bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Routine Pressure Wire Assessment Influence Management Strategy at Coronary Angiography for Diagnosis of Chest Pain?
Authors: Curzen Nick , Rana Omar , Nicholas Zoe , Golledge Peter , Zaman Azfar , Oldroyd Keith , Hanratty Colm , Banning Adrian , Wheatcroft Stephen , Hobson Alex , Chitkara Kam , Hildick-Smith David , McKenzie Dan , Calver Alison , Dimitrov Borislav D. , Corbett Simon 
Published: March 2014

Background—
The use of coronary angiography (CA) for diagnosis and management of chest pain (CP) has several flaws. The assessment of coronary artery disease using fractional flow reserve (FFR) is a well-validated technique for describing lesion-level ischemia and improves clinical outcome in the context of percutaneous coronary intervention. The impact of routine FFR at the time of diagnostic CA on patient management has not been determined.

Methods and Results—
Two hundred patients with stable CP underwent CA for clinical indications. The supervising cardiologist (S.C.) made a management plan based on CA (optimal medical therapy alone, percutaneous coronary intervention, coronary artery bypass grafting, or more information required) and also recorded which stenoses were significant. An interventional cardiologist then measured FFR in all patent coronary arteries of stentable diameter (≥2.25 mm). S.C. was then asked to make a second management plan when FFR results were disclosed. Overall, after disclosure of FFR data, management plan based on CA alone was changed in 26% of patients, and the number and localization of functional stenoses changed in 32%. Specifically, of 72 cases in which optimal medical therapy was recommended after CA, 9 (13%) were actually referred for revascularization with FFR data. By contrast, of 89 cases in whom management plan was optimal medical therapy based on FFR, revascularization would have been recommended in 25 (28%) based on CA.

Conclusions—
Routine measurement of FFR at CA has important influence both on which coronary arteries have significant stenoses and on patient management. These findings could have important implications for clinical practice.

Clinical Trial Registration—

URL:
http://www.clinicaltrial.gov
. Unique identifier: NCT01070771.
Translational Neurorehabilitation Research in the Third World
Authors: Anjos Sarah M. , Cohen Leonardo G. , Sterr Annette , de Andrade Karina N.F. , Conforto Adriana B. 
Published: March 2014

Background and Purpose—
Most stroke rehabilitation studies have been performed in high-income countries. The aim of this study was to identify the main barriers for patient inclusion in a research protocol performed in Brazil.

Methods
—

We evaluated reasons for exclusion of patients in a pilot, randomized, double-blinded clinical trial of stroke rehabilitation. Descriptive statistical analysis was performed.

Results
—

Only 5.6% of 571 screened patients were included. Recurrent stroke was responsible for exclusion of 45.4% of potentially eligible patients.

Conclusions
—

Recurrent stroke represented a big barrier to enroll patients in the protocol. External validity of rehabilitation trials will benefit from definition of study criteria according to regional characteristics of patients, including rates of recurrent stroke.

Clinical Trial Registration
—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01333579.
Accuracy of Emergency Medical Services–Reported Last Known Normal Times in Patients Suspected With Acute Stroke
Authors: Curfman David , Connor Lisa Tabor , Moy Hawnwan Philip , Heitsch Laura , Panagos Peter , Lee Jin-Moo , Tan David K. , Ford Andria L. 
Published: March 2014

Background and Purpose—
The last known normal (LKN) time is a critical determinant of IV tissue-type plasminogen activator (IV tPA) eligibility; however, the accuracy of emergency medical services (EMS)-reported LKN times is unknown. We determined the congruence between neurologist-determined and EMS-reported LKN times and identified predictors of incongruent LKN times.

Methods—
We prospectively collected EMS-reported LKN times for patients brought into the emergency department with suspected acute stroke and calculated the absolute difference between the neurologist-determined and EMS-reported LKN times (|ΔLKN|). We determined the rate of inappropriate IV tPA use if EMS-reported times had been used in place of neurologist-determined times. Univariate and multivariable linear regression assessed for any predictors of prolonged |ΔLKN|.

Results—

Of 251 patients, mean and median |ΔLKN| were 28 and 0 minutes, respectively. |ΔLKN| was <15 minutes in 91% of the entire cohort and <15 minutes in 80% of patients with a diagnosis of stroke (n=86). Of patients who received IV tPA, none would have been incorrectly excluded from IV tPA if the EMS LKN time had been used. Conversely, of patients who did not receive IV tPA, 6% would have been incorrectly included for IV tPA consideration had the EMS time been used. In patients with wake-up stroke symptoms, EMS underestimated LKN times: mean neurologist LKN time−EMS LKN time =208 minutes. The presence of wake-up stroke symptoms (
P
<0.0001) and older age (
P
=0.019) were independent predictors of prolonged |ΔLKN|.

Conclusions—
EMS-reported LKN times were largely congruent with neurologist-determined times. Focused EMS training regarding wake-up stroke symptoms may further improve accuracy.
Excitotoxicity and Metabolic Changes in Association With Infarct Progression
Authors: Woitzik Johannes , Pinczolits Alexandra , Hecht Nils , Sandow Nora , Scheel Michael , Drenckhahn Christoph , Dreier Jens P. , Vajkoczy Peter 
Published: March 2014

Background and Purpose—
We investigated to what extent excitotoxicity and metabolic changes in the peri-infarct region of patients with malignant hemispheric stroke are associated with delayed infarct progression.

Methods—
In 18 patients with malignant hemispheric stroke, 2 microdialysis probes were implanted within the peri-infarct tissue at a distance of 5 and 15 mm to the infarct. Precise probe placement was achieved by intraoperative laser speckle imaging. Glutamate, glucose, pyruvate, and lactate levels were monitored for 5 days after surgery. Delayed infarct progression was determined from serial MRI on the day after surgery and after the monitoring period.

Results—

Initial stroke volume ranged from 122 to 479 cm
3
with a median of 295 cm
3
. Nine of 18 patients (50%) had delayed infarct progression (median, 44 cm
3
; range, 19–93 cm
3
). In these patients, glucose and individual pyruvate levels were significantly lower when compared with patients without infarct progression, whereas glutamate and the lactate–pyruvate ratio were significantly elevated in patients with infarct progression early after surgery (12–36 hours) at the 15-mm microdialysis probe location. Lactate was elevated but without difference between groups.

Conclusions—
Excitotoxic or metabolic impairment was associated with delayed infarct progression and could serve as a treatment target.
Cerebral Cavernous Malformations Arise Independent of the Heart of Glass Receptor
Authors: Zheng Xiangjian , Riant Florence , Bergametti Françoise , Myers Cynthia D. , Tang Alan T. , Kleaveland Benjamin , Pan Wei , Yang Jisheng , Tournier-Lasserve Elisabeth , Kahn Mark L. 
Published: March 2014

Background and Purpose—

The Heart of Glass (HEG) receptor binds KRIT1 and functions with KRIT1, CCM2, and PDCD10 in a common signaling pathway required for heart and vascular development. Mutations in
KRIT1, CCM2
, and
PDCD10
also underlie human cerebral cavernous malformation (CCM) and postnatal loss of these genes in the mouse endothelium results in rapid CCM formation. Here, we test the role of HEG in CCM formation in mice and in humans.

Methods—

We constitutively or conditionally deleted
Heg
and
Ccm2
genes in genetically modified mice. Mouse embryos, brain, and retina tissues were analyzed to assess CCM lesion formation.

Results—

In postnatal mice, CCMs form with
Ccm2
−/−
but not with
Heg
−/−
or
Heg
−/−
;
Ccm2
+/-
endothelial cells. Consistent with these findings, human patients with CCM who lack exonic mutations in
KRIT1, CCM2
, or
PDCD10
do not have mutations in
HEG
.

Conclusions—
These findings suggest that the HEG-CCM signaling functions during cardiovascular development and growth, whereas CCMs arise because of loss of HEG-independent CCM signaling in the endothelium of the central nervous system after birth.
Incident Stroke Is Associated With Common Carotid Artery Diameter and Not Common Carotid Artery Intima-Media Thickness
Authors: Polak Joseph F. , Sacco Ralph L. , Post Wendy S. , Vaidya Dhananjay , Arnan Martinson Kweku , O’Leary Daniel H. 
Published: March 2014

Background and Purpose—
The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke.

Methods—
We studied 6255 individuals free of coronary heart disease and stroke at baseline with mean age of 62.2 years (47.3% men), members of a multiethnic community–based cohort of whites, blacks, Hispanics, and Chinese. Ischemic stroke events were centrally adjudicated. Common carotid artery interadventitial diameter and IMT were measured. Cases with incident atrial fibrillation (n=385) were excluded. Multivariable Cox proportional hazards models were generated with time to ischemic event as outcome, adjusting for risk factors.

Results—
There were 115 first-time ischemic strokes at 7.8 years of follow-up. Common carotid artery interadventitial diameter was a significant predictor of ischemic stroke (hazard ratio, 1.86; 95% confidence interval, 1.59–2.17 per millimeter) and remained so after adjustment for risk factors and common carotid IMT with a hazard ratio of 1.52/mm (95% confidence interval, 1.22–1.88). Common carotid IMT was not an independent predictor after adjustment (hazard ratio, 0.14; 95% confidence interval, 0.14–1.19).

Conclusions—
Although common carotid IMT is not associated with stroke, interadventitial diameter of the common carotid artery is independently associated with first-time incident ischemic stroke even after adjusting for IMT. Our hypothesis that this is in part attributable to the effects of exposure to blood pressure needs confirmation by other studies.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00063440.
Effect of a brief stress on progesterone plasma levels in pregnant and non-pregnant guinea pigs
Authors: Michel Catherine L. , Bonnet Xavier 
Published: March 2014

Steroid hormones are essential for vertebrate reproduction. They are involved in the regulation of major female reproductive events like ovulation, embryo implantation, or gestation. For instance, progesterone promotes foeto-maternal exchanges whereas glucocorticoids stimulate the mobilization of the required energy resources. However, glucocorticoids are key effectors of the stress response; chronic elevations of these hormones can exert negative effects on reproduction. Yet, little is known about the effects of a brief exposure to a stressor on the respective plasma concentrations of sex steroids and glucocorticoids, notably during pregnancy. We examined the impact of a brief stress (handling + 1.5 hours in a bag) on progesterone and cortisol plasma concentrations in pregnant and non-pregnant female guinea pigs. Analyses revealed that: 1) pregnant females exhibited higher baseline progesterone and cortisol concentrations compared to non-pregnant females, as expected; 2) cortisol concentrations increased rapidly following manipulation, revealing a typical hormonal stress response; and, 3) progesterone concentrations decreased on average by 50.9% following the brief stress period, both in pregnant and non-pregnant individuals. These experimental results show for the first time a drastic and rapid impact on progesterone concentration caused by a brief stress.
A field study on using artificial substrate for nesting of introduced pumpkinseed sunfish, Lepomis gibbosus (Linnaeus, 1758)
Authors: Petrova Uzunova Eliza , Studenkov Slavi , Simeonovska-Nikolova Danilela 
Published: March 2014

We experimentally tested the potential use of artificial substrate – plastic bottles for egg deposition of non-native pumpkinseed sunfish,Lepomis gibbosusL. in a former sand-pit lake in western Bulgaria. The lake is situated close to an urban area, and is characterised by high pumpkinseed abundance. The study was carried out for a period of 105 days during the active pumpkinseed breeding season (from May to August). Five sites along the littoral area of the lake, with different habitat characteristics were selected. Each site was divided into two sections – an experimental and a control section. The plastic bottles (cut into two) were fixed to the lake bottom in the area of the experimental sections. Pumpkinseeds actively used the artificial substrate for nesting and the average use of each bottle was 2.3 times. Simultaneously, on the natural substrate of the experimental sections a total of 372 nests were built. The results showed that the choice of artificial substrate was neither associated with the type of bottom substrate, nor the remaining environmental traits that were studied. However, the use of artificial substrate has made a significant contribution to the total number of nests only on sites with “unsuitable” habitat parameters. These results show that waste products can seriously facilitate pumpkinseed’s abundance.
Selfing and brooding in Alinda biplicata (Gastropoda: Pulmonata: Clausiliidae) – life history traits of a good coloniser
Authors: Maltz Tomasz K. , Sulikowska-Drozd Anna 
Published: March 2014

Alinda biplicatais capable of uniparental reproduction (selfing). The snails need 18 to 24 weeks to reach their ultimate size, and the first reproduction takes place 26 to 39 weeks after shell growth completion. Besides giving birth to juveniles, which is typical ofA. biplicata(39% of litters), the uniparentally reproducing individuals laid egg batches (38%) as well as mixed batches (eggs and juveniles; 23%). Within a few days the eggs decomposed, and in mixed batches they were often consumed by the accompanying neonates. In the next season, 70% of the remaining 20 snails reproduced (all of which had reproduced in the previous season). In the first season the neonate:egg proportion was 54:46, in the second 74:26. The egg-laying should be regarded as an anomaly – getting rid of eggs which were not fertilised or in which embryos died at early cleavage stages. The combination of selfing and brooding may explain the wide distribution and wide range of habitats occupied byA. biplicata.
Legitimate Representation: Civil Society Actors in Peace Negotiations Revisited
Authors: Zanker Franzisca 
Published: March 2014

AbstractCurrent research suggests that negotiations which are more inclusive are more likely to achieve durable peace since they speak to the entire population. One way to ensure public support is through the inclusion of civil society groups, either directly at the negotiation table or indirectly in supportive roles. It is argued that through their inclusion there is a positive effect on the legitimacy of negotiations which in turn leads to more durable peace. Nonetheless, the reasons why and how involving civil society groups improves the legitimacy of negotiations remains little understood. This article considers the gap in research by using original empirical data to look at the peace negotiations held in Liberia in 2003 and Kenya in early 2008. A theoretical model of legitimate negotiations will be used to show in what ways the involvement of civil society groups can in fact make the conduct of negotiations and the outcome of an agreement more legitimate for the aggrieved population.
On Success and Failure: Readiness Theory and the Aceh and Sri Lanka Peace Processes
Authors: Schiff Amira 
Published: March 2014

AbstractThis study presents a comparative analysis of two case studies in which attempts were made to resolve intractable ethno-national conflicts: the peace process undertaken in Aceh between the Government of Indonesia and the Free Aceh Movement, which led to the signing of the Helsinki Memorandum of Understanding (mou) ending the conflict in Aceh; and the process conducted in the Sri Lanka conflict from 2001 through 2004 between the Government of Sri Lanka and the Tamil Tigers, which failed to yield an agreement. The two peace processes will be examined using readiness theory, which focuses on the factors influencing the decision to enter into negotiations. This article also attempts to extend the hypotheses of readiness theory to explore the process of concession-making during the negotiations that took place in the two case studies. The findings indicate that the theory does contribute to understanding the dynamics of the pre-negotiation in both case studies and that applying its hypotheses may contribute to the understanding of the dynamics of the process of reaching an agreement in the Aceh process and of the factors leading to the failure of the negotiations in the Sri Lanka conflict. The analysis also gives rise to some questions that challenge readiness theory and its hypotheses – empirically and methodologically.
Faith, An Alien and Narrow Path of Christian Ethics in Migration
Authors: Asamoah-Gyadu Johnson Kwabena 
Published: March 2014

Abstract
The rise of African immigrant communities in the diaspora, especially in Europe and North America, have contributed significantly to the renewal of Christian presence in those contexts. There are significant numbers of the membership of African immigrant congregations who are economic migrants and whose immigration statuses have not been regularized. The average undocumented migrant lives a very difficult life due to the inability to provide authentic papers for work. This affects the lives of immigrants in several ways, including access to healthcare and education for children. In those circumstances the temptation to survive by assuming false identities is very strong.
The mission of immigrant churches includes the provision of ‘protection’ for their vulnerable members who need to survive a physically precarious diaspora. That African immigrants often reinterpret their problems in terms of attacks from supernatural forces and envious witches at ‘home’ in Africa informs the approach of the leadership to care and counselling. This paper proposes to identify the pastoral problems of African immigrant Christians within the context of situation ethics and how the inability to regularize their stay in Europe and North America affects Christian morality and mission in ‘alien lands’.
The French Counter-Reformation
Authors: Woodcock Philippa 
Published: March 2014

This article discusses the redecoration of the rural French parish church in the French diocese of Le Mans from 1620–1688. Scholars have argued that the diocese’s prolific commissions of terracotta statues and retables represented the impact of the Council of Trent’s drive to educate the clergy and instill in them a sense of connoisseurship; the clergy led the diocese as patrons. Yet, these works of art are also quite particular to the region, suggesting that other factors were responsible for their proliferation. This article examines the statues and retable of St-Léonard-des-Bois, commissioned in c. 1630 and 1684. Using previously unavailable archival material, it proposes two new patrons for these commissions, and reconsiders the motives for clerical and secular leadership in this rural parish. It demonstrates that the rural world was not isolated and it is significant that both patrons came from beyond the parish. The article evaluates the influence upon the statues and retable of the centralising ‘Counter-Reformation’ and local factors such as geography, regional traditions, and local events. It argues that the rural Counter-Reformation had a paradoxical identity. It belonged to wider currents in Catholic Reform, and in the case of St-Léonard, was driven by two patrons determined to create a new position for themselves. However, as both of these commissions were accepted by the church’s fabrique, it is evident that subject choices persistently reflected older traditions, and images responded to very local circumstances.
The Hybrid Tracheoesophageal Puncture Procedure
Authors: Damrose Edward J. , Cho Do-Yeon , Goode Richard L. 
Published: March 2014

Objectives: This report aimed to describe a novel and efficient method of tracheoesophageal puncture using a hybrid device assembled from 2 commercially available puncture kits; to demonstrate the utility of this technique in the performance of primary and secondary procedures, under general and local anesthesia, with and without flap reconstruction; and to evaluate the efficacy of concurrent puncture and valve placement. Methods: Thirty-four patients who underwent either primary or secondary tracheoesophageal puncture for voice restoration. Charts were reviewed retrospectively for complications, time to first valve change, operative time, and blood loss. Results: Using this novel hybrid device, simultaneous puncture and valve placement was achieved in 34 consecutive patients. There was 1 major complication; blood loss was negligible; and the procedure could be accomplished in all cases. There were no cases of prosthesis failure as a result of the insertion technique. Conclusion: Concurrent tracheoesophageal puncture and voice prosthesis placement is a simple and efficient method of voice restoration in the laryngectomized patient and can be more easily accomplished with a hybrid device assembled from the components of 2 commercially available puncture kits. It can be performed under local as well as general anesthesia. The procedure is adaptable to a variety of clinical situations.
Research output of health research institutions and its use in 42 sub-Saharan African countries: results of a questionnaire-based survey
Authors: Kebede Derege , Zielinski Chris , Mbondji Peter Ebongue , Sanou Issa , Kouvividila Wenceslas , Lusamba-Dikassa Paul-Samson 
Published: March 2014

Objective To describe and analyse research output from surveyed national health research institutions in Africa. Design The survey used a structured questionnaire to solicit information from 847 health research institutions in 42 countries of the World Health Organization African Region. Setting Eight hundred and forty-seven health research institutions in 42 sub-Saharan African countries. Participants Key informants from the health research institutions. Main outcome measures Volume, type and medium of publications, and distribution of research outputs. Results Books or chapters for books accounted for the highest number of information products published (on average 16.7 per respondent institution), followed by patents registered in country (8.2), discussion or working papers (6.5) and conference proceedings (6.4). Publication in a peer-reviewed journal constituted only a minor part of research output (on average about 1 paper per institution). Radio and TV broadcasts on health research accounted for the highest number of products issued by institution staff (on average 5.5 per institution), followed by peer-reviewed journals indexed internationally (3.8) or nationally (3.1). There were, on average, 1.5 press releases, 1.5 newspaper or magazine articles, and 1.4 policy briefs per institution. Over half of respondent institutions (52%) developed briefs and summaries of articles to share with their target audiences, 43% developed briefs for possible actions and 37% provided articles and reports upon request. Only a small proportion of information products produced were available in institutional databases. Conclusions The research output of health research institutions in the Region is significant, but more effort is needed to strengthen research capacity, including human and financial resources.