bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Update on the Management of Atrial Fibrillation
Authors: Danelich Ilya M. , Reed Brent N. , Hollis Ian B. , Cook Abigail M. , Rodgers Jo E. 
Published: April 2013

Atrial fibrillation (AF) is a cardiac arrhythmia associated with significant morbidity and mortality, affecting more than 3 million people in the United States and 1–2% of the population worldwide. Its estimated prevalence is expected to double within the next 50 years. During the past decade, there have been significant advances in the treatment of AF. Studies have demonstrated that a rate control strategy, with a target resting heart rate between 80 and 100 beats/minute, is recommended over rhythm control in the vast majority of patients. The CHA2DS2≥ (congestive heart failure, hypertension, age ≥ 65 yrs, diabetes mellitus, stroke or transient ischemic attack, vascular disease, female gender) scoring system is a potentially useful stroke risk stratification tool that incorporates additional risk factors to the commonly used CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke transient ischemic attack) scoring tool. Similarly, a convenient scheme, termed HAS‐BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), to assess bleeding risk has emerged that may be useful in select patients. Furthermore, new antithrombotic strategies have been developed as potential alternatives to warfarin, including dual‐antiplatelet therapy with clopidogrel plus aspirin and the development of new oral anticoagulants such as dabigatran, rivaroxaban, and apixaban. Vernakalant has emerged as another potential option for pharmacologic conversion of AF, whereas recent trials have better defined the role of dronedarone in the maintenance of sinus rhythm. Finally, catheter ablation represents another alternative to manage AF, whereas upstream therapy with inhibitors of the renin‐angiotensin‐aldosterone system, statins, and polyunsaturated fatty acids could potentially prevent the occurrence of AF. Despite substantial progress in the management of AF, significant uncertainty surrounds the optimal treatment of this condition.
Evaluation of Pharmacologic Prophylaxis for Venous Thromboembolism in Patients with Chronic Liver Disease
Authors: Barclay Sean M. , Jeffres Meghan N. , Nguyen KimChi , Nguyen Tamdan 
Published: April 2013

Study ObjectiveTo determine whether pharmacologic prophylaxis for venous thromboembolism (VTE) was associated with a decrease in the incidence of VTE or an increased incidence of bleeding in patients with chronic liver disease (CLD).DesignSingle‐center, retrospective cohort analysis.SettingUniversity medical center.PatientsA total of 1581 adults with CLD hospitalized over a 3‐year period for longer than 24 hours.Measurements and Main ResultsMedical records were reviewed for the primary outcome of VTE and documented episodes of bleeding during hospitalization and were divided into two groups based on receipt of pharmacologic VTE prophylaxis. During the 1581 hospitalizations, 392 (24.7%) patients received pharmacologic VTE prophylaxis. The incidence of VTE in the prophylaxis group was 0.5% compared with 1.8% in patients without prophylaxis (p=0.05). Documented bleeding rates were lower in the prophylaxis group (2.0% vs 10.3%, p<0.001). Multivariate logistic regression identified active malignancy (odds ratio [OR] 8.76, 95% confidence interval [CI], 2.56–29.58), trauma or surgery during hospitalization (OR 10.29, 95% CI 1.18–89.51), and history of VTE (OR 26.48, 95% CI 6.93–101.16) as risk factors of VTE. Use of pharmacologic VTE prophylaxis was protective against VTE (OR 0.34, 95% CI 0.04–0.88).ConclusionPharmacologic VTE prophylaxis was associated with a decreased incidence of VTE in patients with CLD without an increased rate of bleeding and should be routinely considered on admission to the hospital. Patients with CLD and active malignancy, trauma or surgery during hospitalization, or history of VTE appear to be at highest risk of VTE and thus warrant pharmacologic prophylaxis. Prospective studies must validate these findings.
Cost and Quality Implications of Opioid‐Based Postsurgical Pain Control Using Administrative Claims Data from a Large Health System: Opioid‐Related Adverse Events and Their Impact on Clinical and Economic Outcomes
Authors: Kessler E. Richard , Shah Manan , K. Gruschkus Stephen , Raju Aditya 
Published: April 2013

Study ObjectiveTo determine the prevalence of postsurgical opioid use in the inpatient setting, to ascertain the frequency of and risk factors for opioid‐related adverse drug events (ORADEs) among patients who received opioids, and to evaluate the impact of ORADEs on clinical and economic outcomes.DesignRetrospective cohort study using administrative data.SettingHospital system encompassing 26 hospitals in the southeastern United States.PatientsA total of 37,031 patients aged 18 years or older who underwent a common surgical procedure between January 1, 2009, and December 31, 2010.Measurements and Main ResultsPatients were evaluated for receipt of postsurgical opioids. Outcomes among opioid users included ORADE rates, hospital length of stay, total hospitalization costs, 30‐day readmission rates, outlier status, and inpatient mortality. Factors associated with ORADEs were evaluated; length of stay, costs, readmissions, and mortality were compared between patients experiencing and not experiencing ORADEs by using propensity score matching on age, race‐ethnicity, sex, presurgery opioid use, and comorbidities. Length of stay and cost rate ratios were generated by using negative binomial regression and generalized linear models. Odds ratios for 30‐day readmissions and inpatient mortality were generated by using logistic regression. Among all surgical patients, 36,529 (98.6%) of patients received opioids, of whom 4955 (13.6%) experienced an ORADE. Increased risk of ORADEs was associated with age 65 years or older, male sex, obesity, presurgery opioid use, and higher score on Charlson Comorbidity Index. Patients with an ORADE had a 55% longer length of stay, 47% higher costs of care, 36% increased risk of 30‐day readmission, and 3.4 times higher risk of inpatient mortality than did patients who did not experience an ORADE.ConclusionOpioid use was ubiquitous among hospitalized patients who underwent common surgical procedures. The observed negative outcomes of ORADEs and their impact on patients and the health care system should be considered when evaluating the balance between effectively managing postsurgical pain while minimizing the risk of ORADEs.
Once‐Weekly Exenatide: An Extended‐Duration Glucagon‐Like Peptide Agonist for the Treatment of Type 2 Diabetes Mellitus
Authors: Minze Molly G. , Klein Mary S. , Jernigan Michelle J. , Wise Stephen L. , Frugé Kristian 
Published: April 2013

Type 2 diabetes affects over 25 million people in the United States. There are many treatment options for patients with type 2 diabetes, but current treatments must be administered on a daily basis. Once‐weekly exenatide, an extended‐duration glucagon‐like peptide‐1 (GLP‐1) agonist, provides an option for patients to take a drug weekly, with pharmacotherapeutic effects that are superior to twice‐daily exenatide and sitagliptin and comparable to insulin glargine. The DURATION trials provide evidence that once‐weekly exenatide reduces hemoglobin A1c, and may result in weight loss. Once‐weekly exenatide is marketed as a 2‐mg injection administered subcutaneously once every 7 days. Adverse effects of once‐weekly exenatide include gastrointestinal effects, hypoglycemia, injection‐site reactions, pancreatitis, and antibody development. Patients with a self history or family history of thyroid tumors should avoid using once‐weekly exenatide. Delayed gastric absorption with orally administered drugs is possible, and monitoring should occur to avoid loss in therapeutic effect. Once‐weekly exenatide is a new extended‐duration agent with efficacy and tolerability profiles comparative to older therapies. Appropriate patients for once‐weekly exenatide would be those who are concerned about weight gain, hypoglycemia, or those who do not wish to administer injections daily.
Baseline Albumin Is Associated with Worsening Renal Function in Patients with Acute Decompensated Heart Failure Receiving Continuous Infusion Loop Diuretics
Authors: Clarke Megan M. , Dorsch Michael P. , Kim Susie , Aaronson Keith D. , Koelling Todd M. , Bleske Barry E. 
Published: April 2013

Study ObjectivesTo identify baseline predictors of worsening renal function (WRF) in an acute decompensated heart failure (ADHF) patient population receiving continuous infusion loop diuretics.DesignRetrospective observational analysis.SettingAcademic tertiary medical center.PatientsA total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009.Measurements and Main ResultsThe mean patient age was 61 years, 63% were male, ~45% were classified as New York Heart Association functional class III, and the median length of loop diuretic infusion was 4 days. Forty‐eight patients (27%) developed WRF, and 34 patients (19%) died during hospitalization. Cox regression time‐to‐event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3 g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60–5.16, p=0.0004), which remained significant despite adjustments for other covariates.ConclusionSerum albumin 3 g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics.
Lack of Effectiveness of Sodium Bicarbonate in Preventing Kidney Injury in Patients Undergoing Cardiac Surgery: A Randomized Controlled Trial
Authors: Kristeller Judith L. , Zavorsky Gerald S. , Prior John E. , Keating Doris A. , Brady Mary Ann , Romaldini Theresa A. , Hickman Tiera L. , Stahl Russell F. 
Published: April 2013

Study ObjectiveBecause alkalinization of the renal tubules can theoretically protect against the mechanisms of acute kidney injury, we sought to determine whether a sodium bicarbonate infusion can prevent acute kidney injury after cardiac surgery.DesignProspective, randomized, double‐blind, controlled trial.SettingCardiac surgery service in a community hospital.PatientsNinety‐two patients with stage 3 or higher chronic kidney disease who underwent cardiac surgery using cardiopulmonary bypass.InterventionForty‐eight patients received a perioperative intravenous infusion of 0.9% sodium chloride 154 mEq/L, and 44 patients received an infusion of sodium bicarbonate infusion 150 mEq/L in 5% dextrose solution; the infusions were started 1 hour preoperatively and continued for 6 hours after cardiopulmonary bypass.Measurements and Main ResultsThe primary outcome was the development of any stage of acute kidney injury within 5 days after surgery as defined by the Acute Kidney Injury Network criteria. No statistically significant difference in the primary outcome was noted between the two groups: 32% in the bicarbonate group versus 42% in the sodium chloride group (p=0.12). Likewise, no significant differences in the 30‐day hospital mortality rate or other adverse outcomes were noted between the two groups.ConclusionA perioperative infusion of sodium bicarbonate did not reduce the rate of acute kidney injury or adverse outcomes in patients with chronic kidney disease who underwent cardiac surgery.
Synthesis and characterization of resorcinarene‐centered amphiphilic A8B4 miktoarm star copolymers based on poly(ε‐caprolactone) and poly(ethylene glycol) by combination of CROP and “click” chemistry
Authors: Gao Chen , Wang Ying , Gou Pengfei , Cai Xia , Li Xiaodong , Zhu Weipu , Shen Zhiquan 
Published: April 2013

ABSTRACTWell‐defined amphiphilic A8B4 miktoarm star copolymers with eight poly(ethylene glycol) chains and four poly(ε‐caprolactone) arms (R‐8PEG‐4PCL) were prepared using “click” reaction strategy and controlled ring‐opening polymerization (CROP). First, multi‐functional precursor (R‐8N3‐4OH) with eight azides and four hydroxyls was synthesized based on the derivatization of resorcinarene. Then eight‐PEG‐arm star polymer (R‐8PEG‐4OH) was prepared through “click” reaction of R‐8N3‐4OH with pre‐synthesized alkyne‐terminated monomethyl PEG (mPEG‐A) in the presence of CuBr/N,N,N′,N″,N″′‐ pentamethyldiethylenetriamine (PMDETA) in DMF. Finally, R‐8PEG‐4OH was used as tetrafunctional macroinitiator to prepare resorcinarene‐centered A8B4 miktoarm star copolymers via CROP of ε‐caprolactone utilizing Sn(Oct)2 as catalyst at 100 °C. These miktoarm star copolymers could self‐assemble into spherical micelles in aqueous solution with resorcinarene moieties on the hydrophobic/hydrophilic interface, and the particle sizes could be controlled by the ratio of PCL to PEG. © 2013 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2013, 51, 2824–2833.
New photo‐induced thiol‐ene crosslinked films based on linear methacrylate copolymer polythiols
Authors: Zhang Qian , Hwang Ji Won , Kim Kyung Nam , Jung Hyun Wook , Noh Seung Man , Oh Jung Kwon 
Published: April 2013

ABSTRACTThiol‐ene radical addition by photolysis is a highly efficient click reaction of sufhydryl groups with reactive enes that has been extensively explored as a promising means to construct multifunctional materials. Here, photo‐induced thiol‐ene crosslinked films composed of linear methacrylate copolymer polythiols (MCPsh) are reported. Well‐defined MCPsh copolymers were prepared by thiol‐responsive cleavage of pendant disulfide linkages positioned in the corresponding methacrylate copolymers with narrow molecular weight distribution which were synthesized by a controlled radical polymerization method. With a commercially available multifunctional acrylate as a model ene, photo‐induced thiol‐ene radical polyaddition of these polythiols is competitive to free‐radical homopolymerization of acrylates, yielding crosslinked films exhibiting rapid cure, uniform network, and enhanced mechanical properties; these properties are required for high performance coating materials. © 2013 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2013, 51, 2860–2868.
Multidirectional associative memory with two hidden layers
Authors: Kobayashi Masaki , Nakajima Akihiro , Kitahara Michimasa 
Published: April 2013

AbstractMultidirectional Associative Memory (MAM) is an associative memory model that can deal with multiple associations. It can be considered as a generalized Bidirectional Associative Memory (BAM). Multidirectional Associative Memory with a Hidden Layer (MAMH) improves the storage capacity of MAM. However, the improvement is limited. In this paper, we propose Multidirectional Associative Memory with Two Hidden Layers (MAMTH). It can provide, theoretically unlimited, much larger storage capacity. © 2013 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Construction of an in vitro model system for the anatomical reentry phenomenon of cardiac tissues by using microfabrication techniques
Authors: Yasukawa Akane , Takayama Yuzo , Suzuki Takafumi , Mabuchi Kunihiko 
Published: April 2013

AbstractAnatomical reentry has been identified as a major cause of clinical cardiac arrhythmia. The probability for anatomical reentry is strongly dependent on the structures and cell characteristics of the causal cardiac regions. In this paper, we propose a simple in vitro model system for analyzing and simulating the anatomical reentry phenomenon in cardiac tissues. Rat ventricular myocytes were cultured and aligned in predesigned structures by using a microcontact printing method. Excitation propagation in the cultures was visualized and evaluated by applying electrical stimulation and the calcium imaging technique. We confirmed that differences between passage times along the two excitation pathways were modulated by changing the structures of cultured myocytes. This simple in vitro model system will be useful for studying the anatomical reentry phenomenon. © 2013 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Pulmonary artery blood flow patterns in fetuses with pulmonary outflow tract obstruction
Authors: Peyvandi S. , Rychik J. , McCann M. , Soffer D. , Tian Z. , Szwast A. 
Published: April 2013

ABSTRACTObjectivesFetuses with pulmonary outflow tract obstruction (POTO) have altered blood flow to the pulmonary vasculature. We sought to determine whether pulmonary vascular impedance, as assessed by the pulsatility index (PI), is different in fetuses with POTO compared with normal controls.MethodsBranch pulmonary artery PI was evaluated in age‐matched normal control fetuses (n = 22) and 20 POTO fetuses (pulmonary stenosis n = 15, pulmonary atresia n = 5). Pulsed‐wave Doppler was performed in the proximal (PA1), mid (PA2) and distal (PA3) branch pulmonary artery. The direction of flow in the ductus arteriosus was noted. The study and control groups were compared with Student's t‐test and ANOVA. A linear mixed model evaluated the relationship between PI and ductus arteriosus flow patterns.ResultsThere was no difference in PI between control, pulmonary stenosis and pulmonary atresia subjects at PA1 and PA2; however, there was a significant difference at PA3. Subjects with pulmonary atresia had a lower PI at PA3 than did controls (P = 0.003) and pulmonary stenosis subjects (P = 0.003). Subjects with retrograde flow in the ductus arteriosus had lower PIs in PA2 and PA3 than did those with antegrade flow (P = 0.01 and 0.005, respectively). The PI in PA3 was lower in fetuses that required prostaglandin postnatally than in those that did not (P = 0.008).ConclusionsFetuses with pulmonary atresia or severe pulmonary stenosis with retrograde flow in the ductus arteriosus have decreased PI in the distal pulmonary vasculature. Our findings indicate the capacity of the fetal pulmonary vasculature to vasodilate in response to anatomical obstruction of flow. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd
Cytoplasmic protein motility and polarized sorting during asymmetric cell division
Authors: Keder Alyona , Carmena Ana 
Published: April 2013

AbstractCell polarity is inherent to the process of asymmetric cell division, which relies on the asymmetric distribution of multiple polarity proteins and cell‐fate determinants in the cell cortex. The establishment and maintenance of cell polarity require the orchestration of numerous cellular processes. These include cytoplasmic movements, cytoskeleton dynamics, and different signaling events. Equally relevant is the plasma membrane composition, such as the lipid environment that endows particular membrane subdomains with specific characteristics. Sorting receptors and sorting determinants, including posttranslational modifications, also contribute to cell polarization. Together, all these mechanisms would be expected to have great relevance in the context of asymmetric cell division, an essential process in both physiological and pathological conditions. WIREs Dev Biol 2013, 2:797–808. doi: 10.1002/wdev.116This article is categorized under:

Establishment of Spatial and Temporal Patterns > Cytoplasmic Localization
Performance of complex snow cover descriptions in a distributed hydrological model system: A case study for the high Alpine terrain of the Berchtesgaden Alps
Authors: Warscher M. , Strasser U. , Kraller G. , Marke T. , Franz H. , Kunstmann H. 
Published: April 2013

Key Points
Complex snow descriptions reproduce observed snow distribution
Energy balance method enhances modeling daily snowmelt and discharge variations
Simulating lateral snow transport improves runoff modeling in the catchment
Spectrum of storm event hydrologic response in urban watersheds
Authors: Smith B. K. , Smith J. A. , Baeck M. L. , Villarini G. , Wright D. B. 
Published: April 2013

Key Points
Peak discharge and runoff ratio distributions vary greatly between urban basins
Stormwater detention infrastructure increases response times and runoff ratios
Spatial and temporal properties of flood‐producing rainfall vary over the basins
Determination of phosphorus and other elements in atmospheric aerosols using synchrotron total‐reflection X‐ray fluorescence
Authors: Fittschen Ursula E. A. , Streli Christina , Meirer Florian , Alfeld Matthias 
Published: April 2013

In this study, P and other low Z elements were determined in aerosol particulates from ambient air using synchrotron radiation‐induced total‐reflection X‐ray fluorescence analysis.Atmospheric transport of nutrients such as P or Si to the oceans is a key factor to marine plankton growth. Concentration of these elements in marine air masses is generally low (P < 10 ng/m3). Therefore, analytical procedures enabling for low detection limits are of interest. Because particle size is strongly correlated to its origin and sedimentation, the aerosols were collected with the aid of a low‐pressure Berner impactor, which separates the aerosol particulates in nine size fractions with the smallest fraction from 15 to 30 nm.To be able to determine low Z elements, measurements were performed under vacuum conditions at the FLUO beamline at the ANKA synchrotron. An excitation energy of 3.5 keV near the P K‐edge but below the Ca K absorption edge was chosen to avoid interferences of the P K‐line with the detector escape artifact of the Ca‐Kα line.The result showed P was present in concentration from 2 to 180 ng/m3. Detection limits were found to be generally 0.2–0.3 ng/m3 for a collecting time of 1 h for the aerosols, which is an improvement to detection limits reported in other studies. Other elements such as S, Cl, and Si were determined as well. Si like P is a nutrient for marine plankton (diatoms). S and Cl play an important role in cloud formation, e.g. polar stratospheric clouds. Copyright © 2013 John Wiley & Sons, Ltd.
Factors Associated With Uterine Endometrial Hyperplasia and Pyometra in Wild Canids: Implications for Fertility
Authors: Asa Cheryl S. , Bauman Karen L. , Devery Sarah , Zordan Martín , Camilo Gerardo R. , Boutelle Sally , Moresco Anneke 
Published: April 2013

AbstractThe ability to safely and effectively manage reproduction is central to the success of AZA captive‐breeding programs. Although the AZA Wildlife Contraception Center routinely monitors contraceptive safety, there have been no studies that compare the effects of contraceptive use to separation of males from females, the other option for preventing reproduction. We used retrospective medical records and pathology reports submitted by AZA and related facilities for the seven AZA‐managed canid species to assess rates of uterine pathology relative to female reproductive life histories. Our results showed that the prevalence of both pyometra and endometrial hyperplasia (EH) was associated not only with treatment with the two most common contraceptives (Suprelorin® and MGA implants) but also with the number of years barren (i.e., not producing a litter and not contracepted). Rates of pyometra and EH were especially high in African painted dogs and red wolves, but lowest in swift and fennec foxes. The number of years producing a litter had a low association, suggesting it could be protective against uterine pathology. A more recently developed Suprelorin® protocol using Ovaban® to prevent the initial stimulation phase, followed by implant removal when reversal is desired, may be a safer contraceptive option. These results concerning the relationship between reproductive management and uterine health have important implications for AZA‐managed programs, since the unsustainability of many captive populations may be due at least in part to infertility. Managing a female's reproductive lifespan to optimize or maintain fertility will require a reconsideration of how breeding recommendations are formulated. Zoo Biol. 33:8–19, 2014. © 2013 Wiley Periodicals Inc.