, 26.4%, and 26.3%, respectively (
P
=0.06). One-year risk of a major vascular events was not significantly different in the 3 groups.

Conclusions—
Transient ischemic attack diagnosis should be considered and investigated in patients with isolated atypical TS.
Circulating FABP4 (Fatty Acid–Binding Protein 4) Is a Novel Prognostic Biomarker in Patients With Acute Ischemic Stroke
Authors: Tu Wen-Jun , Zeng Xian-Wei , Deng Aijun , Zhao Sheng-Jie , Luo Ding-Zhen , Ma Guo-Zhao , Wang Hong , Liu Qiang 
Published: May 2017

Background and Purpose—
FABP4 (fatty acid–binding protein 4) is an intracellular lipid chaperone involved in coordination of lipid transportation and atherogenesis. This study aimed at observing the effect of FABP4 on the 3-month outcomes in Chinese patients with acute ischemic stroke.

Methods—
In a prospective multicenter observational study, serum concentrations of FABP4 were on admission measured in plasma of 737 consecutive patients with acute ischemic stroke. Serum concentrations of FABP4, National Institutes of Health Stroke Scale score, and conventional risk factors were evaluated to determine their value to predict functional outcome and mortality within 3 months.

Results—

During follow-up, an unfavorable functional outcome was found in 260 patients (35.3%), and 94 patients (12.8%) died. In multivariate models comparing the third and fourth quartiles to the first quartile of FABP4, the concentrations of FABP4 were associated with poor functional outcome and mortality. Compared with the reference category (Q1–Q3), the concentrations of FABP4 in Q4 had a relative risk of 4.77 (95% confidence interval [CI], 2.02–8.15;
P
<0.001) for poor functional outcome and mortality (odds ratio, 6.15; 95% CI, 3.43–12.68) after adjusting for other significant outcome predictors in univariate logistic regression analysis. Receiver-operating characteristic curves to predict poor functional outcome and mortality demonstrated areas under the curve of FABP4 of 0.78 (95% CI, 0.75–0.82) and 0.83 (95% CI, 0.79–0.88), which improved the prognostic accuracy of National Institutes of Health Stroke Scale score with combined areas under the curve of 0.83 (95% CI, 0.76–0.89;
P
<0.01) and 0.86 (95% CI, 0.81–0.92), respectively.

Conclusions—
Data show that FABP4 is a novel independent prognostic marker improving the currently used risk stratification of stroke patients.
Are People Born to be Believers, or are Gods Born to be Believed?
Authors: Shook John R. 
Published: May 2017

AbstractProposals that god-belief is an innate capacity of all humanity have not been confirmed by empirical studies. Scientific disciplines presently lean against god-belief’s innateness. Perhaps religion should be relieved that belief in gods is not innate. Intuitive cognitive functions supporting god-belief offer little convergence upon any god. Religious pluralism back to the Stone Age displays no consensus either. Any cognition for god-belief can only be deemed as mostly or entirely misleading. Theology has tried to forestall that skeptical judgment, by dictating what counts as authentic religiosity and who enjoys a valid idea of god. Justin Barrett exemplifies this theological interference with scientific inquiry. Contorting the anthropology and cognitive science of religion too far, his quest for a primal natural religion won’t match up with his search for intuitive conceptions of god. His quest for god-belief’s innateness devolves into theological dogmatism, deepening doubts that scientific theories of religion will validate god-belief.
A Model of Sea Ice Formation in Leads and Polynyas
Authors: Heorton Harold D. B. S. , Radia Nikhil , Feltham Daniel L. 
Published: May 2017

AbstractCracks in the sea ice cover break the barrier between the ocean and atmosphere, exposing the ocean to the cold atmosphere during the winter. These cracks are known as leads within the continuous sea ice pack and polynyas near land or ice shelves. Sea ice formation starts with frazil ice crystals in supercooled waters, which grow and precipitate to the ocean surface to form grease ice, eventually consolidating into a layer of solid sea ice that grows downward. In this study, a numerical model is formulated to simulate the formation of sea ice in a lead or polynya from frazil ice to a layer of new sea ice. The simulations show the refreezing of a lead within 48 h of its opening. Grease ice covers the lead typically within 3–10 h and consolidates into sea ice within 15–30 h. This study uses its model to simulate an observed polynya event in the Laptev Sea showing the vertical distribution of frazil ice and water supercooling. Sensitivity studies are used to investigate the dependence of ice growth on the ambient environment with the surface wind speed shown to be of greatest importance to lead exposure time and total ice growth. The size and distribution of frazil crystals and the time taken for the lead to freeze over is shown to be highly dependent upon the ambient forcing and lead geometry.
The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials
Authors: Wang Chong-Wen , Chow Amy YM , Chan Cecilia LW 
Published: May 2017

Background: Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive. Aim: To evaluate the effects of therapeutic life review on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer. Design: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Data sources: Five databases were searched from their respective inception through February 2017 for relevant randomized controlled trials. The effects of therapeutic life review were pooled across the trials. Standardized mean differences were calculated for the pooled effects. Heterogeneity was assessed using the I2 test. Study quality was assessed using the Cochrane criteria. Results: Eight randomized controlled trials met the inclusion criteria. The pooled results suggested a desirable effect of therapeutic life review on the meaning of life domain of spiritual well-being (standardized mean difference = 0.33; 95% confidence interval, 0.12 to 0.53), general distress (standardized mean difference = −0.32; 95% confidence interval, −0.55 to −0.09), and overall quality of life (standardized mean difference = 0.35; 95% confidence interval, 0.15 to 0.56) when compared to usual care only. Of the three outcomes examined, only the pooled effect on overall quality of life remained statistically significant at follow-ups up to 3 months after the intervention (standardized mean difference = 0.82; 95% confidence interval, 0.47 to 1.18). Conclusions: Therapeutic life review is potentially beneficial for people near the end of life. However, the results should be interpreted with caution due to the limited number of randomized controlled trials and associated methodological weaknesses. Further rigorously designed randomized controlled trials are warranted.
Hospital Length of Stay Among Patients Receiving Intermittent Versus Prolonged Piperacillin/Tazobactam Infusion in the Intensive Care Units
Authors: Chan Jeannie D. , Dellit Timothy H. , Lynch John B. 
Published: May 2017

Objectives: We sought to evaluate clinical outcomes of intensive care unit (ICU) patients following a hospital-wide initiative of prolonged piperacillin/tazobactam (PIP/TAZ) infusion. Methods: Retrospective observational study of patients >18 years old who was hospitalized in the ICU receiving PIP/TAZ for >72 hours during the preimplementation (June 1, 2010 to May 31, 2011) and postimplementation (July 7, 2011 to June 30, 2014) periods. Results: There were 124 and 429 patients who met inclusion criteria with average age of 54.3 and 56.9 years, and average duration of PIP/TAZ therapy was 6.1 ± 2.8 days and 5.9 ± 3.4 days in the pre- and postimplementation period, respectively. Intensive care unit and hospital length of stay (LOS) following initiation of PIP/TAZ were 8.0 ± 8.4 days versus 6.4 ± 6.8 days and 26.3 ± 22.8 days versus 20.4 ± 16.1 days among patients in the pre- and postimplementation periods, respectively. Compared to patients who received intermittent PIP/TAZ infusion, the adjusted difference in ICU and hospital LOS was 0.6 ± 0.8 days (95% confidence interval [CI]: −0.9 to 2.1 days) and 5.6 ± 2.1 days (95% CI: 1.4 - 9.7 days) shorter among patients who received prolonged PIP/TAZ infusion. At hospital discharge, 19 (15.3%) intermittent infusion and 74 (17.2%) prolonged infusion recipients had died. In comparison to intermittent infusion recipients, the adjusted odds ratio for mortality was 1.17 (95% CI: 0.65-2.1) with prolonged infusion. Conclusion: Our study demonstrated a reduction in hospital LOS with prolonged PIP/TAZ infusion among critically ill patients. Randomized trials are needed to further validate these findings.
Psychodynamic formulation in the era of the brain – towards integration
Authors: Newman Louise K 
Published: May 2017

Objective: The objectives of this study were to describe advances in neurosciences and their relationship to psychodynamic models of psychopathology and to present an integrative approach to psychodynamic formulation which incorporates the neurobiological underpinnings of self-functioning and a model of relational trauma. Conclusion: Developmental psychopathology is now better able to describe the significance of early developmental periods and the interpersonal context of self-development. These findings contribute to an integrated biopsychosocial psychodynamic formulation based on core principles of early development.
Efficacy and safety of daily mirabegron 50 mg in male patients with overactive bladder: a critical analysis of five phase III studies
Authors: Tubaro Andrea , Batista José E. , Nitti Victor W. , Herschorn Sender , Chapple Christopher R. , Blauwet Mary Beth , Siddiqui Emad , Huang Moses , Oelke Matthias 
Published: May 2017

Background: Oral pharmacotherapies to treat overactive bladder (OAB) are used less in men despite a similar prevalence of storage symptoms as women. The efficacy and safety of once-daily mirabegron 50 mg was evaluated in male OAB patients from five phase III studies that included placebo or antimuscarinic (tolterodine ER 4 mg or solifenacin 5 mg) as a comparator. Methods: Three pooled 12-week placebo-controlled studies (mirabegron 50 mg versus placebo) and one 12-week non-inferiority phase IIIb study (BEYOND; mirabegron 50 mg versus solifenacin 5 mg) were used for efficacy (daily micturition frequency, urgency and incontinence episodes) and safety analyses. An additional 52-week active-controlled phase III safety study (mirabegron 50 mg versus tolterodine ER 4 mg) was included in the safety analysis. Male patients aged ⩾18 years with OAB for ⩾3 months were included in the analyses. Patients may also have a history of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH)/benign prostatic enlargement (BPE) or concomitant use of α1-blockers. Results: In the pooled studies, mirabegron 50 mg demonstrated superiority versus placebo (treatment difference: −0.37 [95% confidence interval (CI): −0.74, −0.01]) for reducing micturition frequency; improvements in urgency and incontinence were not significantly different between mirabegron 50 mg and placebo. In BEYOND, mirabegron 50 mg was comparable with solifenacin 5 mg for reducing micturition frequency, urgency, and incontinence episodes. Mirabegron was well tolerated at 12 and 52 weeks and overall treatment-emergent adverse events (AEs) were similar to those with placebo. Conclusions: In a male OAB population with or without LUTS associated with BPH/BPE, mirabegron 50 mg provided similar improvements in urgency, frequency, and incontinence as solifenacin 5 mg, and is a well-tolerated alternative to antimuscarinics. In the three pooled 12-week studies, significant differences were not seen for urgency and incontinence versus placebo, although mirabegron 50 mg did demonstrate significant improvements versus placebo for frequency.