bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and Survival of Malignant Cardiac Tumors
Authors: Oliveira Guilherme H. , Al-Kindi Sadeer G. , Hoimes Christopher , Park Soon J. 
Published: October 2015

Background—
The aim of this study was to investigate the incidence, histopathology, demographics, and survival associated with primary malignant cardiac tumors (PMCTs).

Methods and Results—

We queried the Surveillance, Epidemiology and End Results (SEER) 18 registry from the National Cancer Institute for all PMCTs diagnosed from 1973 to 2011. We describe PMCT histopathology and incidence, comparing characteristics and survival of these patients with those of patients with extracardiac malignancies of similar histopathology. From a total of 7 384 580 cases of cancer registered in SEER, we identified 551 PMCTs (0.008%). The incidence of PMCT diagnosis is 34 cases per 100 million persons and has increased over time (25.1 in 1973–1989, 30.2 in 1990–1999, and 46.6 in 2000–2011). Most patients are female (54.1%) and white (78.6%) with median age at diagnosis of 50 years. The most common PMCTs are sarcomas (n=357, 64.8%), followed by lymphomas (n=150, 27%) and mesotheliomas (n=44, 8%). Most patients are diagnosed with tissue sample (96.8%). Although use of chemotherapy is not documented in SEER, 19% of patients received radiation and 44% had surgery. After a median follow-up of 80 months, 413 patients had died. The 1-, 3-, and 5-year survival rates were 46%, 22%, and 17% and have improved over the eras, with 1-, 3-, and 5-year survival rates of 32%, 17%, and 14% for 1973 to 1989 and 50%, 24%, and 19% for 2000 to 2011 (
P
=0.009). Cardiac sarcomas and mesotheliomas are the most lethal PMCTs, with 1-, 3-, 5-year survival rates of 47%, 16%, and 11% and of 51%, 26%, and 23% compared with 59%, 41%, and 34% for lymphomas, respectively (log rank test
P
<0.001). Patients with cardiac lymphomas and sarcomas are younger and have worse survival than patients with extracardiac disease of similar histopathology (
P
<0.001).

Conclusions—
PMCTs are extremely rare and continue to be associated with poor prognosis. Over the past 5 decades, the incidence and survival of patients diagnosed with PMCT appear to have increased. Compared with those with extracardiac cancers of similar histopathology, patients with PMCTs are often younger and have worse survival.
Feasibility and Accuracy of Cardiac Magnetic Resonance Imaging–Based Whole‐Heart Inverse Potential Mapping of Sinus Rhythm and Idiopathic Ventricular Foci
Authors: Bhagirath Pranav , van der Graaf Maurits , van Dongen Elise , de Hooge Jacques , van Driel Vincent , Ramanna Hemanth , de Groot Natasja , Götte Marco J. W. 
Published: October 2015

Background

Inverse potential mapping (
IPM
) noninvasively reconstructs cardiac surface potentials using body surface potentials. This requires a volume conductor model (
VCM
), usually constructed from computed tomography; however, computed tomography exposes the patient to harmful radiation and lacks information about tissue structure. Magnetic resonance imaging (
MRI
) is not associated with this limitation and might have advantages for mapping purposes. This feasibility study investigated a magnetic resonance imaging–based
IPM
approach. In addition, the impact of incorporating the lungs and their particular resistivity values was explored.

Methods and Results

Three volunteers and 8 patients with premature ventricular contractions scheduled for ablation underwent 65‐electrode body surface potential mapping. A
VCM
was created using magnetic resonance imaging. Cardiac surface potentials were estimated from body surface potentials and used to determine the origin of electrical activation. The
IPM
‐defined origin of sinus rhythm corresponded well with the anatomic position of the sinus node, as described in the literature. In patients, the
IPM
‐derived premature ventricular contraction focus was 3‐dimensionally located within 8.3±2.7 mm of the invasively determined focus using electroanatomic mapping. The impact of lungs on the
IPM
was investigated using homogeneous and inhomogeneous
VCM
s. The inhomogeneous
VCM
, incorporating lung‐specific conductivity, provided more accurate results compared with the homogeneous
VCM
(8.3±2.7 and 10.3±3.1 mm, respectively;
P
=0.043). The interobserver agreement was high for homogeneous (intraclass correlation coefficient 0.862,
P
=0.003) and inhomogeneous (intraclass correlation coefficient 0.812,
P
=0.004)
VCMs
.

Conclusion
Magnetic resonance imaging–based whole‐heart IPM enables accurate spatial localization of sinus rhythm and premature ventricular contractions comparable to electroanatomic mapping. An inhomogeneous VCM improved IPM accuracy.
Influence of Synoptic Sea-Breeze Fronts on the Urban Heat Island Intensity in Dallas–Fort Worth, Texas
Authors: Hu Xiao-Ming , Xue Ming 
Published: October 2015

AbstractWhen assessed using the difference between urban and rural air temperatures, the urban heat island (UHI) is most prominent during the nighttime. Typically, nocturnal UHI intensity is maintained throughout the night. The UHI intensity over Dallas–Fort Worth (DFW), Texas, however, experienced frequent “collapses” (sudden decreases) around midnight during August 2011, while the region was experiencing an intense heat wave. Observational and modeling studies were conducted to understand this unique phenomenon. Sea-breeze passage was found to be ultimately responsible for the collapses of the nocturnal UHI. Sea-breeze circulation developed along the coast of the Gulf of Mexico during the daytime. During the nighttime, the sea-breeze circulation was advected inland (as far as ~400 km) by the low-level jet-enhanced southerly flow, maintaining the characteristics of sea-breeze fronts, including the enhanced wind shear and vertical mixing. Ahead of the front, surface radiative cooling enhanced the near-surface temperature inversion in rural areas through the night with calm winds. During the frontal passage (around midnight at DFW), the enhanced vertical mixing at the leading edge of the fronts brought warmer air to the surface, leading to rural surface warming events. In contrast, urban effects led to a nearly neutral urban boundary layer. The enhanced mechanical mixing associated with sea-breeze fronts, therefore, did not increase urban surface temperature. The different responses to the sea-breeze frontal passages between rural (warming) and urban areas (no warming) led to the collapse of the UHI. The inland penetration of sea-breeze fronts at such large distances from the coast and their effects on UHI have not been documented in the literature.
Predictors of Posterior Glottic Stenosis
Authors: Hillel Alexander T. , Karatayli-Ozgursoy Selmin , Samad Idris , Best Simon R.A. , Pandian Vinciya , Giraldez Laureano , Gross Jennifer , Wootten Christopher , Gelbard Alexander , Akst Lee M. , Johns Michael M. ,   North American Airway Collaborative (NoAAC)
Published: October 2015

Objective: To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. Methods: Patients diagnosed with PGS between September 2012 and May 2014 at 3 tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, endotracheal tube (ETT) size, and indication for intubation were recorded. Patients with PGS were compared to control patients represented by patients intubated in intensive care units (ICU). Results: Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia ( P < .05), diabetes ( P < .01), and length of intubation ( P < .01) were significant risk factors for the development of PGS. Fourteen of 14 (100%) males were intubated with a size 8 or larger ETT compared to 47 of 65 (72.3%) male controls ( P < .05). Posterior glottic stenosis ( P < .01), length of intubation ( P < .001), and obstructive sleep apnea ( P < .05) were significant risk factors for tracheostomy. Conclusion: Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.
Office-Based Subglottic Evaluation in Children With Risk of Subglottic Hemangioma
Authors: Chun Robert H. , McCormick Michael E. , Martin Timothy , Drolet Beth A. , Kerschner Joseph E. 
Published: October 2015

Purpose: Children with V3 cutaneous infantile hemangiomas (IH) and PHACE syndrome have a high incidence for airway hemangioma, 29% and 52%, respectively. Therefore, a clinical evaluation for these high-risk children is essential. We report our experience with in-office lower airway evaluation (OLAE) in these high-risk children. Results: Since 2003, 5 children with IH of the V3 cutaneous distribution and 3 children with PHACE syndrome underwent OLAE. Average age of presentation was 2.75 months. Two children had stridor at initial evaluation, and 1 child had subglottic hemangioma. This child was evaluated serially with OLAE to monitor disease progression and treatment response. A total of 10 upper tracheoscopies were performed on the 8 patients without respiratory complications. Conclusion: An airway evaluation is essential to evaluate and manage this high-risk population. Typically, operative endoscopy requires general anesthesia. However, in these high-risk children, we have performed OLAE without sedation to evaluate the trachea. High-speed recording and playback is essential in this method. Our series demonstrates that awake OLAE is possible and may be a safe technique to evaluate and monitor disease progression in these high-risk patients. These patients avoided general anesthesia and delay in diagnosis and did not incur any complications during or after OLAE.
Speech Recognition in Noise by Younger and Older Adults
Authors: Vermeire Katrien , Knoop Allart , Boel Carolien , Auwers Silke , Schenus Laura , Talaveron-Rodriguez Marilina , De Boom Chloë , De Sloovere Marleen 
Published: October 2015

Objectives: Purpose of the present study is to evaluate the effects of aging on temporal resolution and speech understanding in noise. Methods: Twenty-seven young and 33 older normal hearing adults participated in this study. Temporal resolution was investigated using the Gaps in Noise (GIN) test. Understanding sentences in noise was investigated using a Dutch sentences (LIST) test. Results: Results demonstrated that older adults have significantly worse temporal resolution scores and significantly greater difficulty understanding sentences in noise than younger adults. In the group of older adults, the ability to understand sentences in noise correlated with hearing and age. A stepwise regression analysis showed that age was the best predictor for the speech in noise results. However, temporal resolution correlated with hearing, not with age. Results from the GIN test did not correlate with the results from the LIST test. Conclusions: The present study shows that with advancing age, both temporal resolution and speech understanding in noise significantly diminish. Temporal resolution correlates with hearing, not age, while speech understanding correlates more with age than hearing. These results could have implications for the outcome of auditory prostheses in older adults, as both diminished temporal resolution and speech understanding have to be taken into account.
Neutrophil to lymphocyte ratio: a novel marker for predicting hospital mortality of patients with acute type A aortic dissection
Authors: Kalkan Mehmet Emin , Kalkan Ali Kemal , Gündeş Ahmet , Yanartaş Mehmed , Oztürk Semi , Gurbuz Ahmet Seyfeddin , Ozturk Derya , Iyigun Taner , Akcakoyun Mustafa , Emiroglu Mehmet Yunus , Tuncer Mehmet Altuğ , Koksal Cengiz 
Published: October 2015

Introduction: The inflammatory process has been reported to be associated with aortic dissection (AD) from the development to the prognosis. The aim of the study was to investigate a relationship between the neutrophil to lymphocyte ratio (NLR) and in-hospital outcomes in patients with acute aortic dissection (AAD) who underwent surgical repair. Methods: One hundred and eighty-four patients who were admitted with the diagnosis of type A AAD who underwent surgical repair at two large tertiary hospitals. According to their NLR, 91 patients had high NLR (>6.0) and 93 patients had low NLR (⩽6.0). Results: The frequency of major bleeding, hospital-related infection, multi-organ dysfunction and mortality in hospital were higher in the high NLR group compared to the low NLR group. NLR, WBC count and operation duration were found to be independent predictors for in-hospital mortality. Conclusions: The novel inflammatory marker NLR may be used to predict worse outcomes and hospital mortality in patients with AAD treated by surgical repair.
Medial Subluxation of the Tibia After Anterior Cruciate Ligament Rupture as Revealed by Standing Radiographs and Comparison With a Cadaveric Model
Authors: Thein Ran , Boorman-Padgett James , Khamaisy Saker , Zuiderbaan Hendrik A. , Wickiewicz Thomas L. , Imhauser Carl W. , Pearle Andrew D. 
Published: October 2015

Background: Biomechanical studies indicate that the tibia shifts medially and has a more valgus orientation in the anterior cruciate ligament (ACL)–deficient knee. However, it is not known whether these differences can be detected on standing radiographs. Purpose: To determine whether medial subluxation and more changes in coronal alignment of the tibia are detectable in both weightbearing radiographs and a cadaveric model simulating quiet standing. Study Design: Case series; Level of evidence, 4, and Descriptive laboratory study. Methods: Radiographic data were available for a cross-section of 74 patients with unilateral ACL tears. Tibial subluxation and coronal limb alignment were measured on hip-to-ankle weightbearing radiographs. Eight cadaveric knees were mounted on a 6 degree of freedom robot. Mediolateral position and varus-valgus alignment of the tibia relative to the femur were measured in response to 300-N axial compression simulating quiet standing at 5° and 15° of flexion with the ACL intact and sectioned. Results: Across all 74 patients included in the clinical study, the ACL-injured knee experienced 1.6 ± 2.3 mm (mean ± SD) of medial tibial subluxation compared with the contralateral uninjured knee ( P < .001). The 24 patients with isolated ACL rupture exhibited 2.0 ± 1.8 mm of medial subluxation ( P < .001). The mean coronal alignment of all 74 patients in the study was 0.7° ± 2.8° varus in the injured limb and 1.3° ± 2.6° varus in the uninjured contralateral limb ( P = .0187). In the cadaveric model, the tibia translated 0.4 ± 0.5 mm more medially after sectioning of the ACL at 15° of flexion ( P = .0485); however, no changes in coronal alignment were detected. Conclusion: The tibia shifts medially and is less varus in the ACL-deficient knee on standing radiographs. The medial tibial shift is reproduced in an axially loaded cadaveric model. Clinical Relevance: Medial tibiofemoral subluxation seen on frontal plane standing radiograph is an underappreciated sequela of isolated ACL rupture. The ability of ACL reconstruction to restore this aspect of ACL injury is not well understood and should be investigated further. Cadaveric models may be used to directly measure the mechanical effect of subtle changes in mediolateral position on articular contact stress as an indicator of the importance of this finding.
Vulnerability and Economic Re-orientation
Authors: Jacoby Wade , Korkut Umut 
Published: October 2015

To what extent do Euroskeptic parties in Eastern and Central Europe have viable alternatives to the European Union and the broad basket of liberal policies promoted by the EU? In recent years, Hungarian Prime Minister Viktor Orbán has used his overwhelming parliamentary majorities to chart a partially new course, and this article inventories one aspect of this new course. The article asks whether Hungary can gain any potential benefits from closer links to China as a partial replacement for resources that might not be available (or that might be lost) from its more conventional European partners to the west. Orbán has often justified both radical constitutional change and economic nationalism as powerful medicines to push back against Hungary’s vulnerability at the hands of its foreign and domestic enemies. In this context, China emerged as both a potential source of new revenue and rhetorical trope that seemed to fit in a broader Fidesz discourse of an “Eastern opening.” This article makes a first attempt to separate rhetoric and reality. It first explores how the ongoing consolidation of illiberalism in Hungary has now also sparked a geopolitical repositioning through the “Eastern opening” during Fidesz’s second term. Second, it seeks to understand the theoretical proposition that new sources of external funding—including FDI and government bond purchases—can help enable a state to execute such a broad geopolitical shift. To do so, it develops empirical material from the fascinating Hungarian efforts to position themselves as a major beneficiary of Chinese engagement with Europe. The article concludes that Orbán’s policies have indeed been broadly consistent with his party’s new rhetoric, but it also concludes that the amount of Chinese investment is, in aggregate, still modest to date.
Maternal and Infant Secretory Immunoglobulin A across the Peripartum Period
Authors: Hibel Leah C. , Schiltz Hillary 
Published: October 2015

Background: Salivary secretory immunoglobulin A (sIgA) concentrations change over early infancy. The primary immunoglobulin in breast milk is sIgA, however, no study has examined the role of maternal sIgA in relation to infant salivary sIgA. Objectives: This study aimed to examine within-source associations and mean level changes of maternal and infant sIgA across the first 6 months of life, to examine the interrelations between maternal and infant sIgA across the first 6 months of life, and to determine the association between breastfeeding and infant sIgA. Methods: Participants were a convenience sample of 51 mother–infant dyads. Salivary sIgA was collected from the mother in the third trimester. Infant and maternal salivary and maternal breast milk sIgA was collected at approximately 1, 3, and 6 months postpartum. Results: Maternal salivary sIgA showed no mean level change across the visits, and levels were moderately associated over time. Breast milk sIgA was moderately associated over time; infant salivary sIgA was weakly associated over time. Both breast milk and infant sIgA levels decreased from 1 to 3 months postpartum. Maternal salivary sIgA was not related to infant or breast milk sIgA. Breastfed infants had lower levels of salivary sIgA. Likewise, higher concentrations of breast milk sIgA were related to lower concentrations of infant sIgA. Conclusion: Maternal salivary sIgA is highly stable over the peripartum period, whereas breast milk and infant salivary sIgA was variable. Infant secretory IgA development does not depend positively on maternal salivary or breast milk sIgA.
Patterns and Predictors of Use of Anticoagulants for the Treatment of Venous Thromboembolism Following Approval of Rivaroxaban
Authors: Dault Roxanne , Vanasse Alain , Blais Lucie , Perreault Sylvie , Farand Paul , Le Templier Geneviève , Beauchesne Marie-France 
Published: October 2015

Background: Few studies have identified patterns and predictors of use of direct oral anticoagulants for venous thromboembolism (VTE). Objective: To describe the use of anticoagulants and assess predictors associated with the prescription of rivaroxaban over vitamin K antagonist (VKA) for the subsequent treatment of VTE. Methods: This cross-sectional study was built with all consecutive patients newly diagnosed with acute VTE admitted between February 18, 2013, and September 18, 2013, in an academic tertiary care center in Quebec, Canada. Patient characteristics and VTE treatments were described. Univariate analyses and a multiple forward stepwise logistic regression were performed to assess predictors of rivaroxaban use over VKA for the subsequent treatment of VTE. Results: The study included 256 patients, 36.7% with a diagnosis of deep vein thrombosis (DVT) and 63.3% with pulmonary embolism (PE). Mean age was 63.1 years, and 28.1% of patients had cancer-associated VTE. Overall, rivaroxaban was prescribed in 1.6% of patients for the initial treatment and in nearly 20% of patients for the subsequent treatment of VTE. Low-molecular-weight heparin and VKA were mostly prescribed. Independent predictors associated with the prescription of rivaroxaban over VKA were as follows: age < 65 years (OR: 2.86, 95% CI 1.29-6.37), a diagnosis of DVT versus PE (OR 2.54, 95% CI 1.20-5.40), and an emergency department visit rather than a hospitalization (OR 2.24, 95% CI 1.06-4.71). Conclusion: Several months following its availability, rivaroxaban was rarely prescribed for acute VTE disease. It also appears to be prescribed in different patient populations than VKA.
Smartphone hearing screening in mHealth assisted community-based primary care
Authors: Yousuf Hussein Shouneez , Wet Swanepoel De , Biagio de Jager Leigh , Myburgh Hermanus C , Eikelboom Robert H , Hugo Jannie 
Published: October 2015

Introduction Access to ear and hearing health is a challenge in developing countries, where the burden of disabling hearing loss is greatest. This study investigated community-based identification of hearing loss using smartphone hearing screening (hearScreen™) operated by community health workers (CHWs) in terms of clinical efficacy and the reported experiences of CHWs. Method The study comprised two phases. During phase one, 24 CHWs performed community-based hearing screening as part of their regular home visits over 12 weeks in an underserved community, using automated test protocols employed by the hearScreen™ smartphone application, operating on low-cost smartphones with calibrated headphones. During phase two, CHWs completed a questionnaire regarding their perceptions and experiences of the community-based screening programme. Results Data analysis was conducted on the results of 108 children (2–15 years) and 598 adults (16–85 years). Referral rates for children and adults were 12% and 6.5% respectively. Noise exceeding permissible levels had a significant effect on screen results at 25 dB at 1 kHz ( p<0.05). Age significantly affected adult referral rates ( p < 0.05), demonstrating a lower rate (4.3%) in younger as opposed to older adults (13.2%). CHWs were positive regarding the hearScreen™ solution in terms of usability, need for services, value to community members and time efficiency. Conclusion Smartphone-based hearing screening allows CHWs to bring hearing health care to underserved communities at a primary care level. Active noise monitoring and data management features allow for quality control and remote monitoring for surveillance and follow-up.