bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth Differentiation Factor 15, a Marker of Oxidative Stress and Inflammation, for Risk Assessment in Patients With Atrial Fibrillation
Authors: Wallentin Lars , Hijazi Ziad , Andersson Ulrika , Alexander John H. , De Caterina Raffaele , Hanna Michael , Horowitz John D. , Hylek Elaine M. , Lopes Renato D. , Åsberg Signild , Granger Christopher B. , Siegbahn Agneta 
Published: October 2014

Background—
Growth differentiation factor 15 (GDF-15), high-sensitivity troponin, and N-terminal pro-brain natriuretic peptide levels are predictive of death and cardiovascular events in healthy elderly subjects, patients with acute coronary syndrome, and patients with heart failure. High-sensitivity troponin I and N-terminal pro-brain natriuretic peptide are also prognostic in patients with atrial fibrillation. We evaluated the prognostic value of GDF-15 alone and in addition to clinical characteristics and other biomarkers in patients with atrial fibrillation.

Methods and Results—

The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial randomized 18 201 patients with atrial fibrillation to apixaban or warfarin. Biomarkers were measured at randomization in 14 798 patients. Efficacy and safety outcomes during 1.9 years of follow-up were compared across quartiles of GDF-15 by use of Cox analyses adjusted for clinical characteristics, randomized treatment, and other biomarkers. The GDF-15 level showed a median of 1383 ng/L (interquartile range, 977–2052 ng/L). Annual rates of stroke or systemic embolism ranged from 0.9% to 2.03% (
P
<0.001); of major bleeding, from 1.22% to 4.53% (
P
<0.001); and of mortality, from 1.34% to 7.19% (
P
<0.001) in the lowest compared with the highest GDF-15 quartile. The prognostic information provided by GDF-15 was independent of clinical characteristics and clinical risk scores. Adjustment for the other cardiac biomarkers attenuated the prognostic value for stroke, whereas the prognostic value for mortality and major bleeding remained. Apixaban consistently reduced stroke, mortality, and bleeding, regardless of GDF-15 levels.

Conclusions—
GDF-15 is a risk factor for major bleeding, mortality, and stroke in atrial fibrillation. The prognostic value for major bleeding and death remained even in the presence of N-terminal pro-brain natriuretic peptide and high-sensitivity troponin I.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00412984.
Electrophysiologic Substrate in Congenital Long QT Syndrome
Authors: Vijayakumar Ramya , Silva Jennifer N.A. , Desouza Kavit A. , Abraham Robert L. , Strom Maria , Sacher Frederic , Van Hare George F. , Haïssaguerre Michel , Roden Dan M. , Rudy Yoram 
Published: October 2014

Background—
Congenital Long QT syndrome (LQTS) is an arrhythmogenic disorder that causes syncope and sudden death. Although its genetic basis has become well-understood, the mechanisms whereby mutations translate to arrhythmia susceptibility in the in situ human heart have not been fully defined. We used noninvasive ECG imaging to map the cardiac electrophysiological substrate and examine whether LQTS patients display regional heterogeneities in repolarization, a substrate that promotes arrhythmogenesis.

Methods and Results—

Twenty-five subjects (9 LQT1, 9 LQT2, 5 LQT3, and 2 LQT5) with genotype and phenotype positive LQTS underwent ECG imaging. Seven normal subjects provided control. Epicardial maps of activation, recovery times, activation-recovery intervals, and repolarization dispersion were constructed. Activation was normal in all patients. However, recovery times and activation–recovery intervals were prolonged relative to control, indicating delayed repolarization and abnormally long action potential duration (312±30 ms versus 235±21 ms in control). Activation–recovery interval prolongation was spatially heterogeneous, with repolarization gradients much steeper than control (119±19 ms/cm versus 2.0±2.0 ms/cm). There was variability in steepness and distribution of repolarization gradients between and within LQTS types. Repolarization gradients were steeper in symptomatic patients (130±27 ms/cm in 12 symptomatic patients versus 98±19 ms/cm in 13 asymptomatic patients;
P
<0.05).

Conclusions—
LQTS patients display regions with steep repolarization dispersion caused by localized action potential duration prolongation. This defines a substrate for reentrant arrhythmias, not detectable by surface ECG. Steeper dispersion in symptomatic patients suggests a possible role for ECG imaging in risk stratification.
Application of Single-Stage Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations >10 cm
3
Authors: Hanakita Shunya , Koga Tomoyuki , Shin Masahiro , Igaki Hiroshi , Saito Nobuhito 
Published: October 2014

Background and Purpose—
Stereotactic radiosurgery (SRS) is a safe and effective treatment for small arteriovenous malformations (AVMs), the use of this modality for the treatment of large AVMs is still controversial, although it has been used in difficult cases. The aim of this study was to evaluate the treatment outcomes of patients who underwent single-stage SRS for large AVMs and to discuss the role of SRS in the treatment of these challenging lesions.

Methods—

Between 1998 and 2010, 65 patients with AVMs >10 cm
3
underwent single-stage SRS using the Leksell Gamma Knife. Patients who had prospective volume-staged SRS were excluded from this series. Outcomes including the rates of obliteration, hemorrhage after treatment, and adverse events were retrospectively evaluated.

Results—

The mean nidus volume was 14.9 cm
3
(±3.8 cm
3
), and a mean margin dose of 20 Gy (±1.5 Gy) was applied. The mean observation period was 60 months (range, 7–178 months). The nidus obliteration rates after SRS were 44%, 76%, and 81% at 3, 5, and 6 years, respectively. The annual hemorrhage rate after SRS was 1.94% and permanent adverse events were observed in 2 patients (3%).

Conclusions—

For large AVMs <20 cm
3
, single-stage radiosurgery by applying >16 Gy marginal dose presented favorable obliteration rates with relatively low rate of morbidity. Further accumulation of cases is awaited to fully evaluate the results of single-stage radiosurgery for large AVMs.
STAMP-Based HRA Considering Causality Within a Sociotechnical System
Authors: Rong Hao , Tian Jin 
Published: October 2014

Objective: The study contributes to human reliability analysis (HRA) by proposing a method that focuses more on human error causality within a sociotechnical system, illustrating its rationality and feasibility by using a case of the Minuteman (MM) III missile accident. Background: Due to the complexity and dynamics within a sociotechnical system, previous analyses of accidents involving human and organizational factors clearly demonstrated that the methods using a sequential accident model are inadequate to analyze human error within a sociotechnical system. Methods: System-theoretic accident model and processes (STAMP) was used to develop a universal framework of human error causal analysis. To elaborate the causal relationships and demonstrate the dynamics of human error, system dynamics (SD) modeling was conducted based on the framework. Results: A total of 41 contributing factors, categorized into four types of human error, were identified through the STAMP-based analysis. All factors are related to a broad view of sociotechnical systems, and more comprehensive than the causation presented in the accident investigation report issued officially. Recommendations regarding both technical and managerial improvement for a lower risk of the accident are proposed. Conclusion: The interests of an interdisciplinary approach provide complementary support between system safety and human factors. The integrated method based on STAMP and SD model contributes to HRA effectively. Application: The proposed method will be beneficial to HRA, risk assessment, and control of the MM III operating process, as well as other sociotechnical systems.
Individual Differences in Verbal-Spatial Conflict in Rapid Spatial-Orientation Tasks
Authors: Barrow Jane H. , Baldwin Carryl L. 
Published: October 2014

Objective: The impact of interference from irrelevant spatial versus verbal cues is investigated in an auditory spatial Stroop task, and individual differences in navigation strategy are examined as a moderating factor. Background: Verbal-spatial cue conflict in the auditory modality has not been extensively studied, and yet the potential for such conflict can be high in certain settings, such as modern aircraft and automobile cockpits, where multiple warning systems and verbally delivered instructions may compete for the operator’s spatial attention. Method: Two studies are presented in which participants responded to either the semantic meaning or the spatial location of directional words, which were presented from congruent and incongruent locations. A subset was selected from the larger sample for additional analyses based on their navigation strategy. Results: Results demonstrated greater interference when participants were responding to the spatial location and thus attempting to ignore conflicting semantic information. Participants with a verbal navigation strategy paralleled this finding. Conversely, highly spatial navigators responded faster to spatially relevant information but did not show corresponding interference when trying to ignore spatial information. Conclusion: The findings suggest that people have fundamentally different approaches to the use of auditory spatial information that manifest at the early level of orienting toward a single word or sound. Application: When designing spatial information displays and warning systems, particularly those with an auditory component, designers should ensure that either verbal-directional or nonverbal-spatial information is utilized by all alerts to reduce interference.
Sclerotherapy for rare bleeding stomal varices after ileal conduit urinary diversion: an effective and noninvasive method
Authors: Tan Shu-Tao 
Published: October 2014

Introduction Bleeding stomal varices after ileal conduit urinary diversion are rare, but they can develop in patients with portal venous hypertension caused by cirrhosis. Case presentation We report the case of a 68-year-old man who developed stomal haemorrhage two months after radical cystectomy and ileal conduit urinary diversion to treat invasive bladder cancer. Alcoholic cirrhosis and portal venous hypertension were considered to be the causes of varices and bleeding. We chose to control the stomal varices using sclerotherapy. The stomal varices disappeared and no bleeding recurred during one year of follow up. Conclusion We believe that sclerotherapy is a suitable treatment for bleeding stomal varices.
Transplantation of bone marrow stem cells during cardiac surgery
Authors: Ali-Hassan-Sayegh Sadegh , Mirhosseini Seyed Jalil , Lotfaliani Mohammad-Reza , Dehghan Hamid Reza , Sedaghat-Hamedani Farbod , Kayvanpour Elham , Rezaeisadrabadi Mohammad , Ghaffari Naser , Vahabzadeh Vahid , Jebran Ahamd Fawad , Sabashnikov Anton , Popov Aron-Frederik 
Published: October 2014

Background This systematic review with meta-analysis sought to determine the efficacy and safety of intramyocardial transplantation of bone marrow stem cells during coronary artery bypass graft surgery on postoperative cardiac functional parameters such as left ventricular ejection fraction and left ventricular end-diastolic volume. Methods Medline/PubMed, Embase, Elsevier, Sciences online database, and Google Scholar literature search were searched. The effect sizes measured were risk ratio for categorical variables and weighted mean difference with 95% confidence interval for calculating differences between mean values of baseline and follow-up cardiac functional parameters. A value of p < 0.1 for Q test, or I2 > 50%, indicated significant heterogeneity among studies. The literature search retrieved 2900 studies from screened databases, of which 2866 (98.6%) were excluded and 34 (619 patients) were included for scoping review. The final analysis included 9 studies (335 patients). Results Pooled effects estimates of left ventricular ejection fraction and left ventricular end-diastolic volume showed that bone marrow stem cell transplantation had a weighted mean difference of 4.06 (95% confidence interval: 0.41–7.72; p = 0.02) and 7.06 (95% confidence interval: −8.58–22.7; p = 0.3), respectively. Conclusions Intramyocardial transplantation of bone marrow stem cells improves cardiac functional parameters, significantly increasing left ventricular ejection fraction with a nonsignificant reduction in left ventricular end-diastolic volume. Also, this therapeutic method has no life-threatening complications and was therefore found to be an effective and safe method.
Interleukin-10 gene –1082 G/A polymorphism in cervical cancer and cervical intraepithelial neoplasia: Meta-analysis
Authors: Zhang Shuo , Kong Ya-Lin , Li Ya-Li , Yin Yan-Wei 
Published: October 2014

Objectives To assess the association between polymorphism in the interleukin (IL)-10 promoter region of 1082 G/A and the risk of cervical cancer and/or cervical intraepithelial neoplasia (CIN), using meta-analysis. Methods The electronic literature databases PubMed®, Embase®, Web of Science, CBMdisc and CNKI were searched for relevant studies. The strength of association between IL-10 gene −1082 G/A polymorphism and cervical cancer and/or CIN was measured using pooled odds ratios with 95% confidence intervals in four genetic models: allelic model (A allele versus G allele); additive model (A/A versus G/G); recessive model (A/A versus G/A+G/G); dominant model (A/A+G/A versus G/G). Results Eight studies involving 1983 cases and 1618 controls were identified and included in the meta-analysis. No significant associations were found between IL-10 gene −1082 G/A polymorphism and cervical cancer and/or CIN in any of the genetic models. Conclusions IL-10 gene −1082 G/A polymorphism does not appear to be associated with the risk of cervical cancer and/or CIN.
Migraine and cerebral blood flow in the general population
Authors: Loehrer Elizabeth , Vernooij Meike W , van der Lugt Aad , Hofman Albert , Ikram M Arfan 
Published: October 2014

Introduction Observations that migraine increases risk of cardiovascular disease and ischemic brain changes may suggest sustained vascular differences between migraineurs and controls. In a population-based setting, we compared cerebral blood flow between migraineurs in the attack-free period and controls. Methods Between 2006 and 2008, 2642 participants, aged 45–65, from the Rotterdam Study completed a migraine questionnaire and had complete usable MRI data. Participants were classified into controls (N = 2033), probable migraine (N = 153), or migraine (N = 456). Using 2D phase contrast MRI, we performed a cross-sectional analysis of the effect of migraine on total cerebral blood flow (tCBF), parenchymal cerebral blood flow (pCBF), and blood flow in each intracranial arterial using linear regression. Additionally, we performed stratified analysis of subtypes of migraine. Results Compared with controls, migraineurs had higher pCBF (1.07 ml/min/100 ml, 95% CI 0.08; 2.05). In particular, migraineurs had significantly higher blood flow in the basilar artery (4.70 ml/min, 95% CI 0.77; 8.62). Discussion Migraineurs in the attack-free period have higher pCBF, particularly basilar artery flow, compared to controls, supporting the notion of sustained vascular differences between these groups outside of migraine attacks.
The effect of osteotomy dimension on osseointegration to resorbable media-treated implants: A study in the sheep
Authors: Galli Silvia , Jimbo Ryo , Tovar Nick , Yoo Daniel Y , Anchieta Rodolfo B , Yamaguchi Satoshi , Coelho Paulo G 
Published: October 2014

The drilling technique and the surface characteristics are known to influence the healing times of oral implants. The influence of osteotomy dimension on osseointegration of microroughned implant surfaces treated with resorbable blasting media was tested in an in vivo model. Ninety-six implants (ø4.5 mm, 8 mm in length) with resorbable blasting media-treated surfaces were placed in the ileum of six sheep. The final osteotomy diameters were 4.6 mm (reamer), 4.1 mm (loose), 3.7 mm (medium), and 3.2 mm (tight). After three and six weeks of healing, the implants were biomechanically tested and histologically evaluated. Statistical analysis was performed using Page L trend test for ordered and paired sample and linear regression, with significance level at p < 0.05. An overall increase in all dependent variables was observed with the reduction of osteotomy diameter. In addition, all osseointegration scores increased over time. At three weeks, the retention was significantly higher for smaller osteotomies. The histological sections depicted intimate contact of bone with all the implant surfaces and osteoblast lines were visible in all sections. The resorbable blasting media microroughed surfaces achieved successful osseointegration for all the instrumentation procedures tested, with higher osseointegration scores for the high insertion torque group.
Risk of Venous Thromboembolic Events in Pregnant Patients With Autoimmune Diseases
Authors: Bleau Nathalie , Patenaude Valerie , Abenhaim Haim A. 
Published: October 2014

Objective: The objective of this study is to evaluate the effect of autoimmune disease on the risk of venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) in pregnant women. Methods: Using the Health Care Cost and Utilization Project, Nationwide Inpatient Sample database from 2003 to 2011, the risk of developing DVT, PE, and VTE among pregnant patients with selected autoimmune diseases was estimated using unconditional logistic regression analysis. Results: Our study cohort consisted of 7 917 453 women of which 43 523 had underlying autoimmune diseases. Risk of VTE was high in pregnant women with systemic lupus erythematosus, dermatomyositis, rheumatoid arthritis, type 1 diabetes mellitus, ulcerative colitis, and Crohn’s disease. Conclusion: Most autoimmune diseases considerably increase the risk of VTE. Thromboprophylaxis may be considered in pregnancies with autoimmune disease, particularly those with systemic lupus erythematosus and dermatomyositis.
Data for action: the use of formative research to design a school-based intervention programme to increase physical activity in adolescents
Authors: Murillo Pardo Berta , Camacho-Miñano Maria José , Generelo Lanaspa Eduardo , Julián Clemente José Antonio , Novais Carina , Maia Santos Maria Paula 
Published: October 2014

Formative research is a critical step for the development of interventions aimed at changing behaviours, as is the case of physical activity. This process permits obtaining detailed information about the programme application context. ‘Follow the Footstep’ is a quasi-experimental and longitudinal study in secondary schools, the aim of which is to increase levels of physical activity among adolescents. To inform the design of the intervention programme, formative research has been carried out to analyse the perceptions of parents, teachers and students, through six focus groups. The social–ecological model was used both to carry out the formative research and then to design the programme, including five levels of influence on behaviour (individual, interpersonal, organizational, community and political), which are important when it comes to adopting a comprehensive intervention approach. The authors describe how the results of formative research were transferred to guide the design and development of the intervention. As results indicate, parents, teachers and students agreed on a need to intervene by engaging adolescents and their close social environment. The school centre is the key organizational structure to implement this intervention, supported by professionals and the community.
Quantifying the risk of malignancy in patients with visible haematuria presenting to the emergency department
Authors: Gan JH , Harris AC , Green JSA 
Published: October 2014

Introduction: Visible haematuria (VH) is a very common presentation to the emergency department (ED). In an outpatient setting, 18%−24% of such patients have been shown to have an underlying malignancy. The aim of this study is to determine the malignancy rates of patients presenting acutely to ED and whether the degree of bleeding or presence of clots is a higher risk factor for cancer. Method: We retrospectively collected data from adult patients (>18 years) presenting to ED with VH for a six-month period. Diagnostic outcomes after one year were assessed. Results: Our study population has 96 patients (male = 77, female = 19) with a mean age of 68 years (SD = 20.2). Twenty-eight patients (29%) had haematuria with clots. Twenty-five patients (26%) had a new diagnosis of malignancy, and 10 had a known diagnosis of malignant disease. Bladder cancer was the most commonly found malignancy, in 17 patients (15 new diagnoses), while prostate cancer was second with 14 cases (six new). Renal cancer two, testicular one and colorectal one accounted for the other new malignancies diagnosed following presentation. All but one patient with cancer were male. Although most malignancies were found in patients over 70 years old, the two youngest patients were in their 30s. The incidence of malignancy appears to increase in patients who have urinary blood clots (58%), p = 0.08. Conclusion: A third of patients presenting to ED with VH will have a urological cancer. Patients with VH and clots have a significantly higher incidence of malignancy. We recommend expedited referral of all such patients to a urologist.
Antiretroviral Therapy in Zambia
Authors: Jones Deborah , Cook Ryan , Spence Andrew , Weiss Stephen M. , Chitalu Ndashi 
Published: October 2014

Background: Adherence to antiretroviral therapy (ART) is essential to optimize HIV treatment outcomes. Among individuals on ART, targeted peer support has been found to support adherence. This study of Zambian heterosexual couples living with HIV examined whether partners would exert a positive influence on each other's adherence, and compared adherence between couples in which either one or both members were on ART. Methods: Couples (n = 446 participants), in which either or both member were on ART were assessed at baseline, 6 and 12 months. Results: Most participants (64%, n = 263) were on ART; overall, uptake of ART increased to 74% at 12 months. At baseline, 76% reported near perfect adherence; at 6 and 12 months, 66% and 70% were adherent, respectively. A regression analysis indicated that the decline in adherence did not differ between those couples in which one or both partners were on ART [F (2, 624) = 0.37, p = .692]. Pairwise comparison indicated that adherence primarily decreased between baseline and 6 months (t = 2.72, p = .007), and was stable 6 to 12 months. Conclusions: This study of couples in Zambia found adherence was not enhanced by having a partner on ART, and that adherence declined over time. Partners on ART may not necessarily provide support for adherence to each other. Partners may represent an untapped resource for optimizing adherence; results highlight the need for provider guidance and structured adherence interventions targeting partner adherence support.