bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Heart Rate Is Associated With Higher Mortality in Patients With Atrial Fibrillation (AF): Results From the Outcomes Registry for Better Informed Treatment of AF (ORBIT‐AF)
Authors: Steinberg Benjamin A. , Kim Sunghee , Thomas Laine , Fonarow Gregg C. , Gersh Bernard J. , Holmqvist Fredrik , Hylek Elaine , Kowey Peter R. , Mahaffey Kenneth W. , Naccarelli Gerald , Reiffel James A. , Chang Paul , Peterson Eric D. , Piccini Jonathan P. ,   the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT‐AF) Investigators and Patients
Published: September 2015

Background

Most patients with atrial fibrillation (
AF
) require rate control; however, the optimal target heart rate remains under debate. We aimed to assess rate control and subsequent outcomes among patients with permanent
AF
.

Methods and Results

We studied 2812
US
outpatients with permanent
AF
in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. Resting heart rate was measured longitudinally and used as a time‐dependent covariate in multivariable Cox models of all‐cause and cause‐specific mortality during a median follow‐up of 24 months. At baseline, 7.4% (n=207) had resting heart rate <60 beats per minute (bpm), 62% (n=1755) 60 to 79 bpm, 29% (n=817) 80 to 109 bpm, and 1.2% (n=33) ≥110 bpm. Groups did not differ by age, previous cerebrovascular disease, heart failure status,
CHA
2
DS
2
‐
VAS
c scores, renal function, or left ventricular function. There were significant differences in race (
P
=0.001), sinus node dysfunction (
P
=0.004), and treatment with calcium‐channel blockers (
P
=0.006) and anticoagulation (
P
=0.009). In analyses of continuous heart rates, lower heart rate ≤65 bpm was associated with higher all‐cause mortality (adjusted hazard ratio [
HR
], 1.15 per 5‐bpm decrease; 95%
CI
, 1.01 to 1.32;
P
=0.04). Similarly, increasing heart rate >65 bpm was associated with higher all‐cause mortality (adjusted
HR
, 1.10 per 5‐bpm increase; 95%
CI
, 1.05 to 1.15;
P
<0.0001). This relationship was consistent across endpoints and in a broader sensitivity analysis of permanent and nonpermanent
AF
patients.

Conclusions

Among patients with permanent
AF
, there is a J‐shaped relationship between heart rate and mortality. These data support current guideline recommendations, and clinical trials are warranted to determine optimal rate control.

Clinical Trial Registration

URL
:
http://clinicaltrials.gov/
. Unique identifier: NCT01165710.
Thirty Years of Atmospheric Extinction from Telescopes of the North Atlantic Canary Archipelago
Authors: Laken Benjamin A. , Parviainen Hannu , García-Gil Alejandro , Muñoz-Tuñón Casiana , Varela Antonia M. , Fernandez-Acosta Sergio , Pallé Pere 
Published: September 2015

Abstract
This study examines 30 years of atmospheric extinction, τ, obtained from both stellar and solar telescope measurements, at ~2.4 km MSL, from the North Atlantic Canary Archipelago—an island chain located at approximately 28°N, around 100 km from the west coast of Africa. Data from three AERONET monitors, located at varying heights on one of the main islands, were also used, although these are only available over a shorter (&lt;10 yr) period. The Canary Archipelago is regularly affected by dust intrusions into the local atmosphere as they intersect one of the primary export pathways of mineral dust from the Sahara. The τ of “baseline” and “dust influenced” conditions were statistically distinguished by fitting normal-gamma mixture distributions to the observations using Markov chain Monte Carlo methods, and then the seasonal and long-term characteristics of these data were examined. The telescope data show that baseline conditions are usually stable at τ &lt; 0.1 (except during periods influenced by volcanic aerosols) and indicate the existence of a low-amplitude () seasonal variation. During dust-influenced conditions, τ regularly reaches values of a factor of 2–6 times higher than normal. The majority of dust intrusions take place during the months of July and August, when they may occur 44 ± 15% of the time, predominantly at high altitudes (with ~94.3 ± 1.6% of intrusions occurring ≥ 2.4 km), whereas during the months of November–May, dust intrusions occur far less frequently (~19 ± 7%) and are more common at lower altitudes—with intrusions at &lt;2.4 km comprising ~ 79.5 ± 3.2% of all outbreaks. Year-to-year variations in the frequency of dust-influenced conditions (of ~9%) were found but no long-term trend over the observed 30-yr period.
Influence of the Monsoon Trough on Westward-Propagating Tropical Waves over the Western North Pacific. Part II: Energetics and Numerical Experiments
Authors: Wu Liang , Wen Zhiping , Wu Renguang 
Published: September 2015

Abstract
Part I of this study examined the modulation of the monsoon trough (MT) on tropical depression (TD)-type–mixed Rossby–gravity (MRG) and equatorial Rossby (ER) waves over the western North Pacific based on observations. This part investigates the interaction of these waves with the MT through a diagnostics of energy conversion that separates the effect of the MT on TD–MRG and ER waves. It is found that the barotropic conversion associated with the MT is the most important mechanism for the growth of eddy energy in both TD–MRG and ER waves. The large rotational flows help to maintain the rapid growth and tilted horizontal structure of the lower-tropospheric waves through a positive feedback between the wave growth and horizontal structure. The baroclinic conversion process associated with the MT contributes a smaller part for TD–MRG waves, but is of importance comparable to barotropic conversion for ER waves as it can produce the tilted vertical structure. The growth rates of the waves are much larger during strong MT years than during weak MT years.
Numerical experiments are conducted for an idealized MRG or ER wave using a linear shallow-water model. The results confirm that the monsoon background flow can lead to an MRG-to-TD transition and the ER wave amplifies along the axis of the MT and is more active in the strong MT state. Those results are consistent with the findings in Part I. This indicates that the mean flow of the MT provides a favorable background condition for the development of the waves and acts as a key energy source.
A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy
Authors: Preston Nick , Weightman Andrew , Gallagher Justin , Levesley Martin , Mon-Williams Mark , Clarke Mike , O’Connor Rory J 
Published: September 2015

Objective: To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. Design: A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference. Setting: Intervention was home-based; recruitment took place in regional spasticity clinics. Participants: A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group. Interventions: Both study groups received ‘usual follow-up treatment’ following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device. Main measures: ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and 12 weeks. Results: An analysis of covariance showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric analysis of variance on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (χ2 (2,15) = 6.778, p = 0.031), but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target owing to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits. Conclusion: This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out.
Stress Testing of an Artificial Pancreas System With Pizza and Exercise Leads to Improvements in the System’s Fuzzy Logic Controller
Authors: Mauseth Richard , Lord Sandra M. , Hirsch Irl B. , Kircher Robert C. , Matheson Don P. , Greenbaum Carla J. 
Published: September 2015

Background: Under controlled conditions, the Dose Safety artificial pancreas (AP) system controller, which utilizes “fuzzy logic” (FL) methodology to calculate and deliver appropriate insulin dosages based on changes in blood glucose, successfully managed glycemic excursions. The aim of this study was to show whether stressing the system with pizza (high carbohydrate/high fat) meals and exercise would reveal deficits in the performance of the Dose Safety FL controller (FLC) and lead to improvements in the dosing matrix. Methods: Ten subjects with type 1 diabetes (T1D) were enrolled and participated in 30 studies (17 meal, 13 exercise) using 2 versions of the FLC. After conducting 13 studies with the first version (FLC v2.0), interim results were evaluated and the FLC insulin-dosing matrix was modified to create a new controller version (FLC v2.1) that was validated through regression testing using v2.0 CGM datasets prior to its use in clinical studies. The subsequent 17 studies were performed using FLC v2.1. Results: Use of FLC v2.1 vs FLC v2.0 in the pizza meal tests showed improvements in mean blood glucose (205 mg/dL vs 232 mg/dL, P = .04). FLC v2.1 versus FLC v2.0 in exercise tests showed improvements in mean blood glucose (146 mg/dL vs 201 mg/dL, P = .004), percentage time spent >180 mg/dL (19.3% vs 46.7%, P = .001), and percentage time spent 70-180 mg/dL (80.0% vs 53.3%, P = .002). Conclusion: Stress testing the AP system revealed deficits in the FLC performance, which led to adjustments to the dosing matrix followed by improved FLC performance when retested.
Lighting and Nurses at Medical–Surgical Units
Authors: Hadi Khatereh , DuBose Jennifer R. , Ryherd Erica 
Published: September 2015

Objective: This study investigates the perception of nurses about their lighting environment at medical–surgical hospital units in order to understand areas of improvement for lighting at these units. Background: The bulk of the research about nurses and lighting is focused on nighttime nursing, exploring the disruptions of nurses’ circadian rhythm and maintaining alertness. The understanding of nurses’ perception about lighting and its impact on nurses’ task performance and patient examination remains imprecise. Methods: This study used an online survey to ask a set of questions about lighting in medical–surgical units at five key locations including centralized nurse stations, decentralized nurse stations (DCNS), patient bedsides, patient bathrooms, and corridors from 393 survey participants. It then explored the survey findings in more depth through conducting focus groups with eight volunteer nurses. Results: Lighting conditions at patient besides and DCNSs were significantly less desirable for nurses compared to other locations. A significant relationship between nurses’ access to lighting controls (switches and dimmers) and satisfaction about the lighting environment was found. No significant relationship was observed between the individual characteristics of nurses (such as age, years of experience, etc.) and findings of this study. Conclusions: Thoughtful design of the lighting environment can improve nurses’ satisfaction and perception about their working environment.
Evolution of the avian β-defensin and cathelicidin genes
Authors: Cheng Yuanyuan , Prickett Michael Dennis , Gutowska Weronika , Kuo Richard , Belov Katherine , Burt David W. 
Published: September 2015

AbstractBackgroundβ-defensins and cathelicidins are two families of cationic antimicrobial peptides (AMPs) with a broad range of antimicrobial activities that are key components of the innate immune system. Due to their important roles in host defense against rapidly evolving pathogens, the two gene families provide an ideal system for studying adaptive gene evolution. In this study we performed phylogenetic and selection analyses on β-defensins and cathelicidins from 53 avian species representing 32 orders to examine the evolutionary dynamics of these peptides in birds.Results and conclusionsAvian β-defensins are found in a gene cluster consisting of 13 subfamiles. Nine of these are conserved as one to one orthologs in all birds, while the others (AvBD1, AvBD3, AvBD7 and AvBD14) are more subject to gene duplication or pseudogenisation events in specific avian lineages. Avian cathelicidins are found in a gene cluster consisting of three subfamilies with species-specific duplications and gene loss. Evidence suggested that the propiece and mature peptide domains of avian cathelicidins are possibly co-evolving in such a way that the cationicity of the mature peptide is partially neutralised by the negative charge of the propiece prior to peptide secretion (further evidence obtained by repeating the analyses on primate cathelicidins). Negative selection (overall mean dN < dS) was detected in most of the gene domains examined, conserving certain amino acid residues that may be functionally crucial for the avian β-defensins and cathelicidins, while episodic positive selection was also involved in driving the diversification of specific codon sites of certain AMPs in avian evolutionary history. These findings have greatly improved our understanding of the molecular evolution of avian AMPs and will be useful to understand their role in the avian innate immune response. Additionally, the large dataset of β-defensin and cathelicidin peptides may also provide a valuable resource for translational research and development of novel antimicrobial agents in the future.
To beta block or not to beta block; that is the question
Authors: Ince Can 
Published: September 2015

AbstractThe fast-acting β-1 blocker esmolol has been the center of attention since the landmark article by Morrelli and colleagues suggesting that, in patients with sepsis, reducing heart rate by administering esmolol can result in a survival benefit. However, the use of esmolol for the treatment of sepsis and the underlying mechanism responsible for this benefit remain controversial. This commentary discusses the study by Jacquet-Lagrèze and colleagues, who in a pig model of sepsis tested the hypothesis that administration of esmolol to reduce heart rate may correct sepsis-induced sublingual and gut microcirculatory alterations which are known to be associated with adverse outcome.
Targeting stem cell niche can protect hematopoietic stem cells from chemotherapy and G-CSF treatment
Authors: Li Sidan , Zou Dehui , Li Changhong , Meng Hengxing , Sui Weiwei , Feng Sizhou , Cheng Tao , Zhai Qiongli , Qiu Lugui 
Published: September 2015

AbstractIntroductionHematopoietic stem/progenitor cells (HSPCs) reside in a tightly controlled local microenvironment called bone marrow niche. The specialized microenvironment or niche not only provides a favorable habitat for HSPC maintenance and development but also governs stem cell function.MethodWe investigated the effect of cytotoxic drugs on bone marrow niche. To mimic the multiple rounds of chemotherapy followed by autologous hematopoietic stem cells (HSCs) transplantation in a clinical setting, we further verified the hypothesis that targeting the niche might improve stem cell–based therapies in mouse models.ResultsWe found that multiple rounds of cytotoxic drug treatment significantly disrupted niche and serum osteocalcin level was significantly reduced after treatment in autologous HSPCs transplanted patients (P= 0.01). In mouse models, the number of CD45−Ter119−OPN+osteoblasts was significantly reduced after multiple rounds of chemotherapies and granulocyte colony stimulating factor (G-CSF) treatment (P < 0.01). Parathyroid hormone (PTH) or receptor activator of nuclear factor kappa-B ligand (RANKL) treatment significantly increased the number of HSCs mobilized into peripheral blood (PB) for stem cell harvesting and protected stem cells from repeated exposure to cytotoxic chemotherapy. Treatments with G-CSF and PTH significantly increased the preservation of the HSC pool (P < 0.05). Moreover, recipient mice transplanted with circulation HSPCs that were previously treated with PTH and RANKL showed robust myeloid and lymphatic cell engraftment compared to the mice transplanted with HSCs after chemotherapy or G-CSF treatment.ConclusionThese data provide new evidence that the niche may be an important target for drug-based stem cell therapy.
Incidence of differentiated thyroid cancer in Canada by City of residence
Authors: Corsten Martin J. , Hearn Matthew , McDonald James Ted , Johnson-Obaseki Stephanie 
Published: September 2015

Background Thyroid cancer incidence in Canada is increased in high socioeconomic groups, and in urban compared with rural areas. The objective of this study was to analyze patterns in thyroid cancer incidence across Canada, particularly with respect to the major urban areas across the country, to identify whether there are any discrepancies in thyroid cancer incidence between Canadian cities. Methods Cases were drawn from the Canadian Cancer Registry. Demographic and socioeconomic information were extracted from the Canadian Census of Population data. We linked cases to income quintiles (InQs) by patients’ postal codes, and categorized residence by census metropolitan area ((CMA), population >100,000). Within the Toronto CMA we further classified by census subdivision (CSD). Results There were a total of 33 CMAs across the country. After controlling for demographic and socio-economic factors, we found that the Toronto CMA had an IRR of thyroid cancer that was significantly higher than all other CMAs across the country. For 70 % of CMAs and CAs across Canada, the IRR for thyroid cancer was less than half of the IRR for thyroid cancer in the Toronto CMA. As Toronto is one of the largest CMAs, we then subdivided the Toronto area into CSDs to examine how incidence of thyroid cancer varies within this large area. The Toronto City core was used as the reference category and all other areas were compared directly to it. In doing so, we found that a contiguous area of three CSDs North of Toronto had higher IRRs compared with the Toronto city core: Markham, Vaughan and Richmond Hill. Conclusions After controlling for demographic and socioeconomic factors, we found that the Toronto CMA has the highest incidence of thyroid cancer nationwide. Several explanations could account for this discrepancy including increased detection due to increased access to imaging, differences in ethnicity or environmental exposures.
Correlation of PET-CT nodal SUVmax with p16 positivity in oropharyngeal squamous cell carcinoma
Authors: Clark Jessica , Jeffery Caroline C. , Zhang Han , Cooper Tim , O'Connell Daniel A. , Harris Jeffrey , Seikaly Hadi , Biron Vincent L. 
Published: September 2015

Background The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has been rising in recent years. Given the clinical impact of HPV/p16 positivity in OPSCC, identifying surrogate markers of this disease early in the diagnostic work-up of these patients could improve patient care. Methods Demographic, pathologic, staging and PET-CT data from patients diagnosed with OPSCC from 2009–2014 were obtained from a prospectively collected provincial cancer registry. Tumor HPV/p16 status was correlated to the maximum standard uptake value (SUVmax) of the primary tumor and cervical nodes. Comparisons of means and multinomial regression models were used to determine associations between p16 status and SUVmax. A diagnostic odds ratio was calculated using a cut off value for predicting HPV/p16 positivity based on nodal SUVmax. Results PET-CT and HPV/p16 data was obtained for 65 patients treated surgically for OPSCC. Significantly higher nodal SUVmax was associated with HPV/p16 positive nodes (SUVmax 10.8 vs 7.9). No significant differences were seen between HPV/p16 positive vs negative primary tumor SUVmax (10.3 vs 13.7). In combination with other clinical parameters, higher nodal SUVmax was highly correlated with HPV/p16 positivity. Conclusion Elevated nodal SUVmax is a significant predictor of HPV/p16 positive disease.
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study
Authors: Solin Lawrence J. , Gray Robert , Hughes Lorie L. , Wood William C. , Lowen Mary Ann , Badve Sunil S. , Baehner Frederick L. , Ingle James N. , Perez Edith A. , Recht Abram , Sparano Joseph A. , Davidson Nancy E. 
Published: September 2015

Purpose To determine the 12-year risk of developing an ipsilateral breast event (IBE) for women with ductal carcinoma in situ (DCIS) of the breast treated with surgical excision (lumpectomy) without radiation. Patients and Methods A prospective clinical trial was performed for women with DCIS who were selected for low-risk clinical and pathologic characteristics. Patients were enrolled onto one of two study cohorts (not randomly assigned): cohort 1: low- or intermediate-grade DCIS, tumor size 2.5 cm or smaller (n = 561); or cohort 2: high-grade DCIS, tumor size 1 cm or smaller (n = 104). Protocol specifications included excision of the DCIS tumor with a minimum negative margin width of at least 3 mm. Tamoxifen (not randomly assigned) was given to 30% of the patients. An IBE was defined as local recurrence of DCIS or invasive carcinoma in the treated breast. Median follow-up time was 12.3 years. Results There were 99 IBEs, of which 51 (52%) were invasive. The IBE and invasive IBE rates increased over time in both cohorts. The 12-year rates of developing an IBE were 14.4% for cohort 1 and 24.6% for cohort 2 (P = .003). The 12-year rates of developing an invasive IBE were 7.5% and 13.4%, respectively (P = .08). On multivariable analysis, study cohort and tumor size were both significantly associated with developing an IBE (P = .009 and P = .03, respectively). Conclusion For patients with DCIS selected for favorable clinical and pathologic characteristics and treated with excision without radiation, the risks of developing an IBE and an invasive IBE increased through 12 years of follow-up, without plateau. These data help inform the treatment decision-making process for patients and their physicians.