bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Operator Procedure Volume and Patient Outcomes in Percutaneous Coronary Intervention
Authors: Strom Jordan B. , Wimmer Neil J. , Wasfy Jason H. , Kennedy Kevin , Yeh Robert W. 
Published: June 2014

Background—
The growth of centers capable of performing percutaneous coronary intervention (PCI) has outpaced population growth despite declining incidence of myocardial infarction and prevalence of coronary artery disease, potentially increasing the proportion of operators falling below minimal yearly volume standards set by professional societies.

Methods and Results—
Electronic literature search of MEDLINE and the Cochrane Library for English-language articles published between 1977 and November 2012 was performed. Title and abstract review followed by full-text and references review were performed by 2 authors independently to identify studies examining the association between operator volume and outcomes in PCI. Using a standardized form, 2 authors abstracted information on study design, methods, outcomes, statistical methods, and conclusions. Studies were categorized according to methodological quality and outcomes. Meta-analyses were performed by outcome using a random-effects model. Of the 23 studies included in the analysis, 14 (61%) evaluated mortality, 7 (30%) evaluated major adverse cardiac events, and 2 (9%) evaluated angiographic success. In total, the studies evaluated 15 907 operators performing 205 214 PCIs on 1 109 103 patients at 2456 centers with a mean follow-up of 2.8 years. Eleven (48%) were considered higher quality. Studies with higher methodological quality and large sample sizes more often showed a relationship between operator volume and outcomes in PCI. Higher volume was associated with improved major adverse cardiac events at every threshold, regardless of the threshold evaluated.

Conclusions—
Mortality and major adverse cardiac events increase as operator volumes decrease in PCI. Among studies showing a relationship, high-volume operators were defined variably, with annual PCIs ranging from >11 to >270, with no clear evidence of a threshold effect within the ranges studied.
Age-Specific Exercise Capacity Threshold for Mortality Risk Assessment in Male Veterans
Authors: Kokkinos Peter , Faselis Charles , Myers Jonathan , Sui Xuemei , Zhang Jiajia , Blair Steven N. 
Published: June 2014

Background—
Mortality risk decreases beyond a certain fitness level. However, precise definition of this threshold is elusive and varies with age. Thus, fitness-related mortality risk assessment is difficult.

Methods and Results—
We studied 18 102 male veterans (8305 blacks and 8746 whites). All completed an exercise test between 1986 and 2011 with no evidence of ischemia. We defined the peak metabolic equivalents (METs) level associated with no increase in all-cause mortality risk (hazard ratio, 1.0) for the age categories of <50, 50 to 59, 60 to 69, and ≥70 years. We used this as the threshold group to form additional age-specific fitness categories based on METs achieved below and above it: least-fit (>2 METs below threshold; n=1692), low-fit (2 METs below threshold; n=4884), moderate-fit (2 METs above threshold; n=4646), fit (2.1–4 METs above threshold; n=1874), and high-fit (>4 METs above threshold; n=1301) categories. Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across fitness categories. During follow-up (median=10.8 years), 5102 individuals died. Mortality risk for the cohort and each age category increased for the least-fit and low-fit categories (HR, 1.51; 95% CI, 1.37–1.66; and HR, 1.21; 95% CI, 1.12–1.30, respectively) and decreased for the moderate-fit; fit and high-fit categories (HR, 0.71; 95% CI, 0.65–0.78; HR, 0.63; 95% CI, 0.56–0.78; and HR, 0.49; 95% CI, 0.41–0.58, respectively). The trends were similar for 5- and 10-year mortality risk.

Conclusion—
We defined age-specific exercise capacity thresholds to guide assessment of mortality risk in individuals undergoing a clinical exercise test.
Clinical Prediction Model Suitable for Assessing Hospital Quality for Patients Undergoing Carotid Endarterectomy
Authors: Wimmer Neil J. , Spertus John A. , Kennedy Kevin F. , Anderson H. Vernon , Curtis Jeptha P. , Weintraub William S. , Singh Mandeep , Rumsfeld John S. , Masoudi Frederick A. , Yeh Robert W. 
Published: June 2014

Background

Assessing hospital quality in the performance of carotid endarterectomy (
CEA
) requires appropriate risk adjustment across hospitals with varying case mixes. The aim of this study was to develop and validate a prediction model to assess the risk of in‐hospital stroke or death after
CEA
that could aid in the assessment of hospital quality.

Methods and Results

Patients from National Cardiovascular Data Registry (NCDR)'s Carotid Artery Revascularization and Endarterectomy (CARE) Registry undergoing
CEA
without acute evolving stroke from 2005 to 2013 were included. In‐hospital stroke or death was modeled using hierarchical logistic regression with 20 candidate variables and accounting for hospital‐level clustering. Internal validation was achieved with bootstrapping; model discrimination and calibration were assessed. A total of 213 (1.7%) primary end point events occurred during 12 889 procedures. Independent predictors of stroke or death included age, prior peripheral artery disease, diabetes mellitus, prior coronary artery disease, having a symptomatic carotid lesion, having a contralateral carotid occlusion, or having New York Heart Association Class III or IV heart failure. The model was well calibrated and demonstrated moderate discriminative ability (c‐statistic 0.65). The
NCDR CEA
score was then developed to support simple, prospective risk quantification in the clinical setting.

Conclusions

The
NCDR CEA
score, comprising 7 clinical variables, predicts in‐hospital stroke or death after
CEA
. This model can be used to estimate hospital risk‐adjusted outcomes for
CEA
and to assist with the assessment of hospital quality.
Predictive Value of Newly Detected Atrial Fibrillation Paroxysms in Patients With Acute Ischemic Stroke, for Atrial Fibrillation After 90 Days
Authors: Higgins Peter , Dawson Jesse , MacFarlane Peter W. , McArthur Kate , Langhorne Peter , Lees Kennedy R. 
Published: June 2014

Background and Purpose—
Extended cardiac monitoring immediately after acute ischemic stroke (AIS) increases paroxysmal atrial fibrillation (PAF) detection, but its reliability for detection or exclusion of longer term paroxysmal PAF is unknown. We evaluated the positive and negative predictive value (PPV and NPV) of AF detection early after AIS, for PAF confirmation 90 days later.

Methods—
We investigated 49 patients within 7 days of AIS for PAF according to current guidelines; 23 patients received 7 days of additional noninvasive cardiac event monitoring with an R-test device early after their stroke (ISRCTN 97412358). Ninety days after AIS, everyone underwent 7 days of cardiac event monitoring. We calculated the PPV and NPV of immediate PAF detection through extended cardiac event monitoring and through any investigative modality, for the presence of PAF on the 90-day event monitor.

Results—
PAF detected by a 7-day event monitor within 2 weeks of AIS had a PPV of 100% (95% confidence interval, 72%–100%) for PAF confirmation after 90 days. NPV after 7 days of event monitoring was 64% (95% confidence interval, 35%–87%). PAF detected early through any modality had a PPV of 100% (95% confidence interval, 76%–100%). However, the NPV in the absence of R-test monitoring was only 42% (95% confidence interval, 28%–58%).

Conclusions—
AF detection through any means immediately after stroke holds strong PPV for confirmation after 90 days, justifying treatment decisions on early monitoring alone. However, failure to identify AF through early monitoring has only modest NPV even after 7 days of monitoring; repeated investigation is desirable.
World Christianity and Postcolonial Mission: A Path Forward for the Twenty-first Century
Authors: Clarke Sathianathan 
Published: June 2014

In this article, I first interrogate the in vogue yet ambiguous term “world Christianity.” After assessing alternate nomenclature, I make the case for why “world Christianity” best represents this emerging discipline. Second, I examine two pathways that world Christianity carves out for postcolonial mission in the twenty-first century. While one trajectory falls backward reclaiming and reconfiguring past objectives of evangelization for Christ, the other launches forward engendering dynamic visions of mission made possible by trinitarian reflection. Third, I suggest postcolonial mission is an area of contestation but also negotiation; where these movements intersect paves a way forward for mission thinking and practice. I conclude by reflecting on emerging missiological challenges as these collectives seek to be collaborative and fruitful instruments of God's presence in the world.
Depression and Adherence to Lifestyle Changes in Type 2 Diabetes
Authors: Sumlin Lisa L. , Garcia Theresa J. , Brown Sharon A. , Winter Mary A. , García Alexandra A. , Brown Adama , Cuevas Heather E. 
Published: June 2014

Purpose Depression affects millions of people worldwide and is prevalent among those with diabetes. The purpose of this review was to synthesize recent research on depression and adherence to dietary and physical activity recommendations in persons with type 2 diabetes (T2DM). Methods This systematic review is a subanalysis of an NIH-funded model-testing meta-analysis. Thirteen electronic databases were searched using terms: depression, adherence, T2DM, diabetes. Selected studies: were reported in English between 2000 and 2012, focused on adults with T2DM, and measured depression and dietary and/or physical activity adherence. Results Twenty-seven studies involving 7266 participants were selected; participants were 54% female and 62 years of age, on average. When reported, depression prevalence in study samples ranged from 4.5% to 74%. Six intervention studies targeted diabetes treatment, with or without depression treatment; no studies focused solely on treating depression. Twenty-one descriptive studies examined relationships between depression and diet/physical activity adherence, finding a negative association. Only 2 of the 6 intervention studies examined this relationship; findings were inconsistent. Conclusion Depression was associated with lower adherence to diabetes self-care, as evidenced primarily by descriptive studies; results of intervention studies were conflicting. Future research should focus on the effects of treating depression on diabetes health outcomes.
Intra-arterial and intravenous applications of Iosimenol 340 injection, a new non-ionic, dimeric, iso-osmolar radiographic contrast medium: phase 2 experience
Authors: Meurer Karoline , Laniado Michael , Hosten Norbert , Kelsch Bettina , Hogstrom Barry 
Published: June 2014

Background Iosimenol 340 injection is a new, dimeric, iso-osmolar, iodinated contrast medium for X-ray angiography. Purpose To compare the safety and efficacy of iosimenol injection to iodixanol injection in two randomized, controlled phase 2 trials. Material and Methods One hundred and forty-four adult patients were enrolled in the two trials, one for evaluation during arteriography and the other for evaluation during computed tomography. Safety was compared by assessing adverse events, vital signs, ECGs, and laboratory parameters. Efficacy was assessed as X-ray attenuation in the computed tomography (CT) trial and as the quality of contrast enhancement in the arteriography trial. Results There were no statistically significant differences in terms of safety or efficacy between the two contrast media. Both were well tolerated upon intravenous as well as intra-arterial injection. The most common adverse event was a feeling of warmth (observed in 35.1% of the patients with Iosimenol injection and 44.3% with iodixanol injection). Conclusion Iosimenol upon intravenous as well as upon intra-arterial injection exhibits a safety profile and shows an efficacy similar to that of iodixanol.
Diagnostic performance of indirect MR arthrography for the diagnosis of rotator cuff tears at 3.0 T
Authors: Lee Ji Hyun , Yoon Young Cheol , Jee Sukkyung 
Published: June 2014

Background Indirect magnetic resonance (MR) arthrography is a non-invasive method for shoulder imaging. However, there are no studies that have examined the diagnostic performance of indirect MR arthrography for the diagnosis of rotator cuff tears in a large patient population. Purpose To assess the diagnostic performance of indirect fast spin-echo (FSE) MR arthrography for the diagnosis of rotator cuff tears at 3.0 T. Material and Methods A total of 149 patients who had undergone indirect shoulder MR arthrography followed by arthroscopic surgery were enrolled in this retrospective study. Two musculoskeletal radiologists evaluated images from each patient for the presence of supraspinatus-infraspinatus (SSP-ISP) or subscapularis (SSC) tendon tears. Using the arthroscopic findings as the reference standard, the overall diagnostic performance and detection rates for SSP-ISP and SSC tendon tears were calculated. Results The sensitivity, specificity, and accuracy of readers I and II for the diagnosis of SSP-ISP tendon tears were 94% and 95%, 89% and 85%, and 93% and 93%, respectively. The sensitivity of imaging for detection of SSP-ISP tendon tears by readers I and II were 100% and 100% for full-thickness tears and 84% and 86% for partial-thickness tears, respectively. The sensitivity, specificity, and accuracy of readers I and II for the diagnosis of SSC tendon tears were 80% and 76%, 89% and 93%, and 85% and 85%, respectively. Conclusion Indirect MR arthrography is useful for the detection of SSP-ISP and SSC tendon tears.
In vivo characterization of urinary calculi on dual-energy CT: going a step ahead with sub-differentiation of calcium stones
Authors: Acharya Sudeep , Goyal Ankur , Bhalla Ashu Seith , Sharma Raju , Seth Amlesh , Gupta Arun Kumar 
Published: June 2014

Background The role of dual-energy computed tomography (DECT) in characterization of urinary calculi is evolving and literature regarding differentiation of calcium calculi is sparse and confounding. Purpose To evaluate the capability of DECT in assessing the urinary calculi composition in vivo, especially in differentiating various types of calcium calculi. Material and Methods One hundred and twenty patients underwent DECT for characterization of urinary calculi. Seventy patients with 114 calculi, including 93 calcium stones, were retrospectively analyzed. DE ratios and attenuation differences were compared using ANOVA and receiver-operating-characteristic (ROC) analysis was done to predict cut-off values, in particular for detecting calcium-oxalate-monohydrate (COM) stones. Results DE ratio ≤1.14 accurately detected uric acid calculi, ≥1.29 was definitive for calcium and intermediate values were characteristic of cystine stones. DE ratios were significantly different between group 1 (COM [ n = 32]; mean 1.376 ± 0.041), group 2 ([calcium oxalate dihydrate (COD) + COM] [ n = 51]; 1.416 ± 0.048), and group 3 ([carbonate apatite (CaP) + COD + COM] [ n = 10]; 1.468 ± 0.038) (group 1 vs. 2, P = 0.001; 1 vs. 3, P = 0.000; 2 vs. 3, P = 0.004). More importantly, pure COM calculi (group 1) had significantly lower DE ratio compared with mixed calcium calculi (groups 2 and 3) ( P = 0.000). Attenuation differences (between low and high kV images) could not distinguish between COM and mixed calculi. ROC analysis for detection of COM calculi yielded AUC of 0.770 with cut-off DE ratio 1.385 (sensitivity 65.6%, specificity 82%) and value <1.335 was seen only with COM calculi (100% specificity). Conclusion DECT can be employed for in vivo differentiation of various types of calculi and for detection of relatively lithotripsy-resistant COM calculi.
Invasive cribriform carcinoma of the breast: mammographic, sonographic, MRI, and 18 F-FDG PET-CT features
Authors: Lee Young Ju , Choi Bo Bae , Suh Kwang Sun 
Published: June 2014

Background Invasive cribriform carcinoma (ICC) of the breast is a rare type of invasive carcinoma which shows a favorable prognosis and a lower frequency of axillary nodal metastases. Few imaging findings related to ICC have been reported. Purpose To evaluate imaging findings with multiple imaging techniques in ICC of the breast. Material and Methods Twenty-eight cases of histopathologically proven ICC of the breast were gathered for this study. We retrospectively reviewed the mammographic, sonographic, and magnetic resonance imaging (MRI) findings of ICC according to the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) lexicon. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography (18 F-FDG PET-CT) findings were also evaluated. Microscopic slides of surgical specimens were reviewed by a breast pathologist. Results The mean age of the patients was 51 years. The most common mammographic findings were irregular shape (72.8%), spiculated margin (63.7%), and a high density (81.8%) mass. Microcalcifications were noted in 9/28 cases. The most common shape was pleomorphic (66.7%). The most common sonographic findings were irregular shape (77.8%), spiculated margin (29.6%), hypoechogenicity (81.5%), and no posterior acoustic features (85.2%). On MRI, most ICCs presented as irregular shaped mass (62.0%) and irregular (42.9%) margin. All four patients (16.0%) who presented with non-mass-like enhancement pattern showed a segmental distribution. The 18 F-FDG PET-CT showed a mean maximum standardized uptake value (SUVmax) of 5.90. Axillary nodal metastases were found in 17.9% (5/28) of the surgical specimens. Immunohistochemical studies showed a high positivity for estrogen and progesterone receptor (100% and 87.5%, respectively). Conclusion The imaging features of invasive cribriform carcinoma are highly suggestive of malignancy and are not distinguishable from those of other breast cancers like infiltrating ductal carcinoma.
Probable Tolosa-Hunt syndrome with a normal MRI
Authors: Abdelghany Mahmoud , Orozco Daniel , Fink William , Begley Christopher 
Published: June 2014

Background We are reporting a rare case of a 60-year-old woman with a past history of end-stage renal disease and non-Hodgkin lymphoma who presented to our hospital with confusion, unilateral headache, painful ophthalmoplegia and ptosis. The patient was diagnosed clinically with Tolosa-Hunt syndrome (THS). Results THS is a diagnosis of exclusion. Other diseases were ruled out. Magnetic resonance imaging (MRI) of the brain and orbit was negative twice within a week. The patient was treated with corticosteroids with marked improvement of the orbital pain and headache and mild improvement of the cranial nerves palsy. Conclusion Clinical diagnosis of THS could be supported by radiological findings. According to the International Classification of Headache Disorders (ICHD)-3 beta diagnostic criteria, the diagnosis must be confirmed with an abnormal MRI and/or pathological sample. We add to the previous findings of THS with a normal MRI. Although MRI plays a crucial role in differential diagnosis, it should not, nor should the biopsy, be a must for the diagnosis. Limitations of using MRI in some patients are another problem.
Psychosocial Predictors of Primiparous Breastfeeding Initiation and Duration
Authors: Mathews Meagan E. , Leerkes Esther M. , Lovelady Cheryl A. , Labban Jeffrey D. 
Published: June 2014

Background: Many US women fall short of meeting the recommendations on breastfeeding. Whereas prenatal demographic factors have been well researched in relation to breastfeeding, psychosocial maternal characteristics are less understood but could be important predictors of breastfeeding initiation and duration. Objective: This study examined primiparous maternal psychosocial characteristics and temperamentally based negative infant affect as predictors of breastfeeding initiation and duration while accounting for depression and sociodemographic covariates. Methods: Prenatally, 237 primiparous women were administered the Adult Attachment Interview and completed a measure of beliefs related to infant crying. At 6 months postpartum, negative infant affect was assessed via mother report. Breastfeeding was assessed at 6 months and 1 year postpartum via mother report. Results: Results indicated that younger, low income, less educated, single, ethnic minority mothers and mothers with elevated depressive symptoms were less likely to initiate breastfeeding and breastfed for a shorter period than other women. Women who initiated breastfeeding tended to have higher adult attachment coherence scores (more secure attachment) than those who did not initiate breastfeeding (median score of 6.00 vs 4.00). An interaction was observed between negative infant affect and beliefs about crying related to spoiling, such that earlier cessation of breastfeeding was observed among mothers who reported high levels of negative infant affect and strongly endorsed the belief that responding to cries spoils infants (hazard ratio = 1.71, P < .01). Conclusion: Although these psychosocial variables predicted relatively little variation in breastfeeding over and above covariates, the results suggest some novel approaches to promote breastfeeding.
Polyunsaturated Fatty Acid Content May Be Increased in the Milk of Women with Pregnancy-Associated Breast Cancer
Authors: Qin Wenyi , Raatz Susan , Zhang Ke K. , Rosenberger Thad A. , Sauter Edward R. 
Published: June 2014

Background: Pregnancy-associated breast cancer (PABC) is aggressive and difficult to diagnose. High intake of most types of dietary fat is thought to increase breast cancer risk; however, results in humans supporting this premise remain equivocal. Fatty acid (FA) concentrations in the body comprise both dietary intake and endogenous FA production. Most assessments of FA levels have been performed on blood, with little information on the effect of FA levels in breast milk on PABC risk. Objective: This study aimed to determine if FA concentrations in the milk from women diagnosed with breast cancer while nursing were different in the cancer-containing breast and opposite breast. Methods: We quantified 16 long-chain FA and soluble FA synthase (sFAS) enzyme levels from 4 women diagnosed with PABC, comparing results from the cancer-containing breast to those from the normal breast. Results: Fatty acid concentrations consistently exceeded and trended higher ( P < .10) in each cancer-containing breast for 20:4n-6 (arachidonic acid [AA]), 20:5n-3 (eicosapentaenoic acid [EPA]), and 22:5n-6 (docosapentaenoic acid [DPA]). Soluble FA synthase levels were similar in the cancer-containing and normal breasts. Conclusion: Breast milk concentrations of AA, EPA, and DPA increased in the cancer-containing breast of women with PABC. This increase was not associated with higher sFAS levels.