bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathology of Second-Generation Everolimus-Eluting Stents Versus First-Generation Sirolimus- and Paclitaxel-Eluting Stents in Humans
Authors: Otsuka Fumiyuki , Vorpahl Marc , Nakano Masataka , Foerst Jason , Newell John B. , Sakakura Kenichi , Kutys Robert , Ladich Elena , Finn Aloke V. , Kolodgie Frank D. , Virmani Renu 
Published: October 2013

Background—
Clinical trials have demonstrated that the second-generation cobalt-chromium everolimus-eluting stent (CoCr-EES) is superior to the first-generation paclitaxel-eluting stent (PES) and is noninferior or superior to the sirolimus-eluting stent (SES) in terms of safety and efficacy. It remains unclear whether vascular responses to CoCr-EES are different from those to SES and PES because the pathology of CoCr-EES has not been described in humans.

Methods and Results—

A total of 204 lesions (SES=73; PES=85; CoCr-EES=46) from 149 autopsy cases with duration of implantation >30 days and ≤3 years were pathologically analyzed, and comparison of vascular responses was corrected for duration of implantation. The observed frequency of late and very late stent thrombosis was less in CoCr-EES (4%) versus SES (21%;
P
=0.029) and PES (26%;
P
=0.008). Neointimal thickness was comparable among the groups, whereas the percentage of uncovered struts was strikingly lower in CoCr-EES (median=2.6%) versus SES (18.0%;
P
<0.0005) and PES (18.7%;
P
<0.0005). CoCr-EES showed a lower inflammation score (with no hypersensitivity) and less fibrin deposition versus SES and PES. The observed frequency of neoatherosclerosis, however, did not differ significantly among the groups (CoCr-EES=29%; SES=35%; PES=19%). CoCr-EES had the least frequency of stent fracture (CoCr-EES=13%; SES=40%; PES=19%;
P
=0.007 for CoCr-EES versus SES), whereas fracture-related restenosis or thrombosis was comparable among the groups (CoCr-EES=6.5%; SES=5.5%; PES=1.2%).

Conclusions—
CoCr-EES demonstrated greater strut coverage with less inflammation, less fibrin deposition, and less late and very late stent thrombosis compared with SES and PES in human autopsy analysis. Nevertheless, the observed frequencies of neoatherosclerosis and fracture-related adverse pathological events were comparable in these devices, indicating that careful long-term follow-up remains important even after CoCr-EES placement.
Vascular Progenitors From Cord Blood–Derived Induced Pluripotent Stem Cells Possess Augmented Capacity for Regenerating Ischemic Retinal Vasculature
Authors: Park Tea Soon , Bhutto Imran , Zimmerlin Ludovic , Huo Jeffrey S. , Nagaria Pratik , Miller Diana , Rufaihah Abdul Jalil , Talbot Connie , Aguilar Jack , Grebe Rhonda , Merges Carol , Reijo-Pera Renee , Feldman Ricardo A. , Rassool Feyruz , Cooke John , Lutty Gerard , Zambidis Elias T. 
Published: October 2013

Background—
The generation of vascular progenitors (VPs) from human induced pluripotent stem cells (hiPSCs) has great potential for treating vascular disorders such as ischemic retinopathies. However, long-term in vivo engraftment of hiPSC-derived VPs into the retina has not yet been reported. This goal may be limited by the low differentiation yield, greater senescence, and poor proliferation of hiPSC-derived vascular cells. To evaluate the potential of hiPSCs for treating ischemic retinopathies, we generated VPs from a repertoire of viral-integrated and nonintegrated fibroblast and cord blood (CB)–derived hiPSC lines and tested their capacity for homing and engrafting into murine retina in an ischemia-reperfusion model.

Methods and Results—

VPs from human embryonic stem cells and hiPSCs were generated with an optimized vascular differentiation system. Fluorescence-activated cell sorting purification of human embryoid body cells differentially expressing endothelial/pericytic markers identified a CD31
+
CD146
+
VP population with high vascular potency. Episomal CB-induced pluripotent stem cells (iPSCs) generated these VPs with higher efficiencies than fibroblast-iPSC. Moreover, in contrast to fibroblast-iPSC-VPs, CB-iPSC-VPs maintained expression signatures more comparable to human embryonic stem cell VPs, expressed higher levels of immature vascular markers, demonstrated less culture senescence and sensitivity to DNA damage, and possessed fewer transmitted reprogramming errors. Luciferase transgene-marked VPs from human embryonic stem cells, CB-iPSCs, and fibroblast-iPSCs were injected systemically or directly into the vitreous of retinal ischemia-reperfusion–injured adult nonobese diabetic-severe combined immunodeficient mice. Only human embryonic stem cell– and CB-iPSC–derived VPs reliably homed and engrafted into injured retinal capillaries, with incorporation into damaged vessels for up to 45 days.

Conclusions—
VPs generated from CB-iPSCs possessed augmented capacity to home, integrate into, and repair damaged retinal vasculature.
Electromagnetic Interference With Implantable Cardioverter-Defibrillators at Power Frequency
Authors: Napp Andreas , Joosten Stephan , Stunder Dominik , Knackstedt Christian , Zink Matthias , Bellmann Barbara , Marx Nikolaus , Schauerte Patrick , Silny Jiri 
Published: October 2013

Background—
The number of implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death is continuing to increase. Given the technological complexity of ICDs, it is of critical importance to identify and control possible harmful electromagnetic interferences between various sources of electromagnetic fields and ICDs in daily life and occupational environments.

Methods and Results—

Interference thresholds of 110 ICD patients (1-, 2-, and 3-chamber ICDs) were evaluated in a specifically developed test site. Patients were exposed to single and combined electric and magnetic 50-Hz fields with strengths of up to 30 kV·m
−1
and 2.55 mT. Tests were conducted considering worst-case conditions, including maximum sensitivity of the device or full inspiration. With devices being programmed to nominal sensitivity, ICDs remained unaffected in 91 patients (83%). Five of 110 devices (5%) showed transient loss of accurate right ventricular sensing, whereas 14 of 31 (45%) of the 2- and 3-chamber devices displayed impaired right atrial sensing. No interference was detected in 71 patients (65%) within the tested limits with programming to maximum sensitivity, whereas 20 of 110 subjects (18%) exhibited right ventricular disturbances and 19 of 31 (61%) subjects exhibited right atrial disturbances.

Conclusions—
Extremely low-frequency daily-life electromagnetic fields do not disturb sensing capabilities of ICDs. However, strong 50-Hz electromagnetic fields, present in certain occupational environments, may cause inappropriate sensing, potentially leading to false detection of atrial/ventricular arrhythmic events. When the right atrial/right ventricular interferences are compared, the atrial lead is more susceptible to electromagnetic fields.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov/ct2/show/NCT01626261
. Unique identifier: NCT01626261.
Assessment of a Short Diabetes Knowledge Instrument for Older and Minority Adults
Authors: Quandt Sara A. , Ip Edward H. , Kirk Julienne K. , Saldana Santiago , Chen Shyh-Huei , Nguyen Ha , Bell Ronny A. , Arcury Thomas A. 
Published: October 2013

Purpose The purpose of the study was to assess the performance of a Short Diabetes Knowledge Instrument (SDKI) in a large multi-ethnic sample of older adults with diabetes and to identify possible modifications to improve its ability to document diabetes knowledge. Research Design and Methods A sample of 593 African American, American Indian, and white female and male adults 60 years and older, with diabetes diagnosed at least 2 years prior, was recruited from 8 North Carolina counties. All completed an interview that included a 16-item questionnaire to assess diabetes knowledge. A subsample of 46 completed the questionnaire a second time at a subsequent interview. Item-response analysis was used to refine the instrument to well-performing items. The instrument consisting of the remaining items was subjected to analyses to assess validity and test-retest reliability. Results Three items were removed after item-response analysis. Scores for the resulting instrument were lower among minority and older participants, as well as those with lower educational attainment and income. Scores for test-retest were highly correlated. Conclusions The SDKI (13-item questionnaire) appears to be a valid and reliable instrument to evaluate knowledge about diabetes. Assessment in a multi-ethnic sample of older adults suggests that this instrument can be used to measure diabetes knowledge in diverse populations. Further evaluation is needed to determine whether or not this instrument can detect changes in knowledge resulting from diabetes education or other interventions.
Aortic valve replacement in over 70- and over 80-year olds: 5-year cohort study
Authors: Wang Tom Kai Ming , Sathananthan Janarthanan , Chieng Nicholas , Gamble Greg D , Haydock David A , Ruygrok Peter N 
Published: October 2013

Background Demand for aortic valve intervention remains high, and together with the recent introduction of transcatheter aortic valve implantation, this motivates a review of surgical aortic valve replacement in elderly recipients. Methods Consecutive patients over 70 years of age having isolated aortic valve replacement during 2007–11 were retrospectively identified and divided into 70–79 and ≥ 80 years age groups for analyses. Results 62 octogenarians and 121 septuagenarians were eligible. Among octogenarians, a lower proportion were in Canadian Cardiovascular Society angina class 3–4 (3.2% vs. 14.0%, p = 0.022) and fewer had diabetes (11.3% vs. 24.8%, p = 0.034), but a higher proportion had infective endocarditis (6.5% vs. 0%, p = 0.012), and EuroSCORE II was higher (4.9% vs. 3.7%, p < 0.001). Despite this, operative mortality was lower in octogenarians (0% vs. 7.4%, p = 0.029), although hospital stay (11.7 vs. 8.9 days, p = 0.026) was longer. One-, 3-, and 5-year survival rates were 95.2%, 90.1%, and 75.3% for octogenarians and 89.2%, 81.7%, and 70.2% for septuagenarians ( p = 0.398). Canadian Cardiovascular Society angina class 3–4 and the presence of other valvular stenosis or regurgitation were independent predictors of mortality. Conclusion Octogenarians had lower operative mortality despite a higher predicted risk preoperatively. Other factors beyond age and EuroSCORE, such as frailty, may be important in deciding whether elderly patients should undergo aortic valve replacement.
Heart transplant survival rate in Iran: a single-center registry report
Authors: Salehi Mehrdad , Bakhshandeh Ali Reza , Latifi Sahar , Rahmanian Mehrzad 
Published: October 2013

Aim to determine 1-month and 1-year survival rate in recipients of heart transplants in Imam Khomeini Medical Center. Methods we analyzed the outcomes of 69 patients who underwent heart transplantation between 2007 and 2010. The 1-month and 1-year survival rates were calculated, and we assessed prognostic factors such as donor and recipient age and sex, graft ischemic time during surgery, and liver and kidney function tests. Results increased donor age had a significant negative effect on survival rate ( p = 0.005). Sex differences between donor and recipient had no association with transplant outcome and survival rate. The overall 1-month and 1-year survival was 82.6% ( n = 54) and 70% ( n = 48), respectively. Conclusion heart transplantation is a lifesaving procedure for end-stage heart disorders. Mortality after heart transplantation depends on numerous factors, and thus survival rates differ among centers. The 1-month and 1-year survival rates after heart transplant in our center currently stand at 82.6% and 70%, respectively.
Preoperative levosimendan in ischemic mitral valve repair
Authors: Sharma Pranav , Malhotra Amber , Gandhi Sanjay , Garg Pankaj , Bishnoi Arvind , Gandhi Hemang 
Published: October 2013

Background Levosimendan is a new calcium sensitizing drug with vasodilatory and inotropic properties, which is used for the treatment of postoperative low cardiac output syndrome and difficult weaning from cardiopulmonary bypass. Objective To evaluate the hemodynamic effects of levosimendan during and after coronary artery bypass grafting on cardiopulmonary bypass and mitral valve repair in patients with low left ventricular ejection fractions (<30%). Methods 40 patients were enrolled in this double-blind prospective randomized controlled trial. They received either levosimendan or a placebo preoperatively ( n = 20) for 24 h. Clinical parameters were measured before and after administration. Any adverse events during and after drug administration and postoperative complications were evaluated. Results Patients treated with levosimendan exhibited a higher cardiac index and mean arterial pressure intraoperative and in the early postoperative period, compared to the control group. Patients treated with levosimendan required less ventilatory support ( p < 0.0001) and had shorter intensive care unit ( p < 0.0001) and hospital stay ( p < 0.0001). Conclusions Preoperative treatment with levosimendan in patients undergoing coronary artery bypass grafting and mitral valve repair resulted in improved hemodynamics and a stable postoperative course.
Oral sumatriptan for migraine in children and adolescents: A randomized, multicenter, placebo-controlled, parallel group study
Authors: Fujita Mitsue , Sato Katsuaki , Nishioka Hiroshi , Sakai Fumihiko 
Published: October 2013

Objective The objective of this article is to evaluate the efficacy and tolerability of two doses of oral sumatriptan vs placebo in the acute treatment of migraine in children and adolescents. Background Currently, there is no approved prescription medication in Japan for the treatment of migraine in children and adolescents. Methods This was a multicenter, outpatient, single-attack, double-blind, randomized, placebo-controlled, parallel-group study. Eligible patients were children and adolescents aged 10 to 17 years diagnosed with migraine with or without aura (ICHD-II criteria 1.1 or 1.2) from 17 centers. They were randomized to receive sumatriptan 25 mg, 50 mg or placebo (1:1:2). The primary efficacy endpoint was headache relief by two grades on a five-grade scale at two hours post-dose. Results A total of 178 patients from 17 centers in Japan were enrolled and randomized to an investigational product in double-blind fashion. Of these, 144 patients self-treated a single migraine attack, and all provided a post-dose efficacy assessment and completed the study. The percentage of patients in the full analysis set (FAS) population who report pain relief at two hours post-treatment for the primary endpoint was higher in the placebo group than in the pooled sumatriptan group (38.6% vs 31.1%, 95% CI: −23.02 to 8.04, p = 0.345). The percentage of patients in the FAS population who reported pain relief at four hours post-dose was higher in the pooled sumatriptan group (63.5%) than in the placebo group (51.4%) but failed to achieve statistical significance ( p = 0.142). At four hours post-dose, percentages of patients who were pain free or had complete relief of photophobia or phonophobia were numerically higher in the sumatriptan pooled group compared to placebo. Both doses of oral sumatriptan were well tolerated. No adverse events (AEs) were serious or led to study withdrawal. The most common AEs were somnolence in 6% (two patients) in the sumatriptan 25 mg treatment group and chest discomfort in 7% (three patients) in the sumatriptan 50 mg treatment group. Conclusions There was no statistically significant improvement between the sumatriptan pooled group and the placebo group for pain relief at two hours. Oral sumatriptan was well tolerated.
Ultrasound Morphology of the Achilles in Asymptomatic Patients With and Without Diabetes
Authors: Abate Michele , Salini Vincenzo , Antinolfi Pierluigi , Schiavone Cosima 
Published: October 2013

Background: The prevalence of tendinopathies is increased in subjects with diabetes mellitus. However, there are few data on the structural abnormalities of Achilles tendons in asymptomatic diabetic patients. The aim of the study was to assess the morphologic characteristics of the Achilles tendon in subjects with diabetes in comparison with controls without diabetes. Methods: Participants were consecutively recruited from an outpatient population. Ultrasound longitudinal and transverse scans were performed bilaterally along the full length of Achilles tendon from the musculotendinous junction to the insertion. Degenerative features (abnormal fibrillar pattern, hypo-hyperechoic areas), signs of enthesopathy (bony erosion, enthesophytes, and bursitis), and intratendinous neovessel formation were recorded. Results: Asymptomatic sonographic abnormalities (ASA) were significantly increased in subjects with diabetes (35/136 [25.7%] vs 32/273 [11.7%], P = .0003). Sixty tendons with ASA were observed in the first group and 45 in the latter because ASA were bilateral in 25 and in 13 subjects, respectively. ASA were more frequently localized at the enthesis (32/60 [53.3%] vs 9/45 [20%], P = .0005) in the diabetes group, whereas, on the contrary, they were more prevalent at the midportion in controls (38/45 [84.4%] vs 36/60 [60%], P < .006). Conclusion: Diabetes may predispose to Achilles tendinopathy and particularly to Achilles enthesopathy. Longitudinal studies, evaluating the progression of the lesions not only in the midportion of the tendon but also at the insertion are needed to support this conclusion. Level of Evidence: Level III, comparative series.
Silfverskiöld’s Test in Total Ankle Replacement With Gastrocnemius Recession
Authors: DeOrio James K. , Lewis John S. 
Published: October 2013

Background: For patients undergoing primary total ankle replacement (TAR) with an equinus contracture, gastrocnemius recession may be performed to increase dorsiflexion. We examined whether gastrocnemius recession would significantly increase dorsiflexion even with a negative Silfverskiöld test. Methods: Data were prospectively collected on a consecutive series of 29 patients who underwent TAR. All were deemed to require lengthening of the posterior soft tissue structures for unacceptable equinus contracture. Once each patient was under anesthesia, Silfverskiöld’s test was performed. A digital photograph was taken with the ankle at maximum passive dorsiflexion with the knee at 0 degrees of flexion and again with the knee at 30 degrees of flexion. Strayer gastrocnemius recession was then performed in standard fashion in every patient. After recession, Silfverskiöld’s test was again performed with photographs obtained in the same manner. The digital photographs demonstrating the results of the preoperative and postoperative Silfverskiöld’s tests in both knee positions were analyzed and the degree of ankle dorsiflexion measured. Results: Regardless of the results of Silfverskiöld’s test, after gastrocnemius recession, patients had an average increase of 12.6 ± 1.6 degrees of dorsiflexion with the knee extended compared to the same position preoperatively ( P < .0001) and an increase of 10.1 ± 2.0 degrees with the knee flexed ( P < .001). In 6 patients Silfverskiöld’s test was markedly positive preoperatively; in this group, recession resulted in an average increase of dorsiflexion of 17.8 ± 3.6 degrees with the knee extended ( P = .004) and 13.4 ± 5.4 degrees with the knee flexed ( P = .055). For the remaining 23 patients with a negative preoperative Silfverskiöld’s test, dorsiflexion increased by 11.3 ± 1.6 ( P < .0001) and 9.3 ± 2.2 degrees ( P = .0003) with the knee extended and flexed, respectively. Conclusion: Our data show that a gastrocnemius recession resulted in a significant, reproducible increase in dorsiflexion regardless of the results of the Silfverskiöld test while avoiding potential push-off and plantarflexion weakness associated with an Achilles lengthening. Level of Evidence: Level IV, case series.
Control of a class of nonsmooth dynamical systems
Authors: Erfanian Hamid Reza , Skandari Mohammad Hadi Noori , Kamyad Ali Vahidian 
Published: October 2013

In this paper, the authors propose an approach to control a class of nonsmooth continuous and discontinuous dynamical systems which is based on a generalization of derivative and Chebyshev pseudospectral (PS) methods. First a generalized derivative for nonsmooth functions, which is proposed by Kamyad et al. is considered. Therefore the obtained generalized derivative of a nonsmooth function is approximated with the Fourier series. So, the nonsmooth control problem is approximated by a smooth optimal control problem and in what follows, it is solved by Chebyshev PS method and the approximate solution for the state and control of the main problem is achieved. Finally, some numerical examples of the control of nonsmooth dynamical systems are solved to illustrate the efficiency of the authors’ approach.
A new tool for hazard analysis and force-field analysis: The Lovebug diagram
Authors: Card Alan J 
Published: October 2013

Background Fishbone diagrams have been widely promoted as a systems-focused hazard analysis tool for use in root cause analysis, but they suffer from a number of structural weaknesses, including a unidirectional structure that only takes into account forces that promote an accident (ignoring those that make the accident less likely or less severe) and a means of displaying these forces that does not convey any difference in strength of influence. In a separate but related issue, many healthcare organizations suffer from a lack of change management expertise. Proposed solution To address these concerns, I present a novel technique, the Lovebug diagram, which draws from both Fishbone diagrams and force-field analysis (an approach to analyzing planned change). This new technique adds value to both its progenitor methods, while retaining their key strengths and ease of use. It can be used both prospectively, to assess planned changes, and retrospectively to assess unplanned (accidental) departures from the status quo. Discussion The Lovebug diagram is a more powerful analytical tool than its progenitor methods; however, overall adoption of systems-focused tools for root cause analysis remains suboptimal. Additional research is needed to determine how best to promote a truly systems-focused approach to healthcare root cause analysis. Beyond this retrospective use of the technique, it represents a simple tool to assist healthcare organizations with prospective change management.
Welfare Homes for Patients Living with HIV/AIDS in Andalusia
Authors: Ivanova Radka , Vergara Salvador , Milla Manuel , Lozano Fernando , Santos Jesús 
Published: October 2013

Aims: To study the AIDS welfare homes (AWHs) in Andalusia, assess their resources and the services provided, and describe the characteristics of their residents. Patients and Methods: Cross-sectional, observational study; an interview questionnaire technique was used with the managers and the residents of the AWHs. Results: A total of 7 AWHs and 96 residents were included; 32% of the staff were health care workers and 45.5% volunteers. The occupancy rate was 86% (2007) and 96% (2008). Residents’ characteristics: mean age 45.6 years, 73% male, 92% with at least 1 AIDS-defining disease, median Karnofsky index 60 (50-80), and median Barthel index 80 (40-100). Half the residents had physical sequelae and 31% mental sequelae. Conclusion: The AWHs perform an important role in the care of certain types of patients with HIV infection. They require human and material resources to be able to tackle the immense difficulties associated with this group of patients.