bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does an electrocardiogram add predictive value to the rose angina questionnaire for future coronary heart disease? 10-year follow-up in a Middle East population
Authors: Khalili Davood , Hadaegh Farzad , Fahimfar Noushin , Shafiee Gita , Sheikholeslami Farhad , Ghanbarian Arash , Azizi Fereidoun 
Published: April 2012

BackgroundTo evaluate the power of abnormal resting ECG versus Rose Questionnaire angina and its additive value in predicting 10-year coronary heart disease (CHD) risk in an Iranian urban population with high prevalence of CHD.MethodsThere were 5101 subjects ≥30 years (2900 women), free of CHD at baseline; they were categorised in to four groups according to their Rose Angina and ECG status for ischaemia as Rose−/ECG−, Rose+/ECG−, Rose−/ECG+ and Rose+/ECG+. HR of CHD was estimated using Cox regression analysis, given Rose−/ECG− as the reference. The authors used Akaike information criterion, C-index and integrated discrimination improvement indices to evaluate the prognostic value of ECG when would be added to Rose Questionnaire.ResultsDuring follow-up, 387 CHD events (169 women) were observed. Multivariate analysis showed a HR of 2.59 (95% CI 1.71 to 3.91) and 2.26 (1.48 to 3.44) for Rose+/ECG− group in men and women, respectively. These figures for Rose−/ECG+ were 1.36 (0.90 to 2.05) in men and 2.09 (1.40 to 3.12) in women. There was no any interaction between Rose Questionnaire and gender to predict incident CHD, in age-adjusted analysis. Akaike information criterion, C-index and relative integrated discrimination improvement did not show any difference between models including Rose alone and Rose plus ECG to predict CHD events especially in men.ConclusionsRose Questionnaire as a simple screening tool is equally important to predict incident CHD in both genders. Adding abnormal ECG to angina did not culminate in higher risk for future CHD events.
Construction of an adaptable European transnational ecological deprivation index: the French version
Authors: Pornet Carole , Delpierre Cyrille , Dejardin Olivier , Grosclaude Pascale , Launay Ludivine , Guittet Lydia , Lang Thierry , Launoy Guy 
Published: April 2012

BackgroundStudying social disparities in health implies the ability to measure them accurately, to compare them between different areas or countries and to follow trends over time. This study proposes a method for constructing a French European deprivation index, which will be replicable in several European countries and is related to an individual deprivation indicator constructed from a European survey specifically designed to study deprivation.Methods and ResultsUsing individual data from the European Union Statistics on Income and Living Conditions survey, goods/services indicated by individuals as being fundamental needs, the lack of which reflect deprivation, were selected. From this definition, which is specific to a cultural context, an individual deprivation indicator was constructed by selecting fundamental needs associated both with objective and subjective poverty. Next, the authors selected among variables available both in the European Union Statistics on Income and Living Conditions survey and French national census those best reflecting individual experience of deprivation using multivariate logistic regression. An ecological measure of deprivation was provided for all the smallest French geographical units. Preliminary validation showed a higher association between the French European Deprivation Index (EDI) score and both income and education than the Townsend index, partly ensuring its ability to measure individual socioeconomic status.ConclusionThis index, which is specific to a particular cultural and social policy context, could be replicated in 25 other European countries, thereby allowing European comparisons. EDI could also be reproducible over time. EDI could prove to be a relevant tool in evidence-based policy-making for measuring and reducing social disparities in health issues and even outside the medical domain.
Outcome of forced-suction thrombectomy in acute intracranial internal carotid occlusion
Authors: Hwang Yang-Ha , Kang Dong-Hun , Kim Yong-Won , Kim Yong-Sun , Park Sung-Pa , Suh Chung-Kyu 
Published: April 2012

ObjectivesIschemic stroke from acute intracranial distal internal carotid artery (ICA) occlusion usually carries a poor prognosis. Despite the intra-arterial revascularization therapies, the results are still unsatisfactory. The aim of this study was to compare the outcomes between two endovascular techniques, the modified Penumbra System (mPS) and mechanical clot disruption (MCD), and to confirm the influence of recanalization on the outcomes.MethodsIn a retrospective review of 39 consecutive cases of acute distal ICA occlusion, the recanalization rates and functional outcomes at 3 months of the two intra-arterial techniques during two consecutive periods (May 2006 to February 2009: MCD technique (n=19) vs March 2009 to August 2010: mPS technique (n=20)) were compared. Univariate and multivariate analyses were performed to determine the predictors of a favorable functional outcome.ResultsThe rate of successful recanalization (Thrombolysis In Cerebral Infarction score 2 or 3) was significantly higher in the mPS group than in the MCD group (85% (17/20) vs 32% (6/19); p=0.001). Favorable outcomes at 3 months (modified Rankin Scale score 0–2) were achieved in 9/20 and 3/19 in the mPS and MCD groups, respectively (45% vs 16%; p=0.048). Binary logistic regression analysis showed that younger age and successful recanalization were independent predictors of a favorable functional outcome.ConclusionsForced-suction thrombectomy using the mPS technique may be a viable option for acute distal ICA occlusion and could result in more successful recanalization and a more positive clinical outcome.
Marked decrease in coil and stent utilization following introduction of flow diversion technology
Authors: Crobeddu Emanuela , Lanzino Giuseppe , Kallmes David F , Cloft Harry J 
Published: April 2012

BackgroundFlow diversion represents a major paradigm shift in the treatment of unruptured intracranial aneurysms. The potential impact of this technique on coil utilization and adjunctive techniques such as balloon-assisted and stent-assisted coiling is unknown. In this study, the effect of introduction of flow diversion devices on the utilization of coil and adjunctive techniques was assessed.MethodsA retrospective review was conducted of consecutive patients with unruptured aneurysms treated at our institution comparing two groups: Group 1 (patients treated in the 2-year interval preceding the introduction of the Pipeline Embolization Device (PED) and Group 2 (patients treated during the 2-year interval following introduction in our practice of the PED).ResultsMean aneurysm diameter was 8.7±6.3 mm in Group 1 and 8.5±6.1 mm in Group 2 (p=0.79). PED therapy was employed in 38 (21.7%) of 175 aneurysms in Group 2. The proportion of stent-assisted procedures was significantly less in Group 2 than in Group 1 (6.9% vs 14.7%, p=0.04), as was the proportion of patients undergoing parent artery sacrifice (0.6% vs 3.9%, p=0.046). The mean and median number of coils used per aneurysm were 5.4±3.6 and 5 (range 1–18) for Group 1 and 3.2±3.2 and 3 (range 0–19) for Group 2 (p≤0.0001).ConclusionsFlow diversion represents a disruptive technology. More than one-fifth of unruptured aneurysms at our institution were treated with PED after introduction of this technology, resulting in marked decreases in coil and stent utilization.
Wingspan experience in the treatment of symptomatic intracranial atherosclerotic disease after antithrombotic failure
Authors: Samaniego Edgar A , Tari-Capone Francesca , Linfante Italo , Silva Christine F , Spilberg Gabriela , Gounis Matthew , Wakhloo Ajay K , Dabus Guilherme 
Published: April 2012

Background and purposeIntracranial stenting with the Wingspan system has been used as a revascularization strategy in symptomatic patients with intracranial atherosclerotic disease (ICAD). The latest results of the Stenting versus Aggressive Medical Therapy for Intracranial Artery Stenosis (SAMMPRIS) trial challenge this approach. Our experience in the treatment of symptomatic ICAD with the Wingspan system is reported.Materials and methodsPatients who underwent stenting for symptomatic ICAD were included in the analysis. Demographic data, periprocedural complications, long term radiological and clinical outcomes are reported.Results46 lesions were treated in 45 patients. 13 patients (29%) presented with a transient ischemic attack and 32 (71%) with a stroke. 43 patients (95.5%) failed antithrombotic therapy at presentation. One (2%) symptomatic periprocedural (24 h) complication occurred. The 30 day incidence of stroke and vascular death was 6.6%—a fatal hemorrhagic stroke and two non-fatal hemorrhagic strokes. In-stent stenosis (≥50%) was seen in nine (42.8%) lesions, two were symptomatic.ConclusionsThis cohort of patients with symptomatic ICAD who failed antithrombotic medications benefited from angioplasty and stenting with the Wingspan system.
Early and late mortality in hospitalised patients with raised cardiac troponin T
Authors: Wong Peter Sze Chai , Jones Julia Dawn , Ashrafi Reza , Khanzada Omer , Wickramarachchi Upul , Keen Touran Heidi , Robinson Derek Richard 
Published: April 2012

Abstract

Aims
Cardiac troponins are measured in acute coronary syndrome (ACS) and other conditions. The authors investigate the prognostic significance of cardiac troponin T (TnT) test and comorbid medical conditions.

Methods
Consecutive patients admitted to the Aintree University Hospital, Liverpool, between 2 January 2004 and 29 February 2004 who had TnT measurement were included. Patients were separated into normal (&lt;0.01 μg/l) or raised TnT levels (≥0.01 μg/l), and further categorised into: (1) normal TnT with unstable angina; (2) normal TnT with non-ACS; (3) raised TnT with ACS; and (4) raised TnT with non-ACS. Cox regression was used to identify prognostic variables, and logrank test to compare 7-year survival.

Results
Of 1021 patients, 313 had raised TnT (195 ACS, 118 non-ACS) and 708 normal TnT (80 ACS, 628 non-ACS). Age (HR 1.06; 95% CI 1.05 to 1.07), congestive cardiac failure (HR 1.37; 95% CI 1.11 to 1.69), cerebrovascular disease (HR 1.37; 95% CI 1.10 to 1.71), chronic obstructive airway disease (HR 1.44; 95% CI 1.19 to 1.75), liver disease (HR 4.16; 95% CI 2.37 to 7.31), renal disease (HR 1.83; 95% CI 1.27 to 2.64), tumour (HR 1.39; 95% CI 1.07 to 1.79), lymphoma (HR 4.81; 95% CI 2.07 to 11.16), metastatic cancer (HR 3.55; 95% CI 2.32 to 5.45) and a higher Charlson's comorbidity score (HR 1.20, 95% CI 1.13 to 1.26) were adverse predictors. Both raised TnT with ACS (HR 1.92, 95% CI 1.54 to 2.39) and raised TnT with non-ACS (HR 2.37, 95% CI 1.87 to 3.00) were associated with worse survival. Raised TnT with non-ACS had a worse survival than raised TnT with ACS (p=0.001).

Conclusion
Hospitalised patients with raised TnT levels from any cause predicted a higher mortality than normal TnT, with worst survival in those without an obvious ACS.
Decline of the new Swedish variant ofChlamydia trachomatisafter introduction of appropriate testing
Authors: Persson Kenneth , Hammas Berit , Janson Håkan , Bjartling Carina , Dillner Joakim , Dillner Lena 
Published: April 2012

ObjectiveThe longitudinal epidemiological development of the new variant ofChlamydia trachomatiswas studied after appropriate testing procedures had been introduced when the strain was detected in 2006.MethodsThe number of cases of the new variant ofC trachomatiswas followed from 2007 through 2011 from the laboratory records. Testing forC trachomatisis centralised to one laboratory with around 80–85 000 persons being tested annually in a population of 1.1 million.ResultsDuring the 5-year period, 410 973 patients were tested of which 25 723 cases were positive. The proportion of the new variant of all positive cases declined from 30% in 2007 to 6% in 2011. While the number of the new variant ofC trachomatisdeclined, the ordinary wild-type strains remained largely unchanged.ConclusionsA selective decline of the new variant ofC trachomatishas occurred after appropriate laboratory testing was introduced. A new balance point between 5% and 10% for the new variant seems to be gradually approached.
Observations from the large, rapid Yigong rock slide – debris avalanche, southeast Tibet
Authors: Xu Qiang , Shang Yanjun , van Asch Theo , Wang Shitian , Zhang Zhuoyuan , Dong Xiujun 
Published: April 2012

The Yigong rock slide – debris avalanche (YRA), which occurred on 9 April 2000, received worldwide attention as one of the largest nonseismic landslides in recent years, with a volume of 0.3 × 109 m3. Sixty-two days after this landslide event, a catastrophic flood happened because of landslide dam failure. One of the special features of this debris avalanche is liquefaction, which plays an important role in the entrainment and long run-out distance and high-speed movement of the debris avalanche. Numerous sand boils were found in the deposition zone, providing strong evidence for liquefaction. The YRA provides the first actual evidence for a theoretical model where the mechanisms of excess pore pressure and liquefaction induced by undrained loading, and entrainment and dissipation control the run out and deposition of the debris avalanche. The damage mode to trees and the presence of debris cones or molards with a rounded top is proven to be the result of strong air waves and eddies. These features all imply that the YRA is a solid–liquid–air mixed-debris avalanche.
Profiling Three-Dimensional Nuclear Telomeric Architecture of Myelodysplastic Syndromes and Acute Myeloid Leukemia Defines Patient Subgroups
Authors: Gadji Macoura , Adebayo Awe Julius , Rodrigues Prerana , Kumar Rajat , Houston Donald S. , Klewes Ludger , Dièye Tandakha Ndiaye , Rego Eduardo Magalhães , Passetto Roberto Falcão , de Oliveira Fábio Morato , Mai Sabine 
Published: April 2012

AbstractPurpose: Myelodysplastic syndromes (MDS) are a group of disorders characterized by cytopenias, with a propensity for evolution into acute myeloid leukemias (AML). This transformation is driven by genomic instability, but mechanisms remain unknown. Telomere dysfunction might generate genomic instability leading to cytopenias and disease progression.Experimental Design: We undertook a pilot study of 94 patients with MDS (56 patients) and AML (38 patients). The MDS cohort consisted of refractory cytopenia with multilineage dysplasia (32 cases), refractory anemia (12 cases), refractory anemia with excess of blasts (RAEB)1 (8 cases), RAEB2 (1 case), refractory anemia with ring sideroblasts (2 cases), and MDS with isolated del(5q) (1 case). The AML cohort was composed of AML-M4 (12 cases), AML-M2 (10 cases), AML-M5 (5 cases), AML-M0 (5 cases), AML-M1 (2 cases), AML-M4eo (1 case), and AML with multidysplasia-related changes (1 case). Three-dimensional quantitative FISH of telomeres was carried out on nuclei from bone marrow samples and analyzed using TeloView.Results: We defined three-dimensional nuclear telomeric profiles on the basis of telomere numbers, telomeric aggregates, telomere signal intensities, nuclear volumes, and nuclear telomere distribution. Using these parameters, we blindly subdivided the MDS patients into nine subgroups and the AML patients into six subgroups. Each of the parameters showed significant differences between MDS and AML. Combining all parameters revealed significant differences between all subgroups. Three-dimensional telomeric profiles are linked to the evolution of telomere dysfunction, defining a model of progression from MDS to AML.Conclusions: Our results show distinct three-dimensional telomeric profiles specific to patients with MDS and AML that help subgroup patients based on the severity of telomere dysfunction highlighted in the profiles. Clin Cancer Res; 18(12); 3293–304. ©2012 AACR.
Impact of MiRSNPs on Survival and Progression in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation
Authors: de Larrea Carlos Fernández , Navarro Alfons , Tejero Rut , Tovar Natalia , Díaz Tania , Cibeira María Teresa , Rosiñol Laura , Ferrer Gerardo , Rovira Montserrat , Rozman María , Monzó Mariano , Bladé Joan 
Published: April 2012

Abstract
Purpose: A distinctive new group of polymorphisms is constituted by single-nucleotide polymorphism (SNP) in miRNA processing machinery in miRNA precursor molecules and in miRNA-binding sites, known as miRSNPs. The aim of this study was to ascertain the prognostic impact of six miRSNPs in patients with multiple myeloma and analyze the functional consequences.
Experimental Design: One hundred and thirty-seven patients with chemosensitive multiple myeloma (73M/64F) intensified with autologous stem cell transplantation (ASCT) were studied. The median follow-up was 4 years. The genes and SNPs evaluated in genomic DNA by allelic discrimination were KRT81 (rs3660), AFF1 (rs17703261), FAM179b (rs1053667), and MIR196A2 (rs11614913) for miRNA target genes and TRBP (rs784567) and XPO5 (rs11077) for miRNA biogenesis pathway.
Results: Overall survival (OS) was significantly longer in patients with KRT81 rs3660 C/C variant (P = 0.037). Functional analysis showed that the presence of C variant in KRT81 3′ untranslated region (UTR) is related with a reduction of the protein levels. Moreover, the reduction of KRT81 protein levels by siRNA in multiple myeloma cell lines is related to a decreased proliferation. On the other hand, OS was significantly longer in patients with C/C or A/C variant in XPO5 rs11077 (P = 0.012). There was also a significantly longer progression-free survival (PFS) for this SNP (P = 0.013). This SNP retained its prognostic impact on PFS and OS in a multivariate regression analysis (P = 0.028 and P = 0.014, respectively).
Conclusion: This is the first report that relates miRSNPs with prognosis in multiple myeloma either in a keratin gene (KRT81), target of diverse miRNA multiple myeloma clusters, or in the miRNA biogenesis pathway–related protein exportin-5. Clin Cancer Res; 18(13); 3697–704. ©2012 AACR.
Esophageal Hematoma After Atrial Fibrillation Ablation
Authors: Kumar Saurabh , Ling Liang-Han , Halloran Karen , Morton Joseph B. , Spence Steven J. , Joseph Stephen , Kistler Peter M. , Sparks Paul B. , Kalman Jonathan M. 
Published: April 2012

Background—
Esophageal hematoma recently has been reported as a form of esophageal injury after atrial fibrillation (AF) ablation, attributed to the use of transesophageal echocardiography (TEE). We sought to determine the incidence, clinical features, and sequelae of this form of esophageal injury.

Methods and Results—
This was a prospective series of 1110 AF ablation procedures performed under general anesthesia (GA) over 9 years. TEE was inserted after induction of GA to exclude left atrial appendage thrombus, define cardiac function, and guide transseptal puncture. The procedural incidence of esophageal hematoma was 0.27% (3/1110 procedures, mortality 0%). Odonyphagia, regurgitation, and hoarseness were the predominant symptoms, with an onset within 12 hours. There was absence of fever and neurological symptoms. Chest computed tomography excluded atrio-esophageal fistula and was diagnostic of esophageal hematoma localized to either the upper esophagus or extending the length of the mid and lower esophagus; endoscopy confirmed the diagnosis. Management was conservative in all cases comprising of ceasing oral intake and anticoagulation. Long term sequelae included esophageal stricture formation requiring dilatation, persistent esophageal dysmotility (mid esophageal hematoma), and vocal cord paralysis, resulting in hoarse voice (upper esophageal hematoma).

Conclusions—
Esophageal hematoma is a rare but important differential diagnosis for esophageal injury after TEE-guided AF ablation under GA, and can result in significant patient morbidity. Key clinical features differentiate presentation of esophageal hematoma from that of an atrio-esophageal fistula.
Mechanisms behind the Temporary Shutdown of Deep Convection in the Labrador Sea: Lessons from the Great Salinity Anomaly Years 1968–71
Authors: Gelderloos Renske , Straneo Fiammetta , Katsman Caroline A. 
Published: April 2012

Abstract
From 1969 to 1971 convection in the Labrador Sea shut down, thus interrupting the formation of the intermediate/dense water masses. The shutdown has been attributed to the surface freshening induced by the Great Salinity Anomaly (GSA), a freshwater anomaly in the subpolar North Atlantic. The abrupt resumption of convection in 1972, in contrast, is attributed to the extreme atmospheric forcing of that winter. Here oceanic and atmospheric data collected in the Labrador Sea at Ocean Weather Station Bravo and a one-dimensional mixed layer model are used to examine the causes of the shutdown and resumption of convection in detail. These results highlight the tight coupling of the ocean and atmosphere in convection regions and the need to resolve both components to correctly represent convective processes in the ocean. They are also relevant to present-day conditions given the increased ice melt in the Arctic Ocean and from the Greenland Ice Sheet. The analysis herein shows that the shutdown was initiated by the GSA-induced freshening as well as the mild 1968/69 winter. After the shutdown had begun, however, the continuing lateral freshwater flux as well as two positive feedbacks [both associated with the sea surface temperature (SST) decrease due to lack of convective mixing with warmer subsurface water] further inhibited convection. First, the SST decrease reduced the heat flux to the atmosphere by reducing the air–sea temperature gradient. Second, it further reduced the surface buoyancy loss by reducing the thermal expansion coefficient of the surface water. In 1972 convection resumed because of both the extreme atmospheric forcing and advection of saltier waters into the convection region.
Methods to Overcome Lightning Location System Performance Limitations on Spatial and Temporal Analysis: Brazilian Case
Authors: Bourscheidt Vandoir , Cummins Kenneth L. , Pinto Osmar , Naccarato Kleber P. 
Published: April 2012

Abstract
One of the most interesting attributes of Lightning Location Systems (LLSs) data is that they can be analyzed in several ways according to the objectives of the study. However, the quality of the data is governed by the system performance and has some limitations when analyzed at different temporal/spatial scales, and these limitations will depend on the analysis method. This work focuses on approaches to minimize the variations associated with LLS performance. In this way, specific network configurations for the Brazilian Lightning Detection Network (BLDN) were obtained through the reprocessing of selected sensor data, resulting in three distinct datasets. Each dataset was then evaluated using different procedures: trimmed flash (exclusion of low current discharges), thunderstorm days (TDs), and thunderstorm hours (THs). The comparison between TDs obtained from the LLS and TDs available from surface stations shows consistent results with a good correlation of those datasets. An 11-yr analysis of BLDN data also shows that improvement (over time) of the system sensitivity has led to the detection of an increasing number of low peak current events. By eliminating low peak current discharges (less than 19 kA), the sensitivity variation was significantly reduced, partially “normalizing” long-term performance. TDs and THs were the most effective method to normalize temporal variations of the lightning activity, overcoming most of the network performance variations. From the spatial perspective, TDs and THs also seem to produce the most reliable lightning distribution. These results might guide long-term temporal and spatial analysis of lightning data, providing a more stable approach that is independent of system performance.