bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute kidney injury and outcomes in acute decompensated heart failure: evaluation of the RIFLE criteria in an acutely ill heart failure population
Authors: Hata Noritake , Yokoyama Shinya , Shinada Takuro , Kobayashi Nobuaki , Shirakabe Akihiro , Tomita Kazunori , Kitamura Mitsunobu , Kurihara Osamu , Takahashi Yasuhiro 
Published: December 2009

AimsThe clinical course including the outcome of acute decompensated heart failure (ADHF) correlates with renal dysfunction, but the evaluation of renal function has not yet been standardized. We therefore investigated the relationship between the prognosis of ADHF and acute kidney injury (AKI) evaluated using the risk, injury, failure, loss, end stage (RIFLE) criteria.Methods and resultsThis study assessed 376 consecutive patients with ADHF admitted to the intensive care unit (ICU) (mean age 71.6 years; 238 male). The underlying aetiology was ischaemic heart disease, hypertensive heart disease, cardiomyopathy, valvular diseases, and ‘other’ in 124, 70, 60, 107, and 15 patients, respectively. We defined AKI according to the RIFLE criteria, and the most severe RIFLE classifications during hospitalization were adopted to assess patient outcomes. The in‐hospital mortality was significantly higher among patients with AKI (29 of 275; 10.5%) than in those without AKI (1 of 101; 1.0%, P = 0.0010). Both ICU and hospital stays were longer for patients with AKI (8.8 ± 15.4 vs. 48.6 ± 47.6 days), than for patients without (5.0 ± 2.8 vs. 25.7 ± 16.8 days, P < 0.05 and P < 0.001).ConclusionAcute kidney injury evaluated by the RIFLE criteria was associated with a poorer outcome for patients with ADHF.
An economic evaluation of rosuvastatin treatment in systolic heart failure: evidence from the CORONA trial
Authors: Lorgelly Paula K. , Briggs Andrew H. , Wedel Hans , Dunselman Peter , Hjalmarson Åke , Kjekshus John , Waagstein Finn , Wikstrand John , Jánosi András , van Veldhuisen Dirk J. , Barrios Vivencio , Fonseca Cândida , McMurray John J.V. ,   on behalf of the CORONA Study Group
Published: December 2009

AimsTo estimate the cost‐effectiveness of 10 mg rosuvastatin daily for older patients with systolic heart failure in the Controlled Rosuvastatin Multinational Study in Heart Failure (CORONA) trial.Methods and resultsThis within trial analysis of CORONA used major cardiovascular (CV) events as the outcome measure. Resource use was valued and the costs of hospitalizations, procedures, and statin use compared. Cost‐effectiveness was estimated as cost per major CV event avoided. There were significantly fewer major CV events in the rosuvastatin group compared with the placebo group (1.04 vs. 1.20 per patient; difference 0.164; 95% CI: 0.075–0.254, P < 0.001). The average cost of CV hospitalizations and procedures was significantly lower for those receiving rosuvastatin (£1531 vs. £1769; difference £238; 95% CI: £73–403, P = 0.005); the additional cost of the statin resulted in significantly higher total costs for the rosuvastatin group (£1769 vs. £2072; difference £303; 95% CI: £138–468, P < 0.001). Overall, rosuvastatin was found to cost £1840 (95% CI: £562–6028) per major CV event avoided.ConclusionThis economic analysis showed that a significant reduction in major CV events with rosuvastatin led to significantly reduced costs of CV hospitalizations and procedures. The reduction in associated costs for major CV events was found to offset partially (by 44%) the cost of rosuvastatin treatment in patients with systolic heart failure.
Differential prognostic effect of systolic blood pressure on mortality according to left‐ventricular function in patients with acute heart failure
Authors: Núñez Julio , Núñez Eduardo , Fonarow Gregg C. , Sanchis Juan , Bodí Vicent , Bertomeu‐González Vicente , Miñana Gema , Merlos Pilar , Bertomeu‐Martínez Vicente , Redón Josep , Chorro Francisco J. , Llàcer Angel 
Published: December 2009

AimsTo evaluate the relationship between systolic blood pressure (SBP) and long‐term mortality in patients with acute heart failure (AHF) stratified by ejection fraction (LVEF): reduced (≤40%) vs. preserved (≥50%).Methods and resultsWe studied 1049 consecutive patients admitted with AHF. Systolic blood pressure was determined in the emergency department. Left‐ventricular ejection fraction was categorized as ≤40% (n = 288), 41–49% (n = 174), or ≥50% (n = 587). Cox regression analysis was used for multivariable analysis. Mean age and SBP were 73 ± 11 years and 150 ± 36 mmHg, respectively. During a median follow‐up of 18 months, 290 deaths (33.1%) were identified. Higher SBP was associated with lower mortality. In multivariable analysis, a differential effect of SBP across LVEF status was documented (P‐value for interaction = 0.036). In linear models, SBP was shown to be inversely related with mortality in both groups (per 10 mmHg decrease): HR(LVEF ≥ 50%): 1.06, CI 95% = 1.01–1.11; P = 0.016, and HR(LVEF ≤ 40%): 1.16, 95% CI = 1.08–1.25; P < 0.001). When SBP was modelled with restrictive cubic splines, an inverse and almost linear relationship with mortality was shown in patients with LVEF ≤40% (P < 0.001), whereas in patients with LVEF ≥50%, SBP followed a J‐shape curve.ConclusionIn patients with AHF, SBP showed a differential prognostic effect on mortality according to LVEF status; when LVEF was ≤40%, SBP was linearly and inversely associated with mortality. Conversely, in patients with LVEF ≥50% this relationship showed a J‐shape pattern.
Sources of bycatch of loggerhead sea turtles in the western Mediterranean other than drifting longlines
Authors: Álvarez de Quevedo Irene , Cardona Luis , De Haro Andrea , Pubill Eva , Aguilar Alex 
Published: December 2009

Abstract
Álvarez de Quevedo, I., Cardona, L., De Haro, A., Pubill, E., and Aguilar, A. 2010. Sources of bycatch of loggerhead sea turtles in the western Mediterranean other than drifting longlines. – ICES Journal of Marine Science, 67: 677–685. A survey, including questionnaires to fishers and observers on board fishing vessels, was conducted to assess turtle bycatch in the waters off Catalonia (northeastern Spain), a region inhabited mainly by loggerhead sea turtles (Caretta caretta) from the highly endangered eastern Mediterranean rookeries. Observer reports confirmed that the data produced by the interviewees were reliable, so interview results were used to estimate turtle bycatch. The number of turtles caught monthly per vessel was estimated at 0.01 for bottom longlines, 0.02 for trammelnets, 0.07 for bottom trawling, and 1.2 for drifting longlines. From these values, 481 (95% CI: 472–491) turtles were estimated to be taken annually as bycatch by the whole fleet. Bottom trawling and trammelnets were the most widely used fishing gears (33 and 31% of the total 11 237 fishing months), but most turtles were caught either by bottom trawlers (249; 95% CI 83–415) or by drifting longlines (124; 95% CI: 40–199). Ivlev's electivity index revealed that bottom trawler bycatch was higher than expected in areas with a wide continental shelf. Given the heavy turtle mortality associated with bottom trawling and the fact that, in southern Catalonia, the fleet mainly takes turtles from western Mediterranean rookeries, it is suggested that the fishery be regulated through winter fishing restrictions, reducing the number of bottom trawlers working in the area, reducing the time the net is in the water to prevent turtle suffocation, or being obliged to use turtle excluder devices.
Increased mortality and morbidity in mild primary hyperparathyroid patients. The Parathyroid Epidemiology and Audit Research Study (PEARS)
Authors: Yu Ning , Donnan Peter T. , Flynn Robert W. V. , Murphy Michael J. , Smith David , Rudman Andrew , Leese Graham P. 
Published: December 2009

SummaryObjective  To describe mortality and disease‐specific morbidities in patients with mild primary hyperparathyroidism (PHPT).Design  Retrospective population‐based observational study.Setting  Tayside, Scotland, from 1997 to 2006.Participants  Patients with mild PHPT were selected from a predefined PHPT cohort between 1997 and 2006.Main outcome measures  Standardised mortality ratios (SMRs) were examined for all‐cause mortality, as well as cardiovascular and cancer mortality. Standardised morbidity ratios and standardised incidence ratios were also calculated for eleven observed co‐morbidities.Results  In total, there were 1683 (69·1% female) patients identified with mild PHPT in Tayside. Patients were found to have an increased risk of all‐cause mortality and cardiovascular mortality (SMR‐all cause 2·62, 95% CI 2·39–2·86; SMR‐cardiovascular 2·68, 95% CI 2·34–3·05). Patients with mild PHPT had a significantly increased risk of developing cardiovascular and cerebrovascular disease, renal dysfunction and fractures compared to the age‐ and sex‐adjusted general population.Conclusions  Mortality and morbidity were increased for patients with mild untreated PHPT, which is similar to more severe PHPT.
Cerebral cavernoma: an emerging long‐term consequence of external beam radiation in childhood
Authors: Liu Y. , Preston R. , Thomas S. M. , Brackenridge A. , Carroll P. V. 
Published: December 2009

SummaryThe long‐term effects of cranial external beam radiotherapy are emerging as survival rates for cerebral tumours improve. Cerebral cavernoma are a recognized consequence of cranial irradiation. Endocrinologists managing the life‐long complications of hypopituitarism associated with irradiation need to be aware and vigilant of the risks of cavernoma formation, in particular in the population with a history of childhood irradiation. We present three cases of young patients who were diagnosed with cerebral cavernoma many years after childhood irradiation treatment and review the current literature on this condition. We discuss implications for endocrine practice as rising numbers of patients survive childhood cancer and irradiation and are now attending adult endocrine services for long‐term management of secondary hypopituitarism.
d3‐GHR genotype does not explain heterogeneity in GH responsiveness in hypopituitary adults
Authors: Moyes V. J. , Walker D. M. , Owusu‐Antwi S. , Maher K. T. , Metherell L. , Akker S. A. , Monson J. P. , Clark A. J. L. , Drake W. M. 
Published: December 2009

SummaryObjective  Heterogeneity in growth hormone (GH) responsiveness in adult hypopituitary patients receiving recombinant human GH (rhGH) is poorly understood; doses vary up to fourfold between individuals. Deletion of exon 3 in the GH receptor (d3‐GHR) has been linked to enhanced rhGH responsiveness in children. We investigated the role of the d3‐GHR polymorphism in determining adult rhGH responsiveness.Methods  One hundred and ninety‐four patients treated with an identical rhGH dosing protocol in a single centre were genotyped for the d3‐GHR, and the results correlated with changes in serum IGF‐I and clinical parameters of GH responsiveness after 6 and 12 months of GH replacement therapy.Results  Allele frequencies for homozygous full length (fl/fl), heterozygous d3 (fl/d3) and homozygous d3 (d3/d3) were 52%, 38·7% and 9·3%, respectively, and were in Hardy–Weinberg equilibrium. Baseline IGF‐I and ΔIGF‐I at 6 months were comparable between groups. ΔIGF‐I at 12 months was significantly greater in the d3/d3 group (P = 0·028). No difference was detected between fl/d3 and fl/fl groups. Regression analyses of ΔIGF‐I at 12 months and ΔIGF‐I/rhGH dose confirmed a significant relationship of d3/d3 genotype on rhGH response. There was no difference between groups in maintenance rhGH dose between genotypes.Conclusion  Homozygosity for d3‐GHR confers a marginal increase in GH responsiveness at 12 months but without a detectable change in maintenance rhGH dose required. Both d3 alleles are required to achieve this response; given that only 10% of the population are d3 homozygotes, the d3GHR does not explain the marked heterogeneity of GH responsiveness in hypopituitary adults.
Feasibility and challenges of independent research on drugs: the Italian Medicines Agency (AIFA) experience
Authors:   Italian Medicines Agency (AIFA) Research & Development Working Group
Published: December 2009

Eur J Clin Invest 2010; 40 (1): 69–86Key points

National Health Service (NHS) is becoming increasingly aware of the need to support independent research to answer some important questions for patient care in areas of scant commercial interest.
This article reports the main features and strategies of the independent research programme on drugs launched by the Italian Medicines Agency (AIFA) in 2005.
In the three bids launched between 2005 and 2007, a total of 151 studies have been approved for funding for a total of about 78 million Euro.
In this article we describe the Italian legislative framework under which the programme was launched, the types of research funded and discuss how the supported studies could contribute, in an international framework, to the knowledge needed on drug efficacy, effectiveness and safety.
TEM investigation of reaction zone products formed between molten Al and CoO monocrystalline substrate
Authors: MORGIEL J. , SOBCZAK N. , POMORSKA M. , RADZIWIŁŁ W. , NOWAK R. , KUDYBA A. , WOJEWODA‐BUDKA J. 
Published: December 2009

SummaryThe research was aimed at microstructure characterization of the reaction products formed between molten aluminium and CoO single crystal during a sessile drop wettability test performed in vacuum at 700 and 1000°C for 120 min using contact heating procedure. The solidified Al/CoO couples were sectioned and used for cutting thin foils with focused ion beam. The transmission electron microscopy and energy dispersive X‐ray spectroscopy were used for microstructure and local chemical analysis. The interaction of molten aluminium with CoO substrate at 700°C caused the formation of a corrugated 10–40 μm thick reaction zone (RZ). It consisted of aluminium matrix and Al2O3 crystallites varying in size, i.e. of ∼0.2 μm near the Al drop/RZ interface, growing up to 1–2 μm at the RZ centre and very fine nano‐crystallites near the RZ/CoO interface. The reaction of aluminium with CoO at 1000°C produced much thicker RZ of ∼280 μm characterized by layered microstructure of alternating fine crystalline Al2O3 and coarser Al13Co4 layers. Moreover, at the RZ/CoO interface the presence of a cobalt layer was also identified.
Fractal‐like behaviour of the BCC/FCC phase separation in the iron‐gold alloys
Authors: BŁACHOWSKI A. , RUEBENBAUER K. , RAKOWSKA A. , KĄC S. 
Published: December 2009

SummaryIron‐gold alloys with compositions Fe70Au30 and Fe50Au50 were prepared by arc melting. The alloys were investigated by means of the high‐resolution scanning electron microscopy (SEM‐FEG) in the as‐cast state and upon annealing in two steps, i.e. at 250°C for 24 h and subsequently at 500°C for 48 h. The alloys were composed of two phases, i.e. a BCC phase rich in iron and a FCC phase rich in gold. The single‐phase regions have equivalent diameter of about 50 nm. SEM images show self‐similar structure for the spatial distribution of the above phases on scales ranging from about 1 mm till about 100 nm. The roughness of the images has been used to estimate a fractal dimension of the phase mixture. For larger scales of the as‐cast samples one finds fractal dimension of about 1.7 for Fe70Au30 composition, i.e. very close to the dimension of typical diffusion limited aggregation (DLA) fractals. For annealed samples, dimension 1.1 was found.
The effect of carbide precipitate morphology on fracture toughness in low‐tempered steels containing Ni
Authors: KRAWCZYK J. , BAŁA P. , PACYNA J. 
Published: December 2009

SummaryNickel is known to increase the resistance to cleavage fracture of iron and decrease a ductile‐to‐brittle transition temperature. The medium‐carbon, low‐alloy martensitic steels attain the best combination of properties in low‐tempered condition, with tempered martensite, retained austenite and transition carbides in the microstructure. This paper is focused on the influence of Ni addition (from 0.35 to 4.00%) on the microstructure and fracture toughness of structural steels after tempering. In this research, four model alloys of different concentration of Ni and constant concentration of carbon and other elements were used. All samples were in as‐quenched and tempered conditions. Quenching was performed in oil at room temperature. After quenching, samples were tempered at 200°C for 2 h. The microstructure of the investigated steels was analyzed using JEM200CX transmission electron microscope. An increase of nickel content in the investigated structural steels causes a decrease of ɛ carbide concentration in their microstructure after tempering. In these steels, cementite precipitates independently in the boundaries of martensite needles and in the twin boundaries in the areas where the Fe2.4C carbide has been dissolved. These results will be used to design new technologies of tempering of structural steels with nickel addition.
Effect of annealing temperature on the structure and mechanical properties of mechanically alloyed AlMg–Nb2O5 and AlMg–ZrSi2 composites
Authors: KULA A. , BLAZ L. , KANEKO J. , SUGAMATA M. 
Published: December 2009

SummaryMechanical alloying and hot extrusion method were used for manufacturing AlMg‐based composites reinforced with addition of niobium oxide (Nb2O5) and zirconium silicide (ZrSi2) particles. High mechanical properties of the materials were found to result from heavily refined structure of composites. It was found that the composite structure was transformed at high temperature as a result of irreversible chemical reaction between disperse reinforcements and surrounding matrix. Chemical reaction for AlMg–Nb2O5 composite results in a growth of intermetallic grains of Al3Nb type and very fine oxides particles of 5–20 nm in diameter. In the annealed AlMg–ZrSi2 composite, new grains of Al3Zr, Mg2Si and Al(Mg)O are formed as a result of zirconium silicide decomposition. Hot compression tests were performed at constant true strain rate of 5.10−3 s−1 within the temperature range of 293–823 K. The high flow stress values are attributed to highly refined structure of the materials that essentially did not coarsen in spite of high deformation temperature.
Imaging using pulses: a simple and fast (>100 kHz) solution
Authors: UDALAGAMA C. , BETTIOL A.A. , WATT F. 
Published: December 2009

SummaryImaging is an important component of spectroscopy. A good imaging system is expected to work with a high‐pixel resolution using signals of high count‐rates with as little dead time as possible to deliver an image quickly and reliably. It is not uncommon for such a system to be highly specialized, expensive and to consist of many dedicated electronic components. In this work, we present a simple imaging algorithm that can be used with a pulse (TTL) data signal, such as that produced by some photomultipliers and electron detectors. This algorithm works with only a simple general purpose data acquisition computer card (NI PXI/PCI‐6259) from National Instruments residing in a computer. The system has been tested with signal rates in excess of 100 kHz to produce images at a pixel resolution of 512 × 512. The system's ability to handle such high count‐rates hinges on utilizing the buffered data collection feature on the said card, in a hitherto unreported configuration. This system now offers a simple and cost‐effective manner of incorporating high count‐rate imaging features, such as in a scanning electron microscope, into a purely spectroscopic system. Further, since the use of the NI DAQ cards are supported under other computer platforms, the current imaging formalism is readily transferrable to computer platforms such as Linux or Mac OS.
Prevalence and severity of renal dysfunction among 1062 heart transplant patients according to criteria based on serum creatinine and estimated glomerular filtration rate: results from the CAPRI study
Authors: Crespo‐Leiro Maria G. , Delgado Juan F. , Paniagua Maria J. , Vázquez de Prada Jose A. , Fernandez‐Yañez Juan , Almenar Luis , Diaz‐Molina Beatriz , Roig Eulalia , Arizón Jose M. , Alonso‐Pulpón Luis , Garrido Iris P. , Sanz Maria Luisa , De La Fuente Luis , Mirabet Sonia , Manito Nicolas , Muñiz Javier 
Published: December 2009

Crespo‐Leiro MG, Delgado JF, Paniagua MJ, Vázquez, de Prada JA, Fernandez‐Yañez J, Almenar L, Diaz‐Molina B, Roig E, Arizón JM, Alonso‐Pulpón L, Garrido IP, Sanz ML, de la Fuente L, Mirabet S, Manito N, Muñiz J. Prevalence and severity of renal dysfunction among 1062 heart transplant patients according to criteria based on serum creatinine and estimated glomerular filtration rate: results from the CAPRI study. Clin Transplant 2010: 24: E88–E93. © 2009 John Wiley & Sons A/S.Abstract:  Chronic kidney disease (CKD) is staged on the basis of glomerular filtration rate; generally, the MDRD study estimate, eGFR, is used. Renal dysfunction (RD) in heart transplant (HT) patients is often evaluated solely in terms of serum creatinine (SCr). In a cross‐sectional, 14‐center study of 1062 stable adult HT patients aged 59.1 ± 12.5 yr (82.3% men), RD was graded as absent‐or‐mild (AoM), moderate, or severe (this last including dialysis and kidney graft) by two classifications: SCr‐RD (SCr cutoffs 1.6 and 2.5 mg/dL) and eGFR‐RD (eGFR cutoffs 60 and 30 mL/min/1.73 m2). SCr‐RD was AoM in 68.5% of patients, moderate in 24.9%, and severe in 6.7%; eGFR‐RD, AoM in 38.6%, moderate in 52.2%, severe in 9.2%. Among patients evaluated <2.7, 2.7‐6.2, 6.2‐9.5 and >9.5 yr post‐HT (the periods defined by time‐since‐transplant quartiles), AoM/moderate/severe RD prevalences were <2.7, SCr‐RD 74/21/5%, eGFR‐RD 47/47/6%; 2.7‐6.2, SCr‐RD 73/22/5%, eGFR‐RD 37/56/7%; 6.2–9.5, SCr‐RD 69/24/7%, eGFR‐RD 37/54/9%; >9.5, SCr‐RD 58/32/10%, eGFR‐RD 32/52/16%. The prevalence of severe RD increases with time since transplant. If the usual CKD stages are appropriate for HT patients, the need for less nephrotoxic immunosuppressants and other renoprotective measures is greater than is suggested by direct SCr‐based grading, which should be abandoned as excessively insensitive.
Secreted frizzled‐related protein 1 (SFRP1) is highly upregulated in keratoconus epithelium: a novel finding highlighting a new potential focus for keratoconus research and treatment
Authors: Sutton Gerard , Madigan Michele , Roufas Athena , McAvoy John 
Published: December 2009

AbstractPurpose:  To investigate the expression of Wnt signalling pathway genes in keratoconic (KC) epithelium.Methods:  RNA was extracted from the epithelium of four KC patients undergoing corneal transplantation and five age‐matched controls. The expression of 84 genes known to be involved in the Wnt signalling pathway was tested by reverse transcription‐polymerase chain reaction (RT‐PCR) with a pathway‐targeted array (Human Wnt RT2 Profiler PCR Array, Superarray).Results:  Using RT‐PCR arrays, LEF1, PITX2 and secreted frizzled‐related protein 1 (SFRP1) were upregulated more than twofold in KC compared with control epithelium. Only SFRP1 was significantly upregulated, ∼25‐fold compared with pooled controls (range 9.12‐fold to 98.6‐fold; P = 0.019). SFRP1 expression was associated with patient age and possibly the rate of progression of the keratoconus. Immunohistochemistry was used to assess SFRP1 protein distribution and confirm the SFRP1 microarray result (n = 3 KC and n = 2 control corneas). SFRP1 immunolablelling was seen in all KC corneas, mostly in the basal epithelium; however, control corneas showed minimal SFRP1 immunoreactivity.Conclusion:  SFRP1 is highly upregulated in the epithelium of these KC patients, suggesting a role in the pathogenesis and progression of keratoconus. Future investigations are required to establish if SFRP1 may be a potential marker of KC progression or if manipulation of its expression can be used to therapeutic effect in this disease.