bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sirolimus-Eluting Stent Implantation for Ostial Left Anterior Descending Coronary Artery Lesions
Authors: Kishi Koichi , Kimura Takeshi , Morimoto Takeshi , Namura Masanobu , Muramatsu Toshiya , Nishikawa Hideo , Hiasa Yoshikazu , Isshiki Takaaki , Nobuyoshi Masakiyo , Mitsudo Kazuaki ,   for the j-Cypher Registry Investigators
Published: June 2011

Background—
Ostial left anterior descending coronary artery (LAD) lesion has been regarded as a lesion subset unsuitable for coronary stenting. Long-term outcomes of sirolimus-eluting stent (SES) implantation for ostial LAD lesions have not been adequately evaluated.

Methods and Results—

Among 12 824 patients enrolled in the j-Cypher Registry, 3-year outcomes were compared between 481 patients with SES-treated ostial LAD lesions and 5369 patients with SES-treated nonostial proximal LAD lesions. Patients with ostial LAD lesions had similar incidences of target lesion revascularization (TLR) as those with nonostial proximal LAD lesions (9.4% versus 9.7%;
P
=0.98; adjusted hazard ratio [HR], 0.99; 95% CI, 0.7 to 1.36;
P
=0.94) and death/myocardial infarction (MI) (10.7% versus 11.4%;
P
=0.82; adjusted HR, 1.05; 95% CI, 0.76 to 1.4;
P
=0.77). Among the patients with ostial LAD lesions, those undergoing both main and side branch stenting (n=62) compared to main branch stenting alone (n=419) had a higher risk for TLR (adjusted HR, 4.65; 95% CI, 2.32 to 9.25;
P
<0.0001) but similar risk for death/MI (adjusted HR, 1.15; 95% CI, 0.49 to 2.41;
P
=0.73). In patients with main branch stenting alone, outcomes after crossover stenting across the circumflex coronary artery (n=225) were not different from those after ostial stenting (n=194) for TLR (adjusted HR, 0.77; 95% CI, 0.33 to 1.82;
P
=0.55) and for death/MI (adjusted HR, 1.54; 95% CI, 0.78 to 3.2;
P
=0.22).

Conclusions—
In terms of both safety and efficacy, 3-year outcomes of percutaneous coronary intervention using SES for ostial LAD lesions were comparable to those for nonostial proximal LAD lesions. Crossover stenting with a 1-stent approach might be a reasonable option in treating ostial LAD lesions.
Long-Term Follow-Up of Early Versus Delayed Invasive Approach After Fibrinolysis in Acute Myocardial Infarction
Authors: Clever Yvonne P. , Cremers Bodo , Link Andreas , Böhm Michael , Scheller Bruno 
Published: June 2011

Background—
Optimal reperfusion strategy in ST-elevation myocardial infarction is controversial. Failure of fibrinolytic therapy is related to limited efficacy, high reocclusion rates, reinfarction, and systemic bleeding complications. Data on the impact of percutaneous coronary intervention (PCI) after fibrinolysis are conflicting. The Southwest German Interventional Study in Acute Myocardial Infarction (SIAM III) evaluated the effects of transfer for early PCI in acute ST-elevation–myocardial infarction compared with a delayed PCI strategy.

Methods and Results—

SIAM III was a multicenter, randomized, prospective, controlled trial in patients with ST-elevation–myocardial infarction receiving fibrinolysis <12 hours after onset of symptoms. All patients received reteplase, aspirin in combination with ticlopidine, and heparin. Patients of the early PCI group were transferred within 6 hours after fibrinolysis for PCI. The delayed PCI group received elective PCI 2 weeks after fibrinolysis. In total, 197 patients were included; 163 were treated by PCI. The primary end point was the composite of death, reinfarction, target lesion revascularization, and ischemic events. During a mean follow-up time of 7.9±3.4 years (maximum, 11.2 years), early PCI was associated with a significant reduction of the primary end point (hazard ratio, 0.61 [95% confidence interval, 0.42 to 0.88];
P
=0.008). Long-term survival was higher in the early PCI group (
P
=0.057). Ischemic events were significantly reduced after early PCI (
P
=0.003).

Conclusions—
Early PCI after fibrinolysis improves long-term event-free survival compared with a delayed PCI treatment strategy.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01124890.
The Risk of Incident Coronary Heart Disease Among Veterans With and Without HIV and Hepatitis C
Authors: Freiberg Matthew S. , Chang Chung-Chou H. , Skanderson Melissa , McGinnis Kathleen , Kuller Lewis H. , Kraemer Kevin L. , Rimland David , Goetz Matthew B. , Butt Adeel A. , Rodriguez Barradas Maria C. , Gibert Cynthia , Leaf David , Brown Sheldon T. , Samet Jeffrey , Kazis Lewis , Bryant Kendall , Justice Amy C. ,   for the Veterans Aging Cohort Study
Published: June 2011

Background—
Whether hepatitis C virus (HCV) confers additional coronary heart disease (CHD) risk among human immunodeficiency virus (HIV) infected individuals is unclear. Without appropriate adjustment for antiretroviral therapy, CD4 count, and HIV-1 RNA and substantially different mortality rates among those with and without HIV and HCV infection, the association between HIV, HCV, and CHD may be obscured.

Methods and Results—
We analyzed data on 8579 participants (28% HIV+, 9% HIV+HCV+) from the Veterans Aging Cohort Study Virtual Cohort who participated in the 1999 Large Health Study of Veteran Enrollees. We analyzed data collected on HIV and HCV status, risk factors for and the incidence of CHD, and mortality from January 2000 to July 2007. We compared models to assess CHD risk when death was treated as a censoring event and as a competing risk. During the median 7.3 years of follow-up, there were 194 CHD events and 1186 deaths. Compared with HIV−HCV− Veterans, HIV+HCV+ Veterans had a significantly higher risk of CHD regardless of whether death was adjusted for as a censoring event (adjusted hazard ratio, 2.03; 95% confidence interval, 1.28 to 3.21) or a competing risk (adjusted HR, 2.45; 95% confidence interval, 1.83 to 3.27 respectively). Compared with HIV+HCV− Veterans, HIV+HCV+ Veterans also had a significantly higher adjusted risk of CHD regardless of whether death was treated as a censored event (adjusted hazard ratio, 1.93; 95% confidence interval, 1.02 to 3.62) or a competing risk (adjusted hazard ratio, 1.46; 95% confidence interval, 1.03 to 2.07).

Conclusions—
HIV+HCV+ Veterans have an increased risk of CHD compared with HIV+HCV− and HIV−HCV− Veterans.
Upstream Use of Small-Molecule Glycoprotein IIb/IIIa Inhibitors in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes
Authors: Tricoci Pierluigi , Newby L. Kristin , Hasselblad Vic , Kong David F. , Giugliano Robert P. , White Harvey D. , Théroux Pierre , Stone Gregg W. , Moliterno David J. , Van de Werf Frans , Armstrong Paul W. , Prabhakaran Dorairaj , Rasoul Saman , Bolognese Leonardo , Durand Eric , Braunwald Eugene , Califf Robert M. , Harrington Robert A. 
Published: June 2011

Background—
The use of upstream small-molecule glycoprotein (GP) IIb/IIIa inhibitors in non–ST-segment elevation acute coronary syndromes (NSTE ACS) has been studied in multiple randomized clinical trials. We systematically reviewed the effect of upstream GP IIb/IIIa inhibitor use in NSTE ACS as reported in published clinical trials.

Methods and Results—
Randomized clinical trials of upstream small-molecule GP IIb/IIIa inhibitors in NSTE ACS were identified through a PubMed and EMBASE search and were included if they contained 30-day outcome data. Odds ratios were generated from the published data and pooled by means of random effects modeling. The primary outcome measures were 30-day death and 30-day death or myocardial infarction. Primary safety measures were major bleeding and transfusion during the index hospitalization. Twelve clinical trials were included, evaluating tirofiban, eptifibatide, and lamifiban. Of these, 7 evaluated upstream GP IIb/IIIa inhibitors versus placebo (n=24 031) and 5 evaluated a strategy of upstream GP IIb/IIIa inhibitors versus upstream placebo with later provisional use at the time of percutaneous coronary intervention (n=19 643). Overall, upstream GP IIb/IIIa inhibitor use was associated with an 11% reduction in 30-day death/myocardial infarction (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.83 to 0.95) but no significant mortality effect (OR, 0.93; 95% CI, 0.83 to 1.05). The risk of major bleeding was 23% higher in patients treated with upstream GP IIb/IIIa inhibitors (OR, 1.23; 95% CI, 1.02 to 1.48). Results were similar when only trials comparing upstream GP IIb/IIIa inhibitors versus placebo were considered: 30-day death/myocardial infarction (OR, 0.88; 95% CI, 0.81 to 0.95); 30-day death (OR, 0.89; 95% CI, 0.76 to 1.03); and major bleeding (OR, 1.17; 95% CI, 0.88 to 1.54). Upstream versus selective use at percutaneous coronary intervention trended toward lower 30-day death/myocardial infarction (OR, 0.91; 95% CI, 0.82 to 1.01) but had no effect on mortality (OR, 1.00; 95% CI, 0.81 to 1.23) and increased major bleeding risk by 34% (OR, 1.34; 95% CI, 1.10 to 1.63).

Conclusions—
In NSTE ACS, treatment with upstream small-molecule GP IIb/IIIa inhibitors provides a significant but modest ischemic benefit when compared with initial placebo. Compared with delayed, selective use at percutaneous coronary intervention, early upstream use is associated with a trend toward fewer ischemic events. However, these modest benefits are associated with an increased risk of bleeding.
The Business Case for Quality Improvement
Authors: Rose Adam J. , Berlowitz Dan R. , Ash Arlene S. , Ozonoff Al , Hylek Elaine M. , Goldhaber-Fiebert Jeremy D. 
Published: June 2011

Background—
The potential to save money within a short time frame provides a more compelling “business case” for quality improvement than merely demonstrating cost-effectiveness. Our objective was to demonstrate the potential for cost savings from improved control in patients anticoagulated for atrial fibrillation.

Methods and Results—
Our population consisted of 67 077 Veterans Health Administration patients anticoagulated for atrial fibrillation between October 1, 2006, and September 30, 2008. We simulated the number of adverse events and their associated costs and utilities, both before and after various degrees of improvement in percent time in therapeutic range (TTR). The simulation had a 2-year time horizon, and costs were calculated from the perspective of the payer. In the base-case analysis, improving TTR by 5% prevented 1114 adverse events, including 662 deaths; it gained 863 quality-adjusted life-years and saved $15.9 million compared with the status quo, not accounting for the cost of the quality improvement program. Improving TTR by 10% prevented 2087 events, gained 1606 quality-adjusted life-years, and saved $29.7 million. In sensitivity analyses, costs were most sensitive to the estimated risk of stroke and the expected stroke reduction from improved TTR. Utilities were most sensitive to the estimated risk of death and the expected mortality benefit from improved TTR.

Conclusions—
A quality improvement program to improve anticoagulation control probably would be cost-saving for the payer, even if it were only modestly effective in improving control and even without considering the value of improved health. This study demonstrates how to make a business case for a quality improvement initiative.
Influence of Humidified Aerosol on Lidar Depolarization Measurements below Ice-Precipitating Arctic Stratus
Authors: van Diedenhoven Bastiaan , Fridlind Ann M. , Ackerman Andrew S. 
Published: June 2011

AbstractLidar measurements obtained during the Surface Heat Budget of the Arctic Ocean (SHEBA) experiment under a mixed-phase stratus cloud that was lightly precipitating ice show a range of surprisingly low depolarization ratios (4%–23%), despite an absence of cloud droplets there. These depolarization ratios are much lower than the range of theoretical values obtained for various ice habits. The depolarization ratios correlate well with radar reflectivity, suggesting that the variation in depolarization ratios results from variations in ice water content, rather than variation in ice habits or orientation. By calculating lidar depolarization based on (i) large-eddy simulations and (ii) in situ ice size distribution measurements, it is shown that the presence of humidified aerosol particles in addition to the ice precipitation can explain the distribution and vertical profile of the observed depolarization ratios, although uncertainties related to the aerosol size distributions are substantial. These calculations show that humidified aerosol must be taken into account when interpreting lidar depolarization measurements for cloud and precipitation phase discrimination or ice habit classification, at least under conditions similar to those observed during SHEBA.
Experiences of dying, death and bereavement in motor neurone disease: A qualitative study
Authors: Whitehead Bridget , O’Brien Mary R , Jack Barbara A , Mitchell Douglas 
Published: June 2011

Objectives: to explore the experiences of people with Motor Neurone Disease (MND), current and bereaved carers in the final stages of the disease and bereavement period. Methods: a qualitative study using narrative interviews was used to elicit accounts from 24 people with MND and 18 current family carers and 10 former family carers. Results: the needs of patients and carers are not being adequately met in the final stages of MND and there appears a need for increased, co-ordinated support from palliative care services. The use of advance care planning tools is regarded as beneficial for patients and carers, but health professionals demonstrate a limited understanding of them. Anxiety and distress in patients, carers and bereaved carers is heightened during this period. Carer burden is excessive and may exacerbate patient distress and desire for hastening death. Conclusion: this study has identified a number of issues people with MND and their carers face in the final stages of the illness, indicating some ways in which health, social and palliative care services could be improved or co-operate more effectively in order to better meet their needs.
Quality of Life and Clinical Outcome Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts for Anterior Cruciate Ligament Reconstruction
Authors: Sajovic Matjaz , Strahovnik Andrej , Dernovsek Mojca Z. , Skaza Katja 
Published: June 2011

Background: There are still controversies about graft selection for primary anterior cruciate ligament reconstruction. Prospective, randomized long-term studies are needed to determine the differences between the graft materials. Hypothesis: Eleven years after anterior cruciate ligament reconstruction there is no difference in functional outcome and quality of life between patients with patellar tendon or hamstring tendon autografts; however, the patients with patellar tendon autograft would have a higher prevalence of osteoarthritis. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: From June 1999 to March 2000, 64 patients were included in this prospective study. A single surgeon performed primary arthroscopically assisted anterior cruciate ligament reconstruction in an alternating sequence. In 32 patients, anterior cruciate ligament reconstruction was performed with hamstring tendon autograft (semitendinosus and gracilis [STG] group) while in the other 32 patients the reconstruction was performed with patellar tendon autograft (PT group). Results: At the 11-year follow-up, no statistically significant differences were seen with respect to the Lysholm score and Short Form-36, KT-1000 arthrometer laxity testing, anterior knee pain, single-legged hop test, or International Knee Documentation Committee (IKDC) classification results. Positive pivot-shift test (1+) was significantly more frequent in the PT group ( P = .036). Twenty-two patients (81%) in the STG group and 18 patients (72%) in the PT group were still at their preinjury level of activity. Graft rupture occurred in 2 patients from the STG group (6%) and in 4 patients from the PT (12%). Grade B and C abnormal radiographic findings were seen in 84% (21 of 25) of patients in the PT group and in 63% (17 of 27) of patients in the STG group ( P = .008). Conclusion: Both hamstring and patellar tendon autografts provided good subjective outcomes and objective stability at 11 years. Positive pivot-shift test (1+) was significantly more frequent in the PT group. No significant differences in the rate of graft failure were identified. Patients with patellar tendon graft had a greater prevalence of osteoarthritis at 11 years after surgery.
Nurses with disabilities: a pilot test of the Nurses’ Attitudes toward Nurses with Disabilities Scale
Authors: Matt Susan B. 
Published: June 2011

The aims of this pilot study were to describe registered nurses’ attitudes toward nurses with disabilities in the hospital nursing work force, explore factors contributing to these attitudes and explore the concept of disability climate in the hospital workplace. The web-based 37-item Nurses’ Attitudes toward Nurses with Disabilities Scale (NANDS) was administered to a convenience sample of 131 registered nurses working in three urban tertiary care hospitals. Respondents with experience caring for patients with disabilities indicated a significantly more positive perception of accessibility in the workplace and more positive attitudes toward the capability of nurses with disabilities than those without patient exposure. Respondents with higher levels of education indicated a higher level of Americans with Disabilities Act awareness. The disability climate was significantly more positive in outpatient clinics than in intensive care unit environments. Nurses with physical and sensory disabilities may feel more welcomed in areas serving patients with lower acuities. Greater exposure to individuals with disabilities positively impacts attitudes toward this population. The NANDS may be useful to assist employers and nursing administrators in assessing and creating healthy, disability-friendly work environments that promote a positive disability climate and improve the work experience for nurses with disabilities.
Lack of the T cell–specific alternative p38 activation pathway reduces autoimmunity and inflammation
Authors: Jirmanova Ludmila , Giardino Torchia Maria Letizia , Sarma Nandakumara D. , Mittelstadt Paul R. , Ashwell Jonathan D. 
Published: June 2011

AbstractStimulation via the T-cell receptor (TCR) activates p38α and p38β by phosphorylation of p38 Tyr-323 (p38Y323). Here we characterize knockin mice in which p38α and/or β Tyr-323 has been replaced with Phe. We find that p38α accounts for two-thirds and p38β the remainder of TCR-induced p38 activation. T cells from double knockin mice (p38αβY323F) had defects in TCR-mediated proliferation and Th1 and Th17 skewing, the former corresponding with an inability to sustain T-bet expression. Introduction of p38αY323F into Gadd45α-deficient mice, in which the alternative p38 pathway is constitutively active, reversed T-cell hyperproliferation and autoimmunity. Furthermore, p38αβY323F mice had delayed onset and reduced severity of the inflammatory autoimmune diseases collagen-induced arthritis and experimental autoimmune encephalomyelitis. Thus, T cell-specific alternative activation of p38 is an important pathway in T-cell proliferation, Th skewing, and inflammatory autoimmunity, and may be an attractive tissue-specific target for intervention in these processes.
Obscured phylogeny and possible recombinational dormancy in Escherichia coli
Authors: Leopold Shana R , Sawyer Stanley A , Whittam Thomas S , Tarr Phillip I 
Published: June 2011

Abstract

Background

Escherichia coli is one of the best studied organisms in all of biology, but its phylogenetic structure has been difficult to resolve with current data and analytical techniques. We analyzed single nucleotide polymorphisms in chromosomes of representative strains to reconstruct the topology of its emergence.

Results
The phylogeny of E. coli varies according to the segment of chromosome analyzed. Recombination between extant E. coli groups is largely limited to only three intergroup pairings.

Conclusions
Segment-dependent phylogenies most likely are legacies of a complex recombination history. However, E. coli are now in an epoch in which they no longer broadly share DNA. Using the definition of species as organisms that freely exchange genetic material, this recombinational dormancy could reflect either the end of E. coli as a species, or herald the coalescence of E. coli groups into new species.
On the alleged origin of geminiviruses from extrachromosomal DNAs of phytoplasmas
Authors: Saccardo Federica , Cettul Emanuele , Palmano Sabrina , Noris Emanuela , Firrao Giuseppe 
Published: June 2011

Abstract

Background
Several phytoplasmas, wall-less phloem limited plant pathogenic bacteria, have been shown to contain extrachromosomal DNA (EcDNA) molecules encoding a replication associated protein (Rep) similar to that of geminiviruses, a major group of single stranded (ss) DNA plant viruses. On the basis of that observation and of structural similarities between the capsid proteins of geminiviruses and the Satellite tobacco necrosis virus, it has been recently proposed that geminiviruses evolved from phytoplasmal EcDNAs by acquiring a capsid protein coding gene from a co-invading plant RNA virus.

Results
Here we show that this hypothesis has to be rejected because (i) the EcDNA encoded Rep is not of phytoplasmal origin but has been acquired by phytoplasmas through horizontal transfer from a geminivirus or its ancestor; and (ii) the evolution of geminivirus capsid protein in land plants implies missing links, while the analysis of metagenomic data suggests an alternative scenario implying a more ancient evolution in marine environments.

Conclusion
The hypothesis of geminiviruses evolving in plants from DNA molecules of phytoplasma origin contrasts with other findings. An alternative scenario concerning the origin and spread of Rep coding phytoplasmal EcDNA is presented and its implications on the epidemiology of phytoplasmas are discussed.