bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Two Exercise Training Programs on Cardiac Responsiveness to β-Stimulation in Obesity
Authors: Carroll Joan F. , Thaden Jeremy J. , Wright Allison M.
Published: December 2017

We demonstrated previously that exercise training did not restore normal cardiac β-adrenergic responsiveness in obese rabbits. This study tested the hypothesis that an increased training volume was required to attenuate obesity-related reductions in isolated heart responsiveness to isoproterenol. Female New Zealand White rabbits were divided into lean control, lean exercise-trained, obese control, and obese exercise-trained groups. For the exercise-trained groups, total treadmill work over 12 weeks was increased 27% when compared with lean and obese animals trained with lower total training volume. After 12 weeks, Langendorff isolated hearts were used to study developed pressure, +dP/dtmax, and –dP/dtmax responses to isoproterenol (10−9 – 3 × 10−7 M). Concentration-response data were fit to a sigmoidal function using a four-parameter logistic equation. Controls were compared with animals trained under the low– and high–training volume programs using one-way analysis of variance and Tukey's post-hoc test; separate analyses were conducted for lean and obese rabbits. In both lean and obese groups trained under the high–training volume program, EC50 values for +dP/daytmax and –dP/dtmax were higher compared with same-weight controls and animals trained under the low–training volume program, indicating that contractility and relaxation responsiveness to isoproterenol was reduced by the higher training volume. Therefore, these data indicate that increased training volume failed to attenuate obesity-related decrements in isolated heart responsiveness to β-adrenergic stimulation and caused reduced sensitivity to isoproterenol in both lean and obese animals.
Soybean-Derived Phytoestrogens Regulate Prostaglandin Secretion in Endometrium During Cattle Estrous Cycle and Early Pregnancy
Authors: Wolawek-Potocka Izabela , Bah Mamadou M. , Korzekwa Anna , Piskula Mariusz K. , Wiczkowski Wieslaw , Depta Andrzej , Skarzynski Dariusz J.
Published: December 2017

Phytoestrogens acting as endocrine disruptors may induce various pathologies in the female reproductive tract. The purpose of this study was to determine whether phytoestrogens present in the soybean and/or their metabolites are detectable in the plasma of cows fed a diet rich in soy and whether these phytoestrogens influence reproductive efficiency and prostaglandin (PG) synthesis during the estrous cycle and early pregnancy in the bovine endometrium. In in vivo Experiment 1, we found significant levels of daidzein and genistein in the fodder and their metabolites (equol and p-ethyl-phenol) in bovine serum and urine. The mean number of artificial inseminations (Als) and pregnancy rates in two kinds of herds, control and experimental (cows fed with soybean 2.5 kg/day), were almost double in the soy-diet herd in comparison with the control animals. In in vivo Experiment 2, three out of five heifers fed soybean (2.5 kg/day) became pregnant whereas four out of five heifers in the control group became pregnant. The concentrations of a metabolite of PGF2α (PGFM) were significantly higher in the blood plasma of heifers fed a diet rich in soybean than those in the control heifers throughout the first 21 days after ovulation and AI. The higher levels of PGFM were positively correlated with equol and p-ethyl phenol concentrations in the blood. In in vitro experiments, the influence of isoflavones on PG secretion in different stages of the estrous cycle was studied. Although all phytoestrogens augmented the output of both PGs throughout the estrous cycle, equol and p-ethyl-phenol preferentially stimulated PGF2α output. The results obtained lead to the conclusion that soy-derived phytoestrogens and their metabolites disrupt reproductive efficiency and uterus function by modulating the ratio of PGF2α to PGE2, which leads to high, nonphysiological production of luteolytic PGF2α in cattle during the estrous cycle and early pregnancy.
A Nonspecific Phosphotyrosine Phosphatase Inhibitor, Bis(maltolato)oxovanadium(IV), Improves Glucose Tolerance and Prevents Diabetes in Zucker Diabetic Fatty Rats
Authors: Winter Carol L. , Lange Jana S. , Davis Michael G. , Gerwe Gina S. , Downs Thomas R. , Peters Kevin G. , Kasibhatla1 Bhavani
Published: December 2017

The molecular basis of insulin resistance, a major risk factor for development of Type II diabetes, involves defective insulin signaling. Insulin-mediated signal transduction is negatively regulated by the phosphotyrosine phosphatase, PTP1B, and numerous studies have demonstrated that organo-vanadium compounds, which are nonselective phosphotyrosine phosphatase inhibitors, have insulin-mimetic properties. However, whether or not vanadium compounds can prevent the transition from insulin resistance to overt diabetes is unknown. We compared the ability of bis(maltolato)oxovanadium(IV) (BMOV), an orally bioavailable organo-vanadium compound, and rosiglitazone maleate (RSG), a known insulin sensitizer, to prevent development of diabetes in Zucker diabetic fatty (ZDF) rats. Treatment began at 6 weeks of age when animals are insulin resistant and hyperinsulinemic, but not yet hyperglycemic, and ended at 12 weeks of age, which is 4 weeks after ZDF rats typically develop overt diabetes. BMOV-treated ZDF rats did not develop hyperglycemia, showed significant improvement in insulin sensitivity, and retained normal pancreatic islet morphology and endocrine cell distribution, similar to RSG-treated animals. BMOV and RSG treatment also prevented the hyperphagia and polydipsia present in untreated ZDF rats; however, BMOV-treated ZDF rats gained much less weight than did RSG-treated animals. Circulating levels of adiponectin decreased in untreated ZDF rats compared to lean controls, but these levels remained normal in BMOV-treated ZDF rats. In contrast, in RSG-treated ZDF rats, plasma adiponectin levels were nearly 4-fold higher than in lean control rats, primarily as a result of a large increase in the amount of low–molecular weight forms of adiponectin in circulation. These data demonstrate that phosphatase inhibition offers a new approach to diabetes prevention, one that may have advantages over current approaches.
Anticancer Effects of a Plant Lignan 7-Hydroxymatairesinol on a Prostate Cancer Model In Vivo
Authors: Bylund Annika , Saarinen Niina , Zhang Jie-xian , Bergh Anders , Widmark Anders , Johansson Anders , Lundin Eva , Adlercreutz Herman , Hallmans Göran , Stattin Pär , Mäkelä Sari
Published: December 2017

Clinical intervention studies and experimental studies with lignan-rich diets suggest that lignans may have inhibitory effects on prostate cancer, but no clinical or experimental studies with purified lignans have been published. The purpose of this study was to investigate the effect of a plant lignan 7-hydroxymatairesinol (HMR) on LNCaP human prostate cancer xenografts in athymic mice. Athymic nude male mice were injected subcutaneously with LNCaP cells. Starting 3 days after tumor cell injections, a control diet or a control diet supplemented with 0.15% or 0.30% of HMR was administered to mice and the tumor take rate and growth was observed for 9 weeks. HMR diet inhibited the growth of LNCaP tumors. Mice treated with HMR had smaller tumor volume, lower tumor take rate, increased proportion of nongrowing tumors, and higher tumor cell apoptotic index compared with controls. Furthermore, the cell proliferation index was reduced in mice receiving the 0.30% HMR diet compared with mice receiving the control diet. Our results suggest that dietary HMR started at the early phase of the tumor development inhibits the growth of the LNCaP human prostate cancer xenografts in athymic male mice.
How is cardiac troponin released from injured myocardium?
Authors: Mair Johannes , Lindahl Bertil , Hammarsten Ola , Müller Christian , Giannitsis Evangelos , Huber Kurt , Möckel Martin , Plebani Mario , Thygesen Kristian , Jaffe Allan S
Published: December 2017

Cardiac troponin I and cardiac troponin T are nowadays the criterion biomarkers for the laboratory diagnosis of acute myocardial infarction due to their very high sensitivities and specificities for myocardial injury. However, still many aspects of their degradation, tissue release and elimination from the human circulation are incompletely understood. Myocardial injury may be caused by a variety of different mechanisms, for example, myocardial ischaemia, inflammatory and immunological processes, trauma, drugs and toxins, and myocardial necrosis is preceded by a substantial reversible prelethal phase. Recent experimental data in a pig model of myocardial ischaemia demonstrated cardiac troponin release into the circulation from apoptotic cardiomyocytes as an alternative explanation for clinical situations with increased cardiac troponin without any other evidence for myocardial necrosis. However, the comparably lower sensitivities of all currently available imaging modalities, including cardiac magnetic resonance imaging for the detection of particularly non-focal myocardial necrosis in patients, has to be considered for cardiac troponin test result interpretation in clinical settings without any other evidence for myocardial necrosis apart from increased cardiac troponin concentrations as well.
An APRIL-based chimeric antigen receptor for dual targeting of BCMA and TACI in multiple myeloma
Authors: Lee Lydia , Draper Benjamin , Chaplin Neil , Philip Brian , Chin Melody , Galas-Filipowicz Daria , Onuoha Shimobi , Thomas Simon , Baldan Vania , Bughda Reyisa , Maciocia Paul , Kokalaki Eva , Neves Margarida P. , Patel Dominic , Rodriguez-Justo Manuel , Francis James , Yong Kwee , Pule Martin
Published: December 2017

Key Points

APRIL is a compact, self-protein that binds 2 MM antigens (BCMA and TACI) with high affinity; we present an APRIL-based CAR. Dual-antigen targeting increases the availability of tumor-binding sites and reduces the risk of antigen-negative disease escape.
Measurable residual disease detection by high-throughput sequencing improves risk stratification for pediatric B-ALL
Authors: Wood Brent , Wu David , Crossley Beryl , Dai Yunfeng , Williamson David , Gawad Charles , Borowitz Michael J. , Devidas Meenakshi , Maloney Kelly W. , Larsen Eric , Winick Naomi , Raetz Elizabeth , Carroll William L. , Hunger Stephen P. , Loh Mignon L. , Robins Harlan , Kirsch Ilan
Published: December 2017

Key Points

HTS identifies MRD at the conventional clinical cutoff in more patients than FC, and these patients have worse outcomes. A subset of B-ALL patients essentially cured using current chemotherapy is identified at end of induction by HTS.
The effects on calcaneofibular ligament function of differences in the angle of the calcaneofibular ligament with respect to the long axis of the fibula: a simulation study
Authors: Edama Mutsuaki , Kageyama Ikuo , Kikumoto Takanori , Nakamura Masatoshi , Ito Wataru , Nakamura Emi , Hirabayashi Ryo , Takabayashi Tomoya , Inai Takuma , Onishi Hideaki
Published: December 2017

Background

In the present study, CFLs harvested from cadavers were categorized according to the differences in the angle of the CFL with respect to the long axis of the fibula and their shape, and then three‐dimensional reconstructions of the CFLs were used to simulate and examine the differences in the angles of the CFLs with respect to the long axis of the fibula and how they affect CFL function.

Methods

The study sample included 81 ft from 43 Japanese cadavers. CFLs were categorized according to their angle with respect to the long axis of the fibula and the number of fiber bundles. Five categories were subsequently established: CFL20° (angle of the CFL with respect to the long axis of the fibula from 20° to 29°); CFL30° (range 30–39°); CFL40° (range 40–49°); CFL50° (range 50–59°); and CFL2 (CLFs with two crossing fiber bundles). Three‐dimensional reconstructions of a single specimen from each category were then created. These were used to simulate and calculate CFL strain during dorsiflexion (20°) and plantarflexion (30°) on the talocrural joint axis and inversion (20°) and eversion (20°) on the subtalar joint axis.

Results

In terms of proportions for each category, CFL20° was observed in 14 ft (17.3%), with CFL30° in 22 ft (27.2%), CFL40° in 29 ft (35.8%), CFL50° in 15 ft (18.5%), and CFL2 in one foot (1.2%). Specimens in the CFL20° and CFL30° groups contracted with plantarflexion and stretched with dorsiflexion. In comparison, specimens in the CFL40°, CFL50°, and CFL2 groups stretched with plantarflexion and contracted with dorsiflexion. Specimens in the CFL20° and CFL2 groups stretched with inversion and contracted with eversion.

Conclusions

CFL function changed according to the difference in the angles of the CFLs with respect to the long axis of the fibula.
The FOCUS, AFFINITY and EFFECTS trials studying the effect(s) of fluoxetine in patients with a recent stroke: statistical and health economic analysis plan for the trials and for the individual patient data meta-analysis
Authors: Graham Catriona , Lewis Steff , Forbes John , Mead Gillian , Hackett Maree L. , Hankey Graeme J. , Gommans John , Nguyen Huy Thang , Lundström Erik , Isaksson Eva , Näsman Per , Rudberg Ann-Sofie , Dennis Martin
Published: December 2017

Background

Small trials have suggested that fluoxetine may improve neurological recovery from stroke. FOCUS, AFFINITY and EFFECTS are a family of investigator-led, multicentre, parallel group, randomised, placebo-controlled trials which aim to determine whether the routine administration of fluoxetine (20 mg daily) for six months after an acute stroke improves patients’ functional outcome.

Methods/Design

The core protocol for the three trials has been published (Mead et al., Trials 20:369, 2015). The trials include patients aged 18 years and older with a clinical diagnosis of stroke and persisting focal neurological deficits at randomisation 2–15 days after stroke onset. Patients are randomised centrally via each trials’ web-based randomisation system using a common minimisation algorithm. Patients are allocated fluoxetine 20 mg once daily or matching placebo capsules for six months. The primary outcome measure is the modified Rankin scale (mRS) at six months. Secondary outcomes include: living circumstances; the Stroke Impact Scale; EuroQol (EQ5D-5 L); the vitality subscale of the 36-Item Short Form Health Survey (SF36); diagnosis of depression; adherence to medication; serious adverse events including death and recurrent stroke; and resource use at six and 12 months and the mRS at 12 months.

Discussion

Minor variations have been tailored to the national setting in the UK (FOCUS), Australia, New Zealand and Vietnam (AFFINITY) and Sweden (EFFECTS). Each trial is run and funded independently and will report its own results. A prospectively planned individual patient data meta-analysis of all three trials will provide the most precise estimate of the overall effect and establish whether any effects differ between trials or subgroups. This statistical analysis plan describes the core analyses for all three trials and that for the individual patient data meta-analysis. Recruitment and follow-up in the FOCUS trial is expected to be completed by the end of 2018. AFFINITY and EFFECTS are likely to complete follow-up in 2020.

Trial registration

FOCUS: ISRCTN, ISRCTN83290762. Registered on 23 May 2012. EudraCT, 2011-005616-29. Registered on 3 February 2012.

AFFINITY: Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Registered on 22 July 2011.

EFFECTS: ISRCTN, ISRCTN13020412. Registered on 19 December 2014. Clinicaltrials.gov, NCT02683213. Registered on 2 February 2016. EudraCT, 2011-006130-16. Registered on 8 August 2014.
Using single‐cell multiple omics approaches to resolve tumor heterogeneity
Authors: Ortega Michael A. , Poirion Olivier , Zhu Xun , Huang Sijia , Wolfgruber Thomas K. , Sebra Robert , Garmire Lana X.
Published: December 2017

It has become increasingly clear that both normal and cancer tissues are composed of heterogeneous populations. Genetic variation can be attributed to the downstream effects of inherited mutations, environmental factors, or inaccurately resolved errors in transcription and replication. When lesions occur in regions that confer a proliferative advantage, it can support clonal expansion, subclonal variation, and neoplastic progression. In this manner, the complex heterogeneous microenvironment of a tumour promotes the likelihood of angiogenesis and metastasis. Recent advances in next‐generation sequencing and computational biology have utilized single‐cell applications to build deep profiles of individual cells that are otherwise masked in bulk profiling. In addition, the development of new techniques for combining single‐cell multi‐omic strategies is providing a more precise understanding of factors contributing to cellular identity, function, and growth. Continuing advancements in single‐cell technology and computational deconvolution of data will be critical for reconstructing patient specific intra‐tumour features and developing more personalized cancer treatments.
Reproductive Alterations in Chronically Exposed Female Mice to Environmentally Relevant Doses of a Mixture of Phthalates and Alkylphenols
Authors: Patiño-García Daniel , Cruz-Fernandes Leonor , Buñay Julio , Palomino Jaime , Moreno Ricardo D
Published: December 2017

Endocrine-disrupting chemicals (EDCs) are exogenous compounds that modify hormone biosynthesis, causing adverse effects to human health. Among them, phthalates and alkylphenols are important due to their wide use in plastics, detergents, personal care products, cosmetics, and food packaging. However, their conjoint effects over reproductive female health have not been addressed. The aim of this work was to test the effect of chronically exposed female mice to a mixture of three phthalates [bis (2-ethylhexyl), dibutyl, and benzyl butyl] and two alkylphenols (4-nonylphenol and 4-tert-octylphenol) from conception to adulthood at environmentally relevant doses. These EDCs were administered in two doses: one below the minimal risk dose to cause adverse effects on human development and reproduction [1 mg/kg body weight (BW)/d of the total mixture] and the other one based on the reference value close to occupational exposure in humans (10 mg/kg BW/d of the total mixture). Our results show that both doses had similar effects regarding the uterus and ovary relative weight, estrous cyclicity, serum levels of progesterone and 17β-estradiol, and expression of key elements in the steroidogenesis pathway (acute steroidogenic regulatory protein and CYP19A1). However, only the 1-mg/kg BW/d dose delayed the onset of puberty and the transition from preantral to antral follicles, whereas the 10-mg/kg BW/d dose decreased the number of antral follicles and gonadotropin receptor expression. In addition, we observed changes in several fertility parameters in exposed females and in their progeny (F2 generation). In conclusion, our results indicate that chronic exposure to a complex EDC mixture, at environmentally relevant doses, modifies reproductive parameters in female mice.
Class II HLA Genotype Association With First-Phase Insulin Response Is Explained by Islet Autoantibodies
Authors: Koskinen Maarit K , Lempainen Johanna , Löyttyniemi Eliisa , Helminen Olli , Hekkala Anne , Härkönen Taina , Kiviniemi Minna , Simell Olli , Knip Mikael , Ilonen Jorma , Toppari Jorma , Veijola Riitta
Published: December 2017

Context

A declining first-phase insulin response (FPIR) is characteristic of the disease process leading to clinical type 1 diabetes. It is not known whether reduced FPIR depends on class II human leukocyte antigen (HLA) genotype, islet autoimmunity, or both.

Objective

To dissect the role of class II HLA DR-DQ genotypes and biochemical islet autoantibodies in the compromised FPIR.

Design, Setting, Participants

A total of 438 children with defined HLA DR-DQ genotype in the prospective Finnish Type 1 Diabetes Prediction and Prevention Study were analyzed for FPIR in a total of 1149 intravenous glucose tolerance tests and were categorized by their HLA DR-DQ genotype and the number of biochemical islet autoantibodies at the time of the first FPIR. Age-adjusted hierarchical linear mixed models were used to analyze repeated measurements of FPIR.

Main Outcome Measure

The associations between class II HLA DR-DQ genotype, islet autoantibody status, and FPIR.

Results

A strong association between the degree of risk conferred by HLA DR-DQ genotype and positivity for islet autoantibodies existed (P < 0.0001). FPIR was inversely associated with the number of biochemical autoantibodies (P < 0.0001) irrespective of HLA DR-DQ risk group. FPIR decreased over time in children with multiple autoantibodies and increased in children with no biochemical autoantibodies (P < 0.0001 and P = 0.0013, respectively).

Conclusions

The class II HLA DR-DQ genotype association with FPIR was secondary to the association between HLA and islet autoimmunity. Declining FPIR was associated with positivity for multiple islet autoantibodies irrespective of class II HLA DR-DQ genotype.
Effects of Hypoglycemia on Circulating Stem and Progenitor Cells in Diabetic Patients
Authors: Fadini Gian Paolo , Boscari Federico , Cappellari Roberta , Galasso Silvia , Rigato Mauro , Bonora Benedetta Maria , D’Anna Marianna , Bruttomesso Daniela , Avogaro Angelo
Published: December 2017

Context

Iatrogenic hypoglycemia is the most common acute diabetic complication, and it significantly increases morbidity. In people with diabetes, reduction in the levels of circulating stem and progenitor cells predicts adverse outcomes.

Objective

To evaluate whether hypoglycemia in diabetes affects circulating stem cells and endothelial progenitor cells (EPCs).

Design

We performed an experimental hypoglycemia study (Study 1) and a case-control study (Study 2).

Setting

Tertiary referral inpatient clinic.

Patients and Other Participants

Type 1 diabetic patients (Study 1, n = 19); diabetic patients hospitalized for severe iatrogenic hypoglycemia, matched inpatient and outpatient controls (Study 2, n = 22/group).

Interventions

Type 1 diabetic patients underwent two in-hospital sessions of glucose monitoring during a breakfast meal with or without induction of hypoglycemia in random order. In Study 2, patients hospitalized for hypoglycemia and matched controls were compared.

Main Outcome Measure

Circulating stem cells and EPCs were measured by flow cytometry based on the expression of CD34 and kinase insert domain receptor (KDR).

Results

In Study 1, the physiologic decline of CD34+KDR+ EPCs from 8 am to 2 pm was abolished by insulin-induced hypoglycemia in type 1 diabetic patients. In Study 2, diabetic patients hospitalized for severe iatrogenic hypoglycemia had significantly lower levels of CD34+ stem cells and CD34+KDR+ EPCs compared with diabetic inpatients or outpatient controls.

Conclusions

In diabetic patients, a single mild hypoglycemic episode can compromise the physiologic EPC fluctuation, whereas severe hypoglycemia is associated with a marked reduction in stem cells and EPCs. These data provide a possible link between hypoglycemia and adverse outcomes of diabetes.
A Simulation Study to Evaluate Improvements in Anesthesia Work Environment Contamination After Implementation of an Infection Prevention Bundle
Authors: Porteous Grete H. , Bean Helen A. , Woodward Crystal M. , Beecher Ryan P. , Bernstein Jennifer R. , Wilkerson Sarah , Porteous Ian , Hsiung Robert L.
Published: December 2017

BACKGROUND:

Microbiological contamination of the anesthesia work environment (AWE) is a potential source of health care–associated infections. Medication syringes, stopcocks, and many other areas are routinely contaminated during anesthetic care, and adherence to hand hygiene recommendations is poor. Using a simulation model, we investigated whether AWE contamination could be reduced by implementing an intervention bundle focused on infection prevention.

METHODS:

Twenty-five anesthesia providers were enrolled in this nonrandomized simulation scenario crossover design study. Subjects were asked to complete 2 general anesthesia scenarios in a mock operating room: a baseline scenario and an intervention scenario in which the bundle was implemented. The bundle included: double gloving before intubation, confining all airway equipment to 1 area, and performing hand hygiene before touching the anesthesia cart. Before each scenario, a manikin’s oropharynx and face were marked with ultraviolet fluorescent tracers. After each scenario, the AWE was inspected with a ultraviolet light source to detect contaminant, and all sites were photographed. A blinded observer scored the images for the presence or absence of tracer at 20 sites. Videos of the scenarios were analyzed for duration and number of hand hygiene and glove removal events. Data were analyzed using a mixed effects model. Subjects completed a survey about their experience and the value of the scenarios.

RESULTS:

The intervention was associated with a decreased subject contamination score of 4.0 (95% confidence interval, 2.2–5.6; P < .001), a 27% reduction in score between baseline and intervention scenarios. Some sites were universally contaminated despite the intervention (eg, laryngoscope handles). The intervention had a statistically significant impact on reducing contamination on medication syringes and the anesthesia cart. There was no significant difference in time needed to complete baseline and intervention scenarios. The majority of subjects felt that the simulations had significant value and would affect their future clinical behavior.

CONCLUSIONS:

Our results support the concept of an infection prevention bundle in reducing AWE contamination. Anesthesia providers deliver care in a unique environment in which “clean” and “contaminated” tasks are performed rapidly and often in parallel. Linking hand hygiene to specific high-impact tasks such as administering medications, designating areas for contaminated equipment, and double gloving before airway management are simple steps that can be implemented rapidly and are compatible with timely patient care. Our study has improved awareness of infection prevention issues in our department, and has highlighted simple and achievable actions that have the potential to reduce health care–associated infections.
Anesthetic Management and Procedural Outcomes of Patients Undergoing Off-Pump Transapical Implantation of Artificial Chordae to Correct Mitral Regurgitation: Case Series of 76 Patients
Authors: Samalavicius Robertas Stasys , Norkiene Ieva , Drasutiene Agne , Lipnevicius Arturas , Janusauskas Vilius , Urbonas Karolis , Zakarkaite Diana , Aidietis Audrius , Rucinskas Kestutis
Published: December 2017

BACKGROUND:

Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure.

METHODS:

All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study. Balanced anesthesia with a combination of fentanyl, propofol, and sevoflurane was used in all patients. Each patient’s core temperature was maintained at >36°C whenever possible. Two- and 3-dimensional transesophageal echocardiography was used in all patients to navigate the device to the posterior mitral valve leaflet (68 of 76 patients), anterior mitral valve leaflet (3 of 76 patients), or both leaflets (5 of 76 patients). After effective leaflet capture, the artificial chordae were deployed. Position and function of the artificial chordae were assessed by evaluating the degree of MR when the neochordae were tensed. After surgery, all patients were transferred to the intensive care unit.

RESULTS:

The mean age of the patients was 60 ± 13 years (range, 33–87 years), and the male/female ratio was 52/24. Most patients had severe MR (grade 4+ in 25 [33%] patients, grade 3+ in 51 [67%] patients). The average preoperative EuroSCORE II was 1.23% ± 1.16% (range, 0.46%–4.23%). The median duration of the procedure was 120 minutes (interquartile range [IQR] 115–145 minutes). After the procedure, 42 (56%) patients had trivial MR, 27 (36%) had grade 1+ MR, 4 (5%) had grade 2+ MR, and 2 (3%) had >2+ MR. One patient underwent conversion to conventional mitral valve repair due to perforation of the posterior mitral valve leaflet. The whole procedure was well tolerated by the patients, with hemodynamics remaining stable in the majority of the cases. Only 20 (26%) patients needed low-dose inotropic support perioperatively. All patients had an uneventful postoperative course. The median time to extubation was 4 hours (IQR, 2.6–6), and the length of intensive care unit stay was 22 hours (IQR, 21–24). Five (6.6%) patients required allogeneic blood products.

CONCLUSIONS:

Anesthesia for transapical NeoChord implantation can be safely performed under beating-heart conditions, with low perioperative morbidity and rare blood transfusions. Transesophageal echocardiography is crucial for the guidance, safety, and effectiveness of the procedure.
THE EDUCATION OF PATRIOTISM AND TRADITIONS FOLK CULTURE
Authors: Сабашкина Лидия , Sabashkina Lidia
Published: December 2017

This article outlines the cultural and educational role of the library and patriotic education of the younger generation through the formation of spiritually-moral principles and environmental awareness. Describes the traditional attitude of the Altaians to nature, family, ethical and moral rules of life. In detail the results of the library. The material is arranged in sections: Teaching activities; Library museums; Library names; Patriotism and love through ecological education. The section «Patriotism and love through ecological education» includes an overview of the most important events held in 2017 - the Year of ecology.
Pathological jealousy from forensic psychiatric perspective
Authors: Cynkier Przemysław
Published: December 2017

Zazdrość jest definiowana jako złożony stan psychiczny wywołany realną, bądź fałszywą – urojoną zmianą w sposobie postrzegania zagrożenia utratą cenionego związku z partnerem na korzyść prawdziwego lub wyobrażonego rywala. Oprócz zazdrości ujawnianej przez osoby zaburzone psychicznie, ale bez objawów chorobowych oraz zazdrości obsesyjnej, wyróżnia się także zazdrość o nasileniu psychotycznym. Trudnością diagnostyczną jest rozstrzygnięcie, kiedy zwykła zazdrość o partnera nabiera charakteru urojeniowego i granica pomiędzy tymi dwoma stanami bywa czasami trudna do uchwycenia, z czym mają do czynienia szczególnie często psychiatrzy sądowi. Popełnienie pomyłki diagnostycznej niesie ze sobą poważne konsekwencje w zakresie opiniowania i następstwa prawne. Istnieją doniesienia, że do pojawienia się zazdrości o charterze urojeniowym dochodzi na drodze pewnego kontinuum od tzw. normalnej zazdrości do zazdrości chorobowej. Urojenia niewierności małżeńskiej występują w różnych zaburzeniach psychotycznych, a ich podłoża upatruje się w czynnikach endogennych, organicznych zmianach w o.u.n. oraz uzależnieniach. Osoby wykazujące tego typu zaburzenia urojeniowe są uznawane za niezwykle niebezpieczne dla otoczenia, nie tylko z powodu obecności objawów psychotycznych, ale także udziału różnych czynników środowiskowych i partnerskich, które uczestniczą w genezie ich przestępczych zachowań. Dokonanie trafnych i rzetelnych ocen sądowo-psychiatrycznych w odniesieniu do tej grupy sprawców przede wszystkim dotyczy oceny zagrożenia z ich strony, zasadności ewentualnego stosowania środków zabezpieczających oraz rodzaju oddziaływań terapeutycznych.
Deconstructing the Outsider Puzzle: The Legitimation Journey of Novelty
Authors: Cattani Gino , Ferriani Simone , Lanza Andrea
Published: December 2017

The proposition that outsiders often are crucial carriers of novelty into an established institutional field has received wide empirical support. But an equally compelling proposition points to the following puzzle: the very same conditions that enhance outsiders’ ability to make novel contributions also hinder their ability to carry them out. We seek to address this puzzle by examining the contextual circumstances that affect the legitimation of novelty originating from a noncertified outsider that challenged the status quo in an established institutional field. Our research case material is John Harrison’s introduction of a new mechanical method for measuring longitude at sea—the marine chronometer—which challenged the dominant astronomical approach. We find that whether an outsider’s new offer gains or is denied legitimacy is influenced by (1) the outsider’s agency to further a new offer, (2) the existence of multiple audiences with different dispositions toward this offer, and (3) the occurrence of an exogenous jolt that helps create a more receptive social space. We organize these insights into a multilevel conceptual framework that builds on previous work but attributes a more decisive role to the interplay between endogenous and exogenous variables in shaping a field’s shifting receptiveness to novelty. The framework exposes the interdependencies between the micro-, meso-, and macro-level processes that jointly affect an outsider’s efforts to introduce novelty into an existing field.

The e-companion is available at https://doi.org/10.1287/orsc.2017.1161 .
A Review on Advanced Oxidation Processes for Effective Water Treatment
Authors: Mishra Nirmalendu , Reddy Rajesh , Kuila Aneek , Rani Ankita , Nawaz Ahmad , Pichiah Saravanan
Published: December 2017

Advanced oxidation processes (AOPs) such as fenton, ozonation, sonolysis, photocatalysis, UV photolysis, and wet air oxidation are one amongst the most suitable techniques for water and wastewater treatment. These, AOPs have also been chosen for the complete degradation of various categories of emerging pollutants that could not be managed by any conventional technologies. The mineralization is achieved by chemical reactions between the various reacting species generated and the pollutants. The present article provides a vivid view of the mechanistic features of various AOPs and its possible synergisation for process enhancement to achieve better treatment efficiency.
Environment Impact Assessment of Highway Expansion – A Review
Authors: Walia Kashish , Aggarwal R K , Bhardwaj S K
Published: December 2017

Highway expansion improves the quality of existing roads and enhances the connectivity between prime economic centres. The escalating traffic and need to bolster the economic capability of the area leads to the expansion of highways. Moreover, the accession activity disturbs the ecosystem and induces myriad changes in the surrounding panorama. Also, it affects both abiotic and biotic components, directly and indirectly. Thus, to know and predict the impact on the environment and socio-economic conditions of the residents, Environment Impact Assessment of National Highways is imperative. Therefore, this paper reviews the influence of highway expansion on air, water and soil quality and the socio-economic conditions and health of the natives.
Hydrological Disasters Management and Risk Assessment
Authors: Lohani A.K. , Krishan Gopal , Chandniha Surendra
Published: December 2017

In India, floods and droughts are recurrent hydrological phenomenon causing huge losses to lives, livelihood, properties and infrastructure due to non-uniformly distributed rainfall both in time and space leading to the dimensionally opposite problems of flood and drought in different parts of the country. Out of 3290 lakh hectares geographical area, 40 million hectares is prone to floods which show high risk, vulnerability and is one of the most common hydrologic extremes frequently experienced by our country. On the other hand drought has a varying frequency from once in two years to once in fifteen years. It has been observed that there is flood in one part of country and severe drought in the other part. Various short term and long term measures should be adopted to prevent and mitigate the consequences of floods and drought rather than causing damages and losses due to interfering of the natural processes. In this paper, drought and flood problems in India are highlighted along with some of the important management issues requiring immediate attention. Furthermore, it presents the recently developed non-structural techniques for flood forecasting, flood plain zoning, glacial lake outburst modeling and decision support system.
Statistical Models in Estimating Air Temperature in a Mountainous Region of Greece
Authors: Maniatis Stelios , Chronopoulos Kostas , Matsoukis Aristidis , Kamoutsis Athanasios
Published: December 2017

The current work focuses on the estimation of air temperature (T) conditions in two high altitude (alt) sites (1580 m), each one at different orientation (southeast and northwest) in the mountain (Mt) Aenos in the island of Cephalonia, Greece, by using two well-known statistical models, simple linear regression (SLR) and multi-layer perceptron ( MLP), one of the most commonly used artificial neural networks. More specifically, the estimation of mean, maximum and minimum T in high alt sites was based on the respective T data of two lower alt sites (1100 m), the first at southeast and the second at northwest orientations, and was carried out separately for each orientation. The performance of both SLR and MLP models was evaluated by the coefficient of determination (R2) and the Mean Absolute Error (MAE). Results showed that the examined models (SLR and MLP) provided very satisfactory results with regard to the estimation of mean, maximum and minimum T, regarding southeast orientation (R2 ranging from 0.96 to 0.98), with mean T estimation being relatively better, as confirmed by the lowest MAE (0.83). Regarding northwest orientation, T estimation was less accurate (lower R2 and higher MAE), compared to the respective estimation of southeast orientation, but, the results were considered adequate (R2 and MAE ranging from 0.88 to 0.92 and 1.00 to 1.40, respectively). In general, the estimations of the mean T were better than those of the extreme ones (minimum and maximum T). In addition, better results (higher R2 and lower, in general, MAE) were obtained when T estimations were based on T data derived from sites located at areas with similar surroundings, as in the case of dense and tall vegetation of the sites at southeast orientation, irrespective of applied method.
Heart sounds: auscultation for valvular heart disease
Authors: Hall Angela
Published: December 2017

Nurses are increasingly undertaking additional roles, and auscultation often forms part of the complete patient assessment. This compliments other clinical examination skills and consultation. Further tests are available to assist in informing diagnostic and management options. Repeated exposure increases confidence and aids the practitioner in his or her assessment of the patient. Valvular heart disease can affect any of the four heart valves but, more commonly, the aortic or mitral valve becomes stenotic or regurgitant. Heart sounds can be distinguished by the timing, intensity, duration and pitch, and murmurs can be physiological or pathological.
Cardiac cachexia: addressing the challenge
Authors: Tanner Gill
Published: December 2017

Cachexia is a complex metabolic syndrome associated with many long-term or end-stage conditions, and is characterised by loss of muscle with or without loss of fat mass. The current review examines strategies to help identify and manage cardiac cachexia, as well as research into pharmacological and non-pharmacological interventions, and discusses implications for nursing practice. Despite a lack of available pharmacological therapies to treat this condition, there is still a significant role for cardiac nurses to play. Initially, this will focus on prevention of onset through optimising evidence-based medication. However, important later roles will include identifying patients at risk, onward referral and patient management within the wider multidisciplinary team.
Antidepressants are no panacea for alienation and social angst
Authors: McCrae Niall , Appasamy Nathan , Haddad Mark
Published: December 2017

Niall McCrae and Nathan Appasmy discuss the history of pharmacology in the treatment of depression
Nineteenth century mental health care and its relevance today
Authors: Nolan Peter
Published: December 2017

Peter Nolan details the history and transition of mental health care through the last few centuries
Motivating our youngest learners to never give up
Authors: Francis Jo
Published: December 2017

In this article, we look at how we can successfully use motivation theories, such as Carol Dweck's growth mindsets, through comparison with the Characteristics of Effective Learning in our pre-school settings?
The College of Preceptors and early years education
Authors: Willis Richard
Published: December 2017

Heavily influenced by the works of Frederich Froebel, professor Joseph Payne had a profound impact and lasting influence on not only the college, but also on the burgeoning kindergarten system in England.
Even a minimum rise has an impact
Authors: Tanuku Purnima
Published: December 2017

While we do not want to criticise an increase in pay for the lowest waged in society, we cannot ignore the fact that mounting staffing costs could tip the balance for many providers and put jobs in peril.
Know your patron saints
Authors: Davies Sarah
Published: December 2017

We give you a flavour of what you can do with the saints George, David, Andrew and Patrick, as a starting point to inspire you and the children in your setting to explore the local environment.
Motor imagery training with augmented cues of motor learning on cognitive functions in patients with Parkinsonism
Authors: Mahmoud Lama Saad El-Din , Abu Shady Nawal Abd EL-Raouf , Hafez Ehab Shaker
Published: December 2017

Background/Aims:

Patients with Parkinsonism demonstrate impairments in cognitive functions, such as deficit in attention, planning, and working memory. The objective was to investigate the effect of motor imagery training with augmented cues of motor learning on cognitive functions in patients with Parkinsonism.

Methods:

A total of 30 patients from both sexes participated in this study. All of the patients had been diagnosed as idiopathic Parkinson patients experiencing cognitive dysfunction. The patients were randomly divided into two equal groups: the study group (n=15) received motor imagery training with augmented cues of motor learning and the specifically designed intervention. The control group (n=15) received conventional treatment (cognitive remediation therapy). The treatment took place three times a week for 6 weeks (18 sessions). The patients were diagnosed with a computer-based cognitive assessment device (RehaCom).

Findings:

The result of this study showed that there was a significant difference between the study and control groups (p=0.0001), which indicated that the study group showed a greater improvement than the control group.

Conclusions:

Combined effect of motor imagery training with augmented cues of motor learning improved cognitive functions in patients with Parkinsonism.
Water-based exercise for adults with Down syndrome: Findings from a preliminary study
Authors: Pérez Carlos Ayán , Carral José M Cancela , Costas Alexandre Álvarez , Martínez Silvia Varela , Martínez-Lemos R Iván
Published: December 2017

Background/Aims:

This pilot study aims to analyse the potential benefits of an aquatic exercise programme on the health-related physical fitness and quality of life of people with Down syndrome, as well as to identify the impact that such a programme might have on the self-perceived quality of life of their parents/caregivers.

Methods:

A total of 14 adults (mean age 37±7.24 years) carried out an aquatic exercise programme for 3 months. Health-related physical fitness and self-perceived quality of life were assessed by means of the Assessing the Levels of Physical Activity and Fitness battery and the World Health Organization Quality of life Questionnaire, respectively.

Findings:

No significant impact of the programme was observed on any of the variables tested.

Conclusions:

There was no evidence to support that water-based exercise might be a useful exercise intervention to improve health-related physical fitness and quality of life in adults with Down syndrome. The self-perceived quality of life of the parents/caregivers did not seem to be affected by this kind of intervention either. Future randomised controlled studies with larger samples are needed to confirm these findings.
Balance and falls in people with Charcot-Marie-Tooth disease: A cohort survey
Authors: Williams Shannon , Singer Barbara , Lamont Phillipa
Published: December 2017

Aim:

To explore the relationship between balance deficit, falls, and activities of daily living in a cohort with Charcot-Marie-Tooth disease.

Method:

A cohort survey of individuals with Charcot-Marie-Tooth disease attending a neurogenetic clinic was carried out. Surveys were sent to individuals on a database of a state-wide neurogenetic service located in Perth, Australia.

Results:

Out of 71 surveys, 40 were returned (56%). The cohort were predominantly male (68%), the average age was 55.5 years (range 18–84) and average age at symptom onset was 23 years (range 5–65). Excluding skeletal foot changes, balance deficits (87.5%) and loss of balance confidence (90%) were the most frequently rated symptoms and those most severely affecting physical functioning (71% and 64% respectively). Ankle splinting was frequently reported in this population (65%). The majority of participants (69%) had fallen at least once in the past year and 40% of fallers reported having never seen a physiotherapist.

Conclusions:

Despite balance deficits and loss of balance confidence being frequently reported to impact daily activities, and falls and near-falls being common in this cohort with Charcot-Marie-Tooth disease, more than a third had not seen a physiotherapist. Future management to reduce the disease burden should investigate the effects of a timely multidisciplinary approach to manage balance dysfunction, and strategies to reduce falls in this population.
Urinary tract symptoms in women: Underactive bladder syndrome
Authors: Nazarko Linda
Published: December 2017

Primary care nurses may encounter this common condition, writes Linda Nazarko
LIGHTS OUT! on Cartesian Products
Authors: Peters Travis , Goldwasser John , Young Michael
Published: December 2017

The game LIGHTS OUT! is played on a 5 by 5 square grid of buttons; each button may be on or off. Pressing a button changes the on/o state of the light of the button pressed and of all its vertical and horizontal neighbors. Given an initial configuration of buttons that are on, the object of the game is to turn all the lights out. The game can be generalized to arbitrary graphs. In this paper, Cartesian Product graphs (that is, graphs of the form G\box H, where G and H are arbitrary finite, simple graphs) are investigated. In particular, conditions for which GH is universally solvable (every initial configuration of lights can be turned out by a finite sequence of button presses), using both closed neighborhood switching and open neighborhood switching, are provided.