bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary Artery Bypass Grafting in Patients 50 Years or Younger
Authors: Dalén Magnus , Ivert Torbjörn , Holzmann Martin J. , Sartipy Ulrik 
Published: March 2015

Background—
There are limited data regarding long-term results after coronary artery bypass grafting (CABG) in young adults. We performed a nationwide population-based cohort study to analyze long-term survival, major adverse cardiovascular events, and factors associated with elevated risk in young adults undergoing CABG.

Methods and Results—
We included all adult patients ≤50 years of age who underwent primary isolated CABG in Sweden between 1997 and 2013 from the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) register. Patient data were linked from national Swedish health data registers to create a study database. We identified 4086 young adults with a mean age of 46 years and 18% women. During a median follow-up time of 10.9 years (interquartile range, 6.4–14.1) 490 (12%) patients died. Survival at 5, 10, and 15 years was 96% (95% CI, 95–96), 90% (95% CI, 89–91), and 82% (95%CI, 80–83), respectively, which was significantly better in comparison with patients aged 51 to 70 years and >70 years who underwent CABG during the same period. The cumulative incidence of death or a major adverse cardiovascular event during 17 years after CABG was mainly driven by myocardial infarction or the need for repeat revascularization. The most important risk factors for all-cause mortality were chronic kidney disease, reduced left ventricular ejection fraction, peripheral vascular disease, or chronic obstructive pulmonary disease.

Conclusions—
Long-term survival and freedom from major cardiovascular events after CABG was better in young adults than in older patients. Factors significantly associated with an elevated long-term risk of death or adverse outcome were similar to well-known risk factors for older age groups following CABG.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02276950.
Rethinking the Lower Bound on Aerosol Radiative Forcing
Authors: Stevens Bjorn 
Published: March 2015

Abstract
Based on research showing that in the case of a strong aerosol forcing, this forcing establishes itself early in the historical record, a simple model is constructed to explore the implications of a strongly negative aerosol forcing on the early (pre-1950) part of the instrumental record. This model, which contains terms representing both aerosol–radiation and aerosol–cloud interactions, well represents the known time history of aerosol radiative forcing as well as the effect of the natural state on the strength of aerosol forcing. Model parameters, randomly drawn to represent uncertainty in understanding, demonstrate that a forcing more negative than −1.0 W m−2 is implausible, as it implies that none of the approximately 0.3-K temperature rise between 1850 and 1950 can be attributed to Northern Hemisphere forcing. The individual terms of the model are interpreted in light of comprehensive modeling, constraints from observations, and physical understanding to provide further support for the less negative (−1.0 W m−2) lower bound. These findings suggest that aerosol radiative forcing is less negative and more certain than is commonly believed.
On the Interplay between the Circulation in the Surface and the Intermediate Layers of the Arctic Ocean
Authors: Lique Camille , Johnson Helen L. , Davis Peter E. D. 
Published: March 2015

AbstractThe circulation of the Arctic Ocean has traditionally been studied as a two-layer system, with a wind-driven anticyclonic gyre in the surface layer and a cyclonic boundary current in the Atlantic Water (AW) layer, primarily forced remotely through inflow and outflow to the basin. Here, an idealized numerical model is used to investigate the interplay between the dynamics of the two layers and to explore the response of the circulation in each of the layers to a change in the forcing in either layer. In the model, the intensity of the circulation in the surface and AW layers is primarily set by the ocean surface stress curl intensity and the inflow to the basin, respectively. Additionally, the surface layer circulation can strongly modulate the intensity of the intermediate layer by constraining the lateral extent of the AW current on the slope. In contrast, a change in the AW current strength has little effect on the surface layer circulation. The intensity of the circulation in the surface layer adjusts over a decade, on a time scale consistent with a balance between Ekman pumping and an eddy-induced volume flux toward the boundary, while the circulation in the AW layer adjusts quickly to any change of forcing (~1 month) through the propagation of boundary-trapped waves. As the two layers have different adjustment processes and time scales, and are subject to forcing that varies on all time scales, the interplay between the dynamics of the two layers is complex, and more simultaneous observations of the circulation within the two layers are required to fully understand it.
Novel PTPRQ Mutations Identified in Three Congenital Hearing Loss Patients With Various Types of Hearing Loss
Authors: Sakuma Naoko , Moteki Hideaki , Azaiez Hela , Booth Kevin T. , Takahashi Masahiro , Arai Yasuhiro , Shearer A. Eliot , Sloan Christina M. , Nishio Shin-ya , Kolbe Diana L. , Iwasaki Satoshi , Oridate Nobuhiko , Smith Richard J. H. , Usami Shin-ichi 
Published: March 2015

Objectives: We present 3 patients with congenital sensorineural hearing loss (SNHL) caused by novel PTPRQ mutations, including clinical manifestations and phenotypic features. Methods: Two hundred twenty (220) Japanese subjects with SNHL from unrelated and nonconsanguineous families were enrolled in the study. Targeted genomic enrichment with massively parallel DNA sequencing of all known nonsyndromic hearing loss genes was performed to identify the genetic cause of hearing loss. Results: Four novel causative PTPRQ mutations were identified in 3 cases. Case 1 had progressive profound SNHL with a homozygous nonsense mutation. Case 2 had nonprogressive profound SNHL with a compound heterozygous mutation (nonsense and missense mutation). Case 3 had nonprogressive moderate SNHL with a compound heterozygous mutation (missense and splice site mutation). Caloric test and vestibular evoked myogenic potential (VEMP) test showed vestibular dysfunction in Case 1. Conclusion: Hearing loss levels and progression among the present cases were varied, and there seem to be no obvious correlations between genotypes and the phenotypic features of their hearing loss. The PTPRQ mutations appeared to be responsible for vestibular dysfunction.
Hearing Loss Caused by a P2RX2 Mutation Identified in a MELAS Family With a Coexisting Mitochondrial 3243AG Mutation
Authors: Moteki Hideaki , Azaiez Hela , Booth Kevin T. , Hattori Mitsuru , Sato Ai , Sato Yoshihiko , Motobayashi Mitsuo , Sloan Christina M. , Kolbe Diana L. , Shearer A. Eliot , Smith Richard J. H. , Usami Shin-ichi 
Published: March 2015

Objectives: We present a family with a mitochondrial DNA 3243A>G mutation resulting in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), of which some members have hearing loss in which a novel mutation in the P2RX2 gene was identified. Methods: One hundred ninety-four (194) Japanese subjects from unrelated families were enrolled in the study. Targeted genomic enrichment and massively parallel sequencing of all known nonsyndromic hearing loss genes were performed to identify the genetic causes of hearing loss. Results: A novel mutation in the P2RX2 gene that corresponded to c.601G>A (p.Asp201Tyr) was identified. Two patients carried the mutation and had severe sensorineural hearing loss, while other members with MELAS (who did not carry the P2RX2 mutation) had normal hearing. Conclusion: This is the first case report of a diagnosis of hearing loss caused by P2RX2 mutation in patients with MELAS. A potential explanation is that a decrease in adenosine triphosphate (ATP) production due to MELAS with a mitochondrial 3243A>G mutation might suppress activation of P2X2 receptors. We also suggest that hearing loss caused by the P2RX2 mutation might be influenced by the decrease in ATP production due to MELAS.
Assessing Needs and Feasibility of Diabetes Self-management Coaching at Faith-Based Organizations for Indo-Guyanese Immigrants
Authors: Hosler Akiko S. , Solanki Malini N. , Savadatti Sanghamitra 
Published: March 2015

Purpose The purpose of this study is to explore barriers and needs related to diabetes care and the feasibility of diabetes self-management (DSM) “coaching” at faith-based organizations (FBOs) for the Indo-Guyanese community in Schenectady, New York. Methods Participants were recruited though flyers and mass mailings, and in-depth interviews were conducted at their homes by a team of culturally matched interviewers using a semi-structured questionnaire. Characteristics of participants were compared with existing population-based data to confirm their representativeness. Responses were transcribed, coded, and summarized, and findings are presented along with selective quotations. Key dimensions of feasibility were scored and charted for visualization. Results Findings revealed barriers regarding diet-related knowledge and skills, access to structured DSM education, hyperglycemia control, and environmental support for physical activity. Participants responded positively to receiving free DSM coaching at their FBOs. All participants preferred a qualified health care professional such as certified diabetes educator as their coach and wanted coaching in all aspects of DSM; however, food preparation/diet was the most frequently requested specific topic. Participants uniformly disliked contact with the coach through e-mails and text messages but liked receiving periodic telephone calls at home by the coach. Overall, DSM coaching at FBOs rated high on the key dimensions of feasibility, namely, affordability, accessibility, acceptability, cultural relevance, and safety. Conclusions This study sheds light on the feasibility of an FBO-based DSM intervention for the Indo-Guyanese. It offers insights into developing culturally appropriate DSM intervention format and strategy.
Inflammatory Cytokines and Biomarkers of Cartilage Metabolism 8 Years After Anterior Cruciate Ligament Reconstruction
Authors: Åhlén Martina , Roshani Leyla , Lidén Mattias , Struglics André , Rostgård-Christensen Lars , Kartus Jüri 
Published: March 2015

Background: Patients who sustain an acute anterior cruciate ligament (ACL) rupture are at increased risk to develop posttraumatic arthritis (PTA) in the injured knee whether the ACL is reconstructed or treated nonoperatively. Inflammatory cytokines and cartilage degradation biomarkers are elevated at the time of acute injury and postoperatively. This suggests that one mechanism for PTA may be an inflammatory degradative process initiated on the acute injury and sustained for some length of time independent of whether adequate joint stability is restored. Hypothesis: Inflammatory cytokines and biomarkers of cartilage degradation are elevated in the synovial fluid several years after reconstruction of the ACL, indicating an ongoing imbalance between extracellular matrix destruction and repair. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In 11 patients who had undergone ACL reconstruction 8 years earlier, knee synovial fluid was aspirated from the operated knee and the contralateral nonoperated knee. The synovial fluid was analyzed for interleukin (IL)–1β, IL-6, tumor necrosis factor (TNF)–α, sulfated glycosaminoglycans (sGAG), aggrecan neoepitope fragment (ARGS-aggrecan), and cartilage oligomeric matrix protein (COMP). At follow-up, the patients underwent bilateral weightbearing radiographs and bilateral MRIs of their knees. Results: No significant differences between the operated and the contralateral knee were found for the synovial fluid concentrations of IL-1β, IL-6, TNF-α, sGAG, ARGS-aggrecan, or COMP. There were significantly more radiographically visible osteoarthritic changes in the operated knees compared with the contralateral knees. MRIs revealed that all grafts and all contralateral ACLs were intact and, furthermore, that there was significantly more meniscal and cartilage damage in the index knees than the contralateral knees. Conclusion: Eight years after ACL reconstruction, there were no significant differences in inflammatory cytokines and biomarkers for cartilage degeneration between the nonoperated and the ACL-reconstructed knee, even though there were more osteoarthritic changes and meniscal and cartilage damage in the operated knee, as seen on weightbearing radiographs and MRI.
Deleterious Effect of Radiation Therapy on Epidermodysplasia Verruciformis Patients
Authors: de Oliveira Walmar Roncalli , da Cruz Silva Lana Luiza , Festa Neto Cyro , Tyring Stephen 
Published: March 2015

Background: Epidermodysplasia verruciformis (EV) is a rare genodermatosis caused by specific human papillomavirus (HPV) types associated with the development of multiple squamous cell carcinomas (SCC). The treatment for this skin tumour may be difficult. Among the therapy options, radiotherapy (RT) should be avoided due to its deleterious effects on HPV-induced carcinogenesis. Objective: To describe 4 patients with EV who underwent radiotherapy to treat cutaneous SCC. Methods: This is a retrospective study. The evolution of cutaneous SCC after adjuvant radiotherapy in 4 patients with EV was observed. Results: This study included 4 patients with diagnosis of EV. All 4 of the patients had cutaneous SCC. They underwent surgical resection and adjuvant radiotherapy. Over a period of up to 2 years, there was aggressive tumour recurrence. Conclusion: Radiotherapy might be associated with progression of SCC in patients with EV, and it is recommended that radiotherapy should be avoided in this patient population.
Subjective quality of life of those 65 years and older experiencing dementia
Authors: Stewart-Archer Lois A , Afghani Afrooz , Toye Christine M , Gomez Frank A 
Published: March 2015

Background/Objectives To describe how people experiencing dementia define quality of life and how this may be supported. Design Qualitative descriptive component of mixed methods cross-sectional study. Setting Western Canadian community (4-h weekly care minimum), supportive housing (24-h support/supervision), personal care homes (24-h nursing). Participants One hundred and thirty-six persons aged 65+ experiencing dementia. Measurements Semi-structured interview questions. Rating of meeting life’s goals. Results Participants characterised quality of life as: freedom, independence, having basic needs met, physical health, engagement in meaningful activities and tranquility. A need for self-determination/choice was evidenced across all domains. Increased access to skilled nursing care, support for meaningful engagement with family and meeting life’s goals were endorsed as adding most to quality of life; 43% reported meeting all life’s major goals. Conclusion People experiencing dementia may have better quality of life when choice/self-determination is supported. Enhancements in care environment, independence, engagement and meeting of life’s goals merit urgent attention.
Endograft Planning without Preoperative Arteriography: A Clinical Feasibility Study
Authors: Beebe Hugh G. , Kritpracha Boonprasit , Serres Sharon , Pigott John P. , Price Charles I. , Williams David M. 
Published: March 2015

Purpose: To investigate an alternative method of preprocedural planning for aortic endografting based solely on spiral computed tomography (CT) with 3-dimensional (3D) reconstruction without preoperative arteriography. Methods: From August 1997 to April 1998, 25 consecutive patients with abdominal aortic aneurysms (AAA) were evaluated for endovascular repair by spiral CT scans (2-mm slice thickness) and computerized 3D model construction. No additional imaging for planning was performed. The aortoiliac dimensions, thrombus load, calcification, and vessel tortuosity were measured and evaluated from the 3D model of the aortoiliac segment. These data were used for selecting the patients; the configuration, diameter, and length of the endograft; and the attachment sites for deployment. Results: Primary procedural success was 92% (23/25). All endografts were deployed as planned, and there were no conversions to open repair. Six patients required adjunctive procedures for delivery system access or for iliac aneurysm exclusion, as predicted by the 3D model. Mean procedural time was 91 minutes (range 24 to 273). Two (8%) type II (side branch) endoleaks both sealed spontaneously within 1 month. No graft-related complications or death occurred, for a 30-day technical success rate of 100%. Conclusions: This computerized 3D model provided accurate data for preoperative evaluation of the aortoiliac segment for endovascular AAA repair. Satisfactory technical outcomes for aortic endografts can be achieved without the use of preprocedural invasive imaging.
Immediate Endovascular Repair for Descending Thoracic Aortic Transection Secondary to Blunt Trauma
Authors: Lobato Armando C. , Quick Rhonda C. , Phillips Bradley , Vranic Mitar , Rodriguez-Lopez Julio , Douglas Myles , Diethrich Edward B. 
Published: March 2015

Purpose: To report the immediate endovascular treatment of a thoracic aortic tear secondary to blunt trauma. Methods and Results: A 39-year-old man was injured in a motor vehicle collision. In addition to significant trauma to the head, chest, and abdomen, there were signs of a deceleration injury to the thoracic aorta. After urgent celiotomy to repair a lacerated spleen, the thoracic aortic transection was treated intraluminally using an endograft made of Gianturco Z-stents covered with polytetrafluoroethylene. The patient recovered from his injuries, and the thoracic endograft shows no evidence of endoleak 7 months after treatment. Conclusions: Endoluminal techniques can be used successfully in the immediate repair of thoracic aortic injuries.
Sigmoid Ischemia and the Inflammatory Response following Endovascular Abdominal Aortic Aneurysm Repair
Authors: Elmarasy Nabil M. , Soong Chee V. , Walker Stuart R. , Macierewicz Jan A. , Yusuf Syed W. , Wenham Peter W. , Hopkinson Brian R. 
Published: March 2015

Purpose: To assess the relationship between sigmoid colonic perfusion, endotoxemia, and cytokine generation in patients undergoing elective open repair (OR) or endovascular repair (EVR) of infrarenal abdominal aortic aneurysms (AAA). Methods: Ten patients (9 males; average age 67.6 ± 2.5 years, mean aneurysm diameter 6.9 ± 0.6 cm) undergoing OR were compared to 10 patients (all males; average age 70.3 ± 2.6 years, mean aneurysm diameter 6.5 ± 0.5 cm) whose repair was performed using the EVR technique. The partial pressure of the carbon dioxide gap (Pco2gap = tissue Pco2 — arterial Pco2) of the sigmoid colonic mucosa was measured using a silicone tonometer to evaluate bowel perfusion. Blood samples were collected into pyrogen-free heparinized tubes for quantification of plasma concentrations of endotoxin, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) before, during, and after aortic repair. Results: Patients in the OR group had a significantly greater increase in Pco2gap, suggesting a greater degree of bowel ischemia compared to the EVR group. This was associated with significantly greater postoperative concentrations of endotoxin, TNF-α, and IL-6 in the OR group. A significant correlation was found between Pco2gap, IL-6, and postoperative core temperature. Conclusions: The results suggest that the degree of bowel ischemia, endotoxemia, and cytokine generation following elective infrarenal AAA reconstruction may be reduced if the endovascular technique is used instead of conventional surgery.
Carotid Stenting for Severe Radiation-Induced Extracranial Carotid Artery Occlusive Disease
Authors: Al-Mubarak Nadim , Roubin Gary S. , Iyer Sriram S. , Gomez Camilo R. , Liu Ming W. , Vitek Jiri J. 
Published: March 2015

Purpose: To present our experience with carotid artery stenting as an alternative treatment to endarterectomy in patients with radiation-induced carotid artery occlusive disease. Methods and Results: Fourteen patients (10 males; mean age 61 years, range 52 to 79) underwent percutaneous stenting of 15 carotid arteries for severe radiation-induced extracranial stenoses. Technical success was achieved in all patients, with reduction of the mean stenosis from 77% ± 6% to 8% ± 2%. In 2 patients, ipsilateral vertebral artery lesions were stented concomitantly. One patient had a minor stroke after the procedure but recovered fully in 2 days. No other complications were encountered. Nine (64%) patients had 6-month follow-up imaging (angiography or duplex scanning) that showed no evidence of restenoses (obstruction ≥50%). At 18 ± 2 months, 3 (21%) patients had died from unrelated causes. No neurological events occurred, and no repeat carotid artery interventions were required in the remaining patients. Conclusions: Carotid stenting is an effective treatment option for severe radiation-induced carotid artery occlusive disease.
Endovascular Repair of Thoracic Aortic Aneurysm in Dogs: Evaluation of a Nitinol-Polyester Self-Expanding Stent-Graft
Authors: Formichi Maxime , Marois Yves , Roby Patrice , Marinov Georgui , Stroman Patrick , King Martin W. , Douville Yvan , Guidoin Robert 
Published: March 2015

Purpose: To validate the ease of deployment and in vivo healing performance of a nitinol-polyester self-expanding stent-graft using a canine thoracic aortic aneurysm model. Methods: Arterial aneurysms were surgically created in 8 dogs by sewing a polyester patch onto the anterior side of the thoracic aorta. The nitinol-polyester self-expandable stent-grafts (Cragg EndoPro System 1) were implanted transluminally via the femoral route and deployed at the site of the thoracic aneurysm. Aneurysm exclusion and endograft patency were assessed by angiography after implantation and before animal sacrifice at scheduled periods ranging from 1 week to 3 months. The explanted specimens were examined with magnetic resonance imaging (MRI) to study the position of the stent-graft with respect to the aneurysmal sac. Histological analysis using light microscopy and scanning electron microscopy was performed to examine the inflammatory response and healing characteristics of the device. Results: Seven of 8 stent-grafts were implanted successfully; a bend occurred within the aneurysmal sac in 1 dog, which led to continued perfusion of side branches. This endoleak sealed spontaneously within 1 week, and complete exclusion of the aneurysms in all 8 animals continued throughout implantation. At the time of explantation, all devices were structurally intact and well positioned in the aneurysmal sac. At 1 week, the luminal surface displayed a thin layer of thrombotic matrix, which was gradually replaced by a collagenous internal capsule with endothelial-like cell coverage along both ends of the stent-grafts at 2 and 3 months. No exacerbated inflammatory reaction due to either the nitinol wires or the polyester sleeve was observed after 3 months of implantation. Conclusions: This short-term in vivo study of a nitinol-polyester self-expanding endograft demonstrated the effective exclusion of thoracic aneurysms with a satisfactory healing response and no excessive tissue or inflammatory reactions.