bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in 30-Day Readmission Rates for Patients Hospitalized With Heart Failure
Authors: Bergethon Kristin E. , Ju Christine , DeVore Adam D. , Hardy N. Chantelle , Fonarow Gregg C. , Yancy Clyde W. , Heidenreich Paul A. , Bhatt Deepak L. , Peterson Eric D. , Hernandez Adrian F. 
Published: June 2016

Background—
Reducing hospital readmissions for patients with heart failure is a national priority, and quality improvement campaigns are targeting reductions of ≥20%. However, there are limited data on whether such targets have been met.

Methods and Results—

We analyzed data from the American Heart Association’s Get With The Guidelines-Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. A total of 21,264 patients with heart failure were included from 70 US sites from January 2009 to October 2012. Overall hospital-level, risk-adjusted, 30-day all-cause readmission rates declined slightly, from 20.0% (SD, 1.3%) in 2009 to 19.0% (SD, 1.2%) in 2012 (
P
=0.001). Only 1 in 70 (1.4%) hospitals achieved the 20% relative reduction in 30-day risk-adjusted readmission rates. A multivariable linear regression model was used to determine hospital-level factors associated with relative improvements in 30-day risk-adjusted readmissions between 2009 and 2012. Teaching hospitals had higher relative readmission rates as compared with their peers, and hospitals that used postdischarge heart failure disease management programs had lower relative readmission rates.

Conclusions—
Although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
Pulmonary Vascular Distensibility Predicts Pulmonary Hypertension Severity, Exercise Capacity, and Survival in Heart Failure
Authors: Malhotra Rajeev , Dhakal Bishnu P. , Eisman Aaron S. , Pappagianopoulos Paul P. , Dress Ashley , Weiner Rory B. , Baggish Aaron L. , Semigran Marc J. , Lewis Gregory D. 
Published: June 2016

Background—
Pulmonary vascular (PV) distensibility, defined as the percent increase in pulmonary vessel diameter per mm Hg increase in pressure, permits the pulmonary vessels to increase in size to accommodate increased blood flow. We hypothesized that PV distensibility is abnormally low in patients with heart failure (HF) and serves as an important determinant of right ventricular performance and exercise capacity.

Methods and Results—

Patients with HF with preserved ejection fraction (n=48), HF with reduced ejection fraction (n=55), pulmonary arterial hypertension without left heart failure (n=18), and control subjects (n=30) underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and first-pass radionuclide ventriculography. PV distensibility was derived from 1257 matched measurements (mean±SD, 8.3±2.8 per subject) of pulmonary arterial pressure, pulmonary arterial wedge pressure and cardiac output. PV distensibility was lowest in the pulmonary arterial hypertension group (0.40±0.24% per mm Hg) and intermediate in the HF with preserved ejection fraction and HF with reduced ejection fraction groups (0.92±0.39 and 0.84±0.33% per mm Hg, respectively) compared to the control group (1.39±0.32% per mm Hg,
P
<0.0001 for all three). PV distensibility was associated with change in right ventricular ejection fraction (RVEF, ρ=0.39,
P
<0.0001) with exercise and was an independent predictor of peak VO
2.
PV distensibility also predicted cardiovascular mortality independent of peak VO
2
in HF patients (n=103; Cox hazard ratio, 0.30; 95% confidence interval, 0.10–0.93;
P
=0.036). In a subset of patients with HF with reduced ejection fraction (n=26), 12 weeks of treatment with the pulmonary vasodilator sildenafil or placebo led to a 24.6% increase in PV distensibility (
P
=0.015) in the sildenafil group only.

Conclusions—
PV distensibility is reduced in patients with HF and pulmonary arterial hypertension and is closely related to RV systolic function during exercise, maximal exercise capacity, and survival. Furthermore, PV distensibility is modifiable with selective pulmonary vasodilator therapy and may represent an important target for therapy in selected HF patients with pulmonary hypertension.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00309790.
Transcription Factor 7-like 2 Mediates Canonical Wnt/β-Catenin Signaling and c-Myc Upregulation in Heart Failure
Authors: Hou Ning , Ye Bo , Li Xiang , Margulies Kenneth B. , Xu Haodong , Wang Xuejun , Li Faqian 
Published: June 2016

Background—
How canonical Wnt/β-catenin signals in adult hearts, especially in different diseased states, remains unclear. The proto-oncogene, c-Myc, is a Wnt target and an early response gene during cardiac stress. It is not clear whether c-Myc is activated or how it is regulated during heart failure.

Methods and Results—
We investigated canonical Wnt/β-catenin signaling and how it regulated c-Myc expression in failing hearts of human ischemic heart disease, idiopathic dilated cardiomyopathy, and murine desmin–related cardiomyopathy. Our data demonstrated that canonical Wnt/β-catenin signaling was activated through nuclear accumulation of β-catenin in idiopathic dilated cardiomyopathy, ischemic heart disease, and murine desmin–related cardiomyopathy when compared with nonfailing controls and transcription factor 7-like 2 (TCF7L2) was the main β-catenin partner of the T-cell factor (TCF) family in adult hearts. We further revealed that c-Myc mRNA and protein levels were significantly elevated in failing hearts by real-time reverse transcription polymerase chain reaction, Western blotting, and immunohistochemical staining. Immunoprecipitation and confocal microscopy further showed that β-catenin interacted and colocalized with TCF7L2. More importantly, chromatin immunoprecipitation confirmed that β-catenin and TCF7L2 were recruited to the regulatory elements of c-Myc. This recruitment was associated with increased histone H3 acetylation and transcriptional upregulation of c-Myc. With lentiviral infection, TCF7L2 overexpression increased c-Myc expression and cardiomyocyte size, whereas shRNA-mediated knockdown of TCF7L2 suppressed c-Myc expression and cardiomyocyte growth in cultured neonatal rat cardiomyocytes.

Conclusions—
This study indicates that TCF7L2 mediates canonic Wnt/β-catenin signaling and c-Myc upregulation during abnormal cardiac remodeling in heart failure and suppression of Wnt/β-catenin to c-Myc axis can be explored for preventing and treating heart failure.
Persistence of Severe Pulmonary Hypertension After Transcatheter Aortic Valve Replacement
Authors: Testa Luca , Latib Azeem , De Marco Federico , De Carlo Marco , Fiorina Claudia , Montone Rocco , Agnifili Mauro , Barbanti Marco , Petronio Anna Sonia , Biondi Zoccai Giuseppe , Ettori Federica , Klugmann Silvio , Tamburino Corrado , Brambilla Nedy , Colombo Antonio , Bedogni Francesco 
Published: June 2016

Background—
Severe pulmonary hypertension (PH) is considered to negatively affect the outcome after transcatheter aortic valve replacement. However, a clear understanding of the pattern, evolution, and clinical impact of different grades of PH in this setting is lacking.

Methods and Results—

A total of 990 consecutive patients were enrolled in 6 high-volume centers and analyzed as follows: group 1, systolic pulmonary artery pressure (sPAP) <40 mm Hg (346 patients; 35%); group 2, sPAP 40 to 60 mm Hg (426 patients; 43%); and group 3, sPAP >60 mm Hg (218 patients; 22%). At 1 month, mortality rate did not differ across the groups. When compared with groups 1 and 2, patients in group 3 had a higher-rate of New York Heart Association 3 to 4 (26% versus 12% and 10%), and a higher-rate of hospitalization for heart failure (7% versus 3% and 3%). At 1 year, when compared with patients in group 1, patients in group 2 and 3 had both a higher overall mortality (hazard ratio [HR], 1.5 [1.3–3.2];
P
=0.01 and HR, 2.3 [1.8–2.8];
P
=0.001) and a higher cardiac mortality (HR, 1.3 [1.1–2.1];
P
=0.01 and HR, 1.7 [1.3–2.5];
P
=0.002). After 1 month, the sPAP decreased ≥15 mm Hg in 32% and 35% of the patients in groups 2 and 3. Baseline sPAP >60 mm Hg (HR, 1.6 [1.1–2.3];
P
=0.03) and, in a larger extent, a persistent severe PH after 1 month (HR, 2.4 [1.5–2.8];
P
=0.004), independently predicted 1-year mortality, whereas the 1-month reduction of the sPAP did not.

Conclusions—
The persistence of severe PH after transcatheter aortic valve replacement is a stronger predictor of 1-year mortality than baseline severe PH. The early reduction of sPAP is not associated with a reduced mortality. The benefit of transcatheter aortic valve replacement in terms of quality of life is substantial in patients with and without a reduction of sPAP at early follow-up.
Low Circulating Acute Brain-Derived Neurotrophic Factor Levels Are Associated With Poor Long-Term Functional Outcome After Ischemic Stroke
Authors: Stanne Tara M. , Åberg N. David , Nilsson Staffan , Jood Katarina , Blomstrand Christian , Andreasson Ulf , Blennow Kaj , Zetterberg Henrik , Isgaard Jörgen , Svensson Johan , Jern Christina 
Published: June 2016

Background and Purpose—
Brain-derived neurotrophic factor (BDNF) plays important roles in brain plasticity and repair, and it influences stroke outcomes in animal models. Circulating BDNF concentrations are lowered in patients with traumatic brain injury, and low BDNF predicts poor recovery after this injury. We sought to investigate whether circulating concentrations of BDNF are altered in the acute phase of ischemic stroke and whether they are associated with short- or long-term functional outcome.

Methods—
Serum concentrations of BDNF were measured in the Sahlgrenska Academy Study on Ischemic Stroke. The main outcomes were modified Rankin Scale (mRS) good (mRS score of 0–2) versus poor (mRS score of 3–6) at 3 months and 2 years after stroke, and good (mRS score of 0–2) versus poor (mRS score of 3–5) at 7 years after stroke.

Results—

Acute concentrations of BDNF were significantly lower in ischemic stroke cases (n=491) compared with controls (n=513). BDNF concentrations were not significantly associated with 3-month outcome. However, patients with BDNF in the lowest tertile had an increased risk of experiencing a poor outcome both at 2-year and 7-year follow-up, and these associations were independent of vascular risk factors and stroke severity (odds ratio, 2.6; confidence intervals, 1.4–4.9;
P
=0.002 and odds ratio, 2.1; confidence intervals, 1.1–3.9;
P
=0.028, respectively).

Conclusions—
Circulating concentrations of BDNF protein are lowered in the acute phase of ischemic stroke, and low levels are associated with poor long-term functional outcome. Further studies are necessary to confirm these associations and to determine the predictive value of BDNF in stroke outcomes.
Intracranial Aneurysms in Sickle-Cell Disease Are Associated With the Hemoglobin SS Genotype But Not With Moyamoya Syndrome
Authors: Birkeland Peter , Gardner Kate , Kesse-Adu Rachel , Davies John , Lauritsen Jens , Rom Poulsen Frantz , Tolias Christos M. , Thein Swee Lay 
Published: June 2016

Background and Purpose—
Intracranial aneurysms and aneurysmal subarachnoid hemorrhage may occur more frequently in sickle-cell disease (SCD), and this could be related to the sickle genotype and moyamoya syndrome seen in SCD.

Methods—
Records from a total of 1002 patients with SCD attending 2 specialized adult hematologic services were retrospectively reviewed. We analyzed data of a cohort of 767 patients attending 1 SCD clinic between 2002 and 2013 and of 235 patients from the other clinic who have had neurovascular imaging between 2007 and 2014.

Results—
We identified 4 patients in the cohort who had an aneurysmal subarachnoid hemorrhage during 9063 patient-years. The highest incidence rate was seen among women in the age group 30 to 39 years with the hemoglobin SS (HbSS) genotype (440 per 100 000 patient-years). Unruptured intracranial aneurysms were found in 20 of the 324 patients, who had imaging data; the prevalence was significantly higher in patients with HbSS genotype compared with other sickle genotypes with the highest prevalence (15%) observed in women in the age group 30 to 39 years. Fifty-one HbSS patients had a moyamoya vasculopathy, but only 3 of these had concomitant intracranial aneurysms.

Conclusions—
Intracranial aneurysms are common in HbSS SCD. There was also a trend toward more common occurrence of aneurysmal subarachnoid hemorrhage in HbSS; women in the age group 30 to 39 years were most at risk. There was no correlation between the occurrence of intracranial aneurysms and moyamoya syndrome.
Long-Term Risk of Stroke in Myocardial Infarction Survivors
Authors: Sundbøll Jens , Horváth-Puhó Erzsébet , Schmidt Morten , Pedersen Lars , Henderson Victor W. , Bøtker Hans Erik , Sørensen Henrik Toft 
Published: June 2016

Background and Purpose—
Improved survival after myocardial infarction (MI) has increased the number of patients at risk of post-MI stroke. We examined risks of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in patients with MI compared with the general population.

Methods—
We conducted a nationwide population–based cohort study using Danish medical registries. During 1980 to 2009, we identified all patients with a first-time inpatient diagnosis of MI and formed a sex- and age-matched comparison cohort. We computed cumulative stroke risks and adjusted stroke rate ratios with 95% confidence intervals (CIs).

Results—
We identified 258 806 patients with an MI and 1 244 773 individuals from the general population. For patients with MI, the cumulative stroke risks after 1 to 30 years were 12.6% for ischemic stroke, 1.2% for ICH, and 0.24% for SAH. During the first 30 days after MI, the adjusted stroke rate ratio was 30-fold increased for ischemic stroke (31.9; 95% CI, 28.4–35.8), 20-fold for ICH (21.8; 95% CI, 16.6–28.5), and 15-fold for SAH (16.6; 95% CI, 8.7–32.0). The adjusted stroke rate ratio remained increased during 31 to 365 days (3-fold for ischemic stroke, 2-fold for ICH, and 1.5-fold for SAH). During the ensuing 1 to 30 years, the risks remained increased for ischemic stroke (1.6; 95% CI, 1.6–1.6) but decreased to near unity for ICH (1.1; 95% CI, 1.0–1.2) and SAH (1.1; 95% CI, 0.94–1.2).

Conclusions—
MI was a risk factor for all stroke subtypes during the first year of follow-up, but only for ischemic stroke thereafter.
Prophylactic Antiepileptics and Seizure Incidence Following Subarachnoid Hemorrhage
Authors: Panczykowski David , Pease Matthew , Zhao Yin , Weiner Gregory , Ares William , Crago Elizabeth , Jankowitz Brian , Ducruet Andrew F. 
Published: June 2016

Background and Purpose—
The utility of prophylactic antiepileptic drug (AED) administration after spontaneous subarachnoid hemorrhage remains controversial. AEDs have not clearly been associated with a reduction in seizure incidence and have been associated with both neurological worsening and delayed functional recovery in this setting.

Methods—
We retrospectively analyzed a prospectively collected database of subarachnoid hemorrhage patients admitted to our institution between 2005 and 2010. Between 2005 and 2007, all patients received prophylactic AEDs upon admission. After 2007, no patients received prophylactic AEDs or had AEDs immediately discontinued if initiated at an outside hospital. A propensity score–matched analysis was then performed to compare the development of clinical and electrographic seizures in these 2 populations.

Results—

Three hundred and fifty three patients with spontaneous subarachnoid hemorrhage were analyzed, 43% of whom were treated with prophylactic AEDs upon admission. Overall, 10% of patients suffered clinical and electrographic seizures, most frequently occurring within 24 hours of ictus (47%). The incidence of seizures did not vary significantly based on the use of prophylactic AEDs (11 versus 8%;
P
=0.33). Propensity score–matched analyses suggest that patients receiving prophylactic AEDs had a similar likelihood of suffering seizures as those who did not (
P
=0.49).

Conclusions—
Propensity score–matched analysis suggests that prophylactic AEDs do not significantly reduce the risk of seizure occurrence in patients with spontaneous subarachnoid hemorrhage.
Some new and known species of Hatschekia Poche, 1902 (Copepoda, Siphonostomatoida, Hatschekiidae) parasitic on the branchial lamellae of Japanese actinopterygian fishes belonging to Perciformes (2)
Authors: Izawa Kunihiko 
Published: June 2016

Twelve species ofHatschekiaPoche, 1902 are (re-)described based on specimens recovered from the branchial lamellae of Japanese actinopterygian fishes belonging to Perciformes. They areH. aigoisp. nov.,H. aulacocephalisIzawa, 2016,H. cepolaeYamaguti, 1939,H. crenataHewitt, 1969,H. gymnocraniisp. nov.,H. iniisticolasp. nov.,H. japonicaJones, 1985,H. leptoscariYamaguti, 1939,H. novaculopsisp. nov.,H. rhombocephalissp. nov.,H. rotundigenitalisYamaguti, 1939, andH. thyrsitoidesisp. nov., in addition toH. priacanthisnom. nov. (= H. jonesiIzawa, 2016a).
Effect of white spot syndrome virus (WSSV) infection on immune enzyme activity and ultrastructure in the haemolymph tissue of Cherax quadricarinatus (Decapoda, Astacidea)
Authors: Ning J. J. , Zhang M. M. , Tong Q. Q. , Cao X. , Wang D. L. , Zhao Y. L. 
Published: June 2016

To explore the pathogenic mechanism of white spot syndrome virus (WSSV) in crayfish (Cherax quadricarinatus), we analysed activities of the three immune-related enzymes PO, SOD and LSZ in haemolymph tissue ofC. quadricarinatusbefore and after infection, and simultaneously studied the ultrastructural pathology. The results show that WSSV infection affects activities of the three enzymes. After 6-24 h of WSSV infection, the activities of PO, SOD and LSZ increased, but decreased significantly during longer infection times. The enzyme activities in WSSV-infected crayfish were significantly lower than those in controls at 72 h, except for LSZ (). Interestingly, the activities of PO, SOD and LSZ in the group treated with immune-polysaccharides before challenge with WSSV were higher than in the directly infected group, and the immune protection rate reached 51.9%, suggesting that the polysaccharides could improve enzyme activities and enhance antiviral defences of the organism. Ultrastructural pathological changes showed damaged haemolymph tissue, deformed golgiosomes, fuzzy damage in the mitochondrial structures, and nuclear membrane deformation and fracture. High levels of heterochromatin appeared in the nucleus; organoid and chromatin dissolved in dying blood cells, cytoplasm appeared oedematous and cells dissolved. WSSV particles were visible in blood cell nuclei of infected crayfish.
Growth patterns and population dynamics of the kelp crab Pugettia vulgaris (Decapoda, Brachyura, Epialtidae) on the coast of Sagami Bay, Japan
Authors: Ohtsuchi Naoya , Kawamura Tomohiko , Hayakawa Jun , Kurogi Hiroaki , Watanabe Yoshiro 
Published: June 2016

Investigating the possibility of diverse patterns in habitat use of spider crabs requires to distinguish the growth phase of each sampled individual. In this study, ontogenetic stages (OS) were set on the basis of the different combinations of several secondary sexual characteristics, and used to describe the population dynamics of a small species kelp crab,Pugettia vulgarisOhtsuchi, Kawamura & Takeda, 2014. Morphometric analysis, together with an estimation of the size at 50% maturity, confirmed that each OS is a statistically independent group in both sexes, and that this species reaches Stage III (fully grown stage at terminal anecdysis) at around 4-5 mm CW in both sexes. Monthly quantitative sampling during two years, which was carried out in 11 different subtidal habitats (<0.1-8 m deep), revealed thatP. vulgarispreferred lower subtidal (2-8 m deep) red algal turfs with physically complex structures as their habitat, and will stay there throughout their entire post-settlement life history. The densities ofP. vulgarisrapidly increased during summer to late autumn due to the successive recruitments of juveniles, and the highest mean density (315 ± 72 ind./m2) was recorded at lower subtidal gelidiacean turfs (Rhodophyta, Gelidiaceae) in September 2009. Females were ovigerous at >4.28 mm CW, during spring to autumn. Stage III individuals died out by autumn. Thus, the longevity ofP. vulgarisis estimated to be approximately one year. Although the CW class frequency composition did not differ clearly, the OS frequency composition differed among populations in three algal turfs, suggesting settlement selectivity, and a different mortality among these different populations.
A new secondary ecotope for talitrids: driftwood in the Bay of Fundy
Authors: Wildish David J. , Robinson Shawn M. C. 
Published: June 2016

Platorchestia platensis(Amphipoda, Talitridae) was previously known ecologically as a wrack generalist, but here we describe a secondary driftwood ecotope for this species. The trophic dependence of driftwood-acclimatedP. platensison rotting wood was confirmed by successfully culturing it within driftwood, without further addition of food. The stranded driftwood in whichP. platensiswas found contained gribble burrows (round and of 0.6 to 5 mm diameter). We hypothesize thatP. platensisused the empty gribble burrows for interspecific squatting (to gain initial entry to driftwood and for shelter). We found eleven driftwood depositories in a 230 km length of shoreline in Passamaquoddy Bay. The commonest driftwood was of spruce and eastern white cedar. The small marsh at Hartley Cove contained a driftwood depository, where the new driftwood ecotope was discovered. This site was studied temporally to understand how wind and tidal forces might affect import and export of driftwood.
Improved Retrieval of Cloud Liquid Water from CloudSat and MODIS
Authors: Leinonen Jussi , Lebsock Matthew D. , Stephens Graeme L. , Suzuki Kentaroh 
Published: June 2016

AbstractA revised version of the CloudSat–MODIS cloud liquid water retrieval algorithm is presented. The new algorithm, which combines measurements of radar reflectivity and cloud optical depth, addresses issues discovered in the current CloudSat–MODIS cloud water content (CWC) product. This current product is shown to be underconstrained by observations and to be too dependent on prior information incorporated into the Bayesian optimal-estimation algorithm. The most significant change made to the algorithm in this study was decreasing the number of independent variables to allow the observations to constrain the retrieved values better. The retrieval was also reformulated for improved compliance with the mathematical assumptions of the optimal-estimation algorithm. To validate the accuracy of the revised algorithm, the path-integrated attenuation (PIA) of the CloudSat radar signal was computed from the algorithm results. These modeled values were compared with independent measurements of the PIA that were obtained using a surface reference technique. This comparison shows that the cloud liquid water retrieved by the algorithm is close to being unbiased. The revised algorithm was also found to be an improvement over the current CloudSat CWC product and, to a lesser degree, the MODIS-derived cloud liquid water path.