bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival After Implantable Cardioverter-Defibrillator Implantation in the Elderly
Authors: Yung Derek , Birnie David , Dorian Paul , Healey Jeffrey S. , Simpson Christopher S. , Crystal Eugene , Krahn Andrew D. , Khaykin Yaariv , Cameron Douglas , Chen Zhongliang , Lee Douglas S. 
Published: June 2013

Background—
The benefit of implantable cardioverter-defibrillators (ICDs) among elderly patients is controversial and may be attenuated by nonarrhythmic death. We examined the impact of age on device-delivered therapies and outcomes after primary or secondary prevention ICD.

Methods and Results—

In a prospective, inclusive registry of 5399 ICD recipients in Ontario, Canada (February 2007 to September 2010), device-delivered therapies and complications were determined at routine clinic visits. Among primary prevention ICD recipients aged 18 to 49 (n=317), 50 to 59 (n=769), 60 to 69 (n=1336), 70 to 79 (n=1242), and ≥80 (n=275) years, mortality increased with age, as follows: 2.1, 3.0, 5.4, 6.9, and 10.2 deaths per 100 person-years, respectively (
P
<0.001). Secondary prevention ICD recipients aged 18 to 49 (n=114), 50 to 59 (n=244), 60 to 69 (n=481), 70 to 79 (n=462), and ≥80 (n=159) years also exhibited increasing mortality, as follows: 2.2, 3.8, 6.1, 8.7, and 15.5 deaths per 100 person-years, respectively (
P
<0.001). However, rates of appropriate shock were similar across age groups: from 6.7 (18–49 years) to 4.2 (≥80 years) per 100 person-years after primary prevention ICDs (
P
=0.139) and from 11.4 (18–49 years) to 11.9 (≥80 years) per 100 person-years after secondary prevention ICDs (
P
=0.993). Covariate-adjusted competing risk analysis demonstrated higher risk of death (
P
trend
<0.001 for both primary and secondary prevention) but no significant decline in appropriate shocks with older age after primary (
P
=0.130) or secondary (
P
=0.810) prevention ICD implantation.

Conclusions—
Whereas elderly patients exhibited increased mortality after ICD implantation, rates of appropriate device shocks were similar across age groups. Decisions regarding ICD candidacy should not be based on age alone but should consider factors that predispose to mortality despite defibrillator implantation.
Riociguat for Patients With Pulmonary Hypertension Caused by Systolic Left Ventricular Dysfunction
Authors: Bonderman Diana , Ghio Stefano , Felix Stephan B. , Ghofrani Hossein-Ardeschir , Michelakis Evangelos , Mitrovic Veselin , Oudiz Ronald J. , Boateng Francis , Scalise Andrea-Viviana , Roessig Lothar , Semigran Marc J. 
Published: June 2013

Background—
Pulmonary hypertension caused by systolic left ventricular dysfunction is associated with significant morbidity and mortality; however, no treatment is approved for this indication. We hypothesized that riociguat, a novel soluble guanylate cyclase stimulator, would have beneficial hemodynamic effects in patients with pulmonary hypertension caused by systolic left ventricular dysfunction.

Methods and Results—

Overall, 201 patients with heart failure resulting from pulmonary hypertension caused by systolic left ventricular dysfunction were randomized to double-blind treatment with oral placebo or riociguat (0.5, 1, or 2 mg 3 times daily) for 16 weeks in 4 parallel arms. The primary outcome was the placebo-corrected change from baseline at week 16 in mean pulmonary artery pressure. Although the decrease in mean pulmonary artery pressure in the riociguat 2 mg group (−6.1±1.3 mm Hg;
P
<0.0001 versus baseline) was not significantly different from placebo (
P
=0.10), cardiac index (0.4 L·min
−1
·m
−2
; 95% confidence interval, 0.2–0.5;
P
=0.0001) and stroke volume index (5.2 mL·m
−2
; 95% confidence interval, 2.0–8.4;
P
=0.0018) were significantly increased without changes in heart rate or systemic blood pressure compared with placebo. Both pulmonary (−46.6 dynes·s
−1
·cm
−5
; 95% confidence interval, –89.4 to –3.8;
P
=0.03) and systemic vascular resistance (−239.3 dynes·s
−1
·cm
−5
; 95% confidence interval, –363.4 to –115.3;
P
=0.0002) were significantly reduced with riociguat 2 mg. Riociguat reduced the Minnesota Living With Heart Failure score (
P
=0.0002). Discontinuation of treatment was similar between treatment groups.

Conclusions—
Although the primary end point of the study was not met, riociguat was well tolerated in patients with pulmonary hypertension caused by systolic left ventricular dysfunction and improved cardiac index and pulmonary and systemic vascular resistance.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01065454.
Dynamic Analysis of Naive Adaptive Brain-Machine Interfaces
Authors: Kowalski Kevin C. , He Bryan D. , Srinivasan Lakshminarayan 
Published: June 2013

The closed-loop operation of brain-machine interfaces (BMI) provides a context to discover foundational principles behind human-computer interaction, with emerging clinical applications to stroke, neuromuscular diseases, and trauma. In the canonical BMI, a user controls a prosthetic limb through neural signals that are recorded by electrodes and processed by a decoder into limb movements. In laboratory demonstrations with able-bodied test subjects, parameters of the decoder are commonly tuned using training data that include neural signals and corresponding overt arm movements. In the application of BMI to paralysis or amputation, arm movements are not feasible, and imagined movements create weaker, partially unrelated patterns of neural activity. BMI training must begin naive, without access to these prototypical methods for parameter initialization used in most laboratory BMI demonstrations. Naive adaptive BMI refer to a class of methods recently introduced to address this problem. We first identify the basic elements of existing approaches based on adaptive filtering and define a decoder, ReFIT-PPF to represent these existing approaches. We then present Joint RSE, a novel approach that logically extends prior approaches. Using recently developed human- and synthetic-subjects closed-loop BMI simulation platforms, we show that Joint RSE significantly outperforms ReFIT-PPF and nonadaptive (static) decoders. Control experiments demonstrate the critical role of jointly estimating neural parameters and user intent. In addition, we show that nonzero sensorimotor delay in the user significantly degrades ReFIT-PPF but not Joint RSE, owing to differences in the prior on intended velocity. Paradoxically, substantial differences in the nature of sensory feedback between these methods do not contribute to differences in performance between Joint RSE and ReFIT-PPF. Instead, BMI performance improvement is driven by machine learning, which outpaces rates of human learning in the human-subjects simulation platform. In this regime, nuances of error-related feedback to the human user are less relevant to rapid BMI mastery.
Dependence of Precipitation Scaling Patterns on Emission Scenarios for Representative Concentration Pathways
Authors: Ishizaki Yasuhiro , Shiogama Hideo , Emori Seita , Yokohata Tokuta , Nozawa Toru , Takahashi Kiyoshi , Ogura Tomoo , Yoshimori Masakazu , Nagashima Tatsuya 
Published: June 2013

AbstractPattern scaling is an efficient way to generate projections of regional climate change for various emission scenarios. This approach assumes that the spatial pattern of changes per degree of global warming (scaling pattern) is the same among emission scenarios. The hypothesis was tested for the scaling pattern of precipitation by focusing on the scenario dependence of aerosol scaling patterns. The scenario dependence of aerosol scaling patterns induced the scenario dependence of the surface shortwave radiation scaling pattern. The scenario dependence of the surface shortwave radiation scaling pattern over the ocean tended to induce the scenario dependence of evaporation scaling patterns. The scenario dependence of evaporation scaling patterns led to the scenario dependence of precipitation scaling patterns locally and downwind. Contrariwise, when the scenario dependence of aerosol scaling patterns occurred over land, the scenario dependence of surface shortwave radiation scaling patterns induced the scenario dependence of the scaling patterns of evaporation, surface longwave radiation, and sensible heat. Consequently, the scenario dependence of evaporation scaling patterns was smaller over land, and the scenario dependence of precipitation scaling patterns tended to be insignificant. Moreover, the scenario dependence of the southern annular mode and polar amplification caused some of the scenario dependence of precipitation scaling patterns. In this study, only one global climate mode was analyzed. In addition, sensitivity experiments that remove aerosol emissions from some regions or some kinds of aerosols are ideal to separate the impacts of aerosols. Thus, an analysis of the dependencies of precipitation scaling pattern among global climate models and the sensitivity experiments are required in future work.
Principal Components of Multifrequency Microwave Land Surface Emissivities. Part I: Estimation under Clear and Precipitating Conditions
Authors: Turk F. Joseph , Haddad Ziad S. , You Yalei 
Published: June 2013

Abstract
The upcoming Global Precipitation Measurement mission will provide considerably more overland observations over complex terrain, high-elevation river basins, and cold surfaces, necessitating an improved assessment of the microwave land surface emissivity. Current passive microwave overland rainfall algorithms developed for the Tropical Rainfall Measuring Mission (TRMM) rely upon hydrometeor scattering-induced signatures at high-frequency (85 GHz) brightness temperatures (TBs) and are empirical in nature. A multiyear global database of microwave surface emissivities encompassing a wide range of surface conditions was retrieved from Advanced Microwave Scanning Radiometer for Earth Observing System (EOS; AMSR-E) radiometric clear scenes using companion A-Train [CloudSat, Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO), and Atmospheric Infrared Sounder (AIRS)] data. To account for the correlated emissivity structure, the procedure first derives the TRMM Microwave Imager–like nine-channel emissivity principal component (PC) structure. Relations are derived to estimate the emissivity PCs directly from the instantaneous TBs, which allows subsequent TB observations to estimate the PC structure and reconstruct the emissivity vector without need for ancillary data regarding the surface or atmospheric conditions. Radiative transfer simulations matched the AMSR-E TBs within 5–7-K RMS difference in the absence of precipitation. Since the relations are derived specifically for clear-scene conditions, discriminant analysis was performed to find the PC discriminant that best separates clear and precipitation scenes. When this technique is applied independently to two years of TRMM data, the PC-based discriminant demonstrated superior relative operating characteristics relative to the established 85-GHz scattering index, most notably during cold seasons.
A Handheld Sampler for Collecting Organic Samples from Shallow Hydrothermal Vents
Authors: Wu Shi-Jun , Yang Can-Jun , Arthur Chen Chen-Tung 
Published: June 2013

Abstract
This study describes a new handheld sampler, specially designed to be deployed by scuba divers, to collect fluid samples from shallow hydrothermal vents. The new sampler utilizes a syringe-like titanium sampling bottle with a regulated filling rate to collect samples. The filling rate regulation mechanism of the new sampler was studied. Through theoretical analysis and simulation, it is found that the filling rate can be regulated by either an orifice or an annular gap on the sampler. Further study indicates that the orifice is superior to the annular gap, since the former has a much lower requirement of machining accuracy. Moreover, the filling rate regulated by the orifice is independent of temperature and ambient pressure. The new sampler also features a compact structure, simple operation, and gas-tight performance. Efforts were made to minimize the organic carbon blank of the sampler by careful selection of the materials that may come into contact with the fluid samples. The sampler has been tested at the shallow hydrothermal vents off northeastern Taiwan. High-purity organic samples were successfully collected.
A Comparison of the Canadian Global and Regional Meteorological Ensemble Prediction Systems for Short-Term Hydrological Forecasting
Authors: Abaza Mabrouk , Anctil François , Fortin Vincent , Turcotte Richard 
Published: June 2013

Abstract
Meteorological ensemble prediction systems (M-EPS) are generally set up at lower resolution than for their deterministic counterparts. Operational hydrologists are thus more prone to selecting deterministic meteorological forecasts for driving their hydrological models. Limited-area implementation of meteorological models may become a convenient way of providing the sought after higher-resolution meteorological ensemble forecasts. This study aims to compare the Canadian operational global EPS (M-GEPS) and the experimental regional EPS (M-REPS) for short-term operational hydrological ensemble forecasting over eight watersheds, for which performance and reliability was assessed. Higher-resolution deterministic forecasts were also available for the study. Results showed that both M-EPS provided better performance than their deterministic counterparts when comparing their mean continuous ranked probability score (MCRPS) and mean absolute error (MAE), especially beyond a 24-h horizon. The global and regional M-EPS led to very similar performance in terms of RMSE, but the latter produced a larger spread and improved reliability. The M-REPS was deemed superior to its operational global counterpart, especially for its ability to better depict forecast uncertainty.
Biological variation of thiopurine methyltransferase enzyme activity: when has a significant change taken place?
Authors: van Egmond Remco , Barclay Murray L , Chin Paul KL , Sies Christiaan W , Florkowski Christopher M 
Published: June 2013

Background Thiopurine methyltransferase (TPMT) enzyme activity is measured before initiating thiopurine therapy to reduce the risk of severe drug-associated myelotoxicity in patients with low enzyme activity. TPMT activity may vary over time in relation to drug treatment and patient clinical condition. What constitutes a significant change in TPMT activity can be derived from biological variation and analytical imprecision. Methods A large national laboratory database was used to identify patients with three or more TPMT activity measurements. Variance of TPMT activity was analysed by determining the total coefficient of variation (CVTOT) of repeated measurements and by correlation with parameters including gender and follow-up time. Between-run analytical imprecision (CVa) was determined by replicate analysis ( n = 314). Results Of 7383 patients with TPMT measurements, 136 were identified as having three or more measurements over time (range 3–14). Median CVTOT for individual patient results was 14.5% (range 2.5–36.7%). Analytical imprecision (CVa) was 10.3%. A reference change value (or critical difference) with 95% probability was calculated as 42%. Therefore, a change in measured TPMT activity above 42% should lead to considering sources of variation other than biological variation and analytical imprecision. Conclusions TPMT enzyme activity needs to change by at least 42% to determine that a true change has taken place beyond biological variation and analytical imprecision. A single measurement of TPMT activity is sufficient for most clinical purposes.
Social and functional capacity of schizophrenia patients: A cross-sectional study
Authors: Mohr Pavel , Rodriguez Mabel , Bravermanová Anna , Melicher Tomáš , Čeplová Zuzana , Čermák Jan , Pečeňák Ján 
Published: June 2013

Background: The chronic course of schizophrenia typically results in severe social, vocational and functional impairment, interferes with patients’ autonomy, reduces quality of life and increases disability. Aims: The aim of our study was: (1) to assess social and functional impairment in schizophrenia outpatients from the Czech Republic and Slovakia; and (2) to examine a relationship between functioning and antipsychotic treatment and demographic variables. Methods: Schizophrenia outpatients in a stable phase of illness, treated with current antipsychotic medication for a minimum of one month, were enrolled for the study. Demographic and medication data were recorded. The Personal and Social Performance (PSP), Subjective Well-Being under Neuroleptics (SWN) and Clinical Global Impressions (CGI) scales were administered. Results: The total number of study subjects was 926. Most PSP values were within the interval of moderate impairment. Functional performance correlated positively with subjective satisfaction with medication and negatively with symptom severity. Higher education predicted better functioning on PSP. The best performance was associated with a stable relationship and a useful work role. Patients who showed the best level of functioning were more likely to be treated with antipsychotic monotherapy. No difference among drugs in monotherapy was found in subjective satisfaction. Conclusions: The PSP values of stable schizophrenia outpatients indicated a moderate degree of impairment. Improvement of functional capacity remains one of the unmet needs of schizophrenia patients.
The Banco del Sur and the Return to Development
Authors: Rosales Antulio 
Published: June 2013

The proposal of a Banco del Sur began to be discussed in 2007 and generated important debates about the need to establish a new regional financial architecture. These discussions resulted in consensus about the importance of financing development at the regional level. An analysis of the positions and development visions of four key states—Argentina, Brazil, Venezuela, and Ecuador— in the negotiations for the establishment of the Banco del Sur and their implications for its design reveals important differences about its purpose—whether it should be the center of an institutional network aimed at the construction of a new regional financial architecture or simply a development bank. La posibilidad de un Banco del Sur se comenzó a discutir en 2007 y generó importantes debates sobre la necesidad de establecer una nueva arquitectura financiera regional. Estas discusiones dieron lugar a un consenso sobre la importancia de financiar el desarrollo a nivel regional. Un análisis de las posiciones y visiones de desarrollo de cuatro naciones clave (Argentina, Brasil, Venezuela y Ecuador) en las negociaciones para el establecimiento del Banco del Sur y sus implicaciones en dicho proyecto revelan importantes divergencias sobre su presunto propósito: ¿debe ser el centro de una red institucional destinada a la construcción de una nueva arquitectura financiera regional o simplemente un banco de desarrollo?
The New Canadian Imperialism and the Military Coup in Honduras
Authors: Shipley Tyler 
Published: June 2013

Canada’s key role in supporting the 2009 coup d’état in Honduras is emblematic of a new Canadian imperialist positioning in world affairs. A close reading of Canadian state responses to the coup and the repression that followed points to the apparent contradiction in its being an outspoken supporter of a violent and antidemocratic regime despite rhetorical commitments to peace and security. The contradiction can be explained in terms of the extent of Canadian economic investment in Honduras and an understanding of Canada as a secondary imperial power committed to imposing and maintaining conditions in Honduras that will protect that investment. The promotion of hyper-neoliberalism in Honduras, then, is representative of Canada’s larger projects for the Global South in a context in which Canadian capital is aggressively expanding its reach. Shipley (número abierto de septiembre) El rol clave de Canadá en apoyar el golpe de estado en Honduras es emblemático de un nuevo posicionamiento imperialista canadiense en los asuntos mundiales. Una lectura detallada de respuestas gubernamentales canadienses al golpe y la subsiguiente represión señala su aparente contradicción entre ser un abierto defensor de un régimen violento y antidemocrático a pesar de los compromisos retóricos con la paz y la seguridad. Se puede explicar la contradicción en términos del alcance de la inversión económica canadiense en Honduras y una percepción de Canadá como un poder imperial secundario comprometido con imponer y mantener condiciones en Honduras que protegerían esa inversión. Promover el hiper-neoliberalismo en Honduras es entonces representador de los proyectos mayores de Canadá para el Sur Global en un contexto donde el capital canadiense está ampliando su alcance de manera agresiva.
Multiple Glucagon-Producing Pancreatic Neuroendocrine Tumors in a Horse (Equus caballus)
Authors: Herbach N. , Nagel L. , Zwick T. , Hermanns W. 
Published: June 2013

Pancreatic neuroendocrine tumors of glucagon-producing cells are extremely rare in domestic animals. In this report, we describe for the first time, to our knowledge, the incidental finding of multiple glucagon-producing neuroendocrine tumors of the pancreas of a horse. The animal was euthanized due to severe local infection after tooth extraction. On postmortem examination, multiple white nodules of up to 4 cm in diameter were observed in the pancreas. Histologically, pancreatic nodules had the appearance of neuroendocrine neoplasms with positive immunoreactivity for glucagon, synaptophysin, chromogranin A, and neuron-specific enolase. Electron microscopy revealed numerous electron-dense granules, similar to those observed in normal pancreatic alpha cells, in the neoplastic cells. In addition, the left adrenal gland showed multiple hyperplastic foci and adenomas in the medulla that were identified as pheochromocytomas. Based on the morphologic appearance and immunohistochemical staining pattern of pancreatic nodules, a diagnosis of multiple glucagon-producing neuroendocrine tumors was made.
The Institutional Cost of Acquiring 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit
Authors: Jegier Briana J. , Johnson Tricia J. , Engstrom Janet L. , Patel Aloka L. , Loera Fabiola , Meier Paula 
Published: June 2013

Background: Human milk from the biologic mother (HM) reduces disease burden and associated costs of care during and after neonatal intensive care unit (NICU) hospitalization for very low birth weight (VLBW; birth weight < 1500 g) infants, when compared to feedings of donor human milk (DHM) or commercial formula (CF). However, compared to DHM and CF, little is known about the institutional cost to acquire HM from the biologic mother. Objective: This study aimed to determine the institutional cost of acquiring HM for VLBW infant feedings during the NICU hospitalization. Methods: This analysis examined 157 maternal pumping records from a prospective cohort study evaluating health outcomes and cost of HM feedings for VLBW infants. The costs for the breast pump rental fee, 1-time pump kit purchase, and disposable food-grade containers for storing expressed HM were evaluated using standard cost analysis techniques. Results: The median cost of acquiring 100 mL of HM varied from $0.51 when mothers pumped ≥ 700 mL daily to $7.93 for those who pumped < 100 mL daily. Mothers who pumped ≥ 100 mL daily had lower acquisition cost compared to both DHM ($14.84/100 mL) and CF ($3.18/100 mL). For mothers who pumped > 100 mL daily, the exact day of pumping where the cost of HM was less expensive than DHM or CF was 4 to 7 days and 6 to 19 days, respectively. Conclusion: Human milk from the biologic mother has lower acquisition cost than DHM and CF when mothers provided ≥ 100 mL daily and pumped for a sufficient number of days (range, 4-19). Neonatal intensive care units should prioritize resources to ensure that mothers achieve this daily milk volume.