bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Countries or Hospitals With Longer Hospital Stays for Acute Heart Failure Have Lower Readmission Rates?
Authors: Eapen Zubin J. , Reed Shelby D. , Li Yanhong , Kociol Robb D. , Armstrong Paul W. , Starling Randall C. , McMurray John J. , Massie Barry M. , Swedberg Karl , Ezekowitz Justin A. , Fonarow Gregg C. , Teerlink John R. , Metra Marco , Whellan David J. , O’Connor Christopher M. , Califf Robert M. , Hernandez Adrian F. 
Published: June 2013

Background—
Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length of stay for the initial hospitalization is not clear.

Methods and Results—

We used hierarchical modeling of data from a clinical trial to examine variations in length of stay across countries and across hospitals in the United States and its association with readmission within 30 days of randomization. Main outcomes included associations between country-level length of stay and readmission rates, after adjustment for patient-level case mix; and associations between length of stay and readmission rates across sites in the United States. Across 27 countries with 389 sites and 6848 patients, mean length of stay ranged from 4.9 to 14.6 days (6.1 days in the United States). Rates of all-cause readmission ranged from 2.5% to 25.0% (17.8% in the United States). There was an inverse correlation between country-level mean length of stay and readmission (
r
=–0.52;
P
<0.01). After multivariable adjustment, each additional inpatient day across countries was associated with significantly lower risk of all-cause readmission (odds ratio, 0.86; 95% confidence interval, 0.75–0.98;
P
=0.02) and heart failure readmission (odds ratio, 0.79; 95% confidence interval, 0.69–0.99;
P
=0.03). Similar trends were observed across US study sites concerning readmission for any cause (odds ratio, 0.92; 95% confidence interval, 0.85–1.00;
P
=0.06) and readmission for heart failure (odds ratio, 0.90; 95% confidence interval, 0.80–1.01;
P
=0.07). Across countries and across US sites, longer median length of stay was independently associated with lower risk of readmission.

Conclusions—
Countries with longer length of stay for heart failure hospitalizations had significantly lower rates of readmission within 30 days of randomization. These findings may have implications for developing strategies to prevent readmission, defining quality measures, and designing clinical trials in acute heart failure.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00475852.
The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease
Authors: Gargiulo Paola , Dellegrottaglie Santo , Bruzzese Dario , Savarese Gianluigi , Scala Oriana , Ruggiero Donatella , D’Amore Carmen , Paolillo Stefania , Agostoni Piergiuseppe , Bossone Edoardo , Soricelli Andrea , Cuocolo Alberto , Trimarco Bruno , Filardi Pasquale Perrone 
Published: June 2013

Background—
Ischemia detection with stress cardiac magnetic resonance (CMR) is typically based on induction of either myocardial perfusion defect or wall motion abnormality. Single-center studies have shown the high value of stress CMR for risk stratification. The aim of this study was to define the prognostic value of stress CMR for prediction of adverse cardiac events in patients with known or suspected coronary artery disease.

Methods and Results—

Studies published between January 1985 and April 2012 were identified by database search. We included studies using stress CMR to evaluate subjects with known or suspected coronary artery disease and providing primary data on clinical outcomes of nonfatal myocardial infarction or cardiac death with a follow-up time ≥3 months. Total of 14 studies were finally included, recruiting 12 178 patients. The negative predictive value for nonfatal myocardial infarction and cardiac death of normal CMR was 98.12% (95% confidence interval, 97.26–98.83) during a weighted mean follow-up of 25.3 months, resulting in estimated event rate after a negative test equal to 1.88% (95% confidence interval, 1.17–2.74). The corresponding annualized event rate after a negative test was 1.03%. Comparable negative predictive values for major coronary events were obtained in studies considering the absence of inducible perfusion defect compared with those evaluating the absence of inducible wall motion abnormality (98.39% versus 97.31%, respectively;
P
=0.227 by meta-regression analysis).

Conclusions—
Stress CMR has a high negative predictive value for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify low-risk patients with known or suspected coronary artery disease.
Nanoparticle PET-CT Detects Rejection and Immunomodulation in Cardiac Allografts
Authors: Ueno Takuya , Dutta Partha , Keliher Edmund , Leuschner Florian , Majmudar Maulik , Marinelli Brett , Iwamoto Yoshiko , Figueiredo Jose-Luiz , Christen Thomas , Swirski Filip K. , Libby Peter , Weissleder Ralph , Nahrendorf Matthias 
Published: June 2013

Background—
Macrophages predominate among the inflammatory cells in rejecting allografts. These innate immune cells, in addition to allospecific T cells, can damage cardiomyocytes directly.

Methods and Results—

We explored whether sensitive positron emission tomography–computed tomography (PET-CT) imaging of macrophages-avid nanoparticles detects rejection of heart allografts in mice. In addition, we used the imaging method to follow the immunomodulatory impact of angiotensin-converting enzyme inhibitor therapy on myeloid cells in allografts. Dextran nanoparticles were derivatized with the PET isotope copper-64 and imaged 7 days after transplantation. C57BL/6 recipients of BALB/c allografts displayed robust positron emission tomography signal (standard uptake value allograft, 2.8±0.3; isograft control, 1.7±0.2;
P
<0.05). Autoradiography and scintillation counting confirmed the in vivo findings. We then imaged the effects of angiotensin-converting enzyme inhibitor (5 mg/kg enalapril). Angiotensin-converting enzyme inhibitor significantly decreased nanoparticle signal (
P
<0.05). Histology and flow cytometry showed a reduced number of myeloid cells in the graft, blood, and lymph nodes and diminished antigen presentation (
P
<0.05 versus untreated allografts). Angiotensin-converting enzyme inhibitor also significantly prolonged allograft survival (12 versus 7 days;
P
<0.0001).

Conclusions—
Nanoparticle macrophage PET-CT detects heart transplant rejection and predicts organ survival by reporting on myeloid cells.
Aortic Dilation in Bicuspid Aortic Valve Disease
Authors: Bissell Malenka M. , Hess Aaron T. , Biasiolli Luca , Glaze Steffan J. , Loudon Margaret , Pitcher Alex , Davis Anne , Prendergast Bernard , Markl Michael , Barker Alex J. , Neubauer Stefan , Myerson Saul G. 
Published: June 2013

Background—
Ascending aortic dilation is important in bicuspid aortic valve (BAV) disease, with increased risk of aortic dissection. We used cardiovascular MR to understand the pathophysiology better by examining the links between 3-dimensional flow abnormalities, aortic function, and aortic dilation.

Methods and Results—

A total of 142 subjects underwent cardiovascular MR (mean age, 40 years; 95 with BAV, 47 healthy volunteers). Patients with BAV had predominantly abnormal right-handed helical flow in the ascending aorta, larger ascending aortas (18.3±3.3 versus 15.2±2.2 mm/m
2
;
P
<0.001), and higher rotational (helical) flow (31.7±15.8 versus 2.9±3.9 mm
2
/s;
P
<0.001), systolic flow angle (23.1°±12.5° versus 7.0°±4.6°;
P
<0.001), and systolic wall shear stress (0.85±0.28 versus 0.59±0.17 N/m
2
;
P
<0.001) compared with healthy volunteers. BAV with right-handed flow and right-non coronary cusp fusion (n=31) showed more severe flow abnormalities (rotational flow, 38.5±16.5 versus 27.8±12.4 mm
2
/s;
P
<0.001; systolic flow angle, 29.4°±10.9° versus 19.4°±11.4°;
P
<0.001; in-plane wall shear stress, 0.64±0.23 versus 0.47±0.22 N/m
2
;
P
<0.001) and larger aortas (19.5±3.4 versus 17.5±3.1 mm/m
2
;
P
<0.05) than right–left cusp fusion (n=55). Patients with BAV with normal flow patterns had similar aortic dimensions and wall shear stress to healthy volunteers and younger patients with BAV showed abnormal flow patterns but no aortic dilation, both further supporting the importance of flow pattern in the pathogenesis of aortic dilation. Aortic function measures (distensibility, aortic strain, and pulse wave velocity) were similar across all groups.

Conclusions—
Flow abnormalities may be a major contributor to aortic dilation in BAV. Fusion type affects the severity of flow abnormalities and may allow better risk prediction and selection of patients for earlier surgical intervention.
Predictors of Long-Term Outcomes in Symptomatic Hypertrophic Obstructive Cardiomyopathy Patients Undergoing Surgical Relief of Left Ventricular Outflow Tract Obstruction
Authors: Desai Milind Y. , Bhonsale Aditya , Smedira Nicholas G. , Naji Peyman , Thamilarasan Maran , Lytle Bruce W. , Lever Harry M. 
Published: June 2013

Background—
We report the predictors of long-term outcomes of symptomatic hypertrophic cardiomyopathy patients undergoing surgical relief of left ventricular outflow tract obstruction.

Methods and Results—

We studied 699 consecutive patients who have hypertrophic cardiomyopathy with severe symptomatic left ventricular outflow tract obstruction (47±11 years, 63% male) intractable to maximal medical therapy, who were referred to a tertiary hospital between January 1997 and December 2007 for the surgical relief of left ventricular outflow tract obstruction. We excluded patients <18 years of age, those with an ejection fraction <50%, those with hypertensive heart disease of the elderly, and those with more than mild aortic or mitral stenosis. Clinical, echocardiographic, and Holter data were recorded. A composite end point of death, appropriate internal cardioverter defibrillator discharges, resuscitated from sudden death, documented stroke, and admission for congestive heart failure was recorded. During a mean follow-up of 6.2±3 years, 86 patients (12%) met the composite end point with 30-day, 1-year, and 2-year event rates of 0.7%, 2.8%, and 4.7%, respectively. The hard event rate (death, defibrillator discharge, and resuscitated from sudden death) at 30 days, 1 year, and 2 years was 0%, 1.5%, and 3%, respectively. Stepwise multivariable analysis identified residual postoperative atrial fibrillation (hazard ratio, 2.12; confidence interval, 1.37–3.34;
P
=0.001) and increasing age (hazard ratio, 1.49; confidence interval, 1.22–1.82;
P
=0.001) as independent predictors of long-term composite outcomes.

Conclusions—
Symptomatic adult hypertrophic cardiomyopathy patients undergoing surgery for the relief of left ventricular outflow tract obstruction have low event rates during long-term follow-up; worse outcomes are predicted by increasing age and the presence of residual atrial fibrillation during follow-up.
Protein Kinase G Positively Regulates Proteasome-Mediated Degradation of Misfolded Proteins
Authors: Ranek Mark J. , Terpstra Erin J.M. , Li Jie , Kass David A. , Wang Xuejun 
Published: June 2013

Background—
Proteasome functional insufficiency is implicated in a large subset of cardiovascular diseases and may play an important role in their pathogenesis. The regulation of proteasome function is poorly understood, hindering the development of effective strategies to improve proteasome function.

Methods and Results—

Protein kinase G (PKG) was manipulated genetically and pharmacologically in cultured cardiomyocytes. Activation of PKG increased proteasome peptidase activities, facilitated proteasome-mediated degradation of surrogate (enhanced green fluorescence protein modified by carboxyl fusion of degron CL1) and bona fide (CryAB
R120G
) misfolded proteins, and attenuated CryAB
R120G
overexpression–induced accumulation of ubiquitinated proteins and cellular injury. PKG inhibition elicited the opposite responses. Differences in the abundance of the key 26S proteasome subunits Rpt6 and β5 between the PKG-manipulated and control groups were not statistically significant, but the isoelectric points were shifted by PKG activation. In transgenic mice expressing a surrogate substrate (GFPdgn), PKG activation by sildenafil increased myocardial proteasome activities and significantly decreased myocardial GFPdgn protein levels. Sildenafil treatment significantly increased myocardial PKG activity and significantly reduced myocardial accumulation of CryAB
R120G
, ubiquitin conjugates, and aberrant protein aggregates in mice with CryAB
R120G
-based desmin-related cardiomyopathy. No discernible effect on bona fide native substrates of the ubiquitin-proteasome system was observed from PKG manipulation in vitro or in vivo.

Conclusions—
PKG positively regulates proteasome activities and proteasome-mediated degradation of misfolded proteins, likely through posttranslational modifications to proteasome subunits. This may be a new mechanism underlying the benefit of PKG stimulation in treating cardiac diseases. Stimulation of PKG by measures such as sildenafil administration is potentially a new therapeutic strategy to treat cardiac proteinopathies.
Cardiovascular Effects of a Novel SIRT1 Activator, SRT2104, in Otherwise Healthy Cigarette Smokers
Authors: Venkatasubramanian Sowmya , Noh Radzi Mohd , Daga Shruti , Langrish Jeremy P. , Joshi Nikhil V. , Mills Nicholas L. , Hoffmann Ethan , Jacobson Eric W. , Vlasuk George P. , Waterhouse Brian R. , Lang Ninian N. , Newby David E. 
Published: June 2013

Background

We examined the effect of the oral
SIRT
1 activator
SRT
2104 on cardiovascular function in otherwise healthy cigarette smokers.

Methods and Results

Twenty‐four otherwise healthy cigarette smokers participated in a randomized double‐blind, placebo‐controlled crossover trial and received 28 days of oral
SRT
2104 (2.0 g/day) or matched placebo. Plasma
SRT
2104 concentrations, serum lipid profile, plasma fibrinolytic factors, and markers of platelet and monocyte activation were measured at baseline and at the end of each treatment period together with an assessment of forearm blood flow during intra‐arterial bradykinin, acetylcholine, and sodium nitroprusside infusions. Three hours postdose, mean plasma
SRT
2104 concentration was 1328±748 ng/mL after 28 days of active treatment. Compared with placebo, serum lipid profile improved during
SRT
2104 administration, with reductions in serum total cholesterol (−11.6±20 versus 6±21 mg/dL), low‐density lipoprotein cholesterol (−10±17 versus 3±21 mg/dL), and triglyceride (−39.8±77 versus 13.3±57 mg/dL) concentrations (
P
<0.05 for all). All vasodilators produced a dose‐dependent increase in blood flow (
P
<0.0001) that was similar during each treatment period (
P
>0.05 for all). No significant differences in fibrinolytic or blood flow parameters were observed between placebo and
SRT
2014.

Conclusions

SRT
2104 appears to be safe and well tolerated and associated with an improved lipid profile without demonstrable differences in vascular or platelet function in otherwise healthy cigarette smokers.

Clinical Trial Registration

http://www.clinicaltrials.gov
. Unique identifier:
NCT
01031108.
Relationship Between Platelet and Urinary 8‐Iso‐PGF2α Levels in Subjects With Different Degrees of NOX2 Regulation
Authors: Carnevale Roberto , Iuliano Luigi , Nocella Cristina , Bartimoccia Simona , Trapè Stefano , Russo Roberta , Gentile Maria Cristina , Cangemi Roberto , Loffredo Lorenzo , Pignatelli Pasquale , Violi Francesco ,   IPINET group
Published: June 2013

Background

Urinary 8‐iso‐
PGF
2α, a marker of oxidative stress, is influenced by the activation of
NOX
2. It is unclear if platelets 8‐iso‐
PGF
2α contribute to urinary 8‐iso‐
PGF
2α.

Methods and Results

In a cross‐sectional study, platelet, urinary, and serum 8‐iso‐
PGF
2α were determined in subjects with downregulation (X‐linked chronic granulomatous disease [
X‐CGD
], n=25) and upregulation (type
II
diabetic patients [T2D], n=121) of
NOX
2 and 153 controls matched for sex and age. In diabetic patients (n=18), the above variables were repeated before and after 7 days treatment with 100 mg/day aspirin or 100 mg/day aspirin plus 40 mg/day atorvastatin. In vitro study was performed to see the contribution of blood cells to serum 8‐iso‐
PGF
2α. Compared with controls,
X‐CGD
patients had lower platelet, serum, and urinary 8‐iso‐
PGF
2α values; conversely, diabetic patients had higher values of 8‐iso‐
PGF
2α compared with controls. Urinary 8‐iso‐
PGF
2α significantly correlated with both platelet and serum 8‐iso‐
PGF
2α in the 2 cohorts. A parallel increase of platelet, serum, and urinary 8‐iso‐
PGF
2α by aspirin and a parallel decrease by aspirin plus atorvastatin were detected in the interventional study. In vitro study demonstrated that platelets contribute to 37% of serum 8‐iso‐
PGF
2α and that only 13% of it is of extravascular origin.

Conclusions

The study suggests that
NOX
2 contributes to the formation of 8‐iso‐
PGF
2α in both platelets and urine. The direct correlation between platelet and urinary 8‐iso‐
PGF
2α suggests that, at least partly, urinary 8‐iso‐
PGF
2α reflects platelet 8‐iso‐
PGF
2α production. Analysis of serum 8‐iso‐
PGF
2α may represent a novel tool to investigate the production of 8‐iso‐
PGF
2α by blood cells including platelets.

Clinical Trial Registration

URL: ClinicalTrials.gov. Unique Identifier:
NCT01250340
.
Evaluation of Alternate Category Structures for the Strain Index
Authors: Meyers Alysha R. , Gerr Fredric , Fethke Nathan B. 
Published: June 2013

Objective: The purpose of this study was to develop alternative Strain Index risk classification categories. Background: Strain Index scores are usually categorized into four Strain Index “risk categories.” The “original” risk categories were developed in the meat-packing industry and may not be fully applicable to other industries. Method: Daily Strain Index scores were estimated among 276 manufacturing workers participating in a cohort study of occupational risk factors for hand–arm musculoskeletal symptoms. Each score was categorized using the original method and a new method based on quartiles of Strain Index score values among symptomatic participants. Models examining associations between original Strain Index risk categories and incident hand–arm symptoms were compared to models examining associations between the alternative Strain Index risk categories and incident hand–arm symptoms. Results: Compared to the respective referent categories, a twofold or greater increase in the risk of incident hand–arm symptoms was observed for the highest original Strain Index risk category (HR = 2.06, 95% CI = [1.08–3.92]) and for the second highest alternate Strain Index risk exposure category (HR = 2.21, 95% CI = [1.26–3.85]). Although significant associations between Strain Index risk category and incident hand–arm symptoms were observed for both Strain Index categorization methods, model fit statistics favored the alternate approach. Conclusion: Results from this study suggests that the Strain Index risk category structure may need to be tailored to specific populations. Application: If verified, results from this study provide a better way to identify hazardous manufacturing jobs and target them for exposure reduction.
Grinding of ethylene–propylene–diene monomer vulcanizates
Authors: Prut Eduard , Solomatin Dmitry , Kuznetsova Olga , Tkachenko Larisa , Khalilov Dmitry 
Published: June 2013

The grinding under the action of shear deformations of vulcanizates of oil-filled ethylene–propylene–diene elastomer cured by a sulfur-based system up to different degrees of cross-linking was studied. Monodisperse powders with a predominant fraction of particle sizes 0.315–0.63 mm were obtained. The effects of the cross-link density of the original vulcanizate on the content of sol fraction and the cross-link density of the rubber powder were estimated. The possibility of producing molding materials from rubber powders with enhanced rigidity using the method of high-temperature sintering was shown. The dependence of the structure and properties of molding materials on the parameters of rubber powders was studied. The mechanisms of the grinding and high-temperature sintering are proposed.
Effects of Music Therapy and Music-Assisted Relaxation and Imagery on Health-Related Outcomes in Diabetes Education
Authors: Mandel Susan E. , Davis Beth A. , Secic Michelle 
Published: June 2013

Purpose The purpose of the feasibility study was to compare the effects of music-assisted relaxation and imagery, administered via compact disc recording (MARI CD) without therapeutic intervention, to the effects of music therapy (MT), facilitated by a board-certified music therapist, on selected health outcomes of patients enrolled in diabetes self-management education/training (DSME/T). Methods A 3-group, parallel, randomized controlled trial with 199 patients, aged 30 to 85 years with type 1, type 2, or prediabetes was employed. Patients were enrolled in a study from 2 hospital sites and randomly assigned to: DSME/T alone, DSME/T plus MARI CD, or DSME/T plus MT. The MARI CD included researcher-selected music and spoken suggestions, while MT included therapeutic experiences with personally preferred relaxing and energizing music. Outcome measures included blood pressure, glycosylated hemoglobin (A1C), body mass index (BMI), trait anxiety, state anxiety, and stress. Results There were no statistically significant differences among the 3 conditions in blood pressure, A1C, BMI, trait anxiety, or stress. Significant changes over time were evident in the MT condition from pre- to post-each session in systolic blood pressure, state anxiety, and stress. Blood pressure changes were compared pre- to postprogram for those patients with a comorbidity of hypertension between DSME/T alone and a combined music intervention group (MT and MARI CD). It was found that the music intervention group had a significantly larger decrease in systolic blood pressure. Themes derived from patient narratives further informed the data. Conclusions The study results support the relationship between DSME/T and improvement on all measured outcomes except blood pressure. Results suggest the feasibility of integrating MARI and MT with DSME/T to potentially lower systolic blood pressure of patients with diabetes and a comorbidity of hypertension. Collaboration between diabetes educators and board-certified music therapists is recommended.