bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lifetime Analysis of Hospitalizations and Survival of Patients Newly Admitted With Heart Failure
Authors: Chun Soohun , Tu Jack V. , Wijeysundera Harindra C. , Austin Peter C. , Wang Xuesong , Levy Daniel , Lee Douglas S. 
Published: May 2012

Background—
Hospital readmissions for heart failure (HF) contribute to increased morbidity and resource burden. Predictors of hospitalization and patterns of cardiovascular events over the lifetime of patients with HF have not been elucidated.

Methods and Results—

We examined recurrent hospitalizations, cardiovascular events, and survival among newly discharged (April 1999–March 2001) patients with HF in the Enhanced Feedback For Effective Cardiac Treatment phase 1 study. During 10-year follow-up, we examined all new cardiovascular hospitalizations and selected predictors of readmission. Among 8543 patients (mean age, 77.4±10.5 years; 51.6% women) followed for 22 567 person-years, 60.7% had ischemic etiology, and 67.3% had HF with reduced ejection fraction (left ventricular ejection fraction ≤45% versus >45% [HF with preserved ejection fraction]). Overall, 10-year mortality was 98.8%, with 35 966 hospital readmissions occurring over the lifetime of the cohort. Adjusted hazards ratios (HRs) for first cardiovascular hospitalization were 1.36 for ischemic HF (95% CI, 1.28–1.44;
P
<0.001), 1.10 for HF with reduced ejection fraction (95% CI; 1.00–1.20;
P
=0.045), and 1.00 for men (95% CI, 0.94–1.06;
P
=0.979). On repeated-events time-to-event analysis, ischemic HF was a predictor of cardiovascular (HR, 1.24; 95% CI, 1.18–1.29), HF (HR, 1.20; 95% CI, 1.13–1.27), and coronary heart disease (HR, 2.01; 95% CI, 1.81–2.24) hospitalizations (all
P
<0.001). Of all recurrent HF hospitalizations, 26.8% occurred in the first and 39.8% in the last deciles of cohort survival duration. Similarly, 29.7% and 52.3% of all cardiovascular readmissions occurred in the first and last deciles of the cohort survival duration, respectively.

Conclusions—
Among newly discharged patients with HF, cardiovascular events were clustered at early postdischarge and prefatal time periods, and were increased among those with ischemic etiology.
Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage
Authors: Connolly E. Sander , Rabinstein Alejandro A. , Carhuapoma J. Ricardo , Derdeyn Colin P. , Dion Jacques , Higashida Randall T. , Hoh Brian L. , Kirkness Catherine J. , Naidech Andrew M. , Ogilvy Christopher S. , Patel Aman B. , Thompson B. Gregory , Vespa Paul 
Published: May 2012

Purpose—
The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH).

Methods—
A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manuscript Oversight Committees. It is intended that this guideline be fully updated every 3 years.

Results—
Evidence-based guidelines are presented for the care of patients presenting with aSAH. The focus of the guideline was subdivided into incidence, risk factors, prevention, natural history and outcome, diagnosis, prevention of rebleeding, surgical and endovascular repair of ruptured aneurysms, systems of care, anesthetic management during repair, management of vasospasm and delayed cerebral ischemia, management of hydrocephalus, management of seizures, and management of medical complications.

Conclusions—
aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care. The guidelines offer a framework for goal-directed treatment of the patient with aSAH.
Ultrasound‐Guided Fine‐Needle Aspiration of the Tongue Base
Authors: Meacham Ryan K. , Boughter John D. , Sebelik Merry E. 
Published: May 2012

ObjectiveThe authors hypothesize that floor‐of‐mouth and tongue base anatomy can be visualized with ultrasound and that ultrasound can be used to accurately guide needle placement and dye injection into the tongue base, serving as a surrogate for fine‐needle aspiration.Study DesignObservation of experimental intervention.SettingMedical school cadaver anatomy laboratory.Subjects and MethodsUltrasound imaging was performed on human cadaveric specimens to visualize the anatomy of the floor of mouth and base of tongue in a midline transcervical approach. Methylene blue dye was injected under ultrasound guidance into the base of tongue. Specimens were dissected, and results were counted and analyzed.ResultsTwenty‐five of 32 (78%) cadaver specimens were found to have correct placement of dye within the posterior genioglossus and intrinsic tongue musculature. Seven cadavers did not have correct placement of dye. Of these, 3 had dye staining the walls of the oropharynx and epiglottis. Two specimens had dye injected erroneously into the geniohyoid muscles. One patient was found to have had a partial glossectomy. Difference in neck circumference was not significant between those with correct (mean, 37.9 cm) and incorrect (mean, 37.4 cm) dye placement (P=. 75).ConclusionAnatomy of the floor of mouth and tongue base can be readily depicted with ultrasonography. After reasonable success of injecting dye into cadaver tongue bases, the authors conclude that there appears to be a future clinical role for ultrasound‐guided fine‐needle aspiration of the tongue base for tongue base lesions.
Epoxidized natural rubber–toughened polypropylene/organically modified montmorillonite nanocomposites
Authors: Balakrishnan Harintharavimal , Attaran Seyed Ahmad , Imran Muhammad , Hassan Azman , Wahit Mat Uzir 
Published: May 2012

The objective of this study is to toughen organically modified montmorillonite (OMMT)-filled polypropylene (PP) nanocomposites with epoxidized natural rubber (ENR). PP, ENR (10–20 wt%), OMMT (6 wt%) and maleated PP (PP-g-MA; 10 wt%) were melt blended using counterrotating twin extruder, followed by injection molding to prepare test samples. X-ray diffraction results revealed that the OMMT platelets in PP/OMMT nanocomposites were intercalated and the incorporation of ENR into the nanocomposites further increased the d-spacing of OMMT layers. The Fourier transform infrared spectra showed that the maleic anhydride group in PP-g-MA reacted in situ with the epoxy groups of ENR, which demonstrates the occurrence of grafting reaction. With slight decrease in stiffness and strength, the addition of 20 wt% ENR increased the impact strength of PP/ENR/OMMT nanocomposites by 521% compared to PP/OMMT nanocomposites. Scanning electron microscopy images revealed that the ENR particle size increased with increasing ENR contents in PP/ENR/OMMT nanocomposites. Differential scanning calorimetry results revealed that the presence of ENR and OMMT had slightly increased the crystallization temperature as well as the degree of crystallinity of PP. Thermogravimetric analysis showed that the blending of ENR decreased the thermal stability of PP/OMMT nanocomposites.
A New Classification of Function and Disability in China
Authors: Purser Jama L. , Feng Qiushi , Yi Zeng , Hoenig Helen 
Published: May 2012

Objectives: To develop a new classification method to describe incidence and prevalence of function and disability and their predictors in Chinese older adults. Methods: Data were obtained from 16,020 older adults in the 2002 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). The subtypes of function and disability were defined by combining physical performance (PP) tests and self-reported assessments of activities of daily living (ADL). Results: The most prevalent subtype involved PP limitations without ADL dependency. Rural living made it more likely that an individual with physical performance limitations would be independent in ADL, whereas city residence made dependence in ADL more likely, regardless of whether performance limitations were present. Discussion: Self-reported and performance-based tools can be used in combination to estimate conceptually different subtypes of function and disability, with different epidemiological rates of incidence and different social, medical, and environmental predictors.
Percutaneous Cholecystostomy in High-Risk Elderly Patients With Acute Cholecystitis
Authors: Kapan Murat , Onder Akin , Tekbas Guven , Gul Mesut , Aliosmanoglu Ibrahim , Arikanoglu Zulfu , Aldemir Mustafa 
Published: May 2012

Purpose: To analyze the results of percutaneous cholecystostomy in in high-risk elderly patients with acute cholecystitis. Materials and Methods: Between June 2010 and May 2011, 11 patients aged over 60 who had at least 1 systemic disease and underwent percutaneous cholecystostomy were reviewed retrospectively. Results: The procedure was technically successful in 10 (90.9%) patients. Clinical improvement was achieved in 81.8% of patients within 72 hours. Two patients received emergency surgery while elective cholecystostomy was performed in 5 patients. Percutaneous cholecystostomy was performed singly in 4 (36.4%) patients. Early complication rate was 18.2%. Two (18.2%) patients died. Conclusion: Percutaneous cholecystostomy can be performed with low mortality and morbidity. Cholecystectomy should be performed in all patients with suitable general conditions due to the high recurrence rates of percutaneous cholecystostomy.
Patient and provider perceptions of sleep disordered breathing assessment during prenatal care: a survey-based observational study
Authors: Bourjeily Ghada , Raker Christina , Paglia Michael J. , Ankner Gina , O’Connor Kathleen 
Published: May 2012

Objectives: Screening for sleep disordered breathing (SDB) remains poor in the general population, despite evidence for association with adverse outcomes and improvement of certain outcomes with therapy. Data from the past decade have suggested an association between snoring and adverse pregnancy outcomes including gestational hypertensive disorders. However, it is unclear how often SDB is screened for in pregnancy. The objective of this study was to evaluate whether, and how, symptoms of SDB are assessed during prenatal care. Methods: This study was designed as a survey-based observational study. Within 48 hours of delivery, English-speaking patients were surveyed regarding prenatal conversations with obstetric providers about symptoms of SDB. During a similar time period, obstetric providers completed an anonymous questionnaire regarding how often they discussed the same symptoms during prenatal visits. Results: A total of 776 patients and 80 providers performing the majority of deliveries at the same hospital answered the survey. Nurse providers asked about sleep quality significantly more often than physician providers; however, responses to questions about snoring were similar in both groups. Resident physicians were the least likely to ask about sleep quality. Less than 3% of providers reported asking about snoring, closely matching patient responses. A total of 44% of patients surveyed were overweight and 21.7% were obese. Although 32% of patients snored, only 5% were asked about snoring during a prenatal visit. Obese women and women with a history of gestational hypertensive disorders were more likely to report being asked about snoring. Conclusions: Based on patient and obstetric provider recollections of discussions, the issue of SDB is poorly assessed during routine prenatal care, despite an increasing prevalence of overweight and obesity in the pregnant population.
Fibroblast growth factor-7 partially reverses murine thymocyte progenitor aging by repression of Ink4a
Authors: Berent-Maoz Beata , Montecino-Rodriguez Encarnacion , Signer Robert A. J. , Dorshkind Kenneth 
Published: May 2012

Abstract
Involution of the thymus results in reduced production of naive T cells, and this in turn is thought to contribute to impaired immunity in the elderly. Early T-cell progenitors (ETPs), the most immature intrathymic T-cell precursors, harvested from the involuted thymus exhibit a diminished proliferative potential and increased rate of apoptosis and as a result their number is significantly reduced. In the present study, we show that these age-induced alterations result in part from increased expression of the Ink4a tumor-suppressor gene in ETPs. We also show that repression of Ink4a in aged ETPs results in their partial rejuvenation and that this can be accomplished by in vivo fibroblast growth factor 7 administration. These results define a genetic basis for thymocyte progenitor aging and demonstrate that the senescence-associated gene Ink4a can be pharmacologically repressed in ETPs to partially reverse the effects of aging.
An open-label, single-arm, phase 2 (PX-171-004) study of single-agent carfilzomib in bortezomib-naive patients with relapsed and/or refractory multiple myeloma
Authors: Vij Ravi , Wang Michael , Kaufman Jonathan L. , Lonial Sagar , Jakubowiak Andrzej J. , Stewart A. Keith , Kukreti Vishal , Jagannath Sundar , McDonagh Kevin T. , Alsina Melissa , Bahlis Nizar J. , Reu Frederic J. , Gabrail Nashat Y. , Belch Andrew , Matous Jeffrey V. , Lee Peter , Rosen Peter , Sebag Michael , Vesole David H. , Kunkel Lori A. , Wear Sandra M. , Wong Alvin F. , Orlowski Robert Z. , Siegel David S. 
Published: May 2012

Abstract
Carfilzomib is a selective proteasome inhibitor that binds irreversibly to its target. In phase 1 studies, carfilzomib elicited promising responses and an acceptable toxicity profile in patients with relapsed and/or refractory multiple myeloma (R/R MM). In the present phase 2, multicenter, open-label study, 129 bortezomib-naive patients with R/R MM (median of 2 prior therapies) were separated into Cohort 1, scheduled to receive intravenous carfilzomib 20 mg/m2 for all treatment cycles, and Cohort 2, scheduled to receive 20 mg/m2 for cycle 1 and then 27 mg/m2 for all subsequent cycles. The primary end point was an overall response rate (≥ partial response) of 42.4% in Cohort 1 and 52.2% in Cohort 2. The clinical benefit response (overall response rate + minimal response) was 59.3% and 64.2% in Cohorts 1 and 2, respectively. Median duration of response was 13.1 months and not reached, and median time to progression was 8.3 months and not reached, respectively. The most common treatment-emergent adverse events were fatigue (62.0%) and nausea (48.8%). Single-agent carfilzomib elicited a low incidence of peripheral neuropathy—17.1% overall (1 grade 3; no grade 4)—in these pretreated bortezomib-naive patients. The results of the present study support the use of carfilzomib in R/R MM patients. This trial is registered at www.clinicaltrials.gov as NCT00530816.
Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment
Authors: Herth Felix J.F. , Eberhardt Ralf , Gompelmann Daniela , Ficker Joachim H. , Wagner Manfred , Ek Lars , Schmidt Bernd , Slebos Dirk-Jan 
Published: May 2012

One-way endobronchial valves (EBVs) have been shown to relieve symptoms of emphysema, particularly in patients without collateral ventilation (CV) between the target and adjacent lobes. In this study, we investigated the ability of the bronchoscopic Chartis™ Pulmonary Assessment System to predict treatment response by determining the presence of CV.80 EBV patients underwent a pre-treatment Chartis assessment. Before and 30 days after implantation, high-resolution computed tomography scans were taken to determine target lobe volume reduction (TLVR). A pre- to post-treatment reduction of ≥350 mL was defined as significant. In addition, clinical outcomes (forced expiratory volume in 1 s (FEV1), 6-min walk test and St George’s Respiratory Questionnaire) were compared over the same time period.Of the 51 patients classified as having an absence of CV according to their Chartis reading, 36 showed a TLVR ≥350 mL. 29 patients were classified as having CV, and of these 24 did not meet this TLVR cut-off. Chartis showed an accuracy level of 75% in predicting whether or not the TLVR cut-off would be reached. Those predicted to respond showed significantly greater TLVR (p<0.0001) and FEV1improvement (p=0.0013) than those predicted not to respond.Chartis is a safe and effective method of predicting response to EBV treatment.
Cerebral cortex oxygen delivery and exercise limitation in patients with COPD
Authors: Vogiatzis Ioannis , Louvaris Zafeiris , Habazettl Helmut , Andrianopoulos Vasileios , Wagner Harrieth , Roussos Charis , Wagner Peter D. , Zakynthinos Spyros 
Published: May 2012

In healthy humans, cerebral oxygen desaturation during exercise affects motor unit recruitment, while oxygen supplementation enhances cerebral oxygenation and work capacity. It remains unknown whether in patients with chronic obstructive pulmonary disease (COPD), the well-documented improvement in exercise tolerance with oxygen supplementation may also be partly due to the increase in cerebral oxygenation.Using near infrared spectroscopy, we measured both frontal cerebral cortex blood flow (CBF) using indocyanine green dye and cerebrovascular oxygen saturation (St,O2) in 12 COPD patients during constant-load exercise to exhaustion at 75% of peak capacity. Subjects exercised while breathing air, 100% oxygen or normoxic heliox, the latter two in balanced order.Time to exhaustion while breathing air was less than for either oxygen or heliox (mean±sem394±35versus670±43 and 637±46 s, respectively). Under each condition, CBF increased from rest to exhaustion. At exhaustion, CBF was higher while breathing air and heliox than oxygen (30.9±2.3 and 31.3±3.5versus26.6±3.2 mL·min−1per 100 g, respectively), compensating for the lower arterial oxygen content (Ca,O2) in air and heliox, and leading to similar cerebral cortex oxygen delivery (CQO2for air was 5.3±0.4, for oxygen was 5.5±0.6 and for heliox was 5.6±1.0 mL O2per min per 100 g). In contrast, end-exerciseSt,O2was greater while breathing oxygen compared with air or heliox (67±4versus57±3 and 53±3%, respectively), reflecting Ca,O2rather than CQO2.Prolonged time to exhaustion by breathing oxygen and heliox, despite these having a similar CQO2to air, a lowerSt,O2with heliox than oxygen, and yet similar endurance time and similarSt,O2in air and heliox despite greater endurance with heliox, do not support the hypothesis that an improvement in cerebral cortex oxygen availability plays a contributing role in increasing exercise capacity with oxygen or heliox in patients with COPD.
Vitamin D and skeletal muscle strength and endurance in COPD
Authors: Jackson Abigail S. , Shrikrishna Dinesh , Kelly Julia L. , Hart Nicholas , Moxham John , Polkey Michael I. , Kemp Paul , Hopkinson Nicholas S. 
Published: May 2012

It is not known whether vitamin D levels make a significant contribution to muscle dysfunction in chronic obstructive pulmonary disease (COPD).In 104 COPD patients (mean±sdforced expiratory volume in 1 s 44±22 % predicted) and 100 age- and sex-matched controls, serum 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) levels were measured and related to quadriceps strength and endurance. In a subset of 26 patients and 13 controls, quadriceps biopsy was performed and mRNA expression of myogenic regulatory factors (mrf) and fibre-specific myosin heavy chains (MHC) was determined.COPD patients were weaker and less physically active than controls. 25(OH)D levels were similar in both groups (48.5±25.5 nmol·L−1COPDversus55.4±28.3 nmol·L−1control, p=0.07) but PTH levels were significantly higher in patients (5.2±2.3 pmol·mL−1versus4.4±2.0 pmol·L−1, p=0.01). 1,25(OH)D was significantly correlated with strength in controls, but not in COPD patients and not with quadriceps endurance assessed using repetitive magnetic stimulation in COPD (n=35) or control (n=35) subjects. In controls, but not COPD patients, muscle biopsy analysis showed a negative relationship between 25(OH)D and MHCIIa expression (r2=0.5, p=0.01) and a positive relationship between mrf4 and MHCIIa expression (r2=0.5, p=0.009), and myogenic regulatory factor myf5 and MHCI expression (r2=0.72, p=0.004).In contrast with healthy controls, muscle strength is not associated with vitamin D levels in COPD, which may represent vitamin D resistance.
Dissociation of electromyogram and mechanical response in sleep apnoea during propofol anaesthesia
Authors: Dotan Yaniv , Pillar Giora , Tov Nave , Oliven Ron , Steinfeld Uri , Gaitini Luis , Odeh Majed , Schwartz Alan R. , Oliven Arie 
Published: May 2012

Pharyngeal collapsibility during sleep is believed to increase due to a decline in dilator muscle activity. However, genioglossus electromyogram (EMG) often increases during apnoeas and hypopnoeas, often without mechanical effect.17 patients with obstructive sleep apnoea were anaesthetised and evaluated from termination of propofol administration to awakening. Genioglossus EMG, flow and pharyngeal area (pharyngoscopy) were monitored. Prolonged hypopnoeas enabled evaluation of the relationships between genioglossus EMG and mechanical events, before and after awakening. Additional dilator muscle EMGs were recorded and compared to the genioglossus. Electrical stimulation of the genioglossus was used to evaluate possible mechanical dysfunction.Prolonged hypopnoeas during inspiration before arousal triggered an increase in genioglossus EMG, reaching mean±sd62.2±32.7% of maximum. This augmented activity failed to increase flow and pharyngeal area. Awakening resulted in fast pharyngeal enlargement and restoration of unobstructed flow, with marked reduction in genioglossus EMG. Electrical stimulation of the genioglossus under propofol anaesthesia increased the inspiratory pharyngeal area (from 25.1±28 to 66.3±75.5 mm2; p<0.01) and flow (from 11.5±6.5 to 18.6±9.2 L·min−1; p<0.001), indicating adequate mechanical response. All additional dilators increased their inspiratory activity during hypopnoeas.During propofol anaesthesia, pharyngeal occlusion persists despite large increases in genioglossus EMG, in the presence of a preserved mechanical response to electrical stimulation.
Reduced lung function due to biomass smoke exposure in young adults in rural Nepal
Authors: Kurmi Om P. , Devereux Graham S. , Smith W. Cairns S. , Semple Sean , Steiner Markus F.C. , Simkhada Padam , Lam Kin-Bong Hubert , Ayres Jon G. 
Published: May 2012

This study aimed to assess the effects of biomass smoke exposure on lung function in a Nepalese population, addressing some of the methodological issues seen in previous studies.We carried out a cross-sectional study of adults in a population exposed to biomass smoke and a non-exposed population in Nepal. Questionnaire and lung function data were acquired along with direct measures of indoor and outdoor air quality.Ventilatory function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory flow at 25–75% of FVC) was significantly reduced in the population using biomass across all age groups compared to the non-biomass-using population, even in the youngest (16–25 yrs) age group (mean FEV1(95% CI) 2.65 (2.57–2.73)versus2.83 (2.74–2.91) L; p=0.004). Airflow obstruction was twice as common among biomass users compared with liquefied petroleum gas users (8.1%versus3.6%; p<0.001), with similar patterns for males (7.4%versus3.3%; p=0.022) and females (10.8%versus3.8%; p<0.001), based on the lower limit of normal. Smoking was a major risk factor for airflow obstruction, but biomass exposure added to the risk.Exposure to biomass smoke is associated with deficits in lung function, an effect that can be detected as early as the late teenage years. Biomass smoke and cigarette smoke have additive adverse effects on airflow obstruction in this setting.