bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness of Computed Tomographic Angiography Before Reoperative Coronary Artery Bypass Grafting
Authors: Gada Hemal , Desai Milind Y. , Marwick Thomas H. 
Published: August 2012

Background—
The risks of repeat thoracotomy can be reduced if thoracic multidetector computed tomographic angiography (CTA) is used to guide preventive surgical strategies (PSS: peripheral cardiopulmonary bypass, circulatory arrest, and nonmedian sternotomy). We sought to define the cost-effectiveness of CTA using a Markov model.

Methods and Results—
We studied outcomes and costs of CTA and non-CTA strategies in a modeled cohort of 10 000 patients undergoing redo coronary artery bypass grafting. Rates of PSS implementation were anticipated to follow identification of risk by CTA. Transitions, costs, and utilities were informed by our experience and the literature. Sensitivity analyses included testing a range of costs of CTA and PSS on model outcome. In the reference case, cost and quality-adjusted life years accrued with the use of CTA ($74 869, 4.63 quality-adjusted life-years) were slightly higher than nonuse ($73 471, 4.59 quality-adjusted life-years), yielding an incremental cost-effectiveness ratio of $34 950/quality-adjusted life-years. Cost of PSS (equipment and operating time) was the most significant determinant of incremental cost-effectiveness ratio. In the reference case (cost of CTA ≈$300), identification and avoidance of potential procedural difficulties with CTA rendered it cost-effective if the cost of PSS was <$12 000. Across a range of CTA costs, incremental cost-effectiveness ratio was not materially influenced by outcomes across a broad range of imputed values.

Conclusions—
The cost of CTA appears justified in the setting of isolated reoperative coronary artery bypass grafting, because it aids in appropriate selection of PSS. The cost-effectiveness of this imaging seems more influenced by the costs of subsequent PSS than by the cost of CTA.
Predictors of Early and Late Enrollment in Cardiac Rehabilitation, Among Those Referred, After Acute Myocardial Infarction
Authors: Parashar Susmita , Spertus John A. , Tang Fengming , Bishop Kathy L. , Vaccarino Viola , Jackson Charles F. , Boyden Thomas F. , Sperling Laurence 
Published: August 2012

Background—
Cardiac rehabilitation (CR) after acute myocardial infarction (AMI) is a Class I recommendation. Although referral to CR after an AMI has recently become a performance measure, many patients may not participate. To illuminate potential barriers to participation, we examined the prevalence of, and patient-related factors associated with, CR participation within 1 and 6 months after an AMI.

Methods and Results—
We studied 2096 AMI patients enrolled from 19 US sites in the Prospective Registry Evaluating outcomes after Myocardial Infarction: Events and Recovery (PREMIER) registry. Analyses were limited to those patients referred for CR at the time of AMI hospitalization. A multivariable, conditional logistic regression model, stratified by hospital, was used to identify sociodemographic, comorbidity, and clinical factors independently associated with CR participation within 1 and 6 months of AMI hospital discharge. Only 29% (419/1450) and 48.25% (650/1347) of AMI patients who received referral for CR participated within 1 and 6 months after discharge, respectively. Women (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.44–0.86), uninsured (OR, 0.39; 95% CI, 0.21–0.71), and patients with hypertension (OR, 0.58; 95% CI, 0.43–0.78) and peripheral arterial disease (OR, 0.43; 95% CI, 0.22–0.85) were less likely to participate at 1 month. At 6 months after AMI, older patients (OR, 0.85 for each 10-year increment; 95% CI, 0.74–0.97), smokers (OR, 0.59; 95% CI, 0.44–0.80), and patients with economic burden (OR, 0.56; 95% CI, 0.38–0.81) were less likely to participate. Caucasians (OR, 1.73; 95% CI, 1.16–2.58) and educated patients (OR, 1.81; 95% CI, 1.42–2.30) were more likely to participate at 6 months. Patients with previous percutaneous interventions were less likely to participate at both 1 and 6 months post-AMI.

Conclusions—
Among patients referred for CR post-AMI, participation remains low both at 1 and 6 months after AMI. Because CR is associated with beneficial changes in cardiovascular risk factors and better outcomes after AMI, more aggressive efforts are needed to increase CR participation after referral.
Therapeutic Impact of Follistatin-Like 1 on Myocardial Ischemic Injury in Preclinical Models
Authors: Ogura Yasuhiro , Ouchi Noriyuki , Ohashi Koji , Shibata Rei , Kataoka Yoshiyuki , Kambara Takahiro , Kito Tetsutaro , Maruyama Sonomi , Yuasa Daisuke , Matsuo Kazuhiro , Enomoto Takashi , Uemura Yusuke , Miyabe Megumi , Ishii Masakazu , Yamamoto Takashi , Shimizu Yuuki , Walsh Kenneth , Murohara Toyoaki 
Published: August 2012

Background—
Acute coronary syndrome is a leading cause of death in developed countries. Follistatin-like 1 (FSTL1) is a myocyte-derived secreted protein that is upregulated in the heart in response to ischemic insult. Here, we investigated the therapeutic impact of FSTL1 on acute cardiac injury in small and large preclinical animal models of ischemia/reperfusion and dissected its molecular mechanism.

Methods and Results—
Administration of human FSTL1 protein significantly attenuated myocardial infarct size in a mouse or pig model of ischemia/reperfusion, which was associated with a reduction of apoptosis and inflammatory responses in the ischemic heart. Administration of FSTL1 enhanced the phosphorylation of AMP-activated protein kinase in the ischemia/reperfusion–injured heart. In cultured cardiac myocytes, FSTL1 suppressed apoptosis in response to hypoxia/reoxygenation and lipopolysaccharide-stimulated expression of proinflammatory genes through its ability to activate AMP-activated protein kinase. Ischemia/reperfusion led to enhancement of bone morphogenetic protein-4 expression and Smad1/5/8 phosphorylation in the heart, and FSTL1 suppressed the increased phosphorylation of Smad1/5/8 in ischemic myocardium. Treating cardiac myocytes with FSTL1 abolished the bone morphogenetic protein-4–stimulated increase in apoptosis, Smad1/5/8 phosphorylation, and proinflammatory gene expression. In cultured macrophages, FSTL1 diminished lipopolysaccharide-stimulated expression of proinflammatory genes via activation of AMP-activated protein kinase and abolished bone morphogenetic protein-4–dependent induction of proinflammatory mediators.

Conclusions—
Our data indicate that FSTL1 can prevent myocardial ischemia/reperfusion injury by inhibiting apoptosis and inflammatory response through modulation of AMP-activated protein kinase– and bone morphogenetic protein-4–dependent mechanisms, suggesting that FSTL1 could represent a novel therapeutic target for post-myocardial infarction, acute coronary syndrome.
Microglia/Macrophage Polarization Dynamics Reveal Novel Mechanism of Injury Expansion After Focal Cerebral Ischemia
Authors: Hu Xiaoming , Li Peiying , Guo Yanling , Wang Haiying , Leak Rehana K. , Chen Songela , Gao Yanqin , Chen Jun 
Published: August 2012

Background and Purpose—
Mononuclear phagocytes are highly plastic cells that assume diverse phenotypes in response to microenvironmental signals. The phenotype-specific roles of microglia/macrophages in ischemic brain injury are poorly understood. A comprehensive characterization of microglia/macrophage polarization after ischemia may advance our knowledge of poststroke damage/recovery.

Methods—
Focal transient cerebral ischemia was induced in mice for 60 minutes; animals were euthanized at 1 to 14 days of reperfusion. Reverse-transcriptase polymerase chain reaction and immunohistochemical staining for M1 and M2 markers were performed to characterize phenotypic changes in brain cells, including microglia and infiltrating macrophages. In vitro experiments using a transwell system, a conditioned medium transfer system, or a coculture system allowing cell-to-cell contacts were used to further elucidate the effect of neuronal ischemia on microglia/macrophage polarization and, conversely, the effect of microglia/macrophage phenotype on the fate of ischemic neurons.

Results—
Local microglia and newly recruited macrophages assume the M2 phenotype at early stages of ischemic stroke but gradually transformed into the M1 phenotype in peri-infarct regions. In vitro experiments revealed that ischemic neurons prime microglial polarization toward M1 phenotype. M1-polarized microglia or M1-conditioned media exacerbated oxygen glucose deprivation–induced neuronal death. In contrast, maintaining the M2 phenotype of microglia protected neurons against oxygen glucose deprivation.

Conclusions—
Our results suggest that microglia/macrophages respond dynamically to ischemic injury, experiencing an early “healthy” M2 phenotype, followed by a transition to a “sick” M1 phenotype. These dual and opposing roles of microglia/macrophages suggest that stroke therapies should be shifted from simply suppressing microglia/macrophage toward adjusting the balance between beneficial and detrimental microglia/macrophage responses.
Quantification of Cerebral Volumes on MRI 6 Months After Aneurysmal Subarachnoid Hemorrhage
Authors: de Bresser Jeroen , Vincken Koen L. , Kaspers Anne J. , Rinkel Gabriel J.E. , Viergever Max A. , Biessels Geert Jan 
Published: August 2012

Background and Purpose—
MRI can be used to assess structural damage to the brain after aneurysmal subarachnoid hemorrhage. We tuned, validated, and applied k-Nearest Neighbor-based segmentation to quantify cerebral volumes on MRI 6 months after aneurysmal subarachnoid hemorrhage.

Methods—
After tuning, the accuracy of k-Nearest Neighbor-based segmentation was assessed with manual segmentations. Next, supratentorial cerebral parenchymal, peripheral cerebrospinal fluid, and lateral ventricular volumes of 55 patients were compared with those of 25 age- and sex-matched control subjects and related to clinical outcome (modified Rankin Scale).

Results—
k-Nearest Neighbor-based segmentation showed good agreement with manual segmentations. Compared with control subjects, patients had a larger lateral ventricular volume (difference: log-transformed values 0.54; 95% CI,0.33–0.75), smaller peripheral cerebrospinal fluid volume (−26 mL; 95% CI, −40 to −11), and similar cerebral parenchymal volume (2 mL; 95% CI, −10 to 15). In patients, parenchymal (median split; OR, 38.8; 95% CI, 4.6–329.0) and ventricular volumes (7.4; 95% CI, 1.6–33.5) correlated with functional outcome.

Conclusions—
k-Nearest Neighbor-based segmentation provides accurate cerebral volume measurements after aneurysmal subarachnoid hemorrhage. In this proof-of-principle study of this volumetric technique, we demonstrated volume changes relative to controls, which correlated with functional outcome.
Variability in Carotid Endarterectomy Practice Patterns Within a Metropolitan Area
Authors: Kansara Amit , Miller Daniel , Damani Rahul , Fuerst Darren , Silver Brian , Chaturvedi Seemant 
Published: August 2012

Background and Purpose—
Previous clinical studies have suggested that patients with carotid stenosis with high surgical risk features may fare better with carotid artery stenting or aggressive medical therapy. The extent to which carotid endarterectomy is still being performed in this group of patients is unclear.

Methods—
A retrospective audit was performed among 4 hospitals over a 2-year period. The proportion of high surgical risk patients was compared and the in-hospital stroke, myocardial infarction, and death rates were compared among conventional and high surgical risk patients.

Results—

Three hundred thirty-five carotid endarterectomy operations were performed (63% asymptomatic) with 37.9% being high surgical risk subjects. The stroke, myocardial infarction, and death rate was 4.6% in conventional risk subjects and 10.2% in high surgical risk patients (
P
<0.05). The only hospital with multidisciplinary carotid conferences had the lowest proportion of carotid endarterectomy operations in asymptomatic patients.

Conclusions—
A substantial proportion of carotid endarterectomy operations are performed in patients with high surgical risk features. These patients experienced a 2-fold increase in major in-hospital complications, raising doubts about whether they benefit from carotid surgery. The use of preintervention multidisciplinary conferences may improve patient safety.
Identification, Emotional Reactions, and Perceived Threat to Persons With Alzheimer’s Disease
Authors: Kalaitzaki Argyroula E. , Kateri Evangellia , Pattakou-Parasyri Vassiliki 
Published: August 2012

Background/rationale: The identification of Alzheimer’s Disease (AD), the emotional reactions, and the perceived threat to AD were compared across 3 Greek samples: 147 primary care health professionals (PCHPs), 74 health and social service graduate students, and 99 laypersons. Within the group of PCHPs, physicians, nurses, and social workers were compared. The factors associated with emotional reactions were examined. Finally, the Emotional Reactions Scale’s (ERS) latent structure was validated. Methods: The participants were asked to identify the disease of a vignette, respond to the ERS and in 3 indices of perceived threat. Results: The PCHPs identified AD equally accurate to laypersons. Students and laypersons reported the most intense emotions. Social workers perceived higher consequences than physicians and nurses. Age, personal experience, education, and perceived concern predicted emotional reactions. Conclusions: Findings underscore the importance of implementing education and training actions to increase AD identification, reduce negative emotions, and further advance care for patients.
Comparison of the resonance behaviour of ottertail and voyageur style canoe paddles during the J-stroke
Authors: Runciman R John , Lyle Kara 
Published: August 2012

The canoe paddle has immense cultural and historical significance. Recognized throughout the world, the paddle has remained largely unchanged since its inception thousands of years ago. A major characteristic of performance in a recreational canoe paddle, and one that distinguishes a good paddle from a bad one, involves its tendency to resonate during use. With paddle resonance comes increased fluid resistance and a less efficient stroke. This study compared resonance tendencies of two major types of recreational canoe paddles, the ottertail and voyageur styles, in stiff and flexible formats. Data was acquired during open water canoe use and canoe velocities up to 2.0 m/s During testing two 3-axis accelerometers were mounted on the shaft of the subject paddle. These accelerometers were then connected to onboard data collection instrumentation to record paddle resonance behaviour. Concurrent GPS-based canoe velocities were also recorded. The conventional J-stroke was used for all testing, and the canoe was repeatedly paddled between known points spaced approximately 100 m apart. Fluid driven resonance was observed at two specific phases of the J-stroke, the beginning of the control phase and the beginning of the recovery phase. The magnitude and characteristics of paddle resonance varied with the specific phase of the stroke, canoe paddle stiffness, style and velocity. The combination of these factors that resulted in the lowest paddle resonance of the combinations studied was a flexible ottertail style paddle, being paddled in the range of 1–1.8 m/s.
Dysfunctional Vγ9Vδ2 T cells are negative prognosticators and markers of dysregulated mevalonate pathway activity in chronic lymphocytic leukemia cells
Authors: Coscia Marta , Vitale Candida , Peola Silvia , Foglietta Myriam , Rigoni Micol , Griggio Valentina , Castella Barbara , Angelini Daniela , Chiaretti Sabina , Riganti Chiara , Guarini Anna , Drandi Daniela , Ladetto Marco , Bosia Amalia , Foà Robin , Battistini Luca , Boccadoro Mario , Fournié Jean-Jacques , Massaia Massimo 
Published: August 2012

Abstract
The role of Vγ9Vδ2 T cells in chronic lymphocytic leukemia (CLL) is unexplored, although these cells have a natural inclination to react against B-cell malignancies. Proliferation induced by zoledronic acid was used as a surrogate of γδ TCR-dependent stimulation to functionally interrogate Vγ9Vδ2 T cells in 106 untreated CLL patients. This assay permitted the identification of responder and low-responder (LR) patients. The LR status was associated with greater baseline counts of Vγ9Vδ2 T cells and to the expansion of the effector memory and terminally differentiated effector memory subsets. The tumor immunoglobulin heavy chain variable region was more frequently unmutated in CLL cells of LR patients, and the mevalonate pathway, which generates Vγ9Vδ2 TCR ligands, was more active in unmutated CLL cells. In addition, greater numbers of circulating regulatory T cells were detected in LR patients. In multivariate analysis, the LR condition was an independent predictor of shorter time-to-first treatment. Accordingly, the time-to-first treatment was significantly shorter in patients with greater baseline numbers of total Vγ9Vδ2 T cells and effector memory and terminally differentiated effector memory subpopulations. These results unveil a clinically relevant in vivo relationship between the mevalonate pathway activity of CLL cells and dys-functional Vγ9Vδ2 T cells.
Elevated serum soluble CD40 ligand in cancer patients may play an immunosuppressive role
Authors: Huang Jianping , Jochems Caroline , Talaie Tara , Anderson Austin , Jales Alessandra , Tsang Kwong Y. , Madan Ravi A. , Gulley James L. , Schlom Jeffrey 
Published: August 2012

Abstract
Tumor cells can induce certain cytokines and soluble receptors that have a suppressive effect on the immune system. In this study, we showed that an extracellular portion of a membrane-bound ligand of CD40 (soluble CD40 ligand; sCD40L) was significantly elevated in the serum of cancer patients compared with healthy donors. In addition, PBMCs from cancer patients had a relatively larger population of myeloid-derived suppressor cells (MDSCs), defined as CD33+HLA-DR− cells, and these cells expressed higher levels of CD40. T-cell proliferation and IFN-γ production decreased when stimulated T cells were cocultured with an increased amount of autologous MDSCs. The addition of recombinant monomeric sCD40L enriched MDSCs and had an additive inhibitory effect on T-cell proliferation. PBMCs cultured in vitro with sCD40L also showed an expansion of regulatory T cells (CD4+CD25highFoxp3+), as well as induction of cytokines, such as IL-10 and IL-6. Moreover, sCD40L-induced enrichment of programmed death-1–expressing T cells was greater in cancer patients than in healthy donors. Preexisting sCD40L also inhibited IL-12 production from monocytes on activation. These data suggest that the higher levels of sCD40L seen in cancer patients may have an immunosuppressive effect. These studies were registered at www.clinicaltrials.gov as NCT00060528, NCT00019695, NCT00179309, NCT00514072, NCT00081848, and NCT00436956.
Roles of microRNAs in atherosclerosis and restenosis
Authors: Chen Li-Jing , Lim Seh Hong , Yeh Yi-Ting , Lien Sheng-Chieh , Chiu Jeng-Jiann 
Published: August 2012

Abstract
Atherosclerosis is commonly appreciated to represent a chronic inflammatory response of the vascular wall, and its complications cause high mortality in patients. Angioplasty with stent replacement is commonly performed in patients with atherosclerotic disease. However, the restenosis usually has a high incidence rate in angioplasty patients. Although the pathophysiological mechanisms underlying atherosclerosis and restenosis have been well established, new signaling molecules that control the progress of these pathologies have continuously been discovered. MicroRNAs (miRs) have recently emerged as a novel class of gene regulators that work via transcriptional degradation and translational inhibition or activation. Over 30% of genes in the cell can be directly regulated by miRs. Thus, miRs are recognized as crucial regulators in normal development, physiology and pathogenesis. AIterations of miR expression profiles have been revealed in diverse vascular diseases. A variety of functions of vascular cells, such as cell differentiation, contraction, migration, proliferation and inflammation that are involved in angiogenesis, neointimal formation and lipid metabolism underlying various vascular diseases, have been found to be regulated by miRs. This review summarizes current research progress and knowledge on the roles of miRs in regulating vascular cell function in atherosclerosis and restenosis. These discoveries are expected to present opportunities for clinical diagnostic and therapeutic approaches in vascular diseases resulting from atherosclerosis and restenosis.
Daidzein induces neuritogenesis in DRG neuronal cultures
Authors: Yang Shih-Hung , Liao Chih-Chen , Chen Ying , Syu Jhih-Pu , Jeng Chung-Jiuan , Wang Seu-Mei 
Published: August 2012

Absract

Background
Daidzein, a phytoestrogen found in isoflavone, is known to exert neurotrophic and neuroprotective effects on the nervous system. Using primary rat dorsal root ganglion (DRG) neuronal cultures, we have examined the potential neurite outgrowth effect of daidzein.

Methods
Dissociated dorsal root ganglia (DRG) cultures were used to study the signaling mechanism of daidzein-induced neuritogenesis by immunocytochemistry and Western blotting.

Results
In response to daidzein treatment, DRG neurons showed a significant increase in total neurite length and in tip number per neuron. The neuritogenic effect of daidzein was significantly hampered by specific blockers for Src, protein kinase C delta (PKCδ) and mitogen-activated protein kinase/extracellular signal-regulated kinase kinases (MEK/ERK), but not by those for estrogen receptor (ER). Moreover, daidzein induced phosphorylation of Src, PKCδ and ERK. The activation of PKCδ by daidzein was attenuated in the presence of a Src kinase inhibitor, and that of ERK by daidzein was diminished in the presence of either a Src or PKCδ inhibitor.

Conclusion
Daidzein may stimulate neurite outgrowth of DRG neurons depending on Src kinase, PKCδ and ERK signaling pathway.