bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exenatide Reduces Final Infarct Size in Patients With ST-Segment–Elevation Myocardial Infarction and Short-Duration of Ischemia
Authors: Lønborg Jacob , Kelbæk Henning , Vejlstrup Niels , Bøtker Hans Erik , Kim Won Yong , Holmvang Lene , Jørgensen Erik , Helqvist Steffen , Saunamäki Kari , Terkelsen Christian Juhl , Schoos Mikkel Malby , Køber Lars , Clemmensen Peter , Treiman Marek , Engstrøm Thomas 
Published: April 2012

Background—
Exenatide has been demonstrated to be cardioprotective as an adjunct to primary percutaneous coronary intervention in patients with ST-segment–elevation myocardial infarction (STEMI). The aim of the post hoc analysis study was to evaluate the effect of exenatide in relation to system delay, defined as time from first medical contact to first balloon.

Methods and Results—

Patients with STEMI and Thrombolysis In Myocardial Infarction flow 0/1 were randomly assigned to intravenous exenatide or placebo continuous infusion. Study treatment was commenced 15 minutes before intervention and maintained for 6 hours after the procedure. The patients were stratified according to median system delay (132 minutes). Final infarct size and myocardial area at risk were measured by cardiovascular magnetic resonance. Among patients with a system delay ≤132 minutes (n=74), treatment with exenatide resulted in a smaller infarct size (9 grams [interquartile range (IQR), 4–13] versus 13 grams [IQR, 8–24],
P
=0.008, corresponding to 8% [IQR, 4–12] versus 11% [IQR, 7–17] of the left ventricle,
P
=0.015). In a regression analysis adjusting for myocardial area at risk the data points of the exenatide group lay significantly lower than for the placebo group (
P
=0.006). In the patients with system delay >132 minutes (n=74) no difference was observed in infarct size expressed as grams (
P
=0.49) or percentage (
P
=0.46). There was significant interaction between system delay (less than or equal to median versus greater than median) and treatment allocation in terms of infarct size (
P
=0.018).

Conclusions—
In this post hoc analysis, exenatide treatment was associated with a 30% decrease in final infarct size in patients with short system delay, whereas no cardioprotective effect in patients with long system delay was seen. However, this finding must be confirmed in larger studies.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00835848.
Patient Satisfaction at America's Lowest Performing Hospitals
Authors: Girotra Saket , Cram Peter , Popescu Ioana 
Published: April 2012

Background—
Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains, such as patient satisfaction, remains unknown.

Methods and Results—

We used Hospital Compare data to identify hospitals reporting acute myocardial infarction (AMI) and heart failure (HF) process measures during 2006 to 2008, and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all 3 years), top-performing (top decile for all 3 years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. Low-performing hospitals had fewer beds, fewer nurses per patient, and were more likely rural, safety-net hospitals located in the South, compared with intermediate and top-performing hospitals (
P
<0.01 for all). After adjusting for hospital characteristics, patients were less likely to recommend low-performing hospitals to family or friends, relative to intermediate and top-performing hospitals (AMI: 58.8% versus 63.9% versus 68.8%, HF: 61.3% versus 64.0% versus 66.8%;
P
<0.001 for all), or provide an overall rating of ≥9 out of 10 (AMI: 56.7% versus 60.7% versus 64.9%, HF: 57.8% versus 61.1% versus 63.6%;
P
<0.01 for all). Despite the association between the hospital's performance on process measures and patient satisfaction, we noted discordance between these measures (kappa statistic <0.20).

Conclusions—
Hospitals with consistently poor performance on cardiac process measures also have lower patient satisfaction on average, suggesting that these hospitals have overall poor quality of care. However, there is discordance between the 2 measures in profiling hospital quality.
Do Differences in Repeat Revascularization Explain the Antianginal Benefits of Bypass Surgery Versus Percutaneous Coronary Intervention?
Authors: Arnold Suzanne V. , Magnuson Elizabeth A. , Wang Kaijun , Serruys Patrick W. , Kappetein A. Pieter , Mohr Friedrich W. , Cohen David J. 
Published: April 2012

Background—
Patients with multivessel coronary disease treated with coronary artery bypass graft (CABG) have less angina than those treated with percutaneous coronary intervention (PCI); however, there is uncertainty as to the mechanism of greater angina relief with CABG and whether more frequent repeat revascularization in patients treated with PCI could account for this treatment difference.

Methods and Results—
In the Synergy between percutaneous coronary intervention (PCI) with TAXUS and Cardiac Surgery trial, 1800 patients with 3-vessel or left main coronary artery disease were randomized to CABG or PCI with paclitaxel-eluting stents. Health status was assessed at baseline, 1, 6, and 12 months, using the Seattle Angina Questionnaire and the Medical Outcomes Study Short Form General Health Survey, and the association between repeat revascularization and health status during follow-up was assessed using longitudinal models. In adjusted analyses, patients who underwent repeat revascularization had worse angina frequency scores than patients who did not in both treatment groups, with differences of 8.5 points at 6 months and 3.1 points at 12 months in patients treated with PCI and 19.8 points at 6 months and 11.2 points at 12 months in patients with patients treated with CABG. Among patients who did not require repeat revascularization, the adjusted effect of CABG versus PCI on 12-month angina frequency scores was nearly identical to the overall benefit in the intention-to-treat analysis.

Conclusions—
Among patients with multivessel coronary artery disease treated with PCI or CABG, the occurrence of repeat revascularization during follow-up did not fully explain the antianginal benefit of CABG in the overall population. The differential association between repeat revascularization and anginal status, according to the type of initial revascularization procedure, suggests that this end point should play a limited role in any direct comparison of the 2 treatment strategies.

Clinical Trial Registration—

http://www.clinicaltrials.gov
. Unique identifier: NCT00114972.
The Chest Pain Choice Decision Aid
Authors: Hess Erik P. , Knoedler Meghan A. , Shah Nilay D. , Kline Jeffrey A. , Breslin Maggie , Branda Megan E. , Pencille Laurie J. , Asplin Brent R. , Nestler David M. , Sadosty Annie T. , Stiell Ian G. , Ting Henry H. , Montori Victor M. 
Published: April 2012

Background—
Cardiac stress testing in patients at low risk for acute coronary syndrome is associated with increased false-positive test results, unnecessary downstream procedures, and increased cost. We judged it unlikely that patient preferences were driving the decision to obtain stress testing.

Methods and Results—
The Chest Pain Choice trial was a prospective randomized evaluation involving 204 patients who were randomized to a decision aid or usual care and were followed for 30 days. The decision aid included a 100-person pictograph depicting the pretest probability of acute coronary syndrome and available management options (observation unit admission and stress testing or 24–72 hours outpatient follow-up). The primary outcome was patient knowledge measured by an immediate postvisit survey. Additional outcomes included patient engagement in decision making and the proportion of patients who decided to undergo observation unit admission and cardiac stress testing. Compared with usual care patients (n=103), decision aid patients (n=101) had significantly greater knowledge (3.6 versus 3.0 questions correct; mean difference, 0.67; 95% CI, 0.34–1.0), were more engaged in decision making as indicated by higher OPTION (observing patient involvement) scores (26.6 versus 7.0; mean difference, 19.6; 95% CI, 1.6–21.6), and decided less frequently to be admitted to the observation unit for stress testing (58% versus 77%; absolute difference, 19%; 95% CI, 6%–31%). There were no major adverse cardiac events after discharge in either group.

Conclusions—
Use of a decision aid in patients with chest pain increased knowledge and engagement in decision making and decreased the rate of observation unit admission for stress testing.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01077037.
Multicenter Experience on Eversion Versus Conventional Carotid Endarterectomy in Symptomatic Carotid Artery Stenosis
Authors: Demirel Serdar , Attigah Nicolas , Bruijnen Hans , Ringleb Peter , Eckstein Hans-Henning , Fraedrich Gustav , Böckler Dittmar 
Published: April 2012

Background and Purpose—
Carotid endarterectomy (CEA) is beneficial in patients with symptomatic carotid artery stenosis. However, randomized trials have not provided evidence concerning the optimal CEA technique, conventional or eversion.

Methods—
The outcome of 563 patients within the surgical randomization arm of the Stent-Protected Angioplasty versus Carotid Endarterectomy in Symptomatic Patients (SPACE-1) trial was analyzed by surgical technique subgroups: eversion endarterectomy versus conventional endarterectomy with patch angioplasty. The primary end point was ipsilateral stroke or death within 30 days after surgery. Secondary outcome events included perioperative adverse events and the 2-year risk of restenosis, stroke, and death.

Results—

Both groups were similar in terms of demographic and other baseline clinical variables. Shunt frequency was higher in the conventional CEA group (65% versus 17%;
P
<0.0001). The risk of ipsilateral stroke or death within 30 days after surgery was significantly greater with eversion CEA (9% versus 3%;
P
=0.005). There were no statistically significant differences in the rate of perioperative secondary outcome events with the exception of a significantly higher risk of intraoperative ipsilateral stroke rate in the eversion CEA group (4% versus 0.3%;
P
=0.0035). The 2-year risk of ipsilateral stroke occurring after 30 days was significantly higher in the conventional CEA group (2.9% versus 0%;
P
=0.017).

Conclusions—
In patients with symptomatic carotid artery stenosis, conventional CEA appears to be associated with better periprocedural neurological outcome than eversion CEA. Eversion CEA, however, may be more effective for long-term prevention of ipsilateral stroke. These findings should be interpreted with caution noting the limitations of the post hoc, nonrandomized nature of the analysis.
Total and High-Density Lipoprotein Cholesterol and Stroke Risk
Authors: Zhang Yurong , Tuomilehto Jaakko , Jousilahti Pekka , Wang Yujie , Antikainen Riitta , Hu Gang 
Published: April 2012

Background and Purpose—
The association of total and high-density lipoprotein (HDL) cholesterol with stroke risk is unclear, especially regarding hemorrhagic stroke.

Methods—
We prospectively investigated the associations of serum total and HDL cholesterol and total/HDL cholesterol ratio with total and type-specific stroke incidence among 58 235 Finnish people aged 25 to 74 years and free of coronary heart disease and stroke at baseline.

Results—

During a mean follow-up period of 20.1 years, 3914 participants developed stroke events (3085 ischemic, 497 intracerebral hemorrhage, and 332 subarachnoid hemorrhage). The multivariable-adjusted hazard ratios at different levels of total cholesterol (<5 [reference], 5–5.9, 6–6.0, ≥7.0 mmol/L) were 1.00, 1.05, 1.16, and 1.22 for total stroke (
P
trend
=0.036) and 1.00, 1.06, 1.19, and 1.27 for ischemic stroke (
P
trend
=0.02) in men and 1.00, 0.58, 0.61, and 0.50 for intracerebral hemorrhagic stroke (
P
trend
=0.02) in women, respectively. Low levels of HDL cholesterol and high total/HDL cholesterol ratio were associated with increased risks of total and ischemic stroke in both men and women. These associations disappeared in men but remained significant in women after further adjustment for body mass index, blood pressure, and history of diabetes.

Conclusions—
The study showed a positive association between total cholesterol and total and ischemic stroke risks in men and an inverse association between total cholesterol and intrahemorrhagic stroke risk in women. The inverse association of HDL cholesterol and a positive association of total/HDL cholesterol ratio with total and ischemic stroke risks were found in men and women. These associations attenuated after adjustment for body mass index, blood pressure, and history of diabetes.
Does the Application of X-Ray Contrast Agents Impair the Clinical Effect of Intravenous Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients?
Authors: Dzialowski Imanuel , Puetz Volker , Buchan Alastair M. , Demchuk Andrew M. , Hill Michael D. 
Published: April 2012

Background and Purpose—
Experimental data suggest a negative interaction between x-ray contrast agents and fibrinolytic efficacy of recombinant tissue-type plasminogen activator (rtPA). We hypothesized that the application of a contrast agent before intravenous thrombolysis with rtPA reduces its clinical efficacy in acute ischemic stroke.

Methods—
We retrospectively studied consecutive ischemic stroke patients receiving contrast agents for computed tomography angiography before intravenous treatment with rtPA. We compared functional outcomes with an historical control group from the Canadian Alteplase for Stroke Effectiveness Study who did not receive contrast agents before thrombolysis with rtPA. Primary end point was favorable functional outcome at 90 days defined as modified Rankin Scale scores 0 to 2. We performed logistic regression analysis and a propensity score matching analysis to estimate the effect size of contrast agent use as a negative predictor of outcome.

Results—

We identified 111 patients for the computed tomography angiography and 1119 patients for the control group. Proportions of favorable functional outcome were 47.7% (53/111 patients) for the computed tomography angiography group and 49.5% (542/1094 patients) for the control group (
P
=0.77). Adjusted probabilities for favorable outcome were 0.48 (95% CI, 0.37–0.58) and 0.51 (95% CI, 0.47–0.54), respectively. Contrast use was associated with reduced odds of favorable outcome (OR, 0.62
;
95% CI, 0.38–0.99). Propensity score matching suggested a larger effect size (OR, 10.0%; 95% CI, 0.5%–19.3%).

Conclusions—
Our study did not show a significant negative clinical effect of x-ray contrast agents applied before intravenous thrombolysis with rtPA. However, to confirm a possible small negative interaction between contrast agents and rtPA, additional experimental and prospective clinical studies are needed.
Removed from the Bargaining Table
Authors: Traverso Diego Barría , Moreno Eduardo Araya , Drouillas Oscar 
Published: April 2012

As a candidate, Michelle Bachelet asserted that hers would be a citizens’ government. This gave the impression that she would create a favorable climate for social actors such as the Central Unitaria de Trabajadores (Unitary Workers’ Federation–CUT) to participate in the policy-making process. Instead, while the government treated the federation as labor’s representative both for negotiating the minimum wage and for reaching agreements in important labor conflicts, these gains took place in a context in which the federation’s action served the government’s interests. In contrast to the situation under previous Concertación governments, the federation, like most social actors, was only allowed to express its points of view before the advisory commissions of technocrats that were entrusted with the responsibility of making policy. Paradoxically, however, the outcome was more favorable for its interests because of the disposition, at least discursively, of Bachelet’s government to move forward on matters that the CUT had long considered “pending issues.” Como candidata, Michelle Bachelet acertó que el suyo sería un gobierno ciudadano. Esto dio la impresión de que crearía un clima favorable para los actores sociales como la Central Unitaria de Trabajadores (CUT) para que participen en el proceso de la toma de decisiones. En vez, mientras el gobierno trataba con la federación como representante laboral en negociaciones sobre el salario mínimo y en acuerdos en importantes conflictos laborales, estos avances tomaron lugar en un contexto en donde las acciones de la federación servían al interés del gobierno. Contrastándose con la situación en previos gobiernos concertacionistas, la federación, a igual que otros actores sociales, solo se le permitía expresar sus puntos frente comisiones de asesoro en donde se confiaba la responsabilidad en la toma de decisiones a los tecnócratas. Paradójicamente y sin embargo el resultado fue mas favorable a sus intereses por causa de la disposición, por lo menos divagadora, del gobierno de Bachelet en avanzar en materia que la CUT había considerado por largo tiempo como “asuntos pendientes.”
The chicken or the egg? The trade-off between bank fee income and net interest margins
Authors: Williams Barry , Rajaguru Gulasekaran 
Published: April 2012

This study considers the time series relationship between bank fee income and bank net interest margins in Australia, applying panel vector autoregressions to a unique, hand-collected dataset. Increases in bank fee income are being used to supplement decreases in net interest margins. The increase in magnitude of fee income associated with reductions in margin income is smaller than the decrease in net interest margins, resulting in a net wealth transfer favouring users of bank services; although not all users of bank services gained and/or gained equally. The overall increase in fee income is marginally greater that the reduction in margin income. It is argued that banks have responded to falling margin revenue by increasing their range of fee-based services, especially insurance. Increases in fee income are found to pre-date declines in margin income, thus Australian banks were pro-active in the process of disintermediation. JEL Classifications: G21, G11, C33
Complications of Arthroscopic Meniscectomy in the Older Population
Authors: Hame Sharon L. , Nguyen Virginia , Ellerman Jessica , Ngo Stephanie S. , Wang Jeffrey C. , Gamradt Seth C. 
Published: April 2012

Background: Complications of arthroscopic meniscectomy in the older population have not been established. Purpose: To determine the risk and relative risk of developing pyogenic arthritis (PA), a deep vein thrombosis (DVT), and pulmonary embolism (PE) in an older population of patients who have undergone arthroscopic meniscectomy. Study Design: Case series; Level of evidence, 4. Methods: Men and women ≥65 years old who underwent procedures coded as CPT-29880 (medial and lateral meniscectomy) and CPT-29881 (medial or lateral meniscectomy) were identified in the Medicare Standard Analytic Files database from 2005 to 2008. Identified patients were analyzed for gender and postoperative complications, including PA, DVT, and PE, occurring within 90 days of the index operation. Results: Overall, 314,578 patients (119,814 men and 194,764 women) were identified. With respect to the Current Procedural Terminology codes, 131,420 patients were coded 29880 and 183,158 patients were coded 29881. In the study population, 0.4% (1107 patients) developed PA, 0.8% (2507 patients) developed a DVT, and 0.3% (982 patients) developed a PE. Among male patients, 0.4% developed PA, 0.7% developed a DVT, and 0.2% developed a PE. Among female patients, 0.3% developed PA, 0.8% developed a DVT, and 0.3% developed a PE. Overall, men had a statistically significant higher relative risk of PA and women had a statistically significant higher relative risk of DVT and PE. Conclusion: Postoperative complications, including PA, DVTs, and PEs, are rare in patients ≥65 years old. However, gender-specific differences in the rate and type of postoperative complications may exist. Further studies in this population are warranted.
Protective effects of protocatechuic acid on TCDD-induced oxidative and histopathological damage in the heart tissue of rats
Authors: Ciftci Osman , Disli Olcay Murat , Timurkaan Necati 
Published: April 2012

2,3,7,8-Tetracholorodibenzo- p-dioxin (TCDD) is a highly toxic environmental contaminant that causes severe toxic effects in animal and human. In this study, we investigated the toxic effects of TCDD and the preventive effects of protocatechuic acid (PCA), a widespread phenolic compound, in the heart tissue of rats. For this purpose, 3–4 months old 28 rats with 280–310 g body weights were equally divided into 4 groups (control, TCDD, PCA, TCDD + PCA group). A 2 μg/kg dose of 2,3,7,8-TCDD and 100 mg/kg dose of PCA were dissolved in corn oil and given orally to the rats for 45 days. The results indicated that TCDD induced oxidative stress by increasing the level of thiobarbituric acid reactive substance and by decreasing the levels of glutathione, catalase, glutathione peroxidase and superoxide dismutase in the heart tissue of rats. In contrast, PCA treatment prevents the toxic effects of TCDD on oxidative stress. In addition, histopathological alterations such as necrosis and hemorrhage occurred in TCDD group, and PCA treatment partially prevents these alterations in heart tissue. In this study, it was concluded that TCDD exposure led to toxic effects in heart tissue and PCA treatment could prevent the toxicity of TCDD.
A Framework for Understanding Modifications to Measures for Diverse Populations
Authors: Stewart Anita L. , Thrasher Angela D. , Goldberg Jack , Shea Judy A. 
Published: April 2012

Objectives: Research on health disparities and determinants of health disparities among ethnic minorities and vulnerable older populations necessitates use of self-report measures. Most established instruments were developed on mainstream populations and may need adaptation for research with diverse populations. Although information is increasingly available on various problems using these measures in diverse groups, there is little guidance on how to modify the measures. A framework of issues to consider when modifying measures for diverse populations is presented. Methods: The authors describe reasons for considering modifications, the types of information that can be used as a basis for making modifications, and the types of modifications researchers have made. Recommendations are made to test modified measures to assure their appropriateness, and suggestions are provided on reporting modifications in publications using the measures. Discussion: The issues open a dialogue about what appropriate guidelines would be for researchers adapting measures in studies of ethnically diverse populations.
Understanding Social Work in the History of Ideas
Authors: Soydan Haluk 
Published: April 2012

Objectives: The purpose of this article is to present a theoretical frame of reference for the study and assessment of social work from the perspective of a history of ideas. Method: The study employed an analysis of primary and secondary historical sources. Results: Social work as a practice and research field is embedded in the genesis of modern social science as developed by the Scottish School of thinking, and organized practice for the betterment of life conditions of individuals, groups, and communities. Conclusion: The history of ideas of social work provides a theoretical frame of reference for identifying the historical roots of social work, defining its core as well as professional and research territory relative to other professions and disciplines, and placing evidence-based social work practice in a historical context.